read at own risk: a few gross descriptions

i graduated from nursing school four years ago! and i can hardly believe it. i've been working on the stem cell transplant unit for 3 years and 8 months. i will admit, it took me a VERY long time to feel comfortable as a nurse. hell, i didn't feel safe for over a year. but it has finally begun to feel natural.

i can handle most situations that are thrown at me - related to transplant that is. i can treat the most severe cases of mucositis; i've seen people vomit the lining of their esophagus. i am not bothered by 4 liters of diarrhea on a 12 hour shift. and i can administer 8 blood products to three different patients before lunch time. but throw something new at me, something i don't see very often, if ever, and i regress.

this morning, in report, i learned that my patient had two holes of which i am unfamiliar. perhaps that's an inappropriate or strange description. but let me explain. my patient had both a PEG tube (a hole on the belly that leads directly to the stomach for feeding) and a tracheostomy (a hole in the neck that leads to the airway to allow for breathing). these are two "holes" that i have very little experience with and instantly, i noted my anxiety and blood pressure quickly increasing. in fact, i voiced my discomfort during report, in front of the entire staff, perhaps in an attempt to ask for help... but maybe, just maybe, to see if someone else was up for the challenge!

my 67 year old male patient has laryngeal (neck) cancer. he's had parts of his tongue removed, in addition to tumors in his neck and throat. he cannot speak. and now, he breathes through a hole in his neck that is kept open by a plastic device. all of that works fine and good when he is "healthy." but add some pneumonia to an already sick man and that airway fills up with gunk fast. i'll spare you ALL of the details, but imagine the most vile and putrid smelling substance. it was hard to even be in the same room as the man because of the stench, let alone up close, in his face, performing tasks i do not feel comfortable with to help him breathe. oh, what an interesting day.

i learned how to suction a patient. it's not that hard. it's just new. and at first, new things are scary to me. but i was reminded, once again, how vulnerable my patients are. this man, who is dying of cancer, cannot speak. he has no words to voice his thoughts, feelings, and emotions. yes, he can write with pen and paper, but imagine how exhausting, challenging, and unsatisfying that would be. i so often get caught up in my own feelings, my own fears and concerns, that i forget how brave my patients are.