I had three patients once again this week. Similar to last week, two were easy and one required a little more attention. She is 40 years old, chronic drug abuser, six kids, and has been in the hospital for over 70 days, and generally has a daily seizure.
My nurse and I got her into a special chair to give her a shower, because it had been QUITE some time. Out of fear (of seizing), she was hollering the whole time. People in the hall were wondering about us, no doubt! Her hair had been in a bun, but when we took it down to wash it we found that it was completely matted. The nurse director went and bought her a special conditioner and a comb. I worked on her hair for about 1 1/2 hours. Didn't get very much accomplished, so they are going to bring someone in to cut it for her.
We wheeled her around the floor to see people and look out the windows before I combed out her hair. She shielded her eyes from the light and sat there limp--she has lost all muscle control (from laying in a bed for two months straight). The nurse director came over and said, "April and Lauren are treating you really well, huh Ms. ____?" She mumbled, "Yeah, and this one is my favorite," and grabbed my hand. That's why I do this. Not to be a favorite, but to make an impact and do what I can to make someone's life or experience a little better. It is so satisfying to love doing something so much and to know that you are right where you should be...I just love this...
Friday, September 19, 2008
Wednesday, September 10, 2008
First time in a long time!
Wow, today was my first day back at the hospital since April! I will be on the same floor for the whole semester and will be shadowing the Charge Nurse to learn her roles. The Charge Nurse I worked with today was awesome and really helpful. It's weird because normally the nurses haven't liked students particularly, but now that I'm close to getting my RN BSN they have made an exception. : )
My 3 patients were all sweet today. One guy was discharged around noon, so then it was down to 2. Then my old lady fell asleep...down to 1. So I hung out in my other patient's room because he was pretty chatty.
26 years old, has AIDS. It's been progressing quickly. He talked about how his life has changed since he was diagnosed with HIV--before, he was focused on his own happiness and making money and traveling the world. Now he sees people as his first priority, he doesn't care about money. He said, "I don't believe in coincidences though, someone has this all worked out," he glanced upwards. I asked him if he believed in God and he enthusiastically said "Yes!" I asked him how he would describe himself spiritually, and he said "Spiritual." He has all sorts of different beliefs. I felt like I was talking to Arnold, my Yosemite tourist friend from Amsterdam.
On great thing about hospitals--they are FILLED with seeking people. Usually, when a 'crisis' occurs, people wonder, "Why is this happening to me? Where's the purpose in this?" And they wonder where this all fits in the plan for their life.
Anyway, I was so happy to be back in the hospital. Of course, I was nervous as all get out last night and this morning, but on the floor today it felt so right. I hope I didn't freak people out due to smiling so much. I just couldn't help it.
My 3 patients were all sweet today. One guy was discharged around noon, so then it was down to 2. Then my old lady fell asleep...down to 1. So I hung out in my other patient's room because he was pretty chatty.
26 years old, has AIDS. It's been progressing quickly. He talked about how his life has changed since he was diagnosed with HIV--before, he was focused on his own happiness and making money and traveling the world. Now he sees people as his first priority, he doesn't care about money. He said, "I don't believe in coincidences though, someone has this all worked out," he glanced upwards. I asked him if he believed in God and he enthusiastically said "Yes!" I asked him how he would describe himself spiritually, and he said "Spiritual." He has all sorts of different beliefs. I felt like I was talking to Arnold, my Yosemite tourist friend from Amsterdam.
On great thing about hospitals--they are FILLED with seeking people. Usually, when a 'crisis' occurs, people wonder, "Why is this happening to me? Where's the purpose in this?" And they wonder where this all fits in the plan for their life.
Anyway, I was so happy to be back in the hospital. Of course, I was nervous as all get out last night and this morning, but on the floor today it felt so right. I hope I didn't freak people out due to smiling so much. I just couldn't help it.
Friday, April 18, 2008
Last day of clinicals, S1 (a follow up post)
It is a good thing, being done with clinicals. I like them--it's what I'll be doing the rest of my life--but I don't like doing paperwork and things like that.
When I got to the hospital, my 23 y.o. patient had been taken to the operating room. His younger brother and sister had decided to donate his liver and kidneys. I guess their reasoning might have been that heart and lungs keeps him whole, still a person. I don't know.
My other patient, the 25 y.o., was extubated yesterday after I left. So today when I walked in, I said, "Hi I'm Lauren. Remember flipping me off yesterday?" He grinned and said, "Yeah." Boy, he has a dirty mouth and was demanding, but sometimes he'd try to make up for it by saying "thanks," or mentioning that he thought we must be pretty tough to be nurses. His parents and girlfriend were there all day. His mom mentioned to me in the hall that she hopes this is a wake-up call for him, because he shouldn't be alive...but she knows that there's a reason for him living.
I forgot to give you his background yesterday--he was driving drunk with his girlfriend and got T-boned by another car. He had multiple injuries from it, the biggest being that his heart was torn away from his aorta...not something you want to mess with. That was Sunday. He's made a pretty remarkable recovery since then.
When I got to the hospital, my 23 y.o. patient had been taken to the operating room. His younger brother and sister had decided to donate his liver and kidneys. I guess their reasoning might have been that heart and lungs keeps him whole, still a person. I don't know.
My other patient, the 25 y.o., was extubated yesterday after I left. So today when I walked in, I said, "Hi I'm Lauren. Remember flipping me off yesterday?" He grinned and said, "Yeah." Boy, he has a dirty mouth and was demanding, but sometimes he'd try to make up for it by saying "thanks," or mentioning that he thought we must be pretty tough to be nurses. His parents and girlfriend were there all day. His mom mentioned to me in the hall that she hopes this is a wake-up call for him, because he shouldn't be alive...but she knows that there's a reason for him living.
I forgot to give you his background yesterday--he was driving drunk with his girlfriend and got T-boned by another car. He had multiple injuries from it, the biggest being that his heart was torn away from his aorta...not something you want to mess with. That was Sunday. He's made a pretty remarkable recovery since then.
Wednesday, April 16, 2008
Surgical ICU
Golly, reading over the last few posts I realized that writing things down in a hurry probably isn't the best thing. I tend to be very factual when doing so. Sorry, makes for a pretty boring read. I'm making some time right now!
Today I was in surgical ICU. The nurse I was shadowing--not helpful at all. Lame. One of my patients was conscious and intubated, and kept on trying to communicate with one hand that was restrained to the bed. He kept asking for water and ice. Then he motioned that he wanted a pen and paper, so after I fetched it he wrote, "You have to take this out." I was impressed because the pen/paper thing usually doesn't work (the patients are too sedated). One time I couldn't guess what he was saying, so he very kindly gave me the birdie. And I very kindly chuckled, said sorry, and left. : ) It would be so frustrating not being able to communicate...poor guy. 25 years old.
My other patient is a very sad story. His dad died earlier this week...I'm not sure if it was natural death or suicide. The patient was distraught so he went to a bar, got drunk, and called a friend to pick him up. When his friend got there he parked across the street, motioned at the patient to come to his car. As the patient was crossing the street he got hit by an oncoming car. He was pronounced brain dead 3 days ago. His mom is already institutionalized, so it was up to his younger brother and sister to make the decisions regarding organ donations. His body could save 7 lives. Right now he's still hooked up to machines that are keeping his body (not brain) alive, so to the family it may appear that he's still alive, but without those things his heart would stop beating in minutes--maybe seconds. It was the saddest thing to see the nurse shine a flashlight in his eyes and there be no reaction. He was 23. He had just gotten out of the military less than a month ago, so all of his buddies were coming in and leaving their patches at his bedside.
I learned alot about organ donations today. In case you are interested, you have to go online and register to be an official organ donor. Having a sticker on your license doesn't do it. If you're not registered online, the choice is up to the family, and it's usually a very hard choice considering the circumstances. As for me, I think I want to donate everything--if it ever came to that.
It was a hard day.
Today I was in surgical ICU. The nurse I was shadowing--not helpful at all. Lame. One of my patients was conscious and intubated, and kept on trying to communicate with one hand that was restrained to the bed. He kept asking for water and ice. Then he motioned that he wanted a pen and paper, so after I fetched it he wrote, "You have to take this out." I was impressed because the pen/paper thing usually doesn't work (the patients are too sedated). One time I couldn't guess what he was saying, so he very kindly gave me the birdie. And I very kindly chuckled, said sorry, and left. : ) It would be so frustrating not being able to communicate...poor guy. 25 years old.
My other patient is a very sad story. His dad died earlier this week...I'm not sure if it was natural death or suicide. The patient was distraught so he went to a bar, got drunk, and called a friend to pick him up. When his friend got there he parked across the street, motioned at the patient to come to his car. As the patient was crossing the street he got hit by an oncoming car. He was pronounced brain dead 3 days ago. His mom is already institutionalized, so it was up to his younger brother and sister to make the decisions regarding organ donations. His body could save 7 lives. Right now he's still hooked up to machines that are keeping his body (not brain) alive, so to the family it may appear that he's still alive, but without those things his heart would stop beating in minutes--maybe seconds. It was the saddest thing to see the nurse shine a flashlight in his eyes and there be no reaction. He was 23. He had just gotten out of the military less than a month ago, so all of his buddies were coming in and leaving their patches at his bedside.
I learned alot about organ donations today. In case you are interested, you have to go online and register to be an official organ donor. Having a sticker on your license doesn't do it. If you're not registered online, the choice is up to the family, and it's usually a very hard choice considering the circumstances. As for me, I think I want to donate everything--if it ever came to that.
It was a hard day.
Friday, April 4, 2008
Never too late?
I feel like if I don't post now, I never will--because there's so much to tell!!
In my last Critical Care rotation (the last one I wrote about) I got to insert and IV and do other nursely things. It was cool.
Then I went to my last 3 week rotation on the Psych floor. It was pretty neat. Basically, patients check themselves in to get re-medicated or to have their prescriptions altered a tad. Sometimes something will happen in their lives that sends them over the edge so they'll check themselves in. At the hospital, there's group activities all day to participate in. There's a recreational therapy group, where they play games and team-building activities; there's art therapy; and there's a couple group sessions with the therapist. It's pretty neat to sit in on group sessions because the patients help each other out so much. We didn't really get to do a whole lot on the psych floor; mainly observe and have a couple short conversations with patients.
This week I was in the Emergency Room! The first day I was there it was pretty slow...nothing too exciting. The second day I got to see some traumas, and one from the very beginning admission. The guy couldn't breathe because he had pericardial effusion, where fluid leaks out and builds up around the heart, causing it to not be able to squeeze efficiently. So they intubated him, got him hooked up to all the machines (where they made their discovery), and stuck a needle into the sack covering the heart to get the fluid out. It was cool because I've read about it in our books, but it's a rare thing to be able to see. Even after that his heart was having some problems and they had to cardiovert him.
Other than that I saw a lady with the flu, a guy with a super swollen eye for no apparent reason (nice, nice guy), girl with an abcess (sick but cool), alot of 'drug seekers' and a few failed suicides. Drug seekers are interesting. They come in complaining of pain, but they end of being 'allergic' to everything except for the drug they want. One guy had been in 7 times in March alone. The doctor walked in knowing the history and said, "So how much cocaine have you had today?"
I liked the ER alot better than I thought it would. It's kind of neat to have quick rotation of patients, close and frequent communication with the doctors, and great variety of presenting problems.
In my last Critical Care rotation (the last one I wrote about) I got to insert and IV and do other nursely things. It was cool.
Then I went to my last 3 week rotation on the Psych floor. It was pretty neat. Basically, patients check themselves in to get re-medicated or to have their prescriptions altered a tad. Sometimes something will happen in their lives that sends them over the edge so they'll check themselves in. At the hospital, there's group activities all day to participate in. There's a recreational therapy group, where they play games and team-building activities; there's art therapy; and there's a couple group sessions with the therapist. It's pretty neat to sit in on group sessions because the patients help each other out so much. We didn't really get to do a whole lot on the psych floor; mainly observe and have a couple short conversations with patients.
This week I was in the Emergency Room! The first day I was there it was pretty slow...nothing too exciting. The second day I got to see some traumas, and one from the very beginning admission. The guy couldn't breathe because he had pericardial effusion, where fluid leaks out and builds up around the heart, causing it to not be able to squeeze efficiently. So they intubated him, got him hooked up to all the machines (where they made their discovery), and stuck a needle into the sack covering the heart to get the fluid out. It was cool because I've read about it in our books, but it's a rare thing to be able to see. Even after that his heart was having some problems and they had to cardiovert him.
Other than that I saw a lady with the flu, a guy with a super swollen eye for no apparent reason (nice, nice guy), girl with an abcess (sick but cool), alot of 'drug seekers' and a few failed suicides. Drug seekers are interesting. They come in complaining of pain, but they end of being 'allergic' to everything except for the drug they want. One guy had been in 7 times in March alone. The doctor walked in knowing the history and said, "So how much cocaine have you had today?"
I liked the ER alot better than I thought it would. It's kind of neat to have quick rotation of patients, close and frequent communication with the doctors, and great variety of presenting problems.
Saturday, March 8, 2008
Wrap up of Critical Care
So. It's been a long time! My rotation in ICU was good. It was different than I thought it would be....generally speaking, the nurses aren't very busy, but they are working with much higher risk patients so that makes up the difference. I didn't know this before, but there's about 5 different ICU floors at S&W all with their own specialties. I got to work in the Cardiac ICU and Medical ICU.
My first patient was in because she used cocaine. When presented in the ER, her blood pressure was 250/160 (ish). Considering normal BP is 120/80, "her head should have blown off," as my nurse put it. The nurse didn't really have sympathy for the patient...I can see why, because there are other people on the unit who take care of themselves and still have major problems, and here this lady is abusing the good body that she has.
The first day of my rotation, a code was called on a room down the hall from mine. When codes are called, EVERYONE on the unit goes to help. My friend and I stood outside the room and watched for about 25 minutes while nurse traded out doing CPR and administering meds on a woman. It was...I don't even know how to describe it. Intense and emotional, I guess. After 25 minutes, everyone just started walking out of the room...they couldn't get her back.
The patient's nurse had grown really close with her, because she had seemingly made huge leaps of progress in the past few days. My instructor volunteered herself and me to clean up the body, seeing how the nurse was emotionally distraught. I thought I was up for it. My teacher gave me the instructions: Take everything out of the body (IVs and stuff) and make her look pretty so the family can have a good last memory. We walked into the room and all I could do was stare at the IV pump stand. I started to cry a little. After collecting myself, we gently took care of her. It was an honor. It was hard. I never imagined I would have to do something like that. I'm so thankful that my teacher was sensitive and helping me--it would have been so difficult to do that on my own for the first time.
After that, I thought I was fine and that it didn't really affect me. It did. Life is just so short. I mean, I imagine myself getting a job, finding a man :D, and growing old and happy, but in reality it could be me in the bed tomorrow. Our futures are so...up in the air. It made me wonder if I'm living my life in such a way that I would be satisfied to go tomorrow. I'm not. I've been living for the future instead of for today.
The rest of my experience seemed a little less great after that. It was a good experience.
Now I'm on the Psych unit at S&W, which I'll document later : ) So far, it's been hopeful.
My first patient was in because she used cocaine. When presented in the ER, her blood pressure was 250/160 (ish). Considering normal BP is 120/80, "her head should have blown off," as my nurse put it. The nurse didn't really have sympathy for the patient...I can see why, because there are other people on the unit who take care of themselves and still have major problems, and here this lady is abusing the good body that she has.
The first day of my rotation, a code was called on a room down the hall from mine. When codes are called, EVERYONE on the unit goes to help. My friend and I stood outside the room and watched for about 25 minutes while nurse traded out doing CPR and administering meds on a woman. It was...I don't even know how to describe it. Intense and emotional, I guess. After 25 minutes, everyone just started walking out of the room...they couldn't get her back.
The patient's nurse had grown really close with her, because she had seemingly made huge leaps of progress in the past few days. My instructor volunteered herself and me to clean up the body, seeing how the nurse was emotionally distraught. I thought I was up for it. My teacher gave me the instructions: Take everything out of the body (IVs and stuff) and make her look pretty so the family can have a good last memory. We walked into the room and all I could do was stare at the IV pump stand. I started to cry a little. After collecting myself, we gently took care of her. It was an honor. It was hard. I never imagined I would have to do something like that. I'm so thankful that my teacher was sensitive and helping me--it would have been so difficult to do that on my own for the first time.
After that, I thought I was fine and that it didn't really affect me. It did. Life is just so short. I mean, I imagine myself getting a job, finding a man :D, and growing old and happy, but in reality it could be me in the bed tomorrow. Our futures are so...up in the air. It made me wonder if I'm living my life in such a way that I would be satisfied to go tomorrow. I'm not. I've been living for the future instead of for today.
The rest of my experience seemed a little less great after that. It was a good experience.
Now I'm on the Psych unit at S&W, which I'll document later : ) So far, it's been hopeful.
Monday, February 18, 2008
Two weeks worth!
I've fallen behind. I want to hit the high points of my last two weeks at the psych ward so I can remember later.
On our unit most of the patients are 'older' and in their early fifties or a little younger, so it really made one patient stick out who was only 26. We saw him on our first week and he seemed really sad and pretty lonely, but generally okay--compared to some other patients. He looked relaxed, his gait was even, ate well and conversed with others during meal time. Well, when we went back on the last week (only two weeks after we saw him initially) he had changed so much. We came on the unit at about 6:45am and he greeted us with a warm 'hello' while he was walking around the floor. We took that as a good sign. He never stopped pacing around the halls. All day. And he had "The Walk" of the other patients who have been on meds for a really long time. It's kind of like a Frankenstein walk; very stiff and slow, and the arms are lifted off the body a little like he was wearing a puffy winter coat. It was so sad. Every time he passed us, I felt just as sad as the first time I saw him all over again. One of the patients even said, "Hey, don't you get tired of walking up and down the halls or somethin?" They young man looked up slowly and said, "Not really." and he kept on walking.
To celebrate the time we had spent there, on the last day we played charades with the patients and ended with fruit salad. Boy, they loved that fruit salad(!) cause they never get fresh fruit...or if they do get fruit it's always yucky. It was so cool to see that patients play the game. The things they were acting out were easy, like surfing, brushing your teeth, dancing, painting, etc. but to see them succeed and feel good and happy about it was so cool. Just to forget about everything and have fun. My favorite character on Lost is Hurley--mainly because he has alot of 'freeing' moments. He often puts problems, gloom, and doom aside and just relaxes and enjoys what is good in the moment. This is one of those moments
I feel like the patients had one of those moments on our last day. The funny thing is, later on the show "Lost," it turns out that Hurley gets put in a mental institution.
My patients were interesting. One woman was in with paranoid schizophrenia and bipolar disorder, and she always thought that people were trying to steal from her or that she was being treated unfairly. Her mood was bizarre because she would be happy and optimistic on moment and fifteen seconds later she would be severely unhappy and depressed.
A guy I had who was 26 was being discharged that same day. He had rage problems and had been having thoughts of hurting people. He also "self medicated" himself with marijuana and alcohol. I'm not sure if he had really improved any, but they needed to get him out to make room for new patients.
One thing that disgusts me about the VA is that they are so concerned with getting people in, that they just shove people out--whether they're ready or not. Also, the nurses sit behind the nurses station at their computers and have NO therapeutic interaction with the patients whatsoever. They basically give meds and chart. What they chart I have no idea, because they don't communicate with or listen to the patients. *stepping off my soap box* : ) It just takes one person who really cares about people to make a difference and set a new standard.
I guess that's about all for the VA. I'll try to update about Cardiac ICU soon!
On our unit most of the patients are 'older' and in their early fifties or a little younger, so it really made one patient stick out who was only 26. We saw him on our first week and he seemed really sad and pretty lonely, but generally okay--compared to some other patients. He looked relaxed, his gait was even, ate well and conversed with others during meal time. Well, when we went back on the last week (only two weeks after we saw him initially) he had changed so much. We came on the unit at about 6:45am and he greeted us with a warm 'hello' while he was walking around the floor. We took that as a good sign. He never stopped pacing around the halls. All day. And he had "The Walk" of the other patients who have been on meds for a really long time. It's kind of like a Frankenstein walk; very stiff and slow, and the arms are lifted off the body a little like he was wearing a puffy winter coat. It was so sad. Every time he passed us, I felt just as sad as the first time I saw him all over again. One of the patients even said, "Hey, don't you get tired of walking up and down the halls or somethin?" They young man looked up slowly and said, "Not really." and he kept on walking.
To celebrate the time we had spent there, on the last day we played charades with the patients and ended with fruit salad. Boy, they loved that fruit salad(!) cause they never get fresh fruit...or if they do get fruit it's always yucky. It was so cool to see that patients play the game. The things they were acting out were easy, like surfing, brushing your teeth, dancing, painting, etc. but to see them succeed and feel good and happy about it was so cool. Just to forget about everything and have fun. My favorite character on Lost is Hurley--mainly because he has alot of 'freeing' moments. He often puts problems, gloom, and doom aside and just relaxes and enjoys what is good in the moment. This is one of those moments
I feel like the patients had one of those moments on our last day. The funny thing is, later on the show "Lost," it turns out that Hurley gets put in a mental institution.
My patients were interesting. One woman was in with paranoid schizophrenia and bipolar disorder, and she always thought that people were trying to steal from her or that she was being treated unfairly. Her mood was bizarre because she would be happy and optimistic on moment and fifteen seconds later she would be severely unhappy and depressed.
A guy I had who was 26 was being discharged that same day. He had rage problems and had been having thoughts of hurting people. He also "self medicated" himself with marijuana and alcohol. I'm not sure if he had really improved any, but they needed to get him out to make room for new patients.
One thing that disgusts me about the VA is that they are so concerned with getting people in, that they just shove people out--whether they're ready or not. Also, the nurses sit behind the nurses station at their computers and have NO therapeutic interaction with the patients whatsoever. They basically give meds and chart. What they chart I have no idea, because they don't communicate with or listen to the patients. *stepping off my soap box* : ) It just takes one person who really cares about people to make a difference and set a new standard.
I guess that's about all for the VA. I'll try to update about Cardiac ICU soon!
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