The Plunge
So. It happened. I had my first day of clinical. And it was... fine. Nice. Which is to say, a bit anticlimactic after the amount of energy I'd put into being crazy-nervous about it.
My preceptor, Julie, was low-key and pleasant and welcoming. She's 34, has been working on the same floor since she graduated from nursing school 12 years ago. She's my height (but slender as a reed), has hair and eyes the same color as mine, and also has a 3-year-old daughter. I could be her older, fatter shadow.
Our patient assignment turned out to be quite light. We had two bone marrow transplant patients, which I guess could be a handful if they were having problems, but one was a new admit who wasn't even due to start his chemo until the next day, and the other was five days post bone marrow transplant, and so they were just waiting for his white blood cell counts to come back up (from essentially zero) so he could go home. He needs to be watched extremely closely for infection and for serious side-effects from the various nasty substances recently or currently pumped into his body, but at the moment he had no signs of infection at all, and all that was going on with him was a little nausea and a moderate elevation in blood pressure (knock wood). The new guy mostly just needed orientation and teaching, along with a general intake assessment. Both of the patients were very, very nice, and cheerful and matter-of-fact despite their rather tenuous prognoses (both having "failed" initial therapy and now having a chance of survival under 30%).
Some moments in my day:
Getting off of the subway just before 7 am with a whole flock of people in scrubs, all crossing together and heading toward the main entrance of Other Famous Hospital (let's call it OFH). I tried to be cool, but it actually kind of gave me chills.
Realizing that hey, it's just about the beginning of July (which is when new interns & residents start), so I probably won't be the only one on the floor with terror in my eyes. And sure enough, in my first half-hour there, some skinny guy in a lab coat is striking up a conversation and trying to be friendly. (New intern. Sign of panic. Otherwise, people with MD after their names in a teaching institution, in my experience, do not spontaneously reach out and gratuitously act friendly and social with people with RN after their names. It just isn't done.)
Going to teaching rounds of the Bone Marrow Transplant team and forgetting my place and asking the attending a clarifying question as he's up at the board explaining the history and theory of the non-myeloablative BMT process. He gives me a weird look but answers my question.
Making a big deal to my preceptor about how I don't have acute care experience and very little clinical experience in general, and how nervous I am. She's then a little surprised when it turns out that I nonetheless do know some stuff about clinical care. Yeah, well, I'm good at the book-learning part, I say. I'm just terrified by the hands-on, practical stuff. She seems distinctly relieved and says oh, well in that case, you'll be just fine.
Learning to do a whole mask-hand wash-glove procedure every time we enter a BMT patient's room. Forgetting to use the alcohol hand scrub and washing my hands with soap and water because that's the habit I'm in from before alcohol hand scrub was made the standard.
Getting the chance to do the intake interview with our newly admitted BMT patient. He and his family talk about how he used to have a mustache, but he ended up getting rid of it after the first time he got alopecia from his chemo. His wife would have to leave early for work, so he would make his teenage children's lunches. They would find little clumps of hair in their sandwiches, but they loved him so much they didn't tell him. (Eventually, they mentioned it to their mom, and she told him.)
Eating a piece of really wonderful coffee cake brought in by the baker husband of a former patient, who was coming in to OFH to get outpatient follow-up.
So, well, I go back on Friday for another 12 hours. I got a book called Oncology Nursing Secrets or something like that and have been reading up about multiple myeloma and leukemia and mucositis and different classes of chemotherapy and bone marrow transplant and tips for giving super-harsh drugs safely by IV and stuff like that. I'm all excited. I can't believe I'm actually going to be useful for something in the foreseeable future. It's such a rush.
My preceptor, Julie, was low-key and pleasant and welcoming. She's 34, has been working on the same floor since she graduated from nursing school 12 years ago. She's my height (but slender as a reed), has hair and eyes the same color as mine, and also has a 3-year-old daughter. I could be her older, fatter shadow.
Our patient assignment turned out to be quite light. We had two bone marrow transplant patients, which I guess could be a handful if they were having problems, but one was a new admit who wasn't even due to start his chemo until the next day, and the other was five days post bone marrow transplant, and so they were just waiting for his white blood cell counts to come back up (from essentially zero) so he could go home. He needs to be watched extremely closely for infection and for serious side-effects from the various nasty substances recently or currently pumped into his body, but at the moment he had no signs of infection at all, and all that was going on with him was a little nausea and a moderate elevation in blood pressure (knock wood). The new guy mostly just needed orientation and teaching, along with a general intake assessment. Both of the patients were very, very nice, and cheerful and matter-of-fact despite their rather tenuous prognoses (both having "failed" initial therapy and now having a chance of survival under 30%).
Some moments in my day:
Getting off of the subway just before 7 am with a whole flock of people in scrubs, all crossing together and heading toward the main entrance of Other Famous Hospital (let's call it OFH). I tried to be cool, but it actually kind of gave me chills.
Realizing that hey, it's just about the beginning of July (which is when new interns & residents start), so I probably won't be the only one on the floor with terror in my eyes. And sure enough, in my first half-hour there, some skinny guy in a lab coat is striking up a conversation and trying to be friendly. (New intern. Sign of panic. Otherwise, people with MD after their names in a teaching institution, in my experience, do not spontaneously reach out and gratuitously act friendly and social with people with RN after their names. It just isn't done.)
Going to teaching rounds of the Bone Marrow Transplant team and forgetting my place and asking the attending a clarifying question as he's up at the board explaining the history and theory of the non-myeloablative BMT process. He gives me a weird look but answers my question.
Making a big deal to my preceptor about how I don't have acute care experience and very little clinical experience in general, and how nervous I am. She's then a little surprised when it turns out that I nonetheless do know some stuff about clinical care. Yeah, well, I'm good at the book-learning part, I say. I'm just terrified by the hands-on, practical stuff. She seems distinctly relieved and says oh, well in that case, you'll be just fine.
Learning to do a whole mask-hand wash-glove procedure every time we enter a BMT patient's room. Forgetting to use the alcohol hand scrub and washing my hands with soap and water because that's the habit I'm in from before alcohol hand scrub was made the standard.
Getting the chance to do the intake interview with our newly admitted BMT patient. He and his family talk about how he used to have a mustache, but he ended up getting rid of it after the first time he got alopecia from his chemo. His wife would have to leave early for work, so he would make his teenage children's lunches. They would find little clumps of hair in their sandwiches, but they loved him so much they didn't tell him. (Eventually, they mentioned it to their mom, and she told him.)
Eating a piece of really wonderful coffee cake brought in by the baker husband of a former patient, who was coming in to OFH to get outpatient follow-up.
So, well, I go back on Friday for another 12 hours. I got a book called Oncology Nursing Secrets or something like that and have been reading up about multiple myeloma and leukemia and mucositis and different classes of chemotherapy and bone marrow transplant and tips for giving super-harsh drugs safely by IV and stuff like that. I'm all excited. I can't believe I'm actually going to be useful for something in the foreseeable future. It's such a rush.
posted by Rosie Bonner at 8:07 AM
2 Comments:
Hoo ha!
You go girl!!
We in WV are holding you close in our hearts!!
xxx
aka Marina
I'm so glad you are taking notes. Oh this is gonna be fascinating. It sounds like you are doing just dandy over there!
p.s. thanks for the birthday wishes ;-) [I'm embarrassed to say it, but I've become a smiley-face prepetrator. Since you can't see my own smiley face.]
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