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Communication and Hirschsprung's Disease

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1 Communication and Hirschsprung's Disease on Fri Dec 02, 2011 11:03 am

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Communication can be hard to have with your patients. Some patients will talk your ear off and some will say very little to you. The ones that say very little to me, I feel like I'm bugging them and feel awkward trying to care for them. I rather have them talk my ear off then not say anything because it is much more relaxing knowing that they want you in the room with them. My clinical experience on Tuesday was pretty eventful. I had exactly what I just described. One patient who talked my ear off once she woke up and my other one said very little to me, only answering my questions. I tried to use open ended questions to keep the flow going. But I did have to use close ended questions for one of them because he did not want to carry on a conversation. He opened his eyes long enough to answer the questions that I was asking him. Throughout my journey in clinical, I have learned to adapt to any situation given to me. It is not going to be perfect, but life is not perfect. I do not necessary think I said anything wrong, or misleading to the nurse when reporting off. I do find myself sometimes feeling overwhelmed when giving report to the nurse. When giving report to Ms. Williams I struggled to find the right words to use. The only word that could come to me was "pole" to describe a type of surgery. But I know "pole" was not the right word, but for the life of me I could not come up with the right word and the word finally dawned on me, "rod!" Needless to say I was totally embarrassed, but made Ms. William's laugh. Smile A time a patient was mean/uncooperative to me was probably back when I was a first year. I have a feeling the patient sensed my nervousness. I do not think she made unkind comments but she sure did make my day difficult. She needed everything under the moon, and when I would come in to do my assessment or vital signs, she would ask a million questions before I put on the blood pressure cuff or placed the stethoscope on her chest. She was definitely testing my abilities and my button. But I did not let her get to me, I treated her like any other patient on her own individual bases. I have sensed many patients of mine to be annoyed to have a student nurse. I understand why they might get annoyed. But were student's just trying to learn how to be the best nurse possible. I have had many wonderful patients who welcome students into their room. Those by far are the best patients to have because you do not feel rushed, inadequate, pressure, and the list can go on and on. I can honestly say my patient experiences have been awesome. I would not trade it.

Hirschsprung's Disease: 12 total caring interventions
1. Assessment- no meconium passed within 48 hours post birth, poor weight gain, and poor feedings
2. Management- no rectal temperature-obstruction; use of stool softeners- makes it easier for them to have a BM and not have to strain; provide emotional support to family/parents- its a hard time on them to see their baby have to go through this, so include them in all the infant care, answer questions honestly and thoroughly, and comfort them
3. Pre-op- NPO, enema, IV fluids and suctioning
4. Post-op- colostomy care, monitor I and O, monitor for infection

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