4N.U.R.S.E.S.
Saturday, October 13, 2007
Critical Care Orientation
4NURSES is my project. None other actually became part of the team for this blog. There are however, some new grads in the "SI," where I now work, which I might enlist in a collaborative discourse on nursing and growth in the profession. The corporate and site specific orientations are over and I have had two days on the floor, and my impression rings true that this is simply the "same job, different place;" however, I am now a critical care initiate, and, while I can rely on all the med-surg experience that I have gained, my clinical ignorance is sorely smarting. I am a hemodynamic novice, green to the patients I am greeted by, fearful that my preceptors will assume me to be more advanced in my understanding and relax so as to allow me to make a potentially mortal mistake, and more. I wonder some that things are not more rigorous, but I have two preceptors and perhaps I am first with the instinctual thinker.
As for the patients, first yesterday, a terminally morbid man, who I gloss over. Today I had a man who hautily held back from any physician for most of his life, then presented with a ten year history of CP & SOB; yet this wasn't his motivation for going to see a doctor. No, he had an ear ache, which rallying after a fifty year holiday, had him seek out his primary and then a specialist, who noticed that tumor growing under his Rt Jaw (perhaps the oral hyperplasias too)--the man was an inveterate tobacconist--by trade however, he was an "inspector" for a car dealership, when he was forced into disability by being "T-boned" by a truck which struck his vehicle--squeaked by that one with only some back and rotator cuff disintegrations. In any case, when intended to do chemo and radiation, they found him to have severe CAD and the decade of doleful dolore, he was sent for a quintuple bypass. I find him the second day after this. Not to mention that he has a PEG for the eventuality of esophageal swelling, and a recent history of stroke, without major residual, but with multiple TIAs that, because ignored, went undiagnosed. Notwithstanding all this, he progressed without complications today, and advanced through a perfect second morning.
As for the patients, first yesterday, a terminally morbid man, who I gloss over. Today I had a man who hautily held back from any physician for most of his life, then presented with a ten year history of CP & SOB; yet this wasn't his motivation for going to see a doctor. No, he had an ear ache, which rallying after a fifty year holiday, had him seek out his primary and then a specialist, who noticed that tumor growing under his Rt Jaw (perhaps the oral hyperplasias too)--the man was an inveterate tobacconist--by trade however, he was an "inspector" for a car dealership, when he was forced into disability by being "T-boned" by a truck which struck his vehicle--squeaked by that one with only some back and rotator cuff disintegrations. In any case, when intended to do chemo and radiation, they found him to have severe CAD and the decade of doleful dolore, he was sent for a quintuple bypass. I find him the second day after this. Not to mention that he has a PEG for the eventuality of esophageal swelling, and a recent history of stroke, without major residual, but with multiple TIAs that, because ignored, went undiagnosed. Notwithstanding all this, he progressed without complications today, and advanced through a perfect second morning.
Labels: heart, hemodynamic, ignorance, inspector, new job, orientation, t-boned
¶ 10:32 PM 0 comments
