{"id":241,"date":"2017-06-22T14:54:53","date_gmt":"2017-06-22T18:54:53","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/?post_type=chapter&p=241"},"modified":"2017-07-26T19:00:10","modified_gmt":"2017-07-26T23:00:10","slug":"surgical-ward","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/chapter\/surgical-ward\/","title":{"raw":"Surgical Ward","rendered":"Surgical Ward"},"content":{"raw":"
\u00a0<\/strong>Day: 1<\/h5>\r\n
Time: 08h00<\/h5>\r\n
Place: Surgical Ward<\/h5>\r\n\u201cGood morning, Aaron. My name is Jeremy and I\u2019ll be the nurse caring for you this fine morning. How are you doing?\u201d\r\n\r\n\u201cI guess I\u2019m doing better,\u201d Aaron whispers. \u201cMy throat is still sore and my voice doesn\u2019t sound like my own.\u201d\r\n\r\n\u201cYeah, that will go away in time. You have had a tough go of it for the last 24 hours.\u201d\r\n\r\n\u201cAny information on my girlfriend?\u201d\r\n\r\n\u201cSorry, I don\u2019t know anything. I just came on. I would ask your Mom when she comes in.\u201d\r\n\r\nLooking disappointed, Aaron nods.\r\n\r\n\u201cI know this is tough. Let\u2019s focus on you. Today will be a bit action-packed for you. Bloodwork today, probably in a couple of minutes. Then Physio is going to see you and get you up and about. Dr. Labinski will come in, and together we are going to change that dressing. If you can tolerate more than a few sips of water, we will see if I can get you something a little more like jello.\u201d\r\n\r\n\u201cCan I have a milkshake?\u201d\r\n\r\n\u201cMaybe later. Let\u2019s see how the water goes down.\" Jeremy pauses. \"Now, if you're up to it, I am going to give you the once over<\/a>, listen to your chest<\/a>, and check your dressing<\/a>.\u201d\r\n\r\n\u201cSure, whatever. The tube that is down there, you know\u2026\u201d\r\n\r\n\u201cThat\u2019s called a foley catheter<\/a> and it goes through your penis to your bladder. It drains your urine out and allows me to see if you are drinking enough or not. If things keep going well today and you are able to tolerate an increase in fluids, I'll remove the catheter. Sound ok?\u201d\r\n\r\nAaron leans back, closes his eyes and nods.\r\n\r\nJeremy efficiently completes his assessment and moves outside the room to record\u00a0his findings.\r\n
Time: 10h45<\/h5>\r\nJeremy feels a light touch on his shoulder and turns away from the computer where he is charting to see a very fit young man in street clothes. \u201cCan I help you?\u201d\r\n\r\n\u201cSorry to disturb you. My name is Chin and I'm the physiotherapist today. Just started here a couple of weeks ago.\u201d\r\n\r\n\u201cOh, hi.\u201d Jeremy looks down to see an ID tag dangling from Chin\u2019s right front pocket.\r\n\r\n\u201cI\u2019m here to check on a patient from last night.\u00a0Mr. Knoll?\u201d\r\n\r\n\u201cYes, he's one of my patients. Doing quite well and is probably ready to get out of bed and begin moving around.\u201d\r\n\r\n\u201cThat\u2019s excellent. Can you tell me more about him?\u201d\r\n\r\n\u201cSure, come closer and I\u2019ll pull his chart up on this computer and we\u2019ll go through the history together.\u201d\r\n
Time: 11h00<\/h5>\r\n\u201cThank you, Jeremy, for walking me through the chart,\" says Chin. \"Are you able to assist me with mobilizing Aaron?\u201d\r\n\r\n\u201cYes, let\u2019s go see him and see if he wants to get up.\u201d\r\n\r\nWalking into the room, they find Aaron and Mrs. Knoll talking.\r\n\r\n\u201cHi, Aaron, Mrs. Knoll. This is Chin. He\u2019s a physiotherapist, and he\u2019s going to help me get Aaron out of bed <\/a>and learn how to move around with the large incision that he has.\u201d\r\n\r\n\u201cDo I have to leave?\u201d Mrs. Knoll asks.\r\n\r\nChin shakes his head. \u201cDefinitely not. I would actually like you to stay and see how we assist Aaron. That way, if he wants to move or needs help, you can provide that assistance.\u201d\r\n\r\n\u201cOh, I would like that,\u201d says Mrs. Knoll, smiling.\r\n\r\nJeremy moves to the opposite side of the bed\u00a0 to arranges the IV pumps and untangles the nasal prongs tubing in order to give Chin and Aaron enough room.\r\n\r\nChin then moves to beside Jeremy and sits on the edge of the bed. \u201cOk, Aaron, we are going to get you standing and maybe taking a couple of steps. Not much activity in comparison to what you were able to do two days ago. It will be uncomfortable and I want you to press your PCA if you're having pain. We need to get you up or you\u2019ll get stiff and your lungs will accumulate fluid.\u201d\r\n\r\nAaron looks around at his mother and she nods to him but looks concerned.\r\n\r\n\u201cJeremy is going to help me. We're going to roll you onto your side. Jeremy will lift you to a sitting position and I will slide your legs off the bed so you are sitting on the edge of the bed. Then we will let you relax and get used to sitting. If things are ok, then we will help you stand. At any point in time, you let us know if this is too much or to keep going.\u201d\r\n\r\nChin stands up and asks Mrs. Knoll to come and stand behind them so she can see what they do to sit Aaron up and to get him to stand.\r\n\r\nMoving slowly, both Jeremy and Chin get Aaron sitting up on the side of the bed.\r\n\r\n\u201cHow do you feel?\u201d asks Chin.\r\n\r\n\u201cVery dizzy and can\u2019t believe I'm so weak.\u201d\r\n\r\n\u201cYes, it will take awhile to get your strength back.\u201d\r\n\r\nAaron reaches for the PCA remote and presses the button once.\r\n\r\nA few minutes go by, with everyone talking about the weather. During a break in the conversation, Chin asks, \u201cYou ready to stand, Aaron?\u201d\r\n\r\n\u201cI think so.\u201d\r\n\r\nJeremy stands close to Aaron\u2019s right side and Chin stands on the left. Both assist Aaron to wiggle a bit forward to the very edge of the bed so he can place his feet flat on the floor.\r\n\r\n\u201cOk. Jeremy and I will take some of the weight by holding your arms and shoulders. If at any time you don\u2019t feel well, just sit back down.\u201d\r\n\r\nAaron nods that he understands.\r\n\r\nMoving quite slowly, Chin and Jeremy get Aaron standing upright. Legs shaking but holding, Aaron looks around and weakly smiles at his mother.\r\n\r\n\u201cWow, that is awesome. You are up out of bed.\" Mrs. Knolls smiles and clasps her hands together. \"Oh, I'm going to have to tell everyone that you are doing so well.\u201d\r\n\r\n\u201cYeah? If this is well, I'll have to lower my standards.\u201d\r\n\r\nChin laughs. \u201cAaron, it\u2019s going to take time for you to get better. You're young and will probably get better faster than other patients. It\u2019s important, though, that as you feel better, you don\u2019t overdo it. I\u2019m going to create an activity plan for you and post it by your bed and on your chart, so that everyone knows and you know what your activity is.\u201d\r\n\r\nChin continues. \u201cOk, let\u2019s take two small steps.\u201d\r\n\r\nAaron shuffles two steps forward, then stumbles.\r\n\r\n\u201cAll right then,\u00a0Aaron. Let\u2019s get you back to bed.\u201d\r\n\r\nJeremy and Chin help Aaron back to bed and settle him in.\r\n\r\n\u201cVery good, Aaron. I'll come back this afternoon and see if you're ready to sit in a lazy boy chair.\u201d\r\n\r\nAaron just nods and closes his eyes. \u201cSo tired,\u201d he says.\r\n\r\nJeremy checks the IVs and then leaves the room with Chin. \u201cThanks for your help, Jeremy,\u201d Chin says.\r\n\r\n\u201cNo problem. If you want help this afternoon, I'm around.\u201d\r\n\r\n\u201cExcellent. If Mrs. Knoll is around, I may see if she can help so she can learn how to assist Aaron when he goes home.\u201d\r\n
Time: 14h50<\/h5>\r\nDr. Labinski enters Aaron\u2019s room to find Aaron sitting in a large grey chair and Mrs. Knoll sitting beside him holding his hand.\r\n\r\n\u201cGood afternoon, Mrs. Knoll and to you, Aaron. Not sure you remember me. I am Dr. Labinski. I operated on you last night.\u201d\r\n\r\nAaron looks up. \u201cI can\u2019t remember anything except having dinner with my girlfriend then going to the library.\u201d\r\n\r\n\u201cNot surprising. Your surgery went well and I expect you will make a full recovery in time.\u201d\r\n\r\nDr. Labiniski then explains the surgery and how he expects the next few days to go. \u201cDo you have any questions, Aaron?\u201d\r\n\r\n\u201cJust one, my girlfriend. What happened to her?\u201d\r\n\r\nDr. Labinski leans forward. \u201cAaron, both you and your girlfriend were in a serious accident that required cutting you out of the car. Your girlfriend was brought to the hospital before you.\u201d\r\n\r\nDr. Labinski goes on to explain what happened to Aaron\u2019s girlfriend.","rendered":"
\u00a0<\/strong>Day: 1<\/h5>\n
Time: 08h00<\/h5>\n
Place: Surgical Ward<\/h5>\n

\u201cGood morning, Aaron. My name is Jeremy and I\u2019ll be the nurse caring for you this fine morning. How are you doing?\u201d<\/p>\n

\u201cI guess I\u2019m doing better,\u201d Aaron whispers. \u201cMy throat is still sore and my voice doesn\u2019t sound like my own.\u201d<\/p>\n

\u201cYeah, that will go away in time. You have had a tough go of it for the last 24 hours.\u201d<\/p>\n

\u201cAny information on my girlfriend?\u201d<\/p>\n

\u201cSorry, I don\u2019t know anything. I just came on. I would ask your Mom when she comes in.\u201d<\/p>\n

Looking disappointed, Aaron nods.<\/p>\n

\u201cI know this is tough. Let\u2019s focus on you. Today will be a bit action-packed for you. Bloodwork today, probably in a couple of minutes. Then Physio is going to see you and get you up and about. Dr. Labinski will come in, and together we are going to change that dressing. If you can tolerate more than a few sips of water, we will see if I can get you something a little more like jello.\u201d<\/p>\n

\u201cCan I have a milkshake?\u201d<\/p>\n

\u201cMaybe later. Let\u2019s see how the water goes down.” Jeremy pauses. “Now, if you’re up to it, I am going to give you the once over<\/a>, listen to your chest<\/a>, and check your dressing<\/a>.\u201d<\/p>\n

\u201cSure, whatever. The tube that is down there, you know\u2026\u201d<\/p>\n

\u201cThat\u2019s called a foley catheter<\/a> and it goes through your penis to your bladder. It drains your urine out and allows me to see if you are drinking enough or not. If things keep going well today and you are able to tolerate an increase in fluids, I’ll remove the catheter. Sound ok?\u201d<\/p>\n

Aaron leans back, closes his eyes and nods.<\/p>\n

Jeremy efficiently completes his assessment and moves outside the room to record\u00a0his findings.<\/p>\n

Time: 10h45<\/h5>\n

Jeremy feels a light touch on his shoulder and turns away from the computer where he is charting to see a very fit young man in street clothes. \u201cCan I help you?\u201d<\/p>\n

\u201cSorry to disturb you. My name is Chin and I’m the physiotherapist today. Just started here a couple of weeks ago.\u201d<\/p>\n

\u201cOh, hi.\u201d Jeremy looks down to see an ID tag dangling from Chin\u2019s right front pocket.<\/p>\n

\u201cI\u2019m here to check on a patient from last night.\u00a0Mr. Knoll?\u201d<\/p>\n

\u201cYes, he’s one of my patients. Doing quite well and is probably ready to get out of bed and begin moving around.\u201d<\/p>\n

\u201cThat\u2019s excellent. Can you tell me more about him?\u201d<\/p>\n

\u201cSure, come closer and I\u2019ll pull his chart up on this computer and we\u2019ll go through the history together.\u201d<\/p>\n

Time: 11h00<\/h5>\n

\u201cThank you, Jeremy, for walking me through the chart,” says Chin. “Are you able to assist me with mobilizing Aaron?\u201d<\/p>\n

\u201cYes, let\u2019s go see him and see if he wants to get up.\u201d<\/p>\n

Walking into the room, they find Aaron and Mrs. Knoll talking.<\/p>\n

\u201cHi, Aaron, Mrs. Knoll. This is Chin. He\u2019s a physiotherapist, and he\u2019s going to help me get Aaron out of bed <\/a>and learn how to move around with the large incision that he has.\u201d<\/p>\n

\u201cDo I have to leave?\u201d Mrs. Knoll asks.<\/p>\n

Chin shakes his head. \u201cDefinitely not. I would actually like you to stay and see how we assist Aaron. That way, if he wants to move or needs help, you can provide that assistance.\u201d<\/p>\n

\u201cOh, I would like that,\u201d says Mrs. Knoll, smiling.<\/p>\n

Jeremy moves to the opposite side of the bed\u00a0 to arranges the IV pumps and untangles the nasal prongs tubing in order to give Chin and Aaron enough room.<\/p>\n

Chin then moves to beside Jeremy and sits on the edge of the bed. \u201cOk, Aaron, we are going to get you standing and maybe taking a couple of steps. Not much activity in comparison to what you were able to do two days ago. It will be uncomfortable and I want you to press your PCA if you’re having pain. We need to get you up or you\u2019ll get stiff and your lungs will accumulate fluid.\u201d<\/p>\n

Aaron looks around at his mother and she nods to him but looks concerned.<\/p>\n

\u201cJeremy is going to help me. We’re going to roll you onto your side. Jeremy will lift you to a sitting position and I will slide your legs off the bed so you are sitting on the edge of the bed. Then we will let you relax and get used to sitting. If things are ok, then we will help you stand. At any point in time, you let us know if this is too much or to keep going.\u201d<\/p>\n

Chin stands up and asks Mrs. Knoll to come and stand behind them so she can see what they do to sit Aaron up and to get him to stand.<\/p>\n

Moving slowly, both Jeremy and Chin get Aaron sitting up on the side of the bed.<\/p>\n

\u201cHow do you feel?\u201d asks Chin.<\/p>\n

\u201cVery dizzy and can\u2019t believe I’m so weak.\u201d<\/p>\n

\u201cYes, it will take awhile to get your strength back.\u201d<\/p>\n

Aaron reaches for the PCA remote and presses the button once.<\/p>\n

A few minutes go by, with everyone talking about the weather. During a break in the conversation, Chin asks, \u201cYou ready to stand, Aaron?\u201d<\/p>\n

\u201cI think so.\u201d<\/p>\n

Jeremy stands close to Aaron\u2019s right side and Chin stands on the left. Both assist Aaron to wiggle a bit forward to the very edge of the bed so he can place his feet flat on the floor.<\/p>\n

\u201cOk. Jeremy and I will take some of the weight by holding your arms and shoulders. If at any time you don\u2019t feel well, just sit back down.\u201d<\/p>\n

Aaron nods that he understands.<\/p>\n

Moving quite slowly, Chin and Jeremy get Aaron standing upright. Legs shaking but holding, Aaron looks around and weakly smiles at his mother.<\/p>\n

\u201cWow, that is awesome. You are up out of bed.” Mrs. Knolls smiles and clasps her hands together. “Oh, I’m going to have to tell everyone that you are doing so well.\u201d<\/p>\n

\u201cYeah? If this is well, I’ll have to lower my standards.\u201d<\/p>\n

Chin laughs. \u201cAaron, it\u2019s going to take time for you to get better. You’re young and will probably get better faster than other patients. It\u2019s important, though, that as you feel better, you don\u2019t overdo it. I\u2019m going to create an activity plan for you and post it by your bed and on your chart, so that everyone knows and you know what your activity is.\u201d<\/p>\n

Chin continues. \u201cOk, let\u2019s take two small steps.\u201d<\/p>\n

Aaron shuffles two steps forward, then stumbles.<\/p>\n

\u201cAll right then,\u00a0Aaron. Let\u2019s get you back to bed.\u201d<\/p>\n

Jeremy and Chin help Aaron back to bed and settle him in.<\/p>\n

\u201cVery good, Aaron. I’ll come back this afternoon and see if you’re ready to sit in a lazy boy chair.\u201d<\/p>\n

Aaron just nods and closes his eyes. \u201cSo tired,\u201d he says.<\/p>\n

Jeremy checks the IVs and then leaves the room with Chin. \u201cThanks for your help, Jeremy,\u201d Chin says.<\/p>\n

\u201cNo problem. If you want help this afternoon, I’m around.\u201d<\/p>\n

\u201cExcellent. If Mrs. Knoll is around, I may see if she can help so she can learn how to assist Aaron when he goes home.\u201d<\/p>\n

Time: 14h50<\/h5>\n

Dr. Labinski enters Aaron\u2019s room to find Aaron sitting in a large grey chair and Mrs. Knoll sitting beside him holding his hand.<\/p>\n

\u201cGood afternoon, Mrs. Knoll and to you, Aaron. Not sure you remember me. I am Dr. Labinski. I operated on you last night.\u201d<\/p>\n

Aaron looks up. \u201cI can\u2019t remember anything except having dinner with my girlfriend then going to the library.\u201d<\/p>\n

\u201cNot surprising. Your surgery went well and I expect you will make a full recovery in time.\u201d<\/p>\n

Dr. Labiniski then explains the surgery and how he expects the next few days to go. \u201cDo you have any questions, Aaron?\u201d<\/p>\n

\u201cJust one, my girlfriend. What happened to her?\u201d<\/p>\n

Dr. Labinski leans forward. \u201cAaron, both you and your girlfriend were in a serious accident that required cutting you out of the car. Your girlfriend was brought to the hospital before you.\u201d<\/p>\n

Dr. Labinski goes on to explain what happened to Aaron\u2019s girlfriend.<\/p>\n","protected":false},"author":60,"menu_order":7,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-241","chapter","type-chapter","status-publish","hentry"],"part":151,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/pressbooks\/v2\/chapters\/241","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/wp\/v2\/users\/60"}],"version-history":[{"count":11,"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/pressbooks\/v2\/chapters\/241\/revisions"}],"predecessor-version":[{"id":891,"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/pressbooks\/v2\/chapters\/241\/revisions\/891"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/pressbooks\/v2\/parts\/151"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/pressbooks\/v2\/chapters\/241\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/wp\/v2\/media?parent=241"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/pressbooks\/v2\/chapter-type?post=241"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/wp\/v2\/contributor?post=241"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/healthcasestudies\/wp-json\/wp\/v2\/license?post=241"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}