...who I wrote about on August 31 is sitting 20 feet from me, dialyzing 'emergently' again. His blood pressures are in the 220s over 130s. Heart rate in the 120s. Potassium is 6.7. Creatinine of 10.1, and BUN of 28.
He left hospital Q on Saturday, against medical advice. Now, he came to this ER and I drew the short straw.
"Zack," I said, with large 15 gauge needle in my hand, "I'm not trying to piss you off or anything here, but seriously, why do you do this to yourself?"
"Do what?"
"Blow off your dialysis appointments, the dialysis that is keeping you alive, and drag your butt into ERs around town when it gets too bad?"
"I'm supposed to go tomorrow."
"Yes, but why didn't you go to the one you were supposed to go to in the beginning? The point is what brought you HERE...TODAY... And every other time we see you?"
"I don't know what you're talking about."
At this point, I jab the first needle into his skin. This is soothing. "I think you do, because I don't think you're an idiot though you are acting like one."
"No I don't!"
"Whatever. Sit back, relax, and I'm not taking you off this machine for four hours even if aliens land, so don't even think about it."
I jab the second needle into his fistula and hook him up. I let his admitting nurse know he's here, what's goin on, brief history, and to be mindful of where her Against Medical Advice paperwork is. She may need it.
Thank you, Colorado taxpayers, for paying for my services today. I'm a nurse and I save lives.
....
(Maybe I'll have some nice, responsible patients who want to get well later this week. One can hope. It does happen sometimes.)
Monday, October 5, 2009
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