Clinical Week 4, Day 1

First of all, YEP, I failed the biomed exam. Nuff said.

Now, today started clinical week 4. Guess what my patient said?

"Yeah, I like you too, but I want that other girl."

I think I smiled in clinical today for the first time ever. Why? Because *I* am "that other girl." His nurse and I were both in his room, but he can only see shadows of figures and ironically his nurse for the day also happened to be black. So as shadows of figures we look the same, but our voices, of course, are different. So when he asked for someone she stepped forward first to see what he needed and he started talking, but when she responded he said "oh, no I thought you were the other girl." And of course she laughed and made some funny comment about not feeling loved anymore (she's great and new and still happy and fresh as a RN) and that's when he gave her the consolation line before turning to follow my voice. You can't imagine. Here he is 80+ years old, been in the hospital for over two weeks for a heartattack because he's homeless and we can't find a nursing home placement. His girlfriend ended up in another hospital right after he came to ours, and they have been evicted from their apartment in the mean time, but he doesn't know that yet. All day he swears it's 1966...must've been a good year for him. None of his daughters visit because he has a history of violence driven by alcoholism. He apparently tried to kill their mother. Oh, and of course he, too, was restrained. Why do I always get the restrained ones? Anyway, I took his restraints off today because he wasn't threatenting to me, but it's always different at night. Patients who are combative usually become that way at night. He also is in chronic pain because of his gout and is used to numbing his pain with alcohol and percocet(oxycodone), but in the hospital he only gets Tylenol. But believe it or not they have given him beer at the hospital the first few days to help his withdrawal! (I'm shocked by this) But whatever, all that matters was that I didn't kick and scream all the way thru clinical today and that my shave, homemade heating pads, and thorough cleansing of his dentures gave me a leg up. Finally.

AND, the patient I took care of last week is still on the floor. Remember he couldn't speak and I had to ask a million questions so I could do a big careplan. Well I went to visit him and his wife and he was truly happy to see me. With his voicebox in working order again, he said "where were you? I've been looking for you." And he actually told me some of the things I had joked about. His wife had told me he had a wicked sense of humor, so I had made lots of jokes while I was giving him his bath - things like how great it must feel to have two women washing you from head to toe, and how I didn't care for his favorite topic (he is an American History PhD) because I didn't think history had been to kind to people like me and what's up with that? etc. So he finally got to talk and tell me about his life. Interesting. Anyway, my clinical day just got better and better with every word.

Then my preceptor told us we can lighten our careplans now which means less work and fewer hours! (This mainly means we only have to do 3 diagnosis for each patient instead of 5, with 4 interventions for each diagnosis instead of 6, and we only have to report abnormal labs instead of ALL labs.) I know it doesn't seem like a lot, but believe me, that's at least an hour less than we normally spend.

What a great day. Not even an F in biomed could bring me down off this high.