Tuesday, January 8, 2008

Reflections

I've been working quite a bit lately. In fact out of the last 7 nights, I will have worked 6 of them. The good news is that after tonight - I'm off until Sunday night. Yay!

I'm not going to go into all of the different patients I had over the last month practically - but there are a few that stand out.

Two of them are related to cancer & we all know that word cancer is not a pleasant one. I had a patient in her early 30's that had come in about 10 days before Christmas. I didn't actually get to meet her until Christmas Eve, but regardless - she came in with the diagnosis of pneumonia. When it wasn't resolving & she began complaining of a sore throat & trouble swallowing her food - they ran more tests. Come to find out she has esophageal cancer...stage 4. She has tumors all over her esophagus. With it being stage 4, there is literally nothing much they can do for her. It is too far gone. We're talking about a mother in her early 30's with 3 kids at home. Sooo heartbreaking! She was going to go ahead with chemo to buy herself a few months. I can't even imagine what it is like for her. You go into the hospital thinking you have pneumonia & get the news that you only have a couple of months left to live. That is so not fair!

My other patient with cancer came in last week. She is in her late 60's & has uterine cancer. She's gone thru 2 rounds of chemo & it's not helping. She started to open up to me about it & I didn't know the right words to say. I told her to try to stay positive - that anything is possible, but I thought to myself how easy that is to say when you're not in her situation. I thought about it a lot the next day & when I had her as a patient again that night, I encouraged her to talk about how she felt. I figured that she felt uneasy doing that with her family as they were very emotional considering the diagnosis and she seemed to want to open up to me. This was also the night in which the doctors informed her that the cancer had spread to her liver....that is really, really bad. She doesn't have much time either. So she told me about how her family was feeling & reacting. I asked her how she was feeling. She told me she was numb. That she's all out of tears. That she doesn't understand why God would take her this way. I told her I didn't understand either. I realized at that moment that she wasn't looking for answers - just someone that could listen without getting upset.

I had another patient - this one didn't have cancer, but boy did she scare me. She had a GI bleed and the GI doctor had found a large stomach ulcer & he cauterized it (to stop the bleeding). My first night with her was began a few hours after she had this done. She was a quiet lady - didn't really ask for much. After a couple of hours, she started vomiting dark colored blood. Not a huge amount, but enough for me to worry. Then she had to go to the bathroom & if anyone is familiar with a GI bleed - you know it has a particular foul scent. This patient definitely had it. So much so...her roommate went running out of the room! I decided it was time to call the doctor because the patient was pale, clammy & cold although her blood pressure and heart rate remained stable. Luckily I had requested another blood count when I started the shift because she had received a unit of blood earlier that day and it was never rechecked. I had the results back by the time I called the doctor. In the meantime, my co-workers were moving the patient to a private room because of that GI bleed odor.

I called the doctor & he was relatively calm. He said he expected her to bleed a bit more and explained to me why he thought this. He asked me if I thought she needed to be transferred to ICU. I told him I wasn't sure - her vital signs were stable, but she was definitely bleeding. He decided she needed something for the nausea/vomiting and another unit of blood. I was worried about her - she was sooooo cold & clammy...yet was complaining she was hot.

I gave her the medication & started the unit of blood rather quickly. Within an hour she had regained her color and now she was freezing instead of hot. I'll take that - much easier to warm someone up than cool them down. I had her the next 2 nights & she did wonderful. What a comeback. I thought for sure she was going to end up coding on me that night. My co-workers are so wonderful - they all helped out in getting her back to feeling better.

Those are the 3 patients of mine that have really stood out and I'll probably never forget those experiences. It's a quick reminder not to take life for granted & whenever I start feeling down about my problems - it shows me that my problems aren't so bad.

Time for me to get some sleep so I can be wide awake tonight. Have a good week everyone!

2 comments:

am4039 said...

I'm so sorry about the 2 cancer patients, how very sad. I'm happy that the last patient is feeling better. Enjoy your days off.

tendernoggle said...

I am so glad that you were there for that cancer patient and took time to hear her out...We do not understand these things now, but someday we will....God bless you.
love ya,
carlene