Saturday, October 30, 2010

What Do You Do With a Difficult Patient?

What do you do when you get an extremely difficult patient? We all know that there are those people in the world who make people's lives hell. Whether they do it on purpose or not, I'm not too sure. Yesterday I had the oppurtunity (if that's what you can call it), to work with a very difficult pt. whose daughter was just like her, if not worse. When this particular patient saw me walk in, she took her finger and motioned for me to go over to her. Well, of course I did. She commenced on giving out to me, and telling me that when she got her food, I was not to just leave her there to eat it. "Well, of course!", I said, "I will help you set it up and make sure that you're comfortable." She thanked me gratefully. Sometime during the day, this woman's daughter came into the room and decided that there was no phone in the room because she couldn't find it. She looked at me and said, "Nancy, WHY doesn't she have a phone?" because obviously, the fact that she was without a phone was my fault. I smiled politely and looked around the room. I couldn't find it either. I told her that I would go and get her one. I got a bit caught up with something else and saw the daughter of the patient was at the front desk talking with the secretary. She had told the secretary that I had told her to ask the secretary to get the phone (if that makes any sense). Well, of course that wasn't the case. Thankfully the secretary was very kind and went to the room with me and found that in reality, there was a phone. I'm not sure why, but this woman was stressing me out. So much, that I wanted to cry. But, I didn't. The patient then got on my case later because her dinner had come while I was busy (bringing a body down to the morgue). This was after the family had left. She yelled at me, telling me that I had "promised" to come, and that I "never came." Yes, I understand, the hospital is a strange and scary place. But as a Tech, I have at least eight other patients to take care of. I was caring for her roommate and she was yelling my name, telling me that she needed her toothpaste at that MOMENT. No matter how many times I told her I would be there as soon as I was finished caring for her roommate, she would not stop yelling. I got so boiled up that I raised my voice. I showed her that she had a roommate by opening the curtain and told her that I have other people to take care of too. That she needs to wait for a while sometimes. She did calm down and did tell me that she would be nicer, but that was deffinitly the INCORRECT way to handle the situation. What should I have done? I was at a loss yesterday. I had been so patient, I had been calm, but my exhaustion got to the best of me. Being a nurses aid or a Patient Care Tech can help so much in learning how to deal with the everchanging situation of a hospital. What I should have done was to say, "Ok, I'm here now, what can I do for you?" In an ideal world. The patient would say thank you and calmly tell you what they need. But, unfortunately, a hospital's situations are hardly ever ideal. That's the truth. Nurses as well as Tech need to be flexible, need to anticipate, and need to be able to handle sitations. This is a job that is full of surprises. You're lucky if you get an "easy" day.

Thursday, October 21, 2010

Clinicals: Day 1

Today was day one of my clinicals at the hospital. I have clinicals once a week for the rest of the semester. I had to wake up at 5am, which was absolute torture because I didn't get home from work until about 23:45 (I'm going to start writing military time because I need to get used to it.) last night. I didn't get to bed until after midnight. So basically I got less then 5 hours of sleep. TORTURE! I got ready, and then went to starbucks to get my drug (caffeine) fix. I felt a bit better once I got to the hospital, but not much better because it was still DARK out!!! Around 7:45 my clinical group got on the floor and I found out that my patient that I was supposed to work with had gone down for a SBFT (Small Bowel Follow Through). The nurse said that she should be back shortly. Well, the patient didn't come back for about 3 hours! I felt so behind! But I did get to do a bit of reading up on my patient and finding out what she had, what her history was, etc. If I haven't clarified already, because of HIPAA, which is the Health Insurance Portability and Accountability Act, I will be saying very little about the patient's condition. Finally when the patient came back I got to perform a little bit of an assessment on her, but I felt pretty bad because she looked exhausted from going through the procedure. She was a very nice woman. I am really hoping that next week I can perform more of a assessment on a patient and hopefully be able to pass meds as well.

Thursday, October 14, 2010

Time to Study is CRUCIAL!!!

Dearest readers, my apologies for not being able to write for so long. School is just, well, like I said in the previous post, overwhelming. This week I had not one, but TWO exams to take. I know that there were people in my classes who had up to four exmas that week, but still, two exams, one being a final, is hard. It was hard too because I worked the night before my pathophysiology exam and stayed up until one cramming for it. Let me tell you, I did not fare well, not at all. I ended up getting a 72% on the exam. That's not a C, that's a D. It shocked me so much. I am not used to getting D's. I had actually walked away from that exam feeling somewhat confident, so why did I do so terribly? I don't know, that's why I am making an appointment to talk to my professor about it. I cannot let that happen again. I took my nursing fundamentals final yesterday. I actually felt somewhat confident about that, but knowing me, I could have failed that one too. Like I said it's overwhelming. Nursing school isn't easy. I don't have much time to go out with friends, if I go out too much, this is what happens, I don't do well on tests and I start to panic. The next patho exam is on Pulmonary diseases. There are two lengthy chapters that I will start reading today. I need to catch up, and stay ahead. Always remember to divide your time wisely. Its a smart move.

Wednesday, October 6, 2010

Friday, October 1, 2010

Med Pass

The other day I had my first skills test on passing medications. There is a lot more to giving a patient medication, then just handing it to them and making sure that they take it (see previous post for more details). At our school, we are lucky enough to have an amazing simulator hospital to practice our skills with. We even have two pyxis machines. Pyxis machines are computerized machines that lock up any medications that we get from the pharmacy. My mentor, who has been practicing this particular skill with me for a hile now, was the one who tested me. I'm happy to say that I passed. She told me a did a wonderful job, but I know there is a lot that I still need to work on. This sort of stuff is eventually going to be second nature to me. Two of the most important things in nursing are Patient Safety and Documantation. Patient safety is something that should always be remembered by any healthcare worker. We have to make sure that they don't fall out of bed, slip on the floor, get the wrong medication, take a medication that they are allergic to, etc. It's a lot of work, but that what we are there for. We also have to constantly document, because for example, if a nurse looks at a patient's wound and doesn't measure the size of it and document it, she could be liable. If a nurse doesn't document that she called a doctor about a certain medication that she/he held because it didn't interact well with another med, or the patient refused, then he/she has no protection if for some reason it goes to court. It's a scary world out there, and a nurse should always protect themselves when they are in the right. I am learning how to do physical assessments now! I feel like I am so behind! But I guess I always say that. Thanks for reading!