Tuesday, April 5, 2011

Cardiology - First Impression

Yesterday was my first clinical day in the hospital setting on the cardiology floor.  I was nervous and slightly scared because I didn’t know what to expect. 
There were ten nurses scheduled that day so each of us students got to shadow a nurse, even though we were only on the actual floor for about an hour.
My nurse’s name was Jessica, who had three patients under her care and one new transfer from the sixth floor.  During the hour I was shadowing Jessica, we went to get supplies for her to change an IV on one of her patients who had been there for more than a week.  This was the fourth day the IV had been in his vein and their policy is to change veins every fourth day, so I tagged along and watched. 
Jessica made light conversation with her patient who was a 57 year old male all the while she was searching and trying to insert a needle into a new vein on his arm.  With no luck, Jessica gave up trying to use the vein she was fishing for because she said every time she tried to inject the saline she kept coming up against a valve, so she was going to try his other arm in a little while. 
While I was looking at the patient’s skin I noticed discoloration probably from the many years of exposure to sun from farming and wondered how Jessica could find a vein at all.  I followed Jessica to the supply closet to get a warm blanket that she explained she would wrap around the patients arm to help bring his veins closer to the surface of his skin(kind of a neat trick but I wasn't there long enough to see if it worked).
While the blanket was warming the patients arm, Jessica and I went to see the new transfer patient.  The new transfer patient was a 68 year old female who had bypass surgery and was accompanied by her daughter and daughter-in-law. 
Jessica came in and did a QUICK head-to-toe assessment first starting with questions on the patient’s pain rating then moving on to her legs.  Jessica looked for swelling and supposedly felt the pedal pulse over the ted hose and slipper/gripper socks(I don't think I'd be able to feel them if I had tried).  Then Jessica listened for respiratory/heart/bowel sounds by only placing her stethoscope on four areas of the patient’s body (this was way different than what we’ve been learning).  Then Jessica finished off by explaining how to use the call light and tested the patient on what button to push. 

The patient was concerned with my lack of talking, which made her nervous and asked me, “Why don’t you talk?”  I answered, “I’m nervous too and don’t know what to say."  Then I went on to say "Never mind me; I’m just here to learn.”  Then because of my admitting being nervous, the room erupted in laughter and the patient winked at me.
I learned what a COW (computer on wheels) was and I’d say my experience was 90/10, meaning 90% of what I heard I didn’t know and 10% I think I knew.  LOL!
Overall, I love the fast pace environment of the cardiac floor, but not too sure I’m smart enough.  Can’t wait to see what happens next Monday when I believe I’m on my own as far as having one patient assigned to me.  I’ll have to do a complete head-to-toe assessment on the individual and document everything I found including vitals.  Please pray for me!


  1. Sounds like you had a good first time out! Next week will be scary on your own, but it gets much easier the more you do it. Most patients are cooperative with us lowly students...they let us annoy them ;-)

  2. I'm so happy you had a good first day full of lots of learning! It has to make it more interesting to go in and pretty much learn all new things as opposed to "knowing it all"

    I'm scared for you for next week!! I feel like every nursing story I read from now until I'm finished with school is going to freak me out and make me ask myself, "Holy cow, what am I getting myself into?! What if I kill someone?!"

  3. I have to tell you (if you don't already know from my first postings) I felt the same way on my first hospital training experience...I thot for sure I was going to kill someone. I am pretty sure everyone thinks that.

    Everyone has to learn sometime, and eventually, you will be *that* nurse! :)

    Many years of doing assessments - honestly it will come easily after you have done it several times. It really will!

  4. You will totally get there. First clinical of first semester to hit a Cardio floor is expected to be hard. Even by the end of the semester you will know so much more.

    The heat trick actually does work to get veins to pop. If you can actually get a good working IV in one... well that is still hit or miss.

  5. My baby sister is going to be a nurse, I still think it's very cool. And I loved hearing the story of your day!

  6. Thanks Kendra, I’m super nervous!! I don’t feel confident as to what I’m doing with assessments. I know what and where I should touch on my hubby’s body but not a complete stranger.

    Marianne – you’re scared for me, I’m scared for me. :-) I only think the stories of nursing school will freak you out if you don’t know what they’re talking about, the more you get to know about procedures and practices the more familiar you’ll be to listening to them. But I do ask myself that every week just about “What am I getting myself into?”

    CC – I’ll have to go back and read through your earlier postings, but I’m frightened to be “that” nurse and excited all at the same time.

    Christine – I hope by the end of the semester I will be 90/10 with the higher number being the material I know as opposed to not knowing.

    Dominique – Thanks woman! I’m glad I’m entertaining at least. :-) And I'm happy you're keeping up with reading my blog.

  7. Ooh, how exciting! You'll be fabulous next week! I think it's completely normal to keep quiet and listen, when you're learning. It's hilarious that the patient asked you why you didn't talk!

  8. Zazzy, My ethics instructor scared the . . . poop out of me regarding assessing pedal pulses. Very few people follow textbook diagrams when assessing pedal pulses. When I started working, I didn't hesitate to use the doppler. Now, assessing pedal pulses are second nature.