First Clinical Experience Of Nursing Student In Clinical Setting

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On my first clinical day, I was assigned to a nurse due to the lack of tech assistants for everyone to be assigned to. Nevertheless, I found myself passed back and forth between both my nurse and another tech assistant, which allowed me to see things from a nurse’s perspective and still get to do hands-on tasks the techs do. I was helping the tech take vitals for a patient who suffered from sickle cell anemia. She appeared exhausted, low in energy, and unable to speak up most of the time I was in the room. The tech gave me the chance to take vitals by myself under her watch so I could have the independent learning experience and practice. After applying the blood pressure cuff and pulse oximeter, I had to place the thermometer under the patient’s tongue, which I had been having a hard time doing properly that day. With that said, I was also having a hard time getting a reading with the temperature under this patient’s tongue as well. After two tries, the tech assistant took the thermometer from my hands and decided to take the patient’s temperature under her armpit using the axillary route. This went on for three times, with the tech sticking the thermometer in the patient’s armpit, telling her not to move her arm or even lift it for the thermometer to be inserted easier. The patient verbally expressed her pain and discomfort with each attempt, and did not appear happy with the tech. After the final and successful attempt at getting a temperature reading, I removed all the equipment from the patient as the tech left the room. I stayed behind to check on the patient and asked if she needed anything before I left, fixing her blankets, warming her food, and making sure she was alright before I moved on to the next room. I got her an extra blanket, assisted her with her breakfast, and closed the door as she requested before I left.

What struck me were the actions of the tech who tried to take the patient’s temperature using the axillary route. I mentioned the tech stuck the thermometer in the patient’s armpit; not under but in it. This happened because the tech didn’t want the patient to lift her arm, for reasons I do not know, even though the patient was willing to lift up her arm for easier access, which she did. I felt uncomfortable watching the patient wince and verbally express her pain as the tech kept sticking the thermometer in her armpit. It seemed as though the tech just wanted to take the vitals quickly and move on, without taking the time and care to make sure the patient wasn’t in pain. I wasn’t happy seeing the harsh actions in front of me, but I tried to reassure the patient as best as I could with a smile. I kept trying to convey my support and sympathy to her with my eyes and a part of me feels as though the patient understood. While this wasn’t a case of a tech verbally abusing a patient or throwing a patient around, even the sight of the harsh poking didn’t sit right with me. It was something, I felt, could’ve easily been done differently had the tech taken the time to stop and remember the patient was already in pain, before inflicting more pain even if it wasn’t her intention to. But even then, the tech had no excuse for what she did.

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During that time, I only thought of one thing to do to help the patient and that was to speak up. To speak up to the tech and inform her that her actions were hurting the patient. To speak up and tell someone above the tech assistant. I say this because, in my position as a student and a future nurse, speaking up on behalf of the patient is crucial and one of the most important things I can do as the patient’s advocate, especially if the patients can’t speak up for themselves. Speaking up and offering helpful guidance to a fellow member of the team helps improve team unity and will promote the patient’s health and recovery. It’s worth nothing this is different from speaking up and bluntly telling the other person that what they’re doing is wrong and they’re terrible for doing it and whatnot. Had I spoken up to the tech, I feel the patient wouldn’t have experienced the discomfort she felt. She was already suffering from a disease that made her feel weak and fatigued. The last thing she needed was to have her temperature taken, only for it to feel as though she was being stabbed in the process. I also think, had I spoken up, the tech would’ve realized the negative effects of her actions and taken the temperature reading more gently and carefully. In the end, I felt I could only do the best I could with what I knew, and given my slight nervousness that day, I wanted to listen and learn and provide whatever comfort I could for the patients, even if it was just a smile. I still have lingering regret for not doing more for the patient, but nurses can only do so much within their scope without overstepping bounds. Because of it, nurses often find themselves “stretched” when it comes to responding to the “weaknesses and wrongdoings of others” (Sato, 2017). This brings me to my next section.

This incident opened my eyes to the possible mistreatment and abuse of patients I’ll witness in the future, no matter how near or far it may be. It showed me possible actions I could take in order to help the patient who’s being harmed. These things, albeit disappointing and shouldn’t happening in a place of healthcare and recovery, do happen and any preventative measures should be taken to ensure the welfare and safety of the patient. It doesn’t start after I graduate and get job; it starts here in Junior 1 of nursing school. My experiences, actions, and choices here will influence how I react in the future when I’m put into a similar situation. It was an incident that will help prepare me to protect patients in the future. While I’m disappointed I didn’t do more for the patient outside of aftercare following the taking of vitals, I saw myself doing my best to take care of the patient calmly and gently with understanding and awareness of their painful situation. As for others, I felt the need to be more cautious of what they do and just how easily patients can be mistreated, even by the nicest people, like the tech in the example. She was wonderful and kind in teaching me, but this one incident still sticks in my head and sheds a negative light on her. But at the same time, I don’t want to be too cautious. I want to, instead, be more aware and offer guidance so the other person won’t repeat the same actions that could hurt someone else.

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