The Good, The Bad, and the Dead
Since last night started with a dead patient and ended with a dead patient (same room, too- not a good night for T-6) I thought I would jot down a few thoughts on dead patients.
Pros:
1. The patient will not put on the call light thirty-eight times in one hour like my other patients are doing.
2. The patient will not attempt to hit, bite, or otherwise molest me.
3. In fact, the patient will not annoy me in any way. It's nice to have one that doesn't whine for a change.
4. I can talk about the patient in front of them and they don't mind.
5. There's no need to do all those admission or transfer papers.
6. The patient will not have to get up to the commode; necessitating a ten-minute-search for the portable potty, a twenty-minute search for the toilet paper, a lower back strain while attempting to hold onto grandma as she pivots her enormous behind from bed to potty, and the cleaning of the portable commode.
Now, if you're thinking a dead patient is pretty much a perfect patient- it would seem that way, wouldn't it? However, there are the Cons.
Cons:
1. The patient will have no identification anywhere on their body. If the patient is female, her purse will contain only candy, cigarettes, lighter, unlabeled pills, hairbrush/comb and makeup bag. If the patient is male, his wallet will contain only: five unused condoms and one that I'd rather not guess; various court citations in which his name is smeared illegibly as if it's been dropped in the toilet one too many times; a few one dollar bills, a pound of change- which will fall all over the floor in the room- a phone number for Bubba (there's always a Bubba) and a pocketknife.
2. Three hours later five family members/friends/live-ins will come into the lobby and start screaming that no one called them. If you call Bubba, he'll sound very panicked and say he doesn't know anybody that could possibly be dead. Bubba doesn't want to give his last name, either.
3. Family members/friends/live-ins will begin to argue over the dead body as to who's fault it is that they're dead and bring up every past grievance they have ever held against the other person. Attempts to redirect their "misplaced grief" (we're hoping that's what it is) will result in said family members/friends/live-ins informing you that they've been through this before and don't need your advice, thank you very much.
4. The Organ Donors must be called. They must. It's a State Law. No matter how long you put it off, eventually you must call them. They will put you on hold for twenty minutes while your other three patients are 1)pulling out their IVs 2)screaming for their pain medicine 3)vomiting in the hallways and 4)getting more short of breath. If you hang up and call back, they'll put you on hold longer. Once they answer, they will ask you five hundred and eighty six questions about the dead person's medical history, medicines, lifestyle, sexual preferences, etc., of which you have absolutely no idea. You're lucky if you get a correctly spelled name out of the family members/friends/live-ins. They will argue with each other over the patient's age, and nobody has a clue as to the birthday. The organ donors will make you go ask the family/friends/live-ins all their questions, and they will shriek at you that they do not know either and is this any time to be asking questions? Because, you know, they're busy fighting with each other.
5. Someone must decide where the body will be sent. In theory this is very simple. "What funeral home do you choose?" "Oh- mother has prior arrangements at Such and Such." This happens once in a freaking blue moon. Or maybe I just don't get those patients. My asking about the funeral home always results in the person asked giving me a horrified look and yelling, "I'M NOT PAYING FOR ANYTHING!" Nobody wants to pay for the funeral, so nobody's picking a funeral home that might possibly expect payment- and NOBODY is going to sign the paper releasing the body.
6. Family/friends/live-ins will begin wandering around the unit, chatting with other patients, bumming cigarettes and coffee, and when asked to remain in their assigned area, will state they are too upset to sit down.
7. The funeral homes take turns accepting bodies that have no responsible person (i.e., the nobodys-paying-the-bills, which is most of them) They are not thrilled when you call them at 3 am and inform them you have such a client and would they please get out of bed and come cart their dead ass away? They do not show up for three hours. When they do, they are very surly. By this time, the patient, who was found down in a field and had probably been dead five hours anyway- (but must be heroically coded for forty-five minutes and brought to the ED to be pronounced- i.e., dumped on us)- has been dead twelve hours and They Don't Look So Good. Dead trauma patients aren't necessarily the most gruesome; although I suppose if severed body parts or gaping holes or brains hanging out bothers you they might be- I vote for the Drowning Victim. They Look Bad. All bloated up and no place to go. It won't keep me from my sphaghetti and meatballs lunch break, though, if said break time ever occurs (generally at the end of thirteen hours)
Every now and then there is that rare exception- an upstanding citizen who actually has a driver's license and a working cell phone; actual grieving relatives, etc. This is not fun because it's very sad. If it's a young person, it's horrible and you don't ever get used to it. Fortunately, most of our deceased fall into the above category.
My Favorite After Death Scene: Momma, in her early fifties, falls off porch and breaks her hip. Momma vomits during surgery, aspirates it into her lungs, codes and dies. Momma's children come in and promptly begin screaming at each other in the waiting room over who is going to get Momma's black-and-white TV, her Frigidaire, and the money she has in her underwear drawer. This is an absolute true story. The 6 foot tall sister has her much smaller brother pinned up against the wall by the time security comes. When the surgeon arrives to try and apologize his way out of a lawsuit, they punch him.
Pros:
1. The patient will not put on the call light thirty-eight times in one hour like my other patients are doing.
2. The patient will not attempt to hit, bite, or otherwise molest me.
3. In fact, the patient will not annoy me in any way. It's nice to have one that doesn't whine for a change.
4. I can talk about the patient in front of them and they don't mind.
5. There's no need to do all those admission or transfer papers.
6. The patient will not have to get up to the commode; necessitating a ten-minute-search for the portable potty, a twenty-minute search for the toilet paper, a lower back strain while attempting to hold onto grandma as she pivots her enormous behind from bed to potty, and the cleaning of the portable commode.
Now, if you're thinking a dead patient is pretty much a perfect patient- it would seem that way, wouldn't it? However, there are the Cons.
Cons:
1. The patient will have no identification anywhere on their body. If the patient is female, her purse will contain only candy, cigarettes, lighter, unlabeled pills, hairbrush/comb and makeup bag. If the patient is male, his wallet will contain only: five unused condoms and one that I'd rather not guess; various court citations in which his name is smeared illegibly as if it's been dropped in the toilet one too many times; a few one dollar bills, a pound of change- which will fall all over the floor in the room- a phone number for Bubba (there's always a Bubba) and a pocketknife.
2. Three hours later five family members/friends/live-ins will come into the lobby and start screaming that no one called them. If you call Bubba, he'll sound very panicked and say he doesn't know anybody that could possibly be dead. Bubba doesn't want to give his last name, either.
3. Family members/friends/live-ins will begin to argue over the dead body as to who's fault it is that they're dead and bring up every past grievance they have ever held against the other person. Attempts to redirect their "misplaced grief" (we're hoping that's what it is) will result in said family members/friends/live-ins informing you that they've been through this before and don't need your advice, thank you very much.
4. The Organ Donors must be called. They must. It's a State Law. No matter how long you put it off, eventually you must call them. They will put you on hold for twenty minutes while your other three patients are 1)pulling out their IVs 2)screaming for their pain medicine 3)vomiting in the hallways and 4)getting more short of breath. If you hang up and call back, they'll put you on hold longer. Once they answer, they will ask you five hundred and eighty six questions about the dead person's medical history, medicines, lifestyle, sexual preferences, etc., of which you have absolutely no idea. You're lucky if you get a correctly spelled name out of the family members/friends/live-ins. They will argue with each other over the patient's age, and nobody has a clue as to the birthday. The organ donors will make you go ask the family/friends/live-ins all their questions, and they will shriek at you that they do not know either and is this any time to be asking questions? Because, you know, they're busy fighting with each other.
5. Someone must decide where the body will be sent. In theory this is very simple. "What funeral home do you choose?" "Oh- mother has prior arrangements at Such and Such." This happens once in a freaking blue moon. Or maybe I just don't get those patients. My asking about the funeral home always results in the person asked giving me a horrified look and yelling, "I'M NOT PAYING FOR ANYTHING!" Nobody wants to pay for the funeral, so nobody's picking a funeral home that might possibly expect payment- and NOBODY is going to sign the paper releasing the body.
6. Family/friends/live-ins will begin wandering around the unit, chatting with other patients, bumming cigarettes and coffee, and when asked to remain in their assigned area, will state they are too upset to sit down.
7. The funeral homes take turns accepting bodies that have no responsible person (i.e., the nobodys-paying-the-bills, which is most of them) They are not thrilled when you call them at 3 am and inform them you have such a client and would they please get out of bed and come cart their dead ass away? They do not show up for three hours. When they do, they are very surly. By this time, the patient, who was found down in a field and had probably been dead five hours anyway- (but must be heroically coded for forty-five minutes and brought to the ED to be pronounced- i.e., dumped on us)- has been dead twelve hours and They Don't Look So Good. Dead trauma patients aren't necessarily the most gruesome; although I suppose if severed body parts or gaping holes or brains hanging out bothers you they might be- I vote for the Drowning Victim. They Look Bad. All bloated up and no place to go. It won't keep me from my sphaghetti and meatballs lunch break, though, if said break time ever occurs (generally at the end of thirteen hours)
Every now and then there is that rare exception- an upstanding citizen who actually has a driver's license and a working cell phone; actual grieving relatives, etc. This is not fun because it's very sad. If it's a young person, it's horrible and you don't ever get used to it. Fortunately, most of our deceased fall into the above category.
My Favorite After Death Scene: Momma, in her early fifties, falls off porch and breaks her hip. Momma vomits during surgery, aspirates it into her lungs, codes and dies. Momma's children come in and promptly begin screaming at each other in the waiting room over who is going to get Momma's black-and-white TV, her Frigidaire, and the money she has in her underwear drawer. This is an absolute true story. The 6 foot tall sister has her much smaller brother pinned up against the wall by the time security comes. When the surgeon arrives to try and apologize his way out of a lawsuit, they punch him.
posted by cherigrace | 6:03 PM
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