Week Five: November 30-December 2, 2009

I forgot to tell you all about the most exciting part of my week last week! Right as we were all supposed to be leaving last Wednesday, my teacher grabbed me to do a quick straight catheter insertion! I sort of freaked out-knowing that it was a sterile procedure that I have never in my life ever preformed before. A sterile procedure is one in which you wear sterile gloves and have to be so careful of the sterile field. The only time I have used sterile technique is in the classroom so when you actually do make a mistake it is not such a big deal. But this is real life and requires knowledge, confidence, and coordination! I needed to remember that once I touch the patient with my non-dominant hand I have contaminated that hand and may not touch anything else with that hand. The patient had a urostomy (a surgical opening into the bladder) which ultimately allows the patient to excrete his urine. So basically I needed to open up the sterile straight catheter kit very carefully and set everything up. I needed to apply the antiseptic solution to the cotton balls and one by one clean the ostomy site. After I lubricated the catheter tube I could begin inserting it into the opening, this was the scary part-especially because this young guy had a sense of humor and knew I was terrified. As I pushed as gently as I possibly could he made all sorts of facial grimaces and painful noises-I think my heart stopped I was so scared of hurting him. But he eventually let me know he was “joking” and that I needed to move around the tube until it was placed correctly. I never thought I could be so happy as to see a stream of urine in my life! The hard part was finished; I had reached the bladder and was finally draining the urine out! It was pretty fun for my first real ‘nursing’ task. This week started with Gweon & I in ICU, nothing really too exciting. It was a nice break from the fast pace of the second floor. It was pretty cool because I was able to see a chest x-ray. I was even able to see the progress of the patient; the x-ray taken the previous week seemed to be very cloudy, which I learned was the presence of fluid in the lungs and the most recent x-ray was very clear which showed almost no fluid. The most exciting part of that day was when I was able to observe the insertion of a PICC line. A PICC line is a peripherally inserted central catheter or in other words a very thick tube going in your arm right to your heart to give you lots of drugs/antibiotics for a long time! It was also a sterile procedure and was a trip to watch! I won’t go into detail because it was pretty gruesome involving the insertion of wires and tubes into one small area. If anyone thinks they can stomach it you should check it out on youtube.com. The next day I was back on the floor and had two very “easy” patients. One I was already familiar with and she needed very little assistance throughout her day. The other was a very confused elderly man who was at a risk to fall which also meant he had a 1:1 sitter. Today could have possibly been my favorite day so far! I had the sweetest patient ever. First of all, she was a nana! If any of you have a nana and have ever had a nana you know how special these women are! She was so sweet and totally appreciative of my time. We chatted so much I think I could even write a book about her life! I enjoyed every minute of it. I found out all of her children and grandchildren’s names, ages, occupations. She and her husband (a dentist) have been happily married for 60 years. She was born in Albuquerque, raised in San Francisco, lived in New York, worked at the modern art museum, was a flight attendant for 2 years, loved to play golf. I could go on and on...I absolutely loved taking care of her and it was my pleasure to accompany her at her meals. She will always have a special place in my heart and I hope her pneumonia goes away ASAP so she can go home to her family!!! I feel like I am rushing but I think I am just very hungry, maybe I will post more later tonight. Thanks for reading!

Katie VNSROP