There’s a lot of information covered in nursing school. So much information, in fact, that it’s completely overwhelming. As a nursing student you feel as if your brain will burst with the weight of all the knowledge being quickly poured inside your skull. Yet in all that info there’s some things that slip through the cracks.
I’ve often said that the “real world” of nursing is far removed from that presented in school. That’s just a fact. And being thrown into the refining fire that is actual patient care is the only true test of if you have what it takes to be more than just a nurse, but rather a really good nurse.
There are many things you will learn in just that first year out, and actually that learning of new things will never end. There’s only so much they can present in an educational setting, and while there are a number of things you won’t learn until you’re on the job, these are a handful I find extremely significant.
Those nursing professors are pure gold, and they try to impress the relevance of all facets of patient care, but here are five things you just can’t learn in nursing school.
1. How to cry with your patient.
You learn about sympathy, empathy, and emotional support, but until you sit with a 32 year old mother of young children who has just learned she has terminal cancer, you will never understand.
Sometimes you cry right along with them, and other times your shoulder serves as a bucket for their plentiful tears. Either way, you won’t understand the significance of that moment until it happens.
When a tough guy in his fifties, with no medical history, suddenly faces the reality that he has to have a major heart surgery that day you will let him squeeze your hand tightly as silent tears roll down his ruddy cheeks, and you will finally get it.
You will finally learn that some days you don’t do something incredibly skillful and clinical, but instead you do something completely compassionate and wonderful. You cry with your patient.
2. The importance of holding hands.
In clinicals it’s so exciting to get your first IV, and nothing compares to sinking that nasogastric tube the seasoned nurse had trouble with. But I tell you this. Sometimes, often times, the most important things you do will go unseen. The thing most remembered by your patient will not be how you gave their medicines on time, or got a foley catheter in place without difficulty. No. What they will remember are the small things you might have thought were insignificant at the moment.
When an elderly woman gets confused at dusk, and she becomes very frightened, your soft voice and caring touch will be the key to her comfort. The time you spent holding her hand as she drifts to sleep will mean more than any other intervention you could perform.
In school they’ll use terms like “therapeutic touch,” but until you help lessen a young woman’s pain and anxiety after she loses a baby by simply holding her clinched hand while she unleashes her grief on your bent ear, you won’t fully understand just how important a simple thing like holding hands can be to a patient in need.
3. How it feels when a patient dies.
In school you will learn extensively about death and dying. They will try their very best to prepare you for the reality of healthcare, and this reality is that people die. You will know this. You’ll even think you understand. But then you will experience your first unexpected code.
Even as emergency meds are being pushed, hard, fast compressions are being delivered, and crisp, perfunctory orders are given, you will feel almost separated from your own body. You’ll perform in a professional manner as you fight to save your patient’s life even as you hear their family crying loudly in the hall. You will work efficiently and instinctively, albeit likely nervously, until someone finally calls time of death.
Later that night, well after hours of charting and a silent drive home, it will hit you like a ton of bricks. You might cry like a baby. However you react, you will grieve. You will question yourself and your actions. You may even question your profession choice. You will finally know what death and dying really means when you’re the nurse.
Then you’ll get up the next morning to go fight another day.
4. The joy of little things.
In nursing school you will learn so many big things. You’ll learn big words and even bigger definitions. You’ll learn big medicines and big, big side effects. You’ll learn big laws that govern your practice and the big responsibilities that will become your own.
Then you’ll experience the little things, and you’ll learn how big they are.
Listening. Just listening.
Washing a woman’s hair who has been in the hospital a while, and making her feel pretty.
Laughing with your patient. Laughing loud and heartily.
Feeding an elderly man whose hands shake too much to do it himself.
Giving a bath to someone too weak to do it themselves.
So many things that seem so insignificant and small, but that you learn are in reality totally huge.
5. How to walk in someone else’s shoes.
In school you learn about cultural diversity, mental illness, addiction, and all the different peculiarities that will make your patient a unique individual. But then you enter the real world of nursing, and you’re astounded by the people you meet.
You meet all kinds. All kinds. You’ll even encounter some of the meanest, rudest, most cruel types of people you’ve ever come across in your life. But you’ll also hopefully learn a very important truth; that being sick is hard work.
Becoming ill, feeling helpless, and being forced to lay still in an uncomfortable hospital bed as tons of wires course across your body, a plentitide of tubes exit every orifice, and disturbingly loud and scary alarms sound relentlessly is awful. It’s just awful. And it tends to bring out the worst in people.
If you can learn this, understand this, and allow it to guide your care of the patient then you’ll be on the right track. If you can sympathize with the addict and be patient with the mentally ill, combative patient, then you will start to understand. You will strive to walk in the shoes of the person who walked/rolled into your hospital. And only then can you really and truly help them. Only then can you make a difference.
Nursing is a lifelong learning experience, and school is just the beginning. The bedside is where the real education starts, and then it just keeps on going. So don’t forget to pay attention. You might just learn something that will make you more than just a nurse, but rather a really good nurse.
Molly Mcpeek says
Hi Brie. I’m a nurse too but in 2014, I spent over 30 days in the hospital due to multiple abdominal surgeries. I reflect often on those nurses because there were a few who were just really good nurses. The ones who held my hand while I learned to deal with an ileostomy and wiped away my tears, the ones who mysteriously “closed the other side of the room for repairs” so my husband could spend New Years Eve at my bedside, the one who hooked up my NG to suction to let me have a few sips of Champagne on that New Years, and so many more memories. I don’t remember those who were efficient with starting my IV or bringing my meds- I remember those who were there for me. I am thankful for some really good nurses. I wish all could read this.
brieann.rn@gmail.com says
Thank you so much for commenting and sharing!
Denise says
I am forwarding this to my daughter, Katie, who is in her senior year of nursing school. This is the concept that I have continuously been telling her, and I am 110% certain that not only does Katie “get it”, but she’ll be that really good nurse. It’s the passion that I carried when I practiced my nursing career, and it’s my life’s passion in everyday life: loving and serving others.
Thanks Brie for saying it so well.?
brieann.rn@gmail.com says
Thank you!