My very first day of clinical was pretty overwhelming. The entire day was spent orienting all of the students with the ROP standards of conduct and also the facility’s policies and procedures. Kindred Westminster is an acute long term facility, which basically means each patient is in such severe condition that a skilled nursing home does not have the means to take care of them. Majority of the patients have Tracheostomies (A direct opening into the trachea through the neck to facilitate breathing or the removal of secretions), Ventilators, Feeding Tubes, Catheters, and IVs, pretty exciting stuff, huh? I am one of twelve students placed in this facility and we are all under the supervision of one ROP teacher, her name is Mrs. Shaff. I will be staying at this site until Christmas break and then I will most likely be moved to another facility. My day began with a long meeting discussing the hospital codes and safety guidelines. We were then given a tour of the hospital with a scavenger list in hand. It was very helpful because we were able to find the locations of all the important supplies we would need on a daily basis. Once the day was over, we were responsible for reading about five million pages of informative material. It wasn’t too bad; a lot of it was pretty repetitive but still important enough to be emphasized one more time. Now the nerves are setting in, tomorrow I will have my first patient! To my excitement, Mrs. Shaff decided to pair us up and the two of us were responsible for one patient. Thus far, we have learned how to give basic patient care (bathing, feeding, cleaning, and assisting with activities of daily living) along with a head-to-toe physical assessment. My partner for the day was Lorena; she is a high-school graduate with her EMT (Emergency Medical Technician) certificate. Once we were together, we were both dying to know more information about our patient. Everyday before we get on the floor, our class meets for pre-conference. During this time, we receive our assignments and we were given our Kardex (A document that is used for easy reference to patient’s condition, medical background, current medications, etc.) for our patient of the day. We were excited to find at our patient had a lot going on! She was admitted for a Stage IV Decubitis Ulcer (Also known as a pressure sore, stage four is categorized by full-thickness skin loss with damage to underlying structures such as tissue, muscle, and even in some situations bone) and Renal Failure. Along with these medical diagnoses came Depression, Hypertension, Chronic Anemia, Deep Vein Thrombosis (Blood clot), and Paraplegia. She also had a Foley catheter draining her urine and a nasal cannula giving her oxygen. She, along with the majority of the patients at Kindred, was placed in contact isolation because she has an infection in her wound called MRSA. MRSA is Methicillin-resistant Staphylococcus aureus, in other words, an infection caused by an organism resisting medicine. Certain standard precautions need to be met each time you enter a patient’s room that is in isolation, in this case, the facility requires wearing gloves and a gown. As you can see, there was a lot to consider while caring for this patient. I think the most overwhelming thing for me was getting used to all of the tubes! I have now realized that a patient with two tubes is much less overwhelming than a patient with four of five! The day ran very smoothly because Lorena and I were helping each other out. I couldn’t have imagined doing everything all on my own. Even the activities that seem the least stressful can be very difficult in the medical setting. Something as simple as repositioning the patient is not so easy when they weigh five times your own body weight! The following day we both had the same patient and continued giving our assessments, feeding and bathing the patient, along with making sure she was as comfortable as she could be. At this point, I can’t wait to see more patients and learn as much as I possibly can.
Katie VNSROP
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