During the clinical experience this week I was able to interview a 79 year old woman who is wheelchair bound and has a colostomy. She reports she performs colostomy bag changes and dressing. She also reports she has an open wound near colostomy site due to a “popped stitch”. She is currently being treated for Arthritis, Sciatica, Fibromyalgia, Anemia, Depression and Panic attack disorder. She reports she recently suffered a myocardial infarction but states she never had hypertension, hyperlipidemia or hyperglycemia. She currently takes Oxycontin, Endocet, Xanax and Ambien. She has a VNS nurse the visits regularly and a home aide that is there daily. She was friendly and cooperative with a sad demeanor. She reports her depression symptoms are so extreme at times that she will not leave the house. She has attempted suicide in the past.
It was a great experience to meet with her since my current employment deals with mental health and substance abuse. I felt rushed while interviewing her because I had to return to the group within a certain time frame and her nurse would be coming to take her to a follow up appointment. Due to the time constraint I was unable to conduct any teaching with her which was necessary regarding the myocardial infarction, colostomy and medication management. More time needed to be dedicated to her or a follow up visit needs to be conducted. This experience reminds me how health care professionals need to slow down and take more time with certain individuals. Certain populations are more vulnerable than others and need our full undivided attention, thorough assessment and appropriate follow up.
I had a short community clinical experience during my associate degree education shadowing a VNS nurse to patient needing wound care. I realized at that time community health nursing required excellent time management skills and a vast array of knowledge and resources to care for these clients. I am aware that my nursing and case management skills are a work in progress but I am lacking in the time management area. This clinical experience will make me aware of the areas I need to focus on to be a competent community health nurse when the time comes.
