My last night with a preceptor went well. I pretty much handled everything on my own, but I think I'll always have a few questions to ask here & there. It was my first night having 5 patients. They were all ladies - very nice ladies. My first one was in with an allergic reaction. She's 49 yrs old, was in a motorcycle accident last year that pretty much destroyed her left foot. She was on antibiotics to control the infection & even though she had been taking the antibiotics for over 6 months, she somehow developed an allergic reaction to one of them. The thing is - they don't know which antibiotic is causing the reaction. So they have taken her off all antibiotics for a few days & will restart her on them one at a time to try to figure out what is causing the reaction. She has to have antibiotics in order to fight off the infection, so they need to figure out what will work for her. I felt bad for her, she was itching all the time. She had a red rash all over as well as a prickly type rash where you could see the red raised bumps. She did a show & tell with the x-rays of her left ankle & leg. It's unfortunate, she'll probably never be able to bear any weight on that leg because it was so mangled in the motorcyle accident.
My next patient was a new admit, an older woman (in her late 80's) that came in with difficulty breathing. She was exhausted from being in the emergency room for so long, she just wanted something to eat & to get to bed. She had a really bad cough, one of those where you cough so much it actually hurts your body. I showed her how to use a pillow to splint while coughing. She said it helped a little.
My third patient was another older woman. At the moment I can't even remember why she was there. Aacckk, I'm losing my short-term memory! Oh wait, she came in because of syncope (dizziness). She has muscle spasms that travel from one leg, then across her back & down the other leg & she loses her ability to stand. Her & my first patient were fixated on having a bowel movement - funny how people in the hospital are so focused on that. Gave her a little prune juice & she slept pretty quietly through the night.
My fourth patient came in with a nosebleed that would not stop along with pneumonia & a COPD exacerbation. The bleeding had finally stopped the day before, but now instead of coming out her nose, it was going into her intestinal track & she had a consult with the GI doctor today. She kept asking me for a back massage - as if I was a massage therapist. Needless to say, that didn't happen. I didn't have the time to devote to giving massages.
My fifth & final patient was a woman on reverse isolation. Her WBC count was 0.5 - that is very, very low. She also was very pruritic (medical term for itchy...lol). They didn't know what was causing her to be having that reaction, but luckily the medication we switched her to finally kicked in after a couple of hours (Atarax). After being in her room & my first patient's room - I was suddenly starting to feel itchy after watching them scratching all over - weird how that happens, isn't it? Although I think my itchiness is from changing both my laundry detergent & fabric softener. Thing is, I'm not sure which is causing the reaction. I guess I'll throw them both out & just go back to my usual.
Anyways, another uneventful night. Uneventful - I like that word. It sounds so meaningful & descriptive, doesn't it? Basically it means the night went well & there were no crazy episodes that had me running around not sure of what I was doing. My preceptor filled out my final evaluation form & my check-off skills pages (so to speak). And that is it. The past 10-12 weeks have flown by. Amazing how much I've learned & how much confidence has been built up. I'm no longer a student nurse, no longer a grad nurse, no longer an orientee. I am finally on my own. I am a nurse.