Sunshine

This week was amazing, and not because of the nurse I worked with. No, I had to find my own work and fill my own time. Last week I wrote about not having a computer, and this week I write about not having a computer or a nurse to work with. The nurse I was assigned to, who I’m sure is a nice girl,  clearly did not want to be bothered by a nursing student. If you were a fly on the wall watching the scene, you’d think this nurse was alone with no assigned students, as though Ali and I were not there. Maybe you’d see me and Ali as ghost’s hovering over her as though she was all alone, going about her usual business.

As I first walked up to introduce myself, this nurse turned quickly away from me. Then I tried again by saying, “Hi I’m Lorena and I’ll be working with you today.” She just looked at me and said, “Oh ok.” Ok then. Then she was off down the hall. When she found a spot to stop, I stopped with her and stood there watching her wipe down her  rolling computer station, assemble her pen, sharpie, scissors and  marker in her front pocket, and fill out her report sheets. There was dead silence as she did this, and I kinda get it, because I’m sure I’ll have a big set up too, in order to get my ducks in a row before a long shift. Then she was off again, this time to the med room in a racie manner to pull meds. I stood there watching as she sped through pulling everything she needed, never asking if I’d like to try.  There was never a point when even a little conversation started, like two people do when they know they’ll be spending a shift together, and maybe they’ll try and make the best of it.

So, I decided to do my own thing. But, occasionally, a little bit of sunshine light would glimmer through her dark and sarcastic demeanor, and she’d fetch me to pass meds or inject Lovenox. I forgot to tell you she has a bit of sarcasm in her, just a BIT.

Anyways….enough negativity, because I realize that there will always be the less then pleasant people I’m forced to work with.  It’s good practice in learning how to deal with all types.

On a brighter note, it was a great clinical week, because I got to see the beautiful couple that had come to the unit two weeks prior, with the horrible news of pancreatic cancer. If you didn’t read that post, read it hereMy patient was to have a whipple procedure performed, and on this particular shift on Thursday, he was on the unit as a two day post-op patient. Ali and I went to see him and his wife. As we walked into his room, the wife jumped up and gave both of us the biggest hug. The patient had tears in his eyes, and said, “I was hoping I’d get to see you guys again. Thank you so much for all you did for me, and for transferring me into a private room.” Then the wife chimed in and said, “We have your card on our fridge.” He continued by telling us that his procedure went perfectly and that the surgeon was able to get all of the mass from his pancreas. He has a better chance of survival now. It was the greatest feeling ever and I’m reminded  once again why I love what I do. Nurses get to be so intimately involved in every aspect of our patient’s lives: physical, emotional and spiritual. We get to comfort our patients through the dark days, and celebrate with them during the  bright days. It’s awesome.

On another note, I had a most interesting experience on Friday. A young kid, not quite an adult yet, lay in pain in a bed in one of the isolation rooms. My friend Toni Anne was assigned to his care and room. This young homeless orphan, who has “many girls” and who’s an IV drug user, has about 15 small bullet shaped open tunneled wounds all over his body. They appeared on his arms, legs, buttocks, scrotum, and neck. It’s like this internal bug tunneled it’s way through portions of his body, surfacing and then resurfacing again and again. As my friend Vickie so perfectly described it, it’s like a gopher digging up at the surface of the soil, and then going back in, only to dig up through a new surface..…except, again and again.  It was so odd, and so interesting. I wish I could tell you what his diagnosis is, and what was going on, but no one could answer these questions I had with certainty. The nurse assigned to his care  pulled me and 3 other nursing students in to help her with the dressing changes. We knew that even with the 5 of us, we’d be busy for at least an hour with all of the dressings that needed to be changed. We made sure to ask the patient if it was ok for all of us to be in his room, and he consented with no hesitation.

At first, the director (nurse) who wore blue scrubs, led the show. The 4 of us (nursing students) wearing white, stood over her watching as she worked. You could discriminate the nursing students from the nurse, and not because of the different colored scrub attire. On the first bullet shaped wound, the nurse soaked the outer portion of the wound with normal saline. Then she  pulled out the endless amount of packing, that looked kind of like a thick flat shoelace. Then she rinsed with normal saline again, and repacked the wound with this string of dressing by gently using a long q-tip to advance the dressing down to the base of the wound. That hurt the patient. He cried and grabbed his leg. I grabbed his hand and tried to distract him by rubbing his leg ever so softly. Then she placed the gauze over the wound and used paper tape to attach it to his leg, making sure to date the dressing as well. The nurse did this for about 3 cycles and by that point, each nursing student had a job. Toni Anne prepared the gauze pads and tape, Star cut the wound packing, Vickie was available with the normal saline and sharpie (which later was handed over to Ali), and I attended to the patient, trying to calm him down and provide  a hand for squeezing.

Then I decided it was time for me to practice wound care. I love wound care. It goes along with my passion for trauma and ER. I asked the nurse if I could take over, and she consented. And believe me when I say it, I took over. I was in my element. From that point on I continued to change each dressing. My friends were there and ready to hand me everything I needed: packing, scissors, NS, gauze and tape. I rinsed, unpacked the old dressing, rinsed again, repacked and dressed each wound. I love wound care, and I was into it. I never felt grossed out, or like I’d need to leave. This is confirmation that I’m destined for trauma, ER or wound care. It was amazing. Better then that, I took my time, as to take into consideration the amount of pain the patient was experiencing. I focused hard core on my task at hand, but tried to comfort him as well. I could tell he was happy with my work, and more-so with my confidence. He gave me a smile and a wink when we finished, and I know he was relieved to be done. I felt this kid may have been embarrassed at times, and also I sensed he felt dirty (because of statements he made), so I did everything in my power to provide him with dignity and the sense that all of this was “no big deal.” We also helped him get cleaned up, and into a new fresh gown. It wasn’t pretty. There were times I had to consciously think about my facial expressions, when the smell got to be too much, or when looking at the really big open wounds on his back side. But, I always try and and give my patients the dignity and respect I’d want. My goal was to help him feel more comfortable and clean, and most of all to care for the wounds that were eating holes into him from the inside out.

It was a great week, even despite the detached nurse I was assigned to. I got to experience a lot, and the experiences were things I love: wound care. I realize that no one can decide how my day will go, only I can choose to decide how I want my day to go. Wether I’m assigned to a great nurse, or a rude nurse, I can still choose my path, attitude and plan for the day. You may be unhappy about having a nursing student for the day nurse, but that won’t stop me from learning and from experiences. That has been proven after the kind of week I had, and the fact that I found a willing nurse and awesome experiences on my own.

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