Learning Your Patient Isn't Going to Make It

Well, a week off from school flew by!  I had planned to spend a lot of time studying but the week was over before I knew it.  

The week started off with sad news.  Bridget had passed away the Thursday before. It broke my heart that this woman did not make it to her 30th birthday. This was her goal for so long.  So many, many sad tears were shed and again as I write this.  My heart still hurts.  29 year old women should NOT die from breast cancer. This is why I walk, this is why I fight, this is why my husband stands beside me in this fight (he crews for the walkers)!!

So back to the real reason I blog . . .

I was excited to get back to the hospital again Monday and Tuesday. We also had lab twice this week. On Wednesday, we learned about administering parenteral medications. These medications are given my injection. So when we go back to the hospital this coming week we will get to give injections!!  Nervous and exciting. Today we learned about nasogastric tube. How to insert them, remove them and irrigate them. Not a pleasant experience for the patient but some times the patient is not able to get nutrition through the mouth so it is sent down this tube directly into the stomach.

But onto the 'real' stuff. So Monday we were back in the hospital. For anyone who lives nearby, you know that Monday it was absolutely gorgeous out. Just a week ago, it was cold, rainy and even snowed one day. But summer hit Monday (and it's gone again). It was just beautiful walking into the hospital. So we get to our meeting spot and are handed our patient assignments and begin to review the information. At that point I realize, DARN, my glasses are in the car. I'm not sure if I mentioned this before, but the student parking area is about a 10 minute walk to the hospital lobby. The unit I'm assigned on is a little further away. Thankfully one of my classmates read my patient info for me to make sure there was nothing dire that I needed to know for when our instructor asks us questions before going to the assigned rooms. As soon as we were dismissed, I booked out to my car to get my glasses. Thankfully I've been trying to get my training runs in for the Broad Street Run, so my walk is much faster than it used to be. As soon as I got back to my assigned area the nurse going off duty was ready to give report to the nurse coming on.  My patient this evening had MS and had had a fall but had just been released to go to rehab. I only assisted with this patient for a little bit. Assisted the patient with getting dressed in street clothes (they did not want to go on the transfer in the hospital gown). Shortly after that the team arrived to transfer my patient to the new facility. After dinner I was able to assist other students as needed since I would not get a new patient for the short time after our dinner break.

On Tuesday I was given a new patient. The patient was just returning to the room from receiving some therapy. As soon as we started to transfer the patient back to bed it was apparent they needed to use the bedside commode. I jumped right in to assist my patient (funny how things that might of 'bothered me' before were not an issue at all now). Shortly after getting my patient back to bed, I began getting their vital signs and starting with the full body assessment. My patient was very tired so I left them to nap a bit while I documented my findings in my paperwork and the hospital computer system.  We get to document certain things in the electronic medical records here. I love when I have to sign my name to the paper chart and put "SN" after it for 'Student Nurse'! So while I was working on the computer another doctor went in to see my patient. A short time later the doctor came out asking where my patients nurse was. She was assisting another patient and I explained I was this patients student nurse for the day, could I help with anything with. At that point, this doctor told me that my patient was just told that there was not much time left. The disease this patient had was not responding to the aggressive treatment. Due to the other medical conditions this patient had, once they discontinued certain things the end would be imminent. I was heartbroken again. Granted I'd only just met my patient, but I would have the rest of the evening to assist them and wasn't sure how I would do. I initially went back to my patients room and 'acting' as if I knew nothing different.  I was able to assist my patient with their dinner tray and finished my assessment. It was our dinner break at that point, so I told my patient I'd be back in a little bit. After dinner when we returned to the floor my patients own doctor was in to discuss 'options' with them and to explain information over the phone to the family members. At that time, my instructor came by. She visits each of us throughout the day to check out some things on our patient.  She's one to just 'knock and enter'. As she was walking into the room, I grabbed her and told her to wait. Explained what was going on. That's when it really hit me. This person was going to die soon. Shortly after that the doctor came out asking the nurse to get something for the patient. This patient was trying desperately to not throw up while the doctor was talking to them. The nurse was explaining that it was too soon to give the next dose of what was administered earlier. At this point the doctor went into 'overdrive'. Her patient was suffering and she wanted something done NOW. So an order was provided for some fast acting meds. I n the meantime I went into the room and was hit with the thing I'd been dreading. I've dealt with all kinds of bodily fluids but I do not do well when someone vomits. When the kids were little, I would call Dale at work as I could not clean up the vomit when one of the kids threw up.  My patient had thrown up on them-self. I went right to work, got an emesis (vomit) basin and started to clean up my patient. The nurse then came in and administered the meds and soon my patient was started to feel better! As the evening wrapped up and I had gotten my patient all freshened up it would soon be time to leave. I spent some quiet time with my patient where we just talked. My patient was not scared of what was coming and told me that with my care and compassion that I will make a great nurse.

I was sad leaving the hospital. 

Yesterday was our third exam for the one course and this coming Thursday is the third for the other course.  I got a C.  I was bummed but accepted that I passed and that is what is most important.  We always get a chance to review our exams to see what we got wrong and what the correct answer was.  I had changed my response on FOUR questions!!!  Four questions would have given me a solid B in this course!  I will NOT second guess my answers on the rest of my exams!

Today I had my interim evaluation (from my time at the nursing home) and received a great review.  I am truly enjoying EVERYTHING I am learning!