Another Good Nursing Story

Nursing Students General Students

Published

Wonderful article. I hope that I turn out to be that kind of nurse.

I couldn't view it for some reason:o

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.

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Abstract

On a student nursing rotation.

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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."

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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.

Specializes in ICU.

wow...neat story.

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.

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