Despite It All

Chapter 15

"Seventh floor, this is Lauren."

"Hey Charge, it's Priya. I have to drop an NG in 739, do you have time to help?"

Ugh, a nasogastric tube. Nasogastric tubes are small, flexible, plastic catheters that are manually inserted through the nostril and fed down the throat and into the stomach. They are secured on the patient's face with tape and can stay indwelling for quite some time. The tube is used to instill liquid medication and provide nutrition directly into the stomach through the use of formula. They're actually very useful because they allow patients to receive their important medications that they may otherwise refuse to take voluntarily.

The downside is that insertion is very, very uncomfortable. I mean, we literally hold the patient down and shove a couple feet of plastic down his or her nose. The patient screams and cries, and it's incredibly heartbreaking. Once, a resident insisted on having the procedure performed on him in front of the patient to "prove" that it isn't so bad. Nursing staff warned him that it was likely not the smartest idea, since he had never had one before. In the end, he insisted and nursing complied.

He cried.

Literally.

Cried.

So, that backfired. Of course, the observing patient screamed bloody murder the whole time, and the whole process was likely even more challenging as a result. Poor kid. Don't really feel bad for the resident, though. I mean, we told him.

I hate dropping NGs. I'd honestly rather do a lab draw or insert an IV than drop an NG. But, alas, being a Charge Nurse means helping all of my co-workers, no matter what.

So, I acquiesce with a groan, "Ugh, little Sophia? Yeah, are you ready now?"

"Yeah, I'm about to gown up and head into her room."

"Okay, be there in a second."

***

Poor Sophia sits alone in her bed, obviously distressed. She has visible sores around her mouth and her cheeks are flushed. Her skin is pale and her sweet, bald little head has patches of dry, itchy-looking skin on it.

"How bad is her mucositis?"

Priya sighs, "Really bad. She won't take any meds or drink anything at all."

Anger boils in my veins, "They do this every single time! We tell them, 'Hey let's drop an NG before the mucositis kicks in,' and they say, 'No, she's doing so well!' and then she develops mucositis as everyone always does and then we have to inhumanely shove a tube down her throat when it's full of sores!"

Mucositis is a common side effect of chemotherapy. Chemotherapy drugs work by targeting cells that multiply very quickly—the way cancer cells do. Unfortunately, other cells in the body also multiply in the same manner—mostly—the cells in the mouth and intestinal lining. Ultimately, patients almost always end up with painful sores in the mouth and throat, making swallowing especially difficult. At this point, the patient does not want to eat or take medications, and healthcare providers end up exhausting all coercion tactics before eventually deciding it is time for an NG tube. A lot of strife could be avoided if physicians listened, and ultimately it is the patient who suffers. The patients who don't have parents here regularly are the ones who suffer the most, because they don't have anyone but us to advocate for them. And as backwards as it sounds, physicians are more likely to listen to the requests of the parents than the nurses.

Poor Sophia.

"Yeah, well. They're not the ones who have to do it, you know? They don't have to hold her down and hear her scream and watch tears stream down her face as we shove a plastic tube down her sore throat," Priya's expression matches her annoyed voice.