I am reliving my glory days for student nursing long gone by tonight..
What was the most difficult case you had as a student RN?
I had a 12 year old pediatric ( female ) hispanic patient I was caring for during my peds rotation. She had an issue with her liver, and I recall she was jaundiced and very very very underdeveloped for being 12 years old.
I also discovered during a review of her H&P she was HIV + !! This was in the 90's. kids were positive if they were hemophiliacs, which she wasn't. I was lucky to speak to the pediatrician who came through to see her patient.
This little girl was found to be positive a year or so before. She was diagnosed with PCP pnuemonia. At that point the ENTIRE family was tested. Mom and dad were -, however the younger brother was +. How was that?
It was assumed because the children came to the US at the same time, and immigrated here to the states at the same time ( mom and dad were here first ) It was then assumed that in Mexico, they didn't change needles between inoculations. It was the ONLY thing that could explain this situation.
The saddest thing to me? THe parent being migrant workers REFUSED to tell thier daughter she was HIV+. As a nursing student this concerned me knowing that the average age of teenagers having sexual relations was lower than it's ever been, didn't matter the parents declined letting her know.. and mainstreamed her in school.. and they didn't know either.
Had a patient who had end stage liver disease. She was barely awake and coherent when I first took care of her, but then the next day, she started to die in front of my eyes. Her LOC went down within an hour of first assessing her vitals and doing her head-to-toe. I had taken care of sick patients before that one, and have taken care of sick patients since. It was still a bit jarring to see that though.
Another hard patient I had was a middle aged patient who was developmentally at the age of 4, I would say. It took 3 people to hold her down to get a manual blood pressure, when her blood pressure was low. She did not take PO medications that easily, and when I put antibiotic ointment on her leg, she did not that too well either. Had to have people holding her down. It wasn't even a big wound care procedure. The previous day, the nurse taking care of her came to tears because she couldn't do anything with this patient in addition to her other patients.
So far the hardest is a very combative mental patient from the local facility.
He pleasured himself via catheter then pulled it out.
Second hardest was an older larger lady who became unresponsive while sitting in her recliner. It was "give me strength" moment to get her onto the bed.
Specializes in Critical Care; Cardiac; Professional Development.
A six year old child who was a 24 weeker at birth and a NICU survivor (I use that word very lightly) - the size of a one year old, deaf, blind, mute, CP, contractures, inconsolable to everyone but mom, who was absent 90% of the time, in for RSV/pneumonia and got an embolus in his arm just above his PICC site...arm became HUGE over the shift. As the student nurse, this ONE patient kept me exhaustingly busy all day long. I do not know how his actual RN could have cared for him and still had time for any other patients. It was a good day in that the RN was super happy to have me there and we had a great rapport; I was proud of have recognized the arm swelling up and facilitated the call to the doc and went with the patient for sonogram etc etc. But the obvious exhaustion of the mom leading to her pretty much using this as time off from the heavy care this child needed (and who can blame her....she had three other children on top of this one) and just the general heartbreaking condition of this child and the realization that the survival rates for NICU don't mean thriving, productive lives for a lot of those super preemies....I still get very solemn and conflicted inside when I think about it. This little child was beautiful, distraught and so very sick. I felt completely helpless. Decided I am definitely not cut out for pediatrics.
whichone'spink, BSN, RN
1,473 Posts
Had a patient who had end stage liver disease. She was barely awake and coherent when I first took care of her, but then the next day, she started to die in front of my eyes. Her LOC went down within an hour of first assessing her vitals and doing her head-to-toe. I had taken care of sick patients before that one, and have taken care of sick patients since. It was still a bit jarring to see that though.
Another hard patient I had was a middle aged patient who was developmentally at the age of 4, I would say. It took 3 people to hold her down to get a manual blood pressure, when her blood pressure was low. She did not take PO medications that easily, and when I put antibiotic ointment on her leg, she did not that too well either. Had to have people holding her down. It wasn't even a big wound care procedure. The previous day, the nurse taking care of her came to tears because she couldn't do anything with this patient in addition to her other patients.