By Martina Harris, EdD, RN, a UC Foundation assistant professor at the University of Tennessee at Chattanooga School of Nursing
It was 6 am and I was on my way to make patient assignments for my first semester nursing students. Inside the long term-care facility, the hallways were quiet, the majority of patients still in bed. I made my way to the second floor to begin identifying and assigning patients for my fundamental nursing students. Standing at the nurse’s station, my focus was on finding patients who would provide students varied opportunities to reinforce the basic skills they’d been learning at campus lab.
The charge nurse approached me and asked if I would be willing to assign a student to Mr. Hugh, an 84-year-old who was proving to be very “complicated.” Assuming that “complicated” meant that his care required lots of psychomotor tasks, I agreed to her request. She then explained that this patient had been using his call light frequently, but that each time the staff responded, he only wanted someone to sit and visit with him. Though this didn’t seem an ideal opportunity for a student to practice basic nursing skills, I felt the gracious thing to do was to take the assignment.
In the hallway, my group of fundamental nursing students huddled together, dressed in their white uniforms and nervously awaiting the start of their first clinical day. One by one, I went down the list, assigning individual students to particular patients and explaining to each what additional tasks needed to be done for their patient on top of taking vital signs and changing linen.
I decided to assign Mr. Hugh to James, the only male student in this rotation. I told him that there were not a lot of “interesting” skills to practice on this assignment, so he could basically just “hang out” with the patient.
After assignments had been made, I began working with individual students as they administered oral medications, performed subcutaneous injections, and assisted with dressing changes. After a couple of hours, I poked my head in the door to check on Mr. Hugh and James. They were engaged in conversation. “Are you doing okay?” I asked James, to which he emphatically replied that they were “fine.”
I was amazed that James had been in the room for two hours and not complained. When it was time for follow-up conferencing, I began with James, apologizing to him that he had to be stuck in that patient’s room the entire time, without a chance to practice any of the psychomotor skills learned in campus lab.
“No need to apologize,” said James. “I should thank you for this assignment. This was an amazing clinical experience.” He began to describe how the patient had told him all about his life, his world travels, and his time in the military. He’d heard stories about the patient’s beautiful wife of 50 years, who had recently died, and how much Mr. Hugh missed her. He said the patient told him he reminded him of his own son, the one he didn’t get to see as often as he would like. James told me that having a chance to listen to and “swap stories” with this patient had been very rewarding, far exceeding his expectations.
It was at this moment that I realized James was well on his way to becoming a nurse in the truest sense. He’d been able to see the patient holistically, while I’d focused on ensuring the student could perform tasks.
I felt humbled by this experience and determined I’d learn from it. The following week, I returned to the same long-term care facility, expecting to assign that same patient to a different student. This time, I eagerly approached the charge nurse to request a list of potential patients and to let her know I’d love to have a student work with Mr. Hugh. She looked at me with pained eyes and said, “I thought you knew. He died later that evening after your student left.”
I’ve never forgotten that clinical day with Mr. Hugh and James. I often wonder what Mr. Hugh was thinking when he was sitting and talking with James, and if Mr. Hugh in fact knew that he, too, was “well on his way.”