notes from first year on the floor at los angeles county rn school...
things to tell your patients:
~if you have a whoopsy stomach at the sight of blood, don't lean over and watch me change the surgical dressing on your leg. that will lead to vomitus in the wound, and several other people in scrubs answering my call for help. it will also wind up with you in the or again getting irrigated to make sure everything that was in your stomach which is now on your leg is not in your wound.
~if you're a gang banger, got shot in a drive by (for the third time), please don't have your homies come into the hospital and scare other patients by their presence. and please, when i (the student nurse, at that) enforce the 2 at a time rule, don't threaten me with 'making sure' i get mine. and then don't get miffed when i don't run down to the cafeteria to get you a double bacon burger. and it really doesn't help to have an escort watching everything i do. *i* am not the bad guy here...and i don't need monitors. and no, they can't come into the med room to 'watch me get the good stuff.'
~when you're limited to bed rest because you've had hardware put in both your legs, and pt hasn't cleared you for movement and not given you any assistive devices (like that wheelchair you so greatly desire...), don't get your girlfriend to get a rolly-chair from the nurses' station, manage to get into it, use the toilet, and then get back in bed. and when asked, you didn't get that idea from me.
~and yes, when you urinate dark green colored, putrid smelling urine, you're probably not going home tonight. the dr will very likely think you've gotten an infection in your abdomenal gunshot wound, and bring you down for emergency surgery. tell your dad dark green urine is not normal, and he doesn't have to yell at me because he wasted a trip to take you home. i already know parking's terrible...i walk more than 1/2 a mile to work from my parking place in whatever weather is going on. have a towel, and relax a bit. it's probably going to be a long wait. and no, coffee on the floor is for the rns, so we can keep up with people's needs.
~and expect the nurse, and the student nurse, to chastise you when you're caught trying to shoot illegal drugs in to your already ravished body via the iv we put in so we could put medication in there. dude, where'd you get that stuff anyway? and yes, we really did have to call the police.
~when you've asked for yet another ice pack, and i have to make one out of a latex glove because you've used the two dozen we keep on the floor, don't be mad that it leaks. that's why i wrapped it in a towel in the first place...and yes, ice melts when you've got it under your head.
~and yes, i will ignore you wolf whistling at me to get my attention. and don't get embarrassed when, in front of your homies, i explain that using the call light will indeed work...and i know you know where it is, because you've used it before...quite a few times. if you're wolfwhistling, you're breathing...and sometimes, that's all i need to know.
thanks for the learning opportunities:
~leaving the poop in the potty for me to look at. i really do need to chart what it looks like; i don't do this because it's fun.
~making sure i know you need your pain meds. other patients informing me of the screaming woman doesn't actually make my feet move faster, but it does make me laugh.
~keeping your eyes closed and holding your breath when i come in the room, just "to see" what i'll do, especially if i've just given you medication for that pain you were screaming about. i will come and thump your shoulder. be happy i stopped before i decided chest compressions were a good idea.
and for that patient who listened to me, who helped me help him, who asked good questions about his illness, and who hugged me when i told him i was going off shift, thank you, thank you, thank you. because of you, i was able to leave the floor in a good mood. because it only takes one person saying 'hey, nurse, thanks...' to make our day.
and just as a last note, spitting at me and calling me names doesn't really make me want to do anything extra for you, like bring you that burger you're demanding. it was a good idea, and it was a good dinner...sorry you smelled it on me when i came back in the room after lunch.
other adventures which were outstanding:
~seeing how abusive parents explain to the po-po that you weren't actually boiling the baby, you were just "cleaning his ass with hot water." and being able to walk away before i beat the parents.
~watching a patient bleed out and die on tuesday, and calling a code blue on a patient on wednesday.
~doing post mortem care on a patient who, last week, was chitchatting about horrid hospital food.
~finding out as one inserts the syringe that the patient's family has already given him something 'for the pain'...and then discovering that the bottle reads "morphine to be administered sublingually"...and yanking the hypo out as fast as possible so he doesn't get any more.
~discovering that someone really can have a bp of 63/37, and be talking and asymptomatic...while you run into the hall and get help.
ah, first year rn. what an adventure. for the first time since returning to school, i did not make dean's list. i passed, two as, one b, and a c...but there is always next semester to get back onto it. i'll do it, too. and when i came off the dean's list, my instructor asked me if i had a learning disability. no, but you may have a teaching disability...and yes, i did really say that...and walked off very, very quickly (she was too stunned by my comment to say anything that day, and prudently didn't ask me any more about why my grade was slipping in medsurg...during her lectures in particular...smart chick, she.)
i've come to discover that 4 am coolness and dark is a good time to see a quiet, calm city but not a good time to discover that you're out of printer ink; that 3 pm and hot is a better time to find that damned ink; but that it's best to stock up on it in the first place. i've discovered that my local diner really didn't mind that we held study group on the porch, sometimes spreading out "sterile field" on the neighboring table and practicing foley insertions on paper drawings until midnight.
i've learned that even a quick "i love you, dad" makes the difference in my father's day. i've learned that a quick hug for a colleague whose day just got horrendous because a patient let her have it, makes a difference. i've learned that buying the lunch for the person behind you in line makes a difference. i've learned that most kids will respond to you when you make faces and talk in character voices, even if you're doing something scary...and that a bandaid that *they* select will make a difference. i've learned having a license plate holder which says "i save lives; what do you do?" gets you out of tickets...and that really makes a difference (problem with the license plate holder, though, is that you actually come to the police's attention far more often than before). lol. i've learned that the nightmares do go away after a while, and that what bothered you two weeks ago can easily be trumped by what you discover today, and that getting a hug from a colleague - or a patient - will make a difference.
i've learned that fine print and low light do not make the studying go more easily; nor does studying in bed. osmotic absorption from books is a myth, but will leave you with lines on your face when you sleep on the books all night...and those lines can't be covered by make-up. i've learned that cornering my instructor and asking for help is a very, very good thing. i've learned that instructors are people too, make mistakes, and have a lot more pressure on them than i first thought. i've learned that most learning happens on the floor, while struggling to put theory into practice; that things are supposed to go one way, but often go another...and being flexible is key. i've learned that assessment really does drive the train. and i've learned that some doctors really do appreciate your help, and rely on you to catch things and bring it to their attention...even when it's really hard to gather the courage to do so.
but what i've learned most, through the trials and travails of rn school, is that i love this stuff. it's hard. it's trying. it's scary. it's very, very tough. and it's the best thing i've ever, ever done. nursing is the right choice for me.
just thought i'd post this up for you guys.