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Communication and Caring for a Patient with Hirschsprung’s Disease

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Communication with your patients can sometimes be a difficult task, being that you may get that patient that is ill and hateful, doesn’t want to talk or acknowledge you. Then again you may have another patient who is happy go lucky, wants to tell you their life story and is what some call a “Chatty Kathy.”Either way you’re there for the patient, to make them feel better and support them in their care. Myself I adapt to my situations and surroundings. I try to somewhat “just go with it” and make it somehow work, while trying to be myself. I feel like to have effective and open communication you need to be open and honest with your patients, let them know what is going on, ask them how things make them feel and relate to them or find similarities in order to establish a patient and nurse relationship. This past Thursday I had one patient who was recovering from a totally hip, the nicest gentleman ever, loved talking, especially about his discovery of the Lord and his workings. While taking his vital signs and helping him freshen up and bathe we got to talking and come to find out we both live around the same area. From there he went onto telling me about his medical history and what all he had been faced with medicaly. When I interact with patients like this gentleman I try to actively partake in their conversations by listening and responding or trying to find similarities between us (sports teams, music) in hopes of establishing communication and trust.

One difficult patient interaction I will never forget was with a patient and her family when I was in phlebotomy school. I had this lady that I was taking blood on, her son and his wife were in the room and were bring very difficult with the nursing staff, even reporting one nurse for taking too long to respond to a call bell when she was in another room. Prior to obtaining her blood nursing staff warned me about this patient. If being a phlebotomy student wasn’t hard and nerve raking enough, I had a lady’s son literally standing over me as I drew her blood, wanting to know exactly what I was doing and what test I was drawing for. In this situation I explained my procedure to the patient, obtained her blood (while praying I got it in one stick and made it as painless as possible due to the nervousness of making her or her son upset) and answered whatever questions I was allowed to. I guess what really stuck with me with this patient was the part of being afraid to do my job in the event that I might have upset the patient or her family.

Caring for a Pediatric patient Diagnosed with Hirschsprung’s Disease:
1.Failure to pass stool within the first 48 hours.
2.Abdominal distention.
3.Bilious vomiting.
Medical Management:
1.Provide prescribed analgesic for pain.
2.Measure abdominal circumference for distention.
3.Provide support to the patient and the family. Answer questions they may have and provide information on the disease and management to help relieve any anxieties.
Pre OP Surgical Management:
1.Obtain a signed form of consent.
2.Establish IV access to ensure proper hydration.
3.Radiograph study to locate the area of involvement in the intestines.
Post OP Surgical Management:
1.Monitor vital signs for complications of infection.
2.Ensure adequate hydration.
3.Administer prescribed antibiotics and analgesics.

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