Thursday, March 03, 2005

Remembering where I have been....(smile)

I was asked to do a presentation in honor of black history month. I wasn't able to do it at school. So I guess I'll do it here, in my blog.

It was my sophomore year of nursing school, spring semester. We had been in clinical for a few weeks now, and I kinda felt like I knew which end was up. Even though, I knew that I had a lot to learn about becoming a nurse. At this time of my educational career, we started our day at 7am on the floor to get report. (My day started at 5:30, but that is a different story.) Our beloved clinical instructor allowed us to choose our patients and she had a list that she was reading from. I can still remember the smell of warm coffee and banana from the random students having breakfast during report. She read about a patient, and she said that it would be a good opportunity to see a patient with end-stage syphilis. Here's his story:

Past Medical & Surgical History:
COPD, seizures/epilepsy, smoking, angina, HTN, DVT, MRSA, syphilis, hepatitis A, hepatitis C, gastric polyps, ESRD, peritoneal dialysis, MVA 1982 with head injuries, diabetes, IV heroin use, ETOH

Admission diagnosis:
Mental status change, hypoxia, end stage syphilis

History of Present Illness:
The patient was brought to the emergency room from the nursing home with mental status changes. He was hypoxic and hypotensive without his tracheostomy oxygen mask. Although the patient's condition improved with oxygen therapy, he was still admitted for further observation.

I wanted to take care of him, but I didn't want to step on anyone's toes. So I thought I'd wait for someone else to chime in. It was quiet. I looked around the room. No one wanted to take care of this guy. So I asked for him. She said okay. I could tell by the way she said okay, this was going to be an interesting day. I always start my day by introducing myself to my preceptor and reading my chart. I read my chart first, and I didn't know what to expect. I expected an old Caucasian man with soft, swollen, pink skin. I imagined that he would be soft spoken and shameful.

I finally found my preceptor and she said, "I have had to take care of this man everyday this week and it's not fair. These other little nurses should have to be responsible for him. He is mean. He will yell at you. He bites, scratches and spits and oh did forget to tell you he is extremely contagious? Welcome to nursing!" At that moment I turned the corner and went in to see my patient for the first time.

He was a long, thin, mahogany-colored man. He had a moustache and beard mixed with salt and pepper gray hair. He had large droopy brown eyes. He had a tracheostomy so his voice was kinda raspy. His body was covered in crusting sores that had concentric rings. There were a group of doctors standing his bed around admiring his penis, that was covered in golden crusted ulcers/sores that oozed a serous drainage all over the white sheets. It can't be fun feeling like a class assignment, so he was understandably in a bad mood. But as the day passed on, his mood gradually changed from bad to good. At times he became tearful because he wished that he had made some better life choices.

As the day progressed, I found that this man was not really mean (on this particular day), he was misunderstood and he needed someone to listen to him, and have some control over his environment. Then I thought of Nurse Eunice Evers who took care of the young men who were subjects of the Tuskegee experiment. She was a saint. She had patience and understanding. She loved those men. And because of her work, and the sacrifice of the lives of many young men, scientists have been able to study the course of the illness and discover treatment modalities.

The patient had a great sense of humor, he was polite and courteous, and he loved to teach me the different aspects of his care. I hated to see the end of the day. I think he did too. Before I left him, I said my goodbyes, and he said don't care about a dead man. From time to time I wonder how he is doing and if he is still alive. If I had the chance, I would thank him for the honor of being his nurse.

1 comment:

Anonymous said...

I don't know if you will check your blog messages, but just in case, I wanted to leave one. This was very inspiring. I am reading your blog from the beginning and just got to this one, which happened to be on my birthday. I am so glad you're blogging your life as a NONTRADITIONAL student nurse because I too will be one and was having a hard time finding a blog I could relate to! Thanks!