Nurses get to wear comfy scrubs, right?
Becoming a nurse eight years ago, I didn’t anticipate the anxiety it would bring. I knew it would be a challenging career, but I thought it would be a good challenge. That I would be fulfilled. I actually wasn’t one of those people who walked around at 5 years old, a stethoscope around her neck, bandaging dolls and wearing a white coat for Halloween. Growing up, I first wanted to be a writer (back then it was “author”) and then a psychologist. I didn’t know I wanted to go into nursing until I was 18 and did a high school internship.
I did this internship class out of pure laziness, not because I wanted to better myself. We got out of school for the day at noon and I was all about that.
The internship class allowed me to get a job as a personal care attendant (PCA) for kids and I didn’t have to be at that job until 4:00 or so, so I had the afternoon off.
Which mainly consisted of hitting up the Taco Bell drive-thru and shopping at the mall when no one else was there.
I worked as a PCA actually all through my college schooling until I got my first nursing job. It was essentially glorified babysitting, save for the few adults I worked with, including the older woman with two Jack Russells that would bark if I shifted in the chair wrong and pooped all over the floor. I didn’t last long with the adults, but the kids I loved.
It took me applying three years in a row before I was finally accepted into the program at my local community college. I still remember sitting in my car on my way to work, holding the letter from the college in my hand, heart pounding with the anticipation. I had already been attending college for five years. I needed to stay in because that bumped me up higher on the list. I had everything riding on that moment. When I tore into the envelope and saw the word, “Congratulations!” I shrieked.
Nursing school is hard, y’all
The next two years were intense. I would rather go through infertility all over again than nursing school. It was brutal, and many failed out. A lot of people, myself included, took antidepressants to handle the pressure.
But while it was crazy and stressful and I don’t know how I survived it, I still loved it. I loved learning how to be a nurse. And eight-hour study sessions sitting in a booth at Panera became part of the routine.
One of my favorite experiences was interning in an ICU for a few weeks. I was one of the lucky ones, with the experience I had. I couldn’t ask for a better preceptor, who stood there as I repeatedly shook my head no—I couldn’t stick that feeding tube down that guy’s esophagus, and she talked me into it anyway. And I did it. I learned how to give morphine IV, how to monitor a ventilated patient, how to report off to the oncoming shift.
Nothing in my nursing career has been so worthy of accomplishment than that feeding tube though.
I did learn that I loved learning about nursing much more than actually doing it. While my fellow colleagues would confidently walk into their assigned patient’s room to introduce themselves before a clinical shift, I would be having heart palpitations. When the students would eagerly practice their IV skills, I was hyperventilating at the thought. But I loved observing. I got to observe a toe amputation and a C section delivery. I spent hours with a soon to be mom in labor (bless her heart to this day for putting up with me as an overeager student nurse who stared way too much at her vagina than is probably acceptable). I stood and watched as she and her husband welcomed their first baby into the world. Even to this day, I’m so grateful for her. To allow me into the most deeply personal moment of her life all for the sake of my education.
My passion was still there, even through the hard stuff—the anxiety-producing stuff. I could barely allow myself to walk into a patient’s room and introduce myself, but I still subscribed to Nursing magazine and had aspirations of going on to obtain my certification in Cardiac Care nursing.
Graduating as a Registered Nurse was the biggest accomplishment of my life. And even though I’m not actively working, it is a title I have always been proud to have.
I graduated and entered the real world
My first nursing job was in home care. The flexibility for me was awesome. My first client was a person with a brand new tracheostomy and ventilator. I would be working three 12 hour shifts with him a week. I was ecstatic. My mom got me a nice cardiac stethoscope with my name engraved for graduation and a nursing bag. I donned my first pair of professional scrubs. I sat through CPR; several classes at the office on trach care, how to monitor ventilators, medication set up. I adored my client from the moment I met him. I had nerves, but they were excited nerves.
I shadowed another experienced home care nurse at my client’s home for a few days. On my second day there, I plugged up the feeding tube by not crushing the medication enough and we had to call for a ride to the hospital for it to be replaced under surgery. Oh, and the nurse I was shadowing said she couldn’t go with me. To say I felt lost and completely inadequate is an understatement. The nurses at the hospital had no patience for me: the rookie nurse who was still struggling to work the portable ventilator on her client and couldn’t answer half their questions.
My first day on my own (several days after that), my client almost died.
Emergencies really aren’t my thing, you know?
We get training on plugged trachs (the breathing tube that is surgically placed in the neck into the trachea, bypassing the mouth and nose). We had a whole emergency procedure we learned in class for my job that involves a variety of life-saving measures if it ever came to a client’s airway being cut off.
“I have—” the instructor paused during her class to rap her knuckles on the wooden desk, “not had an emergency situation so far like this in my five years here,” she told us.
You can see where I’m going with this.
Before I became a nurse, I worked at an assisted living facility, on the evening shift and when the regular staff went home for the night at 5:00 pm, I was the sole healthcare worker in a building of sixty-five residents.
My mom hated that job for me.
I’ve rescued Alzheimer patients when they would escape outside in the dark. I’ve called 911 to help pick up an obese man off the floor, dodging dirty looks from the paramedics because I didn’t have the strength to lift him. One night, the worst night, I locked myself in the office and with trembling fingers dialed the police as a resident with schizophrenia tried to break down the door. So I’m no stranger to horrible situations in which I’m completely on my own.
But that morning, my 3rd day as a nurse on my own—that day has stuck with me for the last eight years and probably a huge reason why my anxiety became too debilitating.
My client had rung me to come to the room because he was having some trouble breathing. I used the suction machine, but the ventilator alarm started going off and there was a sound—some sound I can’t recall now, but it made me lock eyes with him and I knew his airway had become completely obstructed.
I grabbed the ambu bag, and squirted some saline into the trach tube before attaching the bag to it. I used an ambu bag on a dummy once before. Now, squeezing the bag, literally breathing for him, I thought of the phrase, blinded by fear. When you are so terrified that your vision starts to get fuzzy. That’s what I thought of when my hands squeezing the bag didn’t let in any air.
I almost choke
And I almost stopped. I almost threw up my hands and sobbed and told him I’m sorry I can’t handle this— I’m a brand new nurse and I just need to call 911 and let them do it. But then he would have died. And so I ripped open a package of sterile gloves and replacement trach tube. I tossed the gloves on the floor, picked up the new tube and switched it out with his. This time, when I pumped the ambu bag, the air went in and I knew his airway was cleared.
My hair was plastered to my head. My heart was still beating rapidly. I had supplies littering the bed and floor.
After things calmed, I walked out of the room and burst into tears. It was just past 7:00 in the morning.
I look like an idiot
I called the nursing case manager and she told me I should have him transported by ambulance. I thought my part of the responsibility was over. When the paramedics arrived, I was dismayed that they really had no clue how to work a ventilator. They told me to take the portable vent off the back of his wheelchair so it could be transported on the gurney with him. I spent fifteen minutes holding back tears as I tried everything to get the vent off the back of the chair, thoughts running through my head such as fuck nursing, fuck this job, I should have been a fucking author. I bet they don’t have to do shit like this.
When we got in the ambulance, his trach obstructed again. And the paramedics all looked to me to do something about it. I had no idea paramedics and first responders weren’t trained in trachs and ventilators. By this time, I was nearing a panic attack. I had no idea what I was doing and I couldn’t contain the tears in my eyes as one of them huffed, grabbed the ambu bag and told me to get out of their way.
You guys, it was awful. Reliving it is awful. It was in that moment I knew I wasn’t cut out for this.
He was transported and I had to finish up the paperwork from the hospital. His relative drove me back to the house so I could go home in my car. As soon as I shut the door, I sobbed again. It was now barely 9:00 in the morning.
I keep going though
I went on to work with him for a year and a half and never had another situation like that again. I took on other clients and gained more experience. My confidence though was shot. Everything I thought I knew about nursing was wrong. And I realized how fucking hard this profession was that I got myself into. How could I have worked so hard for something, and sacrificed so much, only to be overcome with crippling anxiety for the next eight years of my career?
Part 2 coming soon…