level I nurse student needs your advice

dragonflyRN · Oct 14, 2006

I had a great ob nurse when delivering my first. She was a big reason I went into nursing. Along the way...I found other interests. Yes..you will have to do all of the courses/clinicals. Look to take what you like and dislike with you. Apply it. Keep a good attitude.

tridil2000, MSN, RN · Oct 14, 2006

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.

no, no, lol, do NOT quit based on this one day! gosh the image you painted, i had to chuckle, but it's really not funny.

first of all, NO one should be sitting in their stool for over an hour, N O O N E!! she is someone's mother and someone's grandmother and someday, could very well be any of us. this story just reinforces my theory that we treat animals better than our elders in america and it H A S to stop.

after an hour, i would have asked for the charge nurse and insisted that she or he personally help me, bc in the end it is their unit. additionally, the instructor leaving you there in basically unacceptable and should be reported to your dean.

the only way things are going to continue to change for nurses and our pts is when nurses SPEAK up and out about unacceptable situations. if the charge nurse threatened you, tell her your going to the board of this ltc first thing in the morning, yet call them the minute you're off the floor. if your instructor gets all pissy with you, tell her you'll be going to not only the dean, but the board of nursing about this if she threatens you in any way, shape or form.

nursing has SO many fields and getting some training in lct will not be the end all of your long and influential career. do not feel badly that you didn't care for this type of nursing.... me i can not fathom sticking a baby over and over to get a line. oh man, that would just kill me. i also could never do hospice... that would depress me. and the smell of cauterized flesh has kept me from the or and crna school.

hang in there. this place sounds awful and your instructor sounds like a hosebag!

GatorRN · Oct 14, 2006

OK, first off, I can't believe that your instructor would leave you all alone on the floor, for over two hrs, without any guidance at all, particularly on your first clinical day. You should of, at a minimum, been introduced to the nurse responsible for the pts you were caring for and briefed on your pts. Where was the nurse at? Where were the CNA's at? Where was your instructor at, for that matter? You should ALWAYS have a reference person on the floor with you, ALWAYS! If what you described is indeed factual, that is VERY unsafe practice. I would most certainly be speaking to your clinical instructor to assure that you are NEVER left in that situation again, if I were you. Explain to her how this situation made you feel, not to mention how unsafe a practice this is.

I wouldn't conclude that you are "not a caring enough person, or not good at caring," I would conclude that you were left in a very unusual, unsafe position. No clinical day should be like that, let alone your first day. It's not uncommon to feel overwhelmed while in nursing school, or even once your a nurse on your own, for that matter. The only way to find out if your actually suited for nursing is to keep plugging along and see if your feelings change over time, under normal nursing conditions. If down the road you still feel the same, then it may be time to reevaluate. But give it some time and see what happens. Good luck in nursing school. :)

anisia · Oct 14, 2006

Thanks for your replies.

As to where was the clinical instructor? she was with 4 of the other students (we are 8 total, but she did not really go to pt's rooms, she was just hanging out in the pt activity area, where students were also hanging-obviously, most of my classmates did not help their pt with any ADLs), and she spent a loooong time w/ one particular student. I told my clinical instructor first thing in the morning that I read for Alzheimer that "you must provide continuity of caregivers and avoid unfamiliar situations and persons", to quote from my book, so I asked if she could make sure the CNA (who is a caregiver familiar to the pt) could come with me when I first go to the room. She said "no, it's ok, just go".

Later, I went to ask for the instructor to come, but she said I'll be fine, just perform oral, perineal, bath care, and she'll come over later. I do not know where the RN or CNA were, probably busy with other patients. I did expect my clinical instructor to pay some attention to my worries in dealing with Alzheimer, but then can't blame her she didn't, because... what do I know? how to i know how things are done in hospitals? i do not know. All i know is that I was very stressed and felt responsible and worried and I was insistant at lunch to get help to get the patient moved to bed to change the diaper, but the instructor sent me to the RN, the RN told me the lift team will come, and the CNA was on break. Eventually, because of my continuous worries and bugging the RN, she came to help me move the pt from wheelchair to bed. I really do have a back problem and don't want to endanger anybody's safety. I had three major sciatic nerve pains which happenned in the past 4 years, and each time it was so bad I could not even breath, not even move one step in front of me for at least half hour, and then move millimiter by millimiter -one of these times it was caused by lifting up a 2-year-old boy. I do try to learn better lifting techniques, I just don't know how much I can count on my back, therefore did not want to do the transfer by myself.

smk1, LPN · Oct 14, 2006

I'm shocked that you didn't have an orientation. You should have had a tour, been shown where clean and dirty linen closets were, supplies etc...I also can't imagine what it must have been like for that patient sitting in her own feces for so long! This does not bode well for your program, however it is a means to an end. Give it more of a chance and maybe things will improve.

mamason · Oct 14, 2006

When I was in school, we were required to write a journal about our clinical experience and hand it in to our instructor the next day. I think I would have wrote about my experience of not getting much needed help. This in turn would have given the instructor much needed feedback on how I perceived my experience. Of course, my instructors were always available in my clinical areas and were very helpful. I guess I was lucky. Maybe you could try talking to your instructor first and explain how you felt during this experience. She may have assumed that you could handle the situation with out any problems. She may surprise you and be very supportive at your next clinical. As far as the unit's staff, they should have helped you when you asked for it. These pts ARE their responsibility. Maybe you should address this with your instructor. She may not be aware that this was going on.

As far as changing your major, I would think about that one first before I do so. It sound to me like you really care about what you are doing and are doing you best to ensure that your pt gets the best care possible. These are great qualities to have if you want to become a good nurse. And Lord knows, we need good nurses! Hang in there!