How do you do it?

[dudette10, MSN, RN]

I'm a student, and I find that the most rewarding part of clinicals is finding the "alertness" in those who don't seem to be A/O at all.

Today, my assigned patient was very difficult to wake, and from listening in one report, she's been like that ever since she came onto the floor. As most of you know, students have a LOT of time on their hands to devote to only one (or maybe two) patients. We aren't responsible for much of the work that the nurses do. That makes me less than confident that school will prepare me for a real job, but that's for another post, I guess...

Anyway, as I tormented this patient with my ubiquitous presence during clinical , she had her moments! I am careful to make sure my bedbaths don't expose my patients too much or that they or cold too much or too long, etc. But, yes, I had to move her around a bit, it seemed to make her uncomfortable because her eyes would occasionally pop open right after I did something, so I kept checking to make sure her limbs weren't being squeezed underneath her, etc.

As is my habit, I talked to her through it. At the end, I said, "I'm all done moving you around now, ok?" She responded in an almost unintelligible grunt, "Good." And, then she made a sound...as if she was laughing.

I helped one of my classmates give another patient a bedbath. The last name sounded familiar, and in looking around at all of the cards and pictures in her room, I realized that I did know one of her relatives quite well. She was also a patient who was considered marginally alert and oriented, but as I talked to her about the pictures and cards in her room, she looked right at me, tried to smile, tried to interact.

I spent six hours with two patients, doing nearly nothing that you would do if I actually worked there as an RN. I want to keep that part of my job when I graduate, but in my inexperience, I don't know how it's possible. While shadowing the longer-term RNs, they will tell me that the charting system is redundant. Their phones ring every 5 minutes. They are pulled in many different directions.

How do you all do it? You are sooooo busy all the damned time! How do you keep the most rewarding parts of your job actually in your job?

[Orca, ADN, ASN, RN]

As most of you know, students have a LOT of time on their hands to devote to only one (or maybe two) patients. We aren't responsible for much of the work that the nurses do. That makes me less than confident that school will prepare me for a real job, but that's for another post, I guess...

Judging from your patient load, you are early in your program. Cases will gradually be added as you progress. By my last semester I was pulling a full load for an eight-hour shift on an oncology unit in clinicals.

How do you keep the most rewarding parts of your job actually in your job?

That is a work in progress, and it is easier some days than others. Every time you believe you have just about had it, that one case comes along that reminds you why you went into nursing in the first place.

[tokmom, BSN, RN]

Yep, what Orca said. You will have days where you just don't think you can do a good job anymore. Then one day, you will have a decent day and be able to really help somebody. That is what keeps me going. It reminds me why I really became a nurse.

[Ranter13]

Just never forget to keep striving for that connection and interaction of which you speak... it is the most important, least encouraged part of our job.

[dudette10, MSN, RN]

Thank you for the replies. Is there a way to do it though, or do I have to resign myself to stolen moments with the occasional patient, rather than having it as an integral part of my job?

FWIW, I noticed the paperwork and the redundant charting and all that on my first clinical day on the floor. As some of you may know, final-semester students sometimes have to do a capstone project in which they recognize a problem specific to the unit that they then research and provide solutions to solve. In my school, one student's solution was implemented system-wide. When I mentioned the paperwork issue to my clinical instructor, she immediately suggested that it could be my capstone project.

To reduce--or at least streamline--some of the paperwork that nurses have to do so that they can return to NURSING may seem like a pipedream, but I think I will end up making it my final project anyway. It may not go anywhere, but at least I tried. :)

[midinphx, BSN]

We do it by multitasking. Once you've done it for awhile, you can connect with your patient AS you hang your meds and do your bath and such. The skills won't take as much concentrated effort and you can chat up your patient while you do it. It is just time and practice. I still have time most nights to connect with my patients. It is a part of the job I really value. But keep in mind, you sometimes simply can not connect with patients/family/staff. Don't take that personally. It's just human nature.

I love nursing students' enthusiasm. Share it!