7.27.2009

Classy

My employer sent me to IV therapy training last week. I only had one overnight shift all week, and two days of Nursing 101 revisited in the staff development room of another facility across town. I kept staring at the door labelled "DSD Office" trying to figure out what it meant. Dry Sterile Dressing office? Day Staff Director? It wasn't until the second day that I figured out that it meant "Director of Staff Development". How great it must be to have one of those around! Before I left the second day I scribbled down the URL on the back of one of the DVDs, Bathing without a Battle.

This was the first "Training" I'd actually received since getting my license. The content was extremely familiar, basically recapping a couple classes in nursing school about IV access devices, very basic level fluid/electrolyte stuff, and reminders about what kinds of complications you'll run into.

The pharmacy we use puts on the classes, apparently it makes them "look good to the state" or something to put nurses who work in long-term care facilities to sit through this class before fiddling with the IV pumps.

The content was all very basic, and I was surprised to find myself sitting through a lecture covering a watered-down, cliff-notes version of content I was responsible for knowing to get licensed in the first place.

The other classmates were mostly LPNs and ranged in age from just-out-of school to grizzled veteran. They all dutifully wrote down everything the instructor said in preparation for a short multiple-choice test on the second day.

Something I noticed back in nursing school is that -not- taking notes tends to disturb or offend the speaker. While everyone else huddled over their notes, I just stared at the presenter intently. She carefully avoided eye contact, I could tell that the fact that I hadn't picked up my pencil in 5 hours was bothering her.

Thankfully there was a minimum of that "Former Acute Care Nurse talking down to us SNF/LTCF-ers", but on some level I couldn't help but find the simple presentation of the material itself to be condescending. Yes, I know the anatomy of a vein. Yes, I know how they are different from arteries. Yes, I will replace a sterile dressing that's starting to pull away at the edges instead of reinforcing it with tape. No, I will not try to pull a PICC line back out if I notice the catheter has migrated deeper into the resident.

For the first time since I really got into my job at the SNF, I found myself missing Med/Surg. I'd probably still be putting up with training there, but at least it would be training that would be picking up where nursing school left off, not rehashing the basic principals of what I got my degree in.

So anyway, now I'm "certified" by our local nursing-home mega-pharmacy to manage IV infusions, a skill I laboriously practiced as a student and then was not allowed to practice at all at my first 9 months with my employer. The infusion pumps we use are the same decades-old model I used as a nursing student at a large inner-city hospital in our state's capital. Peristaltic pumps, no volumetric pumps here. They must be pretty sturdy and reliable if people are still using them. No backprime feature, but our instructors taught us how to do everything by gravity anyway.

The funny thing is, we rarely even have infusions where I work. I've seen IV antibiotics maybe twice, IV hydration once or twice. A CAD pump once. Sitting through a class doesn't replace real-world experience, a point my clinical training made rather forcefully. Even though I've sat through this class, will I be any more competent at managing IV therapy if I don't have any residents receiving IV therapy for another six months?

Fortunately the class reminded me that I DO, in fact, know what I'm doing. Maybe better than some of the people around me.

1 comment:

a.spiked.teapot said...

O my goodness. Freaky stroke of luck i stumbled across your blog!! DUUUDE. I was slowly becoming disillusioned with the 'non holistic' reality of nursing and was really questioning how i came to be at this almost registered point. But you know what?- it is so nice to read others experiences to become newly inspired and kind of 'be the change you wish to see in the world'!Like why not change the current nursing-enviroment. Any who- Thanks so so much for your insights!! I shall be following.:)