Different Worlds

This morning Maria, Marianne and I spent it working at the hospice. Dr. Belknap came with us as well, and we definitely needed her. We started off with a very elderly and frail woman who has cellulitis and has a sore on each leg. The right leg had three very small ones, and Daisy (one of the parish nurses) took off the old bandage, cleaned it and placed a new bandage to show us how it was done. Then we got to do the left leg, which was much bigger but only about 4 inches long and 2 inches wide. It was the biggest sore I had seen in person since I started clinicals, little did we know what was in store for us next. All five of us then went to man’s room who is paralyzed from the waist down. For those in the medical field, he had three very large, unstageable pressure ulcers on his sacral area. Those who have no idea what a pressure ulcer is, in the simplest and least grotesque explanation, due to decreased nutrition, circulation, movement and constant pressure causes the tissue and skin to breakdown. They always showed us horrible pictures of Stage 4 and Unstageable ulcers in class so that we have an idea of what they are, but I think this was the worst than any picture I have ever seen. On top of that, the patient had gone to the bathroom and it was all over and in the ulcers. We had a huge job ahead of us and all ten hands would be needed. It was a very long and tedious process, cleaning, re-cleaning, putting on ointment and then taping it all up. He also had ulcers on both of his heels and on the backs of each knee. Even though the ulcers were definitely in late stages and I have never seen one in the hospital, they could not even compare to what was on his bottom. We changed his clothes and bed and when we were about to leave the room, I finally saw him smile. Even though it was a lot of physical and emotional work, it made it all worthwhile when he smiled. You could tell that even though he may have felt uncomfortable with the entire process, he was so happy to feel clean. We then talked with Daisy and she said usually she has to do all of that ALL BY HERSELF! We were all in shock, with the three of us working and Dr. Belknap and Daisy helping hold the patient, it still took us almost two hours to complete everything! It is absolutely amazing what these nurses do, Daisy was working today from 6am-6pm and was the only nurse for 10-12 very dependent patients. I have so much respect for her and even though it wasn’t my favorite thing to do, I can’t wait to come back and help Daisy out as much as I can. For the last 30 minutes we gave arm and leg massages to a couple of the patients, which they absolutely loved! It is amazing what a little rub on your arms and legs in good company can do for the body.

This afternoon was spent at the nursing home. We just helped feed the women dinner and then put them to bed. I am not the biggest fan of nursing homes, just because most of the nursing homes I visit I feel like many of the workers neglect the patients. Usually it is not because they don’t care, but because there is just not enough people to take care of everyone. That is exactly what this nursing home was like, for more than 15 women there is just one nun. So having the three of us there definitely helped with dinner and putting them to bed. It was interesting to see the difference between how the nun and Daisy (the nurse at the hospice) worked. Both of them are working on their own, but the nun was very harsh, short and not very compassionate with the patients. Daisy was so warm, patient and always had a smile on her face.