Saturday, July 24, 2010

It's getting better....

finally! Thursday ended up being this great clinical day that I was not expecting.As soon as I received report from my RN, she let me know that my patient needed a straight cath for a urinalysis and urine culture. Sweet! Starting the day off with a new procedure is not too shabby. I've done regular indwelling, Foley catheters before but never a straight cath. I've also only done one female cath and it was unsuccessful. The patient was young and in labor with no epidural or pain meds and it was just not going to happen.

I stood in the hallway and talked through the procedure with my professor than headed in. I had my cath kit and I examined the patient first to find my landmarks. Let's just say, the female genitalia is much different on a live person that on the mannequin in skills lab! I than began prepping my sterile field. I donned my sterile gloves and continued with the steps. My first try was unsuccessful but I wasn't upset about it. My patient had an atrophied urethral meatus that had shift to the side and it was pretty hard to see at first. Plus she was so contracted bilaterally on her upper and lower extremities, my instructor was literally holding her legs with her elbows because it was so difficult. On the second attempt with a new sterile field, I nailed it right away. It was such a thrill to see urine filling the bag. I took my sample for the lab and we were good to go!
My patient had a seizure disorder and I ended up putting pads on her rails. She had contractures and was non verbal. Due to her difficulty swallowing, there was consistent, copius amounts of this frothy mucous bubbling out of her mouth. I suctioned her constantly all day. She also hadn't had a bowel movement in 2 days so I administered a few stool softeners. They worked ! She pooped! My friend Gem, who helped me clean her, and I were so excited when she pooped you would have thought we had won the lottery. We changed her and her bed, only to have her go again! Yes! Great job! We waited a bit, just in case, and than cleaned her back up. I felt proud...weird I know....but the meds worked and now she doesn't have an uncomfortable tummy!

I was able to pass her meds through her g-tube and felt 100 x more comfortable than the last time. My teacher even praised me for knowing my meds and their info. Gem and I teamed up as a bed bath team to help each other bathe our patients. They are hard to move with their trachs and tubing....and it's just hard trying to roll a patient who is immobile.

Overal it was a great day. I felt as if I had overcome some fears and challenges as well as tried new things. I don't know what next week will hold, but it can only get better!

God is good :)

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