Bedpans and Learning: Nursing Basics Still Matter

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

Photo by Morrissey, via Flickr. Photo by Morrissey, via Flickr.

There I was, orienting to a busy medical ICU, perplexed over a bedpan. You’d think, since I was just graduating from nursing school, that bedpans would be my area of expertise. Critical thinking and vent strategies came easy; how could I possible admit I had no idea how to give a bedpan to a patient?

Frightening, to graduate from nursing school and a competitive externship program without this competency. Somehow, though, every unit I’d experienced offered patient care assistants, or patients who didn’t need this age-old tool. I’d certainly helped patients to the bathroom and cleaned incontinent ones. Despite the barrage of clinical learning, the basics of offering the pink plastic tool hadn’t sunk in.

Paralyzed, I stood with it in my hand, looking at my intubated, awake patient. I’d had the wherewithal to ask the family to step out, but couldn’t figure out which end went first. The horror of my preceptor finding it backwards would end me. Did the pointed end go towards the patient’s back? The larger end toward the feet for better coverage? Why couldn’t I remember?

Somehow, I managed to decide, […]

2016-11-21T13:02:43-05:00April 8th, 2015|career, narratives, Nursing, nursing perspective, patient engagement|7 Comments
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Patient Safety, Patient Advocacy: In Pediatric Nursing, A Tricky Balance

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

CT Scan ink and watercolor on paper 2014 by jparadisi CT Scan ink and watercolor on paper 2014 by jparadisi

I was precepting a new nurse. She’d earned a job in our PICU during her student clinical rotation. New grads weren’t routinely hired, but her competency led to her recruitment. Precepting her was a joy.

This particular shift, we were assigned one of those midafternoon admissions with the potential to keep us overtime: rule out meningitis. The preschool-aged patient had been brought to the ED after having a first-time seizure. When he reached the PICU, however, we were relieved that he presented more like a febrile seizure.

Besides a fever and runny nose, the only other remarkable characteristic about the child was his utterly charming personality. We drew his labs while starting an IV. An antibiotic infusion was started, and acetaminophen administered. Feeling better, and not the least postictal, he played with our stethoscopes.

This was many years ago. There were standards in place that accompanied certain diagnoses. ‘Rule out meningitis’ came with a CAT scan and lumbar puncture.

Both seemed excessive, given the child’s presentation, but there was the order for CAT scan. He sat upright in his crib singing, […]

2016-11-21T13:03:24-05:00December 3rd, 2014|career, Nursing, nursing perspective, Patients|3 Comments
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When the Preceptor’s Attitude Is a New Nurse’s Biggest Challenge

FirstPreceptorIllustrationHere’s the start of “My First Preceptor,” the Reflections essay in the March issue of AJN.

“Manage your day,” she told me, not for the first time, as if it had been my fault that one patient crashed yesterday just as my second one returned from surgery with a new set of orders. I could not be in two places at once, keeping track of two critical patients, making sure each one received the care she needed at the moment she needed it.

A new critical care nurse has a lot to worry about. It’s easy to feel overwhelmed, even when you’re actually doing a pretty good job. A preceptor can play a crucial role in helping a new nurse find her or his footing. As one might expect, however, some good nurses are not good preceptors. In this essay, the author describes her struggles to deal with the time pressures of her new job, along with her preceptor’s constant admonitions and disapproval.

This fraught nurse–preceptor relationship reaches a crisis point against a backdrop of life and death struggles. I won’t try to summarize what happens in the essay, since different readers may interpret it differently, depending on experience and temperament. But it’s definitely worth a read.—Jacob Molyneux, senior editor

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2016-11-21T13:05:14-05:00March 12th, 2014|career, nursing perspective|6 Comments
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Bed Bath: The First Day of the Rest of Her Life

BedBathIllustration“Bed Bath,” the January Reflections column by pediatric nurse practitioner Kathleen Hughes, is a description of giving a first bed bath as a nurse after many years working in other professions. It’s not the first essay we’ve ever published about giving a bed bath, but it’s wise and meditative and well worth a read. Here’s a small section of this short essay, but please read the whole thing.—Jacob Molyneux, senior editor

An Ivy League degree and 15 years of teaching and writing did not prepare me any better than my mostly 20-something counterparts in the ways of giving a bed bath to a 72-year-old man I’d never met. What might be different for me is that I have known many kinds of professional challenges. What might also be different is that I have lived enough longer to have attended my father’s hospital-bound illness and death, and to have given birth to and cared for two young children. And so when I washed this man, I was washing my father, I was washing my children; I became one of those people who cared for us. Though giving a bed bath is not anything like lecturing to AP students on Faulkner, or writing a newspaper article on gun control or university library funding or modern exorcisms, I am not sure that either of those tasks made me hunker in a corner for five minutes, gathering myself before striding into the room. I’ve […]

2016-11-21T13:05:41-05:00January 6th, 2014|career, nursing perspective|2 Comments
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Get the Job Done

By Marcy Phipps, RN, a regular contributor to this blog. Her essay “The Love Song of Frank” was published in the May (2012) issue of AJN.

Dietetics class for nurses, 1918/Cornell University Library/via Flickr Nursing students, 1918/Cornell University Library/via Flickr

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.” […]

2016-11-29T13:33:01-05:00July 8th, 2013|nursing perspective, nursing stories|3 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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