anxiety

this week, i cared for the same patient that called me the "vagina whisperer."  i like her.  she's young and feisty.  and when i admitted her, she warned, "i call the shots."  if i was a patient, i'd be bossy too.  so i was okay with it.  as long as her demands weren't too crazy.  and they weren't.  really.

although, my patient does have a phobia/allergy to saline.  which in the grand scheme of things is kind of a big deal.  saline is like sterile salt water.  i didn't ask, but i wonder, is she allergic to the ocean?  we use saline ALL the time in the hospital, especially with our patients who are getting multiple medications, multiple blood draws, and have central lines for constant intravenous access.  every time i use a central line, i flush with 10mL of saline - before and after blood draw, before and after administration of medications, blah, blah, blah.  i use saline ALL the time.  getting through transplant without saline is literally impossible.  there is NO alternative.  because NO ONE is really allergic to saline.

my sweet patient has had two transplants prior to this one.  she has spent more days than she can count in the hospital.  and i don't doubt that she's been nauseated, has thrown up, and been miserable numerous times.  and often, patients report that they can "taste" the saline flush (even though we flush it into a VEIN - nowhere near the mouth or stomach or GI tract).  anyhoo.  being the nice nurse that i am and having a case of anxiety myself, i was sensitive.  i went along with her gum-chewing routine pre and post saline flush.  and i went slow, like she commanded.  and i told her every last detail about what i was doing.  so that she would trust me.  and it worked out nicely.  there was very little nausea.  and no throwing up.

at one point, my patient asked me what would happen if she refused to get flushed with saline.  if she refused the IV medications that require saline before and after.  and opted for needles to get her blood instead of her IV access that serves as a faucet for blood.  i was kind of flabbergasted.  this saline thing is a TRUE phobia.  it's anxiety at its extreme.  and so, i point blank told her, she has to get over it.  it sounds insensitive.  but she needs saline.  she won't survive transplant without it.  and i told her that.  i also shared, "dear, i have anxiety too.  only, i haven't figured out my gum chewing routine to get me through it.  you have a solution.  and it works.  you're doing great.  you have to keep going.  and you have to do well."

third time's a charm, right?  i hope this third transplant works.