5. Doctor in Training
I once had a young teenager with sickle cell disease who had been in the hospital for around a week already. He then decided to “manage” his pain himself. This was a few years ago, but I caught him pretending to take his meds. He would tip his head back and gesture that the pill went into his mouth, but really he either kept it in his hand or threw the pill behind his back.
He was also quite a talker, which I then assumed was a tactic to try and distract me. I kept seeing his odd behavior and caught him doing this a 2-3 times by the middle of the shift, so I was definitely onto him. He had a PICC line (which is essentially a long IV where the tubing goes all the way to your heart) in his left arm. I couldn’t have imagined where this was going at the time.
I noticed that it was quite a bit more swollen compared to his other arm. Sometimes clots can happen in PICC lines, so that was my biggest concern at first, but the line was drawing blood fine so I know it wasn’t clotted off. Told the doctor, then I drew blood from his PICC line and sent it down to the lab for it to be cultured to see if there was any bacteria.
Low and behold, it came back positive for a bacteria that is commonly found in tap water and usually not a source of infection in PICC lines. Fast forward a few hours later, he confessed that any oral medication he could slip by the nurses, he saved for later in order to crush them up himself, try to dissolve it with sink water in the bathroom, and inject it into himself via his PICC line.