The night nurse sat down heavily and asked if I was ready for report. I said I was. He assured me that I wasn’t . “Long night?” I asked. “And you’re going to have a long day.”

She called herself a nurse, but it turns out that her late husband had been a doctor.  When I asked about her daughter – who I knew was a nurse , the woman snorted and said disdainfully, “Just a two year degree.” She had a bypass and valve repair scheduled for Monday morning.  It was only Saturday.

From the beginning I could see her confusion.  She simply could not remember that nurses had given her any of her meds.  By noon she was demanding her morning meds, refusing to believe that I had already given them to her. She insisted that no one gave her a single pill for 3 days.  She spoke viciously of  John, the night nurse, and demanded that he be drug tested.  He was lying.  She never received any pain meds, and she knew how nurses were with drugs.  When I asked her if she’d like me to bring her something, she waved me off and said she took care of it already.  I saw a bag of home meds in her closet, so I spoke to her daughter privately of my concerns of over-medication.  Her daughter agreed to take them with her when she left.

And all hell broke loose.  I would say that she was a holy terror, but there was nothing holy about her.  She ranted and bitched up and down the hall, foley in hand.   She demanded to have her medications back in her room and threatened to leave AMA, call the lawyer, call the police, pull the fire alarm…  She’d stop any doctor in the hall to tell of her mistreatment.  There was absolutely no reasoning with her. At one point I was in her way (unintentionally), and she moved to grab my shoulders.  I simply said firmly, “You touch me,  and I will call security on you.” She soon tired and calmed down enough for me to walk her back to her room.  Still very upset, she sat on her bed and  attempted to call all her family and friends (not understanding the need to dial 9 first, thankfully).

I went back to the station and printed out a MAR to show it to her.  I told her it was a list of all her meds, and we went over each one.  I showed her on the print-out when she had received each medicine.  I handed her my pen and told her that she could use this paper to document meds received.  She seemed wary at first, but then I told her these could be her court papers.  That seemed to please her, and she was happy to sign by each med I gave her.  (She drew a line through each med administered by the night nurse.)  I turned to grab my pen before I left, and she pushed it away from me.  Fine.  Keep the damn pen.

It worked beautifully.  She was still a needy patient, but there were no more arguments about her medications.  I printed her a new MAR before I left and told John about our system.

The next morning I was getting report from the same nurse, when she hit the call light.  He rolled his eyes and said he’d go in with me. We found her at the bathroom door.  She held out her foley and said, “This needs to be emptied, and my bed needs to be straightened.”  Whatever.  He took care of the foley, and I moved to the bed.  I pulled back the covers to find a lot of random objects, including the thin, white turban she wore on her head.  I put those things aside and was just finishing folding back the blankets when she and John came out of the bathroom.  I took a double take and nearly bust a gut trying not to laugh.  We tucked her in bed and made it out to the hallway before asking,  “Was she..?” “Did you..?” and bursting out in laughter.  And maybe it’s wrong, but I took such great pleasure  in seeing this proud, disagreeable woman wearing her panties on her head.

* “Dickie Roberts: Former Child Star – Anyone.. anyone?