My First Client

Alright, I suck. I haven’t written lately. Which is lame. So this blog may be one whole cumulation of everything I’ve done in the last week. Meaning, I totally won’t be offended if you don’t read all of this.

Hmm, Monday I had lab where I learned how to do NG tube feedings. Basically, a tube goes up your nose and down to your stomach and liquid nutrition is fed to the body through it. Watching the video made my eyes water though.

Clinicals on Tuesday was awesome. I learned that you have to be physically fit to be a nurse. At least if you’re doing adults. I work around peds whenever I’m at the hospital, so adults was a very different experience. Especially older adults who are ex veterans. We’ve got a clinical focus each week that we try to stick to. Mobility/safety/hygiene was it last week. So, all our patients were immobile in some way and incontinent (couldn’t use the bathroom normally and needed pads/briefs/diapers). My morning started off by getting report and then going to the rooms to see if our clients were awake. My client wanted to sleep in until 10, but I suggested I come in at 9:30 to set everything up and get started. He was asleep again before I got out the door.
That worked out fine though since all of our patients required to people to lift, change, transfer, and bathe them (the whole immobile thing). So I went and helped my partner Jo*. Her client was an amputee who understood everything we said but couldn’t speak very well. He could only repeat the same words over and over.
After we bathed and transferred him to his wheelchair, while learning how to use a mechanical lift for the first time, we made the bed and tried to tidy up.
Now, when using the mechanical lift, you need to press down on the lift part to help sit the client up in their seat better so that when you put them in the chair, they’re already in the right position. But their whole weight is in this sling that I’m pushing on. And this grown man weighs more than me. So I was pushing and jumping to try to adjust him.
Mr. C was a total trooper. He was in pain (not from us- his phantom pains) and had his hair all disheveled in a cute way. He also likes his glasses cleaned just so. And doesn’t like coffee. When he grimaced while in the lift, I asked him if he was okay and caught myself making a pouty face (which I recomposed). I felt so bad! I don’t like to see anyone in pain. He just looked at me and smiled and patted my hand in a way that made me feel like it was all okay. He was reassuring me that I was doing alright. After that, he didn’t grimace again.
We got him settled and he was exhausted. He happily napped away after that.

Mistake of the Day (aka MOD): Jo was passing me his catheter bag and I had it and the tubing to clip to my side of the bed. One of the pieces of tubing was in a loop and unlooped itself causing it to plop down and tug. It wasn’t too bad of a mistake- I just don’t want to do that again. It’s uncomfortable. Bah.

By that time it was 9:30 and time to wake my client up. He was really nice and fun to talk to even though he slurred his words some. He had upper body strength so that made his bath go along much easier. He was more vocal about what he wanted. “More soap, and put more water on that thing- thats dry. Yeah, scrub a little rougher. Oh and get my pouch. Get the nurse to show you how to use it.”
Pouch? What’s that?
Apparently it’s like a second layer inside the diaper that helps prevent leakage. It’s a diaper with a hole for the penis to go through for him to void into. All that goes into the real diaper.
Oh- you know what else is different between peds and adults? The smells. Oh.yes. The smells. Never mind the hallway when all the baths and diaper changes are going on. That’s bad enough. But- wow. My guy gets cold easily, so he likes to sleep with layers and layers of blankets over his pajamas. So, by the time I got to him, his clothes were very damp. When I rolled him over to wash his back- the smell bitch slapped my face. Luckily, he was rolled away from me so that I could do a quick one-two of the gagging and compose myself before he rolled back over.
Jo did the slightest crinkling of her nose it nearly made me burst out laughing. So we got him cleaned up and dressed in time for his 11AM dentist appt. Actually, we got him there at 10:45. They said it wouldnt take long so I figured I would wrap up my physical assessment afterwards and still be able to turn in my paperwork by noon per protocol.
I strolled by the dental office at 10:55 on my way to the Physical Therapy room and noticed my guy wasn’t there. After asking the clerk, she informed me that he was told to come back in 15 minutes since the doctor wasn’t in yet. I walked back to his room and figured I would go in and get the assessment over with. But he wasn’t there. Or in the courtyard. Or the smoking room. Or the two day rooms. Or the laundry room (where we had dropped off his bag of laundry minutes before). Or the TV room. Or the physical therapy room.
I asked the NA who had helped us earlier if she knew where he could be.
“Oh, Mr. S?” She replied. “He’s a roller. He rolls all over this hospital.”
“All over?” I stuttered feeling my heart nose dive into my stomach.
“Yeah, this ain’t a hospital where they’re stuck in they’re beds. If they can roll, they roll. And Mr. S likes to do just that…I’m sorry,” she added in after seeing what must have been horror written all across my face.
I started panicking realizing that I may have lost my patient before I could do my assessment. And it was now 11:10.
I started doing a look-through all the rooms one more time. On my way back to his room, I heard the NA saying out loud, “Yeah, she was just looking for you a second ago…”
Could it be?
I rounded the corner and….there was Mr. S- wheeling himself up the hall muttering to himself.
I was so relieved, I could have done cartwheels down the hall. But not likely- you don’t know what’s on that floor. We went and sat down so that I could finish my assessment. We also continued our conversation from earlier.
I think I’m going to have to start a section of posts called Lessons From My Patients because I’ve already seen greatness in my first one.
I asked him about his service to the country and learned that he served for twenty-three years and in three wars. He was told he should be completely immobile. He didn’t like that answer and began to train himself and force himself to do more. He referred to it as his “willpower that never gave out”. He now has full strength of his upper arms and is steadily working on his legs. And he is no longer bedridden.

My paperwork was turned in right on time (first paperwork handed in actually) and I got my information on my client for next week. Then we had lunch (a half hour late since all our paperwork wasnt in on time) and had our post and pre clinical conferences

I’d say it was a great first day. I got all boxes marked Satisfactory for my clinicals this week. I also went home and passed out for an hour and a half before going to dinner at Baba’s to meet their family friends.

This Tuesday will be challenging again I’m sure.

*=name has been changed

Thanks for sticking around though, seriously.

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