The Following Post is Submitted by an RN named Jessica.
Nursing School Can’t Teach You to Be a Good Nurse
My name is Jessica and I am a registered nurse. I graduated from nursing school in May of 2009. I’m currently employed at a local hospital on a cardiovascular progressive care unit. I have been employed on this floor for approximately 3 years.
Since graduating, I have learned so much about the nursing profession and what type of nurse I want to be to my patients. In nursing school, I learned relevant information about nursing responsibilities and what was expected of me professionally. I learned technical skills such as: Wound care, taking blood pressure, inserting I.V.’s, and more.
When I graduated, I felt like I had a good grasp of the skills, and I was ready to be a nurse. Unfortunately, I soon learned that nursing school did very little to prepare me for the real lifesituations I would encounter while working in this profession. In fact, these real life situations can sometimes define your career.
To truly understand nursing, you must have “feeling.” You must be able to look at your patients and their families, and you must feel what they feel. You must connect with them on an emotional level. To me, this aspect of nursing is just as important as administering medicine, if not more important.
In this article, I would like to share an experience about a patient and family member that helped me learn the true meaning of nursing care. It also taught me that while nursing school can teach you many things, it cannot teach you how to be a good nurse. Being a good nurse is something that comes from the heart.
My Nursing Experience
As I made my journey across the parking lot, up the stairs, and to the time clock–it felt like an ordinary day. I clocked in, and soon discharged a patient. I then received word that I would be caring for an MD link patient from a neighboring hospital.
I received report from the nurse at the other hospital that the patient was being transferred to us for possible gallbladder removal. The nurse vaguely mentioned that the patient’s blood pressure had been high since early that morning, and she was given some Labetol IV just before calling report. The nurse also indicated that the patient’s blood pressure seemed to be stabilizing. Given the nurse’s tone and other normal readings in the report, it seemed that the patient was fine.
The patient soon arrived on my floor. She was a kind elderly woman. She seemed calm and collective, but at times disoriented. The patient knew who she was and could communicate normally, however, she would occasionally speak in broken and incoherent sentences.
The patient was accompanied by her niece, with whom she lived. Her niece was a pleasant young woman who had a strong affection for her aunt. She soon explained that her aunt was behaving this way at random times (which was not normal behavior for her), and it was getting progressively worse. She also explained that her aunt hadn’t eaten since Monday (it was Thursday then) because of the possible gall bladder removal and her NPO (nothing by mouth) status.
By this time, the patient was hooked up to the bedside monitor where her blood pressure was 180-200 systolic. The patient had no headache, nausea, or vomiting, and felt fine. The attending doctor arrived and quickly wrote the admission order. He gave orders for more IV Labetol and said to keep the patient NPO (nothing by mouth) until she was seen by the Gastrointestinal Doctor (GI). He also said to consult the GI doctor for the gall bladder issues. I thanked the doctor, and I explained all of this information to the patient and the niece.
The GI doctor was notified to come and see the patient, and I administered medication to the patient for her high blood pressure. The patients blood pressure was checked 30 minutes after the medication was given and it was still high. Since the blood pressure was still high, I decided to make another call to the admitting physician.
When calling this certain physician’s group, nurses must speak to their answering service first, and then the secretary will page the doctor for you. This can sometimes be very inconvenient and frustrating. So I spoke with the answering secretary and informed her of the doctor I need to speak with from their group.
When the physician answered, I explained that the Labetol IV he prescribed was not lowering the patients blood pressure, and I asked him if he knew what was causing her high blood pressure. He explained that the patient normally takes a home medication called Clondine (0.3 mg) for her high blood pressure, but it was being held at the neighboring hospital because Clondine cannot be given to a patient who is under an “NPO” (nothing by mouth) status. Because the patient was not given anything else to substitute the Clondine medication, the patient was experiencing what is called “rebound hypertension”.
Rebound hypertension occurs when a strong blood medication is stopped abruptly (as opposed to a proper tapering of doses), causing harmful side effects (such as abnormally high blood pressure). Rebound hypertension is difficult to control, and this is exactly what my patient was experiencing.
After explaining this, the doctor gave me more orders for an alternative blood pressure medication, which I soon administered. Approximately 1 ½ hours later, the patients blood pressure was the same and the patient is still asymptomatic (without other accompanying symptoms). So I called the doctor again and I explained the situation to the answering secretary, asking to speak with the doctor again.
Fifteen minutes passed, and the physician had not returned my call. I could see that my patient’s niece was staring to really worry about her aunt. She constantly asked me if her aunt would be okay. I tried to console her and I reassured her that we were doing everything we could to reduce her blood pressure. In all honesty, I was beginning to worry about the patient myself.
The doctor wasn’t returning my call, and the patient’s blood pressure was still at very high levels. So I called back to the call service 3 more times until the doctor’s answering secretary said, “Well Dr. “Anonymous” is going to be off-call soon, and blood pressure really doesn’t get him excited (she knew my patient’s levels), but i can try to page him again for you.”
As I hung up the phone, I wanted to scream. I couldn’t believe that a systolic blood pressure of 200 wouldn’t get a doctor “excited” enough to call me back to give me some orders for an alternative blood pressure medication. This poor patient’s life was hanging in the balance, and I could feel a tremendous amount of pressure building.
During all of this time the niece was getting very anxious. She was constantly asking, “Why isn’t her blood pressure going down? Why won’t the doctor come by to see her? Is she going to be okay? Can’t something be done?”
The niece was also terribly upset because the G.I. doctor had not been by to approve of a meal for her aunt. The niece asked, “Can’t we give her something to eat? Even if it is a cup of Jello?”
When the G.I. (nurse practitioner) finally came to see the patient, he said he didn’t feel comfortable allowing her to eat until her doctor approved first.
So at this point my patient has no diet orders (and hasn’t eaten in days), severe hypertension, a doctor who doesn’t get excited about stroke level blood pressure, and a family member who was on the brink of a nervous breakdown.
As I entered the room to check on the patient, her niece began to cry. “I will never bring another family member to this hospital ever again,” she said. She continued, “I know it’s not your fault, but the doctor-to-doctor communication at this hospital is terrible. My aunt’s health is fading, and the doctors will not even help her.”
As I watched the tears stream down her face, something happened. I suddenly felt her sadness. I felt her frustrations. I felt a strong emotional connection. I began to think to myself, “What if that was my husband, or my mother, or my aunt on that bed? Wouldn’t I feel the same way?”
At this time, I made a decision. I was going to do everything I could to get this patient the help she needed immediately, no matter what sacrifice I had to make. I made the decision to bring in outside resources. I contacted a patient advocate and also spoke to my shift leader about the matter. This turned out to be a blessing in disguise.
The niece was immediately comforted and thanked me for getting help. She was able to vent her frustrations to her patient advocate, who listened attentively.
My shift leader then made the right phone calls, and was able to get a diet plan for my patient, and a medication that helped lower her pressure quickly. The patient’s health continued to improve over my shift and the niece felt relieved. The patient was later discharged.
Approximately two weeks later, I clocked in to work. As I walked past the nursing station, I noticed some decorative roses and a card. The patient’s niece had sent them to the floor staff and myself. The card read, “Thanks for making a stressful situation bearable, and for taking such good care of my aunt.”
As I read the card, I knew I made the right decision. I knew I did my job as a nurse.
Conclusion: Nursing School Can’t Teach You To Be a Good Nurse
This experience taught me so much about nursing. College taught me technical skills, which are extremely important in nursing. However, it didn’t teach me how to care about my patients. That’s something I had to gradually learn by forcing myself to listen to patients, and most importantly, listen to my heart.
Nursing is more than just technical skills learned in a classroom. Nursing is about caring for your patient’s and their family members in a personal way. It is about connecting with them on an emotional level, and doing everything you can to ensure they are happy and healthy.
This experience also taught me the importance of teamwork. Nursing is a team effort. By taking advantage of the great skills and talents of my co-workers, my patient was able to get the medical attention she deserved.
That particular experience helped me grow professionally. It helped defined my job as a nurse, and it taught me the realities of nursing in a way I had never learned before.