TFMITW - The Foulest Man In The World

Disclaimer - This entry may contain profanity. I have censored some of my recent posts as I have been publishing some of my stuff on nursing blog forums, which tend to be more scholarly, and try to be serious/conservative in nature. This is despite the fact that a lot of real life nursing deals with crap and bureaucratic bullshit. I for one, love swearing and crass commentary, and have felt, well, almost suffocated by these fucking boundaries of professionalism.

TFMITW lives in my unit. He won't die, but he also won't get better. He teeters on the edge of life and death all the time, and when he is doing ok, he is rude, is always on his fucking call light, and is always, hideously incontinent. His stench is unbearable and it permeates to your very core when you take care of him for the day. He also refuses to turn, refuses to cough and deep breath for pulmonary hygiene, always is screaming for pain medication, and worst of all, if he doesn't have his speaking valve or call light handy - clicks incessantly with his mouth like a horny Spaniard. He is now basically paralyzed, has an ever oozing trach, and needs everything done for him. Wiping his nose, feeding him, flossing his teeth, "milking" his rectal tube, changing the channels, and moving him repeatedly one inch at a time - "No! Too much, back toward you! Get the wrinkles out, Oh God I hate the wrinkles. Oh my rectum hurts, it burns! I need more dilaudid! Oh Christ, I just crapped again." This is your day with TFMITW. Oh God it burns.

He is the bane of the unit and we trade him off like canned spinach. I have to assign him to people, and will trace it back to the last time someone had him. Sometimes I have to go back over a month in order to make it fair. This whole junior high bullshit pisses me off. People will sigh heavily, whine uncontrollably, and beg to pass him off. I mean he isn't pleasant, but seriously, groveling?

The sad thing now is that he doesn't really bug me anymore. I actually feel bad for him, and have found out over time, that we actually get along pretty well. He calls me Nurse Ratchet. I set limits, tell him no, and say "Jesus Christ TFMITW, give me a fucking break!" He likes this. I am the one who got him out of bed for the first time in two months and took him outside - for a cigarette, of course. The light shone in his eyes as his son held the smoke to his crusty lips, and he winked at me as the sun played on his face. He was so grateful for that moment, and I felt pretty good about it. Then later, we had to go upstairs and replace the large rectal tube that he is always shitting out as he has no more rectal tone. sweet.

He always asks when I am coming back. He has a couple nurses who don't treat him like crap, and he wants to know who is coming on after my shift. He doesn't understand why he always gets a different nurse, and gets depressed and angry that no one listens to him. He doesn't mean to be TFMITW, but alas, it is his fate. He is an asshole, and if he was more proactive and nice, he probably would have gotten better care from everyone. People look at me in horror when I say that I don't mind him. "Well, why don't you just take him all the time then?" they ask smugly with sarcastic smiles. Well, for one thing, bitches, he is a patient and deserves care despite his physical and personal flaws. We all need to do our share and deal with backtalk and crap. So you too, can get off your ass, deal with his needs and find a way to communicate and help him so that he doesn't call you every five minutes. Plus, I am getting tired of coming home and taking a thirty minute shower which includes a complete nasal flush.

TFMITW is looking like crap again by the way. It is nice when he is stuperous and can't get his shit together enough to call for help. But it is sad listening to his confused and rambling hallucinations. He is half the asshole he was, and this is an ominous sign. He is on pressors and is dependent on the vent all the time now. I think that many people on our unit might be happy if he was listening to "smooth jazz", but I would miss him. (Well, I'd miss him as a person, not necessarily taking up a bed for god damned ever)

Good luck TFMITW.