Revised out of HIPAA considerations...
Second day with the ... wound, and first experience of patient vulnerability. Today went much better than yesterday. I even had quite a bit of down time, which was nice, because it means if I had been a "real nurse," I would have had time to take care of some other patients as well...
The one thing that bothered me was that I had come up with a schedule: Percocet prophylaxis, out of bed for lunch, ambulate, dressing change. But the patient was in sort of a bad mood and told me to just go away and not bring any pain meds unless called for. But the patient has to eat, ambulate, change dressing! So, when do I go back in? My instructor kept saying, not now, not now... well, I ended up getting out of clinicals about 1.5 hours late... And I was standing around getting anxious in the meantime...
Anyhow, after having that triple lumen drain come out yesterday, the wound was sopping with liquid today. The surgeon came in just as I was starting the dressing change, poked (poked!!) his finger all around the wound, and declared a dry packing rather than a wet-to-dry. After the surgeon, the patient was in quite a bit of pain, and today I experienced for the first time the feeling of having a patient be extremely vulnerable and the de facto trust in the nursing staff that must occur.
It was a strange, not pleasant, but not unpleasant experience. I myself am quite emotionally vulnerable but keep tight control over the information that people get about me in order to manage that. I don't have much experience of other peoples' vulnerability, either. Or maybe that's not true. Perhaps it is that normally when people seem vulnerable to me, it seems to be because of their own hang-ups and misperceptions, not because of a non-elective surgery or circumstances beyond their control. I found myself feeling quite bad for this person and rather distressed that I didn't have a better and faster technique for changing the wound.
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