My Experience With Dementia

Day four of clinicals was really long. The first patient was scheduled from 8 until 1, he was getting fitted for 4 crowns and an implant crown. When the patient came in he had a horrible odor and looked like he hasn’t taken care of himself in months. I seated him down and the dental assistant just glanced at his teeth and looked at me strangely and whispered come here and look. I look in this old man’s mouth and saw nothing but a brown layer of plaque and calculus build up and it disgusted me. How could someone not take care of their selves? Anyways, we ended up sending him to the hygienist's room next to us and they cleaned his teeth extra good. He came back into the room and Dr. Williams came in and quickly did a check up on his teeth and

My second clinic rotation is internal medicine and I’ve had many encounters, both with patients and colleagues, which have made me pause and reflect. One of those encounters, in particular, will still be on my mind long after I finish typing this reflective journal. The patient at the center of it all is a lady I’ll refer to from here on as “Mrs. Flowers.” Mrs. Flowers is an 81 year old female with dementia and diabetes. She arrived on our unit with a diabetic foot infection that had progressed from a simple toe ulcer to wet gangrene. Over the last 2-3 months, gangrenous changes encompassed the distal half of her left foot. During pre-rounds, our medical team unanimously agreed that we would contact surgery for a consult. At time, it was obvious

Week three in clinical was difficult for me, I had a great experience overall but I hated seeing and holding a baby that had passed away at 21 weeks. To know what the family could possibly be going through was heartbreaking. I wouldn’t exactly know what to do if I was with the patient and her family exactly. I do know that I did place her in the room when she was admitted to triage. I do feel good about seeing the scenario play out, while being a student rather than being in the field alone. Other than that I was able to see the beginning stage of labor as well as a C-section. Everyone was so bent out of shape on making sure I eat and that I don’t faint, but it seriously wasn’t bad. As a matter of fact I was too intrigued with the mother rather

The clinic that I am doing my clinical rotation is a small family medical office with one physician assistant and one doctor. It is located in Collier County Naples, Florida. Naples is considered as one of the richest city in Florida with a diverse ethnic group like Caucasian, African America, Asian, Latinos, Haitian, and much more. They see any patients start from 6 years old. Most of the patients who come to the clinic don’t have a medical insurance. They are self-paid. My preceptor is a professor of physician assistant at Nova University in Florida over 20 years.

Though I have another year and a half before I complete my schooling, it is always important to find out as much information about my future field of work. Knowing what is to be expected when going in for a job interview will not only be a bonus for myself, but allow me to feel confident when giving answers.

I was born on September 20th, 1997 on the coast of Virginia Beach. Now living in South Carolina I am 19 years old and living a very healthy and eloquent lifestyle. As I filled out the Real Age questionnaire I encountered many questions that made me think if my diet and health were flawed, while other times it seemed as if I was the pinnacle of health. I found at the end it had me down as a 16-year-old teenager. This three-year difference in what my age and what Real Age had put me down for really opens my eyes about how well of a healthy lifestyle I am living, and motivates me to continue living it to the best of my ability.

I sat at the kitchen counter, staring at the green cabinets and bowls of fruit. I wanted to play in tonight’s soccer game, but my mind was still foggy from the drugs I received in the hospital the day before. I didn’t want my teammates to see me like this. My hair was matted from where my head rubbed against the blue hospital pillow, and a wrinkled piece of clear tape secured a nasal feeding tube onto my cheek. I hated what the tube meant: that I was inadequate and that I couldn’t drink by myself. I was someone who insisted on doing everything on my own, and the thin, flexible tube was a physical reminder that I could not. My mom and dad lauded my bravery, but I dismissed them. I didn’t believe bravery was dictated by necessity.

I could claim the experience was done out of kindness, but a need to overcome guilt for avoiding a late uncle due to weird behavior was the primary motivator. It was later explained he had dementia, a secret guarded by family fearing social stigma. Early interactions as a companion were often met with unpredictable cries for god and uncontrolled movement frightening and pushing me out of my comfort zone. However working with an interdisciplinary team of dietitians and nurses and attending seminars provided invaluable practical experience and a chance to learn appropriate care procedures for individuals in vulnerable positions. Consistent and proper use of time allowed me to assist staff by looking after additional seniors allowing them to provide more care to each individual.

One thing that did not go as I expected was maintaining professional boundaries with a patient because one of the patients was using appropriate word and make me uncomfortable during the second weeks of clinical which is I didn’t expect to be happening. The second experience that did not go as expected was unexpected behavioral change during community group discussions

Today in clinical, I offered a male patient to perform a full bed bath. It was my first time performing a full bed bath on a male and the thought of this made me feel a little nervous because I had only practiced this task in the simulation lab and the thought of performing peri-care on the male gender was intimidating. I began to gather my items and throughly think about how I would normally perform a bed bath on a female and the difference of genital areas. As I brought the items into the room, my patient was friendly and helpful in directing his preferences of which areas he wanted to be washed first. His friendly personality made me calm down in a situation where I would normally be on my toes, as I was not thinking about my

My first clinical I felt my greatest accomplishment was not being shy and hesitant. The first day we had clinical was the first day that I got the opportunity to float to another floor, I was very nervous at first. Going into a new place for anyone is different at first because you don’t know what to expect. I think what made my experience so great was the endoscopy nurses and doctors, they were some of the nicest and helpful people I’ve met so far. I got a wonderful opportunity to learn next to the doctors doing the procedures and also see other roles of the healthcare team like the nurse anesthesiologist.

Today was the second day of my 6-week placement at Ward 3A-Logan Hospital, I have originally been paired with a demand casual pool RN, however, the said RN is not confident enough to handle me as her student nurse at the time. After the scrum at 7am, and the handover on the 4-bed bay + sides, I politely ask her if I could take one patient as it was one of the instructions of my CF during the orientation on day 1, but I was answered with “I’m not really familiar with the area and I’m from the demand casual pool...” Having sighted my CF at the corridors, I excused myself from the RN and discussed the matter to my CF, and she allowed me to be buddied with a very good EN, informing me that “she is an EN” before letting me to the bay and introducing me to my new buddy EN.

Growing up our fears circle around things like monsters under the bed and in the closet, but once we reach the adolescent stage the monsters are a lot less physical. We almost become like superheroes unable to be harmed, indestructible. Situations where we are the ones lying in the hospital bed are few and far apart. I had forgotten I am not invincible, and rather than blowing off the amount of pain I was in I should have done more about it.

I am sorry for your loss Tacarla. It is important to have advance directives or living will because it will guide family members on what the patient’s wishes are, even if they do not agree with it. I recently took care of a patient with an end-stage renal disease; he stated that enough is enough and he is stopping all treatments. The patient did not have an advance directive or DNR. The doctor explained to him and his family what it means if he stopped treatment and encouraged him to sign a DNR. Refusing treatment is the patient choice of forgoing all life-sustaining treatment; therefore a sign advance directive is needed to honor the patient’s wishes (DeSpelder & Stickland, 2015). The patient was ready, but the family was not. The family asked

Sometimes some doctors do not give enough time to listen their patient. Back in 2011 I had moderate car accident, my pain was mild. I do not remember when the doctor ask me how sever is my pain but after few hours observation they/ED decided to d/c me. The nurse told me the prescription is sent direct to pharmacy, l may pick it up on my way to home. When l went to pharmacy, I found out MD prescribed percocet 10/325 and hydromorphone 8mg po PRN. I was shocked, why the Dr orders the strongest medication 1st? Anyhow I did not take it, instead l bought motrin from overthecounter, it was effective enough to control my pain at that time. If I was not a nurse I would definitely take the narcotics 1st then I might suffer because of the quenceqience.