Student Nurse Residency – Journal 1

(June 11, 2012)

Let me start off by saying that I don’t think I can ever go back to working with adults ever again. Pediatrics has won my heart. I’ve always known it’s where I wanted to be, but the past few weeks have reassured that for me.

I’ve seen a lot of different diseases, and I feel like I’m constantly learning. I’ve had patients with bowel obstruction, a 4 year old being diagnosed with DM 1 for the first time, a 3 year old with pneumothorax (hx of congenital cystic lung disease), an 18 year old with spina bifida, multiple patients with Sickle Cell, and of course Heme/Onc. I know it’s not required, but I try to make care plans for some of my patients. I feel like this is how I learn more about the pathophysiology of their diseases, the clinical manifestation of what brought them in, and the indications and side effects of their medications.

Clinically, I think I’m where I’m expected to be. My preceptor has commented on how well I manage my time. I think I can give credit to my experience in Med-Surg. I used to work in a very busy floor, and I think it has trained me well to stay on top of things. This includes timely documentation, being mindful of my schedule, and being able to prioritize when things get hectic.

Building rapport with my patients and their families is also a strong point I have. It’s very important to me that I make their stay a positive experience (or at least as positive as it can be). I’m very mindful of the fact that these patients and their families are going through tough times that puts stress on them, their families back home, their jobs, etc. I want to make sure that I can help in any way I can, even if it means just listening to them.

One thing that I have been working on is trying to not be too soft. I guess I’m still getting used to the fact that I am working with young people, and sometimes when they cry, I start to hesitate to do things. I still have to ask help from my preceptor to take IV’s out of some patients. I’m starting to learn that I’m most likely not hurting them – they’re probably just scared and freaking out that someone is touching their IV site. And even if a procedure involves some pain, I have to keep reminding myself that it’s for their benefit. I have to keep in mind the big picture. It’s not exactly that I feel bad that I’m hurting them. I think my problem is the crying. When I hear them cry, my first instinct is to make them stop, which means I should stop what I’m doing. Sometimes, I just have to hold them down and do my thing.

My preceptor is always asking me to explain things to her (Why are we giving this med? What steps should we take now that out heme/onc patient has a fever? What are the steps to give blood? How is this diagnosis related to his PMH?) I actually really, really like this method. It’s scary, yes. But being drilled like that is how I learn best. When I don’t know something, she just tells me to look it up and get back to her. This way, it’s not intimidating or embarrassing if I don’t know the answer, which happens quite a lot. But it’s the best way to learn.

I used to dread going to work. It wasn’t something I looked forward to. I would actually be so scared and anxious because I know that it will be overwhelming and stressful. But these past few weeks have been really, really good. I am learning so much. I am not overwhelmed or stressful, or feel like I don’t want to get up to show up to work. I’m actually excited to go to work. When I have free time, I say hi to patients I‘ve had in the past. I know that’s something that makes them happy, but it also makes me happy. I think it’s more therapeutic for me to talk and goof around with my patients than it is for them. I guess it helps me get me through a 12 hour shift. I feel like after 15 minutes of me blowing bubbles with a 3 year old (pneumothorax), I get a second wind, and I leave his room a happier person. Or holding a 13 month old when I have time reminds me why I want to keep doing this. I honestly love it, simple as that.