What's the difference between first and second semester?

[wonderbee]

I'm winding up my first semester experience. As a group, we've gone from pairs of blithering idiots frightened of giving a bed bath or even speaking to a real live patient to independent people injecting needles, measuring solutions and inserting this and d/c'ing that. Poop doesn't scare us anymore and one body part is no more intimidating or embarrassing than another. Our stethescopes are no longer a fashion statement and they actually don't feel foreign to us anymore. We've come to appreciate the smell of a fresh GI bleed first thing in the morning. It's pretty cool when you think about it (Not the GI bleed being cool but.. you know what I mean). We still travel in groups when a new procedure comes up and we ooh ahh and our instructor is still by our side whenever we give meds and do dressings and the like. We started off as 9 and it looks like we will end as a group of 6.

So to those who have gone before me, how will second semester be different? What sticks in your mind as culture shock between the two semesters? Please do tell.

[perksrn]

I guess my biggest complaint is that 2nd year doesn't bring as many changes as we expected. For instance, have you ever had a test question that said: Mr. Smith, an 86-year-old male is receiving a blood transfusion for severe anemia. He is beginning to complain of low back pain, dyspnea, and a generalized rash. What is your priority intervention?

1. Call the physician

2. Stop the transfusion

3. Slow the transfusion to KVO

4. Give the patient a bed bath and change his linens

Not to minimize the importance of being clean in the midst of anaphylactic shock, but we are taught one thing in class, but even in the second year- unable to practice true prioritizing or delegation. Just today, I was trying to finish assessments, administer meds through NG tube, and tend to a patient with a FSBS of 58 when the nurse went to find my instructor to tell her I had not given a patient her bath yet. The nurse was furious. The CNA...chatting with friends down the hall who were thrilled that "the students" were there! Imagine the attitudes we will encounter in a month or so when we try to delegate to these people.

I can hear many of you saying, you are never too good to give a patient hands on care...what better way to inspect your patient....etc. What about teaching me how to prioritize nursing care FIRST, then offering to help with other tasks as able? I am not too good to do ANYTHING, I just want to gain as much experience doing what is practical so that I have more to offer when employed as a new graduate. I have passed up many opportunities to do or see procedures because of this. Sorry for complaining, it was just a heck of a day!

Just 3 more weeks!