I was able to visit with my preferred patient (for care plan purposes) again today. I was able to fill in most of the blanks that I had left behind after yesterday’s shift and got a chance to speak with her about some of the issues that she is facing. I found that this patient’s first priority is to learn better self-health management strategies, especially relating to her diagnosed diabetes. The patient and I talked about some of the things that she thought were important for her to resolve in her own life as well as ways that she could make that difference happen for herself. I was able to advocate for this patient by requesting that a nurse educator specialized in diabetes education come to speak with her about the disease; what it is and how it works, what that means for the patient in her daily life, how she can learn to manage this disease and cope with it, and how she can contribute to bettering her own quality of life.
Today I also got to hang my very first intravenous medication via piggy-back (IVPB) on an actual patient. That was a lot more stressful than I thought it would be but I managed to get it done with the guidance of my clinical instructor. I also got to go with another student nurse present on my unit today to watch one of the registered nurses remove a central line from a patient’s jugular vein. Just seeing the catheter’s injection site on a patient’s neck like that is not too bad but when you really start to think about what it means in terms of risks for the patient it becomes a little scary. This patient was a young female, I would assume not much older than me, which felt as though she was not being treated with respect in the hospital and that the healthcare providers’ intentions were not to heal her but rather to make her suffer. Therefore, this patient was getting ready to leave the hospital against medical advice (AMA) and attempt to find another means of coping with her pain. When the registered nurse was preparing the removal of this internal jugular (IJ) catheter from the patient’s neck, the whole concept started to get real for me. This woman has a fairly large diameter catheter threaded into her jugular vein and directly to her heart that she wants taken out, she has a contagious infection, and she is leaving the hospital without adequate reasoning… This cannot possibly end well. But – the catheter came out alright and the patient went on her way. That was a pretty thought-provoking experience for me.