Thank God It's Friday

Today was my last day in the oncology and haematology ward and it was a very emotional day for me. I had a new nurse buddy (fifth one in five days) and she was really really nice - a very good teacher and challenged me to do things as independently as possible and explain the rationale behind all my procedures and clinical decisions, but she wasn't mean when I didn't know something or if I wasn't confident and asked for her assistance or checking. She also encouraged me a lot and told me I was doing really well and we shared the same philosophy about nursing that I talked about in my previous post. She was also a grad nurse. Each nurse I have worked alongside is so different in their bedside manner, the way they do procedures, the way they teach, the way they write notes in the file. It can be confusing and frustrating. But I was grateful to have her with me today and my clinical teacher was very supportive in making sure I was not buddied up with yesterday's nurse. I got the same room with the same patients though.

The difficult parts of today were firstly one of my patients I've been looking after deteriorated a lot overnight. She has end stage cancer of the colon, liver and kidneys. Although she's only in her sixties she looks very very old, is bald, very skinny but with a very very inflated abdomen, like someone who is about to have a baby. When she lies in bed with no movement she says she's comfortable but as soon as she has to move for anything it's very painful and difficult. It's the first time I've seen someone in that condition in real life. Although I was able to have a nice conversation with her a couple of days ago, this morning it was hard to wake her up. When I took her to the toilet I asked her if she wanted to have a shower or a wash (she was in a commode which is a kind of toilet chair on wheels) and she said 'I'd prefer to have one in the morning'. I told her it is morning now and she suddenly looked really confused and upset. I said 'just relax, you're a little confused that's all, I'm just going to ask you some questions'.I began asking her questions such as 'do you know what day it is? do you know what the date is? the month?' she wasn't sure and seemed upset with herself that didn't know. then i asked questions such as 'do you know where you are?' 'who is the prime minister of australia?' she was able to answer those questions correctly. later that day it began to appear that was losing the ability to control her hands and legs. when she had the cup in her hand she could bring it to her mouth but then couldn't bring it back down it would just drop out of her hand. and she couldn't balance when we tried to get her to sit on the side of the bed. her hands were so cold and we had to tuck her in with lots of blankets like a cocoon. i felt so sorry for her and really wanted to help her and comfort her. I began to feel a bit emotional.

After that my teacher came and got me to go through my first formal assessment of how I've gone so far on this clinical placement. There are some skills that I'm not competent in yet, in the sense that I am not confident doing them independently without any guidance or checking, and I need to be in order to pass this clinical placement. I couldn't help myself, I cried, but he assured me I'm not going to fail and he is going to support me 100% to make sure I succeed. I couldn't stop crying for about half an hour. He said I am a very caring and sensitive person and because of that I'm going to be affected in this career more than some people, but I will get stronger as time goes on. I hope so. I don't want to become insensitive but I need to be strong in the sense that I keep my emotions under control. All the students in my group (all girls) have cried at some stage this week. Between the four of us, four patients have died, and we've seen some really sick people who have little hope of getting any better, so we've all been supporting each other a lot. I'm lucky to have such a nice teacher and nice group but it's still stressful. I haven't been this stressed in a long time.