Monday, November 24, 2014

First Person Chronicles, Chapter 3: Me and Mrs. Jones.

*with minor exceptions, all people included are fictional. The hypothetical experiences are based upon my own observations.


The Unit Clerk

"Miss? Where can I find some gauze and some scissors?"

I was actually on hold with radiology when I heard his voice. Just as I started to address him, someone came in on the line to answer my call. I held up one finger, looked up and smiled. Then I mouthed to him, "Give me just one second." He didn't seem to like that.

"I really need some gauze and scissors now," he repeated. That "now" had a huffiness to it that caused my brow to furrow. I mean, was someone bleeding to death as he stood there? Or had he just decided that his time was exponentially more important than my time--or even the time of the other person I was assisting? "Who is my nurse?" he demanded once more. "I mean, the nurse taking care of 15 bed one?"

At this point he made it clear to me that he was gong to keep hovering right there until I stopped everything to help him. Now I was on hold again with radiology as they looked to see where a patient was and whether transport had picked her up already. I took my chances and put them on hold with me, too.

"Mrs. Okeke." I had checked the board behind me that very clearly indicated who the RN was caring for his patient. The same board he could have looked at. I decided to be a bit passive aggressive when I said it by pointing at the white board.

"Who is that?" he countered without even trying to think more. Just then, Mrs. Okeke walked up.

"This is Mrs. Okeke, " told him while gesturing in her direction. "Okeke, this doctor needs some help with 15 bed one."

He immediately butted in. "I need some gauze and some scissors."

That's it, that's all. No "good morning." No "excuse me, can you help me." No nothing.  Mrs. Okeke just walked off toward the PIXIS to get him what he needed. And that was that.

Just then I remembered radiology and tried to return back to the call I was placing. Before I could, someone else approached the station. "My daddy is cold. Don't Grady have more than just one blanket they give people?" For a moment I wasn't sure who this young woman was speaking to. But then, after a few seconds, it clicked for me that she couldn't be speaking to anyone else but me, the unit clerk.

"Ma'am?" That's all I could think to say. She was clearly frustrated. I needed to prepare myself.

"My daddy is seventy five years old and he in there with just one blanket. He's cold! Can't he have more cover?"

"I don't think that should be a problem. Let me call someone for you."

And with that, she just walked away. No "thank you," no "preciate you," no nothing.

"Is it time yet for me to get something for pain? I'm in pain." This was Mr. Marshall who, every few hours, was at the unit clerk's station asking this same question. His IV pole was right next to him and he still had on his hospital gown. Like always.

Sometimes he started out super, syrupy sweet, complimenting my hair and my skin and then asking me to call his nurse. Other times he was volatile, banking his adhesive taped hand on the counter and gnashing his teeth in my direction. But most of the time, he was somewhere in the middle. Too exhausted to put on a show or rather,  just forgetting. "It's only been about two hours, sir."

"Well, can you call my nurse to come and see me? I'm in pain," he said. His face twisted up and he slumped his shoulders before slinking back toward his room with the IV pole in tow.

Sigh.

I put my hand on the receiver of the phone once more and prepared to call radiology back. Then came that booming voice overhead and those sirens.

"CODE BLUE, SEVEN A. CODE BLUE, SEVEN ALPHA!"

I had noticed a little bit of commotion down on the tail end of the long hall but didn't realize that it was a code situation. Mrs. Okeke came bursting out of room 15 and all of the other nurses began running toward room 26. The rude resident with the gauze ran out next and seconds a later, more doctors of various levels came pouring out of the stairwells and hallways into the corridor.

"Where is it!?" one yelled in my direction.

"26!" I responded.

The entire area outside of the door of room 26 was swarmed with people. Some walking in, some walking out. Some yelling, some looking terrified. And me, I just braced myself and waited for all of the orders that would surely be coming my way.

Whether the patient made it or not.

See, for the clerk? A code means entering orders and making calls. Where those orders and calls go depends upon the outcome. Either way, people often come out of those crazy situations flinging orders like frisbees at your head.

No "please," no "thank you," no nothing.

Which, I guess, I can maybe allow if someone has died. I mean, maybe.

I look at my census to see who is in room 26. Oh no! Sweet Mr. Shaughnessy! Oh no.

I wasn't sure of all the medical parts of what was going one with him. All I knew was that he was homeless, had some psych problems and some kind of medical issue that had made him a real, real long term player. He didn't come out of his room much during the day. Only in the evenings, when things were more quiet. And when he did, he was kind to me. Really and truly kind.

His hair was always matted and he smelled a little bit whenever he came out to the desk. His teeth were all cracked and blackened and his beard so nappy that it resembled taco meat pasted to his face and neck. But that part didn't faze me so much. It didn't. I loved the way he always remembered my name and how, despite his circumstances, seemed to be able to find a glimmer of light everything. I know for sure that he knew my name because every time he approached the counter in the late afternoons or evenings he'd sway from side to side while holding his IV pole like a microphone. Then he'd croon in a really low voice,  "Meeeeee aaaaaaand Mrs.-Mrs. Joooooooones. . . we got a thaaaaaaaaaang . . goin' on. . . . "

And each time I'd just laugh and laugh. Some might have thought he was being fresh, given the nature of that song. But not me. To me it felt like a hug and a big pile of all the "thank yous" and "good mornings" that I hadn't received all day long.

I closed my eyes and said a little prayer for him.



"My daddy stil didn't get no blanket," the same woman said to me. My eyes flung open and I stood up.

"Let me help you," I said. Quickly, I headed over to the laundry cart and slipped a clean blanket out of the stack. "Here you are, ma'am." She took the blanket and marched away, mumbling under her breath something not-so-flattering.

No "thank you," no "preciate you," no nothing.

The phone was ringing when I returned to my desk and from the corner of my eye, I could still see the people milling around room 26.

"Unit 7A, Ms. Jones speaking,"I answered. The person on the other end was a family member of a patient. A seemingly angry one who wanted to know what was going on with a loved one.  Carefully, I did what we are instructed to do, determine who the person is and contact the nurse. But with the code going on, I'd just have to take a message.

"Who am I speaking to?" the person demanded to know.

"I'm Ms. Jones. The unit clerk."

"Well. I need to speak to a doctor or a nurse. Right now."

"Um, okay. Well ma'am, we have an emergency on the floor right now and her nurse is occupied. I can have her call you right back. You said you're her daughter, correct?"

"I'm like a daughter to her, yes. I need to know what's going on right now. I'll just hold."

Like a daughter? I leaned back in the chair and rolled my eyes a little while the receiver was away from my face.

"Ma'am, I will have the nurse or doctor call you back once we get the permission of the patient. Thank you for your understanding."

"This is some bullshit!" the lady on the other end said. And then she hung up. On me.

Sigh.

I looked back down the hall and hoped poor Mr. Shaughnessy was okay. I wished that call had been for him and wondered who would arrange a funeral for him if he passed. I decided that I would go if there was one. To his funeral.

Suddenly, everyone came walking out of the room toward the unit station. Mrs. Okeke was reaching into her pocket for meds that she was obviously about to pass before and the rest of the staff all seemed to be returning to what they were doing. The doctors, even the rude-gauze-and-scissors dude, all walked right by my desk with these nondescript looks on their faces. I couldn't tell from looking at anyone whether or not Mr. Shaughnessy had made it.

So much energy. No answers. No nothing. Chaos one minute, business the next.

I closed my eyes once more and said another little prayer for Mr. S.

"Good morning, Ms. Jones."

That nice greeting--by name--startled me. I looked up and saw the smiling face of what appeared to be a young doctor. I tried to place her--I think she'd been a medical student here first and had stayed on as a doctor. I could usually tell by the length of the white coat which, right now, I couldn't go by since all she was wearing was a set of blue scrubs.

"How are you doing today?" she asked me still smiling. I noticed the tiny freckles spread across her nose and the color of her eyes. Some shade of greenish-blue.  I smiled back.

"Good. Crazy morning."

"Yes, indeed," she replied. "You look a little distracted. Are you okay today, Ms. Jones?"

I felt bad for not knowing her name. But the fact that she'd made up her mind to not only learn my name but use it, spoke volumes of who she was. Though I couldn't place her name, I recalled the team she was on as a student where her attending, Dr. Winawer, always spoke to me in front of all of them. I think she'd learned from that example. Which I appreciated.

"The patient who coded has been here a while. He's such a nice man. I was just feeling a little worried, that's all."

The freckle-faced intern reached out her hand for me and touched my arm. "That's so kind of you," she said softly. "Well, I'm on the ICU team this month. And I want you to know that I'll be taking care of Mr. Shaughnessy up stairs, okay? We got his pulse back and it looks like the nurses called the code so quickly and started compressions so fast that it made a difference. Of course, he's sick. But we will take good care of him, I promise." I could tell that she meant that.

"I'm so glad."

She nodded and began to walk backward toward the room again. Then she stopped and said, "Oh, I almost forgot and I've been meaning to ask. Did your daughter make the dance team?"

I was confused for a moment and then remembered telling Dr. Winawer about my daughter trying out for her high school dance line last year. She was a student and was there and remembered. Which immediately made me feel like crying and laughing at the same time. "She is the captain this year. Her and another girl."

The freckle-faced intern gave me a big thumbs up and shuffled back over to room 26. And that was that.

"Is it time for my pain medicine yet? Is it?!"

It was Mr. Marshall again. This time he was angry. He slammed his hands on the counter in front of me.

"I'm sorry you're in pain, sir. But it's only been a few moments since the last time you were here."

"CALL MY NURSE!" he snarled.

I didn't say another word. I just sat still for a moment. From the corner of my eye, I noticed the bed being wheeled out with Mr. Shaughnessy on it. Someone was bagging him while the freckle-faced intern was holding his the rail of the bed helping guide it. When she passed me, she gave me another thumbs up. "Bye Ms. Jones!" she said. "Thanks for your help!"

As they disappeared down the hall, I realized that I hadn't done anything for her. But that she seemed to appreciate the fact that I stood ready to.

Sigh.

That little bit, that tiny humanistic nod from that intern did my heart good and had given me the charge I needed.  I looked up at Mr. Marshall and softened my expression. "Good morning, again," I said, "Let me see if I can somehow help, okay?"

And he nodded his head and let that angry fire quiet down. Instead of getting his nurse, I put my hand on his back and walked him back to his room. I told him it would be okay and that I'd make sure his nurse knew he was in pain. And that? That seemed to be enough.

Surprisingly enough, it was and all he really wanted after all.




Two lines were ringing when I got back to the desk. One of which was radiology asking why I'd hung up on them. Another resident doctor was asking for something without making eye contact with me.

"Who is O-KEEK?" she asked while looking a bit annoyed.

"Mrs. O-KAY-KAY is right there. Would you like me to get her attention for you?"

That annoyed resident just walked off while muttering what I think just maybe was a thank you. Maybe. She obviously hadn't been on Dr. Winawer's team. Oh well.

Also a patient who was recently discharged was standing at the counter with a prescription that she couldn't afford to fill. I wasn't sure how to fix that, but figured I could at least say I was sorry and get the doctor. Which seemed to make a difference.

I paused for a moment, just long enough to hear Mr. Shaughnessy with his crackly voice singing quietly in my ear and then I smiled, thinking about the care I know for sure that the freckle-faced intern would give him. I knew he was in good hands.

Why?

Because she noticed me. And if she noticed me, then she'll notice him. And to me, noticing people is like telling them they matter. And that you care.  Which, if you ask me, is more important than just about anything else when you're working in a hospital like Grady.

I returned to my work--answering phones and answering questions. Some people were nice to me and some weren't. But me? I made up in my mind to notice them all no matter what. . . .

. . even if they hadn't yet made it up in theirs to notice me.

***
Happy Monday. Will make up for Sunday with two today. Stay tuned.


Now playing on my mental iPod. . . . for all of the wonderful unit clerks at Grady who deserve to always, always be noticed. 




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