Clinical Day 1

I think it will always be a memorable day if only because it most assuredly had some very surreal moments, the kind that will definitely stick with me.

The clinical is more a sampling of what is to come and the first taste was a long term care facility. We had to arrive at the facility at 7 in the morning which might as well be 2am to me. Not a morning person now or ever. Looks like I will have to adjust in the near future anyway. We began by participating in a brief orientation and then went up to our assigned floor in two groups of 8. My group went off to get our patient's charts. I had always thought of a chart as a compact bit of information distilled into a few scant pages in a manilla folder. These were 2" binders packed more tightly than Wal-Mart on Christmas Eve. It was interesting because I could actually understand a fair amount of what I was reading which made me somewhat happy. Unfortunately, what I was reading was mildly disturbing. My patient is morbidly obese, has a trach (and therefore isnt very communicative), a colostomy bag, is not ambulatory, has uncontrolled diabetes and an unpleasant demeanor known on the floor. It is only a three day gig, but I definitely got the prize. Should make for an interesting assessment.

I also had the pleasure (?) to witness not one but two colostomy bags being changed. It was a different experience to be sure, and not because of the odor. The strange thing was that the stoma was protruding, in both patients, a few inches. The stoma is part of the intestine outside of the body. It is a strange thing to see on the outside of the body. I had no idea it protruded to such an extent either.......like 2 or 3 inches. It was truly strange watching the nurse remove the bag and then wash the intestine. I also saw a suppository inserted and a trach cleansed. All in all, a big day. I dont know if long term care is something I would ever be interested in, but it definitely has knocked down some barriers.

Off to relax and sleep. Another early morning awaits.