ADVENTURES IN NURSING

TIME OUT

Please forgive me.  I'm in time out from blogging at present.  I've been sick, and now I'm preparing to downsize from an eight-room house to a three-room apartment.  I should be the current poster child for NOT amassing a boatload of unnecessary CRAP of which you will someday have to dispose!  Does anyone out there want half of my crap?  Well, an emergency yard sale is in my near future, if you're in my neighborhood.

In the meantime, I may appear with a new blog all about my ADVENTURES IN DOWNSIZING, depending on how much material I manage to gather.  (Doesn't that sound like a fun read - probably more fun to read about than to actually experience.)

Have no fear, though.  ADVENTURES IN NURSING will return, so check back occasionally.

You may now return to whatever you were doing previously.

ADVENTURES IN NURSING

FIRST YEAR ENDING

Well, we were finally wrapping up our first year.  We had taken all the skill proficiency tests that were required for our summer hospital clinicals.  Each and every one of us was looking forward so much to the freedom from classes that awaited us.  That didn’t mean we were off the hook, though – far from it.

We were scheduled for a month-long hospital rotation during the summer - first shift, five days a week for four weeks, just like real life.  Luckily, B and I requested and received different rotations so that one or the other of us would be home with the brats ... er, the children, and we wouldn’t have to deal with day care.  Yahoo!  That simplified life quite a bit.

 So, we threw a little “end of the year” party and invited all our classmates and instructors.  Several classmates actually attended and, while the rainy, 50-degree weather threatened to ruin our event, we all had a slightly drunken good time anyway.  It was great to let off some steam, and talk about what was coming next.

B’s rotation came first and as was her routine, she had a little upchuck meeting with the commode each and every day.  Poor baby!  She really didn’t appreciate the stress and responsibility.  While I sympathized with her, I also was thrilled that she was able to prepare me in some small way for my turn.  It was nice to know what was expected of me, so that I could potentially plan ahead.  Naturally, me being me, I didn’t plan ahead at all, but it was nice to know, anyway. 

I had myself a big old honking meltdown right before my month-long clinical.  My boyfriend and I talked about planning a wedding, but there was no money for such frivolity.  Bitterly disappointed, I began playing with the idea of quitting school and finding myself a good-paying full-time job.  I was so tired of always being cash-strapped, and wanted to have a real life, with dinners out, and shopping, and vacations, and decent cars, et cetera.  I wanted more!

Unfortunately, our area wasn’t known for good-paying employment with the skills I had, which were basically office administration and cleaning houses.  I picked up more hours at the restaurant I cleaned, making pizzas, salads and desserts on Friday and Saturday night, but that wasn’t getting me much closer to my fantasy life.  And none of the many places I had applied to was beating down my door to hire me. 

I went into one of my blue funks and that’s where I was on my first day of clinical.  I was determined to make something happen but in the meantime, I continued with nursing school.  The universe was listening.

My very first day, my very first patient – a very sweet, rosy-faced elderly gentleman who was recovering from a heart attack – kinda rocked my world.  When I approached him with his AM meds, he asked if he could tell me something.  He was concerned that I would think he was crazy, but he had to tell someone.  It seems he had “seen” himself die in the emergency room, complete with the bright light and angels you always hear about.  As tears rolled down his face, he grabbed my hand and chills went down my spine.

I was stunned.  I was shaken.  It was another of those “brick-upside-the-head” moments for which the Universe is famous.  This was my sign.  I assured this man that I didn’t think he was crazy at all, and thanked him profusely for helping me come to a decision I had been struggling with.  All I could think of was, “What if I had quit nursing school, and hadn’t been in that particular hospital room, on that particular day, and hadn’t heard that particular man’s story?” 

In turn, he thanked me profusely for listening and not judging.  I realized in that moment that this is why I was here.  I had received so many blessings since I made the decision to become a nurse.  So many people in my life had stepped up to help me make sure I got through the process and achieved my goals.  This was something I needed to see through to the end.

When my instructor and I left the room, I explained to her what had been going on in my life, and the fact that I was thinking of quitting school.  I even shed a few tears, as I recall.  It was such a profound moment for me, I had to share.  Amazingly, even though I had only known this lady for a couple of hours, she gave me a little hug and reminded me why I had started this journey in the first place.

Some might think it was just the luck of the draw that I was assigned to that man that day.  I knew better.  I will be forever grateful that our paths crossed.  Those few minutes we spent together changed my path completely.  What a blessing.    

ADVENTURES IN NURSING

LET’S TALK CATHETERS

“You’re not squeezing hard enough.”  Mrs. B1 faced me across the bed and quietly, urgently repeated, “You’re not squeezing hard enough.”  Aw, geez, this was not going well.

A million thoughts raced through my brain with the speed of a downhill train.  “Why me?”  “Why me in front of Mrs. B1?”  “Why a 75-year-old male dementia patient, with the attendant 75-year-old penis??”  Okay, so it was actually only three thoughts, but they were running in a circle in my head so it might as well have been a million.  What the hell ever made me think I wanted to be a nurse??  I was not having a good time.

Sweat broke across my forehead.  My glasses slid down my nose.  I couldn’t push ‘em back up – had my sterile gloves on and my hands full of penises and catheters.  I said a silent prayer that I could get this thing done before said glasses fell off my face and on to something I didn’t want to contemplate.

I was already a nervous wreck, just from opening my supplies and setting up my sterile field under the watchful eye of my instructor.  So many things to remember – open this first, lubricate that last, yadda yadda yadda.  And now I wasn’t squeezing hard enough?  Could I catch a freakin’ break here?  Apparently not.

My poor, sweet, dear elderly patient was in no position to assist.  If I had known the troubles that awaited me, I would have snuck into his room earlier and taped a Playboy centerfold to the ceiling above his bed, for Pete’s sake.  Too late for all this wisdom now!

I soldiered on, because that’s what we nurses do, right?  Besides that, I needed the grade.  If it wasn’t this guy, it would be the next one.  Gosh, this was fun.

I’ll be honest with you.  I don’t remember now how I got through that day.  I can’t even guarantee that I completed the procedure successfully.  I assume I did because I have no memory of having to repeat it in front of Mrs. B1 again.  Yay me!  I’m pretty damn sure, though, that I didn’t “look like I knew what I was doing.”

That wasn’t my last misfortune with a catheterization either.  It happens.  They don’t always go as planned but when they do, IT IS SWEET!  I’ll tell you one thing, though.  I’m retired now and I’ll never have to do it again, and for that, I am ever so grateful.

As for that poor, dear, sweet demented man who was lucky enough to be my guinea pig, I like to think that he was either (1) blissfully unaware or (2) enjoyed the most foreplay he’d had in years

        ADVENTURES IN NURSING

MORE FIRST YEAR MEMORIES

Life is funny sometimes.  As I was experiencing ... struggling through ... tolerating ... dreading ... nursing school, I was sure that I would never forget one damned thing that happened.  Boy, was I wrong.  Life gets busy, overwhelming, and your brain gets so full of stuff that you have to let some things leak out.  I guess that’s what has happened here.

Now that I’m ready to commit my memories to “paper,” my memories have disappeared.  I know there were exciting things ... dreadful things ... annoying things ... maybe even enlightening and joyous things ... that occurred at least every week, if not every day, but for the life of me, I seem to be tapped out.  Oh, well, I’ll do the best I can.

The first thing that comes to my feeble mind is the day I discovered the autopsy book.  I found it in our class library during break time, and was absolutely fascinated by it.  It was about a foot thick, and had these beautiful overlays of the different body parts and systems during real autopsy procedures.

Yeah, I know it’s weird but hey, I’m nothing if not weird.  Nursing school will do that to you, too, on the off chance you’re not weird when you start.  Trust me, you will be by the time you make it through a nursing program.  No subject will be sacred.  You’ll find yourself discussing the consistency of your patient’s bowel movements over chips and salsa.  You’ll be describing wound drainage over wine and cheese.  If you’re anything like me, you’ll even chat about the color of tenacious secretions over your eggs and toast.  Lord help you!

But I digress.  So, while my classmates spent their break time studying, or gossiping with each other, or just vegging out for 20 minutes, there I’d be paging through the autopsy book while I sipped my soda and munched my Fritos.  I often wondered just how cool it would be to actually witness an autopsy.  Nowadays, after having read too many Kay Scarpetta novels, I realize the smell would get to me long before the various fluids and juices in the human body would. 

I recommend you try to locate a good autopsy picture book, and flip through it for a few minutes.  It’s almost as good as the real thing, and you might just want to find out how strong your stomach really is.  It couldn’t hurt!  

ADVENTURES IN NURSING

I’M WHAT?

I was 43 years old when I began my two-year nursing program.  I was engaged to a perfectly nice man, and he and his two youngest daughters lived with B and me in our gigantic old farmhouse.  He also had four adult daughters who lived on their own, and I had my two sons.

A couple of months after my 44^th birthday, my suspicions were confirmed when my at-home pregnancy test was positive.  It was stunning news.  The fiancé and I were very careful in regards to birth control.  We had six kids between us, the youngest being my 11-year-old son.  Babies were not in our plans, but there you have it ... the best-laid plans. 

I wasn’t thrilled about this development, but abortion was not an option for me.  I just couldn’t even consider it emotionally.  I realized I was going to have to come to terms with the pregnancy and adjust my life accordingly.  That would necessitate speaking to my nursing instructors to find out how this would impact my place in the program.  I wasn’t looking forward to that.

I informed Mrs. B1 on our next clinical day.  Since I hadn’t yet been to an obstetrician, we had no idea how things would play out.  I assumed I would be high-risk due to my age, but was generally healthy overall.  I couldn’t really make any decisions about continuing school until I had talked to a doctor, so we left it at that.

It was about a week later that, while getting ready for school one morning, I noticed I was spotting.  I was a little alarmed, since I’d never had that issue in my previous pregnancies.  I considered keeping it to myself, mainly because if I didn’t talk about it, it wasn’t really happening.  Yeah, I was that deep into denial.

Ultimately, I did mention it to B before we left for class.  Since I wasn’t having any other symptoms, we decided to go on to class and see how things went.  Unbeknownst to me, B called her sister after we got to school, and her sister called the ER of the nearest hospital, just to find out how concerned we should be.  Midway through class, I got a phone call from B’s sister, telling me that I probably needed to go to the hospital immediately, to find out what was going on.  Now I was scared.

After a thorough exam at the hospital, the kindly nurse let me know that I was, indeed, very possibly losing my baby.  My fiancé took me home with orders to stay on complete bed rest for the next few days, in the hopes that my condition would improve.  It was not to be.  After two days of severe cramping and continued spotting, I lost the baby.

I was devastated.  I had already chosen a name for what I was sure would be my daughter.  My fiancé had chosen a name for what he was sure would be his son.  My hormones were off the charts.  I had to go back to the hospital and have a D & C, a most unpleasant experience.  All in all, it was pretty traumatic.

Even now, all these many years since, I sometimes stop and think about how my life would be different if I’d had that baby, who would be 22 years old this year.  I still think of her as Molly Marie.   

ADVENTURES IN NURSING

NURSING HOME CLINICALS

The day finally came when B and I and all of our classmates had our uniforms, our hated blue pinafores, our nursing shoes, our ugly white stockings, and some of “them” had nursing caps.  We scraped together the cash for our very own stethoscopes, the best we could afford at the time.  Some of us even had our own sphygmomanometer, which is just a fancy word for blood pressure cuff.  (I’ve often wondered who came up with this impossible-to-remember-how-to-spell, six-syllable word for the four-syllable term.  This person and their evil spawn need to be cursed, or at least cursed at!)

We were ready for our first nursing-home clinical day.  B spent a few minutes that morning upchucking her tea and toast breakfast, which would become her ritual on clinical days.  We were scared.  We were nervous.  We were student nurses!  Off we went!  Luckily, we were in the same group, so could cry on each other’s shoulders.

The routine was that we would be assigned one patient for the day.  It was our job to familiarize ourselves with our patient’s medical issues, medications, personal care routines, and what activities of daily living we would need to provide for them.  We had to know what medication was for which diagnosis, and any side effects of their meds to monitor for.  Were they independent or dependent as far as bathing, toileting, dressing, eating, et cetera?  We were their nurse for the day, and we’d better start acting like it.

I don’t remember my very first patient’s name.  I recall she was confined to a wheelchair, so my first thought was “easy-peasy.”  At least, I wouldn’t have to chase her down the hallways, trying to corral her into her room so I could do what I had to do.  She was also quite deaf, so there was a great deal of yelling back and forth going on, which really wasn’t all that effective.

I’ve always been a great believer that we should respect our elders.  This was due in large part, no doubt, to my mother trying to beat this philosophy into me for the first 18 years of my life.  It took, believe you me!  I had respect for my elders up the yin yang, and perhaps even a healthy fear.  Old people could be scary, even downright mean in some cases. 

I spent my day being just as polite as I possibly could with my little white-haired, bespectacled charge.  At one point, she was parked in the hall, observing all the hustle and bustle of a typical day in a nursing home.  I was standing beside her, attempting to have a conversation and appear as if I were engaging her in some meaningful way.  Suddenly, there was Mrs. B1, ready to grill me on the whys and wherefores of what we had been doing all day.

Feeling oh-so-indispensable, I leaned over to ask the little varmint if she was warm enough.  Before I could yell, “Holy crap!” her little wrinkled arm snaked out from under her lap robe and slapped me right across the face.  I can only surmise that she didn’t care much for my face being right in her face.  In any case, I valiantly controlled my urge to return the favor and smack her right back.  Please don’t judge me.  The urge was a reflex, for Pete’s sake.

The blow brought tears to my eyes.  That old lady packed quite a wallop.  I tried to regain my composure and not run weeping down the hall in front of Mrs. B1.  I have no idea what she was thinking in those few minutes.  We never discussed the fracas, and we both agreed that, yes, apparently, the ornery little critter was warm enough.  As I stood there gathering my wits about me again, I swore to myself that I would NEVER work in a nursing home or with mean old people once I became a nurse.

Ah, such famous last words.  It turns out, my career consisted of working in nothing but long-term-care facilities, with seniors and developmentally disabled adults.  I developed quite the talent for avoiding kicks, spittle, blows, fingernails, flying objects and many other things my charges might choose to throw at me.  I’m not saying I avoided every potential injury, but I did learn not to stick my face, with its phony plastered-on smile, in another old lady’s face and ask if she was warm enough.  I strongly advise you to do the same!

ADVENTURES IN NURSING

FIRST YEAR HIGHLIGHTS

After B and I got over our initial nervousness at being students again, we began to settle into a routine.  We would study on our own and quiz each other before class each day.  She was such a big help for me when there were things I just didn’t get.  I like to think vice versa was true for her.  In any case, my grades began to improve but, damn it all to hell, B’s quiz and test grades were ALWAYS a few points higher than mine.  Being 12 years older than she, I blamed it on old age and having more stuff to remember.  Her opinion of my opinion?  “Whatever!”

One of the best things about our first year was getting to know some of our classmates.  After the students who weren’t really serious about nursing were weeded out, we became an especially cohesive group.  Some of the teenagers even became friends with the old folk.  It was a real case of, “We’re all in this together!”  Besides the brother/sister duo, there were two or three other cases of best friends who entered the program together.  Even our instructors commented on how unusual that was. 

My fondest memory from our first year would have to be our capping ceremony.  It occurred later in the school year, right before our first nursing home clinical day.  We were required to pay $8 each for our nursing caps, which were part of our official uniform.  Attendance at the ceremony was mandatory.  B and I did not attend.  Allow me to explain.

B and I had long discussions on the subject.  I personally had always detested nursing caps, and saw no good earthly reason for their existence.  There was also the sad fact that I had very fine hair that wouldn’t even hold a barrette, let alone a cap that had to be pinned on.  Besides that, it was just one more surface to harbor germs, as far as I was concerned.  Oh, yeah, and I don’t look good in hats!

For these reasons, B and I decided not to buy the caps and to ditch the capping ceremony, even though it was considered a sacred rite of passage for a nursing student.  Bah, humbug, I say!  I was “morally opposed” to wearing a nursing cap and I wanted no part of it or the ceremony.  As I’ve mentioned before, we paid for this escapade for the rest of the program, having points taken off our grades each clinical day.  Needless to say, the Mrs. Bs were silently disapproving of our shenanigans.

Well, on our first clinical day, the classmates in our group made it perfectly clear to us how they felt about the whole thing.  They presented each of us with a urine “hat” – you know, the white plastic container you hang in the toilet to capture someone’s urine – as our own personal nursing cap.  They even had our names on them.  Isn’t that precious? 

At their insistence, we had to wear them that first day until our clinical instructor entered the room, to ensure that she would know right away who the rebels in the class were.  They all had jolly good fun ridiculing us, which made B and I sit a tad lower on our high horses.  Everyone’s a freakin’ comedian!       

ADVENTURES IN NURSING

THAT “OTHER” INSTRUCTOR

I don’t remember her name, and that’s okay with me.  She was a substitute instructor my clinical group was subjected to during our month-long summer clinical at the hospital.  Thank God we only had to deal with her for one day.  She was just plain old rude!  She seemed to think it was her personal mission to whip us all into shape in one day.  We were not impressed.

A little backstory to this is that my then-fiancee had a daughter who had already been through the two-year program in the class one year ahead of us.  However, she hadn’t been able to attend her summer clinical, since she was busy having a baby during that time.  Consequently, she and I found ourselves in the same clinical group that summer.  Once she got through that, she was eligible to graduate.  She was most eager to finally put it all behind her, and begin her career. 

Well, Mrs. Rude Instructor seemed to zero right in on this perfectly lovely young woman.  Lee (not her real name) had long blonde hair, which she wore up in a ponytail as required by the program.  She did, however, have corkscrew curls that hung loose on each side.  Well, Mrs. RI was not gonna let that go by unnoticed.  Before we even hit the floor, she informed Lee, with a flick of her pen on the aforementioned curls, that “those have to go.”  There would be no loose tendrils on HER watch, by gum and by golly!  Lee’s face turned bright red, and I was thinking, “Oh, sh**, here we go!”  I had witnessed Lee’s temper when she believed she had a righteous rant, and I was concerned that Mrs. RI was about to witness it, too.  Good for you, Lee!  You didn’t let loose on her, even though she probably had it coming. 

Mrs. RI was like those pesky little yappy dogs that latch on to your ankles and won’t let go, no matter what.  She dogged each of us all that day, watching and waiting for someone to screw up.  She criticized every tiny little thing she could find.  I seem to remember getting grilled about why I wasn’t wearing my nurse’s cap, which was required.  You’ll hear more about that in a future blog.  We were so happy to see that day end.

I really don’t know why people have to act like that.  I’m all for making sure that students are well trained before being turned loose on the world of nursing.  I don’t, however, think it’s necessary to just be a bitch to people who are trying their best to learn what they need to know – students who want to learn, and want to do things properly, and want to be proud of their skills and abilities.  The program was tough enough without throwing catty instructors who seem to have their own agendas into the mix.

Here’s the dress code for our clinical experiences:

 

1-     our nails had to be short, no nail polish;

2-   no dangly earrings, no visible necklaces, plain wedding bands only (no stones, no engraving, et cetera), a utilitarian watch with a second hand;

3-   our regulation uniform dress with the much-hated blue pinafore attached for the ladies; our nursing cap; white stockings and regulation nursing shoes;

4-   as mentioned above, hair longer than collar length had to be worn up WITH NO LOOSE HANGY-DOWN CURLS! 

Points were taken off our clinical grades for anything less than all of the above.  I get the concept, but many real-life nurses don’t follow these rules, obviously.  I was actually amazed when I began my career at how some nurses dress.  I continued to keep my nails short and unpolished.  The few times I wore even slightly dangly earrings, I regretted it.  If I didn’t lose an earring in some patient’s bed or clothing, someone with dementia would latch on to that sucker and convince me dangly earrings were not a good idea at work.

I don’t know how many hundreds of times I worked with nurses whose hair was hanging all in their faces, were wearing all manner of multiple rings on both hands, and bracelets on both arms, and necklaces right out there in plain sight, just begging for some unruly patient to grab hold and try to choke the life out of them.  It happens, and it’s not much fun!

I seem to have digressed from my original topic, but you’ll have that when I get up on my soapbox, which I usually carry around with me.  My point, if you’ve been able to follow this at all, is that nursing school isn’t really much like the real world of nursing at all.  Some of the rules of nursing school seem to be fairly arbitrary and perhaps even unnecessary, but we had to abide by them or pay the consequences. 

By the way, B and I, and our friend R, threw those damned blue pinafores in the bonfire at our graduation party.  That was one of the highlights of my life.  

ADVENTURES IN NURSING

MRS. J

I learned my most valuable nursing lesson from Mrs. J.  They are words that I’ve always remembered and apply to many areas of life, not just in the nursing field.

She was a hospital clinical instructor we met in our second year.  She was very pleasant, laid-back, funny as hell, and very down to earth.  She won our hearts when she agreed to adopt one of our too many kittens.  That was a big deal to us, let me tell you.

The lesson she taught us?  I suggest you remember these words and pass them on when appropriate.  “You don’t always have to know what you’re doing, BUT you always have to LOOK like you know what you’re doing.”   Isn’t that brilliant? 

Now, you may be thinking, “What the heck?  You mean the nurses who take care of us don’t always know what they’re doing??”  Let me assure you that nurses DO know what they’re doing, at least 99.999999% of them do.  If you look hard and long enough, you could probably find that one or two nurses on the planet who were taught the proper way to do nursing procedures, but choose to do it “their” way in real life.  Incompetent nurses don’t last long in real life, though. 

Imagine you’re a nursing student, and have practiced your nursing skills on rubber people for months and months.  Then comes the day your clinical instructor informs you that you’ll be catheterizing Ms. So-and-so in Room 839.  Not to worry – you’ve done this before, just not on a real live patient.  How hard can it be, right?  Then your instructor informs you that Ms. So-and-so might be a little testy, since two real live nurses have already attempted to catheterize her without success. 

This is exactly what happened to our classmate T, the tall blonde Viking goddess.  So T, our instructor, and three of us classmates all trooped into Ms. So-and-so’s room to do this thing.  Our instructor had a most ornery grin on her face as she explained to the patient why we were there.  The mildly overweight patient took one look at the tall blonde Viking goddess and said, “You get one shot at this.”

Thank the good Lord she wasn’t MY patient.  I would have dissolved into a puddle of tears at those words.  I was already a nervous wreck and I was just there to observe.  The patient then asked T if she had done this before.  With all the aplomb of a seasoned nurse, T replied, “Oh my gosh, yes, hundreds of times.  Don’t worry about a thing.”  She then proceeded to insert a catheter into an irate, mildly overweight patient without a hitch.  We observers were in total awe, and tried very hard not to act like we were all holding our breath during the procedure.  T was a star that day.  What a gal!

My point here is that T was following that advice.  She walked in that room with confidence, and instilled that confidence in the patient, so everyone relaxed just a little bit, and the procedure went off like gangbusters.  Your attitude can make a large difference to a patient, and can make your job so much easier.

Mrs. J had other sterling qualities that made her an excellent nurse and instructor – things like patience, compassion, empathy, kindness – but what I remember most about her is the advice she gave us.  It is invaluable advice and has served me well lo, these many years.

Thank you, Mrs. J.  I’ve never forgotten you!

HAVE A MOST ENJOYABLE HOLIDAY WEEKEND!

THANK YOU TO ALL WHO SERVE AND THEIR FAMILIES!

EAT, DRINK, BE MERRY, AND STAY SAFE!