Sunday, January 17, 2010

Euphemisms, Confluences of Catastrophe, and Observations

Wouldn't YOU worry if a mortuary van pulled up to your ambulance entrance, and you noticed it bore special "handicap" license plates, with the universal little sign that is supposed to represent a wheelchair? I do. I mean, it's not like the passengers will care if they can't park right in front of the supermarket, is it? They're just going to wait in the van regardless.

It's not great, but it happens sometimes that, at a hospice, a couple of mortuary vans are at the ambulance entrance when a new patient comes in by ambulance. We hate for their first sight to be a mortuary cot with a Very Quiet Passenger on it, but it can't be helped. On the other hand, if a very anxious and stressed family is touring one of the wings, we ask any mortuary drivers picking up Passengers to wait until that family leaves before heading down the same hallway with the cot.

Usually, if the fire department is coming for a random safety investigation, they'll arrive as the charge nurse is trying to take report on a new patient while scanning orders while waiting for a doctor to call back, and while there are tons of people at the desk with questions about their loved ones, and the printer has just jammed.

I think every nurse in the WORLD knows what it means when a handoff report (for a patient coming into a unit) includes the sentence, "Oh... and he's been a little bit agitated this morning." BATTEN DOWN THE HATCHES, is what that means. There are all kinds of very good reasons why patients get agitated and unreasonable. And often, once someone has gotten agitated and unreasonable, it takes awhile to get back to calm and reasonable.

Sometimes the agitated and unreasonable person in a patient room is not the patient.

However, staff members are not allowed to medicate family members, friends, one another, or themselves. So you almost hope the agitated, unreasonable person in the room IS the patient.

If anyone came up with a way to deploy Ativan in a room spray, it would be worth a Nobel prize.

Telling a grieving little kid that his aunt is going to be SO HAPPY in heaven with Jesus is likely to put that kid off theology for a lifetime. Kids are smart that way.


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