There comes a time in everyone’s life when they start to look back at their school days and reflect. Nursing school is certainly included in these reveries whether it's the good, the bad and the ugly! Follow me in my size thirteen orthopedic shoes as we go down the memory corridor you thought you left so far behind.
Early morning, clinical hospital report starts off with the night shift nurses huddling with the newly arrived day shift nurses. As a student nurse, you find yourself physically at the outside perimeter of the nurse’s station. You can see the swivel chairs with people sitting down but you can’t hear anything. Suddenly, you sense the presence of the day nurse to whom you have been assigned for today. She can turn her head in a three hundred sixty degree circle and there are snakes hissing out of her tousled red hair. Danger - you must be careful not to miss report. You know she will not repeat any “pearls of wisdom” from the night nurse. You struggle to hear by holding your breath, while staying outside the nursing station inner sanctum perimeter. Finally, report is over and you meekly introduce yourself as her student nurse for the day. She dismisses you with a wave of her hand and tells you that you are “in charge of that patient.”
Now comes the challenge of writing five pages of nursing documentation including “med cards”, becoming a “patient advocate” without any status and staying under the radar gaze of your intimidating, yet supportive, clinical instructor.
It can be fear that keeps the student nurse from boldly entering the assigned room. It may be that the student nurse has not assembled and placed her “tools of the trade” properly in her pockets for easy access. These tools include three black pens in a pocket protector, goggles for splash, a small volume of paper, “post it notes” (easily ripped off the pad to disburse wisdom and vital signs), scissors, kelly clamp, tape, stethoscope, alcohol wipes, drug book, note cards and, of course, a working pen light. With these many tools, the student nurse feels like she needs a beach bag in order to enter the room!
The actual physical act of entering a patient room may be complicated by tripping over a piece of equipment placed in the path by the door. After summoning the courage to knock on the door, a student nurse may find herself in a compromised position with a bedside commode or walker. It is difficult to maintain a semblance of nursing professionalism while your feet are entangled and you have landed with your hands in a death grip on the side rail.
Finally, the first awkward moments pass with an introduction, explanation and studied observation of the person whose life is in your charge. Your instructor’s words echo in your ears, “Are they breathing?” "What is the environment in the room?" It is difficult to make that initial assessment mentally when there is so much clinical instruction noise in the background of your mind.
Oh no! You notice that you have been totally self absorbed and that the patient shows no response to your voice. You move off the side rail to feel the carotid pulse on one side only. You exhale loudly as you have discovered the patient has fallen back to sleep. At that moment, you decide that no matter what happens, this will be a good clinical day for nursing school!