Long hard day...

Today was very long and very hard physically and emotionally. My primary patient was close my age, and she simply made some mistakes. She was diagnosed with diabetes in highschool and didn't take care of herself. She didn't monitor her blood sugar levels regularly or pay attention to the things she put into her body. One night, while drinking with some friends, she had a little too much and passed out. Her friends took her to the ER, where they found that her blood sugar was in the teens (normal is 70-110). Her drinking had put her into a diabetic coma. She then went into cardiorespiratory arrest - her heart and lungs stopped working, which basically means that she died. They began CPR and had to put in an artificial airway and hook her up to a ventilator. They were able to resucitate her, but she'd gone so long without oxygen that her brain was affected and now she's in a persistent vegitative state. She had to have a tracheostomy in order to breath and a feeding tube surgically inserted into her stomach to receive nutrients. Her parents were unable to take care of her because of how much care she requires, so she was put into a nursing home. After being there a couple of months, they found that she had what's called a rectovaginal fistula, which means that a connection developed between her rectum and vagina, so fecal matter was leaking into her vagina. She was admitted to the hospital once again. The surgeon that took on her case was planning to make a colostomy to fix this problem. While she was on the table and the surgery was about to begin, her heart stopped beating again. She was again resucitated. Now no one will take on her surgical case for fear of her heart stopping again. This means that fecal matter is constantly being introduced into her vagina and causing terrible reccuring urinary tract infections. She was put back into the nursing home, but returned a few days later with pneumonia and tracheitis (a terrible infection of her trachestomy site). After that cleared up she went back to the nursing home, but returned last week due to a high fever caused by yet another urinary tract infection. She's always in pain, even though she receives regular pain medication. Her limbs are contractured- which means that they stay curled up and are very difficult to impossible to straighted. The saddest part of the story - her mind is there. She has absolutely no control over her body. I really felt for her. It was so hard for me to go into her room and see her face grimacing in pain and sometimes crying, then not be able to do anything about it. She couldn't communicate to me what was hurting, how it was hurting, or why it was hurting. I spent all day looking for little things to make her more comfortable. Another thing that was hard, was the fact that she had no visitors all day. I like to think that if I were put into that state I would never have to be alone. All of this because of a few bad decisions because every young adult feels like "it won't happen to me".

I was glad to have my secondary patient for a bit of a comic relief. She had a brain bleed and had to have two holes drilled into her head to drain the blood and relieve the pressure on her brain. Because of this she was a little confused. She constantly asked me to knock on her bathroom door and see if her family was in there. Once she even asked me to look in the shower for them. When her grandson finally did arrive, she made sure to let me know that she had found him. She also kept me on my toes. She was very shaky and it took myself and another nursing student quite a bit of time and effort to get her to the toilet. She told us it might be awile so I told Tara I'd come get her when I needed her help to get the patient back into the bed. I decided to take the opportunity and change her bed. While I was on the other side of the bed I noticed her trying to stand. I asked her what she was doing, and she told me "I'm getting in the bed!" I reminded her that she needed help for that and she was quick to let me know that she could do it herself, as she hoisted herself forward and nearly fell to the ground. I leapt over the bed and reached her just in time - but not before I whacked the back of my leg around the Achille's tendon on something pretty hard. I think it was the metal IV pole. Regardless of what it was, it HURT... and it still hurts!


As for the job - STILL waiting to hear. I should hear something this week or next!