Clinical makes me want to quit

  1. I had my first day of clinicals this week (ever). I have basically been crying ever since. I saw a stage 4 pressure injury (that I had to irrigate and dress). Plus loooots of incontinent patients and bed baths etc. I love the science of nursing and thought I would love the chance to care for patients. But I spent the whole day gagging and trying not to throw up and I can't stop crying. I feel like seeing people like that was worse than I thought it would be- that it's just too hard or sad or draining and I feel like I don't have the stomach for it. I've been a doula for a long time and love birth, so I wanted to get my BSN and eventually become a midwife. But now I literally feel like I can't do the clinicals this semester let alone the whole program. I feel like it's something I *might* get used to but that I don't want to be "used" to seeing wounds like that. And like I'll never be ok with adult urine...it smells so much worse than I thought it would...and I had a patient with a trach and she kept coughing sputum out of it and that made me super sick.

    My family wants me to stick it out and go for it but I don't know if I can. I feel like maybe i would regret it later or I'm worried I would, but I also feel like I definitely don't want to do this bedside care and that I don't want to waste money trying to get through school only to possibly discover when working that it hasn't gotten any better. Help? Thoughts? I'm doing really well in classes but idk about the clinical practice. It's just so much harder in person than I thought it would be
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  2. 13 Comments

  3. by   JCD2712
    You are not alone. Hang in there. I'm a nursing student about to start my third round of clinicals, and they get so much better. I started with med-surg on an adult oncology and transplant floor, and I had some similar experiences: feeling sad, feeling overwhelmed, feeling disgusted. So I repeat: hang in there! So many of my classmates and I have turned to each other and said, "I. HATE. THIS" but we kept going, and things have gotten better.

    There are tricks of the trade to help you not feel physically sick (sniff an alcohol pad after leaving a room to "erase" the smell, ie) but I think you will have to deal with emotional stuff -- you said you don't want to get used to seeing wounds like that, but I think as a nurse you need to have that game face. Your patients and their dignity requires it. More exposure will help. You should get used to it -- don't become emotionally numb to human suffering, but you have to get past the squeamish stage. And you will! It sounds crazy, like how could I ever get used to the smell of urine? But I am now. And you will be too. It's the crucible, so don't give up now.

    Also, someone else correct me if I'm wrong.....but I've heard that once you're an RN working the floor, those beloved CNAs do a lot of the toileting As a nurse you need to know how to clean someone up, but perhaps you won't be doing it all shift.

    And lastly, I've also heard that every nurse has that one thing that makes them gag: vomit, poop, urine, menstrual blood, phlegm, etc. Find a friend with a different gag trigger and trade

    Hope this helps! HANG IN THERE NURSE
  4. by   hopefulmidwife1
    Thank you! That's the same floor I'm on now. I'm struggling and dreading this next week of school. I really appreciate your comment! It's one thing to hear that stuff from my family who doesn't really get it at all since they're all in art/education and never had any experience with this kind of stuff. It is helpful to hear someone who knows what it's like talking about feeling that way too
  5. by   CrunchRN
    Focus on how you are helping them. I know that sounds simplistic, but it will help you adjust.
  6. by   imhorsemackerel
    I nicknamed my clinical experience as Bed Baths & Beyond. You can try putting some Vicks on your nose, if the smell is something you can't tolerate. Does your instructor tell you where you need to improve on?
  7. by   hopefulmidwife1
    No she just told us all we were the best group ever and she didn't really watch us at all. Neither did the nurses. It was sorta go for it yourself...with the wound care she told us what to do and had us do it (unsupervised though, but we had done it on the sims...once...in lab). It was basically "go take care of them" and the nurses on the floor didn't speak to us hardly at all. Only one did and she wasn't even with any of our patients. She just let me follow her around a little.
  8. by   BSNbeDONE
    Quote from hopefulmidwife1
    No she just told us all we were the best group ever and she didn't really watch us at all. Neither did the nurses. It was sorta go for it yourself...with the wound care she told us what to do and had us do it (unsupervised though, but we had done it on the sims...once...in lab). It was basically "go take care of them" and the nurses on the floor didn't speak to us hardly at all. Only one did and she wasn't even with any of our patients. She just let me follow her around a little.
    This is just unacceptable in my opinion. Your instructor should be there guiding you. Being shown in sim lab is one thing. You should be checked off in the lab and on a real patient before being left to perform these tasks alone. No wonder there are those threads surfacing where nursing students are having to retake the NCLEX numerous times.

    There should be someone there to show you where the PPE (personal protective equipment) is located. Lots of actual nurses wear masks during wound care. I, personally, do not because I've been at this long enough to not be phased by the sight or smell.

    My weakness is sputum....cannot stand it at all! Trach patients do not phase me, but sputum that is produced from a non-trached patient just ruins my life for the duration of the encounter. I mean, singing birds choke, sunflowers die, thunder roars, you name it. That's how I feel if I see it. But, I learned to turn away and begin a conversation during those 'special' coughing episodes so that I can't see or hear it.

    If you stick with this, you won't have to endure these types of things every single day. But do realize that if you are assigned such a patient, you may have to view those wounds more than once during your shift, even if it's at the request asking for your assistance to help hold the patient over while patient care is being performed. And be forewarned that these folks are sick. It may be a Stage IV wound today, and something entirely different tomorrow that'll make you wish for the Stage IV wound patient...such as a colostomy patient with diarrhea. This is the reality. I'd much rather change that wound dressing once on my shift than empty a colostomy bag 4 or 5 times (your CNA will have far more patients than you'll have and therefore, won't be available for each diarrhea episode).

    Now, if you cannot stand adult urine (which I believe is the most basic of patient excrement), you are pursuing the wrong career because those bodily fluids, well, let's just say that you ain't seen nothing yet; but even those, too, are things that one can adjust to.

    I'm not trying to discourage you. These are things your instructor should be telling and showing you; these are things that you really need to come to terms with before sinking thousands of dollars into a major that you may not be cut out for. Your instructor should be holding your hand during this introduction to the real world of nursing. It is not a neat and tidy career path in the beginning. That part comes after you've mastered the art of the 'dirty work' and are able to give testimony (so-to-speak) to your time in the trenches; then move up, over, or on to more appealing areas.
  9. by   herwitsend
    Every person with a bed sore or incontinence or disgusting wound (or whatever) is a person.

    Seriously, this keeps me going. They are a person with a story. They have lived and loved and borne children and grieved and they are living in this perpetual state of indignity. They like it even less than you!

    I am a doula as well, and I like to think of it as an opportunity to restore their dignity, to hear their story if they are willing to tell it, to help a family advocate for their loved one, to be (even for just a moment) a loved one if they don't have anybody. NEVER get used to human indignity!! Doula them, hold space for them, speak light into their dark place!

    As for the gagging, I keep peppermint altoids on hand and pop one in my mouth before doing gross stuff. The strong scent and taste help a lot. A small bottle of peppermint EO in your pocket could work too, to sniff. You have obviously overcome bad smells previously in order to be a birth doula. What works for you there?
  10. by   emmjayy
    I felt this way in my first ever clinical rotation. It does get better. You get used to things, you stop being scared of things, you learn to focus on how the patient feels/how to help them rather than on how grossed out you are by their excretions or wounds.
  11. by   Union-Jack
    Get yourself to Dollar Tree and buy a set of 10 face masks and a pot of Vix type stuff. Next time you're in this situation, put on a mask and put Vix under your nose or on the mask itself. That helps a lot!
  12. by   HermioneG
    Quote from herwitsend
    Every person with a bed sore or incontinence or disgusting wound (or whatever) is a person.

    Seriously, this keeps me going. They are a person with a story. They have lived and loved and borne children and grieved and they are living in this perpetual state of indignity. They like it even less than you!

    I am a doula as well, and I like to think of it as an opportunity to restore their dignity, to hear their story if they are willing to tell it, to help a family advocate for their loved one, to be (even for just a moment) a loved one if they don't have anybody. NEVER get used to human indignity!! Doula them, hold space for them, speak light into their dark place!

    As for the gagging, I keep peppermint altoids on hand and pop one in my mouth before doing gross stuff. The strong scent and taste help a lot. A small bottle of peppermint EO in your pocket could work too, to sniff. You have obviously overcome bad smells previously in order to be a birth doula. What works for you there?
    This comment made me tear up a little bit. You seem like a beautiful person, and your patients are lucky to have you.
  13. by   herwitsend
    Quote from HermioneG
    This comment made me tear up a little bit. You seem like a beautiful person, and your patients are lucky to have you.
    Awww. Thanks. <3
  14. by   Froggybelly
    You aren't going to get many tunneling pressure ulcers or trachs in L&D or OB. Stick it out. If you are physically and mentally able to handle your courses, there's a niche out there for you.

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