level I student nurse looking for advice

  1. Hi, everybody!

    I am a student nurse in my first semester of the program! I worked really hard to get into the program, maintained a 3.95 GPA...well, I know I am able to do that. what I do not know is how suitable I am for the real hospital experience. I just started my clinical practice experience. Had an 87-year-old advanced Alzheimer's dementia patient, incontinent and all... Clinical instructor just dropped three of the 8 students of our clinical group on the floor, no instruction, no help, nothing. I had read a lot about Alzheimer a night before, so I had a few concerns -my patient also had a recent (October) vest-restraint order for being "agitated", so you can maybe see why I was a little nervous--the vest was not currently on her.

    Well, to my big surprise, for the first over 2 hours of the morning we were left without any help, no instructor, no CNA around, no RN, they were all gone. This was the first time in my life to be actually on a hospital floor. I did not know which lotion goes in the butt and which in the mouth, did not know where to get diapers from and which size, did not know anything, had to figure it all out, and I was also very stressed about my patient being totally out of it, just making some weird disturbed sounds, it seemed like despite my efforts of talking to her on a caring voice, trying to wake her up, she just could not. But I was obliged by my schedule to take her vitals at 8 am sharp.

    Lunch time came and my patient is on a wheelchair, sitting in her own poop. I tried to get somebody to help me transfer her to bed, since I do not feel at all confident I can transfer her to the bed to change the diaper. As the CNA told me this is my job, and she is there just to help me, I thought she would help me. Unfortunately, she was on her lunch break. I went to the RN and asked for help and I was told the lift team will be called. An hour later the lift team was still not there, but my patient was lifting my uniform blouse, unbinding my pants and pulling them down, to my great surprise, in front of all the patients or personnel who happenned to be around the activities area...I just felt my eyes grow bigger on my face. I think the patient was overstimulated, because of being kept for too long in the patient activities areas in the wheelchair, I don't know why else she would do that. I know nothing about Alzheimer, this is my first semester. She was also pulling her own clothes, later. I was really tired after a whole morning of figuring things out by myself, just me and a classmate who did not know any more than I did.

    Based on this experience, I am pretty scared. I don't know what's supposed to happen in a hospital and what not, but fact is I did try to do my part as well I could, provided oral care, perineal care (yucky), complete bath with moist towelettes and made the bed. I fed lunch to the patient, but she only ate 25%, probably because she was sitting in her own excrements.

    Anyway, after this experience, I feel like I am not a good person for this field. All evening I just felt the smell of this old woman in my nostrils, no matter what I was eating smelled like her, and then in the shower, despite efforts of scrubbing every little inch of my skin, it just seemed I was still smelling like that. I can only conclude that I either am not a caring enough person, or not good at caring, or just too emotional. When I took my own lunch break in the hospital, I was so stressed, worried at the thought that I left my patient in the wheelchair in the activities area, and wondering if she is fine there (I was asked to allow patient longer in activity area, although in patient record it states not to allow her for more than 1 hour at a time in the wheelchair). Well, can you imagine having ten patients at the same time how incapable I would be, would I be crying for each ten of them? That is not caring! in order to care for people, you must stay strong and cool-headed. Right?

    Anyway, my only focus in this nursing career is actually babies. But I have to go through all this old people care during my school. How much I dislike this, truly. Could it be because I am just not someobe destined to be a nurse?

    I am thinking of changing my major, because despite my good intents, I feel overwhelmed. I guess it is normal and all that, but... how do I find out if I am actually suited for this or not? I do know I am really good at school, have great interest in studying all the theory classes, love it! But, I cannot say the same thing about the hospital, no.

    Any help? Help! Should I change my major?
    Thanks for helping me with any advice.
  2. Visit anisia profile page

    About anisia

    Joined: Oct '06; Posts: 4


  3. by   Melina
    First of all, I am so sorry you had such a bad first experience. I am a little shocked your instructor ditched you. I may be wrong, but as a student, aren't you working under her license? I can't believe the site would be okay with students running around unsupervised. Do you have some kind of debriefing session as a class where you can say something to your instructor?

    More concerning to me is your lack of empathy towards your elderly patients. There is nothing wrong with wanting to end up in neonatal, but a student nurse needs to be able to take care of any patient's basic needs. I hope you are just venting from a bad first experience. Keep in mind that as bad as it is for you, it is worse for the "old people." You may have been smelling her, but she was soaking in her stool. Focus on relieving her discomfort.

    Don't get me wrong, because you never should have been left alone in an area you obviously have had no skill training in yet.

    Did you do any research about the profession before you chose it? Volunteer in hospitals, clinics? Did you shadow any nurses, even in the field you aspire to? If not, maybe you should start. It will help you decide whether this is what you want to do. You could even take a CNA course to get a foundation in patient care. I wish you luck in your decision.

  4. by   Tweety
    Give it more time, don't judge nursing on just this one day. It's not fair to yourself to judge yourself either.

    Hang in there and good luck.
  5. by   mysterious_one
    I agree with Tweety, give it more time, I do believe that deep down you did care for this old ladys needs , but you became overwhelmed because no one was there to help you take care of her. Don't give up, I am sorry that not even your instructor was there to give you some advice ( can't you call her up, or something, after all you are there the first time) . My advice for the future , I am also a first semester student, when you took care of your patient and you have some down time, go follow a cna or nurse and watch, help , etc as much as possible can with basic care, even with other patients. This will help you get more confident , the staff will appreciate you more and you will learn so much. Yes , there is lots of paperwork to do ( careplans and all) but my thaught is how are we to learn patientcare if we are there once a week with just one patient, there is really only so much you can do on just one. Hope i make sense. Anyways don't give up, some things in nursing you will see, you will like less then others , but you will have to learn them all to become a great nurse.
    Last edit by mysterious_one on Oct 14, '06
  6. by   BeccaznRN
    Even in your chosen specialty, you'll have good days and bad days as a nurse. This is your first experience in the hospital - give yourself some time to learn and try not to be too hard on yourself. You're only one person, and you won't be able to do it all with your patient. Just go in every day and do the best you can.....that's all you can ask of yourself.

    Hang in there! :icon_hug:
  7. by   jov
    what an extremely unpleasant experience.

    I think what you are saying right now is "if this is nursing, I want out." and I don't blame you. If that is nursing, I want out too. But your experience is only representative of nursing in a specific field, i.e. geriatric patients with Alzheimer's. There's lots and lots of other fields in nursing to go into.

    I think your school is a really poor one. I believe I would look for another program and if I could, I would talk to people who were in the program or through the program, to see what their experience had been. That's ridiculous- to dump a student and expect any sort of functioning on first semester nursing. Our school paired us up for our first day, gave us one patient with a nurse and all we could manage for care was wash her back LOL

    Finally, I want to say I totally disagree with Melina's assessment that you have a lack of empathy. Just because you have a reaction to unpleasant smells, sights and being undressed by a patient does not mean you lack empathy. Any one of us would have been turned off by that. You still did the best you could to provide care, within your capabilities. I think you showed lots of empathy.

    It will be better with babies. Write it on a sign and hang it around your neck.
  8. by   moongirl
    your experience is not the norm. I have never been left "alone" to have to tackle all the things you did- its simply unsafe. Trying to transfer an elderly confused pt by yourself...?????

    Dont feel that it is all YOU- and you are not cut out for this, you were given the worst, and you dealt with it the best you could.
    And you do have empathy- otherwise it would not have bothered you to leave that pt sitting in poo.

    I would def talk to your CI and ask her if that is to be the norm for your first semester, alone with no instruction and providing unskilled unsafe care to the pts, if it is, I would find another program, because it appears that they are not willing to teach, just let you sink or swim
  9. by   Melina
    Just to clarify, I did not think her reaction to being abandoned, nor her distaste for feces, made her seem insensitive, I was referring to her statement:

    "Anyway, my only focus in this nursing career is actually babies. But I have to go through all this old people care during my school. "

    I also said I hoped she was just venting. It sounded like the OP has had no health care experience, and I just recommend she get some before deciding one way or another.

  10. by   Daytonite
    anisia. . .you are running on pure emotion at the moment. and, rightly so. it was a harrowing first experience for clinicals. my first patient glared at me when i asked him if he was ready to take his shower and kicked his overbed table across the room. talk about scared to death of a patient! i wanted to quit right then and there. that was 32 years ago and i can recall it as clearly as if it happened yesterday. nursing home patients are not always the best ones to start off with, but i think the rationale behind it is that they don't complain about students. and, the nursing schools know that the students are going to flub up at first. non-complaining patients and brand new nursing students are a perfect match. kind of like new car drivers and old beaters. it's not a horrid situation if you put another dent in an old beater car. probably not a good analogy, but i can guarantee that nursing home patients often sustain worse than what your patient went through on your watch.

    do you know what you could have done differently in preparing for your day in clinical now? was it enough to know what the textbook said about alzheimer's disease? you got a first hand look at how a dementia patient can behave and express themselves. just a little more emotional for you than the words on the page of a textbook, isn't it? do you now realize that accomplishing daily nursing tasks such as transferring patients, changing them when they are incontinent, dealing with wandering hands, etc. are much different when you are doing them than when you are reading about them. one of the reasons students are put into clinical areas is because there is so much for you to learn that can't be experienced through reading textbooks. this is the practical side of nursing and this is why the state boards mandate that a specific number of hours must be spent in clinical practice. this is the part of nursing that each of us has to experience for ourselves and learn on our own. our unique experiences drive what we will learn and in the order we learn it. our common sense has a lot to do with our clinical performance of tasks.

    did you take down the names of the lotions this patient had and look up information about them when you got home to clarify which went on what end of the patient? were you able to ask one of the cnas about the different sizes of diapers? if not, put it on a mental list to ask about at your next clinical. you've also found that you need to be a little more assertive in looking for answers or help from the staff. you have to make your needs known to them. you cannot assume they know you are a total novice. it would be nice if they took the time to get this information from you, but never assume they are going to take the time to do that. you have to let them know you've never touched a patient before and need mega help.

    i think you did well considering it was your first day at clinical nursing. you did the best you could. each experience will build on all the previous ones. it will get easier. much of your anxiety and stress comes from the unknown as well as not being skilled at knowing how to handle the situation. that will change with time and experience.

    the lessons you learn in caring for adults carry over in caring for babies. patients who are confused are not much different from babies in that they cannot express themselves very well either. your assessment and observation skills have to be very sharp when working with both confused adults and small babies. as your next few months go on you are going to find things moving quickly and many times feeling a bit like you did at this first clinical. we all started out this way. nurses stand tough. if you have the gumption, you'll be there at your nursing school graduation. if not, then you weren't cut out for nursing. it has nothing to do with intelligence and book smarts and everything to do with character and personality.
  11. by   LiLcBaBy154
    I know exactly how you feel. My first clinical was a horrible experience. My teacher left me alone in a nursing home with a 94 yr old patient with lung cancer. The CNAs we no help...everytime I would ask them about my patient they would tell me not to worry about her because she would die soon!! How am I suppose to learn then?!?! The RNs were too busy to even answer any questions. After the first week, I wanted to quit. I feel a little better now. I think the feeling is natural. Hang in there.. I know I am trying too!
  12. by   JentheRN05
    This is the worst I have EVER heard of as far as clinical experiences goes. I have had some doozies myself but to be left alone on your very first clinical is just plain stupid and irresponsible. I'd first go to whoever plans out your program and tell them of your experience. It was NOT right to just dump a student and run! What in the heck is that? Oh - I would want to quit too if I were in your shoes. Go elsewhere and take your money with you (AFTER - telling some top people of what this clinical instructor (if she can call herself that) did!!!
  13. by   Imafloat
    I agree that you should not have been left alone. Your CI sounds irresponsible. I think if I had a day like yours I would question nursing as a profession too. We didn't go to the nursing home until a year into our program and it was the most difficult clinical, especially if you have a client who is not 100% mentally.

    I had a mediocre clinical instructor for geriatrics and I hated that clinical. I love the elderly, but seeing the conditions in the 'posh' private nursing home we were assigned to made my stomach turn. I got so fired up over how the residents lived and how many of the staff treated them. Sadly, the staff members where you are doing your clinicals don't appear to care about the patients best interest to leave a resident sitting in their own excrement rather than help an overwhelmed student clean her up.

    Please don't judge nursing by this experience. Things are better in other areas. Please don't feel bad about speaking from your heart, only when you ask honest questions can you get honest answers. I think if you were complaining about having to work in the nursery because you really didn't want to work with young people, only the elderly when you graduated nobody would have said anything. I think we all get sensitive about the elderly because many of us have seen them receiving less than adequate care. I get so fired up about the elderly, they deserve so much more than so many of them receive. It absolutely breaks my heart.
  14. by   jov
    Quote from Melina
    Just to clarify...I was referring to her statement:
    "Anyway, my only focus in this nursing career is actually babies. But I have to go through all this old people care during my school. "

    I don't like old people care. Heck, I don't even like old people. That doesn't mean I don't have empathy for them.