Peggy, my clinical instructor, said I had to write a journal entry in which I reflected on my experience in the hospital. Rather than write out a new post about Tuesday, I’ve decided to just let you all read the journal I had to write. Feel privileged. 
I’ve read through it three times, checking to make sure there’s no HIPAA violations in it. I think I’m safe…
Driving in to clinical on Tuesday morning, I was really nervous. It didn’t really make sense for me to be; I’d researched my patient’s medical condition and reviewed all the information we’d learned in lab about taking vital signs. I’d even driven to the hospital the night before, so that I’d know exactly how to get there from the college and how long the commute would take. I’d done everything I could possibly think of to prepare myself ahead of time, but was still ridiculously anxious. Meeting the rest of the girls from the clinical group and driving in with them made me feel a little better; they were feeling just as apprehensive and nauseous as me. Our car got stuck in the parking lot, unable to be backed out of the parking space because of all the snow. I was even grateful for that, though, because we had to work together to get the car free, and we all got to laugh about it afterward.
When we actually got to the hospital, I started feeling overwhelmed. In the two hours we spent sitting in the conference room and then touring the hospital, we had so much information thrown at us… Do people actually remember all that stuff after only their first day?
The nurse I was assigned to work with didn’t really talk to me. I honestly only knew her name because you introduced her to me, Peggy. And, I’m pretty sure that the only time I talked to her all morning was when I told her that the patient’s blood pressure had dropped at the end of the rotation. The nurse was really busy (I think one of her other patients was in the process of being discharged), and so I was in the room with my patient, on my own, when I took vital signs. I didn’t feel ready to do it, and I almost wanted to apologize to the patient for my inexperience even before I started doing anything. “Hi. My name’s Melissa. I’m a student nurse from [name of my college], and I’m sorry if I do anything wrong.” I didn’t say that, though. J
I took vital signs. I can’t explain the immense relief I felt when I was able to find the patient’s pulse on my first attempt – for some reason, this was one of the things I’d I really been worried about. I could count her respirations pretty easily, because her breathing was slightly labored and it was pretty obvious when her chest was rising and falling. Even before I started to take her blood pressure, the patient told me that there was no way I’d be able to take it by putting the blood pressure cuff on her upper arm. Because of the edema, I’d have to put the cuff around her lower arm, she told me. She told me which arm to use, and where to put the cuff, and didn’t seem annoyed in the least when I told her I’d not been able to read her BP… I apologized and explained that I’d never taken a blood pressure reading that way before (I didn’t even know you could take blood pressure that way!), and asked if she’d mind my getting a nurse to show me how to do it. One of the care assistants came in, and showed me how to use a machine to measure blood pressure automatically. She walked me through it, step-by-step (it’s really not that complicated – the machine just looks intimidating), and I was really grateful to her. I felt more competent having actually done it myself, rather than if I’d just watched the care assistant use the machine.
The most difficult part of the whole morning for me was actually talking to my patient. She seemed anxious and in pain, and very obviously just wanted to go home. And I couldn’t do anything about that. She talked about how she’d been in and out of the hospital, and how she was tired of being there. I could listen and try my best to be empathetic, saying how frustrating that must be for her… but I couldn’t fix it. I mean, really, what do you say? That is what made me feel incompetent. She said she was thirsty, and I offered to get her more ice. When I saw that she was shifted over in the bed, I asked if she was uncomfortable and offered to help move her a bit. I could do those things. I could fix those things. I couldn’t stand not being able to make her happy, though. And it seems much more important that I should be able to do that, as opposed to count respirations and take temperature efficiently.
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