Clinical: Week of October 13

Background: Monday night compared to the week before went a lot faster. I was able to print out all the assessment data and the complete physical form of my patient. I was able to get out of  Medical Center by 7pm. My patient was one very interesting tough old man— he had multiple cancers (colon-rectal, prostate, bladder), HPT, two open heart surgeries (CABG). He was in for atrial fibrillation but they found that he has rectal carcinoma. I was  pleased that the nurse gave suggested him (i told her i needed a patient I can do a good skin assessment on). He had a stage 2 pressure ulcer on his sacral region (which TMH didnt cover, i dont know why…skin intact though) and he had many variations in his skin, seeing that he was 87. I was excited to talk with him the following day.

Day Of: The day nurse was nice to me for the entire day. My patient was on fall precaution (as well as on a telometry)  so he had a sitter the whole time, who turned out to be the same PCA i had last week.  He was a sweet old man, he talked about his career as an engineer and his wife (he is a widower). Anyway, here is a breakdown of what I did that day (if i could remember…) this is all lesson related…:

- did vitals on my patient (which i totally forgot to do respirations thought machine would do it!!) shame. The nurse told me to get it afterwards, so it was cool. still. shame!
- did a bed bath and assessed skin at the same time
-assessed skin around his ileostomy and perineal region (had a Foley). Also assessed his pressure ulcer.
-learned how to use TMH’s “Accucheck”, or glucose check machine.
-auscultated patient’s abdomen as well as palpated for his dorsalis pedis pulse (hard to find!)
- i was able to let the nurse know about redness on the heels of my patient
- able to mix vicodin and sodium chloride (not for my patient though)
- learned what a whipple surgery is. (whipple surgery is when they take a head of the pancreas and a part of the small intestine out). Thats why some patients are on insulin even if they dont have diabetes.
-help nurse chart my patients assessment data on MetHOD

Hmm. Thats all I could think of. That morning, Spring was so nice, she bought us Kolaches! Yup. So, I have to write a BETTER care plan next time. and type up meds.
This week of clinicals rate a 8/10!

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