The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

Archive for November, 2009

Not Just a Pretty Face: The Ugly Side of Nursing School

Posted by isntshelovlei on November 23, 2009

Clinicals are officially over the semester—praise Flo (Florence Nightingale, that is)! I can retire that mix-matched blue thing of a uniform until late January—shoes too. Of course the last day dragged like hell, and as my luck would have it, I was assigned to one of Nurse Nasty’s patients. She was just as evil as before, except she wasn’t wearing her red scrubs today—still had her horns though. I started to object, but figured that we were only doing a half day and I could put up with her for that long. So I took a deep breath, went into the room where they were giving report and said good morning Nurse Nasty, I’m assigned to your patient, Ms. X today. “WHO?!?” she asks, looking at me as if I had a third eye. Silly me, I must have forgotten that she only recognizes her patients by room number. “Your patient in room 123,” I corrected myself. “Oh.” She then turns her back to me and proceeded to ignore me. I just went about my business; I didn’t have time for her crap. I wasn’t assigned to give meds that day and my patient was on dialysis for four out of the five hours I was there so I basically stayed in the patient’s room trying to keep her comfortable and learning a few things about dialysis from the tech that was running her treatment (in between the tech clipping her coupons of course).

In other news, one of my fellow students made a comment labeling me as “anal.” WTF was that about? I laughed it off at the time, but obviously, days later, I was still bothered by it otherwise I would not be tainting my blog with it. Wikipedia defines anal (retentive) as “a person with such attention to detail that the obsession becomes an annoyance to others…” Nice right? However, in the world of academia, we know that professors hate Wikipedia so I’ll try another source to see if it gets any better. Dictionary.com, defines anal-retentive as “indicating personality traits, such as meticulousness, avarice, and obstinacy, originating in habits, attitudes, or values associated with infantile pleasure in retention of feces.” Wow, all that? Well I’m glad she let me know what she really thinks of me. Thank you Mrs. Freud.  

I’m sure she’s not the only one who feels that way. But what’s interesting is that other students don’t really seem to mind my anal-ness when they’re emailing me with questions about upcoming exams, quizzes, and papers—“I need to talk to you ASAP…call me.” And I wonder if I was being anal when I was out with my family and a student in my clinical group called, completely out of care plans (and we had two due the next morning), and I stopped at her house on my way home to bring her some more? Was that anal too? Though I’m sure only the most anal of nursing students ride around with extra care plans in their trunk… 🙂

I will admit to having a reputation for being a bit “extra” at times. I color-code my note cards and invested in Unbound Medicine’s Nursing Central (HIGHLY recommend!) for my iPhone 3G, though not required, so that I would have a good drug guide (among other resources) at my fingertips while at clinical—meanwhile they’re all scrambling for the one ancient drug book on the unit. I have a coworker who calls me “The Professor” and another student that has nicknamed me “Supa Dupa Student Nurse”—but I know it’s all in fun. Calling me anal though, I interpret a little differently. Over the years I have really gotten sick of taking other people’s shit for doing well and getting good grades. Contrary to popular belief, I bust my ass just like everyone else—I don’t just wake up in the morning with a 4.0 on my transcript. I have everything in the world counting against me and I’m still here, doing the damn thing. There’s nothing wrong with striving to be the best. Who wants a half-ass nurse anyway?

However, I did succumb to my Piscean sensitivity and emotionality and unfriended this person on Facebook. I didn’t do it in an elementary “you’re not my friend anymore!” type of way—because hey, we’re not kids in the sandbox. But my friends on Facebook are my “real” friends and family (on Myspace however, I only know about 2% of my 1400 friends—they’re mostly mob/mafia members for my apps!). I am sharing my real life and my journey through my updates on FB (and Twitter) and I don’t need negative energy or potential trolls in my circle. So I’m sorry if my “attention to detail” annoys you—but as I always like to say “I am who I am—your approval is neither desired nor required.”

UPDATE: My fellow nursing student and I have talked and worked things out. Gotta love the high-intensity stressed-out environment of nursing school where miscommunication runs rampant.

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Nurse Nasty Not Niceness

Posted by isntshelovlei on November 3, 2009

mean-people-suckLast clinical weekend I had a nurse from hell. Not only was she nasty to me, but her attitude even trickled down to my (I guess I should say “our”) patient.  The day started out how clinical days usually do, getting up at the butt-crack of dawn, hot-wheeling (as my children would say) to the hospital with just enough time to grab a cup of Starbucks before running in for report. I find the nurse I’m assigned to—”B”— introduce myself, tell her I’m assigned to such-an-such a patient…all that good stuff. She looks at me like I have three heads. I shrug it off—it’s too early, we’re all a little grumpy and most of us are waiting for the caffeine to kick in. She grudgingly pulls out her little notes to give me report. She tells me a few relevant things about the patient, but mostly just complains that she was “too young to need such total care.” She then asks (herself I’m guessing, because how the hell would I know), “Is this ‘the one’ with MRSA?” And proceeds to go back and forth in monologue about whether or not the patient had MRSA–something you’d kinda wanna to know before going in the patient’s room. We finally did establish that the patient did not in fact have MRSA.

So I go to check on the patient, introduce myself, etc. She’d had a dilaudid PCA from which she was being weaned (or actually by the time I got to her it had already been dc’d). Poor thing was clearly in pain and was wondering why her IV “didn’t seem to be working” so apparently no one had talked with her about it. I got my own set of vitals and asked her to rate her pain for me—which she of course rated as a 10 on a scale from 0 to 10. I reported this back to “B” who replies unsympathetically —“Oh well, she ain’t getting nothing else.” OH-KAY… The patient recently had a lumbar laminectomy, was discharged, then fell and broke her wrist. So she’s laying here with post surgery back pain, which was most likely made worse by her fall, a splint holding her broken left wrist together, and an IV in her right arm which was clearly infiltrated—unpleasant to say the least. So right about now, I’m stumped. Am I supposed to go in and tell my patient that her “real” nurse doesn’t give a crap that she’s in pain?

I return to the patient’s room to find breakfast trays are being delivered—good—a welcomed distraction. I helped her get set up—between the splint and the IV she really had limited use of her hands. She relaxed a little as we talked, but as the last traces of dilaudid wore off you could tell the pain was beginning to bother her again. Usually after breakfast we do hygiene and personal care, but she refused as she was in too much pain and did not want to be touched. I let her be for the meantime and decided to get started with my meds. Nurse Ratched finally allowed me to see my patient’s MAR (medication administration record), so I was able to look up the meds I didn’t know. She did not want to give me the key, nor let me into the drawer so that I could pull my meds. “You don’t need ME, you NEED YOUR INSTRUCTOR!” she snapped. Now at this point I’m seriously wondering what is this chicks’ malfunction? I went to find my instructor, who mind you is running around like a chicken with her head off helping all six of us pull meds (this was the first weekend that ALL of us did meds, previously just one or two of us would). After I returned with my instructor, “B” didn’t want to give her the key to the damn med drawer either!! She walked her devil-red scrubbed arse down to the room with us in tow, unlocked the drawer, and left without a word. Why couldn’t she have just done that 20 minutes ago? So I pull my meds, my instructor double-checks them, and then down the patient’s hatch they go.

At the beginning of the day the nurses were informed that the students would only be doing PO (oral) meds and injections—no IVs. Lo and behold we’re meeting with our clinical instructor in the cafeteria and Nurse Nasty hunts us down, MAR in hand—mind you the unit is two floors up, over the river and through the woods. “Why didn’t you give the such-and-such?” (I don’t remember what it was). I responded that was an IV medication. “Well how was I supposed to know you weren’t giving it?” Now she was really beginning to annoy me. If she took the time to actually l@@k at the MAR which she snatched back from me seconds after I gave the PO meds, she would have seen that I had not signed off on the IV medication—hence I did not give it! My instructor also added “I informed all of you this morning that the students would only be giving PO meds and injections today.” Nurse Nasty turns and leaves, horns just a-glistening. When we returned to the unit she now wanted to know why I also neglected to sign off on the patient’s Desenex powder, “You haven’t even bathed her yet…well what exactly ARE you doing today?” Nurse Nasty aparently forgot that “50” (she referred to all of her patients by room number and not by name) refused hygiene because SHE refused to acknowledge her pain status! Why would I apply desenex powder to a soiled ass behind?!? I figured we (more like I) could give it another try a little later after the oxycontin I had given her had a chance to kick in and her pain was a little more under wraps. Needless to say I could not wait for this day to end.

I realize that most of the time the nurses aren’t given a choice as to whether or not they will have a student nurse—I get that. The clear discontent of some of them is quite evident. And while they may be good at their jobs, some clearly do not have the right attitude to teach. But do they have to take out their frustration on us and even worse, the patients?!? Can’t they remember back to when they themselves were students? Sometimes I really do wonder why certain people have chosen this profession.

Thankfully, the next day I was not assigned to any of Nurse Nasty’s patients (which by the way, sucked for one of my classmates). I had a great nurse and two patients both of whom asked if they could take me home with them :). It was also the first time that I had more than one patient so I was busy—vitals, breakfast, baths, meds, fall risks, bed monitors going off, safety checklists, care plans…the whole shebang. My older patient (I believe she was 85-yrs-old) had literally about 15 9 a.m. PO meds. It took her three tall cups of water and about 30 minutes to get them all down. On top of the PO meds I had to give her a subcutaneous lovenox injection, “up close and personal,” as she called it. But I must admit that I do love when I give injections and they ask “are you done already?!?” It was an exhausting yet exhilarating day, and before I knew it, it was over.

We have clinicals again this weekend so we’ll see if Nurse Nasty remembers to take her happy pill. I guess sometimes the devil doesn’t wear Prada, but scrubs…

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