Tuesday, May 18, 2010

What's in your car?

When my hospice nurse orientation finished and I was officially "set free" to drive the streets of King County visiting patients, I was given my "car kit." It consisted of nursing supplies in four large brown paper bags. No good drugs or anything like that, we're not allowed to carry narcotics in this state. But since I'm on the facility team and almost all my patients are living in facilities such as Assisted Living or Skilled Nursing facilities, I rarely if ever need to bring supplies to them. For several weeks these brown paper bags lived in the back of my car, with adult incontinence supplies embarrassingly peeking from the top of them. Finally, a couple of months into the job, I got fed up enough with shifting them around to accommodate Costco trips to actually organize them. I bought some pretty-colored storage bins from Target and sat myself on the floor, surrounded by nursing supplies, and inventoried. I still don't actually need most of it, but at least now I know what I have:
  • Adult diapers, large and extra large
  • Bath wipes, x 2
  • Dressing supplies, including gauze, abd pads, tegaderms, and even my very own suture removal kit and two pairs of bandage scissors
  • Isolation gown, goggles, and mask
  • Lotsa rubber gloves. Can never have too many of those
  • Foley catheters, urimeters, leg bags, a urinal
  • Various creams, lotions, skin care ephemera
  • Two sizes of emesis basins
  • thermometers
  • A sphygmomenometer! And a stethoscope! Apparently I didn't really need to be using the set I'd purchased seven years ago for nursing school.
  • Lab collection supplies
I feel a bit better now actually knowing what I'm carrying around in my car, should any of my patients need something at the spur of the moment. Typically I can order supplies for them and bring them on the next visit, but there's always the family who waits till the last minute..."Hey, you don't have any extra diapers on ya, do you ?"
"As a matter of fact, I do! Let me just run to my car..." Thusly averting a messy situation.

And also, when your little puddle-drinking poo-sniffing dachshund starts suffering from diarrhea which turns bloody, it sure was convenient to have rubber gloves and a stool specimen cup laying around with which to take a sample to his vet. I don't think that was the intended purpose of the "car kit," but hey, now the little guy is started on his course of Flagyl and hopefully he'll be back to his energetic puddle-drinking poo-sniffing self soon.

So, to answer your question, yes, those are adult diapers in my car. What's in your trunk?

Thursday, May 06, 2010

Nursing from the streets

So here I am, a full-fledged Hospice Case Manager Nurse. A month out of orientation, on my own, managing my own case load, and I can still safely say that I pretty much love this job. I realized that I loved it on Tuesday, after a grumpy, rainy, 45-minute drive to Newcastle. I may be a day-walker now, a recovering night-shifter, but I have not and will never quite get used to having to get up early in the morning. So I grumbled and scowled my way through rush hour traffic, gripping my coffee, trying to hear the bossy GPS directions over NPR, and squinting through the blustery, gray weather. After two wrong turns and a U-turn I finally arrived at my destination, and found my way to my new patient's front door. I met the patient and his wife, answered their questions and explained how our hospice services could help them. Yes, they could call and speak to a nurse 24 hours a day if they needed to. No, we would do everything we can to keep him from having to go to the hospital ever again. Yes, if he wants to eat apple pie, let him eat apple pie (in small bites and sitting straight up, of course). The patient's wife sighed deeply and relaxed back into her chair, years faded from her 84-year-old face, and she finally smiled at me. "Thank you," she whispered. "Thank you for what you do."

So I got back in my car, and steeled myself for a 30-minute drive on the highways through the sheets of rain to Issaquah. But my grumpy mood was gone, and I didn't mind the drive.