Reflective Journal Med Surg, Ridge Meadows, Maple Ridge.

Student Name Dermot Connolly Stenberg College April 14th 2013

Monday April 14th 2013 I was excited to receive a new patient this week, Mr. Freshwater, an 83 year old Caucasian male admitted for aspirations. Mr. Freshwater was moved from his residential care home facility and presented with a unique set of challenges and competencies which I was happy to accept. He suffered from dementia and had a history of aggression while also being unable to communicate coherently. It became apparent after my initial visit with Mr. freshwater that it was not going to be possible to determine his level of orientation or listen to his posterior lung auscultation. All of Mr. Freshwaters medications were on hold while his physician assessed his reduced level of consciousness since his admittance. As a result, Mr. Freshwater did not sleep very well the night before and had become more restless as the morning progressed. I experienced no problems while taking his vitals in the morning where I found him quite cooperative but he did appear a little uncomfortable when I was checking for his bowel sounds and lung auscultations. As I suspected, I was unable to listen to Mr. Freshwaters posterior lung auscultations as he appeared to be in great pain whenever he was moved in his bed. I had also noted from his chart that he had a history of chronic pain back. Mr. Freshwater was a two person assist so I had asked George to help me give him his personal care which proved to be quite a challenge as Mr. Freshwater was not comfortable with being handled, washed or changed. Several times he swore and tried to hit us as we attempted to clean him which was certainly a unique experience. I found that this week was a great opportunity to also practice my maintenance of IV lines competency where I had the opportunity

to administer Mr. Freshwater an antibiotic (Moxifloxacin) via a piggyback line following a physicians order to administer the antibiotic and Haldol for the clients increased levels of agitation. The administration of the Haldol was also a unique experience for me as it was my first subcutaneous injection that I administered that was not insulin. It was also my first time to administer a subcutaneous injection out of a glass vial using both a filter and regular needle. I am quite excited to be getting a second patient next week as it should mean that it will be really busy on the floor which I like. I think it will also be a good opportunity to practice my time management skills while working in a pressured environment.