Today was a nice day on the floor. My patient had a difficult disease process going on, but the day wasn't totally crazy for me. I think the key is being hidden in the corner room... Patient and I had our own little fiesta just chillaxin without the craziness of being in the middle of the floor. He had been in for a week while a bunch of doctors were trying to find out the best option for doing surgery on some internal hemorrhoids he had. Pretty classic ESRD case... labs with a mind of their own, lots of meds, dialysis, etc., with a bunch of other conditions like HTN, CHF, COPD, major dysphasia problems, etc. He was such a sweet man though. He was missing his wife and his dog, and he couldn't wait to watch "The Price Is Right." He was on a thickened liquid diet but was determined to eat every last bite. He was so good about trying to be as independent as he could although he was really weak and had a lot of arthritis pain. I know both of us enjoyed our morning of just being friends. He drew strength from me, and I'm sure he didn't realize, but I drew strength from him.
When I was feeding him breakfast, Patient asked me why my arm was swollen. I had no idea what he was talking about until he pointed to the tiny bruise and inflamed vein from a blood test I had yesterday. I told him it was just from a blood draw, and I could tell he instantly felt connected to me since he, too, had been poked all over for years. It's funny how something little can connect two people so well. While he napped, I sat beside him and comforted him when he woke up in pain. It's times like this that I'm thankful for, because I know when I'm a RN on the floor, sadly, there won't be time for things like that, the things that really matter like sitting beside your patient and just *being*...
Patient had something very neat that I couldn't help but look into. For his kidney dialysis, he had an arteriovenous fistula. I had never seen one before, but it was very cool to look at, and as the RN told me, it had a beautiful bruit when I listened with my stethoscope. An AV fistula is simply a surgical connection of an artery and a vein to provide easier access for hemodialysis in ESRD patients. While blood usually goes from arteries to capillaries to veins to the heart, these fistulas direct the blood directly from an artery to a vein. There is a lot of interesting information about this on VascularWeb.
If you are as medically-nerdy as me, enjoy these pics I found on that page :)
Tres cool. You learn something new every day, right?
Anyhow...
Lots of blah blah blah, but moral of the story? I'm happy I got to share my day connected with a new friend. :)
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