Tuesday, March 10, 2015

Really awful clinical experience

For those that know me, it is no secret that I do not "do" old people. I am not a fan of geriatrics, nursing homes, long term care, etc.

When we got our clinical assignments at the beginning of the semester, I was shocked and slightly horrified that my group would be starting rotation at a local nursing home. One of my friends told me that he thought by the end, it would be my favorite rotation. I was honestly chomping at the bit to get to the hospital. I wanted to be in all the action.

But I waited patiently, and enjoyed my time at the nursing home. I liked the environment of seeing the same patients over and over again. I enjoyed working with the CNA's, who completely work their butts off! I loved working with the med aids to see what their med pass systems were. I loved working with the nurses, who were always willing to let the students work on their skills but still guide us through the steps. I gave tube feeds, did med passes, changed bed linens, helped with baths, fed residents, helped with wound care, performed a straight cath, and did 4 head-to-toe assessments. It wasn't the most sterile environment in the world and the lighting was poor but there was something really satisfying about working with these residents. Even though I enjoyed it, I was so ready for a change.

Thursday morning last week, the last day before Spring Break, we switched and it was time for my group to head to the hospital to work on the med-surg unit. I was so excited that I was up at 4:45 and at the hospital by 6am.

We grouped together into the lounge and got our nurses assignments for the day. We were then left to go find our nurse. I had never even seen that floor. I had no idea what was going on. I asked around for my nurse and no one had seen her. I waited patiently by the nurses station for my nurse. Finally, she arrived and immediately ran for a COW (Computer on Wheels). She put her name on a post-it and claimed a COW as she told me how they fight over these prized possessions. I saw it first hand as several people got heated about their lack of or potential loss of their COW.

I followed her around as she got report from several nurses about her patients for the day. I flipped through the SBARs that were given to me, scanning these new forms, looking for things that sounded familiar to me. I tried to keep each one coordinated with the patients we saw. After a hurried report, I followed her a cubby hole where one of the computers was available. She sat down and began to plan her day. 

I watched her system as she numbered a piece of paper with each patient's room number, their admitting diagnosis, important labs, and meds for the day. She sat at that computer scanning labs, noting other nurse's notes, and planning away. I knew she had to be passing meds soon and was already behind because of report, so I just tried to be quiet and observe.

Then we headed to the nurse's station where she began to pull meds. It was chaos in there. People were walking fast and furious, no one smiled, everyone looked frustrated, and half of them had students like me with them. I stood with her at the Pixus for almost 30 minutes as she gathered all the supplies for the day, and I kept moving as people shuffled in and out around me. The last thing I wanted was to be in anyone's way.

The vibe was not cool. Not cool at all. That was disheartening but I just kept watching. So just as she was getting ready to do her med pass, my professor caught me in the hall and asked for my SBARs. She sifted through them and told me she would pick one of them for me to work with. Of course she picked the one I didn't want.

Let's just say, you never want a patient that is in the medical field themselves and is one day post-op from a replacement. I was scared to death. She went in with me into the room, gave me a crash course in what she was looking for, and told me good luck and to find her when I was finished. I went to get my supplies, came back, and started my assessment.

I had to stop midway through because he wanted to return to bed and they didn't want me to help him back in. They called for the nurse and the CNA came in to get him all settled back in. He had all kinds of equipment that I had never seen in real life. I stood by the door waiting until the CNA had gotten him comfortable and hooked back to everything. She was amazing.

Once I finished, I couldn't find my nurse or my professor, so I went back to the lounge to document my assessment. After about 10 minutes, my professor came in and told myself and a classmate to go to lunch for 30 minutes. So off we go to lunch, I go back up to the floor 30 minutes later, and no one is there.

I walked around, not familiar with my surroundings, worried something was wrong. I went into the lounge where all the nurses were eating and laughing, and they immediately went silent when I walked in. Needless to say, I quickly walked out. I sat in the lounge to finish up my documentation and review my patient's labs. Then my professor found me and told me that all the other students were going to go to lunch and she wanted me to take care of all of their patients!

Um, what?!

How? What the hell do I do? You want me to go deal with 5 patients on my first day of clinical in the hospital as a student!? I was freaking out.

Luckily my nurse came by and asked if I could help with wound care on a patient. So I did that instead. It took much longer than I thought so by the time we were finished, I had to go check on my patient again, who frankly, didn't want me bothering him anymore because he just wanted to take a nap.

So I am standing in the hall with my nurse, watching how she electronically charts, when the CNA from the morning comes by and stands next to me to talk to another employee. Evidently, she had an issue with me from the morning for not helping her with that patient. She told the other employee, in front of me, all about how she felt about me. I was shocked. Things had been going poorly for me that day but I never thought I would be dealt with in such an unprofessional manner. I mean, I liked her. I liked the way she dealt with the patients. There were many things I could learn from her. Before I could even say anything to her, my professor found me for post conference.

I told her about what happened, and in turn, we needed to speak with the charge nurse. I felt like a baby, like a rat, and like someone other than myself. I am perfectly capable of handling this situation, but never wanted to be on the outs with someone on Day #1. That sucks.

So after that, I was just checked out. Our professor handed us a list of things to find on a scavenger hunt, which honestly, would have been more beneficial if we had done it at the beginning of the day. And we were finally released to go home at 3:30.

I couldn't run out of there fast enough. I was shell shocked. I was so surprised at how much I hated that first day. It was nothing that I expected. No one was happy or super willing to help train us. I felt like all the other students got a lot more guidance and I just got thrown into the thick of it. I felt completely lost and discouraged, and honestly, I still feel it. It was so so so disappointing. I have three more days there, then one day at day surgery, and then three more days back there. Then I can change floors. I was so looking forward to spending time with my professor because I LOVE her. She is amazing! I am so hoping that it was just the first day craziness, and that I will have some more guidance from her next week.

Nothing could have prepared me for the disappointment I felt leaving the hospital that day. Like soul crushing, I don't think I even want to do this, I'm not coming back after Spring Break and you can't make me, disappointment. I was actually ready to run back to the nursing home.

Needless to say...I'm hard core doubting myself. But I am forcing myself to stay as positive as possible and continue on. Really, what choice do I have?

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