Monday, June 9, 2014

Nursing School- Year Two

evolution of student nurse uniforms

The challenges of Second year were both dramatic and terrifying!
The attrition factor took its toll.  
Our freshman class began with 33 idealistic young girls.  At the start of junior year, that number had dropped to a mere 22.  By the time we graduated in 1971, only sixteen students would remain!  That is only a 50% survival rate.
The first to go were the “commuters”.
I think this was due in part to their not being present on the hospital campus 24/7.  Because of this, they were perceived as not being as committed and focused as the rest of us.
And, like the married students, I feel there was a certain prejudice against the girls who commuted daily as opposed to those of us who were under their constant surveillance.
My friends and I all lost our original roommates to the survival of the fittest factor.
 The threat of “Probation” and termination was an ever present reality in our scholastic world.
Cindy was a member of the honor society in high school and Donna and I were above average students (when we applied ourselves), but that first year of nursing school was a major struggle for us all. 
Three D’s and you were out of the program.  Period.  No chance for make ups or special credit projects.
I got my first D in Foundations of Nursing.  This was a cake subject and should have been an easy A, but I had difficulty adjusting and slept through much of my first year.  Big mistake in this class!  I think they took my lack of participation very personally.
My second D was in Chemistry, a dubious honor I shared with the majority of the class, including my friends.
There was no grading curve or we all would have passed in better standing.
I remember our  teacher just shaking her head and laughing in astonishment and frustration.  Mrs. Smith had a brilliant mind but did not possess the necessary skills to teach at our level.  Talk about a failure to communicate.
Three strikes and you're OUT! (literally)
Going into my second year, something finally clicked in terms of intellectual comprehension.
 I began to focus and make the grades necessary to remain safe from dismissal.  Actually, by senior year I was pulling all A’s and upon graduation, received the Faculty award for “most improved student”.   Clearly, I had had a long way to go!
Halloween with Donna, Carol and Cindy.  Tee peeing hallway.   Fetal pig!
We left the worst of our "theory" behind us as we began  Junior year. (There was no Sophomore year)
Year two would provide us the opportunity to enter into the clinical phase of our education. 
We had spent endless months cooped up in stuffy classrooms and the most exciting adventure we shared was dissecting fetal pigs.  We now were released into the world of actual patient care.
Our class was divided into groups of five and placed into a variety of nursing specialties, meant to develop our skills and see which direction our future careers might be heading.
These were Medical/Surgical Nursing, Maternity, Operating Room, Psychiatric Nursing, and Pediatrics.  Each course was of approximately three months duration.
Students in today’s culture are on the nursing units for a few short hours with a one patient assignment, shadowed by an ever present  instructor and co assigned with a staff nurse preceptor.  They are overly micromanaged and given few opportunities  to develop their own organizational skills.  There are so many rules and limitations in effect that the student certainly does NOT come away from her experience with a realistic picture of the nurse’s true job description.
 Back in the late sixties, the student nurse was responsible for a full assignment and worked an eight hour shift along with the regular staff. You were expected to assimilate and pull your own weight. 
the old Alcazar with its red tiled roof (Cleveland Metro/Psych)
Our Psych rotation involved our temporary placement into the Metro Health system at the Cleveland Psychiatric Institute, now defunct. It was formerly called The Cleveland Lunatic Asylum!  (really)
This was mostly a ward based, locked  institution for the hard pressed and down-trodden minorities.
In the late 60’s, medication was not nearly as advanced or therapeutic  as today’s modern pharmaceuticals.  Let’s just say there were more leather restraints and electroshock therapy then I would care to see in a lifetime.  Between the staff and patients,  I was exposed to so much second hand smoke that I could hardly wait to return to the fresh air of my dormitory!
The only advantage and perks of being housed in this Metro dorm was that we now had our own sink in our very own private room!  
Our one barred window was permanently stained and overlooked a busy freeway. Located above the Inner Belt Viaduct, traffic sounds and pollution were an ever present background and the constant stench of the area still resides somewhere in my olfactory memory.
Operating Room rotation- Judi and Donna

setting up  my table
The Operating Room rotation was a favorite for my friends, although I never was comfortable with the bad manners of some of the surgeons.
One imposing and particularly cruel man was Dr. Beargie, a vascular surgeon.  He was egotistical and mean and enjoyed humiliating  the student nurses and reducing them to tears.  And yes, some surgeons DID indeed throw instruments as often as they threw temper tantrums.

(I was glad I wore a mask to hide behind for a bit of anonymity!)
Thank God there were also some real sweet hearts in the field like Dr. Driver and Dr. Domingo.  And I could write an entire blog on Dr. Tuason, a Filipino anesthesiologist who stole the hearts of every student on that rotation. (Donna, remember the curious case of the feather in the mailbox?
But I will never forget the day my friend Cindy blew up a surgical instrument sterilization device called the autoclave.  Located between surgical suits in a small ante room, it cleaned instruments by utilizing a high pressure saturated steam at 121 degrees.
We heard the explosive sound as it erupted and seconds later, Cindy staggered into the surgical arena and collapsed on the floor!  We were in the middle of a case and, at first, everyone just froze.  Then all Hell broke loose!  Despite sterile technique, people flew into the room from all directions and even the surgeon broke scrub to assist.
Poor Cindy was taken away on a cart.  She suffered third degree burns on her ankle and had to be housed in the special quarters on first floor of dorm  for weeks.  I am sure she still has scars, emotionally and physically to this day. (Can you even imagine the lawsuit awards and settlements that would have resulted if this had happened in today's sue happy society?!)  Wonder if the laws of limitation apply?
  I have to admit, on some sick level I was a bit jealous of the attention and drama.
My favorite rotation was Pediatrics.  I was a top rated baby sitter with years of experience behind me, so it is not surprising that I would gravitate towards that specialty. Childhood cancer in the late 60’s was a terminal sentence and I have never really come to terms with that concept of death in one so young.
scrubbing up in OB

Maternity nursing was another favorite.  In order to get in the designated amount of delivery experiences, students were placed “on call” and would be summoned back to the hospital in the evening when a birth appeared eminent.
I hated the " labor" stage in this birthing process. (It's not called labor for nothing!) We lived in an area where there was a high population of gypsies. They had a low threshold of pain and were very vocal; a bad combination.  (I can still hear them shrieking their incessant “Aye, yai yai yai yai” in my nightmares!) 
Back then, you had to prep the mother.  That included, among other things, an enema and complete shave.  I don’t know who was more embarrassed, but I was always concerned that the baby’s head would be “down there” and that I would give him his first unofficial haircut!
This was back in the “good old days” before video recorders and smart phones.  Strict visitation rules prevented a cast of thousands of family and friends from converging upon the scene to witness and document the blessed event from every angle. 
weighing the newborn
The father’s to be were corralled into a small smokey room where they would pace and await the announcement of  “It’s a boy”! 
Yes, in the 60’s before ultrasounds and 3 d photographs that showed every nuance of your baby’s profile, the sex of your child was a long anticipated surprise! 
After hearing the news, daddy would hand out cigars, kiss his wife good bye and leave the building.  There was no family centered care or rooming in.  Oh, how I long for those long forgotten times.
I most enjoyed nursery and caring for the mothers after they had delivered.  I loved giving the bath demonstrations using a live newborn to show the proper steps in bathing.  Part of me was always a bit paranoid that I would drop the slippery infant on the floor!
my junior cap with two black bands

Med/Surg did not have the same emotional appeal as the other specialties but this is where we learned our procedures, honed our skills and really earned our bread and butter. Practice makes perfect!

no velcrove!
Our instructor, Miss Jacobson, was the epitome of a professional nurse.  From head to toe, she was dressed in pristine white and her cap graced her perfectly coiffed hair like a hallo.   She was also the most intimidating woman I have ever met!  She had a perpetual pained expression plastered on her face, probably as a consequence of having to supervise students who could never hope to rise to the levels of her expectations.  In our defense, we did try.
glass syringes
I remember the first injection I ever gave was to a handsome young man with tattoos on his upper arm.  I was so distracted that I am not certain I hit my mark, as the tattoo had a face and I was trying to avoid the general area of the eyes!
There was definitely a learning curve involved. 
Organization was a difficult concept and I know I made many needless trips back and forth to the supply room to gather my equipment. It was like an endless scavenger hunt!
Plain and simple, I am a klutz.   That did nothing to endure me to my instructors or hospital staff. 
non disposable mercury filled
I remember dropping an entire metal tray of glass thermometers into the commode when I was leaning down to flush the toilet.  (This was before personal protective equipment was the fashion! Today you wear gown, gloves, mask, goggles, etc. Back then, hand washing was about all we had!) Too little, too late...
When you think of all the mercury in broken thermometers and sphigomos that we were exposed to, it is miraculous that we are not all suffering from some Post Traumatic Mercury Syndrome.  Or perhaps some of us are?

To be continued