Trouble in Two's
This time the “trigger” was the pureed diet. Patients with dysphagia that require pureed foods are at nutritional risk. But not all patients requiring pureed foods need that texture modification because of dysphagia. Some just don’t have any teeth.
There was a speech pathology evaluation scheduled. That procedure would determine the patient's swallowing ability and risk for aspirating food into the lungs, and therefore, what texture modifications and liquid thickeners to use.
When I knocked, and heard a loud audible “come in,” I entered. The lady in the first bed was more or less non responsive at that moment. But it was the lady in the second bed that I was intending to visit. This lady was hidden behind the curtain separating the two beds. I could tell the nurse was there. The nurse was finishing her procedure, took one look at me and gave me a look I could not recognize, and she quickly left.
“Well, you are the handsomest young man I have ever seen in a long, long while.” Ms. [ ], the patient, chuckled.
By now, my attention had shifted from the nurse to the patient propped up in bed. A rotund little thing, Hillary Clinton cheeks, toothless grin, thinning gray hair.
My head is spinning for some kind of response. I dare not agree with her, for that would be a blatant lie . . . not about to confirm that I am both handsome and young. And I didn’t want to provoke a fight by disagreeing with her . . . got to keep the clients happy.
“Well, I will just have to tell my mother that, it will make her feel good,” was the only thing that somehow blurted out of my mouth.
She chuckled in that way that made the covers bounce.
And we proceeded with some kind of a joking nonsensical conversation that just sort of spontaneously erupted. And in the midst of the bantering back and forth, I did learn that she does very well with her pureed foods, that she has no teeth, and that she has a great appetite. It was just her old breathing that was getting her down, and that being the reason for her admission to the hospital.
However, I didn’t learn about a very important physical state that would affect her nutritional requirements. At least not yet. It was not mentioned in her chart.
And she looked at me again.
“You are the youngest, handsomest man I’ve ever met.”
“Well, I don’t know about the young part, and not too certain about the handsome part as well.”
“But you are a hell of a lot younger than me!”
I knew her age. I looked down at my sheet of notes I had made from her chart that I will use in forming and documenting her nutritional care plan.
She was 89 years of age.
“OK, I know how old you are. And you are right, I’m not quite there yet.”
And I’m wondering how is it that I get myself into these jams? Here I am, an ugly old gay man being hit on by a toothless, jovial, 89 year old woman! It is not in my heart to break hers.
And I stammer some more, looking for any excuse for an exit.
“OK, Ms. [ ], it sounds to me like you are having a jolly good old time.”
“Oh, I am! And you are the youngest, handsomest man I have ever seen!”
I laughed. What else could I do?
“Now Ms. [ ], you stay out of trouble now!” And I turned to make a quick exit.
Her response struck me as being quite profound. I just didn’t know it yet.
I got back to the nursing station.
“Well how did your interview go?” the nurse with that-look asked me with a besmirched grin on her face.
I had to chuckle. “Well, she is one character.”
“Yeah, and did she tell you she is pregnant?”
“Pregnant?”
“Oh yes. She is very certain that she is pregnant. Thought you might need to know that as you recommend how many calories and grams of protein she needs!”
Well, yes, there are incremental requirements in the second and third trimesters of pregnancy.
“And just which trimester might she be in?”
And the banter at the nursing station took off on other stories of elderly, delusional patients who have thought they were pregnant or inflicted or blessed with a myriad of other anomalies.
And Ms. [ ]’s parting comment to me now hit me with a poignant stab.
“It takes two to stay out of trouble!”
The Refectory Manager
There was a speech pathology evaluation scheduled. That procedure would determine the patient's swallowing ability and risk for aspirating food into the lungs, and therefore, what texture modifications and liquid thickeners to use.
When I knocked, and heard a loud audible “come in,” I entered. The lady in the first bed was more or less non responsive at that moment. But it was the lady in the second bed that I was intending to visit. This lady was hidden behind the curtain separating the two beds. I could tell the nurse was there. The nurse was finishing her procedure, took one look at me and gave me a look I could not recognize, and she quickly left.
“Well, you are the handsomest young man I have ever seen in a long, long while.” Ms. [ ], the patient, chuckled.
By now, my attention had shifted from the nurse to the patient propped up in bed. A rotund little thing, Hillary Clinton cheeks, toothless grin, thinning gray hair.
My head is spinning for some kind of response. I dare not agree with her, for that would be a blatant lie . . . not about to confirm that I am both handsome and young. And I didn’t want to provoke a fight by disagreeing with her . . . got to keep the clients happy.
“Well, I will just have to tell my mother that, it will make her feel good,” was the only thing that somehow blurted out of my mouth.
She chuckled in that way that made the covers bounce.
And we proceeded with some kind of a joking nonsensical conversation that just sort of spontaneously erupted. And in the midst of the bantering back and forth, I did learn that she does very well with her pureed foods, that she has no teeth, and that she has a great appetite. It was just her old breathing that was getting her down, and that being the reason for her admission to the hospital.
However, I didn’t learn about a very important physical state that would affect her nutritional requirements. At least not yet. It was not mentioned in her chart.
And she looked at me again.
“You are the youngest, handsomest man I’ve ever met.”
“Well, I don’t know about the young part, and not too certain about the handsome part as well.”
“But you are a hell of a lot younger than me!”
I knew her age. I looked down at my sheet of notes I had made from her chart that I will use in forming and documenting her nutritional care plan.
She was 89 years of age.
“OK, I know how old you are. And you are right, I’m not quite there yet.”
And I’m wondering how is it that I get myself into these jams? Here I am, an ugly old gay man being hit on by a toothless, jovial, 89 year old woman! It is not in my heart to break hers.
And I stammer some more, looking for any excuse for an exit.
“OK, Ms. [ ], it sounds to me like you are having a jolly good old time.”
“Oh, I am! And you are the youngest, handsomest man I have ever seen!”
I laughed. What else could I do?
“Now Ms. [ ], you stay out of trouble now!” And I turned to make a quick exit.
Her response struck me as being quite profound. I just didn’t know it yet.
I got back to the nursing station.
“Well how did your interview go?” the nurse with that-look asked me with a besmirched grin on her face.
I had to chuckle. “Well, she is one character.”
“Yeah, and did she tell you she is pregnant?”
“Pregnant?”
“Oh yes. She is very certain that she is pregnant. Thought you might need to know that as you recommend how many calories and grams of protein she needs!”
Well, yes, there are incremental requirements in the second and third trimesters of pregnancy.
“And just which trimester might she be in?”
And the banter at the nursing station took off on other stories of elderly, delusional patients who have thought they were pregnant or inflicted or blessed with a myriad of other anomalies.
And Ms. [ ]’s parting comment to me now hit me with a poignant stab.
“It takes two to stay out of trouble!”
The Refectory Manager
posted by The Refectory Manager | 12:22 AM
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