Chest physiotherapy

Today I did chest physiotherapy on a patient with cystic fibrosis. I've done it several times now with both pediatric and adult patients. The process is also called "cupping". It involves holding your hands like cups and then beating your patient's chest and back hard and fast with both hands for 20 minutes, with the patient in different positions. It helps to loosen thickened bronchial secretions. It is also a pretty good work-out for the person doing the cupping.

It is very bizarre walking past a room where someone is receiving cupping. It sounds like a blend of massage and karate going on inside. It is one of the few very low-tech therapies, but it's kind of fun to do. It's one of the few procedures that you can practice at home on your friends, and they'll still be your friends.

In the unit I am on right now, the repiratory therapist does the cupping. Generally, the patients have it done four times a day. I was watching the respiratory therapist, asking her questions about her technique. "Do you want to do some?" she asked, so I jumped in.

"How am I doing?" I asked my patient after a few minutes. "What grade do I get?"

My patient laughed and gave me passing marks.

Lectures on bladders

The subject of today's lecture was urination. We covered the subject in great detail. We talked about distended bladders, incontinent bladders, urine leakage, and urine output. By the end of this first half hour, I was squirming in my seat, ready for a quick visit to nature. Thank goodness the lecturer called a stretch break. But then the lecture went on. We heard about water intake, stress incontinence, urine back-up, and urgency. In five minutes, I was once again desperate to take a whiz.

They say that when medical students learn about diseases, they tend to become worried that they have the signs and symptoms of the illnesses they've learned about. I haven't felt the least worried that I have Hodgkin's disease or lung fibrosis or kidney stones. But after three hours of listening to a professor talk about bladders, boy did I have to pee.

Discharge teaching

Last week I did my first patient discharge. I was a little surprised when the nurse came up to me, held out a stack of papers, and said, "Here!" I think that most nurses hate the paperwork, and are more than happy to push it off on a nursing student. I'd watched one discharge before, but I really didn't have any idea of where to begin. But I figured the discharge was one more sink-or-swim challenge. How hard could it be?

I went into a corner, and read through all of the papers. I tried to figure out what each piece of paper was, and where the patient needed to sign everything. It felt a little ironic that what I was reading for the first time one moment, I'd be teaching the next.

I knew that the patient would be going home. I had worked with her the whole day prior, and I'd gotten to know her family and her habits. I had admired her embroidery, and chatted about her childhood. Now I'd be sending her home.

I actually loved doing the discharge. I'm sure I was far more conscientious about it than most nurses ever have time to be. I went over each prescription with her, and made sure she knew the dosages and times to take the meds. We talked about wound care and when to call for follow-up. I was enjoying it so much that I sprung a little pop quiz on her. "Tell me the names of the medications you are going home with." "How often should you take the Percocet?" I'm just a teacher at heart.

Once the paperwork was done, I didn't know how to actually send her off. The techs were all busy, so I went down to the lobby to fetch a wheelchair myself. Her husband got the car, while I wheeled my patient out to meet him. As I helped her out of the wheelchair and into the car, she turned, and gave me a big hug, and kiss on the cheek. The nurses really must forget how rewarding a discharge can be.

Pop quiz

In class today, the instructor threw a pop-quiz at us. She put up some questions on the overhead, and told everyone, "Take out a blank sheet of paper." That's a sure sign of a pop quiz. But half the class froze, and looked at her in panic. "We can't!" someone told her bravely. "We don't have any paper. We have laptops!"

Things have gotten a little crazy here. This semester is definitely a challenge of cramming way too much work into way too little time. If my entries are brief, there's a reason. I'm passed out unconscious on my desk from mental overload.

A note on the digital age in nursing school...

Last weekend, I submitted a paper at 11am on Saturday. By noon, my instructor had emailed me back that I needed to re-write the paper. I sent him an email to clarify, and by 2pm, he said he had read my paper, and it was great. This is on a Saturday. On Sunday I took an exam for my Adult Health class. The 1-hour timed exam opened on Friday afternoon, and had to be complete before Sunday night. Someone should write some legislation to shut down the internet on Sundays, so we can at least have one day off.