I remember being a new nurse and having an order to place a Foley catheter in a female patient.
I was filled with dread. Urinary catheter placement was the only skill I’d failed in nursing school (I’d contaminated my sterile field), and placing a catheter in this patient was sure to be a challenge, as she was obese and unable to cooperate. It was not a one-person job, even for a far more experienced nurse.
When I asked a coworker for help, she sighed and said, “I don’t have time. This isn’t nursing school, you know. You just do the best you can and get the job done.”
Oddly, as clearly as I remember the situation and the nurse’s response, I don’t recall the outcome of the task—only my feelings of incompetence and the impression of a complete lack of support. I can only hope that my patient didn’t suffer any consequences of my inexperience, because I’m sure I did what my coworker advised—there’s no doubt I got the job done.
I precept new nurses frequently, and sometimes I hear the echo of that long ago nurse’s response in my mind. Just last week, as I gathered supplies and prepared to place a nasogastric tube in a patient, I asked the student nurse I was working with if she’d placed an NG tube before.
“Only in skills lab,” she said.
I remember well the wooden model we used in nursing school to practice placing NG tubes and the ease with which the tubing slid along the hard tunnel and into the stomach of the faceless form. And I remember, as well, how unprepared I was to perform that skill in reality.
We were rushed; our patient was quite sick, and there were many things to do and little time left in our shift.
“This isn’t nursing school,” I wanted to say. In that moment, I wanted proficiency and efficiency; I didn’t want to teach.
But I bit my tongue, saying instead, “Okay, it’s going to feel like this, and then like this,” describing the angles she’d encounter during insertion, trying to break down the sensory and motor aspects that have become automatic to me.
And we got the job done—or rather, she did.