When it was time to perform a head-to-toe assessment this afternoon, the best option out of the bunch was the patient with the tracheostomy. He was non-vocal (couldn’t speak), had limited range of motion (ROM) in any of his joints, was incontinent for both urine and bowel movements (BM), and appeared to be quite unaware of his surroundings. I doubt that he was oriented at all. Alert? Yes, somewhat but more than likely not oriented in any way. The gentleman’s wife later told me that he had been living with the tracheostomy for about a year already and that he has been bedridden for close to two years. She also mentioned that most of the time she isn’t sure if he can even see her or acknowledge her presence at the bedside. At only 76 years old, I felt a bit sorry for him (and for her). In spite of this, I kept on, attempting to complete my head-to-toe assessment on the patient that has no way of communicating with me about any part of what I am doing. It was hard, really hard. I had to rely on the patient’s wife for most of my information. Although this was a slightly challenging experience I value it for sure. I am glad that I got a chance to learn about the tracheostomy and the effects it can have on a patient’s life as well as the lives of that patient’s family members.
Today was a good first day of clinical rotations in hospital. While assisting the staff with morning care procedures, I was impressed to see such great team work amongst the nurse technicians on the floor. I was also impressed by the fluent communication between the nurse technicians and the nurses on the unit. The level of open communication that the staff members on the unit demonstrated today is great! The nurse technician that I followed this morning had a load of six patients that she was responsible for. One individual was away for dialysis for the entire morning; two patients were able to get up and about on their own (up ad lib) and did not require much assistance; two more patients were expecting to leave shortly; and another was on bed rest with a tracheostomy as well as a jejunostomy (feeding tube). It was a completely different type of patient base than I am used to on my regular floor in the hospital.
When it was time to perform a head-to-toe assessment this afternoon, the best option out of the bunch was the patient with the tracheostomy. He was non-vocal (couldn’t speak), had limited range of motion (ROM) in any of his joints, was incontinent for both urine and bowel movements (BM), and appeared to be quite unaware of his surroundings. I doubt that he was oriented at all. Alert? Yes, somewhat but more than likely not oriented in any way. The gentleman’s wife later told me that he had been living with the tracheostomy for about a year already and that he has been bedridden for close to two years. She also mentioned that most of the time she isn’t sure if he can even see her or acknowledge her presence at the bedside. At only 76 years old, I felt a bit sorry for him (and for her). In spite of this, I kept on, attempting to complete my head-to-toe assessment on the patient that has no way of communicating with me about any part of what I am doing. It was hard, really hard. I had to rely on the patient’s wife for most of my information. Although this was a slightly challenging experience I value it for sure. I am glad that I got a chance to learn about the tracheostomy and the effects it can have on a patient’s life as well as the lives of that patient’s family members.
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