 Though I could not put it into words, I felt a peace that I had longed for envelop me.  The light is sometimes much harder to see in the dark when looking with your eyes closed, but mine were open now.  I understood then what I should have known all along: if I could not see him he could still see me.


	My day began at my arrival to 4 West, not sure as to what it was I was supposed to do.  I was sent to the lounge by a nurse, and waited to attend a nurse’s meeting.  Lana was the nurse I was assigned to, and together she and I went to report. The off-going nurse reported to Lana about the two patients that Lana had been assigned. The off-going nurse gave the most detailed report I had ever heard in my time as a nursing student. I learned an interesting fact, which was that azithromycin, is actually required before endoscopy and not due to its antibacterial properties but for other numerous reasons. 

	At 7:45, we assessed the first patient, Mr. M.A. He had a massive abdominal wound on his right side spanning his upper and lower quadrants. A VAC was hooked up to the wound to assist with healing, along with 3 JP drains that were hooked up to drain sero-sanguineous fluids. We emptied those, which contained about 40ml of fluid, and then we performed a thorough head-to-toe assessment. Three lines were running: one was IV insulin (I had never seen it ran at a basal rate), one was Fentanyl, and one was normal saline. 

Afterward, we went on to the next patient, Mr. S.C. The patient was 67 years old, and had suffered a heart attack which then caused him to fall eighteen feet out of a tree house. (c) pathophys  We did a thorough head-to-toe assessment of Mr. S.C.: he had a long wound on the right side of his back, which spanned about twelve or thirteen inches.  However, his main problem was an interior bleed which was at the current time did not have a known cause, but was suspected to be in his upper GI. Some stressors that my client had from being in the critical care environment were lack of privacy, lack of sleep, and he had not eaten anything by mouth in four weeks. 

At 9:00 Mr. M.A. was scheduled to have a wound change. I got to assist with the wound change. The doctor set up his sterile field and began to cut away the old dressing. This was my first experience with the wound VAC. While I had seen it hooked up in lab, I had never seen it actually used, which was quite different from in lab! The doctor removed the black sponge and white sponge from the wound itself and I assisted with opening new, sterile sponges. The wound was beefy red. 