Student #1 Bless her heart, she thinks it's all about sitting by the bedside and holding someone's hand to make them feel better. Plus you get to buy all those cute little scrubs with all the designs and characters on them and she loves those shoes she saw with the buckle on them, she is going to get her some of those to wear as soon as she graduates. I want to talk to her in a few years while she is scrubbing blood out of those cute buckles, I will then tell her about Crocs, for now I will let her dream. I want to see her face the first time she realizes she can't see the designs and characters on her scrubs because they are now covered in blood, shit and vomit. It won't take her long to learn to just grab a pair from the cart at work and let the hospital worry about cleaning them. Holding someone's hand in a high level trauma until really doesn't do much to help them out.
Student #2 Ah, this one is going to save the world, she is never going to have a patient die on her shift. I will remind her of this some day. I ask her just how she was going to save the motorcycle rider whose brains fall out in her hands when she takes off his helmet. Her reply? I will stuff them back in and then the doctor can stitch them back together. God I hope I live long enough to be able to see that ground breaking procedure done. I ask her how she was going to tell the parents of a three year old that had just drowned in the family pool that the child was dead. Her reply? Well first she won't use the word dead, because it's so...well....final. She will tell them their child is in a better place now. I explained to her that she has to use the word "dead" because in a high trauma situation nice words like "passed away", "in a better place", "living with God now", "we lost him", can fly right over their head, they don't hear it, they can't take it in, their world is upside down and their brains don't have the ability to process the niceties of this world in a time like that. The word "dead" they get, that they understand right away. Dead only has one meaning. As cruel as that sounds it really is the kindest way in the long run, it leaves no illusions. I overheard a doctor telling a family once that they had done everything they could for their daughter and there was nothing else left they could do. The family was ecstatic, what they heard was "we have give her all the medical knowledge we have and now she doesn't need anything else so she is going to be fine" , another time a nurse told someone that she "was sorry but they had lost their daughter", the family became furious because what they heard was "your daughter is someplace in this hospital but we don't know where we seem to have misplaced her". Student #2 informs me she just isn't going to worry about it because if that time ever comes God will be there with her. I reminded her that he will most likely be there with her but he isn't going to be the one that has to inform the family their loved one just died. God is going to need to be with this one because she has a lot to learn and seems intent on learning it the hard way.
Student #3 This one is actually very smart and going to make a great nurse, she knows everything she should know at this level and is actually a little more advanced. She pulls no punches, tells it like it is. She just has to get over her fear of doctors, or rather her idea that they are Gods (actually most doctors need to realize they aren't God's too). I will not be yelled at by a doctor, I just say fuck you and walk away. I will not let a doctor make me feel less than him, I have a doctorate too, I can even use the title Dr just like he can, mine just happens to be in nursing and his in medicine. I never let a doctor bark orders at me (this is not the same as you hear in the middle of a trauma when we all bark orders at each other because we don't have time to be nice), if you want something ask me nicely or I am just going to stand there and ignore you, you respect me and I will respect you. I would love to see one of them ask me to get him a cup of coffee, I see them do it to other nurses but none of them have ever ask me, they probably already know the answer they would get if they tried to ask me. She has to learn that if she has a patient that needs something in the middle of the night and the doctor ignores her call or gives her some "in a minute" excuse that she doesn't have to and can't accept it. Keep calling him and call bullshit on his in a minute. They don't answer me back in a minute then I call them every minute until they do. Ignore me and we will go see the board. Once she learns to handle the doctors and when that student nurse fear leaves her she is one that is going to learn it quickly, she is going to be an excellent nurse.
Student #4 I don't even know why this one is here. She literally can't stand anything to do with nursing. I think she is one of those that just thinks it sounds good to say "I'm a nurse". Her reply to most requests are either "Do I have too" or "Ewww gross". She spends most of the shift either hiding or picking lint off of her scrubs. I called her name the other day and she actually turned around to see if their was anyone miraculously behind her with the same name. We had a nasty trauma come in, knife to the chest with the knife still embedded (that's a good thing, it can help control the bleeding and also gives the surgeon a guide as to exactly what organs could have been damaged) you never, ever pull out any object that could be in a high bleed area outside of the surgical bay with all precautions in place) so since all his vitals were normal and he was awake and aware I send her in to stay with him until we could get him up to surgery. I suddenly hear him scream. I go running back to find her holding the knife in her hands and saying "He kept asking me to take it out, I can put it back" Are you fucking kidding me, you want to stab him again? Now I have a whole host of problems that didn't exist before and wouldn't have if she had just done as she was told and observe him. Now I have a heavily bleeding wound site and I can't tell where or what organ the blood is coming from. I have a a student nurse's fingerprints all over an attempted murder weapon and blood possibly washing away any other potential evidence. I have a student nurse under my watch that did something outside of the scope of her capabilities. I also now have a ton of paperwork to write up the whole mess. She will never know how badly I wanted to take that knife and stab her.
Student #5 This one, well she's kinda cute but that's about it. She carries a tape recorder around with her and dictates every move we make as we are doing something. "Just had a car accident victim come in, the medics have him on a stretcher and are running fast to Trauma Bay 6, they are now in Trauma Bay 6 and a bunch of doctors and nurses are going into the room, let me get closer so I can see better. Ok, here I am at the door. One nurse is trying to start an IV, one nurse is doing vitals, OMG now they are getting out the crash cart, doesn't look good for this guy...and on and on and on. " I don't know if she listens to all of them later when she goes home, if she transcribes them to help her remember but it is annoying as hell. She can't handle bodily fluid in an form. Blood makes her turn white and back away, piss and shit makes her gag and vomit makes her vomit. Now I am cutting her a break on the last one because even after all these years that is the one thing I can't take. If a patient is vomiting he better be prepared to share the basin because I am going to be vomiting with him. She is fine with a nude woman patient but a nude male patient turns her seven shades of red and she is not going to touch "that thing" for anything. She is terrified of dead bodies. She is there and willing to help (with the live ones) and learn but I just don't know if she will make it unless she toughens up a little bit.
Thank God we only have to deal with 5 of them at a time.
LMAO!! Are you sure you aren't my BFF? She is a nurse who has been in nursing forever!! Everything you said, she has told me, especially about the doctors who look down upon the nurses.
ReplyDeleteFWIW - I've been that person who received news of her husband being killed in a motorcycle accident when I was 27. If it wasn't for a doctor being blunt - and a cop right beside him, I never would have "got it", it never would have registered I had just become a widow. So, yes, I had to head "He's dead".
Blunt is the only way to go when delivering the news of a death. People think it sounds so cold but it really is far more helpful in the end.
DeleteShea - I have been reading your blog for some time now, but have never commented before this time. I just had to chime in with this subject. I also teach nurses -but at the university level - in microbiology. I am amazed to hear some of these students express surprise and confusion that they are REQUIRED to take microbiology? I mean - what does that have to do with nursing? scary stuff. I see a few bright stars that I know will be successful and then I also see those who decided at age 4 they wanted to be a nurse and have not made a decision since that time. Most have neither the intellect, patience or intestinal fortitude to be a nurse. Those that do - and those that excel at it - are the few and far between! Thanks for the stories!
ReplyDeleteI have also taught Forensic Nursing at the university level and my favorite was the girl who ask me just why she needed to take Anatomy and Physiology again. Keep in mind her major was Forensic Nursing. I don't think she ever got that just knowing where everything was would not help her determine why someone died.
DeleteGreat post. I did some pre-nursing a long time ago, but life got in the way and I had to go back to work full time. I would have loved to go back and finish, but at 42, I think I am a little too old.
ReplyDeleteYou aren't too old! When I was in nursing school there were several 40 yo women and one 60 yo woman, I was 32. Also, the money is great. Of course now there is more paper work than patient care. That's a minus. Not that I like patients so much but that they need and deserve our attention more than the paper. I just met a woman who just finished nursing school. She was in her 40's. Don't let age stop you if that's what you want to do:)
Delete~Spencer-Woo (the pugs)'s person, Rachel
Roe, your never too old. I like the older students better, they are usually the ones that really want to learn.
DeleteRachel-give a big pug hug to Spencer for me!
Nursing is a profession I have great respect for but would never even pretend that it is something I could do.
ReplyDeleteThat is just what I am talking about Brett, at least you realize it, some don't until they already have the RN status and they usually don't make good nurses.
DeleteThat was a captivating read. When I worked at the nursing home, I dealt with a lot of nurses (different than a trauma unit, true), but you still get those types and the worst were the lazy ones that spent all their time chatting and ignoring call lights and then running out the door as soon as the clock struck 2 whether there was paperwork or another nurse or call lights. It can be hard to find a nurse that cares these days - and sometimes it's hard not to blame them since they are worked to the bone and stretched so thin.
ReplyDeletePS - One f our old customers actually did get in a car accident and had her brains scraped off the pavement and put back in her head and she lived to tell about it. Of course she woke up from the trauma and didn't remember ANYTHING from her loved ones' names to how to pick up a fork to talking or walking. Her fiance left her (way to stick it out in good times and bad asshole), and to this day she will have glass push out of her head from time to time. Obviously, she was a miracle. And a very very sweet woman.
I'm not saying we don't have our miracles but Bird I can guarantee her brain was not separated from the brain stem and then pushed back in and everything worked. There are some areas of the brain we can do without, others we can retrain if injured but the brain stem isn't one of them, if it's gone your gone. You know my son fell and hit his head in a rock bed when he was about 5 and to this day he will sometimes wake up and find a tiny piece of gravel on his pillow that has finally worked it's way out.
DeleteI love you. my mother is a nurse and teaches nursing and the story she tells... wow. It seems a lot of nursing students seem to be lacking common sense.
ReplyDeleteGood luck!
Some of them lack any sense! LOL I have one that I worry about being able to drive herself home.
DeleteI don't know how you do it. I would not have the patience (pardon the pun), it's not the same but when I worked in childrens homes we had a few people who came to work there that ended up causing more problems then the kids because they were either scared of them or just had no fucking clue. There are some jobs where you either have it or you don't and nothing inbetween I guess.
ReplyDeleteI have thought about nursing a few times, blood, guts and gore would not be a problem, I once saved a guys life after my friend and I found an RTA at 3am. He was a mess but the next day a policeman knocked my door to tell me that without what I had done he would've died. And I had a friend who seriously cut her wrists - from her wrists to her elbows - I could see bone, and I sat there and literally held her arms together until the ambulance came.
But it's the vomit. No fucking way. I only have to hear someone throwing up and off I go.
I can't stand vomit either. I can each lunch while watching surgery or a major trauma but one drop of vomit and I am going to vomiting with them. Just one of the things I could never get past. Even at home, if one of my kids vomited we really had a mess because I would vomit too. Hell, I even vomit when one of the dogs do. Just can't handle it.
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