Wednesday, August 22, 2007

Did anyone miss me?

A year? It's been a year since I posted? What? No one noticed? No one has notified me demanding that I entertain with my wit and charm? I'm really hurt.

I have added 2 new grandsons to the family in the last year. Well, actually, I didn't add anyone; my daughter and my daughter-in-law really did all the work. Kevin James Donaldson will be 1 year old on the 30th of August, and Ronin Wayne Ennis entered my son's household on May 7th, of this year.

Let's see, oh yes, I had a little thing happen last week. I work for a hospice organization on a part-time basis. No, it is not depressing, I actually enjoy the families and feel like I help them. On this occasion last week, however, I found myself in an awkward situation. I arrived at a patient's home to administer a pain medication at about 1:30 in the morning. (Don't ask why, it doesn't matter) There was an LPN at the patient's home who was supposed to be caring for the patient (no, she could not administer this medication, that's why I was there.) She was asleep on the couch. Not a big deal, that can happen on occasion, but I was going to have to wake her up and make sure she was doing what she was supposed to be doing. After taking care of the patient, I gently shook the sleeping nurse on the couch. No response except for a snore. I shook her again......................no response. Well, let's try shaking a little harder, she must really sleep deeply. Took hold of both shoulders and shook......................no response. Shook much harder and yelled her name.................now her head was lobbing back and forth................Oh My! Her eyes were rolled up in the back of her head. Kept shaking her and calling her name.....................OK, slap her face several times..................no response................Slap, shake, yell, give a sternal rub..................no response............. Spit on her lips, skin a little gray,.....................what the heck is going on, she is snoring.................she has a pulse........................What is that piece of plastic sticking out between her lips?????????????? Did she choke on something???????? Is her airway a bit obstructed????????????Pulled the piece of plastic out of her mouth.............what in the world is this????????You're kidding, right?????? The printing on the plastic indicates that it is the remnant of a 25mcg fentanyl patch.

For those of you not familiar with fentanyl, it is a pain reliever, is used in anesthesia, and is about 80 times more potent than morphine. It has been popularized around these parts by addicts who die after injecting fentanyl laced herion. It is bad stuff used inappropriately, and can be lethal, especially for those people who wish to get high by letting the patch dispense its properties through the soft tissue of your mouth. No choice here, I have to call 911. So I knocked on the bedroom door of the patients' spouse and said "I need to borrow your phone, I have to call 911 for the nurse." Talk about your awkward moment.

The nurse? You're calling 911 for the nurse?

Yes ma'm, the nurse is not waking up, but don't worry, she has a pulse and is breathing. (However, she has OD'd on your couch)

Hello 911? Yes, I have a non-responsive patient here that needs to go to the hospital. Yes, she is breathing, yes, she has a pulse, no I don't know anything about her. I took a fentanyl patch out of her mouth, yes, you heard me correctly................Yes, I said MOUTH.

Paramedics arrive, get her on a stretcher, start an IV, put on a rebreather mask, administer narcan......that will wake her up. Sure enough, she begins to stir, and as the reality of what has transpired begins to sink in I can see the fear/confusion/terror in her eyes. Whereas I was concerned for her well-being prior, I am now immediately struck by how sorry I feel for her. I almost wish I could have saved her from what will surely become a nightmare in the next few days. She will most likely lose her license, and she will have to face her addiction (I won't go into why I know this was not an accident, but it wasn't. Of course, accidentally putting a fentanyl patch is your mouth is pretty far-fetched.)

So, I am back on the blog trail. Just think about how many stories you missed while I was away!! Maybe I can update the look of the site in the next couple of weeks.

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