Saturday, September 30, 2006

the Good with the Bad

Working in a hospital is always interesting. You see things you would never see in other jobs. To work there, however, you must take the good with the bad. You are usually seeing people at their worst, most vulnerable point, and you have to be sensitive to that.

In the short time I've been working in the radiology department I have seen some great things, but, unfortunately, some not so great things as well.

For example, on Friday I assisted with an UGI Series on a patient who had been complaining of acid reflux and abdominal pain. During an UGI Series the patient swallows barium and we watch it pass thru their GI tract on fluoro. After we were done and the patient was changing back into their clothes, the doctor pulled me aside and showed me some of the shots he took of her stomach during the exam.

He pointed to a large, rough section of her stomach wall and explained that part of her stomach was being destroyed by cancer and could been seen on the film. Stomach cancer is one of the worst to get and metastasizes very quickly.

It was a strange and sad feeling to stand there and know that this person has cancer and probably doesn't have many more months of life left and she didn't even know it yet. Up until then I hadn't really seen too many major pathologys, just broken bones, diverticula and hiatal hernias, all of which are relatively benign compared to this patient's problem. I'm thankful that I wasn't the one to have to give her the bad news, but I'm also thankful that I was involved in diagnosing her problem, so that she may enjoy the time she has left.

Fortunately, I've also been there when patients have received good news. A couple weeks ago we had another patient in for another Upper GI series but this one also included a small bowel follow thru, where you follow the barium through the small intestine until it has reached the juncture with the large intestine.

In this patient's case, the exam was ordered because his doctor suspected the patient had a bowel obstruction, which is a simple thing in concept but can be very dangerous and life threatening for the patient. He drank the barium and we watched for over an hour (taking pics every 15 min) as it passed through his upper GI and into his small intestine. He had already had a barium enema a few days before so the doc knew that his large intestine was not blocked, so if he was obstructed it would have to be in the small intestine.

But as we watched the barium progress through his system it was clear that there was no obstruction, which meant he would not have to have emergency surgery as the doctor suspected. I still remember the look on his face as the doctor told him the news that he wouldn't have to have surgery. He was so happy and relieved I couldn't help but smile and congradulate him on the good news. It was a good moment for me and I felt lucky I could be there for it.

3 comments:

Katie said...

I know exactly what you mean! It is amazing to be there when someone finds out good news (or meets their new baby for the first time!), but it is tough knowing bad news before they do. The worst is when you know the bad news but they haven't heard yet, and they ask, "Do you think I'll be ok?" *gulp* what do you say to that?

I saw a flouro for the first time last week- it was really fascinating!

Take care,
Katie, RN!!! :)

Mary said...

It's hard. It kind of hits you when you realize that wow that person has cancer. And then you start to think of everything. But like you said, you made that experience good, well as good as a UGI can be. You did your part, and did it well.

The hardest thing I had to deal with was a suspected stroke patient. She had been in 2 weeks prior for a broken hip which they didn't operate on due to age and health. To see her again, it was hard. And to watch her family crying as I took her to CT. One of those "walk quickly and try not to let anyone see" moments.

keep up the good work, and I love raeding your updates, so keep doing it! I don't always have time to comment, you know the whole clinical things, plus having kids, I barely have time to do anything!

ArizonaDB said...

Mary,

Thanks for the support. Some days its pretty hard being the student and feeling absolutely useless and in the way. But other days I have my own mini-triumphs and everything seems like it will turn out OK.

Thanks for the comment and I understand about not being able to comment much. At least I know someone is reading. ;-)

Good luck with school and everything.

Katie,

Congrats again on your RN. What an accomplishment. It must feel so good to finally see the "fruits" of your labor. Keep working hard and before you know it you wont remember life before you became a nurse.

Dustin