This week I really started to feel like a nurse. I had my first 12 hour shift at the hospital, which I LOVED. It's so nice to be able to get everything done that I want to get to done for my patients. I was finally signed off on injections and gave 2, did 2 dressing changes, removed a hemovac drain, and admitted a new patient! My friends and family have started to seek me out for medical advice! I am able to explain things to them and actually know what I am talking about. I have recently been having some minor health issues of my own so have been interpreting my own labs, and linking all of my Dr.'s plans together. I love pathophysiology and I find it so fascinating how our bodies just work......until they don't. I appreciate the knowledge that I have gained, and while it is typically very fulfilling to be able to explain to my smoking friends the precise mechanisms by which they are greater risk for a stroke or heart disease, it doesn't always feel so good to know exactly what is going on.
A friend of mine was recently diagnosed with Cancer. He has tumors in his brain, in his lungs, as well as in his GI tract. He recently lost his wife to kidney failure. While he is not the youngest buck in the barn, he is one of the kindest people I know. He has a history of stroke, hypertension, asthma, and continues to be a heavy smoker/drinker. I probably would too if the Dr. gave me such a poor prognosis. I ran into this friend the other day and was greeted with the usual warm smile and hello. Something was different. Up to this point, the disease process hadn't really taken much toll on his outward appearance. I immediately gave him the Nurses hand shake to check his pulse and it was not palpable, his hands were extremely swollen. I looked down and his sandals were completely undone as to try and accommodate his growing feet.....peripheral edema. I took note of his complexion....white as a ghost and clammy.......dammit! I asked if he was having trouble breathing.......of course he was....he was filling up. I demanded a list of his prescriptions and prayed that out of the 10 listed medications, the one that I didn't recognize, was some type of diuretic....not so lucky. Everything in in me says CHF.....Late stage CHF.
I believe this because I decided to be a nurse. I picked out the school I wanted to attend and I devoted every ounce of my brain power to completing my pre requisites and to keeping my marks high, so that I might be accepted into the very competitive program I wanted to attend. I believe this because once I got into school, I worked very hard, I studied....alot. I believe this because after only 2 weeks in school, I was spending 2 days a week in the hospital....dealing with people who were experiencing this. I am confident that given my friends history, this is exactly what is happening, because in the past 10 months, I have learned to trust my gut. If I saw him in this state 10 months ago, I would suggested he put his feet up and get some rest....I know so much more now...because I decided to be a nurse. I am not entitled to make that diagnosis....it is a medical diagnosis after all. And alas, I might be wrong....
I beg him to go to the ER and even offer to drive him. I try to explain in layman's terms, exactly what is happening in his body so he might understand why I want him to go. He explains that he doesn't want to mess up a radiation appointment for tomorrow and might go in in the next couple of days. I ask him again to please go NOW. No luck. A kiss on the cheek and he is out the door...that was Wednesday
There were a few mutual friends around who have decided to be things other than nurses.....They asked what was going on, why was I freaking out....all I could say was that he was really sick and he needs to go to the hospital. I tried to explain what was going on in his body, but either they didn't understand, or they didn't care. It was enough for them to understand that he sick. They attributed it to his Cancer. Suggested that he just needs to go home and rest.....
I got a message last night (Friday) from one of those friends. He was in the hospital "his lungs were filling up with fluid".
Part of me fells like "I knew it!" and part of me wishes I knew as much as everyone else. I only hope he got there in time. Sometimes it feels really good to know exactly what is going on, and sometimes it feels like crap. When you know something is wrong, and you are pretty sure what is causing someones symptoms AND CANT HELP.....
I decided to be a nurse.....that means that I will work as a nurse, probably in a hospital setting. I will do research, I will wear scrubs, I will bring a stethoscope, I will help people....It also means that 24 hours a day, 365 days a year, I know about illness and disease processes, I know signs and symptoms of infection, hypertension, hypotension, hyper/hypoglycemia, shock, DKA, delirium, Alzheimer's, MI, stroke, heart failure, anaphylaxis, allergic reactions, cold vs flu, depression, anxiety, arthritis, ICP, asthma, emphysema.......just to name a few. It means that I am ALWAYS aware of these things. Because I am a student nurse, not a nursing student, and because it is not the scrubs or the environment that magically make me a nurse.....it's who I am all of the time. When I leave the hospital, I can't forget about everything that I know....it's starting to become second nature. I still have sooooo much to learn! but this week, I really felt like "I am getting there".
xo Alana- Student Nurse
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