on monday, i finished my last clinical day on the floor of the 4B unit at san francisco general hospital. this semester, i have been completing my medical surgical clinical units in the 'progressive care and traumatic brain injury unit' working as a student nurse. this is a 30-bed critical care unit serving the san francisco uninsured population with an acuity level ranking between intensive care and step-down. to many, the 4B unit would be considered an intensive care unit, yet the population demands and resources provided at this hospital cause the unit to be labeled progressive care. patients coming to this unit arrive in the emergency department and intensive care unit before being admitted to 4B with approximately half of the beds being filled with traumatic brain injuries and half filling with acute medical conditions.
the patients that i cared for in this unit come with a variety of diagnoses including:
congestive heart failure, respiratory failure, alcohol withdrawal, poly-substance abuse, end stage renal and liver disease, hepatitis c, end stage aids, meningiomeningitis, internal abdominal bleeding, lung and bone cancer, gun shots and stab wounds, pedestrian verses automobile accidents, suicide attempts, and various other medical and trauma concerns.
some of my favorite skills that i have performed:
IV insertion, blood draws, tracheostomy suctioning, catheters, nasogastric insertion, physical assessments, and psychosocial care (you grossed out yet?)
the patient population that i worked with came from a variety of backgrounds and lifestyles including:
homeless, drug addicts and alcoholics, undocumented immigrants, gay and straight individuals , cantonese, english, spanish, and russian speaking, those living in single resident occupancies, international travelers, business men and women, and those young and old.
if you can imagine, i learned a lot, grew a lot, and have been touched by many of the individuals that i have been fortunate enough to work with on my days in 4B. many would think that this is an interesting and somewhat undesirable population to care for, but i can ensure you that there is much to be learned from everyone you meet and an incredible level of human dignity that each person deserves despite their past, present, or potential future.
(readers, meet saw francisco general hospital- an incredible place)
can't wait to see you again next semester, 4B!
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