Clinical Laughs

I've been doing clinical rotations with Batch 3 (from Medical Allied Career Center), in the Sub-Acute Ward at Los Angeles Medical Center. This is our second day already. This is also their first week back from a three week hiatus doing their Fundamentals of Nursing return demonstrations in school.

We've been here before for four weeks and it was really a drag because the students were been exposed to the hospital without doing any return demo of the fundamental nursing skills. It's just like sending a bunch of troops to war without proper training. All they did before was just change G-tube site dressing, do oral care and suctioning, and help the CNA for the patient care. Now that they're back after doing all the skills return demonstrations for three weeks, I felt that they're 110% more ready and well equipped with nursing skills.

Yesterday was their first day. And as I've observe them doing patient care and passing medications they're more adroitly improved and much much more better than the first few weeks that we've started here. We've done a lot of things now compared to before. Aside from changing G-tube site dressings, doing oral care and suctioning, and helping CNAs doing total care, they've been doing various injections now, calculate medication dosages, suction tracheostomies, change tracheostomy cannulas, dressings, and ties, insert foley catheters, do pressure sore dressing changes, perform finger sticks for blood sugar determination for those who are diabetics, assess patient from head-to-toe thoroughly, document patient findings on the MAR and progress notes with precision, etc. Oh my God we did a lot of things now.

Although there were students who were very slow at comprehendingand assimilating the process, I am happy with their overall performances. I can deal with those who are weak and help them improve more. I might need a lot of patience in order to tackle this dilemma but for now my focus is to make them establish a routine so that they can train themselves on what to prioritize first. So far they've been assimilating and applying what I've been teaching them and I am contented with the results.

Today, it's been quite better than yesterday. We started the day right with a very intimate pre-conference reviewing their first day performances and also tackling them some of the important points like interacting with the patients professionally, observing proper infection control and transmission-based-precautions, interacting with the staff in the unit professionally, and also observing proper HIPAA guidelines pertaining to pertinent patient health informations, in short observing proper confidentiality issues which they've been used to do all the time.

At one point, I assigned one of the student to give insulin shot to a young patient in 107A who is extremely obese. The patient is alert and oriented but was connected to a vent via a tracheostomy. I don't know how he ended up being trached but it seems that the patient can able to communicate through gestures but he cannot talk, and can participate in his care.

At the time when we came into the room he was eating graham crackers. He was signing or signaling to me and Yarid, waving his left arm holding a cracker. I thought he was offering it to us so I told him, "No, thanks! You can have it. It's your cracker" I thought he was just sharing the crackers to us. After that he got upset and keeps waving his hands at us indignantly. I looked at Yarid and immediately we bursted into innocent laughter. It never dawned on me that he was asking for more graham crackers. I am so naive about it.

Yarid and I were still smiling at each other and we just couldn't stop giggling and bursting into laughter. I told the patient that we will be getting more crackers for him and then we went out of the room still laughing. I just can't get over thinking about the whole situation. The patient is overweight and always has food at the bedside. I didn't even thought that he was still hungry, we'll he's always eating all the time though. That was a substancial involuntary humor that had gotten me. Some kind of a mild misunderstanding but it brought us to enjoy the moment by laughing and smiling. Oh God, we needed that.

Despite how busy we are we still managed to enjoy those precious and tender moments. It's good to have those sometimes. A chance to unwind and think that our job is not always about being serious and hurried but we also have a time to unwind in the middle of the rambunctious situations. And we have to savor that situation when it happens.

We actually finished early today. Some students were very thorough about their drugs studies, some were not prepared so I have to make sure that they knew what they were giving to their patients. I have one student preparing her meds for thirty minutes because she don't know how to calculate doses and also don't know the vital properties and information about the drugs she was preparing. She was very slow and I made sure that she knows what she was preparing by letting her do everything and not me spoonfeeding her.

I knew that she got irritated and frustrated at me but I have to do it for her sake. I hope she understands what I am doing to her. Hopefully, things will be more better next week I suppose. Can't wait to be back there again and probably encounter more challenging situations that can unwind us from the harsh reality of being a passionate nurse and a loyal caregiver.