code white...

second week on rehab. i picked up a man who suffered a right cerebral artery infarct (aka stroke) in the beginning of last december. reading his H&P, i was amazed he made it to rehab. he was supposed to go to hospice because he declined so rapidly, but then started getting better. now he almost has regained use of his left arm and can walk with assistance. before his stroke he didn't have anything major going on...it's hard to imagine going from being completely independent to that disabled overnight. he was pretty easy to take care of. i'm hoping i'll get a more challenging patient on my next rotation (surgical). i loved the nurses on rehab, but i doubt i'd want to end up working there. it's not as hectic, but it's too laid back for me.

there was a young male on the unit with a TBI (traumatic brain injury) who seemed fine at the beginning of the shift. he kept asking to help...eventually he just got frustrated and started spitting and hitting his CNA. he was restrained, but refused to walk, and laid on the floor instead. a woman came in wearing a pink shirt...pretty much a red flag to a bull. he went after her, which was scary because he's so much bigger than her. eventually they got him in soft restraints, after calling a code white and having 10 people barrel through the door. after it was over and i knew everyone was okay, i couldn't help feeling bad for him. it's through no fault of his own that he's injured, and he's cooped up with a bunch of people four times his age and has little to keep him occupied besides TV. one of the girls in my clinical group said he belonged in a mental facility, which i don't agree with. i don't think he needs something to that extreme, but yet he could clearly be a threat to himself and others on that unit. what do you do when you don't have an appropriate facility for a patient?