When I was little, I wanted to be a bus driver. This is funny for two reasons. One, I have never taken a bus to school—I can count on one hand the amount of times I have actually ridden in one. Two, what elementary schooler looks at an adult with big green eyes and excitedly answers the question of, “What do you want to be when you grow up?” with “a bus driver!” Although it is a very respectable career path, it was a somewhat outlandish job aspiration for my 7 year old self, given the context. What I did not realize at that time was that I was going to go down a bit of a different road (no pun intended).

Those people who choose a profession in the medical field are guaranteed a few things. In my personal experience as a nursing major, I was guaranteed long nights studying and a fair amount of stress, but also a career filled with tremendously humbling experiences. These words of forewarning were echoed throughout the application process, in my acceptance letters, during my first days of college classes, and now, as I go into my third year of school, I hear about the challenges and rewards of nursing almost everywhere I go. However, as often as I hear about the impact nurses have their patients and their colleagues, it’s completely different to experience the interaction first hand. This is why I am a firm believer that the most important lessons that I have learned thus far, I have learned outside the classroom this summer as a nurse’s assistant in a very large and well known local hospital.

Last year, I sat in Pharmacology listening intently to every morsel of information, thinking “If I do not pass this class, that’s the beginning of the end. There is no hope for me if I can’t absorb and understand all of this material. I am surely not meant to be a nurse.” It was not until I began my job this summer that I realized that nurses are more than just walking textbooks; extremely knowledgable, competent, and eager to assist in a patient’s diagnosis and treatment. Nurses have the impact to change someone’s day—and that someone could be anyone. Passing the NCLEX board exam can only take a nurse so far. What makes an excellent nurse is how he or she uses their skills to heal and help others. As a nursing student studying and learning under the advisement of nurses at all stages of their careers, I have learned a tremendous amount about how to interact with patients, their families, and other nurses. These are the lessons that will take me farther than a textbook ever could, and I feel lucky that I am able to share some of these experiences and lessons now

What I Have Learned from Patients- Being a CNA (Certified Nursing Assistant) isn’t what you’d call a glamorous job. A large part of the tasks concern assisting patients with their activities of daily living—waking them up and getting them out of bed, assisting them to the bathroom multiple times a day, washing them, and in some cases, feeding them their meals because they are not able to do these things on their own. For some reason, I had the unfortunate preconceived notion that the patients would not say “thank you” or try to be helpful to me when it came time to do my job. But, I was proven wrong very quickly. I have been blessed to have had a handful of extremely grateful, calm, and pleasant experiences. It’s interactions like those that make the day go a little faster and smoother. However, that’s not to say that I have not been challenged. There have been a few cases that stand out in my mind as ones that I don’t wish to relive…but I know that’s a highly unrealistic hope for an aspiring nurse to have. One patient in particular had a tremendous impact on my perspective when it came to patient care. This man was very sick and had been in the hospital for a very long time, and I was assigned to to nurse who was treating him during his stay. Because of how sick this man was, he was on a list of medications—a few of which had side effects that caused a change in his mental status. These drug induced episodes caused him to act out in ways that were not typical for him, according to his family. He would have days where his aggressiveness would require security and restraints, and days where his lethargy would be so severe that he would be unresponsive. Because of these reactions, it made my job of moving him, washing him, and feeding him very labor intensive. He barely spoke, and when he did, it often didn’t make much sense. But every day when I was with him, I tried my best to make him as comfortable as possible, even though I was the only one doing the talking most of the time. I washed him head to toe every day, under his fingernails, brushed his teeth, and tried my best to feed him what I could before he would eventually spit it up because he had trouble swallowing. One morning, he was surprisingly responsive compared to his usual mental state. The doctors and nurses were very happy to see this change, and it gave them hope that he may have been improving. When I went in that day to bring him some towels and fresh pillowcases, he greeted me with whatever smile he could muster and said “You’ve treated me very well, thank you for all you’ve done for me.” I was almost brought to tears because this was the first time in days that I had heard him speak, and he was speaking of my impact on him. I did not know he was aware of what I had done for him in the days leading up to his kind words, but that doesn’t matter. Now, I will always treat every patient I meet with the same level of compassion and respect, no matter how they treat me.

What I Have Learned from Families- Having a family member in the hospital presents a unique sort of stress. The family knows that the patient is receiving the best possible care, but there’s still an anxiety associated with the patient’s condition, especially if it’s serious. The nurses in the hospital have an amazing gift of calming nerves and being present and available for the concerned family to answer questions. However, with a nurse’s busy schedule, sometimes that responsibility falls on the CNA. I clearly remember a day when I had to be available to a patient’s family member who needed reassurance and relief from distress. One day, when I went in a patient’s room to take his temperature, I was met at the door by a middle-aged man who appeared exhausted and emotional. I told him who I was and explained that I was just here to take his father’s temperature, then he could be alone with his dad again. He nodded and I proceeded to take the patient’s temperature under his arm, because he was too weak to keep his mouth closed around the thermometer’s probe. I got a reading, but it was a notable amount under what a healthy temperature should be. His son asked me what it read, and what it meant. I explained that his dad was not within the normal range, but I would be sure to let his nurse know. I could see how anxious this made him, so I sat down next to the son and assured him that I will let the nurse know immediately and if there is anything to do to improve his father’s situation, it will be done right away. He thanked me and I left the room to find the nurse outside of the door. When I informed her of my concerns, she told me a low temperature is to be expected for a patient who is due to be transferred to hospice care. She told me that she was on her way in the patient’s room to tell him and his son that that was the next step in his treatment. About an hour later, I had to complete my rounds which required me to go back into the patient’s room. His son was visibly more upset, and although neither of us spoke a word to each other, he knew that I knew about the latest news regarding his father. Because I really did not know what to say, I walked over and put my hand in his. He knew that I cared, even without saying a word. I wish that I could have been able to do more, but I knew even that small gesture of compassion made a difference to him.

What I Have Learned from Other Nurses- There is an old expression that students in nursing school hear time and time again, “Nurses eat their young.” This saying may sound strange to anyone who has not experienced nurses interacting with new grads or nursing students first hand, but I can tell you from personal experience that there is some truth to it. In a bustling hospital like mine, the vast majority of nurses are extremely competent, efficient, and have little tolerance for anything that interrupts their daily routine. So you might imagine, I was, and still am, very intimidated by their success and try to stay as “out of the way” as possible. However, as an intern, you also have a drive to learn from these men and women in any way you can. I have had both positive and negative experiences in dealing with nurses at my facility. Certain nurses encourage, others discourage. Some help you realize and learn from your mistakes, some get frustrated with your inexperience. Working with different personalities is inevitable, and learning how to maintain a professional and level head in stressful times is a valuable skill. Someday, I hope that I can be a role model to student nurses as well.