Mrs. Smith is a 94-year-old hard of hearing woman with an advanced case of Alzheimers. Here is what transpired in her room a few weeks ago as I prepared her for transport back to her assisted living home.
Me: "Mrs. Smith you're going home today."
Patient: "I'm going to see Jesus?"
Me (thinking): Oh my word it's true people do see Jesus before they leave this world.
I started checking her breathing pattern, skin color, and O2 sats like a paranoid nursing student thinking that my patient was on her way out when all of a sudden she asked me what I was doing and sat straight up. I then realized she had simply misunderstood me.
Each Friday I walk into the hospital dreading the day ahead but by the end of the shift my attitude has completely changed, I walk out excited for the next Friday. If I'm honest I am very fearful of the unknown and knowing someone's life is essentially in my hand is scary. I must be alert to all kinds of changes in the patient and be ready to care for all kinds of needs. It's scary. I am terrified of failure and not doing my job correctly. But what I have come to realize is that I want to be the best nurse. I want to be exceptionally knowledgeable, attuned to my patient so I catch problems early/as soon as they present, and loving beyond compare. I want all of this not to be "the best" but THE BEST FOR MY PATIENT's SAKE. If someone had to take care of my family members I would want that for them.
I still have a lot to learn and experience and I will never know everything. What I do know is from now on I am going to seek out new experiences and try my hand at new skills even if they are terrifying.
Here are some various stories/lessons from the last few weeks in the hospital...
- Who would have ever guessed that I would give a patient marijuana? Apparently it is balled up in pill form as an appetite stimulator. Ha, go figure that the "munchies" could come in handy...nutrition is vital to a patient's recovery!
- Two things that I have a hard time stomaching - wads of hair (you know like the kind you find in the bathtub drain) and saliva/mucous. I don't know what it is about those things but I instantly want to gag. My more recent patient, Mr. Hill, had a tracheostomy. Naturally they tend to have a lot of secretions that come either out of the trach tube OR if they are fortunate enough they can cough up. The Lord must have really wanted to desensitize me to saliva/mucous because my patient spent the whole shift coughing it up into a mouth basin that I had to hold. Don't get me wrong I felt for this 85-year-old man that could not breathe adequately but when he coughed up phlegm on my arm because he didn't turn his head fast enough for the basin I almost lost my lunch. Being professional of course I just smiled and asked him if he felt better now that his mucous was cleared!
- A sick adult is never to old for a hot compress to make an irritated eye better, a straw for their drink, or a back massage to help their back pain disappear. I often think of the things my mom did for me as a child to make me feel better and apply them to my nursing practice. It's the simple things that make all the difference!
- A confused essentially wheelchair bound patient will try and make a run for it if given the chance. Mrs. Oliver is a 90-year-old woman whose legs cannot move as quickly as her brain anymore but that did not stop her from trying to get out of her wheelchair. Good thing she was sitting on a saddle like contraption that did not allow her to slip/move out of the wheelchair because twice I came back to check on her and she was tapping her feet and leaning forward. As soon as I stepped in the door she would grin and sit back up. She wanted badly to get back in bed - can't say I blame her but she needed the "up in the chair" therapy.
- Getting the hang of diapering an adult is difficult. I still seem to put them on backwards or rip them when trying to situate them under one's hiney. I feel terrible because the patient has to roll back and forth multiple times all exposed before I get it right - they must think I'm an idiot. I'm determined to perfect the diapering process before the end of the semester.
