Finally got back to the hospital this week and had another great day! This time I was much more organized and things flowed a lot better. I got to pass medication for the first time and I wasn't even nervous. I think because I had spent so much time researching all the medications my patient takes they were all very familiar to me so I felt very comfortable administering them. Of course my patient has a gastrotomy tube so all the meds had to be crushed and then dissolved in water or cranberry juice. Then they had to be given one at a time into the tube with a flush in between. Altogether the whole process from obtaining the meds through giving them probably took me 45 min! The good news was that since I had all the other patient care down pat I still finished it all with time to spare. Whew! I didn't get to do anything "new" this week, as in something I have not done thus far on a "real" patient as opposed to a manikin.
I felt frustrated though because my patient seemed agitated and I couldn't figure out why - because X is non verbal X could not tell me. I could just tell by X's facial expression and X's groaning that something was bothering X. I did notice some skin breakdown X has seemed worse this week and X also had an area of nonblanching redness indicative of a stage I pressure ulcer. I brought it to the staff's attention and found that if I placed X on the side opposite the irriation X seemed a lot less agitated. I am hoping that is all that it is and that they can get it under control.
I also learned that X gives "thumbs up". I was talking to one of the nurses and was questioning how much understanding X has and he (the nurse) told me that X gives thumbs up. So the nurse walked over and talked to X and asked him how things were going and if X knew I was there and if I was taking good care of him. X gave the thumbs up (really just a tilting of X's hand to place X's thumb on the upward side)! I was like a proud Mama and almost cried. It's nice to know that he at least responds and understands.
I also put some movies on this week for X. The last time I was there X was watching PBSKids. Now if you could see the pictures of X before X's accident you would understand why I was wondering about the choice of TV channels. Just didn't seem like a good fit! So this week I took charge and popped in a few movies. Who knows if it made a difference, but I did what I could!
The hardest part of all of this for me is that we are not allowed to visit once our clinical is done. Based on the code of ethics, it is not appropriate. My professor says that it is not a friend or a family member, that our relationship with our patient is strictly a working relationship and therefore visiting is not appropriate. Part of me understands this, but the other part of me finds it very hard to just walk away from these patients and never look back. They have all changed my life in some way, big or small, and I wish I could maintain our connections. Bummer. I suppose that even though the experience will stay with me, I have to move on from these patients. I have said it before and I'll say it again, I enjoy working in a long term care setting more than I ever thought I would and if this hospital wasn't almost an hour away I might even consider working there! The staff is AWESOME and the patients are INCREDIBLE. If only it were closer!
I'm feeling a bit overwhelmed this week with school and home. The kids were off two days this week (Tuesday for "professional development" and Friday for Veteran's Day) so I lost two whole days of work time. I have an exam this coming Wednesday and I am teetering on an A in the class (right now I have an A-) so if I do really well on this exam it may boost me up to an A. It's stupid, I know. I just have this thing about A's. ;) In addition, I have my big paper in the works based on my clinical patient and I have to redo the communication assignment that I completely and totally flubbed up (I wasn't the only one who misunderstood the assignment, so that is a consolation). She said she would regrade it if I redid it, so that is what I shall do.
Off to document my procedures for yesterday and email them to my professor. I'd rather be spending my Friday night drinking wine, but I guess this will have to do. . .