The 12 Types of ICU Visitors

Episode 3: Super Greens Pictured: Jackie Peyton (Edie Falco)

You know the drill.

You spent the last two hours bargaining with a resident for a one-time dose of Ativan, you finally got your detoxing patient comfortable in bed … and here comes a conga line of family and friends, entering the unit with all the quiet grace of a high school marching band.

You’re all about creating a calm, healing environment for your patients — but sometimes, forces of nature intervene. Fires, floods, family members, it’s all the same to you.

They’re your other patients — and this is how they roll.

12. The Biographer

“How long have you been a nurse?” … “Where are you from, originally?” … “How many people have you seen die?” … “What made you want to work in this field?” … “What’s your schedule like?” … “Do you work straight nights/days?” … “Are you married/single?” … “Have a boyfriend/girlfriend?” …

Apparently, you are the single most interesting person on Earth, because The Biographer wants to know everything about you.

An intrepid private investigator, The Biographer will attempt to coax the most intimate details out of you as you’re drawing up your morning meds. The Biographer will just keep peppering you with inane personal questions — usually while you’re titrating high-risk narcotics, or troubleshooting a noncompliant A-line — until you just throw up your hands and report back that you live with thirty cats, in a log cabin, in the middle of an enchanted forest, surrounded by witches and wolves.

(Also known as: The Matchmaker, Nosy Ned/Nancy, Twenty Questions)

11. The Historian

A close relative to The Biographer, but with a slight twist: The Historian has a ceaseless, academic curiosity for all things hospital- and unit-related.

“How long has this been a Catholic hospital?” … “Was this always a transplant ICU?” … “When was that new addition built?” …

These are but a few questions The Historian will expect you to field, as if you’re the David McCullough of Sisters of Mercy Medical Center (or whatever). If you’re lucky, your hospital will have one of those nifty “Halls of History” — a walkway lined with the portraits of famous surgeons and wealthy patrons, with plaques commemorating key research breakthroughs and technological milestones — and if you’re really lucky, it will be on the way to the cafeteria.

(Also known as: The Academic, The Distinguished Professor, Trivial Pursuit)

10. The WebMD

If everyone’s a doctor, no one is … but The WebMD doesn’t want to hear about that noise.

For The WebMD, no medical degree from Harvard or Johns Hopkins (let alone a Bachelor’s in Nursing) can ever substitute for a few minutes skimming Wikipedia for the efficacy of certain medications to treat a loved one’s condition. The WebMD has all sorts of fascinating things to say about vaccines and macrobiotic diets, and will not hesitate to drop a TRUTH BOMB during rounds. You’re happy to clear up any confusion, but when things get out of hand, or just plain silly, The WebMD can be thwarted with seven magic words: “Let me get the resident for you.”

(Also known as: Smartypants, Know-it-All, Anecdotal Evidence)

9. The Enabler

Also known as The Mule, The Enabler is notorious for sneaking junk food, herbal remedies, and even illicit narcotics into your patient’s room, sometimes making use of various body cavities that aren’t even covered in advanced Anatomy textbooks.

No contraband is too risky or cumbersome for The Enabler to smuggle onto the unit. Fast-food wrappers in the bedsheets, empty soda bottles in the trash, cigarette butts in the sink … all damning pieces of evidence that The Enabler has paid your patient a Very Special Visit.

A sneaky little devil, you will know The Enabler has been up to his/her tricks when a patient who has been NPO for twelve hours comes back with a blood glucose of 365.

(Also known as: Food Truck, The Lawbreaker, The Hamburglar)

8. The Timekeeper

Similar to The Enabler, The Timekeeper will move heaven and earth to ensure your patient gets his pain medication the minute it is due. Even if your patient reports a pain score of 3, The Timekeeper will demand you give him a dose of morphine that could euthanize an ox, simply because it is ordered q4 PRN.

(Also known as: The Taskmaster, The Alarm Clock, The Egg Timer, Bossypants)

7. The Politician

This cloyingly sweet family member is your best friend … until she isn’t.

The Politician wants you to know you’re a much better nurse than the mean one from yesterday, who had the audacity to ask her to leave the room before performing a digital disimpaction. The Politician promises to “put a good word in” with your unit supervisor, and asks for you by name every time she calls, and jousts with the charge nurse to have you assigned to her loved one’s care … until you decide to enforce visiting hours one night, and later find out she was smack-talking you on her way out of the unit.

(Also known as: Two Face, The Dealmaker, The Strategist)

6. Miss Popularity

Like The Politician — but with a heart of gold. Miss Popularity is celebrated in units all across the globe for her tendency to deposit boxes of cookies and chocolate in the break room like a kind of reverse Santa Claus. Miss Popularity is oftentimes an ex-nurse, or a former schoolteacher; thus, she knows that the best way to ensure her loved one gets some extra TLC is the same way you curry favor with a child: with lethal dosages of sugar.

(Also known as: Poppin’ Fresh, Pastry Fairy, Cookie Monster, Donut Queen, Diet Destroyer, Lunch Lady, The Most Wonderful Person Who Has Ever Lived)

5. The Comedian

A kind of sad clown, The Comedian has quite an unusual response to being surrounded by all this death. Unable to progress through the grieving process in any normal, healthy way, or to watch his relatives suffer the same shared pain, he takes it upon himself to “lighten the mood.” (Even when your other patient is arresting.)

The Comedian cracks lame, poorly-timed jokes about bowel movements and sexy nurse costumes, because it’s all he can do to keep from openly weeping. Beware The Comedian’s seemingly jolly nature — he is not really in control of his emotions, and can go from Denial to Anger with the fiery speed of a rocketship escaping Earth’s orbit.

(Also known as: The Jokester, The Goofball, Mr. Giggles)

4. The Code Cracker

This amateur sleuth is always scrutinizing the ventilator settings for clues to your patient’s condition. Rather than interact with his loved one in any meaningful way, The Code Cracker prefers to stare at the CRRT machine’s readout, watching, with rising interest, as the filter pressure ticks ever-so-upward. (Hours later, he will turn around and victoriously decree: “This is a dialysis machine, isn’t it?”)

Fixated on numbers and lab values, The Code Cracker will call the unit at five in the morning to obtain a daily rundown of blood chemistry results, saying things like: “Have the MRSA levels gone down yet?”

(Also known as: The Scientist, The Mathematician, Inspector Clouseau)

3. The Drama Queen

Perhaps the most difficult (and common) of all the family members on this list, The Drama Queen is known for hovering over your patient’s bed and sternal-rubbing him every time he falls asleep, fearful that even a few seconds of rest will cause him to slip into a coma and never wake up.

The Drama Queen runs screaming from the room every time your patient farts or coughs, and will follow you into the hopper, where you’re emptying the contents of a fecal bag, just to alert you to a slightly loose blood pressure cuff. If you are lucky enough to get a lunch break — as if! — The Drama Queen will track you down in the cafeteria and yell from across the room that your patient “looks uncomfortable.” Gently, and with a mouth full of salad, you will attempt to explain to The Drama Queen that her loved one is very, very sick, and is going to be uncomfortable no matter how much Fentanyl you bolus through his IJ; and that, furthermore, the patient is on a nicardipine drip, and she is doing him no favors by sending him into a hypertensive crisis with her arm-flailing antics. Good luck with that conversation.

(Also known as: Bullhorn, Worrywart, Nervous Nelly, Four Alarm Fire, Academy Award Winning Performance)

2. The Personal Assistant

God bless The Personal Assistant, who you can “put to work” doing mouth care every two hours, so that your patient doesn’t come down with VAP. The Personal Assistant has a lot of nervous energy that can be channeled into performing harmless (but no less important!) tasks — such as moistening your patient’s lips, folding linens, and even giving limited bedbaths — so that she doesn’t stroke out from anxiety or boredom, and herself become an ICU patient.

The Personal Assistant is usually an elderly lady who has been doting on her husband for something like 81 years, and is therefore in a much better position to provide for his safety and comfort than pretty much anyone on the planet. The Personal Assistant is a kind of honorary nurse, and should be encouraged to do as much as possible for your patient — particularly when you’re behind on your charting, and there’s freshly-made coffee in the break room.

(Also known as: The Helper, The Housekeeper, Grandma)

1. The Tenant

It’s unclear if this family member has a home to return to, or if he’s simply using his loved one’s illness as an opportunity to enjoy fresh linens and free cable TV. The Tenant uses the unit bathroom like it’s his personal commode, sometimes even taking the USA TODAY in there with him. The Tenant thinks the nursing station is his living room, and will even hop on a computer to check his email or play online poker. You will eventually put The Tenant in touch with a social worker, who will then make a shocking discovery: Not only is The Tenant indeed homeless — he doesn’t even know your patient.

(Also known as: The Sleeper, The Squatter, Wrapped in Blankets, Hey Where the Fuck Did All the Goddamn Pillows Go?)

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