Someone's hero
By the end of our last day of our long-term care clinical experience (which lasted three days), I was getting a little frayed. I was exhausted from getting up at 5:50am, and pretty maxed out on new experiences. However I wasn't about to pass up on the chance to learn how to clean a tracheostomy.
To clean a tracheostomy, you need to maintain a sterile field while removing the long inner cannula (tubing that lines the inside of the tracheostomy tube) and cleaning it aseptically. I felt like a bumbling idiot as I tried to use sterile technique to get on my gloves. I got the trach tube out OK, but getting it in was another story. I thought to myself, "What's wrong with me? This is much easier than doing an oil change. All you have to do is stick the tube in the hole! Anyone who can baste a turkey can do that!"
However, imagine that you're tired, and you are sticking the tube down the throat of a person who is silently gagging and contorting, with the instructor looking over one shoulder saying "turn it, turn it!", while Spongebob blares out on the TV. A talking yellow sponge will now forever be ingrained in my head as linked to tracheostomies. It was just a little much. I could handle trach care or Spongebob, but I just couldn't take them both together.
Long term care has its good and bad points. The nurses in long term care are mainly the managers, who oversee a unit of nursing assistant. The CNA's provide most of the actual client care. Wound care specialists and respiratory therapists circulate through the unit each day as needed. The nurses manage the nursing assistants, write reports and distribute meds.
Much of what we saw was very sad. Some of it was end of life care, and some residents will be there for years. Some had limited or no cognitive awareness. Some were completely immobile. Some had very tragic stories. Some were comfortable, and some were not. The unit did an excellent job of caring for the residents and the hospital was an outstanding facility, but in some cases, we had to question the quality of life. It took only one day for me to personally feel very much in favor of assisted suicide. One classmate commented, "What kind of nurses are we??!! We want to kill our patients!" I think it was more that we very much wanted to relieve suffering, both physical and emotional.
There were very rewarding moments as well. I was able to take one client out for a walk in a wheelchair. Even if the client doesn't remember it the next day, for a few minutes the resident was outside in a garden. At one other point, another student was trying to understand what a client with a tracheostomy was saying. Finally she deciphered that the client was saying my name, asking for me. Wow. After only two days, I felt like someone's hero. I can see where if you worked there for a long time, you would know all of the residents very well.
To clean a tracheostomy, you need to maintain a sterile field while removing the long inner cannula (tubing that lines the inside of the tracheostomy tube) and cleaning it aseptically. I felt like a bumbling idiot as I tried to use sterile technique to get on my gloves. I got the trach tube out OK, but getting it in was another story. I thought to myself, "What's wrong with me? This is much easier than doing an oil change. All you have to do is stick the tube in the hole! Anyone who can baste a turkey can do that!"
However, imagine that you're tired, and you are sticking the tube down the throat of a person who is silently gagging and contorting, with the instructor looking over one shoulder saying "turn it, turn it!", while Spongebob blares out on the TV. A talking yellow sponge will now forever be ingrained in my head as linked to tracheostomies. It was just a little much. I could handle trach care or Spongebob, but I just couldn't take them both together.
Long term care has its good and bad points. The nurses in long term care are mainly the managers, who oversee a unit of nursing assistant. The CNA's provide most of the actual client care. Wound care specialists and respiratory therapists circulate through the unit each day as needed. The nurses manage the nursing assistants, write reports and distribute meds.
Much of what we saw was very sad. Some of it was end of life care, and some residents will be there for years. Some had limited or no cognitive awareness. Some were completely immobile. Some had very tragic stories. Some were comfortable, and some were not. The unit did an excellent job of caring for the residents and the hospital was an outstanding facility, but in some cases, we had to question the quality of life. It took only one day for me to personally feel very much in favor of assisted suicide. One classmate commented, "What kind of nurses are we??!! We want to kill our patients!" I think it was more that we very much wanted to relieve suffering, both physical and emotional.
There were very rewarding moments as well. I was able to take one client out for a walk in a wheelchair. Even if the client doesn't remember it the next day, for a few minutes the resident was outside in a garden. At one other point, another student was trying to understand what a client with a tracheostomy was saying. Finally she deciphered that the client was saying my name, asking for me. Wow. After only two days, I felt like someone's hero. I can see where if you worked there for a long time, you would know all of the residents very well.
posted by Judith @ 6:18 PM
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