A sorta, maybe good day

I think today was a good day in clinical. Why? Because I was busy pretty much the entire time and I felt like I really did something good for my patient. Unfortunately, the situation that allowed me to be busy and contribute was my patient having a stroke. Does that make today a bad day? It was definitely bad for him, and it was very stressful for me, but I got to learn a lot and while we were rushing down to get a CT scan, I was the one providing the neurology docs with his pertinent history and current medications. I was capable of answering all of their questions, I explained what was going on to my patient, I worked with the team of nurses and docs to get him where he needed to be as quickly as possible. In that sense it was a very good day.

I guess I'm feeling a little bit guilty for being happy with what happened today. I'm glad I got the chance to help with an emergency situation, but I shouldn't be too glad because it means that my patient's health is declining. On top of that, today was my last day on 7-14 and I will probably never find out what happens with him. That part of school bothers me a lot. I want to see my patients' outcomes, I want to know whether they will be okay. Sadly, there is nothing I can do to change that part of the system.

My major frustration today was with the neurology resident. After forcing my patient to get up out of bed, despite being warned that he was very unsteady and barely able to walk, he left me there with a medical student and my patient sort of half sitting on the edge of the bed. This was incredibly unsafe for several reasons. First, my patient weighs about 350lbs. If he falls on the floor (which has happened) it takes about 6 people to lift him back up. Second, he is very weak at the best of times and understandably exhausted from everything he was put through that afternoon, he barely had the strength to help us move him back to bed. So, this doctor finished his exam and just walked away, leaving me and a med student with an incredibly large, exhausted, and weak man who we can barely keep from falling onto the floor. Thank god my clinical instructor was walking by the room and grabbed a few people to help us. I understand that docs are busy and very focused on their specialty and figuring out what's wrong, but the primary focus of every health care worker in the hospital should be patient safety. There is no excuse for what he did.

I have had other bad experiences with providers (doctors and nurse practitioners) lately. They get too focused on diagnoses and orders and forget about the basics, like safety and comfort. I do not expect to ever see a doc giving a patient a bath, but I do expect them to make sure that if they cause a huge mess (such as a patient vomiting all over himself during an NG tube insertion) that the nurses and techs cleaning up that patient are okay and have all the resources and information they need before the doc leaves the room. That way we don't have to go harass the doc while he's writing his orders or seeing another patient.

All of that being said, I am going to miss 7-14. It was a good floor with (mostly) good staff. I've heard very contrasting reports of what my next floor will be like, so I'm keeping my fingers crossed.