Merry Christmas! And to all... a good night?

Please forgive the sabbatical that I've taken since my last post. It honestly took more from my heart to post that last story than I thought. I couldn't place myself near a computer to even think of writing another tale.

This evening, I realized something. I will write when I feel inspired, when I have a funny tale, sad tale, angry tale, or just when I have something to share. There is NO timeline, there is no need to get stressed out. In a way-- sharing my stories, as well as other people's stories, is simply therapeutic. My life is brightened, soiled and sometimes down right ridiculous because of my profession. Please believe that I love every instant (well, maybe not EVERY instant).

Regardless my friends..

I have quite the amazing story that actually fits our current Christmas situation. Without further ado, I shall let the bells ring..

It was another night shift, nearing the Christmas holiday.

You know, the hospital feels very different at night. I don't know about other places, but someone would turn our lights down low and it seemed like a bit of a ghost town. Please, do not get me wrong, this does NOT mean that night nursing is easy. This just means that there aren't oodles of specialists trolling the floors (yes, I did just say trolling). Nor does it smell like way too many meshes of multiple perfumes and colognes, or even general B.O. It smells (mostly) sterile (save code browns), looks sterile, but please believe.. The bells do ring.

If you do not know the pun, then you have not spent enough time in a hospital. Good on you (number one), and may it remain that way (number two). This night was incredible. It was fairly.. How do you say... Admission-less? Yet again, I digress. Nights are typically the stomping ground for insane amounts of admissions that are spilling over from the Emergency Department.

If you've ever been to an ER you will know that the wait (if your situation isn't critical) can be an excruciating process of waiting that likens the years in the desert that you only hear of in the Bible anymore. Some how, some where, there weren't too many admissions. [Praise be to..Florence!] The ED was sleeping like a lamb, but the floor was hopping like John Travolta in Saturday Night Fever. It wasn't really all of the patients with sun-downers syndrome jumping out of bed, but rather a very colorful one.. Who just happened to be my patient.

As this situation was long long ago, I feel safe to tell you the gender of this amazing being (of which I do not say lightly, she was a wonderful, incredible woman).. My little lady was all of 100 pounds of fury with an altered state of mind due to extremely progressive dementia. This disease is an awful thing that can really tear apart a person's life and family, of which I am totally aware. But for lack of a better explanation, I feel that I need to elaborate. There are two kinds of dementia patients, the happy confused, and the combative confused. Sometimes, the combativeness is only for the night, and that happens.. A LOT! Sometimes they are fighting, the whole time. But, more often than not, dementia takes of the form of friendly confusion of dusting for missing fruit-baskets that the elephant from Puerto Rico took on holiday to the Bahamas to share with his cousin Vinny, the girl with the pig-tails. It doesn't make sense, but it makes for the most beautiful conversations.

It is in no one's best interest to correct anyone who is confused. Reoriented is one thing.
Correcting is simply another.

They do not understand, nor do they really care that you have an explanation for everything.

What they know and care about is that everyone is functioning quite happily in 

THEIR world 

that THEY created.

Or really.. That dementia created, but has pulled from interesting areas of the subconscious.

Welcome to digression again people, so sorry. I can't help it. Honestly, my elderly patients with this alteration have definitely made an impact in my career. Whether it was the 90 year old lady who tried to bite me with her gums, and then when I wasn't looking punched me with full force in my sternum, knocking the air out of me. And yes, it DID hurt (and for days afterward).

Or this lady...

My sweet little patient was fairly alert and oriented during the daylight hours. But as the sun went down, so did her capacity to reason and separate hallucinations from reality.

If you think about it. This concept can be absolutely horrifying. Like being trapped in an episode of paranoid schizophrenia. You cannot tell what is real, or what your brain is telling you that's there.. Sights, smells, feelings, sounds. Really though, unsettling!

At times, my little dearest would explain to me that there was a little girl popping in and out to use the swing-set. They also had a picnic. It sounded quite lovely. Almost.. Sound of Music-esque.

As the day grew weary and the night rolled in with a vengeance... So did her hallucinations.

This is when things got serious..

And then again, not so serious.

I should have known there was an "emergency" a-brewing, but this lady was my first patient who ever had VERY lucid hallucinations that accompanied her sun-downing syndrome. She began by pushing her call bell, about q5min (every 5 minutes... don't you feel smarter now?) Her voice was growing more and more distressed, there were people in her room and they were being too loud! So I went in and found an empty room, dark, and very very quiet. So I proceeded to get a picture of what she was seeing.

"How many people are there?" 'Oh, there's at least twenty. Everyone is happy and being loud, like it's a party. I keep hearing them clinking their drinks together. It's very annoying, I'm trying to sleep.'

Right. So.

I was trying to figure out how to reorient my patient, but not entirely upset her. "I don't see all of these people at this party." This was not the appropriate response. Because her reply was almost a high-pitched screech. 'How could you NOT see them? They're right there and now everyone is looking at you!'

The creepy factor increased by ten-fold.

"They are looking at me?" 'Yes... Especially that one.' I didn't inquire about that one. But I should have. I asked permission from my patient if I could ask the party-goers to please leave in order that she could sleep. With the cutest nod that I can only imagine coming from a very saucy lady, I obliged and asked our.. guests.. to leave.

Not particularly sure of my cue to leave, I had to ask.. "Did everyone go?"

'Yes.'

Brilliant!

Back out into the hallway I headed in order to round (aka, check) on my other patients. Who luckily, were all fast asleep-- actually, I could be lying.. I only remember what happened next.

RING RING RING!

The call bell started to go off again for my lady's room. I picked up the phone and sure enough, 'I need some help in here.' Off I headed in that direction, mostly curious what the situation could be this time.

I knocked and announced my presence. She had her covers pulled up to her chin. 'There's a man in here and he's wearing a dark suit.' 

This sent the hair standing up on my neck. Typically, in hospital lore, men in dark suits aren't typically good news. There are tales of people seeing certain things before they leave this World. I was praying that this was not one of those moments. 

"Honey, what is he doing?" She seemed almost too horrified to speak. This really upset me. It's very hard to reason with hallucinations. 'He's looking at me darling. I don't like it. He has very dark eyes. I can't see anything in them.'

At this point I was getting more and more uncomfortable. I had no idea what to do. "Do you think he will leave if I ask him to?" She seemed to agree that this would solve everything. So, with my most demanding and strong woman voice, I spoke up, throwing my arms out like I was splitting the seas.

I don't know why you are here bothering my friend, but I am here to ask you to leave.

Your presence is frightening her, and since I am her nurse, and her guardian,

I have to ask you to leave. So please leave. NOW!

I waited a few moments before speaking.

"Is he gone?" I asked over my shoulder.

'Yes, he left."

"Wow, I'm really glad he listened."

'Me too, I didn't like him.'

"Me either."

I tucked my little lady in again, handed her her phone and call-bell (as we're taught to do, as per nursing-school brainwashing.. And good hospital etiquette). 

I sat down to chart, thinking after a few minutes had passed that it had been awfully quiet.

Then my phone rang.

'Is this (such and such) hospital?' 

"Yes, yes it is, I am Jacquie, a nurse here, how can I help you and who is this?" --> I can't stand it when people don't introduce themselves.. It's awfully rude.

'This is the emergency dispatch calling about a patient report of a gunman in your hospital.'

WHAT?!!!

'There were two phone calls from a patient of yours stating there was a man in their room with a semi-automatic.'

I paused. Looked up and down both the halls. It didn't make ANY sense because I was at the main nurse station, and I could see down the halls perfectly fine. Absolutely no one was walking, anywhere.. Let alone, WITH A WEAPON.

I asked what the man was supposedly wearing.

'A Santa suit.'

"Excuse me? A what?"

'A Santa suit ma'am.'

Then it dawned on me.

"Who called you again please?"

               'Your patient (so and so-- aka cute little older lady who had been hallucinating all night)'

"That makes sense."

'Excuse me?'

"Oh! Sorry, this patient of mine has been hallucinating all night. I'm assuming that because it is near Christmas, she is seeing a man in a Santa suit. Not sure where the gun idea came from through. We actually had a little problem like this earlier."

'So, are you verifying to me, RIGHT NOW, that there isn't a GUN MAN in your hospital wearing a SANTA SUIT?!?!'

I had to pause again to keep from giggling.

And of course, to make it entirely clear.. Rinse. And.. REPEAT!

"No mam, there is NO man in the entire hospital, especially on THIS floor, that is walking around the hallways with a semi-automatic weapon.. Wearing a Santa suit.."

There was an exhalation of annoyance on the other end. 'She sounded pretty distressed.'

"Yes, I understand that, but you would be upset too if you had been hallucinating all night and then saw a man in a Santa suit with a gun and scary eyes.. He is supposed to be jolly and nice... Look, I know how it sounds and that you are to take these things VERY seriously, but I can guarantee you that this is not an actual situation that needs emergency response.."

Pause.

'If she calls one more time, I am sending the rescue squad, you WILL go into lock-down, we will SWEEP the hospital, and YOUR NAME WILL come up in the future. Understood?!'

"Loud and clear."

I hung up the phone.

 Andddddddddddddddd 

sprinted down the hall!

I came to a skidding halt at my patient's door.

Knock. Knock.

"Hey honey, I wanted to come and check on you."

'Oh darling! You missed it! There was a man in here in a Santa suit with a gun! It was awful.'

"Don't worry love, I told him to go away. And I kicked him out."

'Oh thank God! I will call 911 again if he comes back..' CUE IN INTERVENTION HERE.

"You know what love?" as I'm unplugging the phone from the wall. "If you see that terrible man again, you push this red button here. That is the ALARM to let me know that I need to come back in to send him away. Can you do that for me?"

'Like this?!' Here ensues multiple frantic call bell rings, all in a row. With wee hands mashing the "alarm" button.. Over and over again.

As I equally as frantic press the cancel button, "Yes darling, just like that."

With a grin and an air of pride, 'Yes, I can do that.'

With that, there were only a few more call bells. But the little girl came back to swing again, and then wanted to play, but my patient was too tired to play.. So I had to send the little girl home.

But safety was restored.

The next morning and very ANGRY woman walked up to the desk, radiating fury. 'WHO UNPLUGGED MY MOTHER'S PHONE LAST NIGHT?!' With instincts sharp as a whip, and slightly groggy.. "That would be me ma'am." 'HOW DARE YOU UNPLUG HER PHONE, I COULDN'T REACH HER!' "With all do respect ma'am..." I tried to tell her the story about the hallucinations and the MULTIPLE 911 phone calls. How we don't like to cause 'traffic' for emergency dispatch in order that the real emergencies get through.. blah blah blah blah...

She wasn't having it.

'I AM GOING TO REPORT YOU FOR LACK OF CARE FOR MY MOTHER AND HAVING AN AGENDA TO SIT AROUND AND DO NOTHING. HOW DARE YOU. IF YOU UNPLUG THAT PHONE ONE MORE TIME I WILL GET YOU FIRED! DO YOU UNDERSTAND ME?!'

I paused. (As I often do when things like this happen)

Took a very long deep breath.

"Oh, I understand completely. Let me go plug it back in for you."

As I walked down the hall to plug it in, I rounded into the doorway and glanced up at the clock. 0715 in the bright sunny morning. "Good morning sunshine." I said to my saucy little friend. 

A big smile stretched across her face.. Then a furrowed brow. 

'Oh! Hello darling. You wouldn't believe the noise last night! There was a party around here. I'm so sorry you missed it. You really would have loved it. Beautiful dresses. You could have met someone you know...'

With that I walked over. Patted her hand gently.. Then handed her the phone, winked, "Use that wisely."

She smiled big and great, ear to ear even 'Oh! Good-bye darling. See you soon. Maybe we can have a picnic later.'