March 9, 2007

Feeling Overwhelmed

Our last clinical was yesterday and I couldn't be more thankful. Clinicals wear me out. I didn't have a great day yesterday. I had 3 pt's all by myself and they were all pretty intense. 1-rib fractures, was on bedrest but was ordered up to chair when I got there. Tried getting him up to go to the bathroom and he tried passing out on me. His wife and I got him to the bed before he fell, thank goodness. He was very needy all day. Well, his wife was really needy. He was fine after the almost passing out episode. 2nd pt was a woman who had a massive GI bleed. She had had 3 solid blood stools before arriving at the hospital and was getting blood transfusions all day. 3rd pt had a fem-fem bypass the day before. Both of his femoral arteries were occluded. This is the second time he's had this done, poor fella. He had three at both groin areas then one that started towards the middle of the chest and went around his side to his back....craziness. He was the nicest guy. I cannot believe he was even moving around after that, I have to admit his incisions looked pretty painful.

Let me start with why this was a bad day....aunt flo came to visit me before I left the house...ugh. The night before I had started to have a temp and my throat was hurting....uh-oh, I feel some sickness coming on. I felt like absolute shit all day while I was running my ass off. Normally I would have called in, but I wasn't about to miss last clinical. I wanted to get it over with and not have to make it up. I had the worst 3 pt's on the floor...seriously. The night before clinical we always go to our site to get our assignments. 2 of my assigned patients had been discharged which meant I had to pick another 2. I asked one of the nurses who was easier because we are suppose to have 1 complicated patient and 2 relatively easy ones (if there is such a thing) at first. Keep in mind this was the 1st time I had 3 all by myself. She says to me...honey, this is the real world, you ain't gonna get easy pt's. Then she gave me the two worst ones. I told instructor about this and she was pissed at the nurse, but also at me for not listening to my own "judgement" and making my own decisions. Anyway.... All of the other students seemed to have a lot of time on their hands, whereas I did not. That isn't what bothered me, what bothered me was that I was getting behind...really behind on med passes. I didn't even get one med passed until 2 hours after it was due because SOME other pt wouldn't let me leave their side because they wanted to be coddled. THEN the other students kept asking me what was wrong because I looked funny. It's called concentration, being busy, stressed out and working. They kept saying...are you ok? over and over and over. Honestly, I was ok, but I was really, really busy. It wasn't until they all started asking me things that I got upset because I start thinking to myself....does me expression render pissed off, upset, not ok? I've been told before that I look so intense sometimes, when all actuality, that's just my face. LOL I guess it bugged me and made me self concious which led me to telling them to STOP asking me what's wrong because NOTHING was wrong...I WAS JUST BUSY and I FELT LIKE POO! Anyway, it made me more moody...I know they were just trying to help and I love them all for it, I apologized if I seemed snappy, which I probably did. BOO@me. SO....I also had a lot of new things that day that I'd never done before. My fem-fem pt needed his NG tube flushed. I remember doing this as a skill, but couldn't even remember the 1st step at the bedside. It's wayyyyy easier than I thought it would be. Here's the want to insert 30cc's of air (like you can actually measure air pfft) from a big ball plunger/syringe doohickey into their NG tube and listen to the abdomen for the swoosh of air.....and yes it does sound like a Then you fill the syringe with 30cc of normal saline to flush. Once flushed you want to retract the bulb and hope for 30 cc's of content. I only got 20, but she said it was ok. I also had a lot of new med orders come in and that got me even more behind because I was trying to get pharmacy to send the meds up blah blah blah. All of my pt's were diabetic so I had a lot of insulin to prepare. They weren't all sliding scale either. FINALLY I got to go to lunch and I didn't even eat, I was too upset and I can't even really say why. Maybe it's because I felt like I was all thumbs all day, maybe because I felt my confidence was shot that day...whatever it was, I hated the feeling. I sat down with the others and couldn't help it...I cried. If I wanted to, I could have cried more, but I had to contain it because I was in a public place. How embarassing. I think I just felt awful and I was so behind and really overwhelmed. I wasn't wanting sympathy, I wanted a release. They understand, I'm sure they feel this way too from time to time.

Anyhow the day went on and I went on, what else can you do? So here I am and I'm ok, still feeling like crap, but ok.


RN Someday said...

Shiz - that sounds intense. Can't your classmates help you out? I'm scared about going forward. How in the hell will I handle this?

Soulshine ....RN to be (hopefully) said...

My classmates did help me out toward the end of the day, as best they could anyway. You will go forward and you will handle it, just as I have and many others. As you go on you'll gain confidence in your skills, but unfortunately some days you just don't feel you're good enough, and that's ok. I think we all experience this. Some days I felt like I could manage it all, other days I felt I could barely stay above water. It's lessons learned. I need to work on time management and biggest obstacles.