Last night was my first night alone. What I mean is that I have finished the number of shifts required to work with a preceptor and so I had to start working by myself, without my guide following me up.
During the last weeks, I worked with my preceptor Jaime. I followed his schedule, and handled the patients he was having. He provided me with the necessary information about the actual ward work, which cannot be explained in lecture halls. Learning the know-hows in the war are usually learned in the actual battlefield, they say.
And since it was my first night working alone, I expected a chaotic night. Before coming to the unit, I thought I would be given a light load. But I had the same load, as the ordinary staff gets, and so I had a very busy night. I was still very slow with my work, especially since I am still adjusting to the new environment, system and computer documentations.
I had a patient with Non-Hodgkin’s Lymphoma, who always want to get out of his room , so I had to disconnect and reconnect his IV tubing many times. Eventually, his IV cannula site got infiltrated early in the morning. He had very bad veins because he’s been having chemotherapy. He needs a new and good line because he’s having chemo in the morning. He also kept on bugging me about transferring him to a single room because his insurance covers that.
I had an old man who was involved in a road accident previously, which caused him now to be bed-ridden. He is on NGT feeding and because he is confused he pulled out his tube twice. The first time I was able to reinsert it. The second time, I was not able to do it because of a nasal blockage. I got help from my charge who eventually got it inserted. He keeps on sliding down his bed which caused him to reach his NGT even with restrained hands. He is also diabetic with blood sugar monitoring every six hours.
I also had a post tonsillectomy patient who came from surgery just a few hours ago. He complained of throat pain and difficulty swallowing which was relieved by tramadol. He was on IV antibiotics too.
I had a post TURP patient who had a foley’s cath that kept on draining. He was so obsessed about his uring bag that he would press the bell just to get it emptied, even if he did not see how much was in it. It would always be just a quarter full.
I had a patient who was post amputation of some toes on the right foot, and was connected to a vacuum machine. He presses the bell whenever he wants to go to the bathroom because he had to be disconnected from the machine. He also had fever early in the morning and on blood sugar monitoring.
Another patient was also a post op patient whose big ulcer on the sole of the foot was covered with a skin flap from the left thigh. He also spiked fever early in the morning.
My last patient was my admission directly from OR around midnight. I picked him up from the recovery room, and on the way to the ward, he vomited on the bed. My hands got vomitus as well after trying it by the kidney basin. He was on heparin drip, IV fluids, a foleys, and an IVAC. Later in the unit, he complained of pain so he was given tramadol IV. Just minutes after the injection, he felt weird and hallucinating. He started shouting saying he’s going to die. He said he was so dizzy and nauseated so I gave him metoclopromide IV. That settled him down until morning.
When I got home from work this morning, I had no more energy to prepare breakfast. I just had a glass of Horlicks and I crashed on the bed, as if I was knocked out by Manny Pacquiao.
Comments from READERS...