Just a little experience from a while back.

  1. Five months ago I was rotating on a post surgical floor. As I scattered through the charts trying to find a good assignment, I was excited to find a non-fracture patient (I had done about 4 and it was time I learn something new). My assignment was an elderly woman with COPD/Pneumonia.

    I was advised by the unit secretary to not take that patient, I wondered why she said that; but none the less I wanted this challenge! The charge nurse interjects and says, "well he's a student, he needs challenge". I couldn't agree more.

    As I read the chart I ironically began to read the words "psychotic episodes through out the night", as I began to hear "HELP!" "HELP!" "HELP!" from down the hallway- at the point in time I knew why they had said it was a challenge. None the less- I was up for it.

    The next day I learned the power of using a therapeutic voice, I learned the power of holding someone's hand (after you've assessed they are comfortable with that gesture). I had so much empathy for this patient. I heard so many bad things from the night shift nurse, but the day shift nurse told me "There are NO such things as bad patients, just BAD nurses". This will forever stay with me- forever and ever, when I feel frustrated and jaded.

    I was kind to her, I did not patronize her. I treated her like an adult. She warmed up to me, I held gave her hand a tight grip "I'm here to take care of you today" ... although those words weren't echoed vocally I know they were felt.

    My patient had so much phlegm, when she would talk you would hear bubbling (I don't know if there is a term for this phenomenon). I'm sure she felt anxious, if she did indeed have preexisting dementia, I am positive this didn't help her. I put myself in her place ... if I couldn't breathe and had secretions flooding my throat ... I would be extremely anxious.

    Looking back, I wonder now why she didn't have an order for suctioning? Maybe I didn't spot it. I wish I would have... but it was also just my second rotation ... now I know I would have more courage to look through the chart and ask the RN if we could ask the doctor.

    *sigh* I had to get this little one out.

    In essense I learned that sometimes patient may be anxious or "act out" because they want some attention. I know busy nursing staff can't always provide that.

    ....Which is ONE of the reasons I am hoping ICU is good fit for me. I loved my first day in ICU... I saw how the nurse was completely dedicated to two patients and some to one. How they were there watching them like a hawk. How they personally interacted with the family. I truly loved it. I loved all the pathophsyiology behind it. I loved the pharmacology. I was definitely impressed. This was my first official rotation but I had floated to the ICU 2 times before (sneaky devil) ... and I saw the same behavior.

    The machines do scare me... zero-ing it out ... I still don't understand that ... and it sounds pretty confusing to do ... but I hope those are the things you learn with time.

    I dragged this out enough. Sorry! Goodnight !
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