Thursday, March 27, 2008

Things they don't tell you in nursing school

There are plenty of books and articles out there about how to survive your first year or two as a nurse. Most of 'em are pretty useful; they cover things like confidence and time management and self-examination, all of which are important. There's always a "transitions" class in nursing school that attempts to cover the same things.

Nobody, though, gives you the real dirt on being a nurse. Here, then, are ten things you didn't learn in school and which will become obvious soon:

1. Constipation: Your own, not the patient's.

Everybody poops, yes, but some of us have to learn to poop less often. If you're working three or four days in a row, your first day off will be spent pooping and sleeping. Accept this and do not attempt to buck the trend. The downside to not getting to poop when you'd like is hemorrhoids. The upside is stronger sphincters and the ability to work through a case of food poisoning.

2. Did something die, or did you just take off your shoes?

If you wear decent shoes (ie, supportive closed-toe-and-heel shoes made of leather), your feet will stink. If you work a full shift in them, your feet will stink to high heaven. Again, acceptance of your plight is key. Soap and water before bed do a lot to prevent both athlete's foot and the death of your bed partner.

3. Bleach is your friend.

The likelihood of getting something nasty splashed on your scrubs is directly proportional to the amount of white you wear. If, like me, you *have* to wear a white coat as part of your uniform, you should buy stock in bleach companies now. It'll subsidize your retirement.

4. You will become more cynical than you ever thought possible.

Look: It's impossible for a human being with a heart to do what nurses do on a daily basis and not become cynical, both about other people and about the universe we live in. Cynical doesn't mean evil; it just means that you're coping with the stresses of your job. I used to feel bad about the sort of whistling in the dark we do until I realized that it's the only way to keep from crying in the face of three patients dropping dead unexpectedly in one day.

5. You will become capable of both more tenderness and toughness than you ever thought possible.

Nurses soothe people. We ease their fears. The number-one thing that we do is educate our patients about what's going on, and knowledge is power. The number-two thing we do is stop pain. Those two things, taken together, will make you more tender and gentle than you ever imagined. Even turning a comatose patient can be done with gentleness, and you'll find yourself doing it. 

Nurses also have to hurt people. It's part of the job. Shots hurt. Dressing changes hurt. (Cue "Cruel To Be Kind", please.) When you're changing the dressing on a deep, awful wound that hurts, you'll find yourself wincing in sympathy--the first few times. Later on, you'll get tougher, but never to the point of cruelty. Change the dressing, get it over, and go on. This is not a bad thing.

6. Coping mechanisms can be good or bad.

I'm not talking about the people who sneak narcotics out of locked drawers. I'm talking about what I've heard other nurses say: "I never drank this much before I was a nurse."

There are good ways and not-so-good ways of dealing with the stress of the job. If you're coming home and pouring six shots of tequila down your throat, either you need a new coping mechanism or a new job. One glass of wine/liquor/beer, though, done properly and with ritual, can ease the transition from Nurse to Real Person. Do not be ashamed. 

If you *are* ashamed, then get a different way to cope. Buy a treadmill and go for a run after work. Get a puppy. Buy some Mister Bubble and use it. Adopt a new ritual.

7. Doctors are (mostly) people, too.

There are some doctors who came here from Planet Asshole. The same can be said of some chefs, some office bosses, and some bowling-alley customers. The majority of doctors, though, are nice, normal people with nice, normal needs and reactions to things. The same doctor who writes insane orders and demands that crazy things be charted does the in-car butt-dance every time she hears "Girlfriend" come on the radio. Remember that.

8. Dating somebody from the same facility is always, ALWAYS a bad idea.

No matter how discreet you think you're being, somebody's figured it out. 

9. Nurses are nice, normal (mostly) people, too.

All but two of my nursing instructors in school went on and on and on about how dysfunctional and co-dependent nurses are. I figured out pretty quickly that the instructors who were down on nurses were no longer working as nurses because they hated the job and couldn't cut it on the floor of even a moderately busy facility. The two instructors who still worked full-time as nurses had a much better, more realistic attitude. 

Yes, there are bitches and bastards. Yes, you'll run into the occasional young-munching nurse. But they're as rare in this field as they are in others, and you'll learn to avoid them the same way everybody else does. For the most part, nurses become smarter/faster/less inclined to bullshit the longer they work. This makes them good people to work and relax with, both.

If one or more of your instructors is pathological about hating nursing and nurses, ignore them.

10. If you hate it, you can always do something else.

Nursing school has a weird vibe: like this is the be-all, end-all, most important and worthy thing you've ever done. It's incredibly, indescribably stressful--more so than medical school, according to several people I know who've done both. It's also wrapped 'round with the whole Ethos Of Nurse. That makes it hard to admit that you've chosen wrong or that maybe you hate being a nurse.

Let me make this totally clear: If you don't feel like you're a fish finally dropped into water, you don't need to be doing this for a living. It's too hard, and the money's not *that* good. At any point in school or in your career, you are certainly allowed to back out and go be a banker. You haven't wasted your own or anybody else's time; remember all that great stuff you learned?

Don't let one bad day or one bad month or semester or year (whatever) make your decision for you, though. If you have a gut feeling you shouldn't be doing this, then for God's sake back out as soon as you can. If your gut is happy, though, and it's your brain or ego that's bruised, keep on. Things will improve.


Beth Young said...

Thanks for the sagacious post. That's refreshing and inspiring even for a five-year old nurse.

Crystal said...

Jo, you never cease to amaze me with your words of wisdom. As a new grad from December, this comes in very handy! I throughly enjoy reading your blog! Thanks!

shrimplate said...

I used to feel bad about the sort of whistling in the dark we do until I realized that it's the only way to keep from crying in the face of three patients dropping dead unexpectedly in one day.

It's not so much the deaths as it is all the paperwork that goes along with them.

Is that cynical?

Anonymous said...

Oh my true. Are you teaching? You should be.

Beth Coll Anderson said...

Thank you for being the voice of reason.

GingerJar said...

Oh, and to go along with the constipation...urinary tract infections...from holding your urine inmeasurable amounts of time because your so busy seeing to everybody elses needs!

Love your posts.

None said...

Everyone's cynical, not just nurses. It's a hard profession because it feels more like a vocation, a way of life. You don't have to be Nancy Nurse all day (yes you can go out and be a little crazy, and gasp, unhealthy!) but you're right, nursing seems to make you believe that's not the case!

Anonymous said...

Great post: thanks! I can't imagine going for a run after a shift, though. I'm usually lucky to be walking :)

Anonymous said...

hehe, so true. I have been working 3 yrs, this is great.

Anonymous said...

Yet another great post, Jo!

Anonymous said...

Thanks for the great posts. As someone who deals with nurses, but isn't one himself your blog is a great resource thanks for all the good reading.

Anonymous said...

excellent post and oh so true.

Kim said...

Hell, after 30 years, this post hit home! Wonderfully written and I wish I had done it! LOL! : D