Clinical Woes

This  morning, I entered the clinical unit confidently, listened to report, alerted my nurse that I would be providing care for one of his patients, and jaunted off to introduce myself to my patient….The day went quickly South from there.

My guy was 70 years old with about a hundred tattoos. He had returned to the floor after an I&D for a pretty stinky incision that didn’t do well after his cervical spine surgery. He was a pleasant guy and we got on just fine. I held his hand as he got his PICC placed and when they ended up having to retract it. I provided all the AM care and got his meds ready and everything was ok until I had to hang a bag of vanco. Now, I’ve had that Alaris training and have even hung a few bags before but it seemed that over my recent Yule break I had lost whatever minor skill I possessed with the stupid machine and fumbled my way through the entire process, with my clinical instructor standing behind me very patiently indeed and calmly walking me through the bits I was screwing up. First, I didn’t spike the bag fast enough and there were tons of air bubbles all through the line. Then the damn dolphin (an electronic, supposedly time saving, safer way of documenting meds, which hardly ever works properly, even after you wait for it to boot up—can you feel the love?) wouldn’t register the med and I pressed the little buttons until my instructor took pity on me and punched the right one for me. I breathed a sigh of relief and resolved not to let it bring me down. A few hours later, my patient’s pump started screeching. Air in the line (silence…restart), occluded something or other (straighten patient’s arm, silence, restart), BIG BUBBLE over an inch long followed by two more…YIKES (clamp line and yammer incoherently to my nurse until he followed me into the patient’s room to see what I was on about)…and so on. Then I tried to empty a wound vac that was not designed to be emptied and to ice the clinical cake I forgot how to chart a couple of things. When is it that you lose the inept feeling and really start to get it?! At the end of every semester I’m bored and certain that NOW I’ve gotten confident enough that even in my mistakes I will gracefully and calmly ask for help and not repeat retarded moves from previous terms….and at the start of every semester, I feel…well…retarded!

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