Friday, November 27, 2009

end of semester and last clinical day.

so, you know the neat thing about being a student, is the stages of the semester that you go though, and knowing that everyone is right along there beside you.

I have one more week of classes, no more papers, and two final exams on the 9th and 10th. So, it is definitely a feeling of relief. I arrived here in Montreal, with not many expectations, but knowing that I am here to do a program that I firmly believe in. I totally believe that I am 100% in the right place, and that I am doing what I want to be doing for the rest of my life. And, that, is such an amazing feeling.

I am taking on nursing, at a skill level that is a little intimidating. I am in a direct-entry master's program. What that means, is that we are doing nursing at a graduate level, but none of us are already nurses. We come from science backgrounds. Anthropology. Film and photography. psychology. a huge diversity of people from different places and different experiences. and, we all want to be nurses. so, the most common thing amongst us is that none of us know what we are doing when we step into client care.

we have had 3 clinical experiences this fall. one day a week at a convalescent hospital (geriatrics), one visit a week to a healthy older adult, and the task to follow a prenatal class. Today was my last day at the hospital, and I think I made the presumption that I was going to be going in, and it was going to be a semi-quiet day to finish off the semester. well, was I ever wrong.

started off the day with getting a new client, because one of my co-students felt a little overwhelmed with her care last week (patient 1). Then I had a patient that I have been working with for a while (patient 2), and finally, a patient who would be totally new for me (patient 3) I went in the morning to meet each of my clients for the day, and to make a long story short, it was go go go from moment number one.

with patient #1, I had anxiety, diaper changing, and a bathtub that didn't want to plug. I am not going to get totally into it, but all I know is that hopefully diaper changing and wiping peoples... butts!?!?.... gets easier. cause, what do you do in a clinical situation when you feel like you are going to throw up!? that is right... you are thinking exactly right. nope, i didn't throw up on a patient, but definitely gagged. you should've seen my clinical instructor trying to determine with me if it was "abnormally foul" smelling. all i said was "err... well, i don't have much experience in this area, but i know that my experience is that it was very foul smelling..." oh sigh. the next time she had to use the washroom, i definitely did not want to go in. but. i. did.

at the end of the day, though, you put yourself in the clients shoes.
you remember how it must feel like a loss of dignity for someone else to wipe your ass.
you remember how embarassing it must be to not be able to control those actions.

with patient #2, I have been working with him for a while. He is not old, been active, semi-retired, and has recently had his first stroke. He is very independent, pleasant, and very motivated. TOday was a day for him to have his bath, and he was finding that no one was there to help him. So, I asked his nurse in charge, and PAB (nursing assistant) if I could help him. We are taught to ask the client questions that can allow them to feel mastery in their situations, and to consider what the client wants to do... essentially "the client is the expert" in most cases. So, we go in, I ask him what are normal procedures for his bath, and he tells me. We get him ready, and I ask "okay, so, do you need help with bathing? Do you need me to stay?" no. so, i think "okay, well, he says that he feels able to do it himself." I tell him, "okay, here is the call bell, I will be close if you need anything, just let me know." and, i leave. I walk down the hall, to check in on someone else...

3 minutes later, bell is ringing, and people are looking at me, yelling. PAB goes crazy on me, nurse is asking me "where are you!?" and someone else is all "why did you leave!?!?" I go in to see what is the problem... he can't figure out how to properly turn the showerhead on. (ummm, i have that problem a lot of times in strange showers!)
but, it turns out, that you are *never* to leave a patient alone in the shower. this makes the incident seem short, and not very interesting, but let me just say that it is really good that I am who i am.
that i don't lash out at others, that i am somewhat passive aggressive (not in a bad way though. I just know how to deal with judging when it is a good time to respond, and when to let it go), and that i am able to take reactions with a grain of salt. Was i in the wrong? well, yes, sort of. i shouldn't of left the patient alone. but, on the other hand, I took the patient for his word, and I didn't know that I am not able to leave them.

so, learning experiences.
all learning experiences. ass wiping. adverting my vomit. being yelled at by 3 different people at once. and "terminating relationships" with patients.

it was a big day.

and now, it is time to bike.

1 comment:

Bonnieupnorth said...

Ah memories of those early days of student nursing....we had round caps and hair had to be tucked in just so, nails trimmed and never ever forget to check the patients wrist band before giving meds aka a similar experience to yours but at the Good Samaritan geriatric ward at age 19.

Talking to Dr. Jakeway last week and he said of course you will drive them batty as there is nothing worse than a nurse that sks intelligent questions!