Tuesday, August 25, 2020

Nursing School Update: In the Hospital

 It's time for another nursing school update, I think.  The week off between classes was regrettably not much of a week off.  There were several little things that needed doing that week:  we met in person for the first time to practice and test out on skills that required manikins and certain guidance; a number of training pieces for our clinical settings needed addressing prior to clinicals starting; we had to get tested for our N95 masks for our maternal infant clinical; a dozen and a half mini-paperwork moments; and, oh yeah, our basement is in a particular state of shambles as we continue in our renovation process.  

Just like with the basement, though, everything is starting to take shape.  

I had a 22 gauge needle in my hand.  I've had so many IVs in my life, and the needle that I had in my hand was for going into someone else's.  Well, specifically a rubber arm, but, still, there was that moment, that rush of excitement when I saw a flash of "blood" return on my first stick.  The rest were more of a struggle, but that first one, that was edifying.  It will only get better.  It's a matter of time and practice.  It's starting to feel more real.  

We also have had the opportunity to meet some of our peers in person, after months of shared virtual space.  And it's fascinating to see how tall folks are in real life, if nothing else, yet the conversation is different, too, without folks worried about computer lag or whether someone else will speak up by the time they unmute themselves.  Now folks moved with a particular freedom among one another, while somehow still holding on to the awkwardness of moving through an unfamiliar space.  In short, it was an interesting balance between tentative and confident, that we knew one another in a sense but still didn't know how to know each other in this space.  We all had to find new ways to sort out the politics of a strange world--this was a small microcosm of that which fascinated me.  

And now, I can also include some generalities of my first clinical day, which happened last Sunday.  What do I mean by "clinical"?  Great question; glad that I pretended you asked.  It's a place and time where we are in some kind of care setting as students, to work with real patients and situations while supervised.  Most of mine happen to be at Bromenn in town, and I am working through a particular program that has twelve hour shifts, following a nurse for their whole shift.  

I certainly cannot get into the specifics of the persons or cases I saw, but I was astounded that in my first actual day doing anything on the floor, I found some very specific parts of my health history reflected in three individuals that I worked with.  There was an immediate sense of "I know this and I know you in this moment" that I felt for each of them.  In short, I'm going to be processing parts of that for a while, both the edification that my own suffering can benefit my empathy and response to the current suffering of another and sorting out what the bombardment of trauma triggers meant in those moments.  

Other than that, I fought with blood pressure cuff cords, changed linens with the patient in the bed, realized just how long a minute can be when you picked an awkward position to take pulse and respiration counts, hid computers so that I would have one when I needed one, stared at the wall of supplies trying to find that one thing, talked to a patient that was genuinely confused on where they were, pilfered thermometer covers from another room when mine had run out, loaded my pockets with saline flushes and alcohol swabs all used by the end of the day, figured out when to peel off and grab a swig of water, clicked through four screens trying to find where to document a urine output in the right place, rushed to help encourage a patient to sit back down after their bed alarm went off, and all around started to feel like maybe this could very much make sense.  And I'm sure that it was a slow day.

Staring at the patient med list, I'm acutely aware of how much I have to learn.  I still haven't started an IV on a real person, for example, nor have I experienced a number of things outside of a textbook.  Yet, I'm also ready to ask questions, be helpful in turn, and to try.  The time management pieces, I can do that with confidence; the experience pieces will come in time.  I feel a sense of belonging and rightness in these places but without a magical, glowing light or rose-tint around the edges--it's both real and right.  

We're in to week two of classes and many more adventures ahead!

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