Friday, April 23, 2010

Thur-iday.

So yes, I am getting lazy with keeping up with my blogging. Lo siento! Forgive me. Here is my combined blog for Thursday and Friday of this week.

Thursday:
Patient #1: We re-admitted a patient who we discharged right after the start of my internship. I didn't recognize the name or facility, but when I saw the patient, I immediately remember visiting her with the MT back in February. I remembered her to be sweet and kind. Well. Pft. She literally yelled at me because she is hard of hearing and I wasn't singing loud enough. Seriously though, I can only sing so loud. And my voice is just naturally on the soft side. "You really must sing louder. It is entirely too frustrating to struggle to listen to you sing. Now either you sing louder or you might as well stop all together." Frustrated and a bit ticked, I chose a song lower in my range so I could attempt to belt it out a bit louder. "That's hardly better I suppose," she said. That's when her daughter and son-in-law arrived. I thought they were on vacation... but I was wrong. I offered the daughter the packet of songs I was playing out of, and from then on, she dictated which songs I sing. I mean, yes, that was my intentions when I gave her the packet in the first place -- I wanted her to pick the songs her and her mother wanted to hear. It was just how she did it... maybe I'm too sensitive. Nevertheless, we sang some traditional campfire songs, and the patient and her daughter were able to reminisce about their Girl Scout adventures back in the day.

Patient #2:
I visited one of our newer patients. I didn't know much about her, other than she was Jewish. Since I don't know any Jewish songs, I just sang some songs from the 20s and 30s. She smiled at me so sweetly, but never spoke a word. Her tube feed machine started beeping mid-song, so I stopped and went to find a nurse. I was informed that I was not permitted to touch any buttons, which is frustrating to me since I used to be a nursing assistant and know how to turn the machines on silent or at least on standby. I sat with the patient for a good 10 or 15 minutes before a nurse finally came in a turned it off. The beeping was SO loud! I thought it was a fire alarm at first. I felt so bad, but the patient didn't seem to mind at all. Half the time I wondered if she even noticed.

I called the patient's daughter to follow up with her on our visit. When I had called and left her a message this morning that I was planning on visiting, I didn't realize that she would have tried to join. When I spoke with her, she expressed that she would've liked for me to be more specific on the time that I was visiting her mother. Apparently she was fully planning on attending as well. I had no idea. I apologized and ensured her we would better coordinate our schedules for the next visit. I believe we are doing a small birthday celebration for her next week. The daughter also informed me that the patient is verbalizing more, and would like us to try and stimulate her speech as much as possible. Another thing I did not know. I would've just assumed the patient was aphasic. Learning process, right? Right.

Patient #3:
Good 'ol Walter. Think of the puppet Walter from Jeff Dunham. That is our patient. I played piano music for him and the other residents. He actually vocalized some sounds while I was playing, and watched me. I was beyond thrilled that he was attentive to the music!

Patient #4:
Usually when the MT and I go to this facility together, I go and see Walter while she goes and sees the lady. The only time before that I had seen the patient, she was curled up in bed and fast asleep. Since I arrived at the same time as one of our HHAs, we traded off patients. She brought the lady patient back to the group, and I gave her Walter. We discussed in team this week how she has been trying to stand up a lot lately (she is a fall risk.) She again was trying to stand up yesterday, so I grabbed the guitar and went over next to her. I knelt down by her side and sang her a song, occassionally putting my hand on her shoulder to keep her from standing. Then, out of nowhere, the patient made a disgusted face and said, "That's just terrible!" I stopped singing immediately. "Do you really think the music is terrible?" "Why yes! How can you listen to yourself?!" Hmpf. Well then. That was that. No more music for you! That's not really how I felt. I just acknowledged that I was doing more harm than good, so I stopped. I joked with her though and told her that I'll stop singing as long as she stays sitting, but if she tries to stand up again, then I'm going to sing! She didn't find it funny. I talked to one of the facility staff members about the incident, and she informed me that the patient has had an extreme change in personality as of two days prior, and that her visit with her daughter the night before was overly unpleasant, as she presented the same rude and rash behavior.

"Patient" #4:
I went back to visit the 12 year old boy. His father had passed at 5am, so the MT and I both went to visit him. I was preparing myself to have to have a deep discussion with him about grieving and accepting his father's death. Rather, it was more of a play date. The boy's friend from school was over, and I tagged along. He kept referring to me as his "guitar best friend" and said things like "I'm bored. What are we doing now? Can we play this song? What's this do? Ever hear this song? Do you have a youtube account? Lets go on youtube. You have to watch this video." He wasn't grieving one bit. I just wanted to be like, "HELLO!! YOU'RE FATHER JUST DIED LIKE 10 HOURS AGO! AREN'T YOU THE LEAST BIT SAD??"

I worry that he'll feel a rush of grief in a month or two when the MT and I aren't around... since the family is friends with one of our nurses, I'm sure we'll all stay in touch. Poor kid :( COTI!


Friday:
Drove to see the patient at the nunery (the other nunery). When I got there, I was told she was taking a shower, and then going to eat breakfast. Since the nun house is only 3 miles from our office, I decided to just go to the office, pick up my keyboard, the come back and see the patient afer she is clean and fed. So, I drove to the office, and returned about 45 min later. The patient was sitting in a chair in her room, door closed, lights off. She has the coolest Bostonian accent by the way. At any rate, she told me politely that she didn't want muic because it was too early, and to come back in the afternoon. I wasn't about to come back to the nunery for a third time today, so I just told her I'd come back to see her sometime next week. She smile and said she looked forward to seeing me then, which out of her mouth is golden, because she is known to be quite sassy (and all the nuns caring for her just aren't having it!)

Next stop: yes, that place that I think I gave a fake name to in an earlier blog because I go there so often, but now I forget the name... I decided to visit the older patient first. She wasn't sitting in front of the TV in the lobby like she has been the last few times I've been there to visit. Instead, I found her in the activities room fast asleep in her geri chair, in a long line of her fellow residents, also fast asleep in their chairs. It seemed odd to me. It looked like they were on display. Like I could've walked up and down the aisle and picked out my favorite one. But anyway, they were about to have a prayer service, so I went to see Miss Chicago instead. I had found the Elvis song she was talking about during a previous visit, and attempted to sing it for her. Attempted being the key word. Yes, it was an awful rendition, and Elvis was probably frantically searching for some earplugs up in Heaven, but it didn't seem to matter. The patient was so excited to hear the song, that she made me sing it not once but twice. I had a really good visit today with Miss Chicago. We made a list of all her favorite songs that we sing together, and also some of her other favorite songs that I don't know. I'm going to burn her a CD since she asked for a copy of the Elvis song. If you want a copy of one song, might as well make a mix!

When I returned to see our other little gal in the activities room, she was still fast asleep in the long line of sleepers. The whole situation seemed staged... like everything was secretly being filmed. Right as I knelt down next to her to say hello, a big wad of drool dripped from her lips right onto her shirt. Plop. It was lovely. I softly said hello, and sang an acoustic "You Are My Sunshine". She picked her head up, but never opened her eyes. I sang all the verses, and she never awoke. I felt bad waking her, so I just let her be. I'm getting quite attached to her though I've noticed... she's just the cutest little lady you'll ever see... I don't know what I'm going to do when she passes... Ugh I don't wanna think about it....

Fourth patient of the day was our Russian lady. Between deciphering her Russian accent and her caregiver's Mexican accent, it's a miracle the three of us ladies can muster up any conversation whatsoever. We make quite a trio though :) Since the patient was completely uninterested in the music during my last visit, I decided to tote along the piano this time and play some classical music for her (since every single visit with her, she tells me how her father played the violin, and then taught her brother to play as well.) I played some Beethoven, some Chopin, and some Mozart. She closed her eyes and looked very at peace. After each piece, she smiled at me, applauded, and said, "Bravo, bravo." She was so happy with the music. She even gave me a kiss on the cheek before I left, and repeatedly thanked me for the music. Thank god. Finally she actually cared about the music and not just my company! Not that we ever had bad visits... she just was always preoccupied with asking me questions instead of listening to the music.

My last patient today was the angry French woman. When I finally found her in her wheelchair in the hallway, she perked right up and flashed me a big smile. She was happy to see me! What a change from the first time I met her! (She asked me what I wanted with her, then immediately told me to go away.) Today, the patient kept asking when the plane was leaving, and where it was. She said there was 16 people on the plane, all from her hometown in Belgium, and that it left without her. She continued to ask about the plane, so I decided to sing with her "Leaving on a Jet Plane." I was shocked that she actually knew the song, and that she sang along! That girl belted the notes out, and even added octave jumps at the ends of phrases as she closed her eyes and sang her heart out. I felt awful though... she kept talking about how she just wanted to go home, but she was stuck here in this country all alone while everyone else got to leave on the plane and go back to Belgium.

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