The Last Two Days

[zacarias, ASN, RN]

Hey there all,

So the last two days on my tele/stepdown/med-surg/ has been good. The first day I got two admits and had to float to another floor and found about it only 15 minutes prior to having to do it. I came back later on break to organize the bomb explosion of paperwork that I hadn't completed yet.

I was so busy those first four hours but I got to talk with my new admit who was an elderly retired psychologist. She and I bonded so; I haven't seen such a socially-conscious elderly person in such a long time and she reminded me of my late grandmother so much. This elderly patient had seen so many changes in her lifetime, yet she thought it her responsibility to stay up-to-date on everything and not let closedmindedness overcome her.

I could see that behind her pleasant smile she was tired. She was tired of years of fighting for the rights of others. She saw the inequality in the world and fought against it anyway she could. She was tired now wondering how much good it did. I hope my smile, touch, and our conversation let her know that I for one appreciated her efforts now and in the past. I hope she knows that yesterday was the day I met an incredible woman and person whose humanity shined on me like a beacon of encouragement. Let her know she HAS done much for this world and its people in her lifetime.

Today, I took care of an old romanian guy who flew jets for the soviets back in the day. Great guy, but have a question. He had two dehisced abd wounds from an hernia repair. They were wet-to-moist. Both were approx. an inch deep with good granulation. The distal one had slough it looked like at the bottom and it looked like a tendon or something hard. I guess it could have been abdominal muscle but I don't know if that was deep enough. The Dr. on his progress note stated that the base of the wound was "fibrous." Now I'm just wondering, is he talking about it being like some conn. tissue or is he talking about the sloughy part? Of course just like I couldn't read his mind from his note, how can you? However, some of you may know more about it.

Thanks for reading this long post!

[leslie :-D]

it sounds like the md is using "fibrous" interchangeably with "slough" just so he doesn't have to change the dsg order. i mean we know when tissue is no longer viable, right? does the dsg include santyl or panafil ung (enzymatic debriders)? is this a part of the dsg that shouldn't be there? sounds like you might want to get the order changed.......

leslie