Tuesday, June 21, 2011

Learning experiences come in the least expected ways

It is amazing how different the clinical experiences can be from week to week. Last week my nurse taught me quite a bit. She didn’t really let me do much, but she did teach me tons. This week, my nurse didn’t teach me a thing, or at least not like my first nurse did. She pretty much assigned me a patient and let me have at it. I suppose that in itself taught me as well.

I honestly can’t say one was better than the other. I really enjoyed learning from the nurse in that first week, and it was nice to be able to follow her around and get a feel for things rather than jumping in right from the start. It was also nice to be able to actually do things this week though. Today I was able to attempt to start an IV twice, didn’t get it on either try but neither could my clinical instructor so I didn’t feel so bad. I removed a foley, gave meds and water through a PEG, and hung IV piggyback meds/fluids. I’ve done more today than 80% of the students last semester were able to do during their entire semester.

There was something else I learned today though that I think might be even more valuable than any of these skills.

Not to let anyone scare me away from being who I need to be.

My patient today came with a sitter. A PCT that sat with him all day long, repositioning him and making sure he didn’t rip out his IV (which he did), his PEG (which had to be inserted because he kept ripping out his NG tube), or didn’t fall out of bed.

I went in early to look at my patient (yes, I actually did somewhat of an assessment this time, even though he was unresponsive) and to help my nurse and the tech reposition him. The PCT was pretty snotty with me. Snapping at me about which side of the bed I needed to be on, making snide comments about my technique (or lack thereof), didn’t even acknowledge me when I introduced myself and pretty much scared the crap out of me within my first hour on the floor. I walked out of the room very tempted to try to get my nurse to change my assignment. I sat outside his room staring at his chart and told myself “Self, you can do this. Dealing with people that are hard to get along with is part of the learning process”.

And I did just that.

When I went in next it was to try to start an IV. I was scared shitless and a lot of that fear was of the sitter and not the patient. Before I walked in the room, I tried my best to calm my nerves and just went for it. I ignored the PCT and just let my instructor help me. I have no idea what changed but after that the PCT started warming up to me. When I went in again to help reposition, she was completely opposite from the first time. She was friendly and warm, and again when I went in to remove the foley and was struggling with unclamping the drainage bag she offered to help, as friendly as can be.

If I would have let her get to me in the beginning, and got my assignment changed because of her, I would have missed so many great opportunities. I let people scare me too much. I’m not a crier. I can keep my emotions in check pretty well, but my biggest downfall is letting people scare me.

I’m actually really proud of myself for not letting that happen today.

Wednesday, June 15, 2011

I am in Paperwork Hell

As the excitement of my first clinical rotation wears off, I am staring down the massive pile of paperwork that I need to turn in by Friday afternoon. I realized that in all the excitement of the day, I really didn’t get a thorough assessment of my patient. In fact, I didn’t get much of an assessment at all. Most of the information I did get was copied from the chart. I can probably fudge most of it for this one, since it is the first care plan we are to turn in, and it is more of a “practice” one than a strictly graded one but I am a little disappointed in myself that I didn’t get the assessment I should have.

All of this makes me realize that while I have come a long way in the self confidence department, actually talking to some people, and getting in there and doing things rather than just being a fly on the wall, I still have a ways to go before I become who I need to. The assertive, confident student nurse.

So now I will get back to this mountain of paperwork, and figure out what I need to do to make sure the next time I am in the hospital, I actually talk to and assess my patient rather than relying on the chart.

Tuesday, June 14, 2011

I survived.

I had my first clinical rotation today.

I didn’t run from the floor crying.

I didn’t turn into a pile of nervous mush.

I didn’t freeze upon entering my patient’s room.

I didn’t kill anyone.

I DID have an absolutely fantastic time. The nurse I had with me was A-mazing. She used every chance she got to actually teach me. She quizzed me on things like “why does the left lung have three lobes and the right only two?” and when my patient started going south (diaphoretic, nauseous, etc) she calmly talked through checking his blood sugar, and taking his vitals. When his BP popped up at 50/30 she threw him into trendelenburg while quizzing me on why we were doing it. She talked through every step as she hung platelets for the patient who had a level of 7. Explained the reactions we needed to watch for, and talked through exactly what she was doing as she was troubleshooting the IV access line.

Other than the schizophrenic patient who was hitting the nurses, refused to wear clothes, refused his medication, and was constantly stopping his IV infusion, all the patients I had were just as great. They seemed to love having students in there and smiled every time I walked into the room.

This was NOTHING like my mind was making it out to be for the last few weeks. I went to bed last night TERRIFIED of what today was going to be like. I am so glad my fears were unfounded and I can’t wait to get back into the hospital next week!