Confessions of a registered nurse (Confessions of a student nurse): Lessons

The end of the spider-catching cup

Mon, 06 Nov 2006 03:44:41 GMT

As some of you already know, I have issues with killing insects. I just can't do it. I always have to catch them in a cup and bring them outside. Recently I learned an important lesson- never attempt to catch a spider on popcorn ceiling. The cup won't lay flat against the ceiling and bad things can happen....

Cooking tip

Mon, 06 Mar 2006 02:33:03 GMT

I learned something important about cooking today. When the instructions say to broil the food in the oven, this means you are supposed to leave the oven door open a crack when the food is in there. Well, at least we know the smoke alarms work!

John's Lesson

Wed, 01 Feb 2006 21:50:38 GMT

I know I have said this several times, but I really mean it: I would not have made it this far in nursing school if it weren't for my wonderful classmates. They always make me laugh, and we learn a lot from each other. Unfortunately for John, this was his week to be the teacher.
John's patient had an ostomy bag, and John was instructed to "burp the bag" which means to let the gas out of the bag. John had never worked with an ostomy bag before, so he got down close to it and opened the bag very carefully. Still leaning down looking at the bag, John squeezed it, pushing all of the gas right into his face. Lesson for the day: point ostomy bag AWAY from face before squeezing.

Why Dr. Google can be bad

Sun, 29 Jan 2006 19:22:28 GMT

Last night as I was brushing my teeth, I noticed these two weird bumps on my neck that bulged out when I leaned over. They are not lymph nodes, so I was curious to figure out what they were. I went to Google and typed in a few descriptive words, and started reading the summaries of the results to find the closest match. I almost had a heart attack when I read in one summary that bumps on the neck could be larva that had migrated to an area just under the skin where they would mature for three weeks. WHAT?! I clicked on the link and was directed to a Q&A forum on ferret care. That's when I decided to call it a night and go see a doctor (not a vet) sometime in the near future.

We all do stupid things

Sat, 21 Jan 2006 17:43:06 GMT

I know that we all do stupid things. I just seem to do more than my fair share of them. While visiting Mike's family in St. Louis over Christmas, I was taking a shower while Mike was out for a run. I have very thick, long hair, and I happen to be extremely short. This is not a good combination for the type of shower head they have, because it spreads the water out in a big circle, and the farther away from the shower head you get, the farther away the streams of water are from each other. So at five foot ten, you would be hit with all twenty streams. But at five foot one and a half, I was only hit with two little streams. Because of this, I could not get the shampoo out of my hair. I tried standing on my toes to get hit by more streams, but this didn't help too much. Hmm... I'm a college graduate, I can figure this one out... I know! Why don't I wash the shampoo out of my hair using the faucet for the bathtub? I'm going to get really technical here and describe their shower: it has that thingy that you pull up on to get the water to switch from the bathtub to the shower. I pushed down on that and the water started coming out of the tub part at full power. Perfect! So I got down on my knees and was getting all of the shampoo out of my hair. When I was done, I went to stand up but couldn't. My long hair was tangled around the thing you pull on to make the water come through the shower. Oh crap. In a panic, I tried desperately to untangle my hair, but I could not get it out. I couldn't even move my head enough to look at how my hair was tangled. I tried to feel behind me for the razor, but thankfully I couldn't find it. At that point in time, I would have much rather cut off a hunk of hair than have someone in Mike's family kick down the locked bathroom door to come save me. Even though no one knew what was going on, I do not think I have ever been that humiliated in my life. I sat there for a few minutes imagining the stories that would be told for years to come about the time Mike's crazy girlfriend got stuck in the shower. I decided I should wait for Mike to get home before I started screaming for help, at least then he could be the one to come laugh at me. This is about the point where I started praying. I acknowledged that God had a great sense of humor, and asked him when he was done laughing to please get me out of this one. Thankfully, with the combination of my desperate prayer and having time to calm down a little bit, I was able to untangle my hair. In the future, Mike and his family will have to deal with my smelly hair, because I will not even attempt to wash it in that shower again. That, or I'll bring my own shower head with me.

Dangerous!!

Willie ~ I checked this one off my list! ;)

Adding a few pounds....

Mon, 16 Jan 2006 01:55:13 GMT

The next time I go to donate blood, I am going to do something few women have done before: I am going to lie about my weight by ADDING a few pounds. Have I lost my mind? Well, that depends on who you ask. But in this instance, I think I am being wise. Here is what happened on Friday- I went to donate blood and when the woman poked me with the needle, no blood came out. She obviously was new (karma, huh?!), and I told her not to worry about it, just to take the needle out and poke me again. She went and got her supervisor, who informed me that because I do not weigh 125 pounds, they are not allowed to poke me twice. So, my options were to give up or to let them dig around. Not realizing what I was getting myself into, I let them dig. After what felt like fifty jabs, the blood started to flow. Probably due to all the trauma from the digging, my blood clotted with only a few ml to go, and so they were unable to use my blood. What a pain!! So now I have a huge bruise on my arm, I think I broke a few bones in Danielle's hand from squeezing so hard during the "let's rip Katie's veins apart" episode, and I lost a lot of blood for nothing. I will go back and try again in three months, but this time, I will lie and say I weigh 125. Is this rule some sort of punishment for little people!? If any of you medical people can explain this rule to me, I would appreciate it. But until then, I officially weigh 125 (please don't tell on me)!

Edit: A picture from one week later:

Tips on using an elevator

Fri, 13 Jan 2006 04:28:04 GMT

This lesson is courtesy of one of my favorite classmates:
When you first enter an elevator, push the button displaying the floor number you would like to go to. This will cause the doors to close and when they open again, assuming no other buttons were pressed, you will be on the correct floor.
If you enter an elevator and the doors take a few minutes to close, and then several more minutes for them to open again, pay close attention when you walk out of the elevator. Do the pictures on the wall look the same? What about the number on the elevator door frame? Was the number the same as the floor you were just on? If so, this probably means you forgot to press the floor button. Get back on the elevator and try again. With some practice and hard work, you will get it!!
Don't worry, I'm sure many nursing students who have to get to clinicals at 6:45 AM have been stuck in elevators before too.

Thick skin...

Mon, 09 Jan 2006 23:29:57 GMT

Hi everyone,
I appreciate your comments on my last post, and just want to explain what I meant by #3. When I said, "Every day we see nurses with skin that is way too thick, and we never want to be like that," I did not mean that every nurse with thick skin is bad. I agree, most student nurses are too sensitive at this point, and we do need "thicker skin." However, there are nurses whose skin is way too thick. This is what I don't want to be, and I don't think any of you are like that. These are the nurses who have completely lost their compassion, and honestly treat the patient like an object. When one of my patients was told she was going to die, the RN who was assigned to her did not even enter her room. She sat in the nurse’s station telling all the other nurses, "Did you hear 602 (not actual room number) got twelve months!?" as if it was a basketball score. She didn't stay out of her room to give her privacy, it was so she could gossip with the other nurses. Her skin was so thick that she didn't even think about the fact that her patient might need someone. I have seen nurses who, after hearing a patient say they are scared of their upcoming procedure, just shrug it off and say, "You'll be fine," and leave to go talk about the nurse on the 5th floor who was caught stealing narcotics. Would it have hurt her to explain the procedure and let them know that they would not be alone? No. Or there were the nurses my friend Julie had to deal with, who when her patient was having a seizure and she screamed "Help!" from the doorway, actually looked at her and said, "That's not my patient." WHAT?! Yes, people are actually like this. And I don't think they started like this- I think that over time they developed this attitude towards patients. Maybe these nurses will never go home at night and cry over a patient, but I would rather cry every night than lose my ability to care about other human beings. So when I say, “too thick skin,” this is what I am talking about.

I have also seen nurses who inspire me. I worked with one woman named Anne, and I could tell that her patients thought she was an angel. She has found that perfect balance between being compassionate but not bringing the pain home with her. That is my goal. It will probably take me a long time to get there, but having friends or family who simply say, “You need to get a tougher skin,” is not going to help me reach that goal. I actually have not had my loved ones say this regarding my patients, but a few of my friends' families have, and I know it is upsetting. So, if your loved one is a student nurse, please understand that this process takes a long time. There are going to be nights where we want to cry. It is a shock being thrown into the middle of things and dealing with death and suffering. Please comfort us and listen to us. Don’t just act like we need to get over it and move on. And to all you healthy-level-of-thick-skin nurses out there, please do not think that I am talking about you!!

So your loved one's a nursing student....

Sun, 08 Jan 2006 02:30:16 GMT

Here are some tips for those of you who are lucky enough to know a nursing student:

(I put this list together from listening to my classmates and from comments I have received on here- this is not directed at my friends or family!!)

1. One day we will hate nursing, the next we will love it. We are allowed to have mood swings like this, so please don’t point out our inconsistencies.

2. When we complain about our evil teachers, just listen to us and give us sympathy. There are some things we know we can’t change, but we still need to vent.

3. When we are upset by something that happened with one of our patients, don’t just tell us to get a thicker skin. Every day we see nurses with skin that is way too thick, and we never want to be like that.

4. It won’t hurt you to let us practice some of our new nursing skills on you. Well, once we get good at them it won’t hurt you… (Sorry about the blood pressure cuff incident, Michael!)

5. Most of us are broke. So please don’t invite us to go do expensive things and then act offended when we say we can’t go.

6. Please realize that we have a lot of reading and homework to do every weekend. I know for non-students, the weekend means relaxing. But for a lot of us, the weekend is our chance to attempt to catch up.

7. Although we have a ton of work, we do need the opportunity to let off some steam. So if we told you on Friday we couldn’t go to a bar because we needed to study, don’t get upset if you see us watching a TV show or at the mall on Saturday. That might be our only break for the day, and we would probably lose our minds if we didn’t take an hour away from the books every now and then. And unfortunately, we often do have to weigh things against studying- “Should I go spend money at a bar and stay out until two AM, or get fifty pages of reading done and then relax and watch movies tomorrow?” Please don’t be offended if we choose studying.

8. Don’t ever use the line, “Well is your school more important than ME?!” You might accidentally be volunteering your arm for IV practice the next time you fall asleep. You wanted attention, right?!

9. If we are stressed out about a test don’t just say, “You always say that and then get straight A’s. You should quit studying and go out.” Maybe your statement is accurate, but had we stopped studying earlier, as you were suggesting, we would not have done as well. You are always welcome to say you think we will do fine, but don't try to pressure us to quit studying when we don't feel prepared.

10. Don’t compare what we are going through to what you went through in school unless you majored in something in the medical field. If you are an accountant and you didn’t fully understand something in school, you might mess up someone’s finances. This is a big deal, but your mistake will not kill someone. Ours might.

11. Bring us plenty of chocolate, especially Reese’s peanut butter cups.

Did you know...

Thu, 05 Jan 2006 02:28:01 GMT

~ You should never give Aspirin to children. Some Pepto Bismol-like products contain aspirin, so be careful with these!

~ You should never give an infant honey, not even just a little bit on their pacifier.

~ St. John's Wart can make the birth control pill less effective.

~ Depo Provera should only be used if all other methods of b.c. are inadequate, because Depo causes a significant loss of bone density.

~ You should not use Tylenol or Aspirin while drinking to prevent a hangover.

Name that zit!!

Fri, 16 Dec 2005 06:02:13 GMT

This past week has been incredibly stressful. I will spare you all the complaining, and just say that the idiot administrators at my school decided to start the new semester the week after finals. This included three hundred textbook pages of reading, plus two tests in the first four days. As I am sure you can imagine, this has had a devastating effect on our bodies. Many of us have become sick over the last two weeks, and a lot of us suddenly have zits like we did back in high school. I am one of those lucky ones. I was in a crowded elevator with a few of my classmates the other day, and I brought up my new "beauty marks," and how I was thinking about naming them after the people who caused them. Pointing to the zits on my chin, I said, "This one's Karin, this one is Lana..." One of my classmates, who is normally quiet, jumped in and said, "If I get a big zit on my a@#, I am going to name it (name of dean of students)!" We all had a good laugh, and the elevator doors opened. As we were squeezing by the people at the front of the elevator, our wonderful dean said, "After you ladies," as we passed by. I'm sure she was flattered, right? I mean, it's an honor to have something named after you.... I have a feeling I might be changing the name of my site to "Confessions of an Ex-student nurse" sometime soon.

How NOT to drive in the snow

Mon, 05 Dec 2005 06:19:18 GMT

Since some of you are starting to get snow, I thought I would share with you an important lesson I learned about driving in the snow.
One morning, I was running late for a big test and I missed my bus. Everything was covered with ice, with a few inchs of snow on top of that. Since I was in a hurry, and it took forever just to get my car door open (had to chip through the ice), I didn't take the time to clear all the snow off my car. I just cleared a small hole in the windshield so I could see. I turned out of my parking lot and onto the main road, which was still not cleared yet. I thought I was in my lane, when all of the sudden the snow from above my little "viewing hole" caved in, and I could not see where I was going. I stopped the car and jumped out to clear the snow off the windshield. Being the genius I am, I realized I should close my door so the snow wouldn't fall in on my seat. I must have forgotten that my reflex when I open the car door is to hit the lock, and I locked my keys in my running car. "This is not a big deal, I can handle this," I kept telling myself. I was almost convinced that this was true, until I saw a bus coming down the street towards me. I noticed the bus was coming right at my car. "Stupid jerk," I thought. Then I saw the line of cars behind the bus, and I came to an important conclusion: I was parked in the middle of the road. Now what!? I know, I'll run back to my apartment and get my spare key!! I left my car in the road (the bus did manage to go around me) and ran all the way back to my apartment. Once I got to my door, I realized that I did not have a key to get inside. I pounded on my friend Ryan's door and begged him to drive me to a friend's house so I could get my car key. He reluctantly agreed, and we ran out to his little older-than-me Honda. There was a coating of ice on his car, but we didn't have time to fuss over that. He unlocked his door, pulled up on the handle, and it came off right into his hand. It wasn't too long after he ripped off his passenger side handle too that my roommate pulled in and unlocked the apartment door, allowing me to get my car key and move my car out of the road. Why was my roommate back so soon? Our teacher couldn't make it in and had postponed our test. I thought the whole situation was hilarious, but Ryan, who had to crawl through his hatch-back trunk to get into his car for the next two weeks, didn't seem to find the humor in the situation.
The big lesson I learned: Some days, it is better just to stay in bed. Also, if your door is frozen shut, do not try to force it open by pulling on the door handles. Those do have the tendency to snap right off.

Bleach + carpet = oops

Sun, 04 Dec 2005 00:46:20 GMT

If you feed your cats cheap cat food with orange dye in it, and they throw up on your tan carpet, DO NOT pour bleach on the carpet to get the orange stain out. The result will be a permanent white circle with a pink middle.

Construction workers

Mon, 21 Nov 2005 23:12:06 GMT

Ok, I'd like to start off by saying that I am not admitting that this ever happened to me.
I have some advice for those ladies who are overtaken by the urge to holler at the cute construction workers on the side of the road while you are driving by:
Make sure that the traffic ahead of you is actually MOVING!! Because when you holler something, and then traffic stops, and you are stuck sitting right next to the guy you and your girlfriends just hollered at, it can be slightly embarrassing.

Just say it

Wed, 16 Nov 2005 23:31:19 GMT

One of the biggest lessons I am learning is that when dealing with patients, just say exactly what is on your mind. Don't be politically correct or use proper terminology.
1) Danielle's new patient is an alcoholic undergoing withdrawal right now. He is heavily drugged, and pretty much out of it. She came running down the hall looking for a bed pan because her patient had been trying to get out of bed so he could use the restroom. When your patient can't even hold his head up for a minute, you definitely don't want him walking to the bathroom. So I went in to help her with him. We put the bedpan under him, and Danielle said, "Ok, you can use the bedpan now." No response. "Alright, why don't you try to have that bowel movement now?" Nothing. "We have you on your bedpan, do you need to use it?" Blank stare. Now remember, Danielle is the Fecal Queen, so this is probably hurting her feelings! What happened to her mojo? LOL.. Well, I used those handy critical thinking skills they've been cramming down our throats the last few months, and leaned down towards the patient, put my hand on his shoulder, and said, "Poop. Now." Problem solved!
We had the curtain pulled back to give Danielle's patient privacy from his roommate, but when we were trying to get him to use his bedpan, we could hear quiet laughing from the other side of the room. When I was leaving the room, I walked by the roommate and he said, "It sure ain't like that in the real world- cheerleaders while you're pooping!!" Yes people, that's why I am working my butt off in school. To be a poop cheerleader. Thanks for pointing that out, buddy!
2) I kept checking on my patient from last week, and found out that he has not had a bowel movement in three days. He was in a lot of pain because of this, and kept trying to poop. The problem is that he can't get up and go to the restroom, so we need to put a bedpan under him. Well, it takes three people to put him on a bedpan, so it is kind of a big ordeal. Poor guy felt like he had to go every twenty minutes, but it just wasn't happening. I could tell that he was embarrased by this- all these people in & out to put him on the pan, so I told him not to worry about it, that we all understand, and that he should not feel bad if he has to keep on trying. He gave me a disgusted look, and said, "So you want me to crap right now all over the bed?" Uh... let me rephrase that!! I'm glad he let me clarify!!
3) Back to Danielle's detoxing patient. He kept asking her for beer and cigarettes today, but of course, those things are not provided by the nutritionist. Towards the end of the day, he was pretty agitated, and when she brought him a glass fo water, he asked, "Is it beer?" She said no. He responded, "Well f*** you then!" Danielle laughed and said, "You did not just say what I think you said, did you?!" He laughed, she laughed, and he drank his alcohol-free water. Sometimes, you just have to let off some steam I guess!

Things to make your hospital visit more fun if you are fortunate enough to have a nursing student:
~ When they are doing your finger prick for your blood sugar test, scream "OUCH!!!" really loud. When they jump back and look like they are going to cry, laugh and say "just kidding." (happened to Trisha today)
~ When they ask if you know your name (part of the neurological screening), be very calm and serious and say, "George Washington". (Ha ha, very funny punk)
~ If you are a male and the student is helping you pee into the portable urinal, tell her you are done, and then continue peeing once she has moved the urinal away from you. (This one was not fun)
~ When they ask if you have any pain, tell them your (make up a name of a body part that does not exist while holding your stomach) hurts. See if they pretend like they know what you are talking about or not.
~ Scream for help from your bed so the nearest student almost has a heart attack before running into your room to help you.... pull out the extra shelf on your tray table!?

Live & learn

Fri, 11 Nov 2005 06:36:59 GMT

Today we had an occupational therapist teach us the proper body mechanics for moving patients. THREE DAYS after starting to work with my 450-pound patient I was finally taught the appropriate way to move him. And not surprisingly, I was doing everything completely wrong. Somehow, our teachers don't understand that we can't read about something and then just go do it. I need to be shown something & then try it myself while being critiqued. Well, at least I have the weekend for my back, knees, and shoulders to heal from trying to pull my patient up in bed using only my arm muscles. LOL.... you live, hurt, and learn.
The physical therapists worked my patient hard today, so he was cranky and exhausted. The doctor completely discontinued his tube feedings, so my job was to get him to eat as much of his food as I could. Well, once he was cranky from the therapy, he was not cooperative at all, and refused to eat. I finally convinced him to try one bite of the chocolate pudding. He reluctantly took a large spoonfull, and then spit it out, all down the front of his gown. Hmm... you just got pudding all over your face and gown to punish me? You're the one covered in pudding! LOL.. Unfortunately, he was smart and knew that I would have to change his gown, and that doing so takes a lot of effort (this was before our 'body mechanics' class.) Next week, he can spit out all the pudding he wants, because I will know how to change his gown without needing three classmates to help me!
We are still learning how to handle certain situations- such as when a patient asks us to go open the patio door to let his cat in. Well, there is no patio door, and none of us have seen any cats. So do we pretend like we let the cat in?

How NOT to potty train your child

Sun, 06 Nov 2005 06:46:27 GMT

My little brother is going to kill me for posting this story, but like I said a few days ago, it's been a slow news week.

When potty training my brother, my mom always emphasized how big boys keep their pants dry. She even went as far as to iron a picture of his favorite cartoon character onto his underwear, so if he wet himself, he would make Winnie very unhappy. Well, Michael must have been a good listener:
1. My mom went into the kitchen and saw Michael's pants on the floor. Next to his pants, a puddle of urine. Could she get mad at him? Nope. He definitely kept his pants dry!!
2. When she set up a pool in the backyard, she watched as he took off his bathing suit before getting in the water. He knew better than to get his pants wet!! Smart kid, huh?

You have how many siblings?!

Wed, 26 Oct 2005 19:42:53 GMT

During school screenings today, I asked my 8th grader how many siblings he had. He thought for a moment and said, "I have too many to count. They are all over the place. I probably haven't even met them all." What?! Uhh... interesting family!! I tried to play this off like I wasn't shocked, and then changed the subject. A few minutes later, it hit me- he doesn't know what sibling means. So I asked him how many brothers and sisters he had. "Three." LOL... he thought sibling meant extended family, and his mom just got remarried. Mental note: always make sure your patients understand exactly what you are saying!!!

Chocolate macaroni anyone?

Mon, 24 Oct 2005 11:37:28 GMT

You know it's going to be one of those days when...
The milk is expired, so you decide to have a bagle. There is no cream cheese. So you decide to have instant macaroni and hot chocolate. The macaroni powdered cheese comes in a white package, so does the hot chocolate powder..... it's going to be a long day.......

1.5 hours until my big pharmacology test. At this point, it might just be in my best interest to go back to bed.

Oops! Sorry (again)

Tue, 18 Oct 2005 22:30:16 GMT

Unfortunately, a few more lessons:

Lesson 1: When giving an IM (intramuscular - deep) injection, you really have to use a lot of force. It's almost like throwing a dart. Want to know what happens when you don't use enough force because you are shaking and scared you will hurt the person? The needle goes half in, then you have to push it the rest of the way with the patient yelling "OWWWWW, what do you think you are doing?" By this point, your legs feel like jello, and your arms are shaking so badly that you find it hard to push the medicine into the patient. Now to pulling the needle out: Looks easy, but when you've really pissed the person off, and are already shaking and concentrating on not collapsing to the floor or running out of the room screaming, this can actually take some skill. Once the needle is finally out, the cruical moment arrives: running away from the patient as fast as you can before they turn around and smack you (even though you probably do deserve a smack or two for what you put them through). If any of you want me to give you a flu shot, let me know, I'd be glad to help you out!! ;)

Lesson 2: When changing an adult's diaper, make sure you have the front in front and the back towards the back. After all the rolling you have to do (while paying close attention to the rolling lesson from yesterday), it is extremely frustrating to realize the stupid diaper is actually on backwards.

Lesson 3: People with dementia can be extremely convincing. Check their chart before you allow them to do something, like go on a walk outside.

Lessons

Tue, 18 Oct 2005 03:39:33 GMT

I've decided to post the lessons I learn from my patients while I am in my clinicals. Hopefully, I don't have much to say in this area, because every time I learn a lesson, it most likely means something bad has happened to me.

Lesson 1: If your elderly patient is on a feeding tube and her stomach is distended (2x its normal size), when you go to change her diaper, roll her butt AWAY from you. Sudden movements will cause a lot of that built up gas to escape quickly, and you do not want to be in the line of fire.

Lesson 2: It is always a good idea to check the bulletin board to see what your patients will be eating during the week. Jot down any days they will be served peanuts or corn, and make sure you call in sick the morning following that meal.

Lesson 3: The cute little old ladies are the ones that yell at you the loudest.

Lesson 4: No matter how grossed out you are by needles, do not close your eyes when giving someone any type of injection. Especially when you are practicing finger pricks on your friends. They get mad when you almost poke them in the fingernail instead of by the pad of their finger. Sorry Danielle!!