July 31, 2006

The Chosen One

Linda M. LPN
Many years ago.

I would have started this sooner but I couldn’t find my glasses – something very unusual for me because I always put them on top of the file cabinet in case of emergency. If I leave them by the bed so I can read who’s calling on my cell phone or see how to set the alarm clock, they always seem to sprout legs and walk around the room while I’m sleeping.

So now I had to think back to when I might have taken them off. (I did take them off. They are not on my nose!) Nope, not by my favorite living room chair or next to the microwave or on the edge of the bathtub.

Oh yes, when we got home this afternoon the electricity was off and the AC was off and the apt. was very hot. I wanted to change into something cool and that would be in the clothesbasket on the clothes dryer. Sure enough, there they lay nice and safe on the dryer – unable to jump down from such heights and run away from me.

So, here’s the story of how I was The Chosen One today.

Sometimes it’s difficult to know how to write a nursing story. I have to remember you probably don’t know the meaning of words like EDK Box, Texas Catheter or PEARL. The last one meaning, “Pupils Equal and Reactive to Light”. If you could come up with a way to keep a Texas Catheter in place, you would be a rich person, and the EDK Box is where we keep more narcotics than the any pusher on the street.

Last night was my third 12-hour shift in a row and I was a bit discouraged (another name for ‘fairly grumpy’) when I kissed Jim goodbye and told Sheba, “Mommy go to work” so she wouldn’t beg me with her eyes to go for a ride.

Arriving at the nurses’ station, I was slightly annoyed to see the entire day shift crew sitting at the desk reading the newspaper and eating pizza. I have QUIT jobs for less. It’s something akin to putting my glasses in the same place, whatever that is about me. Even at 3 a.m. you will not find me sitting with my feet on the desk reading a book. If I take a little break (because I’m the only nurse there and can’t leave the unit at night), I still want to look like I’m a professional and really care about what I’m doing there.

The day shift couldn’t wait to proclaim, “State Is Here!”

Oh yes, the annual State Survey that can make or break the director of nursing’s position, has cost many an administrator their job and is the bane of every nursing home that collects funds from Uncle Sam.

Of course State wasn’t there when I came on duty last night! They had left for the day, but the word was that they wanted to meet the night shift and would be returning in the wee hours of the morning (this morning).

The biggest concern for the nurse in my position is being tapped on the shoulder by a surveyor to be monitored during a med pass. For the occasional idiot nurse, it’s not a concern but actually a challenge they love. For most, it’s an empty feeling in the pit of your stomach. For me, it’s a strange combination of that ‘old ghost’ feeling of inadequacy mixed with some confidence that after 35 years of passing meds, I couldn’t do anything THAT bad!

And anyway, if I really messed up and they fired me, I had a job interview at a nursing home near downtown Columbus later today! (More on that later.)

I called Jim and told him to forget bringing me supper. I wouldn’t have time to eat. I called a day shift nurse at home who needed to come in and sign a narcotic sheet she had missed a few days ago. I called the evening nurses aides (STNA's) together and reviewed our plan to get all the urinals off the bedside tables in exchange for me not putting any medicine cups into the trashcans during the night.

We were on a mission to have the unit in perfect condition, smelling good and ready for state surveyors any time after midnight! That, even if we are considered the “night shift" staff and not usually recognized as being the brightest or most ambitious people in the world by administration.

In six months working there, I have not seen the administrator once. The unit coordinator refers to me as the ‘night nurse’ while the same position day nurse is referred to as the ‘charge nurse’. But, oh well, it’s that glasses thing again that keeps me proud and busy.

Besides doing all the work that usually keeps me occupied all night, I added things I thought inspectors would (and have) checked. I looked in every bathroom to make sure the sharps container wasn’t too full. I cleaned out the treatment cart and discarded meds for patients no longer there. The medicine cart was washed down and made sure all the open bottles were labeled with an open date and patient name.

I walked the disposable vacuum cleaner up and down the halls. Emptied every trashcan at the nurses' station (all five of them) and refreshed them with clean garbage bags. (Something I think I’m supposed to do this every night, but I've have refused to pick up housekeeping duties!)

I couldn’t start the last 6 a.m. med pass until 5 a.m. (One hour before or one hour after.) But, at 5:01 a.m. I was in the first room doing the accuchecks, tube feedings, eye drops and pain meds. By 5:45 a.m. I was finished! Whew, I was safe! Surveyors hadn’t gotten out of bed at 4 a.m. to beat me, and I could breathe a sign of relief that our unit was spotless and meds were passed!

At 6 a.m., I saw the director of nurses hurrying down the hall towards the nurses’ station. I smiled and said, “Ask me any question.”

She looked surprised and said, “Can I have a million dollars?”

“Yes, but not from me,” I responded with an unusually bright sense of humor.

Next, comes a pretty young woman I’ve never seen, but she’s wearing a professional looking (name-of-our-nursing-home) nametag. I’ve never seen these before either, but they are expensive looking.

“Hi, I’m the administrator. I don’t think we’ve met.”

Soon follows the head maintenance man who flips the light switch and floods the hall with bright lights we aren’t used to at that time of morning.

I say, “Hello Bill”, but he doesn’t respond.

Because surveyors are coming, we have made sure that absolutely every patient has a call light in hand. Even those we know will never wake up and use it.

Suddenly I’m hit with a really strange feeling as the call light comes on in a room where the patient is in a coma and has never opened her eyes and asked for anything. I slowly walk towards the patient’s room as the Unit Coordinator, RN (my direct boss) comes down the hall, looks at the call light flashing above the door and then at me, with a question in her eyes.

“We gave her a call light and she turned it on,” I said to her unspoken question.

In checking, it seems she has moved her arm and activated the call light. Creepy.

So started the procession of employees I’d never met and surveyors I had hoped to miss.

Between 6 a.m. and 7 a.m. I am informed that the day nurse (my relief) has called off. (I think she should be fired.)

An agency nurse will come in who has never been to this nursing home! And, she will be late!

And, I am told The surveyors want me to do the morning med pass! (Not my usual meds either!)

Worst of all, I will have to use the paper method of passing meds instead of the computer method I’ve been using for six months because the agency nurse doesn’t know how to use our computers.

I couldn’t believe my luck! Darn, I was so close!
Shake hands. Glad to meet you. Let’s get started.

I am the Chosen One! Every other nurse in the building breaths a sigh of relief.

Perhaps you would like to know that the surveyor said I “did great”. I remembered to lock the med cart, close the record book, wash my hands between meds, knock on the doors and call the patient by name. I gave at least 4 ounces of water and stood by until the last pill went down. I hope I didn’t accidentally touch the inside of the med cup or touch a pill as I pressed it from the package to the medicine cup.

As I left the building almost two hours late, I passed a note to the unit coordinator.

I deserve a bonus,” it said.

Take Care on the Journey,



Anonymous said...

Linda, good stuff! Your story brought back a memory for me. When I worked at the nursing home, I too, ended up being the Chosen one! Only I was the only person on the floor, I saw the survey team walk into one of my rooms, and pull the call light on. As I walked toward that room, I knew what I was in for, I had to run a fire drill! and I had to do it right! I never missed a beat, did everything I was supposed to. After that day, the state team never intmidated again. There's alot to be said for having confidence in one's ability!

Katy said...

Great job, Mama Linda. I would have been crying in my thickened ensure!

Shallow Throat said...

Wow, how stressful. But it seems you really know what you're doing and made it through the ordeal. Good job, Chosen One.