Clinicals - Week 2

This week I took 2 patients. I wasn't going to be advantageous and take three when my instructor has not forced me yet. After all, I am free labor and I am paying to work at the hospital. It was nice though with two patients to have a little bit of time figuring out my evening routine, meds, charting, patient care and learning new skills. It's wonderful that there is always a learning opportunity, whether it be the patient and their current diagnosis and how to effectively treat it; or learning a new skill by working with IV pumps, and other skills.

Both days this week I had both the same patients. It is nice to have continuity of care and for the patient to see a familiar face. One patient was in for cellulitis on his lower left leg. It was pretty grody to look at, luckily he was all bandaged up. That was the extent of the complications of that patient, besides previous heart problems.

My other patient has had quite a history of events recently that unfortunately she now permanently is mentally impaired. She has history of bipolar and which she took Lithium (a mood stabilizer). It as effective for a long time, but unfortunately it has a small therapeutic range from 0.5-1.3. She collapsed last month and was unconscious for quite a while, leading to oxygen & blood loss to her brain. In the ER her Lithium level was 3.7 and potassium was elevated (which leads to cardiac arrhythmia's). She fractured her femur when she fell, but they were only able to stabilize her femur in traction for a week while she recovered in ICU. She went to surgery and was admitted to my floor. She was anxious, confused and talked incoherently. She called me Sharon. During my shift, she fell on the floor because she was anxious and moving around so much, eventually wiggling out of bed. I was with my other patient, so I didn't see it, nor was I responsible for it. She had wrist restraints placed and closely monitored. I had to feed her and change 2 loose BMs. Not my favorite thing to do, but I breathed out of my mouth to get through it.

I went over my patient with my instructor expressing my concern for her and her state of confusion. I wanted to help her and "fix" her. He taught me a good lesson, that sometimes we can't fix patients. We can only treat them and monitor them and hope they improve.

I was able to assist with a blood transfusion, set up the tubing, spike the blood bag and go through the numerous safety checks for delivering blood. I monitored the patient closely for signs of transfusion reactions. It went a-okay.

Stay tuned. Next week, I will be in the ICU & ER. I am sure I will have stories to tell about that.