As I sit here tonight, thinking about my new job and all the new things I will see and learn….I start looking back to the time before I was a nurse, before I’d had this training and this knowledge base. Going to nursing school, graduating with good grades, and doing it all while raising two kids and having a husband who’s health is sometimes a question mark.
I followed a home care nurse around the worst parts of the city and into roach-infested apartments. I stood for 8 hours in a freezing operating room, watching gallbladder after gallbladder come out. I suctioned trachs, flushed IV lines, gave shots and pills, fluffed and turned. I changed elderly adults soiled briefs, cared for people with ORSA, MRSA, VRE, scabies, lice and C-diff. I did psych where the patients scared the hell out of me. In maternity I saw babies born. This was all stuff that I never dreamed I would be doing.
And I learned. Like a sponge, you learn to soak it all up. Don’t miss anything and write it all down. You never know what will show up on the next test. And then the final exam of the final semester comes almost before you know it. Dread and trepidation keep you up at night, along with the thought that if you don’t know it by now you never will. That final time you close your textbook and put away your notebook…you sigh and leave home for the final exam.
They were still giving out the grades immediately when I took my final. That was the last time they did it. I was the first or second person done with the test. I looked around the room, not believing that I was actually done. I didn’t check my answers. You learn by the middle of the first semester to go with your gut, and take your first answer. It’s always the right one. It was a 100 question test. When I finished I took my test up. I passed! I was done.
I. Finished. Nursing. School.
I hugged the instructors and danced out. Apparently someone after me did not pass, and either fainted or freaked out (depending on who is telling the story) and now no one gets their grades in the test room. Now they all have to wait 24 hours until the grades are posted.
Pinning came a week later, and the ceremony was great. There was a slide show, and awards. We were each pinned by a member of the faculty, and then we took a class picture. 77 of the original 99. Not too bad.
And then there was a huge moment of nothing….I had this sinking, lost feeling. School was over. I’d graduated. And I had nothing to do for two weeks until my new job started.
I felt lost while. I don’t know why. I had a couple weeks of just being ahead of me. No studying, no getting up at the crack of dawn for clinical, no tests. It was odd. I slept a lot. Probably a minor depression. On one hand I was glad for the rest, on another, well, I wanted a party or something.
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The calling. It’s like waking up in the morning and it’s a really nice sunny day. You know you need to study, or do your laundry or something else…but… you just HAVE to go outside. When you have a cast on and it itches, you’ll do anything to scratch that itch. It’s like that.I won’t lie to you, sometimes it’s hard. Sure it is. You have to do stuff that’s really gross, or you have to hold it in when you want to puke. You have to find the words to make people feel at ease and safe. There are easy moments that are good. Maybe not so much the adrenaline rush that comes with the hard stuff, but it’s what helps you to keep coming back each day, knowing that sometimes it might not be so hard. The good times, the special moments. That’s what makes it easy to get up each morning and go back. You just never know when you’ll get a diamond in a pile of dust. You never know when the magic is going to start, that connection or whatever it is. Something…a look, a feeling, or just a hand on someone’s shoulder. When you experience that, when those magical moments happen, you just know it…that’s the pull. It’s that itch you have to scratch, that sunny day you have to experience. The calling to be a nurse.
Last night I was waiting for my patient to return from Xray confirming his epiglottitis. (Major stuff. Could lead to death d/t airway closing up). The Dr. had his results already and the pt was going to be admitted to the acute ED and from there to a critical floor. Note, he was awake, talking and not acting as if he was about to stop breathing BUT, with the swelling of the epiglottis…it can (and does) become an acute and critical situation very quickly.
The patient returned from Xray in a wheelchair and was wearing a surgical mask. He was put in the reception room, where there were a couple of our other patients as well. I knew he had come back because the transportation tech told me he’d put him there. The Dr. looked through the reception window at him and said “Good, he’s back. Here are the orders. ” (IV, lots of labs, blood cultures, NPO status, and an antibiotic shot)
In our ED, we have a program where med students are available to “line and lab” patients in order to give them hands-on experience. I got the supplies for the IV start and labs, and some labels to both identify the patient and to label the blood samples and went to get the patient. I saw through the window that another med student was already lining and labbing him. “Ok, that’s weird” I thought, since I had the order sheet in my hand, and as far as I knew, no one else knew what he needed.
The patient had a big surgical mask on, all that you could see were his eyes. I had only seen him briefly before, so I didn’t really know what he looked like. I went and asked the med student if this was Mr. Jones. “No, this is Mr. Smith” she said as she worked on starting the IV, and pointed to the gentleman’s med sheet on the table next to her. Indeed the med sheet said Mr. Smith.
Hmm…. Maybe I was wrong and Mr. Jones wasn’t put in reception. I looked in each exam room, and found no Mr. Jones. I asked the other nurses if they had seen Mr. Jones? No one had seen him. During this time, the med student was still in reception working on “Mr. Smith”. Finally I asked the Dr. if he’d moved the patient somewhere else. The Dr. said “No, he is right there” pointing through the window at “Mr. Smith” and the med student. I went back to reception and looked at the patient’s wristband. Sure enough, it said Mr. Jones. I asked him to verify his birthday and his last name. This patient is truly the elusive Mr. Jones, and not the Mr. Smith that the med student thought she was lining. The med student looked like she was going to faint. I told her it was fine. Mr. Jones needed the line and labs, just finish and not worry.
If only it had ended there. I picked up Mr. Smith’s med sheet and left the correct one, the med sheet for Mr Jones. After I walked out of the room, I saw that a medication on Mr. Smith’s med sheet had been signed off by a nurse as having been given to Mr. Smith. This normally would not have alarmed me, EXCEPT it was given during the time that the med student (and presumably the other nurse) thought that Mr. Jones was Mr. Smith.
I located the nurse who’d administered the medication. She said “What do you mean that is not Mr. Smith?” We rush back to the patient and the med student. The other nurse said “You aren’t Mr. Smith?” Pt says “Why no, I’m Mr. Jones.” Another pt in the rooms says “I’m Mr. Smith.” The nurse now looked like she might faint. I took her out of the room. She did, in fact, give the wrong med to the wrong patient. Luckily the med itself wasn’t a huge issue. It was ibuprofen BUT, the wrong patient got it! More importantly, the patient who is supposed to have nothing by mouth because of the risk of throat swelling and occluded breathing, was given a pill. To swallow. The med student looked like she was going to cry. Both men needed lines, so that was okay. But, if she’d succeeded in obtaining the labs before the mix-up was identified, she would have sent the wrong labs on the wrong patient with the wrong labels and it could have been bad. She didn’t. So count that as a near-miss. Now the nurse in question… she gave the wrong med to the wrong patient. Not a near miss. A real med error. If that nurse had taken the 10 seconds to look at the patient’s wristband and verify he was who she thought he was…it would not have happened. But she didn’t and so it did. All were wrong in this case. The nurse in question got lucky… the patient did not have an adverse reaction, but the potential was there. Know your patient, and verify their identification EVERY TIME. That nurse and patient got lucky. That may not be the case next time.
Remember:
Right med
Right patient
Right dose
Right route
We are pleased to announce a new contributing member to the Nurses Station Blog.
Deanna, a nurse currently working in emergency care, kept a journal throughout her days as a nursing student. She will graciously share he thoughts, experiences, lessons learned and feelings during nursing school.
My name is Deanna and I am an RN.
I am a nurse in very busy, very large ER. Prior to this, I worked in maternity, oncology/hospice and med/surgical nursing. I’ll soon be starting my Bachelor’s degree and then plan to get my Master’s, with the intention of becoming a Nurse Educator when I am ready to leave bedside nursing.
I first attended nursing school when my son was very young. I’d always had an interest in biology and medicine, but I chose nursing mostly because the talk of the nursing shortage seemed to promise a secure job with good wages. I quickly realized that I was too young and too busy as a new mother to fully appreciate the educational opportunity. I left the program and concentrated on my family instead.
I worked part time while my kids were growing up, and always stayed on the fringes of the medical field. It wasn’t until my husband was diagnosed with leukemia in 2002, that I realized how very much I wanted to continue my nursing education. While we journeyed into the murky waters of being an oncology patient, I began to admire and appreciate what the nurses were doing for us. I was feeling a subtle but urgent scratching that was telling me it was time to revisit my earlier educational pursuits.
After my husband’s health was stabilized, and with the support and encouragement of my family, friends, and co-workers at the clinic, I entered the community college to restart the degree program I had begun almost two decades ago. This time I felt I had a true calling to the profession and that I was prepared for the rigors of nursing school.
I graduated in May 2006, just a month before my son graduated from high school.
Becoming a nurse has fulfilled a space in me that I never knew existed before. I truly feel it is a calling, and one for which I am very thankful.
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