Just had my first day as a student nurse, advice needed....

Here.I.Stand, BSN, RN · Jan 17, 2014

as the field is filling up with younger and younger generations, I can see that the younger branches see things a little differently than the older ones. The educational regimen and academic demand in scientific realm of nursing has augmented exponentially since the beginning of nursing education, and as you all know, becoming an RN is pretty darn difficult challenge now. So now when I hear others say "what did you expect, you should swim in the pool of poop, pee, vomit... Why? Because you are a nurse!" This kind of thinking has engrained deeply well into our profession, but the tide has turned! We are relatively well-paid, highly educated, specialized workforce. I have Bachelor's degree that an engineer, teacher, scientist, biologist or anyone else in the world has, and I do not associate my profession to poop, pee, and vomit! Yes, cleaning is part of our job for it entails patient safety against skin breakdown, but I guarantee you I always let the CNAs know if someone needs cleaning b/c most of times, I am busy doing nursing, such as medicating, assessing, documenting; I know my belief is not one in a million, but I am not afraid to voice it. I really think RNs should value their degree for crying out loud. I refuse to accept that I suffered 4 and half years of my youth to attain a degree and a profession that embraces cleaning body fluids as a measuring stick of how well I am performing.

:poop: happens.

Not flaming...but patients have bodily functions regardless of the mean age of the nursing workforce. (Which is not necessarily getting younger; remember at one time the norm was a hospital-based diploma program fresh out of secondary school. Myself at 23 I was one of the young ones in my graduating cohort.) Patients have bodily functions regardless of which employees are on duty. Patients have bodily functions regardless how much we esteem ourselves and our degrees. I've only read the first 2 pages of replies, but so far haven't seen anyone tell the OP that he should love or embrace poop...but the poop isn't going anywhere.

Not all of us have minions to do the dirty work. We generally have one CNA to 8 pt's in my ICU. Most of our pt's are total care. Most are dead weight. Most are tubefed which results in loose stools, but not always liquid enough or constant enough to justify a rectal tube. It would be completely unreasonable to expect the CNAs to do all of the poop wiping, bed baths, and linen changes alone. Not to mention rude to basically say "I'm too important and educated to clean this pt. That's a lowly aide's job." It's not about celebrating the importance of the nursing profession, it's about working as a team to meet pts' basic needs.

To the OP, I wouldn't throw in the towel just yet if you truly wanted to be a nurse up until this point. Nursing isn't for everyone and that's okay. But the basic nursing class/clinical is just that--the fundamentals. A lot of it is what CNAs take their class to learn; not everyone enters nursing school with CNA experience, so it makes sense schools would need to teach this info. For our first clinicals, we each had one LTC resident and six hours with which to do EVERYTHING for him, from creating a care plan to sitting and talking to helping them with hygiene. As you go you'll start learning the sexier parts of the job.

Elle23 · Jan 17, 2014

I will never, ever forget my first bedpan experience in nursing school. It was an older diabetic double-amputee (not that it matters, but like I said, I've never forgotten her!)

She had the most enormous, didn't-know-it-was-humanly-possible, foul-smelling BM.

And I retched like crazy the entire time I was rinsing the bedpan.

I am quite sure at the time that I had thoughts of giving up swirling around in my head. But you know what? I got over it. The patient got cleaned and the bedpan got rinsed, and I made it through it.

And when I look back on nursing school and my med-surg years, my memories are NOT of pee and poop and bedpans (ok, except for that first one...)

Yes, cleaning patients is part of being a nurse, but it is not the be all and end all. It is a small part of something so much greater and wonderful.

If I had hung up my stethescope after that first incident, I would have missed out on a very rewarding and fulfilling career.

I say "Hang in there" and give it some time. You may find that, in time, baths and bedpans really aren't that big of a deal.

Here.I.Stand, BSN, RN · Jan 17, 2014

Thank you, thank you, thank you. I am also weary of hearing how I probably wouldn't graduate from today's nursing programs or pass NCLEX-RN.

Well, the NCLEX *is* now a grueling written exam that takes 2-3 days to complete. Back in the day it was just a computerized multiple choice test that could be done in a couple hours. :sarcastic:

Been there,done that, ASN, RN · Jan 17, 2014

This post does NOT honor your colleagues.....I always say I seldom become annoyed but I am becoming annoyed more frequently these days. I will tell you that becoming a nurse was a difficult challenge back in my day. My science micro and organic chemistry, were with med students as was gross anatomy.
Your assumption that only the newer nurses are educated correctly is erroneous and insulting to the nurses who are more educated and experienced than yourself.
I am glad that as a new grad you are confident in your skills...but to assume that your college education excludes you from patient care offends me. I view the CNA's as my partner in the patients care...not some lackey to do the dirty work that I do not wish to do. I ask the CNA for help when necessary and will help them at every opportunity for in cleaning the patient I can gain valuable information about my patient and assessment that is otherwise ignored.
I don't like cleaning human excrement...it is definitely the less popular part of my job. But I don't shirk what is my responsibility. I was an innocent 16 year old (almost 17) when I started nursing school and I have never even seen a male member let alone making sure I cleaned certain nether regions correctly....I cried for the first 3 months of school.... all the way home every day...because THIS was NOT what I signed up for. But you know what? It got better.
I find that when I help the CNA's I actually have more time to do my as they respect that I need their help for all of us to do our jobs. It promotes a healthy work environment and a team atmosphere.
As a manager if I discovered one of the nurses on the unit would seek out the CNA for a bedpan or to clean an incontinent patient and had nothing else pressing to do....they would be in my office having a discussion about responsibilities and team work.

Thanks you for that response.

I was "augmented exponentially" to aggravation for disrespect towards the crusty old bat society. :)

smf0903 · Jan 17, 2014

I don't look at it as cleaning up pee and poop, washing etc
I look at it this way:
while I wash and help the pt dress! I am assessing how well they move! what is their ROM? Better than yesterday? Worse? If they are a pt with a stroke, how is their affected side?
What does their pee/poop look like? Are they dehydrated? Developing a UTI? Constipated? Signs of c-diff?
What does their skin look like? Are they developing ulcers?
While I help with the ADLs, I talk to my pt. I can assess their orientation, their memory, their ability to communicate.
In short, a simple 20 minute bath can tell me a lot about my pt.
Now,,as a Canadian nurse, I am more accustomed to more hands on care than my American counterparts, but I often wonder, how can you assess these things when you have CNAs doing most of the hands on care?

Amen to this! Our first instructor stressed the importance of assessment while providing ADLs. In all actuality, it is a timesaver...if one person bathed a patient and the RN came in later to assess things that could have been assessed while bathing/dressing/changing bed sheets, well that's busting the whole shebang up into two separate things that could have been done at once! Granted I know there are times when the nurse/nursing student can't give baths, etc., but I try to work them in as much as humanly possible.

Here.I.Stand, BSN, RN · Jan 17, 2014

I remember back in my CNA days (which began at age 18), an older CNA said, "Every good nurse is a nurse's aide first." She meant it as a pat on our VERY sore backs, to help us feel more elevated while doing the thankless tasks from the bottom of the totem pole.

She had a point, though. No matter how much schooling we do, we can't lose sight of the fact that we are there for our patients. If we can't meet their most basic needs, how are we supposed to meet their other needs? How will a pt be able to get up and ambulate in the hall, getting stronger bodies and cleaner lungs...if they are too embarrassed to leave their room because their long hair is a matted mess on their head and they smell like BO? How is a pt supposed to cough & deep breathe, or relax enough to feel any relief with their pain meds, if they're stuck on a pile of :poop: until the CNA comes back from lunch?

boogalina, ADN, ASN, BSN, MSN, LPN · Jan 17, 2014

My son once asked me why anyone would want to be a nurse or a CNA since it involved "wiping butts." I responded by telling him it wasn't so much about that, as how it felt to see the effect on the patient of being clean, and the opportunity to see what else might be done for that person to enhance their health.

My son, the hopeful future MD, said this conversation inspired him to become a CNA first, so he would understand what it means to provide the most basic care to patients, as well as understand patient needs better.

Maybe looking at the provision of basic patient care as a pathway to better understanding of all nursing work will help.

RetRN77 · Jan 17, 2014

Well, the NCLEX *is* now a grueling written exam that takes 2-3 days to complete. Back in the day it was just a computerized multiple choice test that could be done in a couple hours.

That must be pretty far "back in the day!" :roflmao: When I took it, it was 2 6-8 hour days, and that was 40+ years ago.

FutureRN91 · Jan 18, 2014

I think it is hilarious when people go to school for nursing and think that they won't have to do the dirty work! What are you expecting?

VJ2014 · Jan 18, 2014

It may sound nuts but I find great satisfaction in being able to make people clean, dry and comfortable.A nice bed bath, a dry/clean brief,fresh gown, reposition them, a warm blanket... they are so grateful.

This is exactly what I thought :-) When I started clinical I honestly never thought about all the "gross" aspects of the job because I would hate to have to lay in poop, urine, and/or sweat for very long. Just have to put yourself in the patient's situation.

RunBabyRN · Jan 18, 2014

I don't look at it as cleaning up pee and poop, washing etc
I look at it this way:
while I wash and help the pt dress! I am assessing how well they move! what is their ROM? Better than yesterday? Worse? If they are a pt with a stroke, how is their affected side?
What does their pee/poop look like? Are they dehydrated? Developing a UTI? Constipated? Signs of c-diff?
What does their skin look like? Are they developing ulcers?
While I help with the ADLs, I talk to my pt. I can assess their orientation, their memory, their ability to communicate.
In short, a simple 20 minute bath can tell me a lot about my pt.
Now,,as a Canadian nurse, I am more accustomed to more hands on care than my American counterparts, but I often wonder, how can you assess these things when you have CNAs doing most of the hands on care?

Yes! Bed baths and peri care are fantastic opportunities for assessments, and can save you from having to come back and strip the patient AGAIN (what patient wants to have to do this repeatedly?) to do skin checks and assess for pressure ulcers, edema, etc. It's also a good time to build rapport with your patient, because your patient is putting a lot of trust in you as you care for them in one of the most embarrassing situations a person can be in. Putting yourself in their shoes can really help you to respect the trust and faith that patients put in our hands every day.

There are actually hospitals here in the US now where CNAs aren't allowed to do the bed baths (not sure about peri care), because it IS such a good opportunity to assess the patient, and RNs are required to perform these tasks. I think more and more facilities are moving toward this (but I could be wrong).