Reflection : Thoughts on 2nd Semester

In the first semester, everything was new. The clinical experience was new and many of us, who had previous Patient Care Tech positions felt comfortable with what we knew, which was PCT work. The first day of clinicals and the clinicals to follow felt overwhelming and honestly a little scary. Nursing skills are much different then our PCT skills.  Not that assisting patients with activities of daily living, making beds and checking vitals and CBG’s isn’t important, because as a matter of fact those skills are really important. But, giving injections, passing out meds, trying to understand lab values, learning about diseases, and realizing that a patient’s life lies in the hands of the nurse is quite a big difference.  In the first semester, I felt like I opened the box of a  500,000 piece puzzle and scattered the pieces atop a gigantic table. I felt overwhelmed by the amount of pieces the puzzle contained and although I saw each piece and started to recognize similar pieces, it didn’t make sense yet. I was able to accomplish about 5% of this gigantic puzzle, and that frustrated me.


Now, here I stand in the 2nd semester and it’s still overwhelming and scary, but completely different. I’m learning lab values, which didn’t make as much sense in the 1st semester. I’m learning about the importance of maintaining homeostasis through fluid and electrolyte balance, which I was unsure of in the 1st semester.  I’m gaining a better understanding of certain disease processes like hypertension, diabetes, MI and stroke to name a few. I’m learning how to apply the entire nursing process in my interactions with my patients during clinicals. I’m learning how to manage my time a little better and come up with a plan for the day and for my patient, which starts with assessing my patient, then coming up with a nursing diagnosis, a plan, implementation and teaching. I’ve gotten to experience different parts of the hospital already, such as the operating room and the ambulatory care unit. I’ve learned how to insert Foley catheters,  NG tubes, and hang antibiotics. It’s only been 5 weeks and the gigantic 500,000 piece puzzle is still scattered on my gigantic table, but a little corner of it is complete and this gives me hope.


Starting clinical’s this semester was different then starting clinical’s last semester, obviously. This semester I feel 4 strong emotions which include:  an overwhelming amount of responsible, excitement,  fascination and honor. The overwhelming amount of responsibility I feel stems from the fact that patients will rely on me to provide them with the correct and appropriate care. They will rely on me to administer the correct medication and the correct dose at the right time and to watch for adverse reactions. They will rely on me to provide emotional support and coordinate spiritual support as well. They will rely on me to notice changes that occur that aren’t positive while assessing vitals, listening to the heart, lung and bowel sounds. They will rely on me to coordinate care and promptly contact the doctor when something just “isn’t right”. They will rely on me to hang the appropriate antibiotics and correctly. They will rely on my expert care and knowledge when inserting IV’s, a foley catheter, NG tubes etc. The client relies on the nurse for very important functions related to health and well being. I don’t doubt my ability to become an expert nurse and master all that is required, but in the baby years as a nursing student, the overwhelming responsibility that a nurse carries is huge, and that thought has really hit me head on this semester.


The excitement I feel stems from the fact that every day I learn something new, and everyday I feel a bit more confident, although I realize that the confidence I gain can never turn to complacency. It’s exciting to move from level 1 to level 2, because I’m learning more! I’m growing and getting closer to my goal of becoming an amazing nurse someday. The puzzle continues to come together each and every day. I don’t take anything I learn lightly or for granted, because I know all of it is important and I want to know it, because I want to be the very best for my patients. Level 1 set the foundation and I’m starting to realize now, that just like a 500,000 piece puzzle is daunting at first, with a little time, the pieces slowly come together.


The fascination I feel stems from how amazing our bodies are! I’m fascinated with how our bodies fight, recover and compensate. I’m fascinated that our bodies give us clues about impending danger and that it activates different systems when its not in balance. I’m fascinated by what our bodies can endure and how our bodies can be manipulated and restructured during surgery. I’m amazed out how long and hard our hearts work for sometimes 90+ years. That is absolutely amazing. The complexity of the body is mind boggling. When I observed the surgeon perform a total hysterectomy and then a uterosacral suspension last week,  I was further amazed at how complex and amazing our bodies really are, and how amazing the surgeon is to be able to precisely perform this procedure while maintaining sterility.


Lastly, I’m honored. Honored that I get the opportunity to work with people to help them stay healthy, prevent disease and get better. I’m honored that I get to be involved in the holistic care of the patient, which is so fulfilling to me. I’m honored that I get to be apart of a team of people who care for a patient and solve the mysteries of the body of a particular patient, which is similar to other patients, but completely different. Each patient comes with different past medical history, a different personality and motivation, a different set of beliefs and a completely different physical make-up. Each person is different and each case is different, and that makes nursing exciting and fascinating!


The 500,000 piece puzzle is large and still scattered on the gigantic table before me and I’m starting to think its alive as well. As a matter of fact, I’m convinced it alive, because I don’t think a nurse will ever “finish” this kind of puzzle titled “Nursing”. It keeps growing and changing. New discoveries are made everyday, the patient is always different from the one prior, and learning never stops. So, I will continue to put the pieces together and hope to achieve the 500,000 piece puzzle, right before it grows to one million pieces!

And gosh darnit the front of the box to this puzzle keeps changing too.






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