I think I'm ready for a break...

From med-surg nursing at least. This school was a total pain in the arse to get into (b/c nobody returns phone calls or emails) but once you're in they really do take our feedback under consideration. Previous cohorts have done 20 weeks of med-surg nursing, 10 of which are spent on an ICU step-down unit (we won't be doing any work on the ICU--there's too many of us and not enough space and, good lord, those people have tubes and wires coming out of them like crazy). 20 weeks is a lot without a break. So our cohort is doing 10 weeks of med-surg and then we move on to maternity for 5 wks and pediatrics for 5 wks before going back to med-surg. It'll be nice to have a little break.

We're starting week 9 of med-surg and we've learned a lot to date. There's still more to learn but it's very difficult to get exposed and/or try all the skills we learn in lab for many reasons. For example, foley catheters (the ones that go in your bladder and stay there) have to be changed every 3 days. There are 10 students and maybe a total of 25 patients, some of whom may have a foley but many may not. Of those who do, they may not need a new one. And in some cases, it's okay to do something that's just been done for the benefit of learning but many times it's not feasible. For one thing, the waste involved is enormous. For another, the patients are not guinea pigs. But I would love to put in a foley. Maybe in maternity.

Last week I had my first colostomy patient. For all the joking about colostomies they're not funny to the patient. The bags look like those little bags of air that are used to prevent breakage during shipment of the goodies you ordered from amaz0n.c0m. Except these fill up with poop and gas and you have to go in and empty them out and, whew, it does not smell pretty (did I not tell you it was always about poop?). Still, it was cool to see. And you have to be cool about it b/c the patient is not happy to have one. I know I wouldn't be happy about it.

I also had my first experience with a combative patient. The doctors were trying to figure out what was wrong with her and in the meantime she became very combative. For a pretty small 88-year-old, she was strong and fiesty. It took 4 nurses to hold her down so they could give her a sedative before going for an MRI. She was kicking, yelling, biting and hitting; talk about surreal. And this behavior can occur as a side effect of a number of disease processes but it can be hard to deal with while you're waiting for the docs figure out the underlying issue. The pts have no idea what they're doing and if they did, they would be so embarrassed.

Anyway, this patient grabbed some papers the nurse laid on the bed and flung them (yes, she really flung them) right in the nurse's face and then while I held her down so the nurse could flush her IV, she looked right at us and just yelled right in our faces. And then she took a deep breath and telled some more. And...it's not funny. At all. But I mean to tell you that I was about to start shaking with laughter b/c of the un-funniness of it all. It's sort of like laughing at a funeral. Michael will remember how, at my aunt's funeral last year, I started shaking from head to toe from repressed laughter. The cause? My cousin doing a less than stellar version of "In the Arms of an Angel." I thought I was going to die from lack of oxygen. But, see? Not really funny. Except that it is. In a very inappropriate way. Ah, trench humor. This is how we're able to do what we do without losing our sanity.