Reflections from first time practicum experience...

[angelchick]

Reflections from first time practicum experience

I am a year one nursing student from Waiariki Institute of Technology, doing my Bachelor of Nursing at Windermere in Tauranga. I have just recently been out on my first practicum for three weeks and have come away with a multitude of questions which I am currently reflecting on. I am a 34 year old married woman with a child, and consider myself to be very experienced in the traumas and joys that life can bring. After finishing my practicum of which I thoroughly enjoyed, I was left to reflect on my personal experience with the elderly.

I cared for a dear man whom unfortunately passed away in my second week of being his student nurse; I was so privileged to have spent that time with him and his family. I was somewhat left with a list of questions and thoughts of which I have still to be answered, maybe there are no answers to them and maybe with further experience in nursing these questions will reappear and make sense, but for now I want to share my thoughts and wonder what feed back from other experience nurses or other student nurses who have battled the same questions, and how they may have overcome these thoughts, feelings in what I am about to share.

When I wrote these I was feeling fairly frustrated as you will probably see;

You may wonder why I ask some of these questions, some were personal thoughts and others were pointed out and challenged me in to writing this letter.

1/ Can a nurse "care" too much?

2/ Don't patients deserve my everything?

3/ How do I protect myself and still engage on a deeper level with the

Patient?

4/ How do I avoid burnout? (Been told this could be likely with me).

5/ Why can't I push the nursing practise boundaries, when I see there

could be room for adjustment or improvement?

6/ Isn't it okay to feel emotionally connected to the patient?

7/ With a passion to make certain changes in the nursing industry...

don't I need to continually question the issues, or will that just get

me fired?!

Finally, am I just being a laughable year one student, with hopes and dreams and need a reality check?

I would really appreciate any feedback from either other student nurses who have felt the same or from experience nurses with some insight into these questions, this all leaves me questioning and doubting what kind of

nurse I am going to be.

I wrote this in my first year of nursing school, have done 2nd year, which I had to take some time off, and back in 3rd year doing part of 2nd year again, (confused)? LOL me too. Anyway these questions I am still trying to figure out. Maybe 'llI will still be trying to in 20 years?

[angelchick]

I did write this article into our local nursing magazine and got some wonderful replys and tips. Just thought if anyone had any other words of wisdom??

Cheers:heartbeat

[leslie :-D]

1/ can a nurse "care" too much?

yes- and you will know it when it affects your mental/physical health. many of our stressors are r/t the ideals vs reality.

2/ don't patients deserve my everything?

depends on how you define "everything". we should not be doing what they can do for themselves. many pts lapse into a much sicker role, depending on their nurse for "everything". often, 'tough love' is the key to healing.

3/ how do i protect myself and still engage on a deeper level with the

patient?

i don't know how it is in nz, but here in the states, we don't have the darned time to engage on a deeper level. not an issue here.

4/ how do i avoid burnout? (been told this could be likely with me).

stop doing and being everything for the pt. we are not bionic beings. we are human, first and foremost. acknowledge and understand your limitations.

5/ why can't i push the nursing practise boundaries, when i see there

could be room for adjustment or improvement?

you most certainly can. but do it through legislating, petitioning, getting politically involved. see if you can start a committee. you don't want to rock 'that' boat in the workplace, trust me.

6/ isn't it okay to feel emotionally connected to the patient?

yes, it's ok and it happens. again, as long as we understand our limitations and boundaries.

7/ with a passion to make certain changes in the nursing industry...

don't i need to continually question the issues, or will that just get

me fired?!

absolutely, question the issues, and absolutely, it can get you fired. a nurse needs to be savvy, creative, discreet, gentle but ruthless, in the pursuit of justice. most administrations totally disrespect the contributions of nursing. they just want to see the bottom $$. don't make yourself noticeable in a way that administration feels threatened. and god knows, we are all expendable. to have vision, is admirable. just proceed cautiously when challenging the status quo.

finally, am i just being a laughable year one student, with hopes and dreams and need a reality check?

no, i don't find you laughable at all. i think your aspirations are quite noble. but sadly, yes, you need a reality check. that does not mean to give up. it only means that seeking solutions will not come as easily and readily. i wish all my colleagues shared your ideals- maybe then, we could turn it into a truth.

i wish you many successes.

we all know that it's time we bring nursing to new heights.

it cannot stay the way it is.

something will give, and will take a bunch of 'someones' to begin the process.

go for it.

leslie

.....

[angelchick]

Dear Earle,

Thank you! for your words of wisdom, I really appreciate it, as I question so much and it's great to be able to put these questions to more experienced persons and see where I may be going wrong...

In nursing school we are taught to be "reflective" nurses, reflect reflect reflect, I am a very reflective person anyway, so perhaps I need to be less reflective! Who know's?? This is a wonderful, wild, and scary journey to be on at times, I have a lot to learn!

[november17, ASN, RN]

1/ Can a nurse “care” too much?

Yes, certainly.

2/ Don’t patients deserve my everything?

It depends on how you define your "everything." If you mean your utmost professionalism, top notch care, and compassion, then yes. You may find yourself redefining the meaning of "care" in the near future as your clinicals progress. Remember that basic fundamental of nursing...something along the lines of, "If the patient can do it, then let/make them do it for themselves." Don't feel like you need to sit there and feed them grapes while they relax in bed. That's not the way it works.

3/ How do I protect myself and still engage on a deeper level with the

Patient?

I think you're reading too much into all this. You're not there to fix their problems. That's what the physicians are there for. You are there to help them through the process. Nursing is certainly holistic, but you can be holistic without doing a freudian assessment. How do you protect yourself? Keep it simple.

4/ How do I avoid burnout? (Been told this could be likely with me).

Get a lot of sleep, take time for yourself and do things you enjoy, don't work too many shifts in a row. It sounds like you may need to learn to disassociate yourself from what's going on in the clinical setting. Seriously, professionalism.

5/ Why can’t I push the nursing practise boundaries, when I see there

could be room for adjustment or improvement?

You can. You're just a 1st year student. You'll find what works best for you. Once you are a nurse you can practice in any way you please. Of course, staying within the boundaries of the nursing board that licenses you.

6/ Isn’t it okay to feel emotionally connected to the patient?

Yes that is fine. There are boundaries with how far I go with that. For instance, if I had a patient passing away and I still had other patients to take care of, it would do no good to be alarmed or upset about a patient dying. Does that make sense? That has actually happened to me. I had a patient in Room A actively dying, the family was very upset. yet I had the patient in Room B actively living and she needed to go to the bathroom. Would I benefit the living patient B by acting upset as I took her to the bathroom? Certainly not. Shuffle it away, deal with the emotions later (In a positive way...maybe exercising for 30 minutes after you get home from work?)

7/ With a passion to make certain changes in the nursing industry…

don’t I need to continually question the issues, or will that just get

me fired?!

I would certainly encourage "questioning the issues." Fair warning, every issue you question has probably already been beaten to death with a wet rag, though. I used to be a nurse aide, and now that I'm an RN I listen to the nurse aides complain about the same stuff I complained about 5 years ago when I did the same job. I try to make positive changes in my workplace and for my patients and that's the best I can do.

[angelchick]

Thanks everyone for your insightful suggestions and comments. Much appreciated!