Topic: School

Topic: School

I’ve had a lot of schooling. I got my bachelor’s in English in 1989, my associates in nursing in 1995, and my master’s degree in health administration in 2001. But it was my year and half of LPN school that probably taught me the most. 

I decided to leave being an English teacher and start nursing school in 1990.  The quickest path to transitioning to a career in healthcare was to become a Licensed Practical Nurse first.  As a nursing student I saw, smelled, and experienced things that I still can’t forget.  The memory of the first time I saw a pressure sore on the backside of a 90 year old patient, the kind that you can put your fist in, is with me to this day.  It was in LPN school that I first saw somebody die, watched open heart surgery, and got comfortable doing things I never thought I could do— things like giving an enema, cleaning and replacing a glass eye, giving injections, starting IV’s, taking out stitches, inserting urinary catheters, and doing dressing changes.  

My most memorable patient in LPN school was a 24 year old mom named Tracy.  She had been hospitalized for 6 weeks following a motorcycle accident and had her leg in traction.  When we did our medical surgical rotation it was unusual to have the same patient two weeks in a row.  During my first week with Tracy I became proficient at “pin care”, which involved using sterile q-tips dipped in saline and pushing gently around the metal pin going through Tracy’s leg.  Our instructor used the analogy of having newly pierced ears.  If you don’t clean and move the studs going through your ears, the skin will start to adhere to the earring post.  It was the same thing with Tracy’s pin going through her leg.  Actually it was more like a rod than a pin, and I as I did her pin care I stepped outside my body and watched myself in disbelief.  I said silently, “I can’t believe I’m doing this.  I can’t believe this is my job now.  I never thought I would be able to do something like this.”  

The next week Tracy was scheduled to be discharged.  One of her discharge orders was to have her catheter discontinued.  I had removed catheters a few times before.  It wasn’t a big deal.  You had to insert a syringe into a port in the tubing and remove the saline from the balloon inside the bladder that was keeping the catheter in place.  In fact, it was such a routine procedure that my instructor wasn’t in the room with me.  I had been checked off it by that time.  

After two months Tracy was anxious to have her catheter out and gone.  I followed all the steps in my mind, but when I got to the part where I was supposed to pull out the catheter I felt resistance.  I double checked the size of the balloon.  I made sure I had removed the right amount of saline.  I gave a gentle tug on the catheter again.  It was supposed to slide out.  That’s what had happened when I had done this before.  But it wouldn’t budge.  Tracy cried out in pain, and I stopped.  She urged me to just pull the damn thing out.   One of the hospital nursing assistants ran in because she had heard Tracy cry out.  When the nursing assistant saw what was going in she handed me some bandage scissors and said, “Why don’t you just cut the catheter and pull it out? That’s what the real nurses do.” Tracy agreed.  I told them I needed to find my instructor.  As I left I heard the NA and Tracy question the competence of “student nurses”.  

My instructor got the charge nurse who assessed Tracy and called the doctor.  They took Tracy down to surgery and a urologist ended up surgically removing the catheter.  Somehow it had adhered to the inside of her urethra.  My instructor used the whole thing as a teachable moment.  She pointed out to the class that if I hadn’t followed my instincts and stopped the procedure, I could have seriously injured the patient.  I still have nightmares about what could have happened.  

I learned in LPN school to trust myself and to listen to that still small voice inside.  I learned not to give in to peer pressure and that if something didn’t seem right, it was a good idea to stop and think it through.  

I never saw Tracy again.  She had been discharged when we came back the next week, but the charge nurse told me that she had said to tell me thanks for being her nurse.