Ms. Sassy

Hope the interwebz is doing well today.

Last week at clinicals, we were a little slow. I had an easy patient that was up with assist with no AMS or anything. I assumed that that meant it was going to be an easy day. Nope. She had COPD with an O2 sat of 75%, which isn't that bad, but if she would comply with the nasal cannula, it would have been a lot higher....also, everything I asked her to do, she was pissy about. Just general nastiness in my general direction. Not a big deal, but she softened me during our head to toe assessment together. I had just completed the physical part of it, and I was asking how her general health status was, how she felt, if anything new had come up since yesterday, etc:

Me: Do you have any pain anywhere Mrs. X?

Mrs. X: Counting the pain in my ass that you are causing me, one.

Me: Well, on a 1 to 10 scale, with 10 being the worst pain you have ever felt, how would you rate that pain in your rear?

Mrs. X: Fifteen. Now get out of my room.

Deadpan. No smile. It was hilarious. I had to step out of the room after that.

Eye See You....

This is just a quick note, much to my embarrassment, about myself this time. I was doing a quick head to toe assessment on my patient Thursday, before I really had time to look at her chart (mistake #1). I checked her hearing, a few facial nerves, and then moved on to her eyes. I got my pen light out (that makes me feel like a real nurse...) and went to check her eyes. Right eye first. No reaction. No pupil moving, no blinking, no accommodation, I internally started thinking, "What the hell??" It was the same color as the other eye and everything. Then, my patient says to me, "You know, you don't have shine that flash light at that false eye of mine, I can take it out so you can see better."

It's been a while!

So, our class has survived the first test of the semester! I came away with a smooth 94, and everyone else seemed to come away seemingly well. It seemingly was an effortless test. Seemingly.

Our clinical class was discussing various clinical skills that we have learned since the beginning of nursing school last year. Someone brought up the subject of enemas. That someone is someone in our class that is older and they wear glasses. When we "check off" on things, or basically prove to the instructor that we can do the task, we use dummies and models. We wouldn't want to descend upon the unsuspecting public without practicing on a fake arm, leg, chest or throat first. I digress though, back to the enemas. This woman that is old enough to be my mother, looking particularly thoughtful, carefully raised her hand. She slowly slid those glasses down her nose, looked over the frames at our instructor (Who was doing a very good job at keeping her composure considering she was talking about putting a liter of water in someone's butt), and with the most serious face asked, "Are we going to have a practice hole?"

Round of golf, anyone?

Large Cup o' Joe...Sorta

I am serenely sitting here enjoying my peace and quiet away from school. I don't have to go back for 16 days and 9 hours. I have a cup of tea, television, and no desire to do homework whatsoever. Thank you very much. That doesn't mean I don't have any, it just means that I don't have any desire. You see, desire, also known as motivation, is the key to getting things done. The only thing I want done right now is this blog post.

But, I digress.

As a general rule, when someone is in the hospital you keep track of their I&O, or Input & Output. That means you write down everything they drink, in mL, and everything they put out, in mL. Except for poo, that comes in S, M, L, and XL, and how many a day. We were taught fairly early on in the semester about I&O and what to do to keep track of our patient's "business." However, I guess some of us should have listened a little better, because damn this is the grossest thing I have ever heard of one of our students doing.

You see, a bedpan is a magical thing. It is a great item when used correctly. It has little notches on it to measure urine. URINE PEOPLE. PEE. U-R-I-N-E. Not poop. NO MEASURING OF THE POO. I came upon the occurence of one of my fellow classmates, what seemed like a girl elbow deep in sh*t. I guess she missed the part about S, M, L, or XL. From the looks of what she was packing into this measuring cup, I think that an XXL distinction needs to be added to the list. That girl was just scooping, pouring, tapping, mashing, and packing away. It was all over her gloves, the patient was staring, and frankly, I think the relative was going to throw up (Luckily we don't have to measure anyone's I&O's but the patient's.) She looked like a kid in a sandbox. After I stopped laughing out in the hall, I let our instructor know so that she could fill the girl in. Let's just say, when lunch came, I saw that lady wash her hands 293482093 times before she ate.

Breakfast Time!

One of the many things that first semester students get to do at clinicals is pass out food trays when they come up from the kitchen. You know, the delightful buffet of homogeneous, artificially colored nutritious "food" that the patients get to eat and enjoy("eat" and "enjoy" are loose terms) three times a day, that stuff. My clinical group had just arrived on the floor that day when the tray cart arrived. My fellow class mate dutifully began passing out trays, going from room to room. A few moments later, I saw her pull my instructor (From here on out known as "Mrs. Wonderful" because she is amazing) aside, and this a paraphrased conversation that I overheard:

Student: Mrs. Wonderful, I dropped that tray off in room XXX and a sheet was over the patient's head, and they looked asleep, should I pull the sheet down and turn the lights on and prepare the tray, or should I let them sleep?

Mrs. Wonderful: There was a sheet over their head? Was there family in the room?

Student: Yes ma'am. One of them looked really upset.

Mrs. Wonderful: Umm...they're dead hon.

Student: Huh?

Mrs. Wonderful: Dead! When someone passes, they pull the sheet over their head. You just served food to a dead person. Ha! (Insert lots of laughter)

In the student's defense, she did recover well from it. She went back into the room and explained that she had brought the food in there in case any of the family had wanted to eat or have a snack. Meanwhile, our instructor had to step out of the hallway into the break room to finish laughing.

Super Nurse and her Apathetic Sidekick Cats

Nursing school is an adventure like never before, where Super Nurse (really Student Super Nurse, but we aren't going to get into technicalities here) leaps bedpans with single bounds and dodges exams with her amazing super powers. Her apathetic cats diffuse her textbooks into her mind with their amazing powers of osmosis! Okay, not really. Nursing school is hilarious. There is that single awkward moment where you have your gloved hand on a man's genitals, a catheter tube in the other, and you suddenly realize you dropped the lube. Oh, did I mention that there are three other nurses watching? I need somewhere to record all of these ridiculous moments, and some of the serious ones. There is all sorts of things that go on in a hospital that isn't like what you see on television. What I have discovered is most important in this business is that each and every patient that you have is first and foremost a human being. They are not the condition they have or the disease that has ravaged them. They are a human soul that needs caring for. The nurses that care for these patients are human too, and it seems to be an amazing relationship between the two. Usually the relationship is one of trust and dependence. When someone else is wiping your ass, it can get a little sticky. The doctors may diagnose you, but I am the one that keeps you alive: remember this.