Nursing Students General Students
Published Mar 9, 2003
SN Gone Crazy
25 Posts
the hiv floor.txt
NurseDixie
419 Posts
Wonderful article. I hope that I turn out to be that kind of nurse.
Mkue
1,827 Posts
I couldn't view it for some reason:o
Hellllllo Nurse, BSN, RN
2 Articles; 3,563 Posts
I tried to view it, but was told by my computer that it looked suspiscious for a virus so I shouldn't open it.
The HIV Floor
[Reflections]
Davis, Malia
Malia Davis is a student in the Graduate Entry Prespecialty in Nursing/Master of
Science in Nursing Program, Yale University School of Nursing, New Haven, CT.
The Reflections department is coordinated by Polly Smail, associate editor.
----------------------------------------------
Outline
Abstract
Graphics
Figure. No caption a...
On a student nursing rotation.
FIGURE He is thin, as I thought he would be. He's lying on his belly, his buns
exposed to help the wound heal. He hears me enter the room and quickly covers
himself. I introduce myself and ask to take a look at the opportunistic
infection that invades his body secondary to AIDS. There is an open wound
covering his entire right gluteal and sacral region, and sores descend into the
depths of his groin. Herpes zoster has erupted on his head, around his eye, and
now, open and red on his abdomen, against what was once beautiful dark skin.
Scars from previous episodes, scars like the footprints of toy soldiers
retreating from a lost battle, cover his upper back and neck. Oh, and I notice
them all the way down his right leg to his feet. Nothing seems to help, he says.
It hurts, itches, he cannot stop itching. The dermatologists have looked, the
wound care specialists have looked, we all have looked, and we all have said,
"Wow, that looks painful."
Figure. No caption available.
I see him again the next night. I am working with Kate, a 22-year-old nurse who
doesn't know why she's a nurse, but damn, is she great with people. She is kind.
We give him his meds. He is "noncompliant," the chart says. Everyone says he's
not good at taking his meds. Yesterday I saw another nurse check on that. She
poked her head in the door to his room so as not to have to don the gown and
gloves, and yelled, "Have you taken your meds yet?" and then closed the door
before he could have answered.
Tonight, we go into the room and we talk with him. Such clear eyes for someone
so sick; he has open wounds on his periorbital skin, but I'm astonished by how
clear his eyes are. We give him his meds. He takes the entire cup of 15 pills at
once, washing them down with acyclovir syrup. They taste awful. He says he wants
to throw up. We try to wash the taste out with grape juice, apple juice, cola,
water, but it still tastes like shit, he says. Kate, the kind nurse, says, after
a moment, "I have a Lifesaver, do you want that?" He says "Yeah." His hands
shake so much that he can't get the wrapper off. We let him try for a while.
He's only 38. He tells us he lost two brothers to gunshot wounds here in New
Haven.
Kate finally says, "Here, I'll get it," and opens the wrapper, first try, even
wearing gloves, and says, "You got it started," the way you do when someone
tries to open a jar but isn't strong enough and you do it right away. He says it
tastes good; it's killing the taste of the medicine. One small lifesaver, so to
speak.
Next, we pull the dressing off. He shakes in pain: intense, core-shaking pain.
Every type of bandage has been tried. They sting, stick, or make him stick to
the bed. Kate says she has an idea. We open about 100 of the minuscule
bacitracin containers and squeeze them into a cup. We apply the ointment
liberally. The wound is so raw, so open; the entire world can see into it. We
place petroleum jelly-laden bandages on it and then an abdominal pad. And in a
spontaneous moment, with her brilliance and the excitement of doing a dressing
that maybe doesn't hurt him radiating into the room, we're laughing with him and
seeing that it hurts less, and she pulls out these mesh underpants, and we pull
them up and they hold the covering on his wound without tape, and he turns over
and it hurts less, and he's lying on it and it hurts less.
And then we dress the wound on the front; did I mention the wound on the front?
It is raw and open too, smaller, in the crevice between his narrow belly and his
right leg. We finish the wound care and pull up the underpants and everything is
brilliant and new, like a new kind of art with the same old materials. CD4 count
is 10, did I tell you that? 10. And he says, "I don't know what to say to you
guys... thank you." And Kate, that kind nurse who's 22 and not sure why she's a
nurse, takes off her glove and shakes his hand, holds his hand, as do I, and we
say we hope he's more comfortable. A different definition of comfortable,
Lifesaver and mesh underwear.
RNonsense
415 Posts
wow...neat story.
SingingNurse2
66 Posts
Awesome story. Thanks so much for sharing! It has always amazed me how some can choose nursing as a career and then be afraid of patients - it's such a shame.