The big lesson last night in clinical was learning what kind of nurse we do NOT want to be. Whew. Every single nurse and nursing assistant was in a major funk last night. Maybe someday when I’m a nurse I’ll understand why none of the nurses want nursing students but for right now as far as I can see it’s like having an extra set of hands… I don’t know why that would piss someone off.
The thing about nursing students is everything is new and exciting to us so if the nurse turns to you and says “I need a bandaid, will you go get a bandaid?” You think “SWEET! A task! I hope I do good!” and then run about to find the best band-aid you can find.
For some reason every nurse on our unit that was assigned a student last night gave us nothing but bitchy attitude when asked for report and then anytime we asked them anything.
Our instructor sent us out of our pre-shift meeting to get report from our nurse and assess the patient. There is only so much information we can get from the medical history print out. I’m not asking for a 20 minute dissertation about the patient but a simple “this is what’s going on, this is what we need to accomplish, this is what you should or should not do”. Is that so much to ask?
My nurse gave me a two sentence report “She came in this morning with DKA and blood sugar 452. She’s very groggy, you can help her set up her menu and TV, but don’t wake her up.” Then she was annoyed because I asked how you set up the menu and TV… but I mean for crying out loud it was our second night. I had the best experience trying to get report. By far.
In the first hour we were there our instructor actually filed a report because one of the nurses was so rude to one of the students who had asked for report. Not that the other nurses weren’t, this one just happened to do it within earshot of our instructor. See, the thing some of these nurses don’t seem to have caught onto is that our instructor is actually one of the advanced practice nurses who is in charge of that particular unit (not just some random community college teacher). So it would be a little like giving the finger to someone at work with a bit more authority than you.
Unfortunately for me, my patient I had spent all afternoon preparing to take care of and looking up drugs for had been discharged. Since I got a new spur of the moment assignment I wasn’t allowed to passmeds . As a rule (a big rule) we are not permitted to do ANYTHING drug related without our instructor standing by our side. Since I was not passingmeds I was doubly not allowed to do anything medication related… as a result, when I went into my patient’s room and found her IV pump alarming a “down occlusion” I had to do nothing and report it to the nurse. So I did. She glared at me then went into the room, promptly returned from the room and said “ok, lets look at this pump” I followed, she said, “What does it say”. I said “Down occlusion”. Then she proceeded to explain to me in a sarcastictalking to a three year old tone, “you need to check the line, do this, do this, do this”… To which I really wanted to reply, look lady, I know you’re pissed I dragged you away from your seat by the computer but I’m not allowed to so much as touch this stuff without my instructor present aside from that I’m not doingmeds tonight at all… that’s why I told you.
Then another nurse handed me a stack of drugs and told me to put them in 14’s drug drawer, so I went, but the name on the drawer did not match the stack of drugs she gave me, so I took them back to her. She said “well I KNOW that, it’s a new patient, put them in the drawer and take the name off the drawer” I continued to look puzzled, because I know this is something I shouldn’t be doing till she blasted out of her chair took them from me and said “FINE, NEVERMIND, I’LL do it” and stormed off.
The funny story from last night was our instructor was telling us the importance of visually checking on a patient who’s heartrate monitor has alarmed. When it alarms we’re to go to the nurse’s station, see who’s alarming, then go check the patient in person. (Here again we go excitedly following instructions to the best of our ability)… So a monitor alarms, me and Beth go, see it’s room 13, go to room 13 and stand there staring at the sleeping patient. Just try to visualize this: We’re the first two arriving on the scene, it’s 10pm, the patient is asleep and snoring, the lights are dimmed. The two nursing students stand therewhipsering to each other: “Ok , but how do we know if she’s having a heart attack?” “I don’t know? She’s snoring? So she’s breathing right?” “Would you always wake up if you’re having a heart attack?” “I don’t know? Should we wake her?” “I don’t know, she looks calm maybe we should ask the instructor for some more specific instructions on what to do when we GET to the room to check on the patient”
On our way to find the instructor one of the cranky nurses passed going into the room so we turned on our heels to follow to seeexacly HOW you check on a patient with an alarming heart monitor. The nurse turns and raises her eyebrows and says “Can I help you with something?” So I sweetly replied our instructor sent us to check on the patient but we weren’t sure what to do so we were going to watch you to see what to do.” Then her whole attitude changed and she seemed much warmer. She flicked on the lights and woke the woman and checked the blood pressure, heart rate, asked her how she was feeling, explained why she was there and then showed us how to replace the electrodes and make sure they were all still good. Beth and I were completely thrilled, we thanked her.
I spent most of the night just answering call bells. My patient slept all night, and I mean all night. She would wake, ask for ice, when I got back with the ice she was asleep again. I was incredibly bored last night because all the other students were passingmeds so that was the big focus and I wasn’t. I was ok answering call bells for a while, but with all the attitude we were getting from all directions it made us much less willing to help than we had been the night before