First clinical day was a nightmare

Nursing Students General Students

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So I have had a very rollercoaster day today. I am a Nursing I student, 21 years old and today was our first day of doing clinical at the hospital. I got my patient assignment and she had some major diagnoses of Pneumonia, COPD and CHF. I went into her room at around 9 AM to do vitals, a physical exam and my assessment on her. She was very anxious when I arrive but she was a sweet lady and was very cooperative with the things I had to get accomplished. She had dyspnea, use of accessory muscles, coorifice rales and rhonci on anterior and posterior chest and an irregularly irregular heartbeat. She was very congested and had a nonproductive cough. As I was getting to know her, we had to go down to Chest Xray. She was very anxious going down there and kept saying that she couldnt breathe even though she was on 5 L via Nasal Cannula of oxygen. Once the Xray was over, we headed back upstairs and I was about to prep for my AM care. My instructor came in my room to check on everything and see if there was anything we needed. I told her about my findings on the physical exam and she explained and clarified some things. Then she wanted me to weigh the patient but we couldnt figure out how to work the bed so we looked at the instructions that were on the bottom of it.

As the instructor was reading, I noticed my patient got very quiet and wasnt anxious sounding like she had been all day. I looked up and my patient looked like she was about to sneeze but it wasnt a sneeze. She looked out of it and unresponsive. I told my professor to look at her because she didnt look right and my professor went by her side. My professor and I called her name and she was not alert or answering us. So I called the primary nurse from down the hall to come over to the room. Of course the nurse was probably thinking "What does this student nurse want? Its probably something stupid" Although she was a very sweet nurse, but I think its just a typical response for a nurse to think a student nurse is overreacting. So the nurse came to the room and we told her what happend and then they called the Rapid Response team. They did what they had to do and I was standing at the side lines watching this whole thing. Seeing the different procedures they were attempting to do and how fast everyone rushed to the room. My instructor was helping out the staff which I thought was pretty neat to see my instructor use her skills instead of talking about her skills in lecture all the time. As I watched what was going on I told myself I will be okay and that I think I can handle it. I work as a Nurse's Aide at a hospital so I have done post mortem care before and could handle death pretty well. But as the chaos finally subsided, one of the staff members asked me if I was okay and that it is okay to cry. I think just having someone say its okay to cry made me let it all out. Before the water works came, I told my professor I need to step out for a second and I took my gown and gloves off. I was so numb to the core and walked out shaking and hives all over my body. I went to the bathroom to clear my head on what just happend.

I literally saw the life get sucked out of this woman which I think is what scared me the most. To be interacting with my patient for the 2 hours that I did, I enjoyed it and this was the last thing I was expecting. I saw her go from anxious, to slowly turning blue and unresponsive and then dead. It was interesting to see this happen right before my eyes because not many see the process of when they are on the brink of life and death and boy did it happen quickly. Many just walk into something like that when the patient has already collapsed and dont see that transition. I think its very ironic that this happend to me because I always thought it was so cliche' for something like that to happen to a nursing student on their first day of clinical. My instructor even said out of all the years she has taught, she has never been a part of something like that. It was a mindblowing experience and definetely a story to tell my grand kids. But it is still kind of a shocker for me because I wasnt expecting it and it has left me in this weird funk all day. It was sure a learning experience because I was understanding how Pneumonia and COPD and CHF effect the body and its just interesting how it all plays out in the end and the destruction it can cause on the body.

Anyways, Im sorry this is a long post but I am just venting out my feelings about my day that I was not expecting

To the OP: if the SaO2 is

Specializes in ER/ICU/STICU.

Well her pulse ox was pretty bad, it was still at like 89% on 5 Liters, but Im not the one who wrote the orders and Im not sure what the staffs plan was for her. She was in pretty bad shape and her lungs were a mess when I was listening to them. I kept telling the nurse the patient is very anxious and she just told me that the pt is always like that. So the nurse gave the pt the anxiety meds and then about 20 mins later the patient passed away. Even my instructor said the nurse felt guilty like she shouldnt have gave the pt the anxiety meds. I just wish the nurse paid more attention to her patient because when I was telling her how bad the lady's condition was she kind of blew it off like she already knew the information so I did the best I could in the situation because she is with the patient way more than I was so im not sure what the patient's norm is and if she has always been like that.

She was probably anxious because she couldn't breath.

She was probably anxious because she couldn't breath.

She definetely was anxious because of that and kept saying she couldn't breath

Specializes in NICU, PICU, PACU.

What a first day! Remember, this is traumatic to you since this is all new and if you need to talk to someone make sure you do!

And people need to think before they post, 5 L oxygen isn't what lead to this lady's death, look at the big picture....pneumonia and CHF also. Put the puzzle pieces together.

Wow that must have been a lot to deal with. Don't feel weak for crying, it would have been the same for me too and I'm assuming most first day people too. You will be a stronger nurse for experiencing that. At least you got something like that out of the way on your first day when it is definitely ok to be kinda freaked out. Hope your clinicals are better from here on ;)

That was very interesting. I just put myself in your shoes, I visualized it. Although I'm only in LPN school and I have no clue what CHF is a d some other words. I was walking in your shoes. I wish we could rotate in the hospital more then nursing home but. You took it quite well.

Specializes in ICU.
That was very interesting. I just put myself in your shoes, I visualized it. Although I'm only in LPN school and I have no clue what CHF is a d some other words. I was walking in your shoes. I wish we could rotate in the hospital more then nursing home but. You took it quite well.

CHF = congestive heart failure

COPD = chronic obstructive pulmonary disorder

OP, I can't believe this happened to you but your reaction is normal. Especially with it being the first clinical day, I would react in the exact same fashion. With that being said, you obviously will never forget this patient and you will become an expert nurse on CHF and COPD. I hope the rest of your clinicals are not as crazy as this one!

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