Monday, November 9, 2009

Third Week: New Team

I've finished my 3rd week here in Porto.
I started with a new team this week! We are Medicine Team A on the 3rd floor, and we care for male patients. The set up is almost identical to the women's ward, there are big rooms with several patient beds.
I talked a bit already about what I perceive as a lack of privacy with the current room/bed arrangement in the medicine wards. Today, one of our patients who suffers from heart failure had a "spell" of shortness of breath with a lot of anxiety. He also had other complaints that were suspicious for an acute coronary syndrome, so we had to do vitals, EKG, aspirin, morphine, etc...The point is that there were 2 nurses, 2 med students, 2 residents, and our attending crowded around this patient's bed. Keep in mind that there is another patient within one arm's length of our patient's bed. I knew that my focus should be on our acutely ill patient, but I found it very difficult not to be thinking about this other patient who not only has to witness all of this activity, but also was almost completely involved due to his proximity!
Well, coincidentally, this other patient soon became directly involved in the activity. Once our patient was stabilized and arrangements were made to transfer him to intermediate care unit, I made a quick run to the restroom. As I was leaving the bathroom, I heard a lot of activity around the room. My first thought was that our patient was having another spell. I ran into the room to find that the patient in the bed adjacent to our patient had coded!!! There were now about 10 people, a crash cart, and and EKG machine surrounding the patient's bed. Now, OUR patient, by his proximity, was directly involved in the scenario! At that point, I was worried not only for the coding patient, but also for our patient having to witness all of this. Would the stress be too much for him? Well, to my surprise, he was resting comfortably in his bed. Maybe he was just "morphinized" (as my resident likes to say) and was oblivious to his surrounding. But I looked around and there were 4 other patients in the room, and they were all just going about their business. One guy was eating his lunch and did not seem at all phased by the events going on around him...Anyway, luckily the patient survived the code, and our patient is still "morphinized" and resting comfortably in the intermediate care unit.

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