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Life of a Murse (Episode 4 coming soon and why it has been delayed for so long)

To those who were reading my blogs and wandered why I have not made a new blog episode in two months, I would like to apologize.

The last couple of months I had to deal with a family medical urgent matter which has now consumed most of my life. I won’t get into the specifics but I have decided to reveal this in the future later blogs of life of a murse just to show how sometimes you have to be a nurse 24 hours a day 7 seven days a week even when you are not at work (those who follow me on instagram and twitter will know what family illness I have been dealing with.)

To those who have given me great feedback, I thank you dearly. For those who have sent me questions and I have taken decades to reply back I apologize (wordpress does not really do a good job in my opinion of notifying when you get new messages or alerts…but that could just be me.)

Though I have not blogged in two months there has been still some crazy exciting and heart felt events that I have experienced which I am excited to share with you all.

Stay tuned!!

Medsoulbrother

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Posted by on May 29, 2015 in Uncategorized

 

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Life of a Murse Episode 3: The Lady in White.

IV

The last two years of nursing school were not so bad but the workload was still heavy. Perhaps the most anxious thing was writing the CRNE (Canadian Registered Nurse Exam.) I literally had nightmares of failing the exam (likewise with other fellow students.) While in my last year and juggling two jobs I got a sweet summer job at a hospital close to me working as an extern. For better lack of terms, it was being nursing assistant, and I got to be one in the Emergency Department. At that point this is when I knew I would love nursing. As a nursing assistant I was doing so much and helping the staff. In fact, I was doing stuff that I never got to do in my other clinical settings in school but was only taught in lab. I was putting in Foley catheters, doing ECGs, doing vitals signs, and even helping with doing bloodwork (which was so nerve wrecking at first.) As I was in my final year and continued working as a nursing assistant.(I was working three jobs just so I would not have no school debt) I was encouraged by the educator and the charge nurse to apply for a new grad position in the emergency department. Without hesitation I applied, and I was hired.

One of my first ER shifts was when I was with another nurse in the acute area on a nightshift.
Oh boy.
One of my fondest memories was learning how to start IVs. Doing straight blood draws was not an issue as I learned them quite well when I was an extern. The tricky part came when i had to put in an actual IV. The IVs were quite tricky as you had to make sure you applied pressure so the blood would not spewing all over the place like a bloody crime scene. I said to myself.. nope I am gonna do an IV I don’t care.
Again…..Oh boy.
One night I was working along with my preceptor. It was a Friday night so of course we were getting all the drunks coming in. We had one lady who was dressed in complete white who was here for a problem that to be honest with you I could not remember. All I remember was that she was wearing all white. White blouse, white jacket, white pants and white shoes to match.
Maybe there was a white sale at Sears? Maybe I should have told my mom at the time?
Who the heck knows. Anyhow, the distinct thing I remember about this patient was that she had some form of social issues at home that required to be seen by our crisis worker. The doctor had ordered some blood for work and I told my preceptor that I was going to the blood work.
“And you are putting an IV in her.” she chimed as a reminder.
I closed my eyes for a quick second and kept repeating myself. “Don’t fuck up, don’t fuck up, don’t fuck up. You can do this.. you got this man. You’ve done straight pokes before, you can put an IV, it will be ok.”
Clearly my conscious lied to me.
The patient rolled up her sleeve as I tightened the tourniquet on her arm trying to feel for a vein. I felt a nice fat juicy one right in the centre of her arm. I had all my equipment and blood vials set.
I took a deep breath.
You can do this. You can do this it’s okay you can do this.
Grabbing my 20 gauge IV, I aligned it with her vein and slowly entered. Learning from all the nurses, I would count one to three so the patient would know (for those who had quite apprehensive to needles.)
Immediately I saw blood return to the tip meaning that I had entered the vein.
Great!!! Okay so part 1 was done.. .now I had to remember the rest of the parts. I indistinctly remember to make sure I had placed good pressure over the IV so the blood would not spew out before I attached it to an IV lock.
Ok you are doing good. You got this bro.
The patient then gazed at me with this weird look. “You’re quite good looking you know that?”
I lifted my head surprised by her comment. “Huh??” My fingers immediately released from the IV as I was trying to make sure who she was referring to. I guess you can call me modest but I never considered myself the model GQ type or that attractive so when usually when a woman makes a comment like that either she is intoxicated, high on some kinda of drugs or had a dementia. I forced a smile trying not to be rude but then my eye caught something red on her sleeve.
SHIT!!! I let go of the IV!
I did not even have time to respond as blood started pouring out of her IV like a leaky faucet. The blood started soaking on her white blouse, jacket and her pants.
Fuck my life!
My voice all of a sudden sounded like Grover from Sesame Street. “Uhm, help me here please.” As I turned to my preceptor.
She saw smiled a bit and quickly grabbed a couple of two by twos gauzes. She immediately helped me IV lock the patient but at this point this woman looked like a bloody mess. She look like she was part of a crime scene from criminal minds.
Immediately I began apologizing while we were cleaning up. “I am so sorry about that. ”
Surprisingly the woman did not react or act mad. “It’s ok.”
My preceptor immediately grabbed a patient’s gown and gave it to her to change while we grabbed her white clothes and placed them in a container with hydrogen peroxide.
She turned to me. “And this is why we always tell patients to dress in a gown before they are seen by a doctor.”
I nodded still feeling like shit. “Yeah I got it. ”
“Don’t worry you were okay, you will be a pro at it.”
“But I screwed up. ”
“Trust me, this is so minor compare to other things.”
“Really?”
“Trust me as you work in the ER you will know and you will look back to this and laugh.”
I was not laughing. I just kept thinking how I screwed up.

Later on that week was my actual graduation ceremony. The day I was graduating was such a rewarding time for me. But it was also a time of mixed emotions.
“So, dad are you and mom going to be at my graduation?” I had asked a month ago.
My dad shook his head. “I can’t I am busy.”
“Busy with what?”
“I am going to the racetrack that day for a big race. Sorry.”
“So a bunch of horses galloping around a track is more important than seeing your son cross the graduation stage?”
“I’ve been to your graduation before for your first degree.”
“You really don’t like what I am doing do you?|
My father ignored me and shrugged his shoulders. “All I want to know is what you are going to do after. Do you plan to stay as a nurse are you actually gonna do something better?”
I glared at my father. “I can’t believe this. My father does not want to go my graduation for a degree program that I worked my ass for because it makes him look like a fool in front of his friends.'”
“I am not gonna this discuss with you. ”
“WELL I AM!”
“Don’t you dare raise your voice at me! Have respect for your father!!!”
“Well have respect for me dad!! This is my graduation. Not every parent gets to see their child graduate. Not everyone graduates period. This should be a happy time for me and yet you are making it miserable.”
My dad grabbed his jacket as he headed out the door. “I have other plans. You’re mother is going. She will be there to support you.”
I stared at the half opened door as he started the car and drove off.

 
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Posted by on February 27, 2015 in Uncategorized

 

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Life of a Murse Episode 2: Nursing School (the beginning years)

nursing school

“Remember class, you have your assignment that is due next week, your midterm on Friday and your essay the follow week after that. And don’t forget that online assignment that is worth 15% of your mark due at midnight. No exceptions.”
This was your typical nursing class, but multiply this by four or five of your classes and clearly you had no life.
If anyone says to you that nursing school is easy or if you know any nursing students or nurses who said that nursing school was easy for them, let me be the first out of many people to say this to you:
THEY ARE LIARS.
Nursing school perhaps was one of my most intense programs I have taken but I will say that it was also the one that I was most focused on. From first year straight to your final year, your nights are filled with studying and doing assignments and writing essays, and preparing clinicals. The only thing I was spreading in my bed at nights were the pages of my Nursing Potter and Perry Medical Surgical textbook.
Yes it was that bad.
Perhaps my driving force was that I was paying for this all by myself without the financial assistance of my parents, especially my father who still thought of being a nurse was absurd. What he and others failed to understand was that nursing school was like being in the military. You were up early in the morning for either classes or clinicals, and were at home when it was dark. At times you had to help your fellow comrades who were sinking while you watched others die (well in this case fail or drop out the program) on their own accord. Nursing school also made me realize that were some people who were just not fit to be nurses and should be banned from even touching a blood pressure cuff. I use to call these lost poor souls “Grassclippings”. Why?
Because they literally had an IQ of a grassclipping.
My case in point exhibit A: One day in lab, we were practising on how to insert a foley urinary catheter on a mannequin female patient. One student (who thought she was Miss know-it-all) was eager to go first. As she laid out her equipment she failed to notice that the previous person who had used the mannequin had attached the genitalia upside down (don’t ask) so the anus was on top and the urethra and vagina were at the bottom (you’d think that a nursing student, particularly a FEMALE NURSING STUDENT would have noticed this.) She went on her way and when she tried to insert the foley catheter she immediately noticed it was not going in.
Her face reddened.
Myself and the other students (who were quite aware of what had occurred) decided we would just watch her as she made a fool out of herself.
The instructor stopped her. “Uhm, Jane. Ok, stop. Before we continue can you tell me what is wrong with the mannequin’s anatomy?”
Jane stared at it for a couple of seconds. “Nothing.”
“Are you sure?” The instructor said.
Jane paused before she nodded. “Yeah I think it’s fine.”
Inside my head I felt like pushing Jane across the room. Is Jane that blind of her own anatomy that she can’t tell that it’s upside down on the mannequin?
Frustrated, I put my hand up.
“Yes,” the instructor pointed at me.
“Maybe perhaps Jane is having problems because the anatomy is upside down?”
“BINGO!” the instructor said staring at Jane.
Jane still stood there with the catheter in her hand. “But this is suppose to go in the urethra and the urethra is ALWAYS in that area. ”
The instructor scratched her head. “Yes but honey, look at the anatomy. It is upside down. You need to turn the anatomy right side up.”
Jane shook her head. “Well that is dumb. Who would do that? That is so confusing.”
The instructor though trying to remain calm voiced her frustration which obviously came out insulting. “Well maybe perhaps you need to study your own anatomy first before you start playing with others.”
The other students laughed.
Jane still stood there high and mighty as if we were the idiots.
There were other sad pitiful stories that occurred from just pure stupidity throughout nursing school. One student proudly thought that UTI stood for “University of Toronto Institute” instead of urinary tract infection. One student proudly argued with her clinical instructor that Warfarin, an anticoagulant blood thinner was Tylenol (ironically I never saw her ever again after second year…gee go figure.) One student was so grossed out by the site of a patient’s rather large bowel movement that he threw up on the floor beside the patient’s bed and then try to shift the blame onto the patient when the nurse came in inquiring about the mess on the floor.
Then of course there was the infamous “The Wood” incident in one of my lab classes. There was one student who for the life of god could not comprehend the concept of why it was not a good idea to continue washing a gentleman’s penis while he was erect. Now I would understand that if she was younger and not sexually experienced, but this was a woman was married with two children.
Yes…another unfortunate grassclipping.
The instructor cleared her throat. “So, if that ever happens to you class, you simply stop what you are doing, cover him up and tell him you will be back later.”
“So why can’t you just keep washing him ?” asked the married mother of two nursing student.
I was standing beside my friend Melanie and we both gave each other a look.
“Is she for real?” she asked.
I lowered my head down shaking in shame.
The instructor attempted to answer her without insulting her. “Well honey, because that will get him more excited.”
“Oh okay, ” the mother said. “But can’t he just not get himself excited and tell you no? I mean I don’t get it, if he needs to be clean he needs to be clean. I don’t see why you can’t continue washing it. ”
I bit my tongue.
The instructor’s face got slight annoyed. “Honey, if you continue cleaning him you will end up with more of a mess.”
“How? he is getting clean. What more of a mess can he make?”
Melanie gave me the “Pray for her father Jesus” look. I was too busy giving the mother of two that “But you are married with two children?!! Are you that sheltered?!” look.
The instructor, running out of life lines, simply decided to ignore her.
It took a full 5 minutes before the mother of two said “OH I GET IT NOW” when were discussing on wound care dressings.
Jesus take the wheel.

I was in my room studying when my dad opened the door.
I shot him a look. “Yes?”
“Can I talk to you?”
“Go ahead.”
“Listen, I wanted to talk to you about your schooling.”
I rolled my eyes. “What?”
“I just wanted to know what your next path is going to be ? How long is this going to take you?”
“Dad you keep asking me the same questions and I keep giving you the same answers. It is not gonna change.”
My dad remained silent.
“Listen, I know what I am doing and quite frankly I like it. ”
“Is that right?”
“Yes, that is right. My god dad will stop being closed minded?”
My dad turned around shook his left as he went to the door. “I still think you should be a doctor. You are more smarter to be a nurse.” He closed the door.
I stared at my bedroom door with mixed emotions, the silence deafening my concentration.

——-Stay tuned for Episode 3: nursing school.. the final years—

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Posted by on February 17, 2015 in Uncategorized

 

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Being a New Graduate Nurse: The Feelings, Experiences and the Questions.

      You are a new graduate Registered Nurse starting out on your unit but let’s rewind six months ago when you went through some drastic changes that easily could have been a feature reality show on TLC or the Discovery channel: You’ve made it through your final year.  You pass your pre-grad, you graduate from your program, you walk across that podium and smile like you are constipated shaking the hands of the Dean Chancellor and everyone else on the faculty as you get that degree in your hand.  After celebrating that you are finally graduated, you go back studying like the world is going to end for that CRNE which seems to determine your fate no matter how you look at it.  You write the CRNE not remembering how you got to the examination centre, writing it or even remembering some of the questions but you keep on thinking what would happen if you did not pass the CRNE.  After six agonizing weeks of hell you get the best news of your life that you pass the CRNE so you are now an official Registered Nurse while at the same time landing a new graduate position in a hospital working as a nurse.

     So far so good right?

     But then reality hits.  You are now responsible for everything you do and I mean EVERYTHING.  You are now to trying to juggle what you learned in your four years of nursing plus squeezing in what your clinical teachers and what your pre-grad preceptor has taught you.  You try to remember the right ways that your lab and clinical teacher taught you but you find out that the department you work in does things a bit differently which sometimes causes your mind and thinking to do a summersault.  These are just a few things that as a new graduate nurse you are faced with and perhaps what many new grad nurses are faced with. When I got hired as a new graduate  in the emergency department I was like a child opening his first toy on Christmas morning.  I was happy, excited, contented, flabbergasted, the whole nine yards.  I mean come on, this is the ER we’re talking about right?     As with any job however, there are some challenges that you come across that over time you learn to overcome and adapt to.

      One of my obstacles I faced was prior to me being a new graduate, I worked in the ER as a clinical extern therefore creating job role conflict.  As a clinical extern, I was there to assist nurses and other staff members in the department with anything which included anywhere from helping changing a heavy patient to assisting in a code where I needed to help do chest compressions.  Being an extern was great because I was able to be everywhere and was always be able to jump in and help when the time needed.  Once I became a RN, the roles changed.  I had my own specific area, my own patient assignments therefore, I was only able to help out in my area.  I couldn’t just run off and help someone who needed help or I couldn’t simply stop what I was doing to go run off and do something; I had to prioritize. This was a challenge for some other staff in the department who forgot that I was now a RN and not a clinical extern and would sometimes grab me in the middle of the task and ask me to help them with something.  This leads to my second challenge, the responsibility.

      You now have complete responsibility on what you do which means that you have to triple check if not sometimes quadruple check your stuff to ensure that everything is done right.  I would not call this a challenge but it becomes a challenge when the amount of time used to triple check everything might work against you.  As a new graduate nurse, you will (and I still do) certain things slow because you are still learning.  The last thing you want to do is rush something fast to only find out later on that you made a mistake.  Though taking your time to do something is great, time as mentioned can work against you which leads me to another challenge that I personally face and continue to do so; time management.

     This is perhaps my biggest struggle that I have as a new graduate and likely a skill many other new graduates face.  It’s one thing when you have two or three patients or even four patients with your pre-grad instructor but when you are by yourself and have the responsibility of managing four patients in an environment where the turn over can potentially be fast (especially in the ER) it can be quite challenging.  I personally still find this a challenge for me because throughout my clinical experiences the time management skills I had and were taught throughout school were based on if I was on a floor or a unit.  When you are in a fast pace environment such as ER, you learn to adjust your time management skills to adapt to the fast pace environment.  For someone who is used to working at a constant speed and having time on their hand, this can be quite challenging (which I found out quite easily.)  Despite these challenges which I believe every new nurse will face, I will say that working in the ER has been a blessing. The staff here (and I mean entire staff from the physicians to the nurses to the unit clerks to the patient transport representatives to even the housekeeping staff)  all make the department a great place to work.

     So what advice do I have for upcoming new graduate nurses, pre-graduate students or current new graduates?  First, believe in yourself (I know I sound like a 3am Anthony Robbins self help infomercial) but seriously trusting yourself and having self confidence is key.  Everyone makes mistakes and if you don’t know the answer to something, ask.  As a number of fellow experienced nurses in my department have told me “a nurse who asks few questions are the ones that you want to be careful of instead of the ones who ask a lot of questions.”  Second, everyone has different learning patterns and ways on how you learn and do things.  It does not mean you are stupid, or dumb or slow, it just means you learn things differently.   This leads to my third advice, don’t feel discourage or better yet don’t let anyone make you feel discouraged.  I will admit I have these feelings while working as a new graduate and sometimes like a stubborn cold sore they tend to flare up again.  As a new graduate nurse it is very easy for you be discouraged.  You are working with other staff members who have more experience than you, you might have some nurses who give you that “you should know this by now” look, you sometimes feel nervous when talking to a doctor about a situation and don’t want to appear as a “newbie”, and sometimes even a patient might even question your ability because they can sense that you are fresh young and new.  As nurses, we are constantly learning everyday and our learning curve increases exponentially with our years of experience.  Try not to let someone’s words of discouragement get to you and if it does, focus on something positive.   A couple of weeks ago I was being attacked my own feelings of discouragement and began doubting myself as a good nurse.  Half way through my shift I heard two comments that made my day. “You did an awesome job today.” and “You were a really great nurse today, thanks for taking care of me.” Though for some that might mean a little pat on the back, for me it transformed and transcended my feelings of self doubt to encouragement.  You see, sometimes you worry over the biggest things when it’s the little things as a smile, and acknowledging someone that can make someone else’s day, and in turn yours.

      New graduate nurses should remember that we are now the upcoming new nurses for our health care.  We carry vast amount of knowledge as well as our new learnt experiences.  We are definitely not perfect ( no one is) but as we continue our new path and career we will be absorbing vast knowledge.   With time comes experience; don’t feel discouraged, mislead, and confused thinking that you are not a good nurse when you know deep down you are.  Remember a good nurse isn’t just a nurse who can just read off an ECG flawlessly, insert a Foley catheter with ease, predict an illness before the doctor can, insert an IV after the first try or able to have all their tasks and meds done ahead of schedule and have time to relax. A good nurse is also one that is able to make their patient smile, laugh and have that patient remember who you were and what you did for them, even it was something little like giving them a warm blanket or  asking them if their okay.

     Let’s now fast forward six months ahead.   You are no longer a “new graduate nurse.”  You are now a nurse working on your unit.  You are still learning new skills, tasks procedures but you now have learned to be confident.  More importantly, you push away your discouraging feelings and continue to believe that you are a good competent nurse that will provide the best care you can for your patient that day.  This is what passing that CRNE was for.  This is what graduating from your nursing program was for.  More importantly, this is what makes you stand out as a good nurse from others.  Don’t give up……give in.

Dwight Barrett RN. BSc. BscN. aka medsoulbrother

 
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Posted by on September 15, 2012 in Uncategorized

 

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