Archive for September, 2009

Week 2 of Oncology

I had a patient that had everything but the kitchen sink wrong. From various psychological and psychosocial issues to an extremely advanced form of cancer to an advanced stage of an autoimmune disorder…I saw it all.

It was interesting to see the social stigma when it came to the autoimmune disorder. Some people refused to enter the room even though there was no bleeding or anything. We talked. The first day this patient was alone. So alone. Growing hypoxic and making no sense. Rambling.
Wasting away.
As a student, I couldn’t do much. The doctors were consulting with each other in the hallway.

So I sat. And we talked.
We talked about family and faith.

They told me how they were normally introverted but I was easy to talk to.

The next day, a complete 180 degree turn had occurred overnight. Where their skin had been dry and cool and blue the first day, it was now warm and pink. Up and eating breakfast with family that finally decided to come in after days of being in the hospital.

After the care had been given and the paperwork done- we sat. And we talked.

Sometimes, that’s all you can do I’ve come to realize.
Sometimes, that’s all that’s needed.

The spouse, one with a history of abuse, causing a ruckus in the hospital from being difficult to please, thanked me for the care I had given. The spouse went back to the bedside and watched the patient sleeping in a chair before opening a book.

The prognosis isn’t good. I don’t want to work in hospice or palliative care.
But I am so thankful there are people who do.
Some of the nurses on that floor are beyond amazing.

The prognosis won’t change.
Yet, I walked away still feeling like I made some sort of difference. Or I had some kind of effect.
I think that’s what counts.

20.

Today I am twenty.
I am no longer a teenager.

I am full of shrimp curry, salad, dr pepper, and cake.

I am watching Jericho with my husband.

I am content and happy.

I am finishing up homework.

This is a great start to the new year.

Lucky

My husband is adorable. Can I just say that? I think I will.
In fact, I am so impressed by him on this particular day that I’ve decided to write a whole post about him to stash away in the corners of my blog/journal.
We’ve had a few arguments the last couple of weeks. Not a lot. But more than normal for us.
To be honest, any argument over one in the span of a month (every now and then a week) is pretty rare for us. But we had a few. And as a result we were both in a funk. Cause we hate arguing. It messes up our whole day. It makes me introverted and I don’t particularly like being that way. Any day I can’t share wholeheartedly with my husband is a day wasted in my book.
So, he’s the type of guy that doesn’t consider the matter 100% resolved until we’ve seen each other in person and you can see the resolution on the other’s face.
And today, he called me and said, let’s take our lunch at the same time so that we can play chess. We like to play chess with each other through our iPhones. I readily agreed.
Two nurses were sitting behind me chattering away about their day nonstop. I sat with my hummus, pita bread, and phone chatting in between moves to my husband.
About 20 minutes into our game, I heard the nurses stop and one of them said “awww”. Curious, I looked up.

Standing right over me, was Ishaq.
Ishaq, who I had assumed was in the break room at his own job 15 minutes away, was reaching for my hand- pulling me away from the hummus and the pita.
He told me he could only stay for 2 or 3 minutes but he wanted to see me so that we could make up. I walked him outside with a huge grin on my face.

I adore my husband. He lit up my days and continuously lights up my life.
I’m so lucky.

Oncology Floor

I spent this last week on the Oncology unit. I had to be at my school so that we could carpool at 0545. What a shock to my system! I’m a complete night owl and waking up early is always difficult. Waking up and being ready to work that early is even harder.
Oncology went better than expected. I thought it was going to be 100% depressing and since it was the first time being on a normal floor this semester (as opposed to OR, PACU, and Sim Lab), I was still expecting the same routine as last semester. Alas! I’m a second semester student now and we get to do more than NA stuff alone. Which meant I felt more like a nurse.
These patients were different than the LTC (long term care) facility patients meaning they could bathe themselves, feed themselves, etc. Which was totally awesome.
We didn’t get to give meds on this floor but we did do patient education, vital signs, inital assessments charting, IV flushing, line changes, and so on and so forth. We were assigned one patient for ourselves but assisted our co-assigned nurses with their other patients.
I’ll split my two days up into two different posts.

My first day, my patient, who is so adorably sweet, let me come in and do my assessment and get his vitals. He had melanoma that had metastisized (spread) to various areas ending up in the bone, brain, stomach, and more. Basically, there were too many tumors to count and one was just oozing blood. He didn’t know the extent of the ones in his stomach.
My coassigned nurse and I stayed with him in the room while the doctors told him that they could only do palliative care and were recommending hospice. He just nodded and said okay very matter-of-factly to each statement. Later his family came up for a meeting with the team taking care of him.

It was a very long day.

Feel-Good Moment

How scary is it to be admitted to a hospital? I don’t know. Knock on wood, I’ve never been.
I had a patient who had to go to surgery for a cyst and is pregnant. Terrified she was- and with good reason!
I was talking with my schoolmate about babies today and was reminded of her.
She had the prettiest hair that kept falling in her face that I would push aside for her. We talked about her becoming a first time mother and how she wanted the sex of the baby to remain a surprise. I tried to calm her and keep her company until her doctor arrived.
She was trying to hold it in, the nerves that is, but she kept asking if her baby was okay. The doctor came in with the monitor to listen to the heartbeat and turned it on.
He pressed it against her belly and we heard the whooshing sound of the placenta and nothing else.
After a couple of minutes of this, the doctor reassured her that the lack of heartbeat didn’t mean anything bad, he just hadn’t found it yet. He was moving slowly trying to make sure he didn’t miss it.
The tears started to fall and after another minute that stretched on like an hour….a tiny heartbeat fluttered in our ears.
And it grew louder. And stronger.
Until a full, healthy heartbeat blared through the monitor.

Relief swept over all of us. I hadn’t realized I had been holding my breath until that moment. She cried tears of joy and relief and laid her head back, running her hands through her hair.

I got her cleaned up and some ice chips and then transferred her to the Ambulatory Care Unit where she would get changed and go home.

That was one of those feel-good moments that keeps pushing me forward to get through the program. It’s a reminder of why I’m going to school to become a nurse. Corny? Maybe. But it’s true nevertheless.

Uninteresting.

Last 24 hours:
-Went to clinical, successful skills lab, great clinical feedback, got dismissed early, went home, watched TV, research online, ate dinner with husband, got in argument with him, made up/fell asleep, woke up, went to work, worked, did bills in downtime, waiting to clock out [in a half hour], will go to in-laws house for dinner/tea then head home to build new website and hang out with husband.

Ishaq is so creative. He came up with yet another website idea which we actually bought the domain for today. It’s a tad silly, but we’ll see. More info after its up and running!

Today was a great day in the PICU. Only 2 admits and 6 discharges!!! Huzzah!

I am uninteresting today. Sorry, folks.