Did you ever have one of those days?

Well, did you ever have one of those days? You know, where nothing goes quite as you planned it? I had one of those days today but, in a good way. It’s hard not to plan your day when you are going to spend it visiting patients. I had all my phone calls made by 9:30 this morning.

First stop: a little girl, age 6, with a very serious seizure disorder. I usually access her port, which has been surgically implanted in her chest, and flush it. Not today, I just did it a couple of weeks ago. Today’s visit is for “paperwork”, a general assessment, and recertification for 60 more days of home health services. 

When she gets “a drink” (I flush her port), we do it on the living room floor: mom, patient, nurse and little brother. Since it was just paperwork today, we sat at the breakfast bar. Went through the usual routine: take vital signs on little brother (he’s 5), then sister, then mom. It is a “contest”: who has the highest SaO2 reading, who has the highest temperature, and who has the highest heart rate. The winner gets a “treat” out of nursey’s bag. Little brother won today and he chose a pad of sticky notes.

The pleasant surprise here today was: no seizure activity. Once, we had to call 911 because of the severity of her seizure. Since the paramedics can’t access a central line, they held her down while I stuck the needle through her skin and into the port, providing a lifeline for her. I have seen a lot in thirty years’ of nursing but, nothing before or since has scared me as much as this sweet baby’s seizures! 

The second patient is one I picked up from another nurse who is on vacation. I saw this patient on Tuesday and drew labs on her. It was 2 days early for the lab draw order but, I was concerned that I might not be able to get back out again this week to draw the lab. Good thing I did it Tuesday, she had a critical lab value that required immediate medication adjustment. 

I was back today to see if the medication adjustment had fixed the problem. Short answer: no, it didn’t. More labs were drawn, more critical values, further medication adjustment by the physician. Not following orders can sometimes be a good thing………and the MD did cover me for what I did Tuesday. Phew!

More fun at the third patient’s home: somehow, starting just after I arrived at his house, all calls to the home health agency were being forwarded to my cell phone. I was sitting with this patient, doing medication teaching, and my phone just kept ringing. The patient was laughing: “The Good, The Bad, and The Ugly” playing over and over again….Finally, I got a phone call from my friend, Lisa, from Hospice---she laughed at my request but she did call the hospital operator and ask her to quit calling me! Then the operator called: after giving her one of the “internal” phone numbers at the agency (my boss’ office number, ha ha ha!), the calls stopped just as mysteriously as they had started. 

The last patient of my day is a stroke victim; he was unable to speak for several years but, in the last 2-3 years, he has regained the ability to speak---with a vengeance! I always warn nursing students who may be spending the day with me, not to be too surprised by anything he says. I usually can count on being told to “go to hell” and “kiss my ass”. I usually pass on the invitations……….Today’s visit ended with our usual exchange: “Can I come see you next week?” “NO!” “When can I come see you again?” “NEVER!” Today I couldn’t resist: “I love you!” And then the surprise: “I love you, too!”

The last bit of fun occurred at the end of my day. I went to the Home Infusion Pharmacy, which is also the Employee Pharmacy, to pick up the rest of my prescription. I got 30 pills for my blood pressure on Monday afternoon, with the promise that the rest of the 3-month supply would be ready Tuesday. Imagine their surprise when I came in on Thursday! Apparently, they had some sort of “pool” going on: guessing when I would pick up my meds…….Carolyn chose 17 days, Linda chose 22 days, and Ray, well, he refused to guess: “she’s too unpredictable!”

I love going into the infusion pharmacy: usually it’s to pick up meds or supplies for my patients. I know everybody there and I have a knack for bringing work to a standstill while I am there. Go figure! I guess it’s because I like to tease: everybody in the pharmacy now knows Tim, the pharmacist, as “Shorty” a nickname I gave him. What else would you call a guy who is 7 feet tall? 

Well, now that I know they are betting on when I will pick up my medications, I think I want to get in on the action………not sure what to guess though. I AM unpredictable!

Hope you had as much fun today as I did!