GothNurse, 20, new grad LVN, working in a subacute rehab facility.
No, not drug rehab - postop rehab. My typical patient is 75, female, healthy until they got a left total knee replacement, admitted to Sunshine Manor for physical therapy.
I worked as a CNA for two years in long-term care - if a patient apologizes for bothering me, I tell them, "Hey - you haven't tried to bite me yet!"
Today I admitted a patient with no sternum. Mr Spock* came to us post lung / kidney resection for metastatic cancer - thoracotomy incision, abdominal incision, various skin issues coming with having an albumin of 1.9 and long-term hospitalization. He came to us from Fancy-ass LA Hospital, whose dogma is apparently to never, ever give report.
I had to accept a patient that I knew nothing about, apart from what I could skim from his H&P.
I had taken down his gown to check his skin when I noticed a thrashing motion under the skin of his chest - "Wait, is that your heart?!" "Oh yeah - my sternum got infected after a bypass operation last year. They had to take it out."
It was fascinating, in a weird fashion. The problem came with his code status - full code, but CPR impossible. My facility, in the event of cardiac arrest, provides BLS and calls 911 for ALS.
"So, Doctor... we need to talk about this guy's code status... he's a full code, but he has no sternum. How the heck do we perform CPR?"
"Very, very carefully... like petting a cat."
Shortly thereafter, I ruptured any dignity I may have had left (after one discharge, two admits, a fall, etc) by screaming like a castrated hippo, jumping up onto an empty patient bed, and yelling "Ohjesusgodwhatthef**kisthatthing!!" in the PT's ear.
The cause? Potato bug. Goddamn leggy things.
