Poggles Is A Big Boy Now

When Poggles was a baby, he pooped everywhere.  He couldn't control it.  Today, however, is a big day.  Poggles is a big boy now, and he only does his business in the litter tray (hurray!).

So, the oven tray can now go away.  I will have one less thing to clean, and Poggles can enjoy soft, warm "carpet" everywhere.

After a thorough cleaning of his cage, Poggles was unceremoniously dumped out of his dirty pouch into his clean toilet (poor boy). Don't worry, he is dumped from the ground level.

 He scrambled quickly to hide under the wheel as I began to populate his cage with his belongings.  He got a fresh toilet paper roll to play with, a clean pouch...

 ... his food bowl and water bowl came back clean, his dome and cosy came back, he got a fresh paper towel, his ball... and everything was clean.

Of course, Poggles hated it.  He came out and sniffed everything, deemed them unsuitable, and went back under the wheel.  He did this several times, each time concluding that it was unacceptable.

He slept there all afternoon, and only moved into the new pouch once I gave him back one of his dirty fleece scraps (tsk tsk!)  After that, he pulled the paper towel so that it was plugging the entrance, and hissed at anyone that disturbed him.

Yup, he's a big boy now.  That doesn't change how grumpy he is though  :)

Week 3 of Semester 4

This was a pretty busy week so I was back to my bad habit of not sleeping enough.  I zombied my way through a group presentation, assignments, and homework.  What really tired me out though was clinical.

I had it easy last week.  My patient was only sub-acute and I had a lot of extra time to putter around bonding with patients.  I think my teacher knew I wasn't being challenged enough so she gave me an extra complicated patient this week.  I also got to start on medications.

Tube feeding
This was my first experience with feeding tubes.  I had only seen suctioning tubes before this, and we had only just learned about managing feeding tubes in lab.  Now, here I was with a feeding tube before me.  I was pretty intimidated.

However, once I had gone through the process of delivering medications by the feeding tube once, it began to seem pretty straight forward.

There's a lever on the tubing.  You open the port, put the syringe in, turn the lever, and flush it with 10 ml of water.  Turn the lever, take off the syringe.  Suck up the medication (which is crushed and mixed with 30 mls of water), put it in the port, turn the lever, inject the meds. Turn the lever, take off the syringe, suck up more meds, do the same thing as before.  When you're done, you flush it again with 30 mls of water, close the port, and you're done!

Okay, so it doesn't sound so straight forward in print.  I swear it's easier in real life!

Teacher Feedback
Anyhow, it was quite an experience, and I had to remember to keep the patient upright before doing this to prevent choking.  I liked how the teacher gave me feedback on what she saw, and then asked me how I thought it went and how I wanted to improve for next time.  It made me do some thinking and it helped me to review what I had read and what I had just learned from the experience.

Parkinson's Disease
This was also my first experience with Parkinson's Disease.  The pt basically had no (or extremely limited) control over their own body (twitching, shaking), but the mind appeared to be aware of what was going on.  Worst of all, the patient couldn't talk and sometimes could only whisper quietly.  I found it incredibly distressing.

I felt that the patient was at the mercy of the nurses, and if something went wrong, the patient couldn't call for help or even  push the call button.  I didn't like seeing the patient with such little control over what happened.  It would be one thing to be unconscious like that, or to be a baby, but this patient was aware of what was going on.  I can't put my finger on exactly why I find that so frightening, but it is very scary to me. Maybe it's because it reminds me of being trapped in a doll that can't move or talk, but can move its eyes, think, and feel.

Anyhow, I did my best.

It's Worth It For The Smile
I told the patient every little thing before I did it so that they were not surprised, and I talked the patient through any procedures done by other people (ex. inserting IVs or drawing blood).  I asked for permission before I did things, and the patient nodded or shook their head (thank goodness, they could at least move the head a little).  I leaned in beside the patient's head so that I could catch the whispers when they came through, and heard little comments like "I'm scared" that broke my heart. I felt so bad for the patient.

I did get a smile once though.  That was nice.  Parkinson's often creates a mask-like expression in patients so I didn't expect the smile.

Sore Feet
I don't even remember what I was doing, but I was walking/or speed walking a lot around the ward.  There were always supplies to gather, people to find, things to do.  My feet were super sore at the end of each day.  I was walking gingerly when I got home.  Maybe I need better insoles or something.

Fatigue
I was so tired.  I was emotionally drained from wanting so badly to be good to the patient, and physically tired from lack of sleep and hard work.

It has been a good experience and good learning this week.  I wonder what next week will be like?

Enjoy yours!

Week 2 of Semester 4

The second week of Semester 4 has gone by, and it was a good one.

Homework hadn't quite gone to the killer level yet, and I got my first patient to care for independently in clinical.  He turned out to be a really nice guy, and since I wasn't giving any medications yet, the workload was light.  I ended up helping my nurse out a lot, and the nurse spent time teaching me about different things on the ward, and showing me different procedures.

Some of my favourite moments this week:

Taming the Sheet Monster
There was a patient loudly crying in a room.  The LPN said, "Wow, it's been a long time since I've heard that around here."  Unfortunately, he was on his way to do something so he had to hurry off.  I didn't see anyone else around to intervene and there were no contact precautions on the room door, so I walked in to see what was wrong.

The patient was tossing and turning and crying about how she was uncomfortable.  She seemed to be all tangled up in her sheets.  I know how much that bothers ME, so I talked soothingly to her and set about fixing her sheets up.  I think she was feeling tired, stressed out, and uncomfortable, and the tangled sheets just tipped her scale.  Anyhow, after I fixed her up, she seemed to settle down.  I put her call bell in her hand and told her to call if she needed someone.

You're Not Alone
After I said good bye to my patient, I heard another patient moaning/sobbing in her bed.  I walked over to check what was going on, and found her very distressed.  She told me that she was all alone, and that she was frightened.  I explained to her that she was not all alone - there were three other patients in the room with her.  I pointed them out to her, and reminded her that there were also many nurses bustling about just outside her room.  "I can't see them though!" she said.

I realized that her eyesight must be poor even with her glasses, and that the dimmed room made it impossible for her to see the other patients.  I told her about how it was quiet time in the hospital, and how the lights had been dimmed so that patients could take a nap, watch some TV, and relax quietly.  They were all still there around her, they were just sleeping.  "Just because you can't see them," I said, "doesn't mean that they're not there.  There are people all around you.  You're not alone."

All the soothing talk seemed to make her feel better. She thanked me and I tucked her into bed.  I suggested that she take a nap too, and she agreed that it was a good idea.  I adjusted her call bell so that she could hold it in her hand.  "Push the button if you feel scared, " I told her, "and someone will come here to check on you.  The nurses are just outside your door."  She smiled, and I felt good inside.  It hadn't been a very hard task, but I think it was important.

Why I Do This
That sort of sums up the gist of what the past week has been like.  It was a very good start to the semester, and I am looking forward to the rest of it.  I was worried that I would fail and that the learning curve would kill me, but these experiences have reminded me about why I am going through all this trouble.  I know that I have the ability to help people even if I don't feel confident about my skills yet.

Lovely Teacher
Also, I am starting to really like my teacher.  She is so darn polite!  I could really learn a thing or two from her in the manners department.  I think she could tip-toe around most uncomfortable topics without offending anyone and still get her point clearly across.  She's also very knowledgeable.

I hope you all have a wonderful week!