My patient Harriet is a 91-year-old lady with dementia, in the hospital with a urinary tract infection. She lies in bed, sleeping soundly. I creep up to her at the start of my shift.
“Hello, Harriet,” I croon softly to her.
“Hello, dear,” she responds sleepily.
“Can I check your blood pressure, Harriet?”
“Yes, honey, of course, whatever you need,” she answers sweetly.
So I gently pull down her sheets, and she clutches them tighter to herself.
I gently push up her gown’s sleeve, and she pulls away with a deepening frown, eyes scrunched shut.
I gently place the blood pressure cuff on her arm – and my sweet little patient suddenly explodes.
She turns to me, screaming, “Stop! Don’t do that! What are you doing? Stop stop stop!”
Her hands come zipping out, lightning fast, and seize my hands with unexpected strength. She’s twisting and pinching my hands. She yanks them towards her mouth, gnashing her teeth savagely at the air. She’s trying to bite me, slash my skin! Her hands shake violently as they wring my hands, trying to bruise them. She flails in the bed, she screams at me. She’s a shrieking demon.
Apparently Harriet does not like to be disturbed.
“Okay, Harriet, my dear,” I say hastily, avoiding her gnashing teeth and disengaging myself from her hands with some effort. “I’ll get your blood pressure later.”
She turns happily onto her side, pulls her blankets around her, and sleeps.
Several hours later, I bring her morning medications to her. “Hello, Harriet, I have your pills,” I say sweetly.
“Oh, that’s nice, dear,” she says.
“Will you take them?” I ask cautiously. “Maybe with some nice ice cream?”
“Why yes, of course, honey,” she answers.
I scoop some soft ice cream onto a plastic spoon and place the pills on top. “Okay, Harriet, here you go,” I say, gently touching her lips with the spoon. She shrinks away, bats at the spoon, averts her face.
“Harriet? I have your pills here,” I repeat.
She smiles sweetly at me. “Okay, honey, that’s fine.”
“Here they come, Harriet, here are your pills,” I say, gently placing the spoon in her mouth – and again, my sweet little patient suddenly explodes. She chomps down fiercely on the spoon, holds it in her teeth, shakes her head from side to side, won’t let go.
“Harriet, Harriet!” I say urgently, as calmly as possible but with an edge of hysteria. “Let go of the spoon, Harriet, let go! Swallow the pills!”
But she’s biting down, grabbing my hand, breaking the plastic spoon in half, good God she’s biting the spoon right off, and suddenly she’s showering me with bits of spoon and ice cream and pills, all of it spit energetically out, spraying her gown, raining over her sheets. I step back in utter surprise. She snatches the sheet and forcefully mops all traces of ice cream from her mouth, then flops dramatically back down, pulls the blankets over her, and turns to her side with an indignant snort.
Do not, under any circumstances, disturb Harriet.
I now deeply regret having to inform you: Harriet needed a suppository.
Just think about that for a minute. Sticking a suppository up Harriet’s rear end. And her likely reaction to such impertinence.
I must be crazy to be a nurse! This was not going to go well. I was nearly bitten, just trying to get her blood pressure! What might happen when I attempted a suppository?
It started like this: “Harriet? You need to poop, my dear, you haven’t pooped.”
“Oh?” she says sweetly.
“I need to give you a suppository,” I say unhappily. “Do you know what a suppository is? I need to put it up your backside. See this thing? I have to put it up your rear, Harriet, to help you poop.”
“Oh, okay,” she says happily. “Sure, go ahead.”
“Okay, Harriet,” I say uncertainly. “I’m going to put this up your bottom, then. I need to take off your briefs first.” I reach to unfasten her diapers.
“What are you doing?” she asks sharply, twisting to face me. “What do you think you’re doing? Stop that right now!”
“I need to give you a suppository, Harriet,” I answer mournfully. “See this? It has to go up your bottom, my dear. I’ll do it fast, okay? To help you poop, you need to poop.”
She beams at me. “Okay, honey!”
I could see the headlines: Nurse’s hand clamped upon and held fast by patient’s rectum! Nurse sustains severe bites from surprisingly agile 91-year-old! Nurses’s co-workers baffled: “That patient was always so sweet! What did Carol DO to her??”
I hold the suppository bravely in front of me, like a sword, and prepare to wade into battle. “Okay, then, Harriet, here we go….”
Actually, it went really well.
The antibiotics were clearing up her urinary tract infection, which often manifests itself as confusion in older adults. Harriet was certainly confused and uncooperative (to say the least!) the first day I had her, but really turned around the second day, when she needed the suppository.
She smiled at me. She kept kissing my hands, which I found very sweet but a little unnerving, based on the previous day’s somewhat-traumatic experience of Harriet trying to bite my hands off.
Harriet lay on her side, proffered her rear end to me, and let me stick the thing way the hell up there.
Seriously. It was that easy.
She docilely took all her pills in ice cream. She allowed me take her vital signs. She sat up in a chair. She was an angel – a sweet, perfectly pleasant, beaming angel.
I absolutely loved her. I told her so, too.
I said, “Harriet, my dear, I just love you.”
“Oh, honey, that’s nice,” she responded radiantly, fiercely seizing my hands, yanking them to her lips, and covering them with kisses. “I love you, too.”
I’m so lucky to be a nurse.