My back still hurts
As you know, I sometimes do house calls for home care nursing visits. Last week I went to someone's house after calling him and telling him I was running late and would be there at 5pm. Working day is ostensibly over at 5pm, but I routinely work until 7, 9, 11pm because patients seem to wait for me to show up to dump their utterly self-solvable problems in my lap.

Anyway, I walk in and he is reclining in bed, pants off and mooning me like the Grand Pasha (the Grand Pasha reclining not mooning, that is)and startes berating me that I'm late and all he asks for is the common courtesy for a call, but oh no, I couldn't even do that, he laid down at 2 because I said I'd be here at 2:30 and who did I think I was abusing patients like this...
I cut him off and say "You agreed to 3:30, not 2:30 and I called you well in time to tell you I would be here at 5." I found later he tried that with my supervisor when he called to complain about me but she had overheard the original call and knew I had set the time at 3:30 and told him that.

I asked why in the world would he stay in bed after I didn't show up if it was that important to get up and accomplish something--bear in mind, yes, he's in a wheelchair, but is very independent and active. He transfers himself and is a young, very strong 33 year old. He declines to answer me and throughout the visit keeps looking at his watch and asking his girlfriend (and why can't she accomplish these vitally important errands, I ask you?) when the gravel pit closes since he DESPERATELY needs to pickup some gravel to landscape the house-he's doing it himself, you see. Then what time does the local grocery store close; he needs some milk. And so on and so on...

Somehow his piss poor time management is my fault. Ok, fine-I shrug it off and try to do my job which is to pack a bedsore on his buttock, change an IV dressing and draw some blood. He insists he needs his wheelchair RIGHT NEXT to the bed-I can't possibly move it to do his wound packing. The other side of the bed is shoved up against the wall, a new position I might add, I suspect created solely for me so I can't use that side of the bed. He tells me I have to LEAN OVER the w/c and do this.

While I am in this awkward position, he freely shits all over my field, grunting with the effort, telling me he just can't help it, it's taken me so long to get here he's had to hold it in all this time, etc. The wound is about 2 inches fromt he margin of his anus so I am treated to a lovely scat show.
I ask for applicators - long wooden handled Q tips - to pack the various tunnels and tracts of this bedsore. He tells me ,"We don't have any, just stick them in with your finger." Granted I'm wearing gloves but I can feel in exquisite detail every fucking gooshy, pus filled, nasty passage up his ass wound. I am gagging silently and if you didn't know this already, I'm a big fat tub of an American and almost nothing puts me off my food and makes me gag.

In the subsequent 40 minutes, I attach the vacuum (gross stuff warning: open area of leg muscle. www.youtube.com/watch?v=AYb5HzA0tEw NOT my patient...the black spot on his leg is really black foam rubber packed in there, covered with something like sticky cling film and a vacuum attached to apply negative pressure. For some reason, neg atmo pressure helps wounds heal in a fraction of the time. Coolest part is at 5:50) It works great. He tells me it's not right, it's leaking, he's dissatisfied and I am to START OVER. I grit my teeth, pull it off and start working for another 45 minutes, bending over the whole time. And he's redfaced with the effort to shit on me during the process.

When I change his IV dressing (PICC- an IV 19 inches long through his upper arm almost into his heart) he deliberately jerks and almost pulls it out. This would entail a trip to the hospital and emergency surgery to replace at the tune of thousands of dollars. Most likely at my expense. Thankfully for me, it's sewn to his arm. I don't think he realizes that.

Then for the coup de grace, he moves while I'm drawing his blood and the needle punctures the vein. He does this twice. I stop and apply pressure and try another spot. (For those of you who know, I couldn't take it out of his PICC line the easy way because he forbade me, saying it would clot off if I did. It wouldn't)

While filling the tubes on the third try, I notice he has pulled off the pressure dressing, is dangling his hand down and pumping his fist to make the torn vein push blood into the surrounding areas. I ask him to stop, but he acts as though he can't hear me, staring straight ahead.

By the time the tubes fill, he has worked up a nice little hematoma the size of a hen's egg. It's painful and black and is going to look like hell. In fact, when his body destroys the red blood cells in this huge ass thing, the debris will probably throw off his next lab blood draw.

He looks at it with satisfaction and a grim little smile, "Oh yeah, that's pretty bad. You really don't know what you're doing, do you? Boy, I'm going to have to show this to the doc when I go in tomorrow" and blah blah. He's practically orgasmic over the fact he now has visible evidence of trauma. I want to stab the needle into his eyes at this point and I'm biting back tears because my back hurts so badly.

He finally releases me from my hostage status 2 and a half hours later. I rested over the weekend, but on the next Monday after I drive to work, I can't get out of the car due to back spasms and had to take two days off.

He asked for me the next visit and I catagorically refused to ever go back there again. I told my supervisor I'd quit and file for assault before I'd go back. She sighed and told me he's gone through almost every nurse in our facility, so I'm not alone. I suppose I could have walked out, but I was afraid he'd sue me for patient abandonment.

Apologies for length, I'm too depressed to even make a joke. I hate this job.
(TDub Nunc id vides, nunc ne vides on, Sun 7 Sep 2008, 21:41, 11 replies)

what a prick!
whilst leaning over, i'd have whispered in his ear "fuck with me, pal, you're going to end up with an air bubble injected into your heart."
harsh, i know, but cunts like that deserve to be spoken to in such a way. besides, if his girlfriend didn't hear me, how could he ever prove it? ;)
( Smash Monkey lowering the tone of the whole internet, Sun 7 Sep 2008, 21:53, closed)

Well that certainly reminded me of the typical 'patients' at the prison infirmary.
When I was a guard I was sometimes assigned to protect the nurses in the infirmary and saw some super-gross stuff. Thankfully, being the security officer, I had the authority to deny inmates access to the nursing staff if their behavior was bad or inappropriate because of the prison regulations that allowed me to say that the inmate's behavior was a threat to the safety of a civilian. (you never knew when one might try to make a grab for a nurse) My state believes that the safety of it's citizens is paramount and always comes before the health and well-being of an inmate.

Your guy sounds like an absolute prick. Too bad he isn't in prison where he could be shown some manners.
Edit: SM already hit the 'prick' bit....going to have to think of a different term now....
( flirting with badgers What? It sounded good at the time., Sun 7 Sep 2008, 22:02, closed)

Jesus cunting christ.
I'd vote heavily in favour of tossing the miserable sack in a river.
You must have the patience of a saint to not have reacted.
*click*
(Sundayturkey has the biggest mug of tea, Sun 7 Sep 2008, 22:08, closed)

Tdub
At the risk of sounding glib, or possibly grossly under-informed, do you have any option to transfer or leave?
( jim_bob can herd cats., Sun 7 Sep 2008, 22:21, closed)

You're a hero
nothing less.
(pins, Sun 7 Sep 2008, 22:31, closed)

oh my god
this beats every single person whining about whiney retail customers. TO THE GROUND.
(little fawn, Sun 7 Sep 2008, 22:42, closed)

Erm
Have you ever thought about working in McDonalds? At least you sell haemotomas and don't cause them there.


Mmmm. Haemotoma burger.
(powervator and NONE SHALL PASS, Sun 7 Sep 2008, 23:09, closed)

I didn't click the link
and still felt queasy reading that.

I take my hat off to you, TDub!
( K2k6 has a proper job these days, Mon 8 Sep 2008, 8:47, closed)

You
must have the patience and restraint of saint. Had I been surrounded with lots of surgical pointy things whilst having to deal with that colossal cock-monkey - the end result would have been very different!

*doffs hat & clicks*
(uk_viper stopped lurking on, Mon 8 Sep 2008, 12:29, closed)

Smash Monkey's right.
This spiteful cunt needs a quick lesson in playing fair.
( Fathter Puddytat Kill Kill dat widdle boid is mine on, Mon 8 Sep 2008, 23:57, closed)

I'm not a saint or a hero at all!
I was seething with rage. As much as I would love to beat him about the head with his own ripped off leg, I don't want the trouble of being charged in court for assault. Unfortunately in the States, medically speaking, uttering threatening things is assault and then doing them is battery. He would have had me in court so fast my head would spin.
Thank you-these replies have made me lol and cheered me up no end. Every nurse in the world has to put up with crap like this; comes with the territory.

This job will end soon and I can't wait to go back to delivering babies or taking care of people who are dying, thank God. Ooh, that didn't come out right, did it?
BTW he was in a wheelchair on government assistance because he had crashed a variety of vehicles (planes, boats, cars) not once or twice, but 5 times until he finally made himself into a paraplegic.

My contract is up the 28th and I can tough it out til then. And sometimes I have absolutely delightful patients that I just fall in love with like my elderly Air Force vet who was stationed in England. He's told me many stories about bombing runs over Germany and all the brave RAF guys he knew. He hasn't been there since 1945, but he recalls England with the greatest of pleasure!

But thank you all from the bottom of my fat little heart-vindication is one of the sweetest pleasures known to man or nurse!
(TDub Nunc id vides, nunc ne vides on, Tue 9 Sep 2008, 4:50, closed)