Real Life Patient Scenarios
October 9, 2006 at 4:50 pm | In medication administration, nursing school, transfer of patients | 2 CommentsIn my first week of nursing school, I learned some important skills for patient care. However, these skills were not very exciting. Let’s be honest, washing another person’s hands is not that exciting unless they’re Jessica Alba’s hands. Thankfully we moved on to medication administration and patient transfer.
Medication Administration
On September 22, three premature babies died in an intensive care unit at Methodist Hospital in Indianapolis after a horrible medication error . It was tragedy not only for the families who lost children, but also for the nurses and staff members who will never recover emotionally from these events.
Tragedy and Focus
The mistake in Indianapolis destroyed the careers of several seasoned and gifted nurses. Tragically, they and others will remember the medication errors not the other moments where they provided incredible care and saved countless lives.
As student nurses, our instructors drove with greater conviction, the importance of verifying medication prior to dispensing them to patients. That fear will enable me to diligently focus on the distributing medications to my patients. Knowing my personality, if I caused harm to a patient due to carelessness, I would not be able to live with myself. I wonder if patients realize that their nurses fear needles more than they do.
Safe Transfer of Patients
I understand the statements above are heavy but, they are appropriately so. Fun and laughter returned when we moved to learning how to transfer patients safely. Let me set the stage first so you can picture the events in your minds.
Our clinical lab resides in long room and equipped with the items you would find in a patient’s room. To the untrained eye, the room resembled the hospital ward your grandparent’s remember. At each bed, two instructors would demonstrate transferring a patient from a bed to stretcher; the next station students watched how to move a patient to a chair and lastly transferring a patient using a lift.
The lift resembles a harness that mountain climbers use for students. Staff will slip the harness under the patient then attach hooks to a lift. The lift has a hand crank that when turned will simultaneously lift all the appendages and enable the staff to transfer a paralyzed patient from a bed to a chair. This transfer is incredibly dangerous to the staff and the patient since the patient is lifted off a bed and the only thing preventing the patient from falling to the floor is the common sense of the staff and strength of the harness.
Realistic Patient Scenarios
Our instructors wanted to present the students wtih realistic patient scenarios. Unbeknownst to my group, our instructors were going to shove a patient scenario upon us that resembled a horror movie and SNL skit.
Our patient was our clinical lab leader, a gentleman who demonstrates and exudes such passion for his profession that you wonder to yourself if this is an act or does he really feel this way. (After his HIV lecture, I know he is not faking it.) Our lab leader, in his infinite wisdom or twisted sense of humor, not sure which, transformed himself into the patient from hell on steroids for my group.
The Patient From Hell
Our lab leader jumped into the bed and stated he was spinal cord injury and would not move. Unfortunately, we did not read the fine print and did not assess him for neurological deficits. We novice students thought spinal cord injury equals paralysis; he was not going to move. As we began to place the harness on the bed and roll him from side to side placing him in the harness, the fiendish instructor started to moan and scream. These moans and screams were definitely Golden Globe performances not Emmy level. With each scream he gave me and the other student at the head of the bed a crazed homicidal look. These screams should have sounded alarms in our heads that our patient was not as immobile as we perceived.
After we got all hooked up and began to crank the handle rising above the bed, we supported his head and checked the harness to make sure that he would not slip out. Checks done, we were good to go. As he suspended above the floor away from the bed, our instructor began to fake a seizure and flailing episode, I thought an alien or demon would soon fly out of his thorax.
His Oscar worthy performance elicited a myriad of responses from us students ranging from terror to nervous laughter. After class, we talked about how our instructor should ditch the nursing gig and enter the acting field. He drove the point home well.
Bed Bath
October 4, 2006 at 11:31 pm | In nursing school | 1 CommentDay Two
During our next lab session, every member of the class would watch and perform a bed bath demonstration. As with hand washing, I found this odd and wondered silently why nurse would need to master this skill. In this instance, the bed bath serves as an excellent opportunity for health assessment and therapy for patients. As a patient, you are lying in bed with tubes and apparatuses surrounding your bed. A walk to the bathroom is equivilant to climbing Everest without sherpas.
So a patient may never bath for two to three days and perhaps not change lying positions. After a few days, a patient may feel unclean and emit unpleasant odors. These feelings may impact the patient’s recovery.
Our instructors stated a bed bath may alleviate this and provides ample opportunity to assess a patient’s skin, body and range of motion for potential abnormal ities. Additionally patient has your undivided attention and may open up to other feelings or ailments. After the instructor’s demonstration, each student gathered the required tools and completed a bed bath on a mannequin. I realized it not quite the same thing, but you could see how intimate you become with your patient.
Next week, we learn our clinical assignments and medication administration. I am looking forward to this as we are inching closer to finally entering the hospital and interacting with patients. Injections are included in our medication administration laboratory. We all hated receiving injections as children, in fact today when a nurse injects me I ask for a lollipop for my boo-boo. I just hope that we are not required to inject each other because I do not think lollipops will be available.
First Day of Nursing School
September 29, 2006 at 9:10 pm | In nursing school | 4 CommentsDay One – Washing Hands and Vital Signs
“Great”, I said to myself, “we’re sitting around a table and staring at each other.” Ten of us waited around the lab table wondering what clinical skill the instructor would first present. Our faces reflected fear and uncertainty. Not the fear you see in horror movies before a character enters the haunted house, but the fear of the principal’s office kind of fear. Our instructor informed us we would be measuring blood pressure. Thank god because anything invasive and some of us would require smelling salts.
Does Watching ER Count For Extra Credit?
Prior to the demonstration, we introduced ourselves to the group and described our medical experience. As it turns out, experience ranged from paramedic to watching two or three episodes of “ER.” I think someone asked if watching “ER” would give us extra credit. This question was answered with chuckle and a resounding “no.”
Washing Hands
Our instructors really stressed cleanliness and hand washing before demonstrating blood pressure measurement. This seemed very strange that instructors would spend anytime on this concept. We were all adults and listened to our parents when they said to wash before dinner or following a trip to the restroom. However, the astronomical costs associated to nosocomial infections drove this point home. It seems that healthcare workers move from room to room completing their assigned tasks and forget to wash their hands, resulting in the spread of infection from room 322 to 323. Prior to moving on to the next skill, everyone washed their hands and the instructor critiqued our technique.
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