Monday, April 27, 2009

Week 10 - MCA II Finale - real cute boy

Picture: Courtesy of the Web: National Association Down Syndrome - Adult Center)

We rounded out our medical surgical rotation with a nice little final exam on ICP and other complications from neuro trauma and the like (truly you don't want this) and we had a wrap up in the other classes with presentations and potlucks. I'd collapse in bed at night ...wishing for the end of term.

Clinical found me in the Med Tower with a leukocytosis patient with very loose stools. Nursing students somehow always manage to end up with these patients. I haven't had one until my last rotation day. I guess I was saving the best for last.

As I completed his assessment he asked for a hug and told me that he was a 'real cute boy.' How could I disagree? My patient was a middle aged adult with Down Syndrome. I practically pulled the rug out from under Trudy to get this patient. I have a real fondness for my friends with DS. Giving him a hug and holding his hand, I let him listen to his own lung/heart and bowel sounds. He had ticklish feet and the assessment felt like a fun little game, rather than a chore. Even when feeling like garbage, my patient was happy, albeit in a sore, dehydrated and slightly elevated temp sort of way. He didn't have a care in the world.

My last hours in MCA II were spent watching Bonanza with him and cleaning up some of his 'loose ends' ~ For some reason, I managed to go an entire 10 weeks without a single splash down until the final day. As Trude fetched me some linens and pads (probably relieved that it was me dealing with this for a change) I was intrigued with the notion that I didn't mind how unglamourous it can be (sometimes, it is dirty work)..but there we were -chatting up a storm about Hoss, Little Joe and Pa.

He giggled and laughed about everything and nothing at all. The 7-up tasted good. The rash hurt, the wash cloth felt good. The incentive spirometer was an exercise in futility. I think I needed it more than he did. I charted and tried to figure out what I could do about the perianal rash that was developing due to the two day advent of acid laden loose stools. After a nice paint job with barrier cream, we talked about friends and how everyone had nice eyes, pretty hair (especially care nurse Jaime). We talked about eating slow (I should really take my own advice) and not eating so much. He wiggled his toes, sat up in bed and wanted more 7-up. I remember thinking that the idea of 7-up sounded so good....

I think it was rather cathartic to end the term on this happy note...a pretty rank and dirty splash down...strip bed, paint job, one med, a couple hugs, ticklish feet and a real cute boy.