Talk to the Hand

Even before starting nursing school, one of the things that scared me most was wondering about the reception I would get as a student on whatever hospital ward I was assigned to. I was well aware of the popular saying "Nurses eat their young," and I dreaded the possibility of being taken down by a mean pack of nurses who were hungry for new student blood. This semester I have been working on a surgical ward that, for the most part, has been extremely receptive to students. As I continue to develop new skills and feel more confident in the hospital, I begin to feel like less of a burden to the nurses I am paired with. In fact, I've even begun to feel useful to them at times, as my budding new skills can help to relieve some of their workload. A few weeks ago, however, I was caught off guard when I approached the nurse that I was partnered with to ask her a question about our shared patient. It is always a bit intimidating to approach nurses when they're working because they're obviously busy, so I always make sure I'm tactful about it. I had already gotten the feeling that this nurse was not too thrilled to have a student assigned to her, so I was all the more determined not give her any more reasons to dislike having me around. I waited for a moment when she wasn't doing something that required excessive concentration. Aha! She just sat down to check lab values on the computer. My window of opportunity!

"Sorry to interrupt, but I just had a question about - "

Without even lifting her eyes from the computer screen to look at me, she stuck her hand directly in my face and snapped, "Ugh! I can't talk to you right now!"

I slunk away with my tail between my legs, completely deflated. Did a grown woman with whom I'm supposed to have a professional relationship essentially just tell me to "talk to the hand"? I tried to rationalize her response in my head. People get agitated and short when they're stressed and busy. Maybe she was having a particularly bad day. Maybe she didn't get enough sleep last night. Maybe her cat just died. Or maybe she's just the kind of person who thinks she's exempt from treating others with basic human respect because she's been nursing for longer than I've been alive. The worst part was that I just had to grit my teeth and bear it. I am a guest in her workplace, working with her patients, and threatening her nursing license if I screw up and kill one of them. I know my place at the bottom of the nursing hierarchy. I am just a lowly student nurse, but I am a good lowly student nurse. I am respectful, professional, kind, and cooperative - and not just because my school tells me I have to be.  Being swatted away like an annoying pest after treating her with nothing but professionalism and respect wasn't something I expected or deserved. 

I wish I could say that this type of treatment is the exception and not the rule, but from my (albeit limited) experience and that of my classmates, it happens far more often than it should. In the first week of nursing school we were told that one of the responsibilities you agree to when you become a nurse is that of teaching, supervising, and mentoring new students. When new practicum students are assigned to a ward, the nurses working there are required to collaborate with them. It is not optional. Clearly, some nurses have forgotten this, though thankfully not all.  I have been fortunate to be paired up with nurses who go out of their way to teach me and it truly makes all the difference in the world. On those days, I come home excited about nursing and certain that I've made the right career choice. Other days, I come home wondering if I am strong enough to handle the bullies.

It is so unfortunate that this dynamic exists between some nurses and students. No one was born a nurse, and everyone who chooses to become one requires guidance and mentoring. It is such a disheartening experience to try and work collaboratively with a nurse who obviously doesn't want to have anything to do with you because you're just a student. In those situations, I just want to scream at them, "Teach me! Teach me! I have so much to learn from you! TEACH ME!" I've heard it proposed that perhaps these nurses were also treated poorly as students and are now seeking revenge on the new generation in some kind of twisted power game. I suppose it would be easy for me to do the same, to remember every injustice done to me and save all that anger and resentment to use as ammunition when new student nurses walk into my place of work one day. But thankfully, what stands out to me more than the injustices and the disrespect are the moments when a nurse takes the time to teach me a new skill, or asks me, "What do you think we should do?" in an effort to get me to think critically about a situation, or asks me how I'm coping with the stress of nursing school because they remember how difficult it is. Those moments don't happen as often as they should, but when they do they are golden. 

Future nursing students, one day I hope to show you the kindness and patience that I wish was shown to me more often. I promise to never forget how difficult it is to approach a sick patient in a hospital bed and worry that something you do (or forget to do) will cause them harm. I promise that if I ever get through nursing school myself, I will try and help you do the same.

Back to Basics

I've been waiting for months for something to inspire me to write, which admittedly is a bad strategy because if you're waiting for inspiration, chances are it will never come. Thankfully I was rewarded this week in hospital when someone said something that set my mind on fire. I was talking to one of the nurses on the ward about how my school organizes the progression of our skill development. The semester I'm currently in is traditionally described as being extremely skill-heavy. We learn a large number of technical nursing skills such as injections, sterile wound dressings, managing IV medications, removing sutures and staples, and removing all kinds of exciting tubes and drains from various body parts. The nurse I was talking to gave me a knowing look and leaned in close. 
 
"Must be nice to get away from those bed baths."
 

Oh, the dreaded bed bath. They were one of the first things we learned upon starting nursing school, and as our first clinical placement was on an acute medical ward for geriatric patients, we got more than enough practice giving them. Now, being on a surgical ward, our patients are typically younger and much more independent with their basic needs. Assisting with hygiene is still required of us, but full bed baths are a less common occurrence. I've written about bed baths before and I'm starting to realize that they have a special place in my heart. When I hear someone talking about them disparagingly, I have an overwhelming urge to rush to their defense. They are the underdog, an often-looked-down-upon skill that has been mocked and sexualized by popular culture. But as defensive as I get about it, I understand why they have developed a bad reputation in the hospital: they take time, they can be quite physically challenging if you have a patient with limited mobility, and, of course, they often involve getting up-close and personal with unpleasant sights, smells, and sounds. As technical nursing skills go, they are the bottom of the barrel. How much training do you need to fill a basin with soap and water and wash a body? Anyone can do it.

Giving bed baths and attending to other hygienic needs are the most basic of nursing skills. As student nurses, we are impatient to learn more advanced skills that will bring us closer to the image we have of ourselves doing important things like saving lives. But we quickly learn that most of the time, being a nurse (and especially a student nurse) isn't as glamorous and exciting as TV would have us believe - it's being sprayed with bodily fluids, it's figuring out the best way to roll an obese bedridden patient, it's wiping bums, it's measuring what goes into and comes out of your patients, it's celebrating the first bowel movement after surgery. It's messy, stressful, and downright disgusting at times. 

But along with the mess comes the best part: caring for another human being in their most vulnerable hours and providing the most basic needs for those who can't provide for themselves. What a privilege. 

Ask any nurse or nursing student why he or she pursued nursing and the answer will almost always be, "because I want to help people." As students, I think we fall into the trap of believing that the more skills we have, and the more advanced they are, the more we are helping others. And let's be honest - we want to do the cool stuff. We want to feel like the highly educated, highly trained nurses we are being groomed to become, and the advanced technical skills get us closer to that identity than do some of the basics. But the more we lose sight of the basics, the bare bones of nursing, the more we move away from the ultimate goal of helping others. I've seen nurses talk over patients about their weekend plans while they give bed baths or make gagging faces at each other as they clean up a particularly gruesome mess, and I've seen patients who are overcome with gratitude when someone offers them a toothbrush because nobody thought to do so for three days.

As I progress further into my nursing training, more and more skills are added to my arsenal. I'm grateful to have the opportunity to practice the ones that are more advanced and more interesting, but I never want to lose sight of the basics. Washing a body isn't difficult, neither is wiping a bottom or changing a diaper. The skill of it comes by figuring out a way to do so that preserves the dignity of the human being in the bed, and I would argue that that is a skill worth mastering.

Perspective

Remember back in August when I pledged my commitment to achieving balance in my life no matter how busy or stressful school got?  I wish I could look back on the past three months and say that I kept that promise to myself, but unfortunately if there was one word to describe this semester it would be "unbalanced."  The near-impossible pace with which the semester has moved, the piling up of assignments and exams, the late nights and early mornings, and the emotions that come along with dealing with illness and death have all taken a toll on me.  Keeping up with the workload and getting good grades have taken up the top spots on my priority list, unfortunately at the expense of exercise, quality time with my loved ones, and other activities that bring me joy.  I am the worst kind of student - the kind that burns themselves out studying, gets 90%, and then complains that they didn't get 95%.

On Monday I have an exam on the pathophysiology and genetics of cancer, a huge and complicated topic.  Doing well on this exam has become my latest academic obsession.  I've spent the last week locked away in my office studying, all the while ignoring the fact that I was sick with a bad cold and needed to rest, snapping at my fiancé if he dared break my concentration, and convincing myself that not doing well on this exam would mean that I was destined to be a bad nurse.  I have been eating, sleeping, and breathing intravasation, proto-oncogenes, prostate specific antigen levels, lymphomas, mesotheliomas, and countless other "omas."

Two days ago I learned that my sister-in-law's best friend had passed away after a three month battle with lung cancer.  She was 21. 

Hearing that news turned my world upside-down, my world that has been so focused on pushing myself as hard as I possibly can to achieve academic greatness, even if it comes at the expense of my physical and mental health, my relationships, and my general sense of well-being.  This is the kind of news that shakes you to the core and makes you question the balance of the universe.  

How incredibly unfair it is that the biggest concern in my life right now is doing well on an exam about cancer while my sister-in-law and countless other people that knew and loved this beautiful girl are mourning the loss of a life to it.  How completely random and incomprehensible that, for whatever reason, I get to wake up tomorrow morning and live another day while someone else does not.

Though I wish the circumstances surrounding it were different, I needed this dose of perspective.  I needed something to force me to take a look at my priorities and the way I'm living my life right now.  School is important, my exam on Monday is important, but living my life in a way that puts these things as top priorities isn't sustainable.  I can't even begin to make sense of the tragedy that has touched the lives of this young girl's many loved ones, but what I will take away from it is this: life is short.  That phrase gets thrown around a lot, so much so that I feel like it's become a bit of a cliché.  But all it takes is a situation like this one to make you realize the terrifying and liberating truth that life can be taken away in an instant.

Go tell someone you love that you love them. 

Bed Baths and Beyond

I know, I know.  

I'm the worst blogger ever.  There have been so many times in the past month when I wanted to sit down and write, but something always got in the way - an exam, a paper, the overwhelming urge to take a nap.  Even now I don't really feel like I have the time to be writing a blog post; the lengthy "to-do" list hanging above my desk is looking down disapprovingly at me and reminding me that I should be studying.  But in an effort to keep myself sane, I'm going to ignore the "to-do" list for a little while. 

This week will mark the half-way point of the semester and while part of me is celebrating the fact that I've made it this far, the other part is feeling doubtful that I'll be able to keep this pace up for the next two-and-a-half years.  It has been a grueling eight weeks and I feel like the stress of this program will take years off my life if I'm not careful about dealing with it effectively.  Not that the stress of being a student is anything new to me, though. Writing essays at the last minute, cramming for exams, falling asleep with my face in a textbook, these are all familiar things.  I've spent the better part of my life being a student so I know how it goes. It's the practical experience, the two days a week I spend in hospital, that has proved to be the most challenging thing so far.

I feel like I'm playing dress-up when I'm in hospital.  When you're in a medical uniform, patients and their families expect you to know what you're doing and look to you for answers.  And while I may look the part in my uniform, I am acutely aware of just how little I know and how limited my skills are at this point.  I know it's all part of learning and that every nurse was once in the place I am now, but I can't help feeling like a bit of a fraud when I present myself at a patient's bedside.  Yes, I'm wearing scrubs and a stethoscope, but if something goes wrong you really don't want me around. 

But I don't want to spend any more time focusing on my insecurities (and believe me, there are LOTS more).  Instead, I'd like to share my favorite thing that has happened in hospital, and the thing that - if only for a few moments - made me feel like a real nurse. 

It happened a few weeks ago when I had to give my first bed bath.  We had practiced giving bed baths to the dolls in the simulation lab at school, but no amount of practicing on dolls can prepare you for the first time you have to expose a complete stranger and wash their body.  The nurse that I was working with for the day offered to help me wash the patient as it was my first time doing it.  The patient was agitated and writhing around in bed as the nurse held down her arms, untied her gown, and exposed her frail, wasted body.  I felt so intrusive being there, witnessing this extraordinarily private moment.  The nurse began washing the patient who continued to writhe around anxiously while yelling words in a language I couldn't understand.  I hated that I couldn't understand what she was saying and I hated that her life had come down to this - lying naked in a hospital bed, completely at the mercy of two strangers.  Then she reached out and grabbed my hand, and I felt my heart split wide open.  She continued to hold onto my hand tightly while the nurse finished washing her.  It was the first time since starting in hospital that I felt like my being there had made a difference to someone.  As I mentioned earlier, I am constantly aware of how much I don't know and can't do yet as a brand new student nurse.  I can't yet give drugs to take away pain or anxiety, I can't catheterize, I can't dress wounds, I can't start an IV, and I know a fraction of a fraction of what nurses are required to know. 

But dammit, I can hold a hand.

Let It Bee

1 week down, 114 to go.

It feels like it was months ago that I was sitting down to write my first post about starting school.  It was a whirlwind  first week and I already feel like my brain is nearing maximum capacity with all the new information I've been cramming into it.  Despite feeling a little bit overwhelmed, I'm happy to report that I'm extremely impressed with the program so far, mainly because of the strong emphasis it places on practical experience.  Case in point: Today - six days into the program - was my first day in hospital and my first patient assignment.  As a student nurse in this program, you get thrown right into the deep and and either sink or swim.  It sounds horrible (and it sort of is) but I think it's the best way to learn.  Already this has been a very different educational experience compared to the five years I spent in university getting my undergraduate degree in psychology; my experience at that university was such that I came away book-smart, street-stupid (Sarah Slean reference, anyone?).  Nursing can't be learned by reading a textbook, you have to get in there and (literally) get your hands dirty.  

That being said, however, it was more than a little anxiety provoking to go into the hospital as a student nurse with 6 days of experience under my belt and be assigned a patient.  Not to mention the fact that my day got off to a bit of a rough start: After meeting up with my clinical group and instructor outside, we were just about to enter the hospital when a giant bee landed on my hand and stung me.  I've never been stung by a bee in my life so of course it had to happen for the first time while I was busy trying to maintain a calm, confident demeanor and not let on to my classmates and instructor that I was terrified.  I yelped, the books that I was carrying went flying, everyone turned and stared.  Awesome.  I'm going to be known as that student who went into anaphylactic shock on the first day of clinical.  I tried not to view it as a bad omen, a sign from the nursing gods that I've made a terrible, terrible mistake by choosing their profession, but I have to admit that the thought crossed my mind. 

As much as I tried not to let it, that stupid bee sting threw me off for the first part of my day.  My hand was swollen and painful, I was distracted by the tiniest sensations in my body thinking that they could be signalling the start of a serious allergic reaction, and I felt embarrassed and upset that the calm, confident demeanor I'd been trying to achieve had been spoiled (because nothing makes you feel confident on your first shift as a student nurse like walking around holding an ice-filled specimen sample bag to your hand). 

I met my patient at the end of the day and got to do some very, very basic nursing care.  The only objectives today for the student nurses were to make sure our patients were breathing (always important), take a radial pulse, do a pain assessment, take a brief health history, and to make sure they were comfortable and safe.  I'm not completely happy with how my patient interview went.  After leaving the room I immediately thought of all the different questions I should have asked, the different ways I could have phrased things, the different things I wished I had done.  But I know I'm being hard on myself - I'm not supposed to be good at this yet.  I wish that a lot of things had gone differently today - starting with not being stung by that damn bee - but I know that I'm doing more of a disservice to my learning by sitting around dwelling on what could have been different than to just let it be, think about what I want to improve on, and try again next week.

The Devil on my Shoulder

There are days when I simply can't wait to put on my running shoes and get outside.  On those days, I crave the rush of endorphins and the sound of my feet on the pavement like an addict jonesing for their next hit. 

Today was not one of those days.

I had my day all planned out: school until 12:30, home by 1:15, run for an hour, homework until 5:00, dinner, go watch Dave's soccer game at 8:30, bedtime at 10:30.  Everything was going according to plan until it was time for my run and I realized that I was exhausted, hungry, and that my bed had never looked cozier or more inviting.  And then I heard it - the little voice of the devil on my shoulder telling me to ditch the run, get in my jammies and take a nap.  Thus began the following battle of wills:  

Just go for a run later this afternoon.  You need some time to relax. 

Once you start relaxing you won't want to stop. 

You've had a stressful couple of days.  You need to take it easy on yourself when you're stressed.

Getting some exercise will help with the stress.  You need this. 

But you're so tired. 

Going for a run will make you feel less tired.

You know what else will make you feel less tired? Having a nap.

If you go for a run, you'll feel so much better afterwards. 

But if you have a nap, you'll feel so much better now.

If you go for a run, you can eat that giant piece of leftover lasagna and not feel as guilty about it. 

You and Dave are getting married - he has to stay with you forever even if you get fat.

OK, forget about running for an hour.  Just go for 20 minutes and then see how you feel.

Just nap for 20 minutes and then see how you feel.

...And so on. 

Sometimes that little voice in my head is just a whisper, other times it screams at me.  I've gotten a lot better at standing up to it and reasoning with it, but it isn't easy and it still gets the better of me sometimes.  But not today.  I didn't end up meeting my goal of running for an hour, but I can live with that.  The thirty minutes that I did run for were amazing - not because I ran particularly fast or far, but because they were my time to lose myself in some good songs and be alone with my thoughts.  

Running, like life, is unpredictable.  There are days when it feels effortless to me and then there are days when one kilometer feels like a marathon.  There are times when I'm struggling to put one foot in front of the other but then something happens - the endorphins kick in, the right song comes on, I pass another runner who gives me a knowing smile of encouragement - that gives me an extra spring in my step.   There are days when I head out thinking it's going to be an amazing run and come home 10 minutes later with stomach cramps and runner's trots (don't laugh - it happens).  And there are days - like today - when I'm tempted to listen to the voice of the devil on my shoulder, but I fight back, get out there, and end up loving every second of it.

And yes, I ate that giant piece of lasagna afterwards...and it was delicious.

The Starting Line

Well, hello there!  

Welcome to my humble little blog, born out of a desire to re-engage with writing as a creative outlet, and to share my experiences as a nursing student who runs to stay sane. Tomorrow at crack of dawn I become a student again and begin the long process of becoming a registered nurse. While I've heard nothing but good things about the program I'm about to start, I fully expect that it will make me cry, make me doubt myself, push me to my limits, and be one of the most challenging things I've ever done.  

I am terrified.

I'm terrified of so many things (What if I faint and/or vomit the first time I have to deal with [insert bodily fluid of your choice]? What if I get a crotchety Nurse Ratched-esque preceptor? And - ohmygod - what if I kill someone?), but right now one of the things I'm most worried about is that I will be unable to balance the demands of nursing school with the non-nursing school parts of my life. I already feel like things are a bit out of balance and I haven't even started the program. The past few weeks have been jam-packed with preparations for my new adventure - CPR re-certification, respirator mask fittings, shopping for scrubs, the 23 (no, that's not a typo) chapters of pre-reading that were assigned for one class, transforming our spare bedroom from Craft Room Extraordinaire into Study Central, and countless other little "to-do's" that just seemed to eat up my days. Throw in a whole bunch of shifts at work and some wedding planning and you have a girl who is exhausted before the real work has even begun.

I know that the focus of my life is about to shift dramatically. I won't be able to do as much pleasure reading because I'll be busy reading textbooks. I won't be able to dedicate as much time to making handmade Christmas cards because I'll be studying for exams. I might have to adjust my expectations about how much time and effort I can put into training for races. I probably won't be able to see my family and friends as much as I would like to. I know that nursing school is about to take over a large part of my life, but I am fiercely determined to not lose those other pieces of me - the running piece, the creative piece, the social piece - in the process.

Which brings me to this blog. My hope for this blog is that it will help me find a balance between all those pieces of my life. I want it to not only be a place for me to process all the emotions and experiences that I go through in my training to become a nurse, but to also be a creative outlet, a place for me to share my love of running, and a way for me to keep in touch with family and friends when I get busy. (And who knows, I might even make some new friends along the way. I've already got one page view from Germany. Keep reading, Germany!)

And with that, I'm off to try and calm the butterflies in my stomach and to take my place at the starting line of the marathon I'm about to begin.

Ready, set, go. Right foot, left foot, repeat...