Me, and my job.
“OK people, time to get to work.”
The taped report just finished and Martin, the charge nurse for the evening shift, is done updating us with last minute news from the unit; 203 bed 1 wants to “get the fuck outta here, NOW!” 212 bed 2, aged 72, wants yet another pregnancy test, he is positive he is carrying twins because of an illegal CIA experiment performed on him when he was abducted several years ago. The CNA called in sick, so everyone is doing their own vitals tonight. One of the patient bathrooms is out of order; a male patient tried to launder his scrubs and towels in the toilet. And be sure to check your emails because there are some new policy changes posted. Nothing we don’t hear pretty much every day.
Besides the usual bitching and moaning in the locker room about having to be at work yet again, report is the first thing that I hear at work every day. I’m a nurse, an LPN, or licensed practical nurse to be precise, and I work on the adult mental health ward in a fairly large hospital. My name is Judson Leino, just Jud to my friends, and I’ve been working on this floor for almost fourteen years now. I love what I do.
My day, like everyone’s, begins with report. We have two units on my floor; the North Side, which has about 30 beds, and the South Side, which has 10.
The North Side is our less acute unit, where the patients more-or-less behave appropriately. Of course, that is all in perspective of what is considered appropriate behaviors on a locked adult mental health ward. The South Side is the more acute area, and it can be a place some people just can’t handle working in. But I’ll get there later. I’m on the North today, splitting 30 patients with the other evening LPN, Tammy.
We listen intently to the report, writing notes on our shift sheets. 206 bed 1 is discharging after dinner. 206 bed 2 has new insulin orders. Staff found pills under the mattress of 208 bed 2, probably his new order for Haldol, make sure you watch him swallow. The new guy in 210 is really paranoid and needs to see every pill opened-up in front of him or he will not take them. There are new wound care instructions for 214 bed 1, he has a gunshot wound to the face (self-inflicted), please check the doctor’s note on that. And so on.
Tonight, I have the first fifteen beds, which are all males. Tammy, a great nurse who has been here for what seems forever, has the last fifteen who are mostly women tonight. We need to know what’s going on with every patient, though. A mental health floor isn’t like a typical medical floor where you have your five or so patients and that’s it, other than answering call lights for other rooms when able. No, on a psych ward, you need to know at least a little bit about every single patient. Who has been attacking peers and staff. Which females are prone to yelling “Rape!” when a male staff enters their room. Who’s been caught giving their pills to who. Who is really, really manic and drinking twenty glasses of water a shift. Who is throwing a tantrum at every meal when the kitchen cart shows up, screaming that they didn’t get what they ordered. Who is calling 911 on the patients’ phone at every opportunity telling the operator that they’ve been kidnapped. Who is on strict I&O and has a urinal in their room, but keeps drinking their own pee before staff can measure it. Which two patients were caught having sex in the bathroom yesterday. Which patient can no longer have visitors because the last ones brought him three joints and a lighter.
My assignment tonight looks pretty normal, a couple of diabetics, a couple of dressing changes, and lots of medication changes. Most of my patients tonight I already know. We get lots of frequent flyers here, some we like to see, and some we cringe and begin to silently weep when we first see their names on the report sheet. She’s baaack! Is she going to swallow the batteries from the TV remote again? Is she going to piss on the floor and smear her shit on the walls again? Deep things to contemplate.
Tammy nudges me with her elbow. “Same shit different day, huh?” She smiles while she says it. Nothing fazes her anymore. Not after nearly thirty years on this floor. I mean, there is always something new here to see, experience, smell, recoil from, laugh at, cry because of, run from, or try not to step in. But really, all of that is just normal, everyday stuff that is considered almost mundane on this floor and Tammy just shakes her head and draws up IM shots when needed. And they can be needed pretty often.
I notice a cat hair on my scrub top, smile, and pick it off. Report is over. Time to relieve the day staff, most of whom are more than ready to flee and go and soak their livers in the quiet solitude of their homes. Time for our somewhat fresh faces to hit the floor. Time to expect the unexpected.
