A Seed of Exponential Growth

In my second year of nursing school, the med-surg (medical surgical) rotation was my toughest yet most impactful clinical rotation. Not only was there a steep learning curve in its first few weeks, but the teacher I was paired with, L., was known to be one of the strictest ones at my college. I remember the days leading up to orientation day on the ward, seventeen year-old me was nearly shitting herself. She would stay up all night thinking of the worst case scenarios: failing to give the correct answers to L.'s questions regarding medications, procedures and disease processes which would ultimately lead to failure in clinical. Back then, I was a very shy teenager. Although the previous year, we had practice communicating with patients, it was the communication with my teachers that stressed me out the most. And so, that first day of clinical, despite the churn in my stomach, the large bags underneath my eyes, and the restlessness brewing within, I got out of bed at 05:00 and ventured off in this journey I never knew would change the course of my nursing career.

At 06:30, I arrive at the metro station and hike up the hill leading to the hospital. I see a few of my peers in the entrance hall and we stand there nervously, awaiting our instructor, a stern-looking individual whose appearance at the time was rather intimidating to me.

L. was a peculiar teacher. Every clinical shift, he would have a coffee cup in hand that seemed to infinitely refill itself. I remember thinking to myself "Damn, does this guy ever sleep?". When in second year of nursing school, students are sent their patient assignment the day before. Every Monday night, I would stay up late as L. would send us patient information at around 22:30. Now you may say: "Oh that's not too late, it isn't so bad?". However, when your brain is filled with the bare minimum of nursing content from the previous year, and you are seeing medical terms that you've never encountered in your life, preparing for the interrogation of medically complex patients for L. felt like life or death. As a result of fear, sleep was sacrificed in attempts to prove my knowledge. Our clinical group, back then, coined ourselves as #TeamNoSleep, and we lived up to its name (lol).

During day shifts, keeping up with the various nursing tasks seemed impossible: patient assessments, bed baths, med passes, etc. On top of that, the one task that required much time and dedication: report with L. One by one, L. would take report from each student. L. would listen intently, and once we were done speaking, a dreadful pause of a few seconds would ensue. Every time that would occur, my heart sank deep within my thoracic cavity. "What is he going to ask now?", "Please ask me about this, I know it!" were my thoughts. If we presented uncertain or wrong answers to his questions, rather than clarifying, he would reply with another question. I remember the annoyance and frustration felt during the first few weeks. Additionally, during post-clinical conferences, while sitting all together at the hospital cafeteria, L. would ask each of us how are day went and we would listen to the stories and challenges that we were faced with. On evening shifts, although less hectic, the routines would resemble the one on days. Post-conferences would still occur, and at times, we would end up leaving hospital premises at 23:00. Once the clinical week finished, personal journals were to be submitted to L. You can imagine how arduous having L. as a clinical teacher can be ... but it was the most rewarding to learn alongside him. And here is why ...

Just an FYI, although giving IV medications is a routine for all practicing nurses, as a second-year student nurse, it was a BIG deal. I remember the first time I administered an IV medication: Ancef. I not only had to review what the medication was for (antibiotic), I had to review the steps to reconstitute it and the process of giving it via the selected route.

The patient I was assigned to was an elderly man with severe dementia who had come in due to aspiration pneumonia. He required total care as he barely opened his eyes when addressed. Feeding him required patience as he was a slow eater. Giving him a bed bath was difficult as he was stiff and at times combative; he's the first patient to non-purposefully kick me in the chest. As they say, you never forget your firsts ... And so, I remember being at bedside with L. and explaining out loud how I would proceed to give the prepared Ancef. Then, with shaky hands, I attempted to connect the syringe tip to the patient's IV line. You can imagine how nervous I was with L. watching me closely. Once "connected", I tried to push slowly the medication in, but was faced with resistance. I double-check the line to ensure that the port was indeed unclamped (it was). Then, I tried to add more force into the IV push, and within a split second, Ancef splattered all over the ceiling and onto me. "What did I just do?". I looked at my patient who, thankfully, is unaware of anything happening around him. Then, I looked at L. who bursted out in laughter. My response: PANIC! As L., wipes away his tears of laughter, I froze. As soon as L.'s eyes meet mine, hyperventilation kicks in and tears of anxiety started to flow. L. looked at me with an expression that I could only describe as "Ugh ...". L. then took my arm, and directed me to a chair in the room. He then tells one of my colleagues to look after me until I calm down. Once my nerves began to settle down, I remember feeling embarrassed and thinking it was over for me. I would fail clinical and that would be it. Later that night, as I was writing my journal entry to L., I wrote "I felt stupid". His response: "Never ever use the word stupid to describe yourself".

Looking back at this event now, I realized that L. was always a compassionate teacher (also, seeing him laugh caught me off guard as my first impression of him made me believe he was incapable of doing so). It was from that moment on that I could trust his process into shaping us into better nurses. He, as well, began to trust us as he began to speak with us in a casual, friendly, professional way that conveyed respect and humanity. He set the bar high for my future clinical rotations, and finding another teacher that met my new standards still has not been achieved.

There are many more stories and learning moments during my #TeamNoSleep chapter. But all this to say that I have become the nurse, teacher, mentor, preceptor, human I am today thanks to him. To be patient, humble, empathetic and self-resourceful are life lessons he forever engrained in me. Thank you.