Yesterday was an interesting day. To make a very long story short, I only got four hours of sleep the night before (big test), I got a migraine, and I had to go to school from 8-5:15, then drive across town to the hospital my clinicals would be at (we had to get the information on our patient for the next day). Doesn’t sound like a big deal, and it shouldn’t have been, but the drive in traffic took almost an hour and a half. So we got to the hospital around 6:45, and had to look up all the information on our very first acute care patient. Although the nursing home was a lot of work, it can’t compare to the stress of acute care. So, I have been worried about my first patient, but I was sure my teacher would give us all easy patients to start with. Any humane teacher would do that, right? Wrong. I walk into the hospital smiling and excited. I walk up to the board and find my patient’s name. I look at his chart and on the cover there is a bright sticker that says "Isolation precautions" (This means the patient is sick with something very contagious). I don’t know where they came from, but right there in the nurse’s station in the hospital, tears started running down my face. Crap, I can’t cry before clinicals have even started!! There are nurses everywhere, this is so embarrassing. Thankfully, my friends (also nursing students) took me to a different room and we looked through the chart, hoping it wasn’t going to be as bad as it looked. I look at the first page, and it says 450 pound male stroke patient, unable to communicate, C-difficile infection (causes awful diarrhea), right side paralyzed, feeding tube in place, diabetic. Patient’s mother stays with patient 24hr/day. This is about the point where I started hyperventilating. 450 pounds!!!?!?? His mom will be there scrutinizing my every move? Diarrhea? Feeding tube? "Breathe Katie. Don’t forget to breathe." AAHHHHHHH!!!!! I did my best imitation of the nursing home "NURE!!" lady. I have nothing against people with any of the conditions my patient has. The problem was that I was running on little sleep, I was extremely overwhelmed, I had a migraine, I was expecting a patient with one easy-to-treat problem, I was frustrated, and I am nervous enough having my teacher watch my every move- but a patient’s mom who is probably just waiting to jump on every mistake!?!? I pulled myself together, left without any weird looks, and broke down in the parking lot. We got out of there around 8, and I still had four hours worth of stuff to prepare- look up all his drugs, conditions, make a spreadsheet….. Clinicals start at 6:30 am. I made it home, walked in the door & collapsed again crying. Why do I think I want to be a nurse? Sometimes I completely forget. I don’t want to clean up diarrhea!! I don’t want to try to move a 450 pound patient when my back is already aching. Anything but this!! Have I wasted all this time and money in school for the wrong thing? As I said yesterday, I had a complete mental breakdown. Thankfully, my dad is a doctor, and he was willing to sit down with me and go over the charts, figure out my patient’s diagnosis, look up the meds, and do all the other preparatory work. We finished around 11:30. Had he not helped me, I would have been done closer to 2am. My school is on my crap list. I wasn’t in this predicament because of poor planning on my part, but because some idiot administrators at my school decided it would be fun to see which student snaps first. Well, congratulations to whoever had dibs on me!
Now, moving on to today. The RN who was assigned to my patient was not friendly at all, and was annoyed to have a student nurse working with her. He had a lot of trouble talking from his stroke, but I tried really hard to understand everything he said. At one point, he tried to get himself out of bed (no way- he fell a few days ago, and I was not letting that happen on my watch), and when I stopped him, he said “I’ll never be able to walk again.” Uhh… what do I say? I can’t give him false reassurance, he might be right. But I can’t just pretend like I didn’t hear that comment…. So, I said “There is no way to know right now if you will be able to walk again. But I do know that the harder you work at it now, the better your chances will be. Physical therapy is coming later today, give it everything you can.” He reluctantly said, “Ok.” I could tell he was thinking “shut up and get out of my way.” But he was nice about it. Later, when PT came to work with him, they stood him up three times. Just the act of sitting up is extremely difficult for him, so standing up is a really big deal. After the third and final stand, they were about to take his shoes off and he started mumbling something. They stopped to listen, and he was saying “Again.” I almost started crying right then. They stood him up for the fourth time, and it was obviously really painful and hard for him. But he did it. I have not even known the guy 24 hours, and yet I was so proud of him that I wanted to scream. I kept bringing up his achievement the rest of the day, and filled his mom in on it several times (she was out of the room at the time), and even though she already knew the story, watching his face as I told it was rewarding. I can’t wait to see how hard he pushes himself tomorrow. It’s amazing how one person doing something as simple as standing up changed my whole outlook on the day. Would he have gone for that fourth stand if I hadn’t had that talk with him? Maybe. What if I had left the room and he had no one to prove anything to? Maybe. But maybe not. Could I have given him that little bit of inspiration that he needed? I hope so. Because the little things like this make me remember why I wanted to be a nurse.
If the physical therapy incident wasn’t enough to change my outlook, a comment my patient’s mother made would have done the trick. As I mentioned before, she is at the hospital almost twenty four hours a day. It is obvious that she does not trust the nursing staff to take good enough care of her son (I can’t say I blame her). Well, when my teacher was in the room (perfect timing), the mom was looking at her calendar and asked me, “Will you be here on Friday working with my son?” We don’t have clinicals on Friday, so I told her no. She said, “Dang, because there is a meeting I wanted to go to on Friday, and I’m comfortable with you here. But without you here, I’m not going to go.” Can you believe that? This evil woman waiting to eat me alive at my first little mistake gave me a wonderful compliment right in front of my teacher? A few minutes after she said this, my teacher said, “Katie, I have a question for you, let’s go out in the hall.” Oh, way to burst my bubble!! What did I do?! We get out in the hall and she smiled real big and said, “Did you hear that!?!? Can you believe she will trust you to take care of her son but not the licensed nurses here?” Wow, my day really turned around!! And I just want to mention, his mother was wonderful (besides just making this comment). At one point, I forgot to do something really important, and she brought it up while making fun of me, which I thought was a perfect way of handling the situation. Like always, I learned a lot today. Not much about medicine or taking care of people, but about the importance of human bonds. They are strong enough to make a woman live in a hospital for 21 days to take care of her son. To make a stroke patient push himself harder than he thought possible. To make a crazy nursing student realize, yet again, that it’s not at all about me and my feelings, but about my patients and their feelings.