Clinical is going well. We just finished our rotation through the medical unit and I will be moving to the surgical unit next week. I've had a couple of interesting patients. The most interesting of which was a huge ethical issue. She has a history a mile long, but was brought into the ER for abdominal pain. She coded en route and required 25 minutes of CPR and was put on a ventilator when she got to the hospital. About a month ago she had been in the hospital for other intestinal problems and had a J tube (feeding tube in the jujenum) and an ostomy put in. She's been in the hospital for over a month, is fairly unresponsive, has a trach, and the doctors have determined that she will never recover. Her husband has accused the nursing staff of trying to kill her and the ethical committee had a meeting and was going to stop all of her life saving measures (but for some reason, probably the husband) they never did. Last week when I took care of her, her J tube was leaking copious amounts of bile everywhere and compromising the integrity of the skin around the opening. The husband was also ordered by the doctor to not be involved in any of her care while she is in the hospital - he was doing her tube feedings (mostly legal reasons I would assume). Taking care of her was an interesting lesson in putting your own personal ethics aside and doing what you have to for a patient in any given situation.
This week I had a couple of interesting experiences. I got to take out a chest tube on a deceased patient, and I had a patient that had a 3cm x 3cm abscess on her butt...it was over 8cm deep! I watched the wound therapist when she did a dressing change and repacked it. It was pretty gross.
Since Thursday's are my short days of class, John and I have been doing some hiking which has been great. Our hike last week was an interesting mix of excessive mud and snow. But it was nice to get out and do something!
