I’m pretty sure he’s dead.

Another patient that I had during my ICU clinical rotations was an older man who pretty much had one foot in the grave.  And the other one on a banana peel.  It was awfully sad as he did not have any family at all except one niece who lived far away and would call occassionally to see how he was doing.  It was my first experience witnessing death as it happened.  I was in the room when the old man passed.  It was so strange to see the flat line on the monitor and then take him off of the ventilator. 

A little while later, we began to clean him up, put a toe tag on him and then get the body bag ready to put him in.  Only, his chest started to move up and down like he was breathing.  I almost had a heart attack right then and there on the spot.  I mean, geez, what if he really was alive and we sent him down to the morgue?? This freaked me out.  I went over very carefully and felt for a pulse: nothing.  I then listened for a couple of minutes with my stethoscope to his heart: again, nothing.  But his freaking chest was going up and down!!! 

 Well, apparently, there is a such a thing as reflexes that make this happen. 

“He stuck a bottle up his butt.”

Yeah, you heard me right.  This was my first patient I had as a student in the Intensive Care clinicals.  You would have to understand how timid and shy I was back then to fully appreciate how upsetting getting this patient was. 

So, I came in that morning and got my patient.  Frequently, in the ICU patients get transferred off of the unit to another place as is what happened with the patient that I had the day before.  So, I got a new one.  We’ll call him Mr. Jones.  The nurse always gives the student nurse a full report which includes how the patient’s injury was sustained or a synopsis of their illness.  She began, “Mr. Jones was at home last night and had taken a soda bottle and put in pretty far up into his rectum.  When he could not get the bottle back out, he had to go and ask his elderly mother to take him to the emergency room.  Upon further inspection and tests, Mr. Jones had perforated (torn) his intestine and was seriously septic (infection throughout his body).  He is in critical condition and we are unsure if he is going to make it.” 

 Okay, I turned red, then white, and did not know how I was going to face this person.  A soda bottle up his butt?? I mean, I think, I’m pretty sure I knew what he was doing, but geez……HOW EMBARRASSING!  And now he may die from this?  How would you like to have people ask “What happened?  How did he die?”  I mean, the obvious out was “from an infection”.  But can you believe that he actually had to tell his mother about what he did so she could take him to the emergency room??? 

One other gross story was how a nurse friend of mine ended up in the ICU with a similar story, except he had gotten a gerbil caught up in his butt and hurt himself trying to get it back out. 

What is wrong with people??!!!!!

September 11, 2001

The third semester was getting to work in the OB/GYN and pediatric units at the same local hospital, with some rotations in a much larger place with a NICU and also had high risk OB patients.  Amazingly, I liked these two areas the least.  I never got to see a vaginal birth in nursing school.  All of my patients had complications and had to have C-sections.  I was taking care of a postpartum patient on Sept 11^th when someone gasped whose mother in law had called to tell them that a “kamakazi pilot had flown a plane into the World Trade Center”.  I remember hanging out in the nurses’ lounge and watching all of the things unfold that day in there and on patient’s televisions.  It was just awful.  Our instructor’s daughter was a flight attendant in New York.  Our instructor had a complete nervous breakdown that day (not knowing if her daughter had been killed or not—which thankfully she was fine), and she never returned to teaching.  That was her last day with the school. 

There were a few babies there born on that day.  It will not be one we forget anytime soon.

Clinicals in the Hospital….FINALLY

My second semester was very exciting because we FINALLY got to do clinicals in a real hospital.  I had a fantastic instructor who encouraged learning, did not make you feel like an idiot, was kind and gentle, yet expected nothing less than excellence (or at least that you tried your very best).  No doubt she was called to be a teacher. 

I am honestly having a hard time remembering my first patient in the hospital, but do remember it being the first time that I would have to try and get someone on a bedpan by myself.  In the nursing home, we teamed up a lot to work faster.  But now, we had to learn to manage our time as well.  It took me around an hour to get this poor person on the bedpan, wait for them to finish, and get them off and clean them.  And guess what?? It spilled.  So, now, after making a bed on a bedridden patient, I had to do it all over again.  It was horrible.  I kept thinking, “This is NOT what I signed up to do”.  It was not until later that I truly learned how important it was to know everything from the ground up about skills and how to care for a patient because I would certainly be training, delegating, and evaluating those who were also going to be doing these things.  

Alzheimers and a baby doll

I occasionally think about this one resident in the nursing home that I did my clinicals at.  I remember coming in the door each week and hearing her CONTINUOUSLY mutter (very loudly) “Oh me, oh me, oh me, oh me, oh me” and would keep going.  Stopping only long enough to get a breath to continue saying that.  For some reason I liked her.  She held a baby doll and kept talking about her baby that died.  I have no idea if this were actually something that had happened to her a long time ago, or she had just gotten confused and convinced herself of this.  At any rate, she would speak as if the baby doll were a real baby and she had to take care of it.  Any conversations with her were short and revolved around this doll.  I never saw any family come and visit her while I was there (but I was only there two days a week).  I wonder if she is still alive today. 

  

I never knew osteoporosis could be this bad…….

So, some memorable moments in the nursing home was when my instructor came in to help us give a bath to a rather rowdy resident.  This older lady could be downright MEAN.  She was confused, and got frustrated easily.  When this happened, she could get quite physical.  Yeah.  So, there we were trying to bathe her when my instructor walked in to lend a hand.  The older lady apparently didn’t like my teacher from the time she saw her, so she pinched her on her butt, and my instructor firmly told her that she could not do that.  The older lady did not take well to that, so she reached up and slapped my instructor.  Really hard.  I really didn’t know what to do.  I mean, I’d never seen anything like this in my life.  I think this was the first slapping I’d witnessed.  My instructor was embarrassed, and probably in some stinging pain too.  She had a pretty good red handprint on her face for the rest of the day.

Another resident that I had was an older British lady who had osteoporosis.  She was so frail and had kyphosis (hump back) really bad.  It looked like she was frozen in a position as if she were bent trying to touch her toes.  It was just horrible.  She cried and cried with pain from the osteoporosis.  When we tried to clean her up, we had to get her beautiful Laura Ashley gown off of her.  She screamed when we tried to take it off because it hurt her to move so much.  She cried out for us to just “cut it off” rather than slip it over her head.  I remember somehow getting it off without having to cut it.  But this left such an impression on me.  I had no idea what a severe case of osteoporosis could be like; such pain and suffering.  I WILL remember to drink milk or take calcium supplements!!

Clinicals in the Nursing Home

As a first semester nursing student, you typically do some rotations within the nursing home. (This is, unless where you live has a lot of clinical space at the hospitals, which was not the case where I was.) The day before the clinical, you must go to the facility and get information on the patient which you are assigned. This can take quite a bit of time depending upon which patient you get. Most of the patients in the nursing home have charts that look like novels, and usually are broken down into more than one continuation of their chart. It’s really hard to find where and when problems originated, which is part of the information you are to collect. After doing this, we would go into the room and say hello and let them know that we would be their student nurse the next day. Okay, so I would probably freak out if I knew I had somebody practicing on me. But these folks LOVED having students. And the staff did too; it really helped them out! The nursing home residents would get extra attention and some interesting conversation for the day. I met some of the most interesting people during my clinical experiences.

Although it was a few clinicals later until I got to give medications, I remember just about freaking out over how many pills these people could take. And then you’d crush them all and mix them up in applesauce, YUK!!! Sometimes you would get residents that would refuse their meds, or spit them out at you. It was totally impossible to know how much of what medication they actually took in and how much they had spit out. This made it extra difficult when we would try to evaluate if a new medication was actually working.

Overall, aside from the smell that you pretty much have to get used to, the nursing home is a pretty good place to work. I can say this from experience as a nurse manager now. But at the time, I swore up and down that I would NEVER EVER in a MILLION YEARS work in a nursing home. Yeah, I’ve done a ton of stuff I said I wouldn’t do. Eating my words……is that how I gained that weight?

Starting the ADN program

I began this program having almost all of my prerequisites finished.  This would make my life a ton easier during the program.  I remember the first day: orientation.  I saw the second year nursing students walk in and thought “Wow.  I wish I were one of them.  They are almost done.”  In a two year program, they were considered “Seniors”, while we were considered “Freshmen”.  I never understood how that worked exactly, being a junior college and all, but whatever.  In only one year I would too be a senior nursing student. 

I did feel a little bitter about the fact that the majority of the few hours I had accumulated did not get me out of having to take classes.  This was because the majority of what I had done at the four year university was primarily theory courses.  Like writing papers about Florence Nightengale and such.  Honestly, I still don’t like the theory part of it all. 

What do I remember most about that first year there?  Well, for one thing, my class was definitely a mix of traditional and non-traditional students.  It gave us some mother figures, but they were usually, and very sadly, the ones who struggled the most.  This was certainly not because they were lacking in intelligence, but rather that they had numerous additional responsibilities like two jobs and three kids in addition to full time school. 

This is a tad apart from my nursing course, but I want to share this as well.  I had to take a speech class as part of my requirement (and I think they’ve dropped that requirement now).  One of the assignments was that we had to give a speech on a country that we were assigned.  I don’t really remember what mine was.  For some reason, I’m thinking it was Canada.  In the high school I went to, sadly, the geography teacher taught us that Canada was part of the United States.  What he meant was that it was part of North America. But I’m sure some of my classmates will wander out into the world banking on what he had said was the truth.  But  everyone in the class was totally confused when this one girl who had been given the assignment of speaking on Austria began talking about the kangaroos and the great barrier reef and crocodiles.  Poor thing, it was clear she had thought that Austria was Australia.  I tried to maintain my composure but was dying laughing inside.  I mean, I could have clearly done the same thing, but I did happen to know the difference.  I still laugh about this when I think about it!!

Leaving the Nursing Program (well, the first one)

I finished up that first semester of the BSN program with a solid B average in my classes.  I started into the second semester when to my delight, I got married and was moving.  I think I secretly liked the fact that I had an “excuse” to get out of this particular nursing program.  I liked the program, but really, couldn’t the instructors be any nicer than say, Satan? 

Okay, so I left that program only to find out that I was NOT in fact moving as I had planned.  Great.  What to do now?  So, I thought, can I possibly get done ANY quicker???  I applied to an Associates Degree Nursing Program where I could receive my two year RN degree.  It seemed like a pretty good idea.  I went to talk to an advisor who let me skip taking some kind of entrance exam that was required of the other applicants.  This was because I had been accepted and successfully completed a full semester of a program with a little bit stiffer requirements than the one I was currently looking into.  She also felt sorry for me that my move didn’t work out!

After a few weeks, I finally heard from the program and guess what…I got in!! I was so excited.  Another journey would begin.

My First Clinical Experience

My first clinical ever was in a local nursing home.  My nursing professor/instructor was an older lady who fussed at pretty much everything.  It just changed as to what she was going to fuss about that day.  It was quite a nerve racking experience.  The thing I remember most was first, the smell of the nursing home.  The other thing was that when I went to take my patient’s blood pressure, which I was sooo proud I had done correctly, in walks my nursing instructor.  DON’T DARE PLACE THE BLOOD PRESSURE CUFF ON ANYTHING WITHOUT A BARRIER!!  –she screamed at me.  What she meant was:  when you place any of your personal items (which happened to be the blood pressure cuff I’d recently purchased as part of my essential nursing kit), make sure to place a paper towel or such down and then lay your item down so it doesn’t collect the germs from that patient and then you take it home with you or transport it to the next patient you visit.  Okay, so that made sense.  But why didn’t she say it the way I explained???  This was simply a taste of what was to come in nursing school.  Great.