Thursday, October 7, 2010

"Pink is My Signature Color"

Oh, lord, did I have a flashback.

I was asked to do a blood draw in the outpatient lab on a "tough stick", something I am always happy to do; if it can get done in one rather than repeatedly poking the patient, I am all for it. As is the patient, I'm sure.

She was elderly and was decked out completely in pink from head to toe, including a little pink cloche hat (who even knows what a cloche hat is, anyway?). Sorta like this:

In fact, exactly like this but with only one flower.

Mae was so cute and tiny. Pink flowered blouse, pink sweater, pale pink pants and pink flats with a clip-on flower. She had on bright pink lipstick and had the most beautiful clear blue eyes with a devilish twinkle.

Mae was sporting a sassy pink cane with pink breast cancer stickers, and a pink ribbon breast cancer pin or three. Because she'd had a mastectomy some years ago, we were only able to use one arm--hence the difficulty.

I introduced myself and told her that I was there to help Lynn, the lab tech, get her blood test done.

"So, they called in the top dog, eh?", Mae said with narrowed her eyes and a slight curve of her lips to indicate she was teasing.

"Well, let's see what we can do; no promises, OK?"

She studied me with her little head tilted under the cloche, glancing at me out of the corners of her eyes; the last time I saw an expression like this, it was done by Essie who tortured me in my very first job as a nurse.


I had taken my State Boards (now called NCLEX) out of my home state, thanks to our nursing school director giving us the wrong deadline for application...idiot. So, I was able to take this two-day test (now done by computer with the results immediately available) in the state of NH where I went to school, I could take it with my friends which was a bargain. The downside was that the tests were only given twice a year in those days. If you failed, you were done for six months. In addition, the results took about 4-6 weeks, which was torturous to say the least. But, if you were fortunate enough to get a job, you worked as a glorified nurses aide and could do everything except pass meds; it was worth the crappy pay, and you could also do charting and sign your name "EDNurseasauras, GN" (for graduate nurse).

Since I was back in my home state of Massachusetts, I not only had to wait 4-6 weeks to see if I had passed or not but had to apply for a reciprocal license so I could practice in Mass., which was another 4 weeks or so. In the meantime, I was hired at a rehab hospital. One day of orientation, one day following the RN around, and then I was on my own for the next three weeks, expected to take a full patient care assignment of 6 or 7 patients, which my nursing program had prepared me to do (yeah, diploma programs....the bottom of the food chain as far as education, but prepared to be a nurse right out of the box). Management was biding it's time until I received my Mass. license so I could be in charge. Yes, as a puppy nurse with merely a couple of hundred hours of experience I was to be the sole RN on the floor with one LPN and 4 aides. Three months of 30 hour weeks as a charge nurse in my Leadership course, the finale of my education had also prepared me for this as well. Hind sight only makes me realize how potentially dangerous it could have been, however, it all worked out and we all managed together to give good care.

Although it was a rehab hospital, there were relatively few patients with rehab potential on my floor. We had head injured young people in comas who were complete care and needed tube feedings, etc.; respiratory patients who were basically sent there to live out the rest of their lives on oxygen; a couple of men with cerebral palsy who were wheelchair bound and total care because of their contractures; one woman with some mysterious paralysis-type of thing with a bed-sore that needed to be packed a couple of times per day. There was one brain-injured man who had tremendous mood swings and angry outbursts caused by prolonged oxygen deprivation. He had experienced a cardiac arrest and survived, but in those early days when we had just started not letting people die by doing CPR there was perhaps a lag between the the length of time he was "down" and when he was "saved". He certainly was not the same 43 year old person he had been before he was admitted to my unit as his anguished family constantly reminded me.

I also experienced my first death as an RN. With a nurse's aide who was afraid of dead people, I performed post-mortem care using the directions in the shroud kit. Yes, we used a toe tag. Heidi, the aide, was also my roommate at the time. She had nightmares about this.

There were several older adults with dementia; these days, such patients would not be placed on that kind of floor, but that was the 1970's after all. One of these was Essie Poisson, who was in her late 80's or 90's. In her occasional moments of lucidity she would talk about her days dancing in the Ziegfeld Follies, elaborate Broadway musical shows with gorgeous young women, beautiful costumes and headdresses with towering plumage. Essie, like Mae, was usually dressed all in pink.

Of course, in Essie's less than lucid moments, everything was a fight. The most stressful part of my evening was 1) getting Essie into bed and 2) getting Essie's dentures out.

Essie would give me that side-glance, narrow-eyed, "bring it" devilish look and challenge me to remove those dentures; it may have been stressful for me, but damn if it didn't seem like the highlight of Essie's day. I do believe she looked forward to it.

Essie would resist the removal of those dentures with more enthusiasm than I thought possible in a woman of her frail appearance; underneath lurked steel armor and determination to match.

She shrieked "help, police, murder!!" with all the gusto she could muster, but the dentures ultimately spent the night in a denture cup in a marinade of Polident; she never drew blood but that didn't stop her from trying.

Once in her nightgown, fluffed, puffed, lotioned and soothed, Essie behaved as if nothing was amiss and would always politely ask for a cup of custard before she went to sleep. I retreated, drained, to the nurses station for a cup of coffee and begin my charting. What I really felt like was a stiff drink.
So with nostalgiac if not fond thoughts of Essie in my mind, I drew little Mae's blood.

But out of habit I kept my eye on those teeth....