Day 12 ...and bowel obstructions
So far, so good.
We did a 3 hour study session on Tuesday and one hour session Wednesday and today. We are taking off Friday because both my study buddy and I have plans that evening but we will be back to it on the weekend. I am hoping that the concentrated daily sessions will help me retain all this material.
Today was also my middle clinical day this week. I have two patients with similar diagnosis. Both have bowel obstructions. One of the small bowel and one with the large bowel.
My male patient (SBO) is a very non-compliant with his care and recovery. He has been refusing his ADL's and complains of nausea in order to get out of walking the hallway. And he wonders why he can't pass gas! Walking will wake up the GI and help restore function. Instead of telling him what he had to do today, I said, "Would you like to take your morning walk at 9am or 10am?" That doesn't give him the option to decline and makes him think he is in control. :o)
My female patient (LBO) has not been as fortunate. After her colectomy they discovered the mass was colon cancer. I was with her today when her oncologist went over what to expect the next 12 weeks or so. She will have a port-a-cath inserted so that it will be easier to administer the chemotherapy. That will start in January. It is hard to watch a normally healthy woman in her late 50's be told that she has stage 3 cancer. Her comment was I can't even say the word "cancer". I have to admit the great bedside manner of her Doc helped her absorb all this new information.
Tomorrow I pick up a total hip replacement to make a total of three patients.
We did a 3 hour study session on Tuesday and one hour session Wednesday and today. We are taking off Friday because both my study buddy and I have plans that evening but we will be back to it on the weekend. I am hoping that the concentrated daily sessions will help me retain all this material.
Today was also my middle clinical day this week. I have two patients with similar diagnosis. Both have bowel obstructions. One of the small bowel and one with the large bowel.
My male patient (SBO) is a very non-compliant with his care and recovery. He has been refusing his ADL's and complains of nausea in order to get out of walking the hallway. And he wonders why he can't pass gas! Walking will wake up the GI and help restore function. Instead of telling him what he had to do today, I said, "Would you like to take your morning walk at 9am or 10am?" That doesn't give him the option to decline and makes him think he is in control. :o)
My female patient (LBO) has not been as fortunate. After her colectomy they discovered the mass was colon cancer. I was with her today when her oncologist went over what to expect the next 12 weeks or so. She will have a port-a-cath inserted so that it will be easier to administer the chemotherapy. That will start in January. It is hard to watch a normally healthy woman in her late 50's be told that she has stage 3 cancer. Her comment was I can't even say the word "cancer". I have to admit the great bedside manner of her Doc helped her absorb all this new information.
Tomorrow I pick up a total hip replacement to make a total of three patients.
posted by SVN, prn at
7:37 PM
1 Comments:
Wow, sounds like a tough group, both emotionally and procedurally. I wish you luck. Sounds like your abilities will be tested while treating these patients.
Good job using psychology on the non-compliant patient. Sounds like you are learning how to get done what needs getting done! :-) Bravo!
Dustin B.
By
Dustin, at 10:02 AM
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