The Last Day

My last day in the old hospital, they floated me to the ICU step-down unit. It is dangerous when they do things like that. I have no advanced training; no ACLS, I can't read EKGs. Plus, I really hate their kind of patients. In orthopedics, it is rare that we lose a patient. All of the patients they gave me that last night were about to die. The patients and their families were in various stages of denial while we busied ourselves torturing the patients to try and get a few more hours or days of agonizing life out of them.


One patient, who was confused (actually, they all were) kept saying that she wished that someone would explain to her why she keeps coughing. Silently, I thought about asking her if she remembered smoking for her entire adult life and if she thought that might have played a role in her getting lung cancer. Instead, I just listened sympathetically.


A family member of another patient kept getting me and saying that her mother was complaining of difficulty breathing. Of course she was. Her heart, lungs and kidneys were failing and death was imminent. I offered morphine which the daughter refused. I wish that I could have given it to both of them, but instead, I just had to keep doing vital signs and reassuring them that everything was still okay. I wanted to say that your mom is dying, what do you want from me? Of course, I didn't, but I wanted to run out of the building screaming.


My favorite patient was admitted from a nursing home with pressure ulcers down to the bone. I had to take pictures, measure and chart each individual wound. I went through reams of paper and never got a break all evening. (I couldn't even go to the dinner party to celebrate our last day in the old hospital.) The poor patient's wounds got infected, she developed sepsis and so was admitted for antibiotic treatment. Assuming that she lives, she will be sent back to the same nursing home.


The old lady had one unusual thing about her. Her breasts stood straight up even though she was lying flat on her back. Even young women's breasts don't do that. As part of my skin care assessment, I took a peek. Her breasts looked like two large tennis balls had been placed under the skin. I just had to feel them. Don't look at me like that. You would have too.


They also felt like tennis balls, only harder. That poor woman. In her quest for beauty, she had turned herself into a grotesque caricature of a woman. She couldn't lie on her stomach or even all the way on her side. No wonder the skin on her back had broken down to the bone.


I mentioned this patient to another nurse who had a patient in the same room. The nurse had also noticed her breasts and had taken a peak and a feel, even though it wasn't even her patient. Nurses can be curious and nosey.


She told me a story about a patient she once got report on. The outgoing nurse had said that the patient had had his prostrate removed and now had a prosthesis. Asked what kind of prosthesis the patient had, the reporting nurse said a prostrate prosthesis. When questioned about that, the outgoing nurse said that is what she was told in report.


Assessing the patient, the new nurse took a little peak under the sheets and saw that it was a different appendage that had the prosthesis. I do think it is funny, though, that anyone would think there is such a thing as a prostrate prosthesis. A penile implant, funny in its own way, at least makes sense.

At the end of my shift. I returned to my unit to say good bye. I was alone. My unit had closed the day before. There was a cake left over from the party. I was starving, so I had a piece, took one last look at my home for the past seven years and left.