Clinical weekend 2, day 2.
This morning, my instructor assigned me two patients. I was told to keep the same patient I had from yesterday and to follow up on my patient from last week, who was still in the hospital. She said I was only required to do one assessment on a patient of my choosing.
So, I looked at what was going on with my patient who had the ICD placement, and he was due to be discharged but didn't need his medications until 0900. So, I checked in with my nurse and then went to the other wing to check in with my patient from last week. The nurse was different, which was somewhat disappointing; I was hoping to have the RN who graduated from our program a few years ago.
In any case, I was able to assist with wound dressing changes and medication administration for this patient, as well as do my assessment on her. It was interesting to me that the RN I was with didn't know how to do a dressing change on her; at least, that's what he said. So, I showed him what was shown to me last week for changing the silver-nitrate infused foam with the spray wound cleanser. I felt glad that I was able to advocate for the patient in this way; otherwise, I'm afraid the dressing would have stayed on for another few days, which would have made her more prone to infection.
After this, I checked back in with my "actual" patient for the day. I gave him his medications, pulled one of his IV sites, disconnected him from the bag that was hanging and saline locked that IV site, and then went back to assist with my other patient. During this time, I had to ask her a few more questions, and my "actual" assigned nurse for the day hunted me down to find out why I hadn't done an assessment on her patient. I told her my instructor said I only had to do one assessment, then asked if she wanted me to go do an assessment. She replied with, "Well, it depends on how much you want to learn." Wow, gee thanks for that. I was really learning a lot from doing an assessment on a patient who was about to be discharged and didn't have much in the way of abnormal assessment findings.
At this point in the day, though, it was nearly lunch time, so I finished up what I was working on with my patient from last week, and as I was just about to leave the room, she began sobbing. So, I stayed to sit with her for some time until she had calmed down, and then informed the nurse that she was upset and asked if there was anything we could do for her. There really wasn't much, but it was noted. I then went to lunch.
After lunch, I followed up with my "actual" patient and did a brief assessment on him, took out his other IV site, changed the dressing on his ICD incision site, took the dressing off his groin access site, put a band-aid on his radial access site, and helped him dress for going home. After this, I charted the assessment and then assisted with discharge teaching and saw him to the elevator.
With my last 15 minutes or so before post-clinical conference, I did my journaling, and the nurse who had hunted me down looked over my assessment and added a few things to my notes. NOW I get why she was so desperate for me to do that assessment--she wasn't doing her OWN assessment and was relying strictly on mine. I didn't take vitals on my patient this morning, and neither had she, but thankfully I'm awesome and took his BP and HR before giving him his blood pressure medications, so she had that to chart. It was kind of upsetting, but I am grateful that I was able to see what half of a patient load is like. Right now, it's kind of tough because I'm still not really sure what to do sometimes, and some patients require more time. But, I'm happy to say that I still love what I am doing and look forward to when I will do more of it!
No comments:
Post a Comment