Thursday, January 22, 2009

Interesting Measures of Success

So, the last couple of Thursday afternoons I've been going to the nursing home in Las Vegas to look after a few of the residents. The environment is pretty depressing and some of the patients, I think, would be better off without a lot of the "life-saving" measures we give them. What life is it exactly we're saving?

One of the residents, Mr. A., has been creating a fuss at the home. He's been aggressive with the staff, a few visitors, and apparently the chaplain. Usually if an elderly person has a sudden change in behavior it means that they have a urinary tract infection. Its a simple matter of getting the patient to pee in a cup (or emptying their catheter bag), dipping a stick in it, and giving them some antibiotics and, voila'!, instant behavior correction!

I gave an order for a urinalysis. This was complicated by Mr. A. swinging his walker at the nurses aid sent in with the specimen cup. When I got there this afternoon, the nurses station was abuzz with tales of Mr. A.'s attitude problem. I asked about the urine sample that was requested a week ago. Never got it. Mr. A was headed straight for a psych eval and sedation.

Suddenly, or at least as suddenly as a guy who's had a stroke and uses a walker can go, he was standing in front of the desk. I grabbed my specimen cup and followed him down the hall. It was time to use my advanced clinical skills.

"Mr. A., how are you today". I gave him my biggest smile. He smiled and babbled back.

"Do you remember me?" More smiling on both sides.

"Can you give me a urine sample?" Smiling, babbling, walking towards the bathroom.

"I have a cup right here, will you fill it up for me?" Smiling, nodding, babbling.

He handed me a cup. Half-empty, half-full, didn't matter. It took two minutes to get a urine sample from dangerous geezer. I capped the cup, thanked him sincerely, helped him tuck his shirt into his pants and took my prize down the hall.

The charge nurse on duty saw me coming with the cup wrapped in a paper towel.

"You're kidding!"

"Nope, got some test strips?"

Two minutes later we had a positive test strip for a bladder infection. Mr. A. cruised down the hall and said hello with a big grin on his face. There were no walkers thrown, not even a cross word spoken.

There a couple things to be learned here. If you smile, say please and thank you, and treat people with respect, you'll generally get what you want. This is especially true with people who have lost a good portion of their dignity and freedom.

The other lesson is that old guys love me. I am far more successfull with the 80 and over crowd than I am with men in my own demographic.

No comments: