Trial By Fire

Wow, I have been slacking in the blog department, though I think I have pretty good reason; the week of my first rotation was also the week of Fall Break, so I was busy finishing up some assignments and packing for my trip to Chicago. As soon as I got back and after my second day of rotation, I was studying for a fundamentals test the next day. So, even though I still have 2-3 assignments to do in the next few days, I wanted to go ahead and blog since I have a lot to say about rotations :)
Initially I was too tired my first morning to be nervous (waking up at 5:15 is not an easy feat for someone who’s not a morning person), but as my classmate Haley and I were on the way to the nursing home, we starting talking about what we would be doing, and I got really nervous (though nowhere near my nervousness the very first day of clinicals in the CSL). I already knew who my patient would be and general info about his health history and treatment plans, but I still had no idea what to expect upon actually meeting and working with him. Tracey took Danielle (my partner for the day) and me to our patient’s room, and basically said, “Take his vitals, get him in his wheelchair, and make his bed.” Ready GO! There were a few seconds of Danielle and me staring at each other, somewhat dumbfounded, before we got to work as best as we could. The first day was a roller coaster ride of insecurity and confidence; one minute I would feel totally unprepared and spastic, but the next I was surprising myself by doing something right or without having to be told. Starting at 7 am definitely has its benefits because we get to help with A.M care (bathing, making beds, transporting into the wheelchair), feeding them breakfast, and observing them in rehab; it’s not the most exciting stuff by any means, but staying busy makes the time move quickly, and each thing we get to do is a deposit in the “experience bank,” if you will. The thing I noticed most quickly was that it was so much less awkward touching the patients, especially in private areas, than I expected; I was expecting to be really uncomfortable with things like bathing, but when you’re in a situation where you’re caring for a patient, and especially one who has been in a situation for a while that lets them be at least somewhat used to being changed, bathed, etc. by a stranger, the necessity of what you’re doing makes it less awkward. I don’t really know how to explain it, but I guess it’s a “do what you gotta” kind of mindset. The other healthcare providers, especially the nurse techs we were working most closely with, were so helpful and patient with us; I do realize that we slow things down and get in the way at times, but how else are we supposed to learn? They made a point to commend us on what we were doing well and to thank us for helping them out; it was just a really great experience overall, especially when I’ve heard stories of more experienced HCPs being rude and impatient with us “newbies.” The patients were also really helpful and patient with us; most of them have been there long enough that they know how things are done even better than we do, and I can’t even say how much I appreciate them and their families letting us learn with them. I stayed with my patient for a while until he didn’t need anything else, and then floated around to help my classmates or whoever needed it. In rehab, we just watched the physical therapists work with the patients, which was interesting to compare with my experiences in athletic PT and volunteering with a PT in the hospital; plus it was (finally) an opportunity to sit down. Our lunch break was spent working on our care webs for the week while hastily eating (get used to it, right?). I feel like what I need to work with the most is interpersonal interactions, especially with the patients; I could tell how awkward I was when talking to them, mostly because of being afraid to say the wrong thing. I don’t enjoy being awkward, though I’m almost used to it by now haha, but I know that will come with experience, so I’m not being too hard on myself. I was also proud of how well everyone in my group did, and once again, I’m glad to be working alongside them. My experience with one of my patients really showed me how much I’ve changed in the past few years: I had gotten her to the bathroom and waited outside to give her some privacy. The tech had gone to get something from her car, but I was under the impression that she was coming back, mostly because she didn’t tell me what to do beyond getting the patient to the bathroom and that we were bathing her after. When the lady finished, I was scrambling to figure what to do next and one of my classmates walked in; the patient then starts telling her how she’s been sitting there forever and complaining about me when I was standing right there; in reality, she had been sitting there for maybe two minutes after she had finished. I actually started laughing (not in front of the patient of course) because I knew I hadn’t done anything wrong, but I realized that a year or two ago, I probably would have taken it really personally and gotten upset. The last thing we did was observe an in-and-out catheter; the patient had prostate enlargement so he couldn’t urinate on his own and instead of a continuous catheter, he was just to be catheterized 2-3 times daily to empty his bladder. Our classmate, Christian, actually did the catheter and did it well, which was impressive on his part, especially being watched by all of us. It was another interesting experience with how things are done in simulation versus in “real life.” I also have a new appreciation for my physical independence after seeing just how helpless someone can actually become; we try to maintain independence as much as possible, but it has to be frustrating for the patients, and I’m trying to start sympathizing and thinking more about how I would feel if the roles were reversed. My patient was doing relatively well when I was with him, but knowing his history, it was really sad to realize, in talking with Tracey, just what all he’s dealing with and what kind of prognosis he probably has; it’s sad any time you hear about someone in poor health, but when you’ve met and worked with the person, it’s a new level of emotion. Overall, it was a great experience getting to know a patient as more than a diagnosis and to start gaining experience in the technical and interpersonal aspects.

Orientation

Today we had our orientation at the nursing home; even though it was just an overview and tour of the facility, it got me excited for the upcoming weeks there. We'll be working with rehab and short-term patients (as opposed to Alzheimer's or other long-term patients), so we'll be doing a lot of assisting them with ADLs (Activities of Daily Living) and their rehab. Even though it's not our area, Tracy still had us go through the Alzheimer's unit, and my personal experiences with my grandparents made something already really sad hit even more closely to home. One of the patients there even looked like my grandmother; it was a good lesson in learning how to use your emotions and experiences to your benefit and the benefit of the patients instead of just crying (which I almost did. Day one. Go me). It definitely wasn't all sad though; some of the patients we encountered in the hallways were legitimately excited to see us, which immediately made my day; I'm really excited to see how I can not only make someone feel physically better but also emotionally. We'll each be assigned a patient per week and, since there isn't the constant influx and outflow of patients like in a hospital, will probably have some of the same patients. I'm really excited to be assigned a patient and get to see the diagnosis and treatment process first-hand, as well as to get to know that person as more than a diagnosis. We're given access, even just as nursing students, into patients' confidential information and their physical privacy; it really demonstrates the trust that people give to nurses and that we really need to respect that trust. Once we get our patients at the end of this week, we have to start learning all about them from their medical information, and then next Monday we'll actually meet them and start getting to know them for who they are not on paper. I'm so excited about being a part of the health care team; we meet with the other health care professionals (HCPs) to discuss the patients and the process. Basically, my feelings of legitimacy are off the chart right now haha I think this experience will definitely be challenging at times, but I can't wait to start really being a part of the medical field and start learning who I really am as an almost-nurse.