Clinicals this week were a mixed bag.
We didn't have them on Thursday because the instructor had a prior commitment.
I spent Friday in the MACU (medical acute care unit). It was meh. I am not a huge fan of med-surg nursing. I know it is the ground work of my chosen profession but it just doesn’t interest me. I feel like I am either bored to death or running around like a chicken with its head cut off. There really is no middle ground for me.
Plus the nurse I was working with didn’t seem to want to be bothered with a student for the day. At one point after I asked for her help working with an IV pump (the alarm kept sounding and saying there was an occlusion in the line but I couldn't for the life of me find it), she got frustrated and said "This is why none of the patients want students. None of you know anything."
That was kind of a blow to my ego and a little embarrassing. Especially since she said it in the hallway while one of my classmates was passing. :-(
On Friday, I was able to spend the whole day in the ICU. It was very interesting. The preceptor I had, in addition to being intimating as all hell (at one point she told me "They don't call me the ICU bitch for nothing"), was incredibly smart and took the time to explain EKGs and pressure monitoring to me while working with her 2 patients.
It seems like in the ICU, a lot of the "book learning" goes out the window. Like the therapeutic communication and some of the other concepts of nursing that have been drilled into us, while still important, is secondary to keeping the patient alive. At one point, the nurse was telling us about a ventilated patient and how he had orders for no turning and minimal movement because it caused his oxygen saturation and blood pressure to drop too low. Not seeing the whole picture, I asked "How do you prevent pressure sores?" The nurse turned to me and said, "When your patient is so unstable that turning him over could kill him, pressure sores are the least of your worries."
I would have to say my favorite moment came when a patient who was coding arrived in the unit [as I read this sentence again, I realize how incredibly fucked up that sounds]. She had aspirated during breakfast and wasn't breathing (but she still had a heartbeat). She had been intubated and one of the nurses called me into the room and asked me to bag the patient (use the ambu-bag to breath for her) while she was doing something else.
So for a few minutes, I breathed for someone.
I *breathed* for someone. With every squeeze of the bag, I watched the patient's chest rise and fall.
It doesn't seem like a big deal to anyone else but for a few minutes, I made sure the patient was receiving enough oxygen into her lungs in order to keep her brain and other vital organs functioning. And that's a big deal to me.
So yeah. I am definitely a ICU/CCU kinda girl. :-)