I was 19 years old when I started RN school. And a very young nineteen. I’d grown up in a conservative church, and was an only child. I really wanted to be a nurse, and was determined to get through it, but I’m not sure how that actually ended up happening. I was horribly shy when it came to dealing with the patients when I was a student. My first semester of clinical classes began in September 1983. A lot has changed since then…
My first several patients during clinicals were hemorrhoidectomy patients. There I was, never having seen a naked person, and I had to look at their butts. WAY into their butts. Uh huh. I’m sure nothing about me exuded confidence, so starting with the butt was probably a safe place to put me, but I was mortified, especially since most of them were men. Butts and balls to a naive nineteen year old was almost the death of me. I finally had a chat with my instructor (a very nice instructor, but she was also intimidating with her knowledge). I needed a different view.
I asked if I could possibly have a different type of patient. She said sure. No problem. So when I picked up my next assignment to prepare my careplan, I saw the words ‘esophageal varices’ in an elderly woman. That meant that blood vessels in her esophagus had ‘blown’ and she’d likely been critically sick from blood loss. I was sure my mere presence in the room would have her spewing forth all that kept her alive, and I’d kill her within minutes, even if indirectly. I was terrified. I asked my neighbor (a pediatric cardiologist) about said varices. He told me that it was possible she could bleed to death in minutes if they reopened. Not helpful. I got busy with my careplan, and every horrible thing I’d already heard or read was confirmed. The woman was doomed.
The morning came for me to actually go talk to this lady (this was back in the day when we did all care for the morning for our assigned patient- not following someone else around while they did it). I stood in the doorway trying not to pass out. My instructor came up behind me and physically pushed me into the room, whispering “You actually have to talk to them”…. I was thinking ‘ just shoot me now’.
What I found was a very alert, sweet woman who was cooperative, and didn’t have any signs of getting ready to exsanguinate in front of me. I said hello, and she didn’t die. I did my nursing student assessment, and the woman didn’t seem to suffer any ill effects. Huh. So I’d been a bit more freaked out than necessary. I had the same lady three different days. I even ended up washing and rolling her hair- which she loved. Anybody who knows me is rolling over in hysterical laughter at the thought of me doing anything positive for someone’s hair. I can barely keep mine brushed.
The next horrifying event was bathing a comatose MAN. I’d have to TOUCH him. My instructor seemed to sense my incomprehensible stupidity (inexperience?) and was in the room during the whole process. I didn’t kill him either. The familiar lightheadedness was with ME the whole time, but most importantly the patient didn’t get worse. OK. Check that off the list.
On to the big stuff. I had to give an enema. The ‘serious’ kind with the little soap packet and the big bag that got hung on an IV pole. My instructor was in on this as well. I got the soap into the bag, and was getting the water to the right temperature before I filled said bag. I had the clamp on, so nothing would leak before it was supposed to find its way into the lady’s back door. I put the little packet of lube on the business end of the tubing. Gee, this was going well !
Then my instructor suggested it might be more comfortable for the patient if I let the air out of the tubing before I brought it out to the patient. Well, that sure seemed like a good idea- no point in giving the woman gas. SO, I unclamped the clamp on the tubing, and waited for the air to exit. What I didn’t expect was the lube packet being shot across the room from the force of an entire length of tubing full of air. It was like sniper training in its force and trajectory. I don’t know where that packet ended up, but I know I was ready to die. My instructor was very professional, but I think I remember a slight grin. The patient looked a bit nervous, along with slightly relieved to know that everything was being supervised, and this nineteen year old pre-rookie wasn’t being turned loose on anyone. I got more lube, and the enema went in, and came out, just fine.
I got through my fundamentals class without killing anyone. THAT is why I didn’t die in nursing school. Nobody got worse as a result of my care. I started out with a negative confidence score, and got to the point where I didn’t anticipate disaster. That was the biggest perk in getting through fundies. I had a shot at becoming competent ! All nursing school really teaches is how not to kill someone on purpose. The experience and finesse come later. I was at least on track ! I’d gotten through the checklist of skills, and passed tests with solid grades (anything below %85 was a D; I was usually in the %90s).
In the 20 years I worked as an RN before becoming disabled, I got past the shyness fairly quickly. I just didn’t have time for it. I needed to get in, get information, give care, and get out. On to the next patient. Asking about the color and consistency of someone’s poop was as much a part of my day as parking the car. I had entered an ‘intimate’ profession. I had to know things about the patients that they didn’t tell anyone but their closest friends and relatives- and some things that they didn’t even (or especially) tell them. I had the book knowledge, and I fairly quickly got through the ‘people skills’ that make nursing work. Without them, there’s no chance at giving good care. Without getting up in someone’s business, I couldn’t know what they needed. That trumped my insecurities EVERY time. 🙂