Not what you'd expect

It was education night again recently. I am always amazed that new patients and new nurses can really get the conversations flowing.

A new patient came to the unit recently. He won't be with us long, but for the new nurses, he'll be remembered. He was slight with salt and pepper hair. He had just arrived and since one of the newer nurses gave report again, we had little to go on, so I headed to the chart. Not much there, either, but I managed to piece together a little story.

Patient is living his life with family in a successful blue collar job and has a "nervous breakdown" and never returns to his job. A few years ago, he gets diagnosed with MS. He goes from walking around house to pushing himself in a wheelchair.

The most striking thing among the new nurses is that they're hot for a diagnosis. "Wow, look at him shake doing xx," one exclaimed. "Are we taking Parkinson's patients now?" No, I reply to NN1 (New Nurse 1 --we have several right now), remember Mr. X has MS."And so education begins...

Where do we start? We comb the chart again, and finally, the docs update the notes. We know he has MS and from the chart and meds, we can tell a few things about him. He's got those tremors because he's had lots of issues going on upstairs, because of the infamous plaques. He's had lots of seizures, and tried lots and lots of meds, most of which give him reactions, so he's been switched around a lot. Next, we see he's on some different treatments, too, which are often used in areas outside MS, particularly in transplant patients. Following that, we reviewed some neuroanatomy. The brain is a wonderful thing. It's got several mechanisms to tell you that something's wrong and generally gives you an idea of where the problems might be.

After we looked at his chart for more information, we headed on over to the MS Society website for more information. This had the new kids going for at least an hour, but I suspect a few of them will keep learning, eager to absorb whatever they can. The Professionals section at the MS Society has an area specifically for nurses. More good sites for information are the following:

The MS section of NINDS the National Institute of Neurological Disorders and Stroke (from the NIH)
IOMSN International Organization of Multiple Sclerosis Nurses
MultipleSclerosisProfessional.org
Neuroanatomy online has lots of MRIs and other graphic information on neurological disorders.

Sometimes an unexpected event leads to lots of learning. We'll see where it goes.

More to come...stay tuned.