Yesterday was my last day as a full-time VALOR. And boy did I get a lesson in patience and saying "no."

So my patient assignment was a 63 y/o gentleman...a C4-5 Incomplete Tetraplegic. He was admitted to our Spinal Cord unit from Fresno VA for would care. Apparently we have a great SC unit and it's known for its wound care program. Well on the 13th he came to our unit with hypotension (SBPs in the 50s), altered mental status changes, and possible sepsis. Over the course of the the last couple days he's been intubated, extubated, RE-intubated, extubated, r/o for TB and aspergillus, so of course put in respiratory iso and then taken off.

So I picked him up yesterday. My preceptor gave me some lovely insight before I started. There are two types of spinal cord patients.

1. Completely independent and only need help for activities depending on their level of injury. Can be demanding at times and feel they know better than you. Can be assholes.

2. Completely dependent and need help for pretty much everything. Won't try to do anything on their own and love the fact they now have a nurse to do it for them. Can be demanding at times and feel they know better than you. Can be assholes.

I had the second type of patient. Literally, I wanted to slit my throat. It was 12 hours of constant "Scratch my nose, give me ice chips, I want water, stretch my arm, I'm in pain, shave me, when are you going to shave me, can you shave me now?" There's more, but my headache is coming back just thinking about it.

I was supposed to get the second OR...the L CEA, but my preceptor told me I should just stick with my guy b/c it's a good learning experience and I've had a couple CEAs from the OR already. SHE just didn't want to deal with him either. HAHA.

So he kept asking and at first i kept doing. But then it came to the point where I had to be like "NO." He was lucky he was my only patient, but if I had that other one that came in, it would HAVE to be a different story. So I straight up told him. "I have other things to do. If it's something urgent that needs to be done right now, I can do it. Other than that you're going to have a wait a little bit." It helped for a couple mins then he would just go back to the way he was.

It was tough but I learned a lot from that one day.