Sunday, September 9, 2007

More tales...

I wish, I wish, I could take pictures at work! I wish I could tape record what people say to me. I wish I could video tape situations that only a nurse (and perhaps, cops) see every day. Example: a guy comes in with the complaint of "cut to buttocks". Further investigation reveals he was surfing and was cut with the surfboard fins (which are extremely sharp) about 2 cm away from his anus. We're talking in the butt crack. I guess the fin sliced through his swim trunks and, luckily for him, did not go so far as to slice his anus, or testicles for that matter. I had the happy job of holding his butt cheeks open while the doctor stiched him up. What ensued was awkward, forced conversation. Let me set the stage: Patient: lying face down on the stretcher, naked from the waist down, blue sterile drapes framing his buttocks, which are bathed in bright lights. Me: hands gloved in blue, spreading his butt cheeks as far as they would go. Doctor: 27 gauge needle dripping with lidocaine, sutures at the ready. My job as a nurse, is to not only help the doctor do what he or she needs to do, but to also help the patient feel comfortable. "So," I ask, as I make sure his cheeks are sufficiently spread apart, "do you live around here?" I'm desperately trying to fill the awkward silence. How many of you would be comfortable with your whole anus and butt crack exposed to total strangers? "Uhhh, yeah, I live in Marina", this poor guy responds. "Oh, that's a nice area", I answer. There is a couple of seconds of silence and then we all crack up, the patient included. I mean, how do you turn an uncomfortable situation into a "no big deal, we do this every day" situation?

I really try to encourage people to take pictures of their injuries. I realize that they are not always in the mood at the time because of fear, pain, etc., but I believe eventually they will want to remember their adventure. Most people have a camera on their cell phone so I suggest to friends or to the patient themselves to get a picture before we stitch them up (or put them in a splint). I was in a terrible car accident when I was younger and, at the time, I wouldn't let anyone take a picture but now I wish I would have. It's amazing what the body can heal from. And I also think that scars are a certain rite of passage as human beings in the human race.

A woman, my age, presented with the chief complaint of "bumpy cervix". We brought her into our special room for gynecological problems (we have a special bed with stirrups to do the pelvic exam). She reported having a "drugged out night" with a gentleman and the next morning felt lumps on her cervix. She wouldn't divulge exactly what drugs but told us she had a patchy memory of the night before. Every pelvic exam performed by a clinician needs to have a witness so I volunteered. I set up the usual equipment: lighted speculum, KY jelly, and various lab specimen collection devices. One of my favorite physician's assistant's was performing the exam. She's no-nonsense and extremely professional. The patient's leg's were spread and the PA had already inserted the speculum. I was ready to hand her whatever she needed when she looked at me oddly and said, "Hand me a forcep". I was not ready for this request at all and luckily found a sterile forcep in the cupboard. At this point my curiosity almost got the better of me. What the hell did she need a forcep for during a routine pelvic exam? I maintained my professionalism and handed her the sterile instrument. The PA reached into the womans vagina and pulled out...a latex studded cock ring. "What is that?!", cried the patient. "It's a cock ring", the PA calmly replied as she set the offending article in the garbage. For those of you who don't know, a cock ring is a latex "implement" that is placed around the head of the penis to enhance pleasure for both partners. Unfortunately, this woman's partner did not share with her that he was using one (my guess, small penis) and it must've slipped off at some point. He had to have known that he came off but was maybe too embarrassed to tell her he "lost" something. She couldn't wait to get on the phone and tell him what she "found". Yikes.