One of the concepts that I was able to reflect on for the last clinical experience was adherence. The patient that I was able to spend time with had a long list of comorbidities, some of which include, type 2 diabetes mellitus, congestive heart failure, cardiomyopathy, and coronary artery disease. However, the patient had very poor adherence to the treatment recommendations for these diagnoses. Once diagnosed with heart issues, the patient did not attend any appointments at the hearts doctors and eventually presented back to the emergency department for heart complications. The patient also has very uncontrolled diabetes and has not had a Hgb A1C under 10 upon any hospital admissions. Prior to this clinical experience I realized that a lot of people in the population have poor adherence to treatment regimens, however, this patient’s
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The patient had told a nurse before he was mechanically ventilated that he wanted to be fully sedated, he did not want to remember anything largely due to his anxiety. Therefore, the first nurse kept to the promise and had the patient fully sedated. However, the next nurse wanted to wean the patient to the lowest sedation that she could without agitation. When the nurse got to this level, the patient could be seen with tears falling down his face and was trying to fight the ventilator. The nurse explained that if the patient were fully sedated, his body wouldn’t begin to work on its own and start the recovery process. I understood that, however, it was challenging to see that patient in that state. I told the nurse that the patient was started to get very agitated and she decided to higher the rate of Propofol. As a nurse, I would try and find a medium between the two. I fully understood what the second nurse meant by allowing the patient to begin to recover, but I also felt bad because he was so anxious when the sedation was weaned
The patient had told a nurse before he was mechanically ventilated that he wanted to be fully sedated, he did not want to remember anything largely due to his anxiety. Therefore, the first nurse kept to the promise and had the patient fully sedated. However, the next nurse wanted to wean the patient to the lowest sedation that she could without agitation. When the nurse got to this level, the patient could be seen with tears falling down his face and was trying to fight the ventilator. The nurse explained that if the patient were fully sedated, his body wouldn’t begin to work on its own and start the recovery process. I understood that, however, it was challenging to see that patient in that state. I told the nurse that the patient was started to get very agitated and she decided to higher the rate of Propofol. As a nurse, I would try and find a medium between the two. I fully understood what the second nurse meant by allowing the patient to begin to recover, but I also felt bad because he was so anxious when the sedation was weaned