Truthfully, I came into this cardio placement just hoping for the days to whizz by so I would never have to deal with the topic of sputum again. This placement surpassed my expectations and for that I am thankful!!! Even though I never had much difficulty with the learning of cardio, it always made me a bit nervous - I think due to the fact that I didn't have any experience with anyone with much of a respiratory problem. Thus, even though I could rattle off the lecture notes, I don't believe I ever truly understood them. This placement and exposure to such patients that we have talked about the last 2yrs, really did help me to consolidate and actually learn what Kate/Sue/Nola have been teaching us. The staff on the ward and my supervisors were fantastic in helping me become competent in this area and to appreciate it. I can actually say that sputum no longer scares me and I no longer have the overwhelming urge to race away from a patient's bed the moment they even start to say the 's' word, let alone expectorate!
This last week I have had some interesting patients - all with a neurological twist for good measure! Post-polio syndrome, hydrocephalus and several with motor neurone disease. I have definately learned something about the art of the so called 'quad cough' in these MND pts. I have learned varied ways to go about it. For the one pt, it was only effective if done on her sternum with a wide open hand. For another, it was best to do with both forearms/elbows across the stomach.
In speaking of the MND pts and with reference to a previous posting, one of my MND patients passed away this week. When I was first called for some chest physio I was a little terrified as no nursing staff wanted to do anything due to the fear of putting him into brochospasm and him passing away under your arms. In his end-stage condition, in all reality he wasn't likely to ever leave the hospital. He was not for resuscitation and therefore I was just told to quietly close the door during treatment in the event he did pass away. You can imagine this is a bit overwhelming. He didn't pass away on that occasion, nor on any of the following 5+ treatments. He did slip away quietly later on Friday.
In such situations there is a fine balance between caring too much and trying not to care at all. I know that many who work in such situations all the time cannot afford to care too much because they won't be able to do their job and it may impact too much on their life. I have a tendency to care too much. Whatever one's strategy is for dealing with loss of life, I think it is especially important for those primary health care practionners who will be dealing with terminal cases to show those patients the respect for life that they deserve. I guess that in my mind it means obviously being compassionate and caring, but also taking those extra few moments to consider that person, those that care about them and the life that they have led on this planet - before letting them slip quietly out of your mind so that you can carry on with your job and your own life.
See y'all next week same time, same place, but different placement!
Subscribe to:
Post Comments (Atom)
1 comment:
Hi Donelle,
I think you have explained what i can only imagine was a very difficult situation beautifully. I have also just finished my cardio placement, and have been confronted by several acutely ill patients. Fortunately, none of the patients who I have been directly treating have passed away. Although, in the future if I work in the acute setting I fear it is only a matter of time.
As far as caring for your patients goes, it's only natural (despite what some patients may think of our treatments!) that we want them to get better. If you didn't have that genuine concern and compassion for others you would probably find yourself in a very different profession. Keep up the work!
Post a Comment