Revisiting Old Sorrows

Every week in the nursing program we do a new "clinical prep"- this involves going to the hospital the day before we will provide care in order to pick a patient and do preparatory work (looking over the orders in the chart as well as researching prescribed medications and reviewing disease pathologies).  It's a time consuming process and perhaps the hardest part of my week.

Last week, I picked a patient who had not yet been brought to the unit from the emergency department, so I couldn't peruse the chart noncommittally as I usually do.  The assigned nurse was taking report over the phone.  I was drawn to this particular patient because the one piece of information that I had- that he had a tracheostomy and was on a vent- sounded like it would make for a good learning experience.  So I went into the nurse's lounge to wait out the 20 minutes or so that it would take the RN and ward clerk to gather enough information to put together a rudimentary chart.

After 20 minutes had elapsed, I went back out to the nurse's station, and I could see that it was slow going.  The nurse was on the phone with the physician regarding the patient's medications.  I toyed with the idea of picking a different patient, but I felt committed, so I retreated to the lounge to wait a while longer.

Finally I was able to get my hands on the chart and began the process of sifting through it for the  information that I needed.  As I skimmed through a rather lengthy medication list, hastily scrawling as I went, it became ever more clear that it was going to be a long night.  Prepping meds can be tedious work, but I was comforted somewhat by the fact that most of the meds would be given by G tube, a skill I enjoy practicing.  So I plodded along, until I came across something that stopped me dead in my tracks: Rilutek.  This unusual medication has one purpose: delaying the progress of the degenerative motor neuron disease ALS.  I know this because ALS took the life of my dad 8 years ago- it is an unkind disease that shows little mercy to its victims. "What are the chances?", I asked myself, as well as, "Can I handle this?  Should I pick someone else to care for?"

I can happily report that I did not pick a new patient.  The next two days were hard, but I kept myself together and provided the best care that I was able to provide to this man.  I did not shed a single tear or feel overwhelmed while in the hospital.  I was not preoccupied with memories of my father, nor was I overly detached emotionally.  I feel that I handled myself well.  Of course, once I was in my car and on the way home at the end of my second and final clinical day with him, I did shed some tears as I remembered my dad.  I thought about the cruel course of his illness and the deep, life altering pain that engulfed my entire family for many years.

I am now two weeks from finishing the first semester of the nursing program.  It has been difficult.  I'm still attempting to work full time, averaging 28 hours per week.  I'm still getting little support from my employer regarding my schedule (an ongoing source of frustration and something I don't wish to recount here).  The important thing, though, is that I'm surviving.  It is tough and it is certainly taking a toll on my health and well being, but I have done it.  I guess I shouldn't count my chickens yet, but I'm feeling very proud of myself.  Although it's bittersweet in light of the emotional ups and downs that I am put through, it's a victory.