ONE OF THOSE DAYS |
May 18, 2007
ONE OF THOSE DAYS
Name: RN Clara Hart
Posting date: 5/18/07
Stationed in: a military hospital in the U.S.
I knew Monday was not going to be one of my finer days when I put both contacts in the same eye then had to spend 20 minutes prying them apart. In the end it turned out to be one of those days that was overwhelming, irritating, exhilarating and heartbreaking all at the same time. Tired from a busy weekend packed full of “must do” chores, I came sluggishly into the recovery room. Answering called-out greetings from my coworkers, I stowed my things and wandered to the postings board. As I stood there and reviewed the cases it was apparent we had inherited a new crop of OIF wounded over the weekend.
Feet shuffling, I headed to the computer to check the email and assess how many unimportant messages I could immediately delete without bothering to read. Mentally trying to get myself back into the nursing game I looked across the room to see a young man, lying in a hospital bed, yank at the blankets trying to better cover himself. Realizing the room was far colder for him than for me as I wasn’t the one in an “oh so chic” hospital gown, I grabbed a blanket from our blanket warmer and took it over to him. As I tucked it around his shoulders, he thanked me profusely and we started to talk.
Injured in Iraq when he was thrown off balance carrying a heavy load, he was now on the list for surgery to repair a broken leg. He'd arrived from Germany over the weekend only to be told today that his leg was too swollen, so they would not do his procedure until later in the week. He told me it had taken a week to get him back to the States from Germany. He shook his head and said, “I’m really glad to be here and not still in Germany." I asked why. “In Germany I shared a room with two other guys who had each lost a leg. They cried a lot and it was really hard to listen to them. I felt bad for them, but I was glad at the same time. I can’t relate.” He went on to say that one of his buddies from boot camp had been killed while on patrol in Iraq. We chatted a little while longer, then work called me away.
Halfway through my day the charge nurse asked me to cover another nurse’s patient while she went to lunch. “No problem," I replied, as my patient was stable and I was just waiting for her to wake up. The patient in question was also a wounded OIF, injured last year in a mortar attack. Blind in both eyes, with multiple facial, chest, back and arm injuries, he was doing well now and had a great attitude. I introduced myself, putting my hand on his shoulder to let him know where I was. Working to get his pain under control from the surgery he'd just had, we talked and joked.
He asked me if I was married and had children, and when I responded in the negative he said, “What’s wrong with these men? You’re a good-looking woman."
“Thank you," I replied. “How bad is the damage to your vision?”
“Totally gone, can’t even see a glimmer of light”, came his rueful answer, only to be replaced with a grin. “I could just tell you were good looking.”
Smiling, I shook my head as he began to talk about wanting to run the Marine Corp Marathon.
“Are you running it, Clara?”
“Hell no!” was my ardent response. “I might do the Army 10-miler, but 26 miles? Uh-uh, ain’t noooo way!” He told me he wanted to run both races, but he needed a partner, and that person he did not have. I asked him how that worked and he explained to me about “tethering” and how this partner would help him with direction and keep him on track. As I bounced back and forth between my two patients Joe kept up a running commentary, keeping me entertained and laughing as we together battled his pain and finally won.
My coworker returned and as I gave her an updated report Joe called out to me: “Clara?”
“Yep, I’m here” I said, crossing to the bedside and placing my hand on his shoulder.
“I think I need a good-looking woman to run with me. It would be fun to be tied up to as fine a woman as you, Clara. Why don’t you run with me?” Speechless, I could only stand and stare down at this man who had been through so much. Regaining my composure I told him I would come and visit him in his room tomorrow and we could talk more about it. He seemed satisfied with that answer, and later as he was wheeled down the hall he called out, “See you tomorrow, Clara.” Somehow I think I will be running the Army 10-miler this year, “tied up” to one of America’s most awesome and amazing sons of freedom.
Because I had spent too much time talking with Joe, I forfeited part of my lunch period. Inhaling my food in 15 minutes I was back on the floor just in time to hear “Clara, got a patient coming into 14, OIF, arriving now.” I walked back to my corner with a sense of irritation as my patient arrived. Placing him on the monitor, I apologized for my hands being cold.
“Yeah, they are”, came the soldier's surly reply. As I finished the task, I listened to the report from anesthesia and completed my assessment. Taking in the dressings wrapped around both his legs, the shrapnel wounds that peppered his face, hands and arms, I started to document my findings.
As I was writing, I was interrupted by my patient, who rudely said, “I want some water.” Since water is never an option for a right-out-of-surgery patient, I started to explain to him that as soon as we had finished some things with his care I would get him some ice. Belligerently he snapped at me, “I don’t want ice, I want water!”
My irritation was now at an all time high. I stepped closer to his beside, leaned down and sternly said, “Mark, this is not acceptable behavior. I respond much better to polite, respectful tones of voice and the words 'please' and 'thank you.'" As I held his eyes I added, “We will get along much better if you remember that.”
Turning my back to him I finished reviewing his chart, orders, and writing down my assessment and his vital signs. That completed, I once again asked him if he was in pain. He nodded, and gauging his pain I began to medicate him. As the tech brought me a cup of ice and I scooped it into his mouth he mumbled, “Thank you,ma’am”. Okay then, here’s to new beginnings. My irritation started to wane until I noticed a note stuck to the front of his chart: “Please change IV when in OR”. Wham! The irritation and anger returned; I was pissed off that OR/anesthesia had once again not changed an IV while the patient was asleep, and I stomped off to get the necessary supplies. As I returned to the bed another nurse came over.
"Need any help?” she asked.
“Yeah, definitely,” I grudgingly admitted. “Can you set up his PCA (pain pump) while I start a new IV? Anesthesia didn’t do it in the OR. Again!"
As she went to work I explained to Mark what I needed to do, reaching out and taking his arm. He thanked me.
“For what?” I asked.
“Well, they keep putting the IV in this arm and it’s really sore. You’re the first one to put it in my other arm.” Noticing his arms had no hair I questioned him, he smirked and said, “Yeah, with all the tape you people use you were yanking it all out anyway so I just shaved it off. Makes my life easier and a whole lot less painful.” Again shaking my head in bemusement I set about to do my job. IV completed, PCA hooked back up, I re-evaluated my wounded patient. He told me he was still having significant pain. Maxing out his pain medications, I put another call into anesthesia and was told they would be by to see him.
As we waited, Mark again asked if he could please have some water. After he promised he wouldn’t vomit I gave in and brought him a small cup. Anesthesia arrived, made some adjustments in his pain meds, and said they would be back in 20 minutes. The time passed slowly and Mark continued to complain. Irritated, frustrated and simply wanting my day to end, I took a deep breath and resigned myself to actually having to converse with my patient. Distraction can be a wonderful tool to use when someone is lying in a hospital bed with nothing else to think about other than how bad they feel.
As I medicated him, I asked Mark where he was from. Was his family here with him? (They were, but they’d had to leave today.) Did he like sports? (He did, mostly pro football, basketball and baseball.) Who were his favorite teams? (Too numerous to list.) How long had he been in the military? (Five years.) As conversation turned to his military career he told me he was on his third tour in Iraq and this time had only been there for six weeks before he was hurt.
Having been told that another squad was dropping something off at their outpost, he gathered his soldiers and moved outside the building to wait. Carefully watching as the other squad drove up and exited the vehicle, Mark moved out from cover to meet them. As he did he and his men, as well as the men in the other squad, were hit with an RPG.
Medevaced out of Iraq to Germany and then on to the States, it took him almost a week to reach us. He continued to tell me his story, and as he did his voice took on a tone of anger. He looked at me and exclaimed, “I’m embarrassed, pissed off and depressed I got taken out.”
“Because I’m the leader, I’m supposed to watch out for these guys, the inexperienced guys. They look up to me and here I am the one who gets hurt!”
“Did you step in front of that RPG?” I asked him.
He looked at me as if I had grown two heads and snidely. "Of course not.”
“So what’s there to be embarrassed about? Do you think the other guys are saying, 'Yeah, Mark, what an idiot! Got hit with an RPG!'"
“Naw”, came his reluctant reply.
“Could you have done anything differently?” I pushed on.
“Yeah I could have gotten more guys killed," and he began to diagram for me how that would have happened.
“In the end, could you have done anything else to prevent what happened?”
“This just SUCKS!” he cried.
“Absolutely it does! One hundred percent sucks!” I commiserated.
His face started to get red. “I’m stuck in this fucking bed all the time. I can’t even get up to take a shit! I gotta go in a pan and then wait for someone to come to get rid of it. I’m supposed to be the one in charge, the one responsible, and here I am, in the hospital.” The angry words poured from his mouth as a single tear trailed down his cheek. Lowering the siderail on the bed, I wrapped my arms around him and held him, rubbing his shoulder and wiping the tears that he could not keep from escaping. As I held him I felt his composure slowly return.
“Thank you” he simply said, I nodded my head to show I had heard and then turned away.
“Hey Clara, do you think dinner will be there for me when I get back to my room?” I later heard him ask.
“I’ll make sure of it”, I promised. Time passed and I was able to transfer him back to the floor. As I gave report, I told his nurse what had transpired here in the PACU and how upset he was. She thanked me for the heads-up, and assured me she would keep an eye on him and make sure he had dinner waiting for him. As Mark was rolled out of the recovery room he asked if I would come visit him.
“Of course I will." With a quiet swish of the doors he was gone. I cleaned up my bay and walked over to the nursing station to finally sit down. When one of the other nurses looked at me with a question in his eyes I said, “I hate it when they cry."
He nodded his head. “Yeah, I do too.”
That evening I was sitting at home talking on the phone with my significant other. “How was your day?” he asked.