Day 5 and the end to the first week of the Acute Care Placement, so much learnt and still so much to go. This week has seen so many polished skills, improvements on time management, patient care, and assessment ability. The facility and its staff have been extremely accomodating, patient, and nurturing towards not just myself but the other students as well. The staff afford every opportunity to be exposed to new procedures and give the students a go, often at the expense of efficiency, but never at the expense of patient care.
Today saw a return to the Medical ward for my last Early Shift in the ward, as I will be swapping to the Late Shift from Monday to finish my eight days in Medical. I assisted the RN today with a case load of six patients, two Discharges and three new admits. I monitored a blood transfusion of two units for a patient, completed medication rounds as normal, and completed two ECGs. All together it made for a busy day, but manageable, though having a great RN to work with made the job infinitely more manageable.
Other than the obvious learning previously mentioned, I had an interesting encounter with several of the patients today. Firstly, one of the new admits was a client from my Aged Care placement in 2016, which was kind of surreal. When I last saw the resident she was reasonably healthy, for someone of their age, and it was almost saddening to see them in an acute setting, knowing that their health was deteriorating. In a lot of ways it was a physical representation of the deterioration of the human body as we age, and how sometimes its the mind that lets go, and sometimes the body. It was uplifting to see that the resident was their upbeat, happy self, and that they where in good hands.
During the monitoring of the Blood Transfusion, I took the opportunity to chat to the patient and his wife while I was taking observations, to pass the time for all concerned and to distract them both from the procedure. While talking with them I found out that the wife was a retired RN, and the husband an Army Veteran. We talked about their various conditions, which turned out to be great learning opportunity, and while taking the observations I witnessed a mild fluid overloading, which was characterised by an increase in systolic blood pressure and relieved by passing urine and increasing movement.
Currently on the ward is a palliative patient, as there isn’t a designated ward in the facility. The patient has end stage bowel cancer, with a descended abdomen, fluid collection in the lower extremities, decreased input and subsequently decreased output. They are in the final stages with a subcutaneous infusion, and pressure area care being the only real nursing interventions being undertaken. As someone with an interest in palliation, I ensure I try to extend the comfort afforded to the patient to their family as well. It is something I firmly believe in and thankfully observe the other staff at the facility undertaking as well. Palliative care done right warms my heart.
All in all, a busy day, that was extremely rewarding, and though I feel exhausted, for placement reasons and non placement reasons, I feel invigorated at the same time. Every day I spend on the floor, is another reassurance that I am in the right place, and I am answering my calling.
Until Monday, Maintain the Rage