I think one of the hardest things about being a student nurse is that sometimes, no matter what you do, someone will come by and complain that you are doing it wrong. It never fails. Nurses are creatures of habit and let's face it, most of us are control freaks. It is how we are able to keep track of 6 patients at once, and let's be honest; how we keep our patients alive. So, though I am the last person to ever want to admit that I am wrong, I think the most important thing you can learn as a student nurse is to take it in stride, don't try to defend yourself or point to the page in the book that shows you did everything in the right order, just nod and say I'm sorry. (unless of course they ask you to do something dangerous, then by all means stand up for your patient). It never really becomes easy to do and, for me at least, bashes a huge dent in my ego. Bring on the feelings of inadequacy. Now that is the story of your first year!
It is crazy, you can read the books, take the exams, score 100%s and get straight A's, but the minute you walk onto the floor it all becomes too real. The cases you read about are real and the idea that a small mix up could have monumental consequences makes the pressure build, and before you know it you are second guessing everything you knew only yesterday.
I had a patient today s/p stent placement in the renal artery, with a h/o MI, HTN, chronic pancreatitis, dysrhythmias, you name it, this guy had a lot going on. I checked his vitals in the morning before giving 10am meds (including amlodipine and metoprolol for the HTN), and got a reading 150/90, a little elevated from last night and certainly not what you want to see in a patient on two different antihypertensives, but still not alarming. So I left the room to get supplies for am care, did my morning evaluation, and left to finish up my shift assessment before coming back to do the noon vitals. And wouldn't you know, about 10 min after I left the room (and by the way he was on contact precautions, so leaving and entering takes some time) ... the alarm on his IV infusion line starts going off .... "air in the line." awesome. I am on contact precautions in a private room with a patient getting heparin therapy (and by the way .. this is my 3rd week on med/surg ... awesome.). So my preceptor comes rushing in and asks me what to do next. Well, "remove the air from the line." "how?" "flush the line?" now .. pause .. here, right here is what I mean by the floor turns you into an insta-idiot. On the the exam you know never to push the heparin in too fast but on the floor you think, why not? the only way to get the air out is by running the line down to catch the bubble... dumb. So, preceptor saves the day yet again and my patient lives to see noon vitals. success! well, that is until noon vitals which showed a BP that had now risen to 170/80 and stayed pretty near hypertensive crisis until I left for the day ... looks like the NP is going to have to adjust the dose on those anti-hypertensives...
Everyday is a learning experience and sometimes, on this rotation especially, it feels like you can never leave the hospital with that wow I did good today feeling, but honestly, I don't know if I would want it any other way. It is hard on purpose. If you make a mistake in any other job it is a word or a number, but here is it someone's life.
But there is just so much to learn. About nursing, about work, about communication, and about yourself. I just hope that one of these days that confidence part will come into play.
