First catheter insertion:
I was told each nurse would remember their first catheter insertion. After weeks of practice with the hard plastic makeshift vagina on the simulation dummy, we were warned that in the real world, the holes wouldn’t be so easy to find. Of course they were right. When I got my first gig on a cardiology ward, I was placed in for a 91-year-old lady with urinary retention. I immediately asked if I could do it instead, because, who really isn’t about the gore when it comes to nursing? So the registered nurse (RN) I was with told me to set everything up as I was taught to and proceed with the procedure. It was a good thing that he had a great sense of humour, it definitely took away the nerves I was getting from the old lady breathing down at me while I was looking into her aged vagina. You really couldn’t tell where everything was. So my RN and I went on a quest to find the point of insertion. I had the first go and poked and probed around until the little old lady let out a yelp, which scared me (the dummy never yelped) so I retracted back as far as I could. Assuring her I was definitely going to get it the second time, I lubed up as much as I could and inserted where I thought the hole might be. Finally! Tssssssssssssssssssss. And there it goes, 1L of urine bagging out.
A nurse’s first ever placement would 99% of the time be in an aged care ward—it’s greeeaaat for wound care, and the nastiest kinds. If you take a second to Google stage 4 pressure ulcers, you’ll know what it is (editor’s note: don’t). It’s all kinds of gooey, necrotic, smelly, and downright fun. I saw the nurse unit manager (NUM) who specialises in wound care debride off the necrotic black skin from an old man’s heel and I can tell you from experience, it doesn’t go from black necrosis to healthy skin, but to a red and white weeping wound, the kind that sends you to hospital in the first place. You wouldn’t even know you’re doing it but every student’s face immediately turns sick.
There were even wounds that ran 18cm deep (can you imagine!?) from an operation gone wrong. We had to use a sterile rod to probe the dressing down with crushed morphine.
There were wounds where you could fit a whole fist.
There were nasty surgical wounds, especially from open-heart surgery which ran right down the sternum. I had the chance to flick off every staple running down the patient’s chest, which came out roughly the same way as when you remove a staple from an essay, only with plugs off skin instead of torn paper.
Too many to count. Try being in the ICU where the patients are constantly being pumped with various pain medications which most common side effect is constipation. Needless to say, many enemas were given. Many times were our hands getting right up there, squeezing the bottles in to only have poo running down our arms.
How many of you have heard of a rectal tube? It’s pretty much the butt version of a pee tube. The way it’s inserted is pretty harsh, god forbid you’re awake if it happens to you. At least an inch in diameter is launched up your anus—with heaps of KY jelly of course—to make sure it sits there while saline is pumped into a tiny balloon that sits on top of your anus to prevent it from dropping back out. You might be wondering why this is necessary, well: a side effect of the painkillers and sedatives is constipation and when you’re in pain enough, you’re also probably backed up enough to require intervention. I’ve seen stomachs so bloated they’ve ballooned out to five times their normal size.
Needless to say, these are the moments I live for in nursing.