"I have no graham crackers."

Two posts in one day? Guess I need to make up for lost time.

As a nurse, I find myself surprised by people on a daily basis. It is not always a patient of mine, but hearing stories from other nurses around me, there is something going on during every shift. There are no uneventful days at work.

Sometimes it is the patient, sometimes the patient's family, and of course there is always the mixture of both. The crazy in people really shows up during times of stress, and every person admitted to our unit is stressed.

On one particular night, I was blessed with a patient who has had the unfortunate history of becoming a perpetual patient. I mean that she is almost always sick in some way that ends her up in the hospital or clinic. I do not mean to downplay her illness, per say, but she has become her illness. I think she has been ill for so long that she has no identity of herself without being sick.

I'm actually not entirely sure why she was admitted to the hospital. I didn't do anything she couldn't have done herself at home. She liked to be sedated with pain medications, antiemetics, benzos and benedryl. And since, as I've said before, she is a perpetual patient, she knows a lot about what she should say when she wants something. She said all the right things that would imply that she was getting a kidney infection: it was very hard for her to pee, and she was getting flank/back pain right where her kidneys were. I didn't feel that she was exactly telling the truth, but it is not my call. So I phoned the MD who was on call. He came to see her and felt the same way as I did. He pressed on her abdomen and she screamed out in agony. He listened with his stethoscope and pressed in as hard as he had with his hands and she had no response; no grimace, no whine, nothing. Just a little background on this lady.

At one point she stated that we were not adequately controlling her blood sugars. She demanded I check to see what her blood sugar was. I forget the number exactly, but it was in the normal range in the 110's. I wanted to laugh in her face. She then proceeded to request the fruit plate with cottage cheese she had saved from earlier, and later 2 vanilla puddings.

I can't really put into words how much she drove me crazy. Except to say that near the end of the night, as I was finishing up giving her some medications she said to me: "I have no graham crackers." I stared at her for a second, then replied: "What does that mean?"

I knew exactly what it meant. She had no graham crackers, and wanted some. I wasn't going to take that as a request for graham crackers. I already felt that she was milking the system.

She went on to say that she likes to have graham crackers nearby at all times. This was news to me, it never came up before, and I had her for a 12-hour shift. I think it was about 0500 by this time, so our time together was nearly finished. I was already irritated with her, so I reacted with a little attitude. But I felt it was warranted.

She never did request the crackers. I said "Would you like some graham crackers?" Yes. She would. And also a couple egg custards. (Remember those vanilla puddings she requested earlier? She asked for egg custards then too, only for us to tell her we don't carry them on the floor.) I sent the assistant working with me to deliver a stack of graham crackers and two more vanilla puddings. That was the last time I saw her, except to do the change of shift "bedside" report. (I quoted bedside, only because the pt was up walking around the unit, so we did the check in the hallway.) Later that day, the patient was discharged to home. I talked with the nurse who had her during the day, and she had roughly the same experience that I had. The pt spouted off some other symptoms, the MDs obliged and did tests on her to check on her "symptoms" only to find nothing wrong. It was a difficult discharge. But she will be back.