Wednesday, July 23, 2008

Humor in the Process

Some topics make people really uncomfortable.
The very first clinical day, I mean the FIRST Tuesday of skills practice, one of our instructors did a mock interview and included these words: "Fist Fucking. Depending on where you work, you're going to have to ask questions about things like this, things that make you uncomfortable. Don't shy away. Is that clear?"
The class, half in shock and half in awe, nodded quietly.
Oh yeah. Crystal.

This week's topic wasn't about fisting, but it was about "nutrition and elimination."
I think people forget just how much they lose control of their body when they're really sick, or maybe they just ignore their daily functions, especially those that are a little more private.
But nurses? Nurses cut right to the chase. "Did you have a bowel movement today? If so, how big? What was the consistency? Color?"
A lot of people would run screaming from the very thought of having this conversation.
Nurses have to dive right in, and there's no pussyfooting around it.
We measure pee. We look at poop. We clean up poop.
And we insert catheters. Oooof.
If you've ever had a catheter, you know that you want someone who has some idea of what he or she is doing. It's not pleasant. But guess what? We are about to practice on our unassuming patients (under supervision, of course).
We are also now able to, ahem, administer enemas and do digital extraction.
If you don't know what that is, use your imagination.

There are some things that river guiding actually DID prep me for- there's a saying among guides, "All we ever talk about is boating, sex, and poop."
Oh yeah, and alcohol.
But seriously, having to discuss the groover, asking people on LONG multiday trips if they've used it (a HUGE issue, I assure you), has allowed me to be a little less afraid of this, um, new frontier.

The practice catheterization was hilarious. Imagine walking into a room with a bunch of fake "show-ers-not-growers" mounted on white plastic boards with fake bladders, all set out on a table, next to about 10 other vulva models mounted similarly... and that was Tuesday morning.
I've posted some photos just to let you all know that you, YES you, can be doing the same thing.
Nobody kept a straight face, but it was seriously rewarding when your Foley actually made it into the model bladder. Hope you can see what's up.

We also did NG/FT insertions (naso-gastric and feeding tube), which weren't too troublesome, although on a live person who might puke on you, I'd imagine it's a bit tougher.

This week, we're responsible for total patient care for three patients, including monitoring InO (Ins and Outs - anything that goes in, and anything that comes out).
Soon we'll focus to one, total care, including meds, IV, etc except for narcotics.

And it's only Week 5. Oh yeah, we're about halfway...

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