The Last Mon Standing

My patient yesterday is a 87 year old woman. she was admitted because of depression.

This was the first time that I was able to have a patient with that kind of… erm… should I say… complain(?).

When I was checking her chart, i did not find anything extraordinary about her. Her vital signs are normal (BP 130/90 mmHg). So I read all her lab exams and her glucose level, albumin, creatinine, are all okay. So I asked my Clinical Instructor what’s wrong with my patient.

He told me to read the Patient History. It was hard for me to find the Patient History and it took me a while because that page was written in a very legible handwriting. I thought it was just a part of the Nurse’s note.

So the Doctor’s Diagnosis was;

TC Depression RO Dementia

The patient was suffering of depression but the doctor is also considering a possible dementia… loss of memory.

So I went in her room, room 402, the previous room of the old woman who had her left breast removed. She was sitting in the middle of her room staring blankly at the television that flashes an old Lito Lapid movie.

Her eyes were lined with a really huge darkened eyebags that make her look more miserable. She was accompanied by, I think, her son.

I checked her Intravenous Infusion (Dextrose in layman’s but technically speaking it was a 0.9% NaCl solution, dextrose is sugar, right?) . Then I proceed to catch her Blood Pressure, I could not hear the usual sounds when taking the BP. I took her Bp three times and still I was not sure of the result. I was actually thinking that it was something like 140 over 100. But I was not sure.

Her son asked me what her BP was, so I said 140 over 100 then I immediately added, “it was a little bit high sir, I’ll do it again after I’m through with her pulse.” Then I smiled broadly. Her son agreed.

So I took her Pulse Rate (PR). And his son asked, “What is her PR?” I answered him… it was normal. Then to my surprised he asked, “How about her RR?”

Wait… common people do not use “PR” in their sentences. And how did he know that I took the woman’s RR, Respiratory Rate?

You see this is how it is done. After checking for the Pulse Rate, we do not remove our fingers from our patient’s wrist, we just put it their and pretend that we are still counting for her pulse. But actually, we then look at her breast and start counting the respiration. We cannot let the patient know that we were counting how many times she breathes because she might start controlling her breathing and we won’t be able to get an accurate result. This is pretty hard in public hospitals especially in OB Wards and you are a guy. Because in OB wards, women just let out there tits anytime to breastfeed their babies. So it is a bit embarrassing for the two of us if I’ll look at her breast. And it gets worse when she has her husband with her… her super tattooed husband with piercing on the nose… remind you, Im talking of a public hospital scenario. But I must look at her breast because I must get her RR, right? Man, it is hard being a Nursing Student.

Okay let’s go back with my patient’s son… he used those two magic words RR and PR… It doesn’t take a genius to tell that the guy is somewhat a medical practitioner. So I asked… He said he is a nurse.

And I tell… I am just a nursing student under a supervision of a loving, REGISTERED NURSE, son. And if I do something wrong, I’ll definitely snuff it..

I was so much nervous when I took her second BP… thank goodness I got the same result with the previous BP that was taken by the Registered Nurse on duty four hours ago. Boy, I was so relieved.