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3rd day of clinicals...blood issue rears its ugly head


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Okay. I'm tired. I am on the home stretch now! I have been thinking about ways to be prepared when the issue of blood comes up because you know it will. Since I have not worked as a nurse for 9 years I have been recalling scenarios to mind how I use to deal with it. But, back then I knew the others that I worked with and could trade out a patient or a favor, or on rare occasions administer it in the event of a crisis. But last week our instructors said as 'students' we were not allowed to give blood. Easy peasy! A no brainer---that's right in my wheel house.

Soooo, today the doctor orders blood. No problem. I don't have to give it as a student. Fast forward. Patient is on the bench about taking it. I make myself scarce and retreat to the lounge to work on some care plans. My preceptor finds me and asks me in front of my instructor and a lounge full of various team members if I would mind going to talk to the patient since I had a 'way with the patients' and conscience him to take the transfusion. Okay. Now I am thinking she is waiting for me to jump up and go and my instructor is watching to see how I respond. Do I say 'I'll be happy to help in any way I can because his H and H is critically low' and demonstrate that as a NYSE I realize the 'importance' of a transfusion--and also show I am a team player or do I now make my stand known? I figured that ship had already sailed once I thought I would not have to give blood. I definitely did not want to debate my religious beliefs at this point in a room full of strangers. So I took the 'safe' route and said I was afraid I did not want to be a part of persuading someone who was oriented that they should do something they were not completely comfortable with. I then stated after much studying about blood and the proven risks that I was not convinced that people benefitted firm accepting it. In fact there has been many studies to show contrary. I stared to bore them with bloodless hospitals and the studies they have done that show patients have actually had fewer complications and shorter hospitals by not partaking if transfusions. By this time I was really on a roll. And do you know what? They all looked at me as if I had revealed a third nipple.

After all that the nurse goes 'so I take that as a no?' Some people just don't want to give up...

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On no blood dot org  there is a post with link to Jefferson U showing benefits of a new bloodless liver operation and how bloodless is better for patients. Article is only a couple of days old.  For now you can link to the comment on right side of front page.  I gave the print out to my cardiologist today.

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Whew!!! Had to look that one up!

History of cancer whch has now spread to his lymph system which basically means the cancer is being spread throughout his whole body. In addition to this has developed a new rectal bleed resulting in him laying in a pool of blood. His hemoglobin and hematocrit has dropped crictay low 6 and 18 respectively and will only continue to drop because of the active bleed). This resulting in the decision to give blood. Unles the bleed is stopped they will just be buying time until they figur a game plan. Try and keep him alive till family arrives? Or rush him to surgery when he is such a poor candidate? No good options. I was doing the happy dance when it was time to leave. I can't really see how he could make it through the night. Lots of tough decisions-so thankful none of them depend on me. All I am there for is to keep him clean, as comfortable as he can possibly be for the condition he is in, lend him dignity and support and validate his life. Support, comfort, and a listening ear is just about all I can do. Important? You bet! Will it extend his life? Not by one minute. Only Jehovah can do that. But it is within my scope to extend him compassion up the wazoo and allow him to talk or reflect without judgement and offer whatever hope I can. I love my job!

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I'm glad he isn't suffering anymore.  Sometimes, doctors don't know when to say 'when' with the tx.

 

Leslie, I didn't realize you were in a student position.  Do they make you do a certain number of clinical hours before you can get back in as a full-fledged nurse?

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