The list

I've never been much of a list maker.  My life has been more of a "fly by the seat of your pants" experience, and I'm beginning to realize that if I'm going to make a good nurse, some change may be required on my part.

I'm building a list. The list consists of mistakes I've made in lab class and involve the dummies (lifelike mannikins) we use for training.  It is my wholehearted wish that I do not make these same mistakes when I am allowed to reposition, catheterize, drive needles into or provide bedpans for real people.

Today we were tested on our ability to administer medications - both the oral and inject-able kind.   You'd think that giving the oral kind would be pretty much pop one out of the bottle and hand it to the patient, but instead it is an incredibly complex process including things like checking for contraindications, cross checking the medication with the patient's medication administration record at least three times, educating the patient regarding what the drug does and knowing when, as the nurse, to wear gloves, wash hands, or call the doctor.  Medications to be injected include the same activities, however, they are further complicated by choosing needle and syringe size, figuring out which anatomical site to jab, and learning all the tricks by which nurses avoid needle sticks (and therefore avoid bloodborne diseases nobody wants).  The next time you get a flu shot, look at the person who is about to skewer you and realize that he or she is using about 7,000 snippets of information in order to administer that vaccine.

I got through most of my skill checkoff today and felt pretty good about things.  As a matter of fact, I was taking a last look at my plastic patient when I realized in horror that even though I had carried my new stethoscope into the room with me just in case my instructor wanted me to administer a particular heart medication, I had failed to use it.  I was not supposed to administer the medication if the patient's heart rate was less than 60 beats per minute and I had absolutely no earthly idea if that was the case because I had skipped that crucial step.  My eyes grew wide and I gasped while I advised my instructor that I had made a terrible mistake.  She already knew it, of course.  I said, "Is there an antidote?".  Very stupid question.  This patient is in no danger from this drug because she is plastic and therefore unable to swallow the pill in the first place.  I felt awful. 

My instructor passed me on the skill because I realized my mistake before leaving the patient's bedside, but she cautioned me to pay closer attention.  I left the college and drove to a grocery store where for the first time in my life I bought one of those gizmos they advertise on late night tv: some kind of magical chopper thing.  I felt as though I had failed the exercise, even though I had passed, and retail therapy usually works for me.

I still feel like crying.  If that had been a real patient I could have caused her complications.  This nursing thing is serious, serious business and tonight a tiny part of me is questioning whether or not I have what it takes.

One more for the list.  And tomorrow is another day.