On Bondage

1 Jun

Back when I was a teenager, I would have loved to wear these pink bondage pants. I would still rock that belt with the rings and chains. I love the color pink and most of my clothes are black. I doubt I would like those shoes though, I would be tripping all over myself in those clod-hoppers.

This post is not about my history of dressing punk rock, nor is it about sexual bondage or hidden fantasies. It is about restraints, nursing and patients. I still do want that belt though.

Lately it seems that there have been a few patients admitted to the telemetry floor where I work. They are alcoholics, withdrawing: it is alcohol withdrawal syndrome (AWS).  All I know is that they need to be sedated or they will keep climbing out of bed, all shakes and delirious, trying to leave the hospital against medical advice.

They get admitted to telemetry, because well everyone gets admitted to telemetry, but seriously, usually these people have severe electrolyte imbalances, mostly low potassium levels, which we know is not good for the heart’s rhythm and that is an indicator for a telemetry admit. Potassium is needed for neuro-muscle cells to be able to re-polarize energy, and yes the heart is a muscle we know, and severe low potassium can cause problems with cardiac conduction. Hypokalemia may also cause respiratory problems, muscle weakness, fatigue.

We all know the alcoholic with severe liver disease, that comes in all yellow, big belly, low platelets, anemia, bleeding, low blood pressures, with metabolic encephalopathy, pooping all over the bed from the lactulose you are giving every four hours. They are so sick, it is not so difficult to give them some sedatives, get their bellies drained with paracentisis, transfuse some FFP, and maybe get them better enough to go home for a while longer.

Every RN cries: Restraints! I think it just makes a bad situation even worse. These AWS need medications. You can’t strap a raging alcoholic to the bed without the (med) and expect to manage for 12 hours. ATIVAN it works if you work it.

6 Responses to “On Bondage”

  1. Wanderer June 1, 2010 at 16:05 #

    The biggest fix to all of this is simple: give them a beer.

    Now there are the exceptions to this, like the patient who is willingly admitted for detox, to them I just tell ‘em to cowboy up. But many others, they’re fighting pneumonia, or cellulitis, or COPD or any other innumerable things and just happen to be an alcoholic. So what do we do? We detox them, pretty much against their will. Now in addition to whatever medical problem brings them in, we’ve added detox on top.

    The place where I went to school did this for awhile. The patient got a beer with lunch and dinner. It wasn’t much, but it was usually enough to quell the demons until we 86’d them.

    The docs mean well, thinking they are giving the patient a chance to “clean up”, but they’re not the ones chasing them all night, getting swung at, cursed at, pissed on and generally abused like the bedside nurses. It’s a mental exercise for them, but for us it’s something much more.

    • seejanenurse June 18, 2010 at 11:26 #

      Yes, it is so difficult and it can turn abusive, they are often manipulative as well. There has to be a better way, and I go for the “more sedation” approach, let them sleep it off.

  2. my2ndheartbeat June 5, 2010 at 13:08 #

    I was in restraints for a while after my heart transplant. Apparently, I didn’t like the vent very well and kept trying to take it out. Soooo ….. I was tied down for a few days. I didn’t remember that part at all, but later when I was conscious (and calm) I asked about these odd looking marks on my wrists that appeared to be ligature marks …… that’s when I was informed that I had been a “bad boy”.

    • seejanenurse June 15, 2010 at 01:36 #

      You are not allowed to rip out any tubes or lines!

  3. Robert September 23, 2010 at 06:24 #

    I was taken to a psych hospital in Nigeria after I slapped my lady teacher in the face. They stripped all my clothes off in a locked room with the teacher present and told me to put a tee shirt and pajama on. I did as I was told when a nurse walked in with a medication tray with four syringes. I was scared and started to cry (I was 14). The teacher and the nurses held me down and one nurse rolled up my sleeve all the way up. She then administered a most painful injection in my upper arm. I cried as my arm was held tightly by the teacher and nurses. She then gave me another injection close to the first one. After that they dropped my pajama down and gave me the remaining two injections in my buttocks. My teacher enjoyed all this punishment she was giving me under her authority. I promised her to behave myself, but she arranged for an 8 hour stay with the nurses.
    I could never talk to her again.

Trackbacks/Pingbacks

  1. Nurse Bloggers Best! | The Millionaire Nurse Blog - June 20, 2010

    [...] See Jane Nurse writes about Bondage-now get your mind out of the gutter-not that kind of Bondage… well maybe not, you have to go read to find out. [...]

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