Wednesday, March 24, 2010

Step By Step

Yesterday was Tuesday-- clinical day. This means the joy of getting up at 5 a.m., picking up two of my classmates and being down on the South side of Chicago by 7 a.m.

On the way down, my two classmates and I talked about how dissatisfying our clinical experience has been this semester. Due to various circumstances, we haven't been able to do too much. Happily, this changed yesterday.

When our instructor handed out the assignments, I was happy to see that it was my turn to do Accuchecks-- testing the blood sugar of diabetic patients. I was also nervous. I'd finally gotten to do one on myself in the skills lab last Thursday, but sticking a sharp object into another person and drawing blood is an entirely other matter.

One of the reasons that my clinical experience has been mediocre at best is that I've worked with, by the luck of the draw, a couple of people whose people skills weren't so great. Happily, again, my luck continued-- I had not only a nurse and a nurse's assistant who were great, but a couple of great patients.

When I got up on the floor, I talked to the nurse I'd be working with, who introduced me to the SNA, the nurse's assistant, who would be doing a bunch of Accuchecks. I jumped right in; after showing me one Accucheck, B. let me try one myself. I was all thumbs on my first try, but Mr. G., the patient, was cheerful and told me to try again. After having trouble with the second one, I let B. show me another one and I caught what I was doing wrong.

B. and I chatted as we worked about health care work. She talked about how important it was to remember that it was a person you were working with, and not a "case." Some of the people she worked with, she told me, forgot that. I told her that in the less than a year I've been training to be a health care professional, I'd already observed this a few times.

While working with B., I remembered a conversation we'd had in my Nursing 101 class about working with nurse's assistants, and how if you are respectful and attentive, you can learn a huge amount of information. I also thought about my experiences as a teacher; the first people I made friends with in a school I worked in were the secretaries. I found that not only did they run the school more than the principal or assistant principal imagined they did, but they were generally the "Rodney Dangerfield" of the school-- not getting enough respect. A little respect and recognition toward them went a long way. It's the same way with nurse's assistants. B. eagerly showed me all kinds of stuff I would never have learned in a classroom.

Later in my shift, I went in and introduced myself to the patient I'd be working with. Mrs. A., who was a 75-year-old woman who'd had a fainting spell. It turned out that her heartrate was well below normal. Later I discovered that she was going to have a pacemaker installed.

While giving her a "head-to-toe" exam-- checking pulse, temperature of extremities, blood pressure, pulse, respiration, etc. I got a chance to chat with her. It turned out that her husband was a physician at the hospital-- a neurosurgeon-- and that she was a retired nurse. She was curious about how many male students were in my classes. I realized that a semester before, I was nervous as hell giving a patient an exam. Now I was able to do one while holding a conversation.

Toward the end of the shift, my instructor told me it was time to do my blood sugar tests. I was a little nervous during the first one, but was able to get a good draw. The second one was routine and by the third one, which was back to Mr. G. again, the instructor didn't even go in the room with me-- she was confident in me. I joked with Mr. G. about being a vampire, and Mr. G. wished me luck on my future career.

I went in for one more set of vital signs from Mrs. A. and said goodbye to her. Like Mr. G., she wished me luck on my upcoming nursing career, assuring me I'd do well.

I'd had my best clinical day yet. I'd done something I'd been very apprehensive about-- stuck a needle into someone for a glucose test- and realized that it was a big step toward doing something else I'd been apprehensive about, start an IV. I was elated and exhausted. I dropped my classmates off at their homes, went home, had lunch and crawled in bed for a much-needed nap.


SkylersDad said...

That is very wise advice, to remember the people who don't get a lot of respect sometimes run things!

Churlita said...

Oh, Accu checks. When I worked in the ob/gyn clinic, there were days where I did phlebotomy and did close to a hundred in a day. good luck on the IV insertion.

As a nursing assistant, I wouldn't let the med students see patients if they looked at them like cases instead of people. They'd get all pissed-off and say, "What are you? Just a nursing assistant?" And I'd tell them if they were smart, they'd figure out that we had all the power when it came to assigning patients. Duh.

Mnmom said...

Good for you! You'll be a great practitioner.