Friday, 5 December 2008

Three Patients

Well i'm back to fighting strength, which is good. I'm also doing really well on this I'm told. I have to admit that I am going to miss it. My time with them finishes on the 12th but I have four shifts to make up so it might be a little later than that. Its been a good placement and I've regained all the confidence I lost on my last placement. I am also enjoying being a student nurse on placement with no assignments hanging over my head.

Yesterday we had a patient who went for a liver biopsy, when he came back he hadnt had the biopsy and had an acitic drain inserted(a tube inserted to drain large collections of fluid). The bag this was draining into was only 500mls. after the first two hours of emptying this bag every half and hour I decided to attach a 1.5 litre bag. To my amazement the fluid was draining even faster, it appears as long as there is space it will drain incredibly fast. This fluid loss obviously had to be compensated for so we were hanging bags of FFP(Frozen Fresh Plasma) and towards the end of my shift we had to clamp off the drain and hang bags of saline. All in all the man lost almost 10kg in a few hours. This cant be healthy! but he said he felt great and the doctors didnt seem concerned.

We have another patient who was doing so well, he's been with us for months and was medically fit for discharge until he contracted the D+V the ward was closed with, he finally got over that and seems to be in decline again. His blood pressure is in his boots, he's tachycardic, and very pyrexial. All of which leads me to believe he's septic despite the high doses of antibiotics he's on. This is an example of a patient you cant help but get attached to and at 90 years old I am not sure he'll see discharge this time.

Patient number three had the entire staff of my ward in tears yesterday(myself included). He is dying, he is very much at peace with his fate, he has at best a few weeks left and just wants to die in hospital so his family dont walk into his room one morning and find him dead. He had written a poem to his wife that is by far the most beautiful thing I have ever read.

So theres my three patients, the healthy, the declining and the dying.

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