So, my 6th day is complete. . . 6 more to go.
I am slowly, but surely feeling confident in my ability to handle a 5 patient load. I have to say my weaknesses right now are:
- figuring out what it is that i am responsible for in the chart
- what i am supposed to do exactly for admits and discharges
- when is the time to call the doctors and how much can you do before you call them. If it is late, can this specific problem wait?
So, with that being said, i feel as though my assessments are becoming very streamlined and specific. I also feel as though my skills are coming along. I got to insert my very first FC yesterday!! Seriously, almost 2 years and I have never done it. It wasn't too bad, but that sterile field is a tricky thing!
I am also having to face death or the possibility of death a lot. Some of my patients are very ill. They have had to come to grips with some very difficult things, and I know that I need to work on how to get them through it.
I have not dealt with death much, which I am very thankful for, but it also makes me very uncomfortable.
I am never sure if or what i should say when there is new news of something tragic or a family is going through anticipatory grieving.
I had a patient that I had taken care of for 3 days pass a few days ago. I didn't realize that he had chosen to remove all life prolonging measures and basically rely solely on comfort care to "ease" him into his final moments. I entered his room (not as his nurse) to change a full suction bag, and I am sure that my face changed when i saw the state he was in. It was very clear that he was down to his final moments with us. His appearance was something that I could not explain.
I have made a vow, since beginning on this floor, to take a moment with each patient once/day to stop and think about what is going on with them. I mean, what is really going on.
I know that I need to hand some abx and help them ambulate to the BSC, but remember that they found out 2 weeks ago that they have terminal lung cancer. Each moment they have is numbered. Their quality of life will not get better. They are relying on external factors to keep them "comfortable." How do you make the choice, "even if you can bring me back to life. . .do not do it. i am choosing to die instead of live the life that I have." And for a family member to have to make that choice for another. Regardless of whether or not you feel as though you know if would be "what they would've wanted," the guilt that goes along with this is enormous. How to you tell the doctor that the man that you have loved for 42 years should not be brought back to life if he stops breathing.
I try my hardest to empathize with these grueling decisions, but I hopw to never know the true feeling that comes with it.
Sorry that today's entry is such a downer. It just had to be said.
