"When you get those rare moments of clarity, those flashes when the universe makes sense, you try desperately to hold on to them. They are the life boats for the darker times, when the vastness of it all, the incomprehensible nature of life is completely illusive. So the question becomes, or should have been all a long... What would you do if you knew you only had one day, or one week, or one month to live. What life boat would you grab on to? What secret would you tell? What band would you see? What person would you declare your love to? What wish would you fulfill? What exotic locale would you fly to for coffee? What book would you write?"
Friday, November 5, 2010
We're Not Nurses Yet!
Anyway, yesterday was our clinical and I was one of the two scheduled students to have 2 patients for the day. Although it sounds scary (and it is) for the nursing student, it really is no big deal at all because when the real world is here, I'll be having 6-8 patients per day. 2 would be a walk in the park. But it's not when you're a student.
When I work as an aide, I am very very busy, usually with anywhere between 15-30 patients to be responsible for their safety, overall wellness, attend to their needs...there is rarely a quiet moment. So when I have a patient that has an IV that is beeping and it is bothering them, or I have a patient that is requesting pain meds and wants them right away, I go tell the nurse, who is usually busy with something else. Usually it takes them a long time to attend to "small" matters such as this and I used to think to myself, what is possibly taking them so long? This patient is calling me into the room every 10 minutes and is getting angrier each time.
Now I understand. Now I understand the frustration nurses feel when they are 3 hours into their shift and they have not yet met their 4th or 5th patient yet.
Yesterday we started on the floor at 8am and I got report. My first patient is a middle aged man, with knee replacement , that is threatening to leave AMA (against medical advice) if he does not get adequate pain relief. I also learned that he spent the night crying. I also learned that he is on methadone treatment which is used for taking patients off addictions to heroin or strong opiates. We were giving him pain relief, strong pain relief for the average you-and-me. But he had a significantly higher tolerance and wanted far more than clinically advised for anyone. I've seen this same case - a lot- and it is always an ethical debate. So he was more of my psychological, therapeutic communication need case.
My other one was your typical hospital admission, admitted for constipation, anemia, hyponatremia. They found cancer. She needed a lot of help getting ready in the morning, and could barely stand up, even with two people holding her up. I went in her room to begin my assessment at 845 and basically did not finish with all of her morning activities until 11 am. No joke. Granted that included charting about her too. But still. I helped her to bathroom, back in bed, provided am care, gave her meds, changed her IV, changed her diaper, took her to the bathroom again, charted, put her in a chair, changed her wound dressing...and oh did my assessment. After all that, I had to separate myself and go see my next patient.
So, now I understand. I used to think 12 hours was a wayyyy long shift. Now I don't think 12 hours is long enough for one person to get everything done. I think it would be excellent to have a medication and IV nurse on a floor. This nurse could do the meds for the entire floor the whole shift, start IV's, manage IV's...and on down times would help out with whatever else. The other nurses would have their regular assignments, and would do everything else that nursing really means. Giving meds and fighting with IVs takes up a lot of nurses time. Nurses would have more time to sit and really talk with their patients instead of coming up with ways to escape the room because they have 10,000 other things to do.
So yesterday, despite my classes entire efforts all day, my teacher told us we were still behind and were not thinking on our own yet and were still being hand held and basically were not ready to be nurses yet.
. . .
My response to that? We aren't nurses yet! Just because we are seniors, does not mean we are supposed to know everything. Heck, nurses of 20 years aren't expected to know everything. Nursing is a lifelong learning process. And it should be. I feel like I know a heck of a lot more than I did as a sophomore (as I should) and a lot of things make sense and things are starting to click. I was on my own for the majority of yesterday and did not ask for help except when it was the law that I get help (meds, IVs).
I don't know what made her say that, if one of the other students did something to piss her off, or if she was just having a bad day...but I dont think it was right of her.
I'm scared shitless to be a nurse next year and part of me doesn't feel ready, but who the heck does feel ready day one? You learn.