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Clinical post for Dec. 8

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1 Clinical post for Dec. 8 on Thu Dec 08, 2011 4:47 pm

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This book was hard to put down. I found it very interesting because I was able to see that what we say when we are with our patients can be taken many different ways. I have always tried to remember that my patients are someone’s parent, child, or love one. I know what kind of care I would expect my mother to receive if she was lying in a hospital bed. With that being said it doesn’t necessarily mean that I am going to have a wonderful kind patient like I know my mother would be. However, who are we to judge our patient when we are not the one in the bed, in pain, and facing life threatening situations. I am the world’s worse for wondering if a patient really has a pain level of 8 when they are lying in the bed, talking in a normal tone, about anything on their mind, and acting as if they don’t really know what pain is. But, I am not that person, and I cannot be sincere in my nursing if I doubt their pain level. I think this book has helped me understand the priority that I am to have with my patients.

Saying I am sorry. Sad
I think sometimes when you are classified as a “pleaser” in life you have a tendency to over apologize. I can be that kind of person. I think that saying “oh I am sorry” comes easily because it is what we think people want to hear and we feel like it makes everything okay. It is not always the best thing to say. I had a patient that was dying with cancer. This patient was in their 80’s, and for the most part had lived a healthy life. I just happened to be in the patient’s room when the doctor came in and nonchalantly told him he had kidney cancer that had spread and there was nothing that could be done. This patient was in total shock and wanted to know what he needed to do to get better. He was told that hospice would come into his home and take care of him there or he could elect to go to hospice to receive the care he needed. I will never forget the feeling of sickness and fear I had as I listened to how cold this conversation was. The doctor basically continued on by telling him that he had lived a long life and had been pretty healthy up until now and had been very lucky to have lived his 80 some years. All I could think was when can you just send someone home to die just because they are old. I did not know what to say and all I could say was I am sorry. I just kept looking at him and saying I am so sorry. He said I guess I need to call my daughter and tell her, but I don’t think I can remember her number. Like a dummy I said I am sorry. What I really wanted to say after I look back on it and believe me I have plenty of times is, “you can get a second opinion.” I don’t think as a student I could have said that but I know as a nurse in the future I will.

Watch dog.
I guess I was a watch dog at Broughton. LOL There was a patient that took a liking to me and me only. They would not talk to any other student. I wonder if it was just a control issue. However, this made getting information for their data tool difficult. It’s hard to complete a four page paper on what your patient tells you when all they say is I want to talk to that Angie girl.

Rocking the boat.
I once had a patient that was elderly and very sick. She was totally dependent on others. I had her two clinical days in a row. The second day I had her was a slow day. I was able to spend more time in her room with her. She didn’t seem to be quite herself the second day, or I guess I could tell that she seemed different than the day before. I happened to notice after her bath that she was crying. I was afraid that maybe I had hurt her or maybe she was getting worse. I had never had a patient cry before and I didn’t know quite how to handle it. So I asked her nurse or rather I told her nurse that she was crying and found out that the woman had no family left and was going to have to go to a nursing home as soon as a bed could be found for her. So I did everything I could just to spend time in her room. I am very thankful it was a slow day or I may not have had the time to spend with her. I got her fresh water. Brought a few extra pillows in to her, and tried to talk about what was on the TV. I was hoping that she would talk to me and when I seen that she wasn’t going to tell me why she was crying I decided to just come right out and ask her. I kept trying to remember what Mrs. Flowers had told us about communication. I didn’t know if I should say you seem to be upset can you tell me about it, or can you tell me why you are upset. The poor thing was almost sobbing so any one could see she was clearly upset. "You seem to be upset" just didn't hit the spot. So I just asked her to tell me what was wrong. She didn’t say anything at first and it seemed like eternity was passing by when I asked her if she wanted me to leave her alone. She shook her head no, and asked me to just sit with her. I was really worried that I would get in trouble if my instructor came by and seen me sitting in the chair near her bed like I was just visiting. But I also knew that it was my place to do what made her feel better so I sat down and waited to see if she would talk. She did talk some and it was mostly of how she never thought she would be the last one living in her family. She talked about her children and how she missed them and how she wished every day that she had died first. She didn’t want to leave her home because it was all she had left. I told her that I didn’t know what it was like to lose a child but I knew it had to be terrible. I told her that I knew she was strong and I was sure that after she got settled in she would see that the nursing home was not so bad. I told her that she would get to meet new people and have friends and she might see that she wasn’t so lonely anymore. Our talk seemed to help her settle down, and I ventured in and out as much as I could. When it was time to leave I told her I was leaving and I hoped the best for her. She took me by the hand and told me I would never know how much it meant to her to have me just sit with her. She told me that I would make a wonderful nurse one day. Then I almost cried. I don’t know if I rocked her boat, but I know that she rocked mine. I don’t know where she went, or if she is still alive. I just hope that she is okay and she adjusted to having to leave her home.

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