CVA

New station, new area. Downtown, dirty, grimy hospitals with little to no county funding and nurses that are completely burnt out with their jobs.

I get an IFT call to one of these hospitals to pick up an older female patient who has suffered a CVA (cerebrovascular accident, AKA stroke) a few days prior. She's being discharged to a nursing home a few blocks away, but she had originally come from home. We get there and try to get a report from the nurse, who's waving us off and trying to get away with giving us one syllable answers. We finally decide to just go check out the patient instead of trying to get any info from the nurse.
We walk into the cramped room where surprisingly, 2 beds have been stuffed where only 1 actually fits. Our patient, a middle aged hispanic woman, is lying on her side facing us. Her hand is gripping the siderail of the bed and she appears to be in distress. She also appears to be covered in blood. We furiously search her entire body, trying to figure out where the blood is coming from. It's covering her pillow and sheets, so our first thought is that she's somehow hurt her head. We comb through her hair, but find nothing. She is crying now, moaning something in spanish that neither of us can understand. We find the source of the blood, she's ripped out her IV and has been flailing her arms around for at least 20 minutes.
Her nurse, of course, never noticed a thing.
Irritated, I walk back to the nurses' station and explain the situation. The nurse wanders over to the bed rolling her eyes as if to say "big deal" and cleans the patient up. I ask the nurse if the woman is oriented at all, she says "Yea." I ask "Does she speak or understand any english?" and the nurse replies "No." I ask "Do YOU speak or understand any spanish?" and the nurse says "No."
Then how do you know that she's oriented?
I don't ask this, for fear I'll get a complaint filed against me for being rude, so I shut my mouth and try to communicate in what I call my "broken, stupid spanish." My partner and I manage to figure out that, as far as we can tell, she seems oriented. She's gripping my hand, pleading with me in spanish and sobbing. She keeps saying "I'm ok, ok, bueno" when I ask if she's hurt. She's still crying, but I don't think she's in any pain. I think this poor woman has no idea what's happened to her, she's suddenly been shoved into a closet-sized room in a dingy hospital with mostly korean-speaking nurses who have no idea (or desire) to communicate to her what's going on with her illness or treatment.
The nurse relays to me that this is the patient's first time at the nursing home we're taking her to. Apparently, the family arranged for her to go there because they would be unable to provide care for her. The sad thing is, for the most part this woman is going to be fine. The CVA was minor, she has NO apparent facial drooping or one-sided weakness. She's able to walk and communicate in her native language. She's also fairly young for a CVA.
The family has not been to see her since she's been in the hospital. They have not told her that she isn't going home. When she understood that she wouldn't be going home (the nurse had somehow told her just before we arrived) she got upset. Hence, the crying and ripping out of IVs.

I feel horrible. I wish so badly that I knew spanish, even enough just to tell her that she was going to be ok, though I know that regardless of her condition, she will probably be in the nursing home for the rest of her natural life. She wails in the back of the rig, and with each sob I wince a little. I want to hold her hand, to apologize for the disgusting hospital, for the cold nurse, for her kids who were sending her away. I want to take her home, to her things, her memories. Pictures of her family, late husband, maybe grandchildren. Her own bed, her own space. I don't want to take her to the nursing home filled with screaming dementia patients, the home engulfed with the smell of urine and stale food. The home filled with the same, cold, unapologetic burnt-out nurses.
Inter-facility transports are supposed to be the easy ones. Patients who are usually being discharged, who are feeling better and happy to be getting home.
They're SUPPOSED to be the easy ones.
So why was it so difficult to turn and walk away from this woman after putting her in her new bed??
I couldn't stand to look her in those pleading, tear-filled eyes as I left.
I hope she doesn't hate me for that.

Over and out-
thePSYCHwrangler