What a busy week! Monday morning I was assigned two patients and realized that one of my patients happened to be the same patient on my very first clinical day. It was nice feeling more comfortable with her, especially first thing in the morning. One of the most important assignments to be completed throughout the duration of this program is called a Care Plan. We are assigned to write up six, each having a different body system to focus on. The first one is Integumentary and is due sometime in April, but I noticed a few classmates already have their Care Plan patients. With this in mind, I figured Ofelia would be a prefect patient to consider for my first Care Plan. The purpose of these Care Plans is to prove to your teacher that you fully understand the total care of your patient. This would include knowing and being able to explain the medical diagnoses of your patient, the medications, treatments, therapy, and nursing interventions being given to your patient. I figured that she has “so much going on” I could really have the opportunity to learn a lot along the way. So while I was busy gathering tons and tons of information about her I was also busy taking vital signs every ten minutes for my other patient who was quickly approaching the end of his life. As you can see, the day was done before I knew it! Tuesday I had two very interesting patients. One younger lady clearly had become dependent on her pain medicines and was very out of it-to say the least. She had a lot going on but most of it seemed very psychological. She claimed to have fallen out of bed the night before but showed no signs of bruises or scratches and all three x-rays came back negative for any type of fracture. She had pneumonia but also suffered from “chronic pain” which as you can imagine is unrelated pain traveling all over her body. She would claim the pain was 10/10, the most excruciating pain she had ever known, although her face showed about 1/10. She would scream and scream until a nurse gave her the pain medications. She also was crying for quite sometime because she was convinced she now had right upper quadrant abdominal pain and that it might be a cist. This pain quickly moved to her right lower quadrant and maybe it was appendicitis. She also was very upset because she believed her stool looked black and tarry and maybe she had gastrointestinal bleeding. After a while, it got pretty old- I soon found out she was a former CNA (Certified Nursing Assistant) and it really seemed like she knew what she was doing. She knew what she had to say and do in order to receive her pain medications. It was interesting because in her chart I was able to see which nurses and doctors felt it necessary for her to see a psychiatrist and start getting help for her drug dependency. I also know that the nurse who had her today called a social worker about the patient and her behavior. Meanwhile, I had a second patient suffering from colon cancer and a huge abdominal wound (maybe the worst I have seen yet). This woman was a former RN (registered nurse) and was possibly the most difficult patient I have ever had. She was difficult by means of verbalizing her frustrations and annoyances along with not wanting anyone to touch her. It was actually pretty comical…
Our first conversation went something like this:
Me: Good Morning Mrs. P! My name is Katie; I am your student nurse today and I will be taking care of you. First, I am going to take your vital signs.
Her: (in a very monotone voice) Oh great, another student. Hurry up, I am watching TV.
Me: Okay, I will do this as quickly as possible to get out of your way.
That pretty much set the mood for the rest of the day…she demanded chicken broth when she was brought oatmeal; she scolded me while prepping the entire tip of her finger as she wanted me to only prep the side of the tip for the accucheck (glucose reading); she refused her bed bath; she hates students; she needs the bed pan NOW; she hates getting pricked; she hates doctors; she doesn’t like getting poked; she hates moving; and she definitely hates red jello. At the end of the day I was more than ready to go home. On Wednesday morning I was more than thrilled to find out my only patient of the day just happened to be good ol’ Mrs. P again!
Katie VNSROP
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