[Photo Credit]

Picture my surprise when I peek around the door and I see the tiniest little man lost in a huge air bed, peeking out from beneath 3 blankets.

"Hi, my name is UgRN, and I'll be you're student nurse today, Mr. M!"

He said something very quietly.

"Sorry, Mr. M, what was that?" I leaned in.

He chuckled a little and said "I sez, 'why, halloooo, lass'! They keep sendin' me the pretty young nurses. I haven't had so much attention from the ladies since I was in uniform! Or the men, either, for that matter."

So set the tone for the entire shift.

You may remember that I spent a memorable 6 months gallivanting around Scotland with my backpack, a few pounds in change, and a job working for a coastal horse trekking outfit. So my patient and I had plenty to reminisce about. He's an Edinburgh man and I didn't spend nearly enough time there but I did remember the long ardurous hike from High Street, down to Holyrood, and then over to Princes Street. I also remember how crazy packed the streets were (I kept hitting people with my overstuffed backpack) and how I couldn't afford anything :) But I did buy a tartan Christmas ball.

It was kind of funny, really, how we all seemed to congregate at Mr. M's bed when there was nothing else to do. He kept us in stitches all night. He was a total saint, too, when we were experimenting with proper peri-care for a fully dependent man with an indwelling catheter. It turned out that out of all of us, the one person who did not have a chance to practice peri-care was the only male in our clinical group. So we voted him to be the one to do it. There were 6 of us with nothing to do so we made ourselves "useful" by fetching pillows and offering, uh, "helpful" instructions to our poor classmate who didn't know if he was coming or going. We rolled Mr. M back and forth all over creation and he swiped good naturedly at us, saying "Hey! Don't pull on my FAMILY CREST! There's not much there as it is, you know! You lady nurses are always so rough with it but this man here is ever so gentle." OMG, I was in tears, I was laughing so hard.

A little later I was reflecting that I had a completely wrong impression of him from his chart. He wasn't a scary recluse at all! And how different it must be for him to come from living indepedently with hardly any social interaction at all, to coming into the unit totally bedfast and charming everyone to where his bed was the local muster point.

Anyway. It was a great shift. We also got to watch the nurses swab for MRSA/VRE and then put the swabs in the vacuum tube and shoot it over the the lab. Fricken SWEET!

Yesterday we learned (finally) how to do blood pressures. Man, I can't find a brachial pulse to save my life. I was poking my partner's arms all over the place until our lab instructor whizzed over, touched her lightly on the inner elbow, and said "Here".

We had the coolest stethoscope ever. It's a teaching stethoscope with one chest piece and two earpieces! So she found the brachial pulse and set it all up, and I could finally hear what I was listening for. So we did about 800 BPs on each other until our fingers were tingly from lack of perfusion. My BP was, like, really low. 90/60 or somesuch when the instructor was doing it. She asked me if I was fit - not really! But I guess that explains why I see stars all the time when I stand up.

Anyway, my bus is coming soon so I will complete this when I get home from work. Tsk, blogging at work!

In Potter and Perry, it was mentioned that students can find touch stressful, but they learn to cope with intimate contact by changing their perceptions. As we were getting Mrs. E into bed, she was so tense that she was lifting her head and shoulders right off the bed. As I started the bed bath for her, it was initially very task-oriented for me: now I dip the washcloth in the basin, now I wring it out, is it too wet, oh, now is it too cold? Now I make the mitt – how does that go again? Now I touch the skin, not too firmly, not too gently. As I started getting the hang of it I realized I had run out of limbs to clean and it was time to do her abdomen. Mrs. E didn’t bat an eye when I undid her gown and she had her most private self exposed to me, but I saw a body that at one time had probably been reserved only for her parents or husband to see. And now, just about anyone wearing a uniform and an ID tag could see it.

I knew then that my perception had changed. She was much, much more than the unlucky recipient of my first bed bath. She was a person all her own and I had the privilege of helping her with her most intimate necessities. After that moment I began cleansing her abdomen knowing I was washing a unique human being. The task of washing became more of an act of caring. No longer did I concentrate so hard on the procedure. My focus was on helping Mrs. E take care of her needs. From there, I was more comfortable handling her body and the washcloth. As I relaxed, so did she! By the end of the bath she was lying flat out, completely relaxed. I could see that my touch had probably helped provide both relief from feeling unclean and, when I relaxed, my touch eased her into finding a position of comfort.