By: Debbie Moore-Black, RN

It became a prison to me — impending doom.

I knew I had only three months left before I could retire. Three months isn’t long, but it is a lifetime away.

That long drive to work in that heavy highway traffic where there was always a collision. The anxiety of the drive knowing all along there was even more anxiety to come.

The patients that were involuntarily committed — forever schizophrenics and bipolar, usually non-compliant with their medications. That psychotic look in their eyes when we knew this was it. Another assault in the making.

You can feel the threat, the danger, the fear.

You can be surrounded by public safety officers, but it doesn’t matter. Everyone is fighting for their life.

The psychotic patient is fighting against his demons that he was never able to conquer, and the staff members that I work with were all holding onto their own universe of inner turmoil.

I long for my freedom. I’ve been a nurse since 1976. I yearn to breathe again with no agenda on my calendar. Only to wake up slowly each morning, give my dogs a kiss, have my two cups of coffee before Jack stands on my chest to let me know it’s time to take him for a walk, and before Lucy lets out her puppy growl. It’s a mandatory morning walk for these two.

But that’s OK.

I’ll visit my children, my manna from heaven.

I’ll give hugs to my granddaughters and pull out new books and toys for them, always feeling like their Mary Poppins.

I’ll watch movies; I’ll plan breakfasts and lunches with old nurse comrades.

What a journey.

From a shy redhead born into a house filled with stark black-haired siblings. A family filled with dysfunction. The underdog. The invisible one.

Wanting to be a journalist but was pushed out of the house to be a nurse.

The terror and fright of being a nurse to becoming totally entranced by ICU nursing with all of the intricacies of a body filled with multi-organ dysfunction. Watching each organ improve or deteriorate. Holding the hand of a newborn baby to holding the hand of a little lady gasping her last breath.

There is good and bad nursing management. The ones that cared about us as people versus the ones that treated us as a number as a threat to the “budget.”

I’ve worked in ER, surgery, ICU, surgical-trauma ICU, and behavioral health.

I’ve had three beautiful children in a sad, lonely, almost non-existent marriage.

There were years and years of trying to fix a marriage that was not fixable.

I’ve watched my husband ravaged by cancer until he let out his last breath.

I don’t know what’s in store for me on this last trot through life.

Many mistakes have been made.

But I can hold my head up high and say, “I tried!” — loud and clear.

Tomorrow may be lonely.

Tomorrow may be filled with quiet peace.

But I’ve earned my stripes to finally breathe again.

…

Originally published on KevinMD.com

By Debbie Moore-Black, RN

He was the middleman — the man that took the crack cocaine from the main guy, the drug dealer and then sold it to his “clients” and kept a percentage of the money for himself and the rest to the dealer.

It was a fine-tuned operation. You could make a lot of money. But you had to be precise, or else.

The patient was a tall, slim 20-something man. He had a fistful of crack cocaine rocks to sell. Before selling it, he decided he’d sample some of the crack. So he smoked it. And then he could feel his heart rate go rapidly. He got short of breath. Told his mom he didn’t feel well and that his heart was beating really fast. Mom called 911. He had sickle cell, which, apparently, doesn’t like samples of crack cocaine.

The medics hooked him up to their EKG monitor. Heart rate 180s. The medics sped to the ER, starting an IV and applying O2. He was in SVT.

Oxygen was applied, and adenosine was given, quickly, IVP.

He was transferred to the ICU step-down unit. After one night in the step-down unit, he was getting nervous. He had to get out of that hospital. He had a job to do. He had to sell this crack.

He cut his IV line with a razor blade. The nurses were suspicious, and they called the public safety officers (PSOs) to the patient’s room.

In his hospital room, PSO’s found razor blades and other drug paraphernalia, including crack cocaine pipes. The nurse and PSOs were quite suspicious. So the PSOs hung around as the nurse restarted his IV.

The PSOs did a visual check of his room, and he got scared. He was afraid they would find his crack. He had to leave that hospital soon, and he could not let them find the crack — that was money.

That was his money, his dealer’s money and product for his clients. He was a dead man if he didn’t get out of there soon. So making sure they wouldn’t take crack from him, he ingested a large clear lunch bag with crack cocaine rocks in front of the nurse and the PSOs.

What he swallowed was the size of a large round Christmas ornament.

And then I got the call. I was on call for ICU. Come in, stat. “You have a patient coming to you who just ingested a large bag of crack cocaine.”

This was a first.

Should the bag burst in the patient’s GI tract, he could have a sudden cardiac arrest., seizures or brain bleed. The crash cart was pulled up to the patient’s new room in the ICU.

I explained to the patient why he had to have an IV, why he had to be on an EKG monitor and why he had to have a crash cart in front of his room.

That what he just did was a recipe for disaster and sudden death.

Per poison control, I started a bicarbonate drip to potentially neutralize this lethal dose should it burst inside of him. We also gave the patient kayexalate, hoping that the crack cocaine would increase motility through this induced diarrhea and have crack come out while he excreted.

Everything we did, we explained extensively to him. We now had to attempt to save his life.

During this course of this regimen of care, we frequently had to change the patient’s bed sheets. Sometimes the patient would put his fingers up his rectum. Unsure of exactly what was happening, I sensed that the kayexalate was working its magic.

And there it was: A plastic baggy partially hanging out of his rectum.

“There it is,” a fellow nurse yelled. And with that, the patient jumped out of his ICU bed, tore off his gown, tore his IV out and ripped off his EKG electrodes. He was naked, and he took off running out of the ICU. I chased after him, along with another ICU nurse and a CNA to follow.

A “code gray” was repeatedly called overhead. Code gray is a call for all PSOs, stat.

The potential danger, assault, aggression is why we call a code gray.

Our ICU is on the same floor as the walkway to our orthopedic hospital. A clear glass walkway where cars could drive underneath this bridge/walkway. A large oversized banner proclaimed, “Excellence in care. Excellence in medicine,” right where all of the motorists could see.

The patient almost made it to that walkway. This tall, thin, naked man with a baggy of crack cocaine halfway hanging out of his rectum.

And the PSOs finally grabbed him and pulled him to the floor. He was a strong man. It took four PSOs to tackle him to the ground.
And there it was. A lunch-sized bag, intact and filled with light gray colored crack cocaine rocks.

With my latex gloves on, I pulled the bag of rocks out of the patient’s rectum and handed the bag to the PSOs.

The patient was wheeled back to his ICU room.

Two days later, during our busy visiting hours, the patient put his civilian clothes on and slipped out, looking like one of the many family member visitors.

He slipped out, and no one noticed he was gone. He slipped out somewhere into this large city, most likely hoping not to be found by his dealer or by his clients. We’ll never know his outcome, but we can’t imagine it was a good outcome.

Though this story is a decade old, it is repeated by nurses and doctors as if it were folklore.

But it is, most likely, a one-time-only true story.

Originally published at KevinMD.com

Image credit: Shutterstock.com

By: Debbie Moore-Black, RN

By: Debbie Moore-Black, RN

As I walked through the wine section at the grocery store, I spotted those gallon jugs of wine. I was searching for Christmas presents for my friends. But that brand glared at me.
Daddy.
My IBM executive daddy. We loved him so. But year by year, his demons took over. Every night, a gallon of wine. On weekends he’d alternate with a case of beer. But it was one or the other. No fail.

When I finally got my driver’s license at 17 years old, my job every weekend was to get dad his case of beer. I knew it was wrong. But I felt I didn’t have a choice. He was a loving father for a long time. And funny. His dad came straight from Ireland and my dad was proud of his heritage.

As kids, we only saw dad on the weekends. But he always brought us toys. He was engaging while we were young. He made us laugh. He was our world.

Dad moved up the corporate ladder. The big house was built on the “right” side of town. Private school for us 4 kids. A lake house with a matching boat. Mom wore designer clothes.

On the outside, we were this prosperous family.
On the inside was neglect and verbal abuse, and taunting. Our perfect family began to spiral out of control. I was the forgotten child. The invisible one. And I tried to stay invisible. Because, why would I want to go to proms or football games or basketball games when I was told repeatedly by my mom and dad, that I was fat, and stupid and ugly?

By the time I was in highschool, I watched my dad run into the walls, sometimes he’d fall to the ground. I’d hear my mother cry at night.

We all have our baggage, but by the time we became adults, I was certain it was guardian angels that raised us.

Dad lost his executive job. We were told he took “an early retirement”…. But that was just another lie.
He lost his lake house. The place I loved for its calm waters, gentle breeze through the trees and the quiet peacefulness.
Dad started working for another accounting company and shortly thereafter lost that job too.

As I got older, and finished college and became a nurse, my husband and I had our first child. My pride and joy. By the time we had our second child, I sank into a deep depression. I wasn’t sure if it was postpartum depression. But I felt frequent gloom and doom.
I diagnosed myself and felt it had to do with my parents … the depression and the suppressed thoughts I lived with for so long.
I started therapy sessions and I joined “Adult Children of alcoholics.”
There was one important message I learned from this: you can’t go through life blaming your parents. Eventually you have to deal with the past and grow from the cards that were dealt to you.

Some things can’t be forgotten.
Sometimes it’s that one thing that scrapes the cobwebs of your mind.
Like those gallons of wine at the grocery store.
Like those pretty dresses at the stores that were never attainable because we frequently wore the same clothes every day…. And were laughed at… while mommy wore designer clothes…

Mom died at the age of 63. Colon cancer. I felt no remorse. I cleaned her bowel movements in her bed along with the assistance of the hospice technician. I felt obligated, but I held no love.
I had sadness when my mother died. Sadness for the mother I never had.
Dad died at the age of 77. I ripe old age for an alcoholic. End stage liver disease. I saw him minutes before he died. Just a shell.
A sad life consumed in misery and alcohol.

I chose to remember dad’s sense of humor. The times he made me laugh. The time he brought me flowers when I graduated from Catholic school. The time he insisted on walking me down the aisle, though my mother warned him not to since my husband and I had “lived in sin” before we got married.

A controlled, sad life.
That gallon of wine.