A lesson learned few years ago, but never forgotten.
“No, hon, you’re not going to want that. Those are old. You’re going to want these,” said the nurse, pointing at a rack full of thick binders on the side of the desk.
Bewildered, I put the first binder back on the shelf (it was big and heavy) and turned to face the other rack.
Not really sure what I was looking at but attempting to look professional, I grabbed the binder with my newly acquired client’s room number on the spine, clutched it to my chest, and practically ran from the nurses’ station.
As I fled back to the safety of the visitor’s room that the freshmen nursing students had confiscated for headquarter purposes, I could imagine that poor nurse’s thoughts in the back of my mind. “That freshmen nursing student, thinks that she’ll be an RN someday and she doesn’t even know what a chart looks like!” I could just see her shaking her head and rolling her eyes at the inconvenience of having to deal with a floor full of freshmen. I made it back to the visitor room and sank into a chair with the chart in my lap.
My need to stay in my comfort zone was very quickly overcome by my clinical instructor’s orders to “Find your client’s medications from the chart and write them down.” Then she added with a touch of sadistic delight, “Some of these clients are going to have a lot of meds. One student last year had a client with twenty medications.”
Staring at my instructor with disbelief coupled with shock, I tentatively opened my patient’s chart. Pages and pages of information jumped in front of my eyes. Words that I had never seen before, much less understood, attacked me from the pages. I had no idea where to even begin looking for my client’s medication information.
Suddenly remembering that I would need more care plan information about my client than just medication info, I was struck with the bright idea of taking my client’s chart into her room and sitting with her while I attempted to decipher this terrifying binder. At least I wouldn’t be under the eyes of some of the more experienced freshmen or my clinical instructor. I was still delusional enough to think that my classmates were less confused than I was. If I had actually looked around I think that I would have seen the same deer –in-the-headlights-look on their faces that was so evident on my face.
Quickly sucking in my breath like a diver ready to jump, I rose from my chair, slammed the binder shut, and started walking briskly to my client’s room. As I left the visitor’s room I suddenly felt a surge of confidence. After all, here I was, in my new uniform, young, full of ambition and I had almost four weeks of classrooms lectures and lab time behind me! My self-confidence was returning! I felt knowledgeable, smart, and self-sufficient.
Then I passed the nurses’ station where I had gotten my chart. My confidence quickly dwindled as I walked, no; I sneaked, past that station. No snappy uniform or college based confidence could stand in the face of plain old experience that was represented by those sitting behind that desk. I quivered.
Still clutching my binder, I made it past the nurses’ station and arrived safely, albeit somewhat un-confidently, at my client’s door.
I then gave myself my one thousandth pep talk of the morning. “You’re doing fine, everyone feels like this on their first day. Just relax.”
We had been taught to always knock before entering a client’s room, however, upon meeting my client earlier in the day I had discovered that in my client’s instance that little textbook jewel could be thrown right out the proverbial window. I would have to hit that door multiple times with a crowbar before my client would even hear it. The dear woman’s hearing was not very good, and so, I concluded that all textbook information could be adapted to meet specific client needs. Looking around me, half expecting, half afraid to see my clinical instructor behind me, I discarded textbook policy, and walked right in. I walked up to my client, being careful to approach her from the front so that she could see me clearly. Leaning towards her, I raised my voice ever so slightly. “Hello, Ms. So and So! My name is—— and I am a student nurse. I am going to take care of you today!”
That was my very first ever clinical experience. I wrote about this experience very shortly after it happened. I have learned so much since that day; it would take me thousands and thousands of words to even begin to scratch the surface of all that I have learned since that first clinical day.
First of all, I learned that I was not alone in my feelings of nervousness.
I learned that I was not the only freshmen nursing student in the world to have felt so illiterate at the clinical setting.
I learned that my instructors were and are not sadistic, but in fact want to push me to my limits and challenge me with new experiences.
I learned that my instructors were approachable when I was unsure of myself.
I learned that my instructors didn’t mind me ‘adapting’ textbook policy (within reason of course!)
I learned that it was possible to understand a client’s chart!
I learned that the clinical staff can be invaluable tools for learning.
I learned that if I didn’t know anything, I should ask questions.
And the most important thing I learned that day was how to apply my textbook and lecture knowledge. I learned that no matter how much I learned in school, or how much I knew, when it came down to the client, it had to be personally applied to that client.
Although in the school lab, I would lose points during a re-demo for forgetting to knock on a client’s door, in the “real world”, if my client couldn’t hear me, I had to find another way of making my presence known respectfully without knocking on the door. I had to adapt my knowledge to meet a specific situation.
That little lesson turned the ‘light bulb’ on for me, and helped me to understand the nursing process. It helped me to understand how to critically think a situation, even in a very small way.
I think that I learned more in that one tiny experience, with a hard of hearing lady in a nursing home, than in four hours of lecture on critical thinking. And, small as it was, I know that I will remember what I learned on that first clinical day for the rest of my life.