Tuesday, July 21, 2009

Tuesday Reminiscences: In which I almost kill my first patient

As the likelihood of me ever finding a 40-hour-per-week job is dwindling into nothingness, I was thinking about how I procured the ever-so-promising degree that is now proving to be not very useful.

When you start nursing school, they put you in Long-Term Care, which is a euphemism for Old Folks' Home. You have clients assigned to you, but they mostly take care of themselves, and they don't let you anywhere near medications, so, you mostly just give baths and take blood pressures. After a few weeks of this, you get moved into Acute Care, i.e. a hospital.

In order to let you get near real patients, they make you come to the hospital the day before and write down everything there ever was to know about your patient. Then you go home, and look up everything you wrote down and make sure you know it cold: lab values, diagnostic tests, diagnoses, comorbidities, medications, possible side effects of treatment, and the like. If the instructor catches you in the hallway, they will quiz you and if you don't know the answer to their question, they will incinerate you with their laser beam eyes and then graffiti your grave with big red 'F's. Or so they made it seem.

I was ready. I had done my research. I had reams of paper and cheat sheets hidden in my clipboard. I hadn't slept the night before for looking things up in my Taber's Medical Encyclopedic Dictionary.

My patient was a somewhat elderly woman, I don't quite remember what her diagnosis was. Anyway, I showed up with her breakfast tray and started to introduce myself. Uncovering her tray, I saw that breakfast that morning was pancakes. She asked if I could cut them up for her. Sure, piece of cake. That done, I moved to wheel in the blood pressure machine. As soon as my back was turned, she started coughing. Then coughed more. I sat her straight up in her bed. Then she started gasping and wheezing. I patted her back. Then she turned bright red. I thought about doing the Heimlich Maneuver, but she was so old and frail and the thought flitted across my mind that you weren't supposed to do the Heimlich unless they aren't breathing, or coughing at all. This lady was doing both, so I wasn't sure what the heck to do. I stuck my head out of the room as the floor supervisor happened to be walking passed. I very calmly (actually probably the opposite) asked her to duck in for a moment.

By that time, the old lady had coughed up her little piece of pancake and was laying back down, exhausted. After that big scare, the rest of the day was actually kind of cool, because I got to go with her to have a swallow evaluation, in which she swallowed barium while being x-rayed, so you could watch it go down into her stomach, or lungs... which is what it was actually doing.

To this day, I'm very glad she didn't die, as that would have sort of tainted the rest of my (non-existant) nursing career.


Anne said...

you should rename this "Tuesday Reminiscences: Where an old lady almost choked, but didn't, to no fault of my own."

Anne said...

oh ya - and you already have an 168 hour a week job.

Bridget said...

This is why I am not involved with the medical field at all. I just couldn't deal with the possibility of my mistakes killing people.

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