Wednesday, July 12th, 2017

Geriatrics Is Not Always A Story Of Death

February 22, 2011 by  
Filed under Certified Nursing Assistant

As a nurse, we all have those days, weeks, perhaps months, to get really stressful. Sometimes they are raw and can also leave us wondering why we have chosen a profession both physically and mentally exhausting. Occasionally, however, we are dealing with someone who shows exactly why we do what we do. In these cases, the patients, gives us the inspiration we need to do our job, no matter how much tax you can.

I had a new head nurse on the floor at that time was willing to own. It ‘was his second to last day, so he was doing his thing and I was there for support. It took a full load of patients so that when the UCI wanted to send me a case of palliative care, I brought it to my “just a patient.” I like to be involved in the end, with great care and was happy to see the possibility of being able to devote all my attention to this patient and his family.

She was a 89 year old woman who had come to a pleural effusion in the right lung. His arrival condition was serious enough that she had a chest tube and was sent to intensive care. She was placed on BiPAP where it remained stable for a week without improvement. The 90, the anniversary patient, the family decided to withdraw from BiPAP. ICU staff was out with the family gathered around, but to everyone’s surprise, she kept breathing on his own … effectively. She called oxidation, but only with a nasal cannula. It was still not responding at this point. It was decided to transfer her to the floor and put on palliative care. His transfer orders were only tolerated for food (she did not answer), NS at KVO @ 10cc/hr to Morphine 2mg hours as needed, 02 @ 2 liters and q2 swing. The chest tube was placed waterseal, and it has been.

When they raised it, I took a look at fair and knew that the transfer of bed ICU of our bed, would it. Transfers of patients who had looked so bad, he always was. But it has survived the transfer. During his trip planned fourth night, she opened her eyes. I stayed in the room and did a neurological eval on it. It was not verbally answer me, but I follow his eyes and nodding his head could. Hospice nurse had already spoken with the family about the expectations at the end of life, when they realized that there is often a slight improvement before the final fall. But something felt different to me about it. I leave the rest of the night out just to take care of her, but does not pursue any aggressive.

When I returned the next night, reports nurse said: “I do not think this is all for it.” I felt it yesterday I took it as a single new patient. that night. When I went to my evaluation, which was in a semi-Fowler position and alert, looking around the room. I asked him how was your day, do not expect your response, and to my surprise, she said: “I feel so bad, honey.” !

Granted his speech was very confusing and difficult to understand (he had slept with 10 days of open mouth was dry, and do not have teeth), but I could not do it. I started talking to him and ask him some questions about the nervous system control, which was looking for. It was a bit ‘confused about the dates in a clear and slightly foggy exactly what was in the hospital, but was easily oriented! When I asked him, I said it was 2008 and Bush was in office. He even asked if he had a heart attack! I flabberghasted this level of improvement. I explained to him what had happened and gave an account of his stay until today.

The family did not know what to think. They could not understand his speech at all. It was very frustrating for them and for her, so I spent a lot of time just to interpret the things she said. All she said was so appropriate, and she even joked and told me stories about her late husband and gardens they planted. She told me all about his canned vegetables and pies. When I tell her family what she said they were surprised it was so clear! I sat there all night. She was stiff lying in bed so long, so I kept her legs. She had a firm belief that Aloe Vera was the “cure all”, then I rub almost a whole bottle of the substance on all the pain and grief she had. After “aloe massage” you can see how much more relaxed she was. She thanked me a lot to her. We talked and laughed, and I fluffed and puffed for hours.

We were all surprised when he expressed his interest in girls ice later that night. She had not eaten for almost two weeks! She (very slowly) ate half a cup of vanilla ice cream and drinking water. Then I wanted a Pepsi. His hand-eye coordination was very poor. I tried to help the cup, but she told herself. She did the same. Slow and safe, with a few spills, but it did. I could not believe what I saw!

We tried to get her teeth, so you can understand, but his mouth was so dry and remain in force. Son-in-law sent him out with a new bottle of aloe and some Fixodent. We had a good laugh the last time I used a denture adhesive.

But I do not understand, he was able to give voice to the things that made her uncomfortable, please let us know how to turn it mean to me and his family that he does not want so much morphine. I was so excited and I felt so relieved that he was able to participate in her care. And I can not tell you how good it felt to indulge her every night and spend a lot of time with him and his family. Closer to the morning she told me to go home and tan his shoes (“those are the only ones that fit well”) and his rolling walker, because he wanted to walk!

Now, remember, everything we do for this woman is 10cc of saline in the hours and iv morphine. His family and I, after a good conversation in the lobby, decided it was time to act. They all agree that they still do not want to be “aggressive”, but his support was a must.

I was on the phone all morning, a case management and documentation to get his fluids rose to a surgeon who has a chest tube put back in its case to get things ordered to support him if he wanted to turn his bus and go back the way!

When I left this morning, he sat on the bed to eat cream of wheat and thickening of the Journal. I told him I was going to be away a couple of days (going to a weekend trip) and he shook my hand firmly and said, “Thank you, precious good care of me.” I let go as a child. Tore, tore the daughter of … It ‘was so touching. His family expressed their sincere thanks. Many hugs were handed out.

I told myself that when I’m back at work managing the cases have been domiciled. When I returned from my trip, I happened to see if she was still there. It was. I returned to the stock room and had her little walker and sat in the chair eating his porridge as shoes. He took his daughter to a minute to understand who I was. I think a different look in my clothes. But the second I saw my patient in the door, his face lit up like Christmas. She looked at me, pointing down at his shoes beige and Walker, and gave me a wink. “How was your trip, morning glory?” Question.

I can honestly say that the care of this woman and shows his amazing turnaround has changed I can see my work. Although his result was positive, caring for her has increased my interest in palliative care nursing. I plan to join forces with other nurses in my body and to improve and educate people so that we take care of the dying patient. Because of his nurse, he also stressed that the costs of overtime and that is a step in my patients. You never know how much difference a little time and a bit ‘of aloe vera can do:. Wink2: Finally takes care of this woman made me a better lawyer for the needs of my patients. He made a comeback, all by himself.