catheter pride

Whew! what a week- it's only wednesday but I am just exhausted. I've been up before five am all week, and it's definitely starting to catch up with me. We had our hospital clinicals on monday and tuesday, and they were fantastic! We were there for about five or six hours each day, but the time just flew by because we were constantly moving and working. it was so fun! we were on a neuro rehab floor so we had a lot of recovering stroke patients. (i'm sorry, i mean cerebrovascular accidents - not strokes)

We got to deliver the 0900 meds (no i haven't joined the military, but the hospitals do use the 24 hour clock to diminish errors), and pretty much do complete care for our individual patient each day. It was a little nerve racking at first, because as we're getting all of the meds together, we have a teacher drilling us on what all the meds are for, and what they do. But i was very prepared because i had spent at least 2 hours the day before making a comprehensive chart of all the medications my patients take. the chart includes the mechanism of action for the drug, as well as all the possible (and probable) side effects or interactions, plus any nursing considerations. Those considerations would include knowing to take a blood pressure and pulse before giving a hypertension med (so if for some reason the BP is really low, you don't give them medicine that makes it drop even more).

Yesterday was fantastic! i had a really high functioning patient (who was actually getting ready to be discharged i think today), and he was really patient with me when i ended up trying to get his blood pressure four different times. the machine that they use was not working right, and it kept giving a ridiculous reading (he would not have been calmly sitting in the chair talking to me if his blood pressure were actually 68/64), so i ended up having to move him over to the other side of the room where there was a cuff attached to the wall so i could do a manual reading. The best part of the day, though came when i got to insert my first catheter into a real live patient!! My patient has a neurogenic bladder, and has been cathing himself for the last ten years at least three or four times a day. So right before his 1000 OT (occupational therapy), i got to do a bladder scan to see if we needed to do the cath. The bladder scan is basically just an ultrasound machine, but it has a small digitized circle on the readout screen that will tell you how many mLs are in the bladder! Since he had about 526 mLs, we decided to use and in and out catheter to empty his bladder. The nurse was on the other side of the patient watching me, but i was able to keep my sterile field and get the cath in just fine! (he had brought a couple of extra kits just in case i messed up and broke sterile technique- but i didn't need them!) i was practically skipping down the hall afterwards i was so excited to tell my classmates!