10 years later.. Remembering my first clinical patient
I still remember my first clinical patient well. I was a brand new nursing student, never having touched a patient before starting school, and now she was in my care. She was elderly, although I don't remember her exact age. She had a past medical history list longer than my, everything that could go wrong for this woman had. End stage renal disease on hemo-dialysis. Hypertension, hyperlipidemia, hypereverything as I recall. And of course depression. Always depression.
I remember reading an article on the amount of depression that goes undiagnosed. It's a staggering number of people. This poor woman, cut in pieces, only her brain still working as it should. Lying in a bed. No family. No friends. Medical people were only only connection left to the real world. Who was I to interfere with this process?
As I came to learn over those two days with this women. A student was exactly what she needed. My instructor, an Irish woman with a voice that carried like she was a Greek goddess of old. Would bellow across the unit to her students, "Have you gone in the room yet... I will chase you in there if you don't go now"!!!... This woman changed my life this week and the six that followed. Here's what happened...
I started the week reading the laundry list of problems with this woman, and immediately broke into a sweat. Half of these words I couldn't even pronounce, let alone define. In those days we wrote our care plans the night before clinical, and I had worked so hard on mine. Still I was sure I wasn't ready. How would I get her out of bed. She's non-verbal, how will we communicate?? Incentive spirometer?? Riiiiigghhtttt... I was petrified.
So I did what any well abled nursing student would do. I didn't go in the room, instead ran circles around the unit. ducked in and out of the room. Vitals already done, oh well. Assessment not done, she was sleeping. Residents reading x-rays, that looks like more fun. Then I got caught.
"Go into the room yet", she asked.
"No. She was sleeping and I didn't want to wake her. These residents were nice enough to invite me down to radiology to read xrays with them. I thought I would go. It sounds educational".
"Is this true", she asked... All the residents turned on me then. I guess they were used to the amount of anger heading my way and knew to avoid all eye contact. Traitors...
"It was... Now I'm not so sure. Should I wake her then", I asked with a voice that Mickey Mouse would envy. what happens next is still a legend at the school, it gets talked about every year I come back to teach, and all students hear about it.
"Get out.. of that chair... and get in that room... now...".. I knew Irish folks often had red hair, but I never saw a red face... I swear to this day that a rainbow appeared behind her as she focused on every syllable of each word. I was petrified and like in the old cartoons, a figure of me appeared in the wall I ran through to get in my room.
I walked in to find a woman in a dark room at 3pm, shades down, lights off. She lay there alone, silent, eyes open but unfocused. Not knowing what to do I went to the side of the bed an defined a practice that I still use to this day. See I've always been a bit funny and use sarcasm to drive points home in a good way. So I said Hi ma'am.. I'm Phil and I'm scared to death that I'll do something wrong to you, so If I do, can you please not tell my instructor because I'm sure that window opens and I can't fly.
Her eyes moved. Towards me. Hmm...
So I said next, "ok, maybe we get you out of bed today. That bed looks ok, but really, lying around all day, how will you earn your keep.. Maybe we'll walk the halls together... That'll show my instructor wouldn't it"
Still staring at me... Did her mouth twitch? Was I getting through??
Then it happened. See in all my preparation, I missed the letters AKA... I was about to learn a valuable lesson. I pulled the sheets down and instantly knew what AKA stood for. No legs... I knew my career was over before it started.
"Oh", I said... Pulling myself together, "I guess you and I aren't dancing tonight huh"? It was all I had.. I was beaten... Then something happened...
She laughed. Loud and long. It was like music to my ears. She then said, "Son, I won't tell your instructor I don't have legs if you don't. I have a feeling getting out of this bed would do us both a world of good."
First words since she was admitted. She had been non verbal before that, they weren't sure why but it turns out she was so depressed that she had almost given up. Until that quirky nursing student showed up to walk her around the unit. I spent the next 4 hours in there, telling stories, listening to stories, laughing with a woman who would not survive the year but had changed my life.
I now work for that instructor. We talk of my transformation often. I still use humor and sarcasm with my patients. My favorite line to them is: "You know your sick in the hospital, your family knows your sick in the hospital, there is no need for me to come in here all glum and sad reminding you your here". Magic. I wish you all have a similar story of the "patient" that changed your life. Cherish it and cherish the gift we are given every day. I sure do.
Joined: Aug '06; Posts: 155; Likes: 261
Nurse; from US
10 year(s) of experience in ER, Critical Care, ParamedicineMar 19, '10One of my worries in clinical was going into a patients room. I still get butterflies from thinking about it. But now when I am working I go in patients rooms in and out all night and I dont think anything of it.
Even in OB when the mom was so excited to see me.... in the inside, I was freaking out.Mar 19, '10I wish that I had that witty humor....I just looked at my patient and cried out loud like a baby for half the day.Mar 19, '10It's been just about that long for me. Sure brings me back (the part about the abject fear especially!)Mar 21, '10awesome story! Thanks so much for sharing. It's comforting to know that I'm not alone in that fear of walking through the door for the first time.Mar 23, '10thanks for sharing your story i don't think i would have gone through nursing if it weren't for my patients.when i was a nursing student i spent most of my time listening and talking with patients, and it made my experience so much more meaningful & w/ purpose.i wish i get alot of that oppurtunity when i work as an RN.i know its hard when you have so many patients to care for.but when you take time to talk & listen to them, it just makes their day & your day awhole lot better!Mar 24, '10Funny, funny story. I am a new student and I am very familiar with the anxiety and pretending to be working on something while in clinicals so that my instructor leaves me alone hahaha. I hope to someday to be able to look back and say "what a ride".Mar 24, '10Wonderful story..I so enjoyed it. I related to the fear of going in to a new patient and hoping that I didn't come across like a new student..not knowing much, scared, but wanting the patient to trust me and like me. As a new graduate, working in a nursing home with so many residents to take care of ( and I insanely thought the stress I felt ofwould be over once I started working as a nurse) I miss having time to sit down and talk to my residents. With the med passes, charting, helping at mealtimes, etc,etc, I find my time is so limited. However what little time that I have with my residents is accompanied by my smiles to the residents, laughter and jokes, genuine concern about how they are feeling and very often hugs and caresses to their faces or loving pats to their hands. I realized I don't have a lot of time to spend with them but I can change the quality of the time that I do spend with them. It is a work in progress and I find that the residents look forward to my presence even if it is in 3 min increments. The residents need to feel loved and cared for and I hope that I give them a little of what they deserve..to be treating with kindness and respect for living their lives and not feeling that their lives are over because they can no longer take care of themslves and have to depend on others for a lot of their needs.Mar 24, '10What a great story!! I'll graduate this May, and I remember my first clinical experience like it was yesterday! I was terrified to go in the room. My patient was under 70 and in a nursing home because his wife could no longer care for him on her own due to his MS. He had contractures from the waist down, had lost bladder control, and was beginning to lose the use of his hands as well. I was so afraid to say something or do something wrong...and how in the world was I going to move this guy so I could give him a shower?! And, what if he hates me? Just as I had that thought, I heard "Get the **** outta here!" As something bounced off the wall behind her head, one of my classmates ran to the nurses station in tears. While consoling her...my instructor saw me, and said..."you'd better go in there!" Yeah....right...
Well, after I talked myself into walking in the door, my patient exclamed, "Hey!! The students are back!! Great!!" I immediately felt 100 times better =) Our first task that morning was to take a detailed history of our patients. One of the questions was about sleeping habits...so I asked my patient..."When did you go to bed? (meaning the night before)" He rasied an eyebrow at me, looked down at his contorted lower extremeties, then started laughing and said..."When did I go to bed?? About 8 years ago!! Did you mean what time do I go to sleep?" I was so glad he had a good 'ol sarcastic sense of humor just like me =)
After lots of transferring help from a friendly tech, I was ready to take him to the shower. I was so busy concentrating on looking like I had done this before (ha!), that I failed to notice my left foot was directly in the line of fire of the shower head. On the way back down the hallway, all you could hear was *step, squish, step, squish* My patient looks back at me and says..."umm, honey is that your foot? You know, usually, I'm the only one who gets a shower around here...but don't worry...I'll get you whipped into shape yet!" I was sooo relieved that my first patient care experience started out on a good note, and that gave me the confidence boost I needed to keep on truckin!!
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