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.