I have not been on here for quite some time! I think it is a bit obvious as to why: nursing school is INSANE!!! I literally have no time to myself. Now, it is finally fall break of my Level II semester (Literally the hardest semester of my life!). I worked on this article back in March, a week after I was injured, but never posted it.
Enjoy!
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Within the first three months of nursing school, I have had an incredible and quite terrifying ride as a student nurse. Not only have I been faced with challenges in school, but also in life itself.
In a matter of three months, I had been a patient, a patient's loved one, and a patient's (student) nurse. Although all three of these roles have been challenging and stressful in their own way, I have gained so much from them. Although I would never wish to be on the operating table or in the waiting room again, I would not trade these memories for the world. I believe experiencing these roles has given me the knowledge to become a better nurse. It has shown me what to do, as well as what not to do!
You do not have to be a nurse to gain from these experiences. If you work with people or, hell, if you have daily interactions with people, you can gain from putting yourself in someone else's shoes. I strongly recommend it. Now, I do not mean you should purposefully injure yourself so that you can see what it is like to be a patient. But if you ever find yourself on the opposite side of your role, just take a second to think about how you can make that experience better for others based on the good and bad things
The Patient
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| My Morphine-induced smile in the ER. |
For those who do not know, I love hiking with my amazing boyfriend, Chayton. Nearly two years ago, we went on our first official date at Skyline park. There, we went off-trail hiking/rock climbing straight up to the peak of the mountain. On March 13th of this year, I talked him into going straight up the mountain like good ol' times. About halfway up, we ran into a problem with the lovely desert residents: cacti and bees. He got a small cactus spine stuck in his ankle and I got one stuck in the bottom of my shoe. As we pulled the cacti out of each other's feet, bees buzzed around us. It was an absolute nightmare. So we decided to head back down a different route. Chayton climbed down from the rocky part of the mountain between two huge rocks. I made a smart remark about how he was going to be like the guy from 127 Hours. Little did I know what was to happen... After a bit of trying to get my little legs to climb down, I finally got to him. There were cacti and bees everywhere. So I traveled a little bit downhill, then decided to head back up to the rocky part where there were less bees. There was a wall of rocks about eight feet tall that looked pretty stable. I got myself up halfway and reached up with my left hand to grab the ledge. When I tried pulling myself up, that was when it happened.
It was so fast that I am not exactly sure how it happened. All I remember was seeing a rock fall toward s my face, and I stepped backwards out of the way. Not before having the huge top boulder slam down on my right hand before crashing to the floor. I immediately felt a tingling sensation in my pinky and ring finger. My immediate thought was "Oh, great. I broke them". I looked down at my hand to be greeted with something so much worse. In the movies, when something is cut off, they always show blood squirting out all over the place. It definitely was not like that, but it was still just as terrifying. The blood immediately started pooling in my left hand and dripped down my right arm. My pinky looked like one of those magic tricks where you pretend that you pulled your finger off. Except it really was (mostly) off. The first thing I thought from there was, "If I stand here any longer, I am going to pass out and they will have to helicopter me out of here! I need to run!" So I ran. Down the mountain. Screaming.
After a few yards of that, the nursing student and lifeguard in me kicked in. Chayton lent me his shirt to apply pressure and I elevated as much as I could comfortably. I once again took off. At the time, I thought I was pretty calm. I motivated myself to keep moving in my head. However, Chayton stated later that I was screaming the whole way down things like "Keep calm, Jenna!" and "Will you still love me if I only have four fingers?!" I ended up falling twice on my way down, both times getting a large amount of cactus in my behind. I tried to pull them, but I saw the stars. So I kept running.
About halfway down, I started to give up. I asked Chayton to call 9-1-1. I tried to tell the dispatcher not to send an ambulance, but, again, I must have not been in the right mind. By the time the police got to us, we had already made it back to the trail. They insisted that I needed a tourniquet on my arm. Everything inside me kept saying that was wrong for this type of injury. I told them no, that I had enough pressure on it, but they did it anyway. A bit further, the firefighters made it to us. They immediately removed the tourniquet from my arm and gave me fluids. When we made it back to the parking lot, they helped pull the cactus out of my rear and took my vital signs while waiting for the ambulance. There were about fifteen EMTs, police, and firefighters around us. As they looked at the hand, they said "oh, it's just the fingernail. Do not worry. It is going to be fine!" At this point, my adrenaline levels were so high that I hardly felt the extent of my injury. My being loopy was no excuse for lying.
"No," I said, "I saw it. I am a student nurse and can handle this. Just give it to me straight. Should we ice it so they can reattach it? Am I going to lose it?"
"No. It's just your fingernail," one of the cops restated.
At that point, I second-guessed myself. Maybe I was just overreacting. Maybe, with all of the blood, I became hysterical and hallucinated the whole thing. Temporarily, I felt better. Though believing it was just my fingernail made the truth that much more devastating.
They loaded me into the ambulance. The paramedic gave me my first taste of morphine, which sucked. I immediately felt respiratory depression and nausea. After that subsided, he quizzed me on opiates. I had a pharmacology test coming up and was suddenly super stressed about it. When we made it to the trauma room, I did not want that paramedic to leave. He was one of the only ones who did not treat me like I was incompetent.
During the initial assessment, the doctor came in to take a picture of it. He sent it off to the hand surgeon, and came back with the news. "Well, we are going to have to amputate." My heart suddenly dropped. Everything else he said about skin graft and bones went out the other ear. He spoke about how my "fingernail won't be too pretty" and how I "probably won't be able to paint it" as if my biggest fear was a crappy manicure. "There has to be something else," I spoke with a million different questions running through my head. He assured me that there was nothing. I screamed and kicked and threw myself around on the table. Although it was "just a pinky" as they kept saying, all I could think was "How would this affect my career? How would swimming feel different? Would I be able to draw and paint the way I used to?" Chayton came to comfort me and calm me down.
About thirty minutes later, the surgeon got on the phone with my mom. He said that the doctor misunderstood. In ten hours, he would attempt to reattach the finger. If he could not or the body chose not to accept it, then he would amputate and skin graft over the remaining bone. That was better, although I was still not too sure why he had to wait so long.
The next few hours in the trauma room consisted of getting my butt waxed free of cactus needles, watching a blood clot that was left sitting in my IV, and having my blood drawn three times because the lab kept messing up. I was finally brought to my own room in the ICU, where the best nurse thus far cared for me. She legitimately cared about my family's needs, actually helped me to the bathroom, and answered the call light quickly.
When we were moved to Pre-Op, I was terrified. I had just gotten morphine and oxycodone, so I was just a wee bit high in the sky. The two surgical nurses came in and acted as if I knew what was going on. Next, the surgeon came in. He explained that the surgery would only take fifteen minutes. I asked what he planned to do if he could not reattach it. Instead of showing me that he had a plan, he simply said that it would not happen. I was terrified that this would not end well, and not one medical personnel was willing to give comfort to this.
What happened after the surgery was a blur. I drifted in and out of consciousness. I asked the nurse at my bedside how it went. Without even looking away from the computer, he shrugged, "It went well. Ready to leave?" No one came to give me discharge instructions or tell me if I even had my finger still attached. No one came to tell me what happened in surgery or how to take care of myself until follow-up. My mom was given written discharge instructions that simply said, "Follow up in a week. Leave dressing. Elevate," then they hurried me out of the hospital without being fully conscious. I was still so heavily sedated that I do not remember how I got to the car or home.
"Nurses make the worst patients," my professor once said. Maybe it is because I know a bit about how medical personnel are supposed to treat their patients that I am so critical of them. Some of the big no-no's I was faced with were: condescending attitudes, false reassurance, miscommunication, lack of professionalism, assumptions, lack of patient education, lack of reassurance, and lack of attention. All of which made me feel uneasy, doubtful, and terrified of what was to come.
The biggest issue I had was the false reassurance. Although this calmed me down for a moment, it only made the fall worse when I was told it would have to be amputated. Always be real with people. Do not make them think they are okay when they are not. You may think this is helping them, but it will only harm them in the long run. Some people are stronger than you may think, so just be honest.
It does not take much more effort to give a patient quality care. The nurse in the ICU was busy, but still had the time to walk me to the bathroom and wait outside to walk me back. The nurse in the ER did not put in the same effort. What if I were to go unconscious and fall? Now the ER nurse would have to spend the same amount of time correcting her mistake as she would have if she went the extra mile. Reassure them, but do not give false hope. Look at them when you talk, because they are human. Address their concerns and needs. Educate them as much as possible to avoid things that could have easily been prevented.
Being the patient was honestly not the greatest. However, it showed me so much of what it feels like to be on the other end. Knowing what it was like gave me insight on how I can better help patients who have just been through hell.
The Loved One
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| My boyfriend, Chayton, Post-Op. |
In my opinion, being in the waiting room is so much more difficult than being in the hospital bed. At least that is how it is as a nursing student. Chayton and I took "twinsies" to the next level this semester. A few months before my accident, Chayton broke his fourth and fifth metacarpals (the bones that connect the ring finger and pinky to the wrist).
I remember racing to his house in a panic, because all I could hear was yelling over the phone. I ran across the front yard to his mom's car. Then, she sped to the emergency room. As Chayton groaned, the triage nurse took down his health history painstakingly slow. It took at least ten minutes before he finished the health assessment, Chayton still in a heavy amount of pain. He was taken back to get X-rays done. Finally, he was given Oxycodone for his pain, but the nurse never asked his name or date of birth, nor did she scan a wristband. Chayton asked the nurse for some water. After thirty minutes, I decided I would ask the nurse myself. I snapped at one of the nurses at the nurses station, "Um, he has been waiting to get some water for thirty minutes. Can we please get some?" Wow. I was
that visitor. We then waited for about an hour total until he was moved to an actual room.
The respiratory therapist came in and set up the oxygen.
While he was there, he thoroughly explained to Chayton what blood pressure was and what he looks for on the monitor. They started talking about beard care until the nurse came to have Chayton sign papers. Before leaving, he asked if he could get any of us anything. The doctor finally came in after about an hour or two. She immediately jumped into action for resetting the bone. She began to draw up an IV medication and looked at us, "This is Ketamine. We like to call it the Michael Jackson drug."
"Why is that?" Chayton's mom asked.
"Well, this is the drug that killed Michael Jackson." She blurted out. My heart began beating fast. Suddenly, I went from nursing-calm to loved-one-terrified. "Don't worry. The dose is not that high." She assured, but it was too late. My mind was running rampant.
As they began the procedure, the nurse asked his mom and I to leave. Luckily, or unluckily really, they allowed us to simply wait outside the room and watch from the window. I remember listening to him scream for me to come back, watching him kick and cry as the doctor pulled at his fingers. I peeked over at his mom who was keeping it way cooler than I was. "I need to stay strong for Chayton," I told myself. But it was too hard. His monitor began screeching. His heart rate was in the 120s and oxygen saturation was in the 80s. The respiratory therapist began shouting at Chayton, who was hyperventilating. He sternal rubbed him back to normal, but then Chayton would hyperventilate again. Chayton looked over at me with the worst kind of expression, one I could not even explain in writing. I could not do this. I left to the restroom to shed a few tears (in all honesty, though, I was bawling my eyes out). I heard him screaming behind me, "Where is Jenna?!" as I left. After the tears were all gone, I gave myself a pep talk in the mirror, wiped my tear-streaked face, and went back out there with determination.
After the procedure, Chayton was
crazy. The ketamine had him asking the male nurse to stroke his face and telling everyone that they were beautiful. This nurse comforted him and explained to his mom and me what was going on. Chayton eventually came back to planet earth. They allowed him to rest and eat for a bit, and then the nurse came to discharge him. After explaining to him what he needed to do to heal, she turned and explained to me what I needed to do. She handed me the written discharge instructions, then asked if I needed anything else. I helped walk him out of the hospital.
Seeing someone you love in an environment you are familiar with, but unable to do anything to help was hard. I may not know everything about nursing; in fact, at that time I knew very little. Yet, having the base knowledge to know what is going wrong makes it that much worse. For example, I knew that his diaphragm could have relaxed to the point of death with ketamine. Watching him hyperventilate and seeing his oxygen saturation made me think he was experiencing that. I think being in this position as a student nurse makes you freak out even more than it should, because your mind runs rampant with what little you know.
It is important when communicating with patients to also communicate with patient's loved ones. The patient might be terrified, but so is the patient's family. In some ways, the patient and their family members are one. Whatever you say to one, you should say to the other. Educate them. I loved the way the respiratory therapist went above and beyond to educate us on what was going on.
Please also note that you most definitely should not joke about people dying from a medication when you are about to administer it.
The (Student) Nurse
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| My first time wearing those beautiful purple scrubs! |
My first semester as a student nurse included a clinical at a rehabilitation and long-term care facility. The majority of the patients at this location were the elderly. Honestly, it was really hard to go to those five shifts. Every time my alarm would go off at four in the morning, it was not that it was early as much as I did not want to see how the patients were treated. In all honesty, this clinical rotation made me rethink nursing. If that was "nursing", I wanted no part of it.
I will give the staff this: they were very overworked. Each nurse had between ten and eighteen patients assigned to them. They basically just passed meds all day long, because there was no time to do anything else. Patients were all very sad, they did not want to be there, and they were lonely. No one ever seemed to talk to them. Call lights would be on for quite a long time before they were ever answered. The hallways would consistently smell like bodily fluids and were filled with patients sitting in wheelchairs, begging with their eyes for something they could not verbalize.
Once, one patient suddenly rocked back and forth and groaned. Her eyes were wide as she stared and followed me. I tried to tell a nurse at the nurses station that I felt she was trying to communicate something. She shrugged and went back to her work without delving any deeper into what I had claimed. This attitude was consistent with most of the other staff.
It is sad to think that places like this even exist. I am sure nobody went into the medical field thinking "I am going to give minimal effort in my career". I hope and believe that this facility was a bad case of desensitization and nursing shortage. Although it is hard to watch, it is important to see. Personally, it took a long time for me to have a positive outlook on this experience. Even to this day, I still feel uneasy about it. Eventually, with reflection, I realized that seeing desensitized nurses showed me exactly what I did not want to be. It showed me what a desensitized nurse looked like, and how to avoid being that person.
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With the first three months of my journey into nursing, I have had three very different experiences. Although there were more negatives in these experiences than I would have hoped, I would not change a thing about them. I learned so much from all of these experiences, and they each contributed to my growth as a student nurse and as a human being in general!
I hope you enjoyed my stories! I promise that I do not make this stuff up! My life truly contains one crazy adventure after the other. Comments, questions, or suggestions? Let me know in the comments! 💜
