In need of some pearls of wisdom

[MJane29]

I don't want to sound negative, but am just curious as to whether the majority of patients in the hospital setting are incontinent of stool? I am in my second semester of nursing clinicals (in an accelerated BS program) and have worked with a approximately 11 patients. Thus far, I have only had one continent patient. I certainly do not have a problem with preserving a patients dignity and helping them to get cleaned up. However, at the end of each clinical day, when I reflect on the things that I accomplished and what I learned about nursing, it is always the same. I provided a bed bath and helped out my patient who was incontinent of stool. Is it asking too much to want a little bit more? Is this all there is? Any words of wisdom or advice would be very much appreciated.

[jamisaurus]

You will learn more as your program progresses. A lot of nursing school is assessments and helping clean up patients. Incontinence also depends on which area you are in. You will learn the most when you start working, but bedside nursing involves cleaning up your patients.

For now, look in depth at your patients charts, meds, labs, why they're there.

[MJane29]

Last semester I was on women's med/surg. This semester I am on the trauma unit. I also start psych clinicals next week and I couldn't be more excited. Psych is my speciality (I have a masters degree in counseling psychology), and the main reason that opted to return to school. I plan to pursue a degree in advanced practice psychiatric nursing following completion of the BS degree, so that I can treat my patients using a more holistic approach (meds in conjunction with psychotherapy). I opted for an accelerated BS program over a direct entry program because I felt that having a foundation was important. Thanks for the input! :)

[AspiringNurseMW]

Last semester I was on women's med/surg. This semester I am on the trauma unit. I also start psych clinicals next week and I couldn't be more excited. Psych is my speciality (I have a masters degree in counseling psychology), and the main reason that opted to return to school. I plan to pursue a degree in advanced practice psychiatric nursing following completion of the BS degree, so that I can treat my patients using a more holistic approach (meds in conjunction with psychotherapy). I opted for an accelerated BS program over a direct entry program because I felt that having a foundation was important. Thanks for the input! :)

I'm first semester nursing student and fully expect this semester to be a lot of assessing and ADLs and such. Are you taking the initiative at clinicals within your schools limitations? Asking your nurse to view and possibly assist with other procedures? Really looking into the clients chart and history and paying attention to how and why things were done?

[MJane29]

I definitely believe that I am taking the initiative. However, I'm sure that there is always more that can be done to advocate for myself (and for my learning).

[Here.I.Stand, BSN, RN]

You'll learn more (and be expected to know more of the big picture) as you go. But yes, nursing involves a good bit of ADLs, esp. given that many hospitals are adopting total-nursing care models, i.e. no CNAs/PCTs.

When people are in the hospital, a lot of times they're on antibiotics which can cause loose stools. On my unit, most of my pts are tubefed which comes out as liquid stool -- and unable/less able to communicate their needs, being intubated, sedated, medically paralyzed, aphasic, confused, etc. Getting out of ICU specifics though, your pts also have compromised mobility -- they can't just go to the BR when the urge strikes like they do at home. They have to wait for help even if they were able to hold it for a few minutes. Some pts -- elderly, some bowel conditions -- have continence issues at baseline. But again with abx, scheduled bowel meds, other new meds, tubefeeds, etc. causing their stool to be looser, yeah it makes it hard for the pt to control their bowels.