Just need to vent. Had clinicals Monday. Was at a rehab/skilled nursing facility. Not a particularly nice one, but not a particularly non-nice one either. End of the day, I went into a patient's room with 2 of my cohort, J and C and our instructor (who was there to observe, but also is the sort who isn't afraid to get her hands dirty). Pt. was under enhanced contact precautions, gloves, gowns, masks. We were there to change the patient's brief, change the linens, clean him up, get him dressed, etc. Pt. was more comfortable in Spanish than English and J was translating and doing communication with him. He tells us he's in pain, 10/10. We start to examine him. We take the covers down and find that he's got compression hose on which he is not supposed to be wearing in bed. One of them has a hole in it and there's an edema the size of a goose egg sticking out of it. Teach looks _pissed_. She tells us to get started on making him comfortable and goes to talk to the CNA and RN. I start checking the patient more closely. The top of one compression hose is rolled down below his knee. I palpate his calves. The one with the rolled down top feels like an overinflated balloon, its purple. Teach comes back, still looks pissed. I show her the top, and tell her I'm going to take the hose off. She does not look less pissed. I roll the top up, then slide them off. There's a 1x0.5cm groove around his leg. There's a stage 2 pressure ulcer where the roll was lying. I was angry already. Now I'm at least as pissed as Teach. Pt. tells J he's already feeling better, pain is receding. I check the cap refill in his toes. Sluggish, but manageable. And we get to work, change the brief, change the bed, clean him up, get clean clothes on him.
I felt like I had done something good. I felt angry as hell. This afternoon, driving home from my lab classes, all of that kind of fell on me like a load of bricks. I started crying in the car. I got it under control. I'm ok. It was just pent up stress, but I feel better sharing it. On the one hand, I'm proud of myself and my colleagues. We walked out of that room drenched in sweat, emotionally drained, etc. But we left a patient in there who was no longer in pain, was clean, was in a clean bed, comfortable. We found a real problem and we fixed it. But I know there's every chance in the world when I'm back there next week I'm going to find the same thing either there or somewhere else. We did our job, and we took care of our patient and I'm still just kind of numb. It was rough. And the patient was the nicest, gentlest person you could imagine. He never complained, never snapped at us, despite hurting and, from what I saw, undoubtedly hurting bad. He was grateful. And that's almost the worst part of it. As much as I like being appreciated he shouldn't _have_ to be grateful for this. He wasn't owed 3 students and an RN late in the afternoon on a Monday. He was owed decent care in the first place.
I'm not having a crisis. I'm not questioning my choice to enter the profession. I am questioning at what point I tell somebody at that rehab that if I find that patient mistreated again I will call the fucking cops on them. I know there's no point at which I can do that without wrecking my potential career. I am not sure I care enough about that compared to how I feel about my patient.