This week is coming to a close with over 40 hours spent in clinical related work. So essentially, I am working full time for absolutely no money. I'm fine with it, but I had a little argument with my roommate the other day and she decided to be childish and start insulting. Her ammo was to make fun of the fact that I'm not a real adult because I don't have a job, but it kind of makes it hard because I am always in clinicals. This is the roommate that is diagnosed bipolar so I'll excuse the childishness of her statement, but people tend to tease me about not having a job and I just had to vent about that. I feel better now.
Okay so Tuesday was spent on the psych ward again. One of the admits was a nursing student from another school that was in her last semester. She was admitted for anxiety, depression, and suicide precautions. I feel ya, sister.
After report was given, we headed into the closed ward and within 5 minutes, there were screaming and whistles sounding off. One of the patients that I was with last week decided to attack a Bosnian man for absolutely no reason. Usually, you can tell if a patient is about to get aggressive, but the attacker was just posted up on the wall and just went for it. It was theorized that the attacker's brain just went through the wrong switches for a moment and caused him to attack. He said he really didn't remember what happened, just 5 minutes after the event. It was a scary day for me to start out on because I didn't know how to handle the situation and I am quite small compared to these men and the staff looked scared.
I participated in some art therapy with the open ward and a fresh air walk. The patients were instructed to draw their problems on a piece of paper and express their feelings through it. Some were very innovative. One man drew a picture of himself happy with bright colors behind bars, and then a smaller version of himself in front of the bars. He explained that whenever he is truly himself, he is forced into a mental hospital or jail, but if he conforms to what society wants him to be, he is small enough to fit through the bars and be free. Another woman drew a brick wall, with a few vines of roses over it. She explained that she was about to be discharged and has put up a wall between her past and her current self. The flowers represent her new positive accomplishments, and she wants to keep the positive in her life and leave her negative past behind the brick wall. Very insightful.
Thursday and Friday night were spent on my capstone unit, the Infant Medical-Surgical Unit, from 7 pm-7:30 am. The first night, I assisted my preceptor with charging the unit. It is two floors and it was pretty intense to walk around all night assisting nurses who need help or relief for awhile. We transfered two patients to the ICU. One of the patients was 8 months old and came in with pneumonia, which led to a chest tube, which led to a tension pneumothorax. The mother was sobbing, screaming, and pacing all around. The doctors showed her the chest x-ray, which was semi hard to interpret, but she just freaked out. We expect parents to be scared for this child, but this was too much. She wouldn't listen to anyone and she was making other rooms nervous. Her daughter was put on a ventilator and then banned from the ICU for awhile because she kept runnning up and getting in the middle of all the nurses and doctors, which makes their job quite hard. It also makes it hard when she tried to fiddle with the ventilator machines. I would never dream of trying to touch that piece of equipment without extensive training.
It was hard to stay up the whole night, but I made it and went to bed at 8 am and woke up at 3:30 pm. I worked out, got ready, and headed back into the hospital. I requested to not charge last night so I could get some patient interaction and learn some new skills. I loved my pseudo preceptor. She was a lot like me because she isn't meticulous with everything, but was definitely a great nurse. The hospital was overwhelmed because the news did a story about RSV which led to everyone assuming their child had RSV. There was not one empty bed in the hospital. We double bunked every room, and I even saw one baby's bed in the hallway waiting for a room. It was like everyone in SLC decided to bring their kid in and have a giant sleepover. Slumber party!!
We had 4 patients and never got to sit down. One of my little babies was a 4 month old that was here with a skull fracture from child abuse. His skull was visibly split with a one inch gap and two neuro drains. His head was heart shaped because of the extra fluid from the trauma. The mother's boyfriend and father of the child was accused. She said she should've known because he was angry the whole time she was pregnant and in November there were bruises on the child, but the boyfriend got really angry and started calling her crazy when she accused him. I wanted to advise her that liars usually get angry and accusatory when they are the one at fault. She was scared to go home because they have a gun underneath their bed and she knew that he might want to try and take her out.
It was heart breaking to assess this little boy. He was so adorable, but brain damage was apparent because his sucking reflex was gone, he wasn't smiling, and his eyes paced around the room, unable to focus on anything. His affect was very odd as well. He looked like he was constantly scared and when he would try to cry, nothing would come out except a high pitched squeal. Apparently, this is called a neuro cry. But as somewhat of a happy ending, by 6 am after giving medications and having the drains going on a higher pressure, he was looking a lot better. I was able to get him to start smiling and he reached up to his mobile and was touching it. That signifies that his hand-eye coordination was returning and he was able to process objects in front of him. We won't be able to understand the full extent of his brain damage until he does or doesn't meet milestones, but it is reassuring to see his progress thus far.
Winter is a hard time for many peoples' emotions, but I will never understand how someone can hurt a child. We heard about one child who was 60 days old and was taken to Primary's via ambulance because of a full arrest. The baby was immediately taken to the OR because injuries from child abuse was so bad. There was another child on our floor that was admitted for two broken femurs (thigh bones). It disgusts me to hear parents ask what kind of force it would require to do this injury. The reason for their inquiry is so they can form a more believable story so they don't get charged with child abuse. These are the reasons that I believe people need to apply to be parents.
The rest of my patients were respiratory patients. Nothing too interesting since everyone and their mom has respiratory issues right now. I got pretty delirious this morning at about 5 because I was so tired from the week, and my cool psuedo preceptor just told me to go home and rest. I eventually left at 6:30 am, and it was nice to get in bed when it was still dark.
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