Thoughts on Finishing Med Surg 1

I was supposed to hate it.  It was the “bad” bimester this semester, and I was glad I was getting it over with first before the fun of Peds/OB.  Except as we stood around our post-conference room last week officially All Done with Med Surg 1 clinicals, where I should have felt joy, my heart hurt!

(This is not to say that there weren’t some bad times.  The seven hours I spent cleaning a constant flow of diarrhea out of a rectal wound will be with me to my dying day.)

Our lead instructor showed us this video on our first day of class.  It sums up so beautifully how we all felt 95% of the time.  The way he looks up hopefully with his finger over the various buttons?  SO TRUE.  (If you are a nursing student you have to watch it.)  And yet…

We learned so. much.  Every day you would go into clinicals and inevitably something would happen and you would think “Oh my gosh!  I know this!  I remember that lecture slide/textbook page/test question!”  We got to put in IVs and give a lot of shots (lovenox, anyone?) and place catheters and hang IVs.  My first IV start was a success, so I considered retiring to keep my record clean.  Sadly the instructors did not agree with my perfectly reasonable retirement plan and I went on to ruin my beautiful 100% batting average.  I also managed to poke myself with a (clean) insulin needle, and dropped pills on the floor not once but twice.  I answered questions correctly, and I answered questions with the blank look of someone who doesn’t even understand the language.  I worked with amazing floor nurses who inspired me, awesome floor nurses who were fantastic at challenging and teaching me, and the occasional floor nurse who was most interested in putting me in my place and making me feel like an idiot.  My advice for dealing with those types of nurses is to pretend you are Po from Kung Fu Panda.  Their hatred and condescension go right over your head.  You are just a fat happy panda who loves everyone.  (And you may also be the Dragon Warrior.  That helps things slide right off.)

We changed so. much. We gained confidence, and I know my own comfort level with grossness expanded at the rate of the Grinch’s heart on Christmas morning.  Remember my first day with a cadaver in A&P when I was silently screaming the whole time?  Fast forward to my OR day toward the end of our clinical experience.  I saw brain surgery and when they put up the magnified image on the giant computer screen my first thought was “huh–looks exactly like trying to pick out crab meat.”  (We spent a lot of time with preserved brains in A&P, but it was really different seeing living tissue.  Did you know that your brain visibly pulsates?  You don’t even need to look at the monitors to know what the person’s heart rate is–you can count it just by looking at their brain!)  My next surgery was a total laryngectomy.  When I walked in they were just removing a 3″ segment from the patient’s neck.  The surgeons were covered in blood splatters and the patient was split from ear to ear.  My first thought was “This is a scene from a horror movie.”  My next thought was “Something important inside me is clearly dead now, because I am having no emotional response to this business.”  Whatever nursing school is supposed to do to a person, it’s clearly done its job.  I knew something had shifted when a fellow student was telling our clinical instructor that she hadn’t completed something because her patient had gone down to surgery to have his toes amputated.  “Did you get to go?!” I asked, all excited.  (“GET” to go?!!!!  Excited?!?!?!)  “No,” she said.  “Awwwww,” I said.  MY RESPONSE TO NOT SEEING TOES CUT OFF WAS A DISAPPOINTED NOISE.  I don’t even recognize the things coming out of my mouth anymore.

This was my bimester of logistical insanity.  I showed up to Monday morning’s four hours of testing and lecture having just got off a full 12 hour overnight shift.  My week went Wednesday, Thursday, Friday clinicals from 2-10:30pm, Saturday and Sunday work 7:00pm-7:30am, Monday and Tuesday lecture 8:30am-12:30pm.  The closest thing I had to a weekend was my Tuesday afternoon/Wednesday morning break.  If my bimester was made into a montage (set to Eye of the Tiger of course)  it would be various of clips of me changing in my car/bathrooms from clothes to scrubs or from one color of scrubs to the other, looking at pocket flash cards in elevators and stop lights, and falling asleep in public places.  After one Monday test, I realized I had 15 minutes to spare before lecture started.  I considered going into the lobby like everyone else, but realized the testing room was gloriously quiet.  I fell asleep so deeply I drooled on my hand.  In 15 minutes.  Monday mornings were brutal.  But I got through them and the kids got through them, and Nic got through them, and I got my A.  Which is to say, don’t let people tell you you can’t do crazy things if you’re pretty sure that you can.

In short:  Med Surg.  Don’t dread it.  It’s a huge learning opportunity and you will inevitably find it far more interesting than you ever imagined.  I came out of our cardiac week LOVING the material and hanging on the instructor’s every word.  Who knew I’d be such a cardiac junkie?  If you end up loving something that’s a little weird, be sure to let everyone know.  During our out-rotations we do not provide total patient care, we just shadow a nurse (out-rotations being single days in the OR, ER, and Cardiovascular Unit).  My nurse in the Cardiovascular Unit ditched me in telemetry for an hour so she could get some stuff done and I LOVED IT.  It was the fastest hour of clinicals.  I raved about it so much that my instructor got me an additional three hours in telemetry on a different day.  (We had the best clinical instructors.  Seriously.  I feel so lucky to have learned from them.  Leaving them feels a lot like being left in a box on an orphanage stoop.  It’s really lonely and cold and scary out here.)  Take on extra challenges if you can.  I was starting to get bored on my week on the rehab floor, and so I took on a third patient.  It made the day go much faster and helped me to work on my organizational flow.  It really is the place to push yourself and learn as much as you can in relative safety.

Next up, Peds/OB!  I’m going to confess to being a little nervous about this one.  We had been really excited about it until we noticed that the Peds/OB group always looks like they wouldn’t mind if a meteor ended the world at this very minute.  I think it might be low on patient care and high on busywork paperwork.  Oh well, it will be over before I know it!