Being a student nurse: My first day of placement

15 Sep 2011 6 Comments

by littlenursey in Being a student nurse, Experiences, Placements Tags: dying, first day, hospital, hospital ward, nurse, nurse placement, nurses, nursing, nursing student, pain, stroke, student nurse

The first ward I ever trained on was an acute stroke ward. I had never, ever looked after patients before, so had never dealt with someone else’s bodily fluids, bathed them, helped them eat… you get the picture. The only things I had ever done that were even close to seeing people naked or caring for them were when I had seen women topless as a bra fitter at Mothercare, helped my grandmother get out of my car or cared for my friends when they were really drunk and vomiting. Yes I really did want to be a nurse. It didn’t matter that I had never cared for patients before.

My first shift was on a Monday morning at 7.15am. I arrived at the door on time and pressed the buzzer. I had visited the ward before to look around and meet my mentor, who wasn’t in on my first day. A friendly looking nurse answered the door and welcomed me in, introducing herself as my associate mentor, who I will rename Louise for confidentiality reasons. She was expecting me so knew who I was. The first thing I noticed was that, of course, the ward was still quite dark with the curtains drawn and the only light was coming from the table lamp on the nursing station. The patients were still sleeping so Louise and I had to whisper. The second thing I noticed was that there was a woman screaming at the other end of the ward.

I had literally only had my feet through the door for one minute before Louise said to me “Now I’m really sorry to have to do this to you on your first day Sarah, but the rest of the nurses are in handover in another room and I really need your help with a patient, would you mind giving me a hand with her?”

Before I could even think about it I had agreed to help, and I was quickly ushered along to the nursing station where I shoved my bag and coat under the desk. I was closer to the screaming patient, who was behind a curtain with her bed lamp on. She was making a lot of noise and I understood that she was in agony. I really wanted to help.

Louise explained quickly that the patient had opened her bowels and we needed to freshen her up. She was also in a huge amount of pain and was dying. I remember feeling my heart pounding as I listened to the patient screaming. I was so nervous.
The next thing I knew I was being handed a disposable pinny and gloves and was following Louise behind the patients curtain. Now, I had worn a pinny and gloves before at university in the simulated practice labs, and had practiced the act of changing bed sheets while a student was lay on them, but I had never wiped a patient’s bottom before or even knew what equipment they used.

Once behind the curtain I could finally see the patient who was a very old, frail looking woman. While I was thinking to myself ‘ohhhh myyyy godddd what am I doing’ Louise began talking me through the procedure. It was a good job she was so nice! She had already prepared everything we needed for the procedure such as wet wipes, towels and fresh sheets. We talked the patient through what we were doing as we used the standard procedure (university taught me how to perform manual handling) to roll the patient onto her side. This was difficult as she was screaming all the way through, and after a gentle struggle she told us that she could only roll onto one side. She rolled onto her right. I was stood on her left which meant I needed to do the wiping, which as I said earlier, I had never done before.
An instinct took over me, one which made me forget that what I was doing was considered ‘disgusting’ to most, and also gave me the urge to help this poor lady instead. I got on with it and made sure I was very thorough for the sake of her hygiene and comfort. Louise held the patients hand throughout and comforted her. We changed her sheets after freshening her up.
I noticed as soon as I saw this patient that her arms and hands were very swollen with fluid, to the point where a finger-poke would make her skin ripple a little.  After returning the patient to her back and making up her top sheets, I noticed that the bottom sheet looked wet with water. Confused, I pointed this out to Louise. I thought the patient had urinated after we had replaced the bottom sheet, but it turned out that I had managed to burst the skin on her left arm and the fluid had leaked out onto the sheets!

I was horrified and felt so guilty, and Louise could see it in my face. She immediately began trying to reassure me that it was unfortunately likely to happen. I felt our patient grab my arm. I looked at the patient and I remember being drawn into her eyes. She looked so sad, and with a very sincere look on her face she said “Please, just kill me. I want to die.”
This really shook me but at the same time I felt like I knew what to say. I held her hand for a few seconds, finished making her top sheets to keep her warm and told her that we would do everything we could to make her comfortable and that we would let her rest. She told me that she was in agony and that she just wanted the pain to end. I remember smoothing her hair back from her face and she lay back on her pillow to rest. Soon after, Louise gave the patient a strong analgesic which was very effective. She died after I had finished my shift.

That experience may sound traumatic but I don’t have any bad feelings toward it. I was thrown into the deep end a little, but it was what I needed and was definitely worth it. Louise agreed that I handled it well and was very grateful. My first day was unforgettable – in fact that whole placement was unforgettable. The staff were so friendly and always willing to teach me, and I definitely learned a lot.

An acute stroke ward is quite a difficult ward to train on as a first timer, as it requires a LOT of lifting patients, dealing with patients who are unconscious or paralysed, a lot of incontinence, learning to communicate with patients who have lost the ability to speak normally or at all, assisting some patients with the difficult task of eating and drinking and getting used to medicating patients who can no longer swallow at all. Thinking back now, I can’t believe how much I was exposed to so fast, and I’m very pleased with that fact. My passion for nursing is increasing everyday and I feel that my first placement has a lot to be thanked for.

Good luck with your first placement when it comes around! I hope yours is as interesting and rewarding as mine