Saturday, October 29, 2005

a tale from my surgical internship

this march i did my surgical internship at the gynaecological ward at our local hospital. the patients there were women having hysterectomies, laparotomies, laparoscopies, recto- or cystocele repairs, chemically induced abortions, d&c's, et cetera.

my patient was a young woman of 26 years, a mother of two, having a laparotomy for menstural pains & heavy bleeding. it turned out she had severe endometriosis, and it was during her surgery that the doctor decided to take out her left ovary.

some of the nurses categorized her as a "difficult" patient, because she kept asking for more pain medicine during the first night after her surgery. she had previously had some psych. issues, so they were essentially saying it was all in her head.

the next morning after her surgery, she pressed the call button when she was eating breakfast. the in-charge nurse asnwered her call. the patient said "i am bleeding really bad, please hurry!" we ran to her room. she was sitting on the edge of her hospital bed, her hands pressed against her scar, and there was a large pool of blood on the floor. we had her lay on her bed, raised her feet with pillows and called the doctor. her doctor arrived pretty soon, and started opening her stitches right there. the in-charge nurse and another nurse were assisting her. the surgeon gave her a shot of lidocaine c. adrenaline but it didn't take effect right away, as the doctor was pulling the stitches out. the poor girl was a) very scared and b) in a lot of pain. she was screaming from pain and terror, and kept asking if she was going to bleed to death. her doctor, she yelled at her patient. she said "you need to shut up, and stop this whining! you're a grown woman, for pete's sake!" as the doctor and the nurses were working on the patient, all i could do was to hold her hand, stroke her hair with my other hand, and tell her it was going to be alright. i told her that the analgesic also had adrenaline in it, which would help stop the bleeding, and how i could see the bleeding starting to diminish. the doctor repaired the bleed, stitched her up and added staples so the cut would hold better and left the room.

when i went to see her later during the day, she told me she's always been scared of being operated on without being under general anesthesia. when she had her first baby, she ended up having to have a c-section. she was given an epidural and the doctor started to make the incisions. the epidural had not taken effect, and she could feel it all. her doctor would not believe her and continued on. when she had the next baby, she demanded a general anesthesia. i don't blame her one bit. she said she wanted to get out of this place asap, to which i responded that i understand her feelings but it would be safer for her if she stayed as long as needed.

my next day shift was the evening shift, from 1:30 to 21:30. the patient had already been discharged when i arrived for my shift. the in-charge nurse (the same from the day before) told me that essentially she left against the doctor's orders. she also told me that the patient had asked her to tell me, that i was a big help during her bleeding ordeal and that she wished she had not crushed my hand squeezing it so hard. it felt good to hear that. really good.

P.S. i don't know what the point of this post is anymore! i started writing this in june but never finished it until today.

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