level I student nurse looking for advice

[anisia]

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.

[jov]

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. "

~Mel'

Mel,

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.

[ann945n, RN]

I am so sorry you had such an awful first experience. Please do not change your major until you give yourself some more time. I think if you left so early in the program you would be selling yourself short. You put so much hard work into getting here, we all know. I would say stick with it through quater 2 when you go to a hospital or somewhere else and see how that clinical experience suits you. If I was you I would also talk to my clinical instructor and state how abonded you were by them and the staff, in a nice way of course. If they are not receptive i would go to your program director. Its very unsafe to not have supervision from your teacher or the staff you are working with. Oh and as far as our clinicals go, we help the CNA's until we are ready to be on our own which our teacher decides. Also remember dont do anything without teacher approval and always be supervised. Protect yourself in school cause students are an easy target when something goes wrong. Stick with it, its worth it! Also, even if they are not receptive to you just watch your back from now on, stay with your school since transfering can be difficult and you may not be accepted. you can do anything for 2 years

[tigereyeskp]

I am also a first semster nursing student and I highly recommend you discussing your concerns with your clinical advisor and your faculty. Being left alone puts your patient at risk and your school does not want that. Part of the reason why our first clinical experience is in a long term care facility is to learn how to be a good advocate for your client. Just think about what goes on when you aren't there! The nursing home environment is tough and not for everyone. It has been difficult for me and my clinical group to see things that we know are wrong and watching the staff carry on with a bad attitude and giving subpar care.

So,..Be an active participant in your clinical experience. That means not taking no for an answer. That means physically finding someone that can help you and not leaving them alone until they do. Build rapport with your clinical advisor and your staff. Ask lots of questions. Make the most of your clinical prep. You should have a list of things you are allowed to do on your own or with another licensed health professional and things you can only do under the supervision of your clinical advisor. You have to know these things in advance so that you do not put yourself at risk or your patient.

Clinicals are learning experiences. Learn from the good and the bad. Give your faculty the opportunity to correct these mistakes. Sometimes clinical advisors are new and unfortunately aren't aware of the needs of the students.

If your concerns are not met and addressed then I would take a long hard look at your school. If you want to be a great nurse then you need to be at a school that will facilitate you throughout that process. I'd rather lose six months or a year of school by transferring than to be continually be put in a position like you were.

[Alternator81]

Am I the only one to disagree?

First, did I miss something? Where were the other classmates to help the OP?

The CI should be available at all times, which it sounds he/she was not. But honestly, do you need a clinical instructor to come in the room and tell you which lotion to use?? The student nurse needs to be proactive, and able to problem solve and improvise. So your CI is not around: you needed to look at the pt and then look at the bed, and think how can I safely get the pt in it. Is there a hoyer lift? Is there another student that can help me? Will the pt be safe if I leave the room and check on where the lift team is?

You made it through the first clinical and you are still alive and in 1 piece. You only went once right? Don't you think it's a little early to be thinking about throwing in the towel?

Sorry to rock the boat.

[DesertRain]

To the op: don't give up, give it more time you won't always be in the LTC environment if you don't choose to go that direction

All I really have to say is that I am absolutely appalled and disgusted with your clinical instructor, your classmates, the RN's and CNA's and the facility itself. Are you kidding me? Leaving a student on her very first day of clinicals alone to do all that work? Oh my god, if I witnessed this first hand, I can guarantee a lot of people would be out of work, out of license and a lawsuit initiated. This is outrageous. I can't believe these type of conditions exist and there are people's loved ones being cared for here....absolutely ridiculous!

[bekindtokittens]

Congratulations on making it through your first clinical day!

I will not say that my first clinical day was as bad as yours, but there were some similarities. We were also just given our patients and left on our own. It felt like our CI was always too busy for our questions. (God love those "favorite" students who suck up gobs of time.) And worst of all, several of the RN's and CNA's told us that they did NOT like dealing with students and to stay out of their way. (Yes, the CI heard this too. We were basically told to put up with it because of a lack of clinical sites.) And 5 weeks into my first clinical experience, I still feel like I can't wash the smell of the place out of my clothes and hair. My first day, I was helping a patient with a shower, and out of the blue, he got mad, glared at me in silence (and naked) for a full 30 seconds, and then tried to spray me with the hand-held shower head when I asked if there was something wrong!

Stick with it. It will get better and your confidence will grow, just a little each day. I actually felt comfortable today when I had to tell a patient his comments to me were inappropriate, something I would have stressed about five weeks ago. And just keep asking the nurses and CNAs questions and for help when you need it, no matter what they say. Kill them with kindness. Because really, what's the worst thing they can do, be mean? You may even earn a bit of grudging respect with your persistence. When I get frustrated, I remind myself that my career in nursing is not going to be exactly like this clinical experience.

Good luck and keep us updated!

[beth66335, BSN, RN]

Does anyone else realize this post is from 2006 and the OP hasn't posted again since that day?