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Monday August 13, 2012
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My student was typical: She was highly stressed and didnít have much time to study, but was smart enough to anticipate what might happen with an unexpected patient assignment. Although I was impressed with her background as a practical nurse, I felt the usual nagging feeling of anxiety. I have been a nursing instructor for almost a decade and have learned anything can happen with nursing students in the clinical arena. This would prove to be a unique day.

After having spent hours filling out the multipage preassignment the day before, the student approached me in the morning with a look of disappointment.

"Professor, the patient I did my report on is gone. She was sent home late last night," she said. Having listened to report on 34 patients, I figured there had to be an adequate substitute.

Suddenly, I remembered a new patient on the unit — just arrived a few hours ago — who was transferred from the trauma unit after having been airlifted from an island vacation spot where sheíd been spending her honeymoon. As I continued to present the patientís history, I could see the expression on my studentís face begin to change.

My duties as an instructor included supervising multiple students during medication administration, catheter insertions and anything else their patients needed, so it was about an hour before I saw the student again. I asked whether she had seen the patient yet and done her assessment. "No," she replied in a very distressed tone. "I think you really do not like me," she added.

I asked why she would make such a strange declaration, and she told me the worst story I probably have ever heard. "My patient was on her honeymoon at a resort in the Caribbean when she fell off a second-floor balcony. She fractured her cervical vertebrae and severed her spinal cord. She is a quadriplegic. She will never walk again, and she is only 27 years of age! And she was just married!"

Although I felt bad for the studentís plight, I felt worse for this young girl whoíd had the most tragic thing happen during what was to be the happiest time of her life. Shaking my head in disbelief, I told the student to please visit her new patient. "Donít jump to conclusions," I said. "You never know what you will encounter."

Although a part of me was thinking it would not be as bad as the student was making it sound, I knew in my heart this was not going to be a pleasant situation. I could imagine the mother of the patient at the bedside, crying occasionally, and the patient in a trance-like state.

So when I saw the student again with a big smile on her face, I was rather surprised. "Professor," she said, almost singing every word that came out of her mouth, "you will not believe what just happened!" There was no holding the student still. She jumped, shook and trembled all at the same time. The behavior exuded happiness and enormous relief.

She could not wait to tell me how the experience was nothing like she thought it would be. "Come in and meet her, please; she is so cool," she said with a gleeful expression. "Well, I donít know Ö " I said with real hesitation.

"No, really, I spoke to her for about an hour, and she is not depressed at all," my student said. "She told me about how she believes in God and Jesus and how her fate is in their hands. She was so interesting too; she has been to so many places. Please come and meet her."

When I remember this story, I think about how as clinicians, we have preconceived notions on which we base our opinions and actions, and about how deceiving those notions can be. As humans, we seem to lack the machinery to deal with events such as major illness and death. Our patient was content to fall back on her spirituality. It would bring her solace at a time when most of us would fall apart.

What if we clinicians all could be free from what binds us to programmed emotional responses that filter out other possibilities? We seem so suppressed because society teaches us to be afraid and disingenuous about our limited abilities to intervene. Imagine a world that was free from appropriateness and predictability. We all could live as this young woman, accepting challenges and ready to accept what we are given. •


Andrew Frados, RN, BSN, DNP, ANP-BC, is an associate professor at the Miami-Dade College School of Nursing.Write to editor@nurse.com or post a comment below.