Thursday, May 08, 2008
Medical: They Like Me, They Really Like Me
I'm on to my medical rotation (my last) now. It's here at Hometown Hospital. My patient last night pretty much told me when I came to take his vitals and do an assessment, "I don't want you in my room." Um, OK, Am I going to assess you over the phone? By the end of the night this young man clasped one of my hands in both of his hands and was thanking me and asking if I'd be back the next night.
So, my patients like me. Is that a good thing? Is it like the teenager w/ the "cool mom". You know, the mom who doesn't give the kid a curfew and ignores the smell of pot seeping through the floorboards? Maybe I'm being too easy on my patients. Maybe I'm not pushing them to get out of bed often enough or I'm not encouraging them to do enough coughing and deep breathing or I'm bringing them too many graham crackers. Maybe I'm enjoying the "psychosocial" part of the assessment a little too much: "Oh, hm, do you still talk to your brother after that incident?... And you've been doing that job for how long?" Am I chatting?
God, do I love nursing for all the wrong reasons? I feel so lucky to be in this private universe of a person, to learn interesting things about them, to pick away at their lab values and wonder what is going on inside. It's a privilege to get past the taking of vital signs and to try to figure out what is really going on with someone and then to come up with solutions even if it just means moving a pillow. Maybe I like nursing because I'm nose-y and curious.
And then, at Hometown Hospital, half of my group's patients last night had substance abuse problems. Heck, my patient did. And, hm, half of the patients were in a lot of pain including mine. I'm told: Pain is what the patient says it is. And there are laws 'round these parts that we have to treat pain, but there's also a culture in nursing that suspects substance abusers of being "drug seekers". My nurse last night said "I don't want him to become addicted." (I'm taught: when used for pain treatment, very few people become addicted to narcotics) But, you know, substance abusers often have a lower tolerance for pain and maybe they're substance abusers in an effort to self-treat some kind of pain. Is it for me to judge? Well, yeah. My patient wasn't due for anything narcotic and when I offered him some-perhaps less "fun "-drug to help him out he said he didn't want it, so you gotta wonder. Yeah, he's probably a drug seeker, but he's probably in pain, too.
For my maternity rotation I had to follow up on a family after they'd gone home with their babe. I asked the new big sister (she's five) to draw a picture of her and her brother and that's it above. I love the big smile on the baby. It made my week and, phew, that was a tough week. I think a lot of my fellow Nursing School U students are going through similar breakdowns and burn out. I've heard lots of stories of staring off into space with the inability to do anything, other tales of going home and crying and I pass by tired looking familiar faces on campus where we both just barely pick up the chin for a "s'up" and scurry away with too many books in our backpacks and strategies for making it through the next four weeks in our heads. There's the Muscle Through It Strategy, The Countdowners, the I'm-Just-Going-To-Take-It-One-Day-At-A-Time folks...