Goodbye, Nursing Home

Last Friday marked my last day at the CLC (Community Living Center, or the nursing home), after 3 weeks. I did not expect to have enjoyed working at a long-term care facility as much as I did. I enjoyed it so much (I commend Amanda for preparing me with everything I need to know about working with older adults). At the CLC, assessments are more scheduled and I feel included as a team member alongside the MDs, RNs, CNAs, PTs, OTs, social workers, and recreational therapists. I also enjoyed getting to know the veterans, and their families, better than in an acute setting.

Three of my patients passed away last week. One was a hospice patient with a massive tumor in the abdominal area, whom I had seen for an initial assessment last week. Another was a tube-feeder, already in a pretty bad shape when he was transferred from the ICU just a few days ago (I did get to do the calculations for his tube-feeding and talk to his wife about feeding him for pleasure). And last but not least was my case study guy, a renal & diabetic patient whom I saw as an inpatient when he was getting a BKA, then as a hemodialysis patient. He had a pretty complicated life in the social aspects as well (his wife has dementia and his son passed away a month ago). I am sad. I think I had grown slightly attached to him.

More on working with older adults, I did some education for a guy who has hyperkalemia and "brittle diabetes," which if I remember correctly, is a type of diabetes with episodes of hyper- and hypoglycemia (very unstable). It was also interesting because he had suffered from TBI previously, so he has some cognitive impairment. He seemed to be compliant, but who knows if he can retain all that information.

Although most of the veterans at the CLC are all sweet, and I mean sweet little old men, there have been some difficult, grumpy old men I had to see. In particular, I had to see one who was not satisfied with the meals that he's getting (he has a long list of standing orders because he doesn't like anything). I think he lectured me on how the VA's food service system could be more efficient than the present for about 20 minutes. Fortunately, I was able to escape from his room by making some compromises around his foods and ensuring him that I would take his points to the supervisor. I was glad to have difficult patients as they do exist, and it was good to practice working with them.

3 more weeks of clinicals! I hope you all are enjoying your experiences!