Visiting Nurse Journal

A dog bed caught my eye. I was at my first patient’s house where I was doing a home health aide supervision for another nurse. The dog bed was in the living room. I didn’t see any dog around though. I was able to take a closer look at the dog bed when my patient came out of the shower and slowly walked into the living room with her walker. In the center of the dog bed was a 5×7 photo of a blond cocker spaniel. Next to it was a green tennis ball. This was a memorial to Lady, the late great dear pet of this elderly woman.

There was a live dog that greeted me at the next house. Barney, the enormous giant snauzer, wagged and sniffed and gave me a thorough checking out before I saw his 96 year old owner. I didn’t know this patient very well but I know she was having a hard time with the circulation in her legs. They ached all the time and there was a wound on her ankle that wasn’t healing. I got out some bandages and changed her dressing. Before I left, she showed me a photo of her twin brother and her on their 95th birthday. He lives in a nursing home now. Sometimes her son takes her over to the home for a visit.

I had a bag of isolation gowns and masks to bring into my next patient’s home. This was a new patient. Just home from the hospital, I would spend at least an hour with her going over medications, doing a safety evaluation of her home, taking vital signs, doing a physical assessment, and developing a plan of care. I would do it  dressed in a gown, mask, and gloves. She has MRSA (methyline-resistant staph aureus). We’re seeing alot of this in wounds, in lungs, and in urine. What it means is that she has acquired a common infection that used to easily be treated with an antibiotic. Now the same organism is resistant to the antibiotic that used to cure it. Doctors now have to use a stronger antibiotic that may or may not cure it. MRSA has caused deaths. I’m going to be watching this woman closely. I’ll see her each day this week for sure.

As I left this house, my cell phone went off. A patient I knew well was dizzy and her daughter wanted me to check on her. When I arrived, she told me that the dizziness just started a few hours ago. Since she had a history of a stroke that left her left side a little weak, I wanted to make sure nothing emergent was going on. I worked quickly getting vital signs, listening to her lungs, doing a neuro status check, and checked her oxygen level. Everything was normal. I called her doctor and summed up my findings. Since she was doing okay except for the dizziness, he was going to see her later in the afternoon. I made a note to myself to call her in the morning.

Before I finished my rounds for the day, I had one more patient to see. This was a man with congestive heart failure. Last year he had a major heart attack. Three months ago he was hospitalized for another one. His legs were swelling and he was getting very discouraged. I always saved a little extra time for him. He liked to tell me stories about being a soldier during WW2. No one ever visits him. He had a wife long ago but she left him. He’s been alone ever since. No children. No pets. Just sitting in his recliner watching TV. We have a few laughs and I head on out to go back to the office.

I’ve driven 30 miles, saw five patients, one live dog and a memorial to a dead dog. I’ve had the priviledge to hear old stories, see cherished photos, and be a frequent visitor to the homes of lonely sick seniors. What a job!

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