Sunday, February 24, 2013

Clinicals Journal

Things are busy. It's that time of the quarter. Lots of exams. Lots of deadlines.

In the middle of everything, I've got to stop. I've got to write - partly cause I want to make the most of this learning experience; mostly because I want to remember the journey.

Warning: I'm being very real. Telling you just how it is. You might be panicked. You might think...well, I don't know what... Just know: I am learning and that this is my honest journey. 

Clinicals Day 1:

Today is my first day wearing scrubs. They've been hanging in my closet since Christmas, and today, I finally put them on. I focus on collecting my books and packing my backpack as mom and dad whistle and tease the "nurse" they've got on their hands. They know I'm excited. It's a big day. I have take my nurse 90 theory final at the college before I can drive down to the nursing home facility.

I take the test. I have my normal test jitters (Oh, the joys of college:). Then on to orientation. We form a white processional walking down the nursing home walls- these classmates, Pattie*- my teacher, and me. We stop again and again as *Pattie bends down and talks to the residents. They love her. She knows them...and from here on out, they are her co-teachers for us. They are so excited. They love to teach. They've been waiting for her next class to come since the end of last quarter.

 I'm assigned my clinical partner, *Ina. We've sat together the entire class so far. We're happy. Our first assignment is to go on a scavenger hunt to find all the places and tools that we will need while we are working here. This place is so big and so confusing.

Today, I get a peek into the lives of a few people. I get a peek into the shortness, the fragility, the basicness of living. My crazy world shrinks for awhile. I realize that it doesn't have to take much and just eating, breathing and sleeping is all that could be left. But here, I meet heroes, people who've learned to take things in stride, who live day to day, moment to moment, and who love little things, the simple things, who will bless the little world around them for everyday that they live. They inspire me. I determine to use every moment, every ounce of strength, every breath I breathe to it's fullest.

Clinicals Day 2:

It's not quite 7:45 am. I barely sit down in our makeshift classroom at the back of the nursing home, and I'm sent out on my first mission of the day. My partner, Ina*, and I are supposed to find our patient in the dinning room and assist her with breakfast. We get there, and then we realize that we don't know what she looks like. I run back to Pattie* and explain our situation. She's looks at me and says, "Did you ask?".

"Uhhh, well..."  We step in the dinning room and she confirms that we were pointed to the right one.

Breakfast is a great time. I help the lady beside us while Ina* assists our patient. Pattie* comes around and helps encourage them to eat. There's such a warmth around her. She get's close to them. Her voice is low and caring but normal.  She greets them...they know that she's sincerely happy to see them this morning. She's showing us everything she's taught us in the classroom. She's showing us what it means to care but also respect.

I loved learning in the classroom. I realize how much I'm going to love learning in "real time".

We measure the amounts our patients eat/drink. Just for the record: 240cc for the big cups, 200cc for the little cups.

I wheel the patient to the activities room. I get in trouble with the staff for trying to lock her wheels. I guess that's considered restraint. I quickly take brakes off and hurry to my patients room.

*Ina and I know that the patient's care directives say that she needs to go to bed between meals. We scratch our heads, "Should we put her in bed or should we wait for *Pattie?" We go back and forth for quite awhile. Pattie is busy with a multitude of situations with the other patients and students (she warned us that we would want to clone her!) and so we finally decide that we probably should  go ahead and put our patient in bed. We've learned how to do this in the sim. lab back at school, so we get started. The gait belt, the wheel chair locked and lowered, the patient in bed...quite a process. But as much as we try to be professional and to do things well, we realize that we are not the slickest at this job. We walk around the bed...I'm sure we ask her if she's okay a half dozen too many times, but we can't remember what else to do. SO pathetic! We don't realize how pathetic we are until...I walk back in the room a few minutes later. *Pattie is standing there...she looks at me and realizes that I don't have a clue that I've made a bunch of mistakes. "So you did a transfer?" she asks.


"Did you put a transfer sheet and a barrier pad down?"

"Uhh, no."

"Did you make sure the bed was lowered?"


"Did you check for incontinence?"

"Ummm...Not yet."

"Did you prop her with pillows?"


I've got the picture. We've messed up, and a flickering memory of a skills checklist comes to that she was supposed to sign off each skill when she watched us successfully complete it on a real patient.

We've got some work to do.

First off, we need to do some peri-care. She tells us to get our supplies for the job and that she'll be back in when we are ready to start.  We're embarrassed. Thinking straight at this point is a trial, and so we are racking our brains trying to remember what supplies we will need.


I turn to my partner, "How many?".

"Four, I think." That's how many we used in the sim lab. I find the closet and get a barrier pad and get five rags for good measure. *Pattie meets me in the hall and asks me what I've have got. I explain,"Barrier pad, five rags..."

She gives me that look again. It's not mean or anything. It's kind of a smile. It's kind of understanding cause she knows how much I want to do my best...and somehow, she probably knows that I will. But right now, she knows I've got a few things yet to learn. "Vanessa, do really think that five rags is going to take care of this job?" (by now, we've checked and we know we have a big project on our hands).

My mind is whirling. I blurt out, "Ina* told me to get four". UGH. The stuff that comes out when you're in a pinch...did I say I'm learning from this experience?

"You need more like 10 rags".

Back to the closet. I find five more rags.

I turn back in the hallway. Then I find out that what I have are washcloths and not rags at all. 

"You poor girls." Pattie* brings me back into the closet and shows me what real rags are. Meanwhile, I've "soiled" 10 washcloths that will have to go through the laundry again before they can be put back in the closet.

Our teacher is patient. She makes up for our inefficiencies and shows us how. I'm learning to say "Oh well", learn from my mistakes, and watch and replicate because someday, I will be a nurse like my teacher.

This is just a taste of the first day "on the job". I feel like a deer in the headlights almost all morning, but funny, somehow, I enjoy the whole process despite.

I really mean it when I say: couldn't find anything, couldn't remember anything, and did pretty much everything wrong. I feel kind of like I did when I started driving. That's encouraging cause now, of course, I don't have to strain my poor brain to remember all the steps to change lanes or think about which peddle is the gas and the breaks (good thing:). Someday, this too will be almost as natural as breathing. Someday.

For now, I go back and forth to the room. Undoing, redoing, asking, looking, trying, laughing, loving, and knowing this will forever be on my memorable and most educating experiences list.

Oh, and a couple other things for the record:
 1. I figured out that small gloves are really too small. I'm going for the mediums here on out.
2. I've learned: when in doubt, ask!
3. I've learned what it means to get close to the patient to talk to them


I've had a few more clinical days since DAY 2. I will write about them later. But just FYI, we got into the swing of things faster than I imagined we would.

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