So, Melvin isn't a stranger to the hospital, certainly. But now, Melvin has had a chance to be on the other side of the hospital experience. And subsequently, there are a few different modifications and things that I have to keep in mind.
***SCIENCE BACKGROUND TIME***
The autonomic nervous system is in charge of managing homeostasis in the body, ensuring that your body stays at that right temperature, that you are breathing enough to keep your body oxygenated, that your blood pH stays at the right level (related to breathing, as it happens), that your heart rate speeds up when you need some additional blood flow, that you are conserving water when reserves are low, and many other functions. As part of this process, though, we have the sympathetic and parasympathetic nervous response. The sympathetic response we tend to think of in emergencies, the "fight-or-flight" part of things, which involves all of the associated symptoms: faster heart rate, bronchodilation, blood pressure goes up, eyes dilate, etc. Blood is being shunted away from the digestive system as part of this, slowing gut motility (i.e. the digestive system chills out for a moment, since you might need to fight for your life). Long story short--when anxiety goes up, digestive system slows down (not hunger, necessarily, but the actual digestion part).
SO. New nurse. On the floor. Trying to figure out what the hell is going on. Even though I'm not actively terrified, there is definitely an edge where I am watching for places that I can be helpful and trying to absorb all possible pieces of wisdom and observation that I can manage. No small amount of stimulation there. Melvin has been markedly quiet during some parts of my clinical days, just for the slow-burn of anxiety in my brain.
Actually, I'm not sure if it's the sympathetic nervous system is the real working part in this--I'm also on my feet and moving more than I had been in a while, participating in a twelve hour shift where I'm on my feet for the bulk of it. My energy needs are different than when I'm in my theory days and sitting in class for six hours.
Either way, the results seem to be following a bit of a pattern. I try to eat a decent-ish breakfast before getting into the day--around forty to sixty minutes later, Melvin burbles some air or stool. So normally I get to the hospital and Melvin blorps. Then about fifteen to twenty minutes later, he blorps again. I tend to empty around both of these times, trying to make sure that Melvin is as empty as possible before report and/or immediately after report--either way, before morning meds start. Then, I don't put much into my system for a while, finding a break somewhere to suck down half a liter of water and then eventually lunch. All-in-all, there might be a little bit of air from Melvin, but I have a moment or three to work and forget my stoma for a bit of time, to find myself engaged in other thinking. And then Melvin burbles again, and as soon as I have a moment to pause, I'll take a moment to pop into the bathroom, let out the air, and then go back to the floor, as secretive as I want to be about my ostomy.
That's the physical--what about the emotional/spiritual?
Honestly, pretty good. On the one hand, it's frustrating to have to pause to take care of the physical, to pop off to the bathroom to let out more air. However, it does give me A) a reason to pause and take a breath to run a quick self-assessment or reflection and B) ensure that I actually take a bathroom break, which is good for overall urinary health compared to holding it for six hours. I can make excuses to not go pee, but when it comes to Melvin, I have a different mindset, the "yep, I'd better go address that." I can be annoyed, but it's also a place where I have recognize I have to conscientiously invoke some self-care. And then taking that recalibration step to pause and think has had a number of good benefits, too. It's another opportunity to make an expression of radical self-acceptance.
Spiritually, there's been a boon, too. So far, I have discussed my ostomy with at least seven patients, using it as a point of empathy in particular to those that have their own stomas. It's been an opportunity to educate for those that are medically curious once or twice. I'm cognizant that we don't stay focused on it for too long--I don't want to meet my needs at the expense of the patient's needs--but that doesn't mean that there is no return on empathy. More so, though, I feel that I can use the trauma and experiences that I have had to someone's benefit. One instance was an individual that had a bag and asked if I was allowed to eat normal food--they had not eaten anything in quite some time: I was able to provide hope for a life resembling normal.
So, in short, Melvin and I are both relatively at home in the hospital in some interesting ways.
***Bonus Round***
I DID have a patient one day, though, that made an allusion to "well it could be worse; I could be one of those people that has a bag."
I was grateful that the laugh I was holding back was hidden by my mask--I wasn't upset in this case, and it would have embarrassed this person terribly to say anything, so it was my "*snort,* yeah, I'd hate to be one of those people" secret joke in my mind. Whenever we crack those kinds of jokes, we can seldom be certain of someone's complete history, which is an interesting thing to ponder.
No comments:
Post a Comment