Friday, March 2, 2012
Not for the Faint of Heart
Eight weeks ago I started on the hardest and most fulfilling journey. My entire previous life ended and I was dropped in the pool and forced to sink or swim. This is probably the best thing I've done for myself in 4 or 5 years and I know that it will go by in a blink of an eye, just have these eight weeks have. It was nothing I expected and everything I didn't know that I wanted.
I've never in my life taken tests like the ones they give in nursing school. I consider myself to be a fairly good test taker, especially when it comes to multiple choice. I'm incredible at recognizing but not necessary recalling information. The thing about nursing school is that you are given hundreds of pages to read, you're forced to attend lectures, and then you have to pass tests by choosing not the "right" answer but the "best" answer. For example,
There are several safety hazards on your unit. Which one would you attend to first:
a) The water tank is leaking in the waiting room
b) A medication cart is missing a wheel
c) A patient in a contact isolation room's call light is out
d) A sharps container is full and about to spill over
All of those things are dangerous and could cause injuries and law suits out the wazoo. I went back and forth between a and c for maybe 5 minutes before I realized that my patient should come first before anything else and that there is no way for that patient to ask for help. Every test is like this and frequently I find myself thinking half the answers are the best answer. Thankfully, I've managed to get B's in my classes and I've begun to find out that group studying helps tremendously. You can only read and go over powerpoints so many times. If you get with a group and discuss different scenarios not only are you applying your knowledge but you are also keeping yourself awake and in a support network. Being awake and having emotional support is really have the battle.
I thought that pharmacology would be easy since I worked at a pharmacy management company and I have heard of so many different drug names before. I found out that pharmacology is definitely not just drug names. I learned that every patient is unique and that you have to use the right dosage, right route, right medication, right time, and right documentation. Nothing is as simple as it looks. There are so many factors to consider and since the nurse is the last one to administer the medication, the nurse is responsible for any ill effects or harm. Oh yeah, and they also have to counteract any harm done if that's possible. It's a tremendous responsibility and as we discussed in clinicals, it's sad how common medication errors actually are. I won't even go there, because you don't want to hear these numbers. I'll just keep studying hard.
Assessment skills-frighten me. Hearing heart sounds, lung sounds, and gastric sounds is only half the battle. You have to be constantly aware. By looking at people really closely you can tell so much about their health.
In nursing school, you are learning so much very quickly. You really don't have time to deal with normal life things like moving, bills, laundry, or making dinner. You get help for your family or you make time. It got to the point where after 6 weeks I decided it would be better for me to quit my job and just focus on nursing school. Brandon has been an absolute angel and is picking up so much slack. I can't wait to be the sugar mama of the family in 2 years. I will make it through! You have to keep telling yourself that. Three students have already dropped out of the program due to various issues. There are many students in my program of various ages with children (from a couple of months to teens), jobs, and you know, lives. I have no idea how they do it and try to remind myself that I have it really easy.
The other thing that gets your through is your fellow students. They are they only ones that truly know what you are going though. My class has a private facebook group that helps to keep us all on top of that pertinent question, "Uhhh we were supposed to do this, this, this, and what else again?". Also, it is a great way to organize study groups.
Clinicals have been a profound experience for me. Two weeks ago we started going to long-term care facilities twice a week for 7 hours in groups of 10 or so. My clinical instructor is absolutely amazing. She's calls herself a "dinosaur" nurse because she has been a nurse forever. She always reminds us to not forget about the little things. Nurses today are wrapped up in documenting, assessing, but tend to forget that the patient might want to brush their teeth before they go to bed or that they are in isolation and haven't spoken to or touched a human being in weeks. We always have premeeting and postmeetings where we learn about the body or learn about a few drugs. Then, we have deep life discussions relating to our experiences or research articles that each student presents.
Yesterday, we were discussing an article that talked about how student nurses would care for homeless people as their first clinical experience. In Central Florida, we have a ton of homeless people and many of them live in "communities" in tented wooded areas. They have societal hierarchies, the look out for each other, and if they need medical care they go straight to the ER. Our clinical instructor said that in her community health class they used to drive around to different houses and bring scales along with them to weigh babies or give shots or do whatever needed to be done. They would do something different everyday, learn something new, and they just LOVED it to death. Or as she so eloquently put, "We were like pigs in slop". A year later, a student nurse went to a man's house to provide care to him and was raped and murdered. The school stopped doing community nursing.
This lead to a discussion about whether homeless people should be given the same care as everyone else...we all agreed that everyone should be given the same level of care. We discussed our encounters with homeless people or people dressed like homeless people asking for money and then putting on their work suit and driving away in their BMW. We talked about things like Catholic Charities or the Salvation Army and how some people even when give job skills and resources, still prefer to be or end up in the woods or on the street. We talked about how mental disorders, alcohol, and drugs contribute to homelessness. We talked about how there were no easy answers.
Then, our instructor ended our lesson by telling us about her brother. Her brother would never give homeless people money but he would ask if he could buy them a cheeseburger and fries. Then, he would sit down with them and talk to them like they were the most important person in the world. He did this regularly. Eventually, our instructor's brother passed away and tons of people showed up at his funeral. During the funeral service a homeless women with tattered hair and ragged clothes came in and walked up to the casket with a plastic flower. She was bawling and throwing her body over the man's casket and laid her flower on top of it. Immediately security guards surrounded her and started to drag her away. His sister yelled out, "Stop! Let her be! Leave her alone!" because she knew that's what her brother would have wanted.
Then, I cried in front of my entire group. I wasn't the only one though. That night, I went home with my heart full of the women at the nursing home who could not speak or move, who I had given a bolus feeding that evening. My heart was full of my resident who was only in her 60s but had trouble verbalizing because of her stroke and was in constant severe pain. My heart was full of the woman who I joked around with while I helped her to the bathroom and she just sucked in the attention I gave her like she was starved for it. My heart was heavy for the woman who had to be given Xanax because she was out of money and being sent home. My heart was heavy for the man who was on 3 liters of oxygen a day who wasn't on any oxygen last year, my instructor noted.
Nursing is not a career. It is real and it is life. You learn that you have to treat everyone as you would treat your mom or dad or yourself because no one really knows for sure when and how they will die. Nursing is raw and it's not for the faint of heart or soul.