Just an average night shift....

I have a thing for old men.  Well, at least that’s what my coworkers say after one night I will never forget.

My patient, Louise, was an adorable 88-year-old who was recovering from cystocele sugery.  Her husband, Carl, was always by her side.

My shift started off busy, but I made sure to check on Louise frequently.  She had a catheter in and was on a PCA pump, which is a machine that allows the patient to receive narcotic pain medication by pushing a button.

The first inkling of trouble occurred around 3 am.   When I checked on Louise she was wide awake, her husband snoring in the recliner next to the bed. She gave me a strange look.  “Are you having any pain?” I asked.

“No! Why would I be in pain?”

“Because you just had surgery.”

“I’m fine. But I need to use the restroom.”

I checked her catheter, which was draining properly.  “You have a catheter, do you feel like you need to urinate?”

“Umm…  No, I need to have a bowel movement.”

I assisted Louise to the restroom.  The second she sat on the toilet, she snapped, “Get out!”

I understand wanting privacy, but leaving a wobbly 88-year-old on narcotics alone in the bathroom made me nervous. I put the emergency cord in her hand and left the door open a crack.  Her husband was awake and standing next to the bathroom door with me.

The IV pump, which I had disconnected from Louise, began beeping next to the bed. “I’ll keep an eye on her,” he said.

I walked to the bed to turn off the pump.  Suddenly, I heard the bathroom door slam. I turned towards her husband. “Did you do that?”

“No, it must have closed on its own!”

I ran to the door and tried to turn the handle. It was locked.  Our bathroom doors lock? “Louise, are you ok?”

No answer.

I knocked on the door. Pounded on the door.  Yelled her name.  Nothing.

I grabbed my phone and called my coworker Jackie.  We had eight patients on the floor and it was just the two of us.  “Jackie, where are the keys to our restrooms?”  I tried to keep my voice calm.

“Our bathrooms lock?”

This is when I began to panic.

I dropped to the floor and laid my face on the cold, germ-infested tile, trying to peer under the door at my patient.  I could see a gown on the floor, but not much else. Had she fallen?

I called the house supervisor and security.  “I need you right away, my patient is locked in the bathroom and is not responding.”

Minutes later, the house supervisor and two security guards arrived.  They also had no idea that our bathroom doors had locks.  Which meant that they had no keys.

I grabbed my scissors and handed them to the security guard. “Please get this door open now.”

As the guard tried to pick the lock, I continued pounding on the door and calling Louise’s name. She never responded.  I feared the worst.  If we ever got the door open, my patient would be laying on the floor dead.

While all of this was going on, call lights were going off, IV pumps were beeping, and patients were calling my phone.  This is what it feels like to suffocate.

I asked Jackie, the other RN, to do the most important things, and in an Acadamy Award-worthy performance, calmly told the patients who called with simple requests that I was in the middle of a procedure and would be in to assist them as soon as possible.  Once I was done doing CPR on my patient on the bathroom floor.

After what felt like an hour, but was probably more like two minutes of trying to pick the lock, the security guard looked up at me, helpless.  “I don’t care if you have to break it, please get this door open.”

He took the scissors and jammed them into the latch. The door popped open. The house supervisor Fred, the two security guards, Louise’s husband and I were all huddled together to look into the bathroom.

There stood Louise, butt-naked, holding both arms up in the air.  She had disconnected her catheter from its drainage bag (which she was holding up above her head with her left hand), so the catheter was hanging straight down from her, dripping urine. She had removed her IV and had a trail of blood running down her arm.

All of our mouths simultaneously dropped.  Louise slowly lowered her arms, and then raised the right one back up, index finger pointing straight at me.  “Get her away from me, she is trying to kill me.”

Huh?

I saw the security guards’ shoulders shaking as they were attempting to stifle their laughter.

“Please call the police, I would like to report an attempted murder,” she continued, glaring at me.

All eyes turned to me.  I could feel my cheeks burning and I didn’t know if I should laugh or cry.  “What?” is all I managed to say.

“You thought I was asleep.  But I was just pretending. I heard you and my husband plotting to kill me so you could run off together.”

The almost 90-year-old man whispered, “I’m so sorry,” to me.  I did my best to smile back at him.  I will never live this down.  But at least she is alive.

The house supervisor took over, getting her dressed, back in bed, inserting a new catheter, new IV, and removing the PCA.  I had the privilege of calling her doctor at 4 am and explaining the situation to the cranky man.

The next three hours were spent desperately trying to catch up. By 7:00, the woman was back to her friendly self, and she apologized for her accusation. We hugged and I told her to mention her reaction to narcotics if she ever has to have surgery again.

I was still charting when her doctor arrived at 9:00, and although he is a talented surgeon, he isn’t known for being friendly with the nurses, especially ones who wake him up at 4 am.   I was terrified.

He looked directly at me.  “I am so sorry,” I said before he had the chance to yell.

“What, that’s never happened to you before?” he said.

And for the first time ever, he smiled at me.

“Her husband failed to mention that she had sundowners or I never would have put her on narcotics,” he said.

“And Katie failed to mention that she has a thing for ninety-year-old men,” Jackie shouted from behind the nurses’ station.

And so it began…..

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