Supportive supervision

Hi All,

I am on my Cardio placement and on Wednesday, I had experienced hard time from one of my new patients.
Mr.NT is 65 years old male after CABGx5 with pulmonary complication. I checked the patient’s X- ray and blood results. I found that the patient has ¯Hb (below 90).When I came to perform cardiopulmonary subjective and objective assessment and gather missing SHx information I could felt that patient is not in “good mood” however; the patient let me do assessment. I found some very “interesting information” such for example patient was using puffer (Ventolin) 2 puffs every 2 hours. I went to my clinical supervisor to present my findings and discuss my treatment plan( DBExs, supported huff ect). Additionally, I was going to provide some information to the patient about Ventolin and reviewed his technique. When I came back, the patient was standing at doorframe and he stated that either I take him outside or I can go away. I did not wanted be bossy and tell that I in charge so first, I tried to explain to the patient what is treatment plan and why. I mentioned as well that I would like to have a look how he is using his puffer. Automatically, patient commented this that I am saying he is using wrongly his puffer. I kept trying to clarified and explained, however in vain. Finally, I decided to clarify whether the patient refusing treatment. The answer was yes. I went to my clinical supervisor and I reported this situation and documented in patient’s notes.
My supervisor was supportive and said I should treat this as a good experience and do not take personally. Later afternoon my supervisor asked me again if I am OK and added that this patient was grumpy to other medical staff too. He refused blood transfusion and was unpleasant to nursing staff. He said that not all patients are compliant.
It is hard especially at the beginning do not take this sort of situation personally but it was good lesson. I am glad I had this lesson now.

Open Heart Surgery outcomes

I am currently on my cardio placement. I am treating the patients who have undergone cardiothoracic surgery such as CABG as well as I have opportunity to conduct pulmonary rehabilitation classes. That is great experience to observe how patients attitudes toward lifestyle are changing.

Hi Guys,
I has treated patient that had CABGx3 performed 2 weeks ago. The patient had presented in ED with chest pain and SOB. PMHx included Ca throat, IHD, high cholesterol, DM, #jaw, ETOH abused. When I asked the patient about smoking history, the patient reported that he had been smoking for 50 years about 40 cigarettes per day before admission. He did not quit smoking after diagnosis of throat Ca but this time the patient said he had his lesson. The patient reported he has not been participated in any regular physical activities or structured exercises. However, because of education about his disease and effects of physical activity, the patient was more than happy to take part in Cardiac Rehabilitation after being discharge.
It is great to treat this very compliant patient with very good outcomes, immediate release of symptoms, good posture, full UL ROM, ability to walk independently and frequently including 2 flights of stairs.

Thanks