One of the first things a new clinical rotation does to you is create a sense of anxiety. It seems like you don’t know anything (this is only me, after all, what do I know?). Reading stuff in a text book is WAY diferent than confronting a patient face-to-face. Each knock at the exam room door before you enter has a particular uncertainty to it. What will you see on the other side? Will the parents be nice, or look at you with that look that says “Not only are you not a doctor, but a student nurse practitioner”? Will the problem be obvious, or will it be one of those times where the diagnosis could be one of a dozen options, for example: rash or a fever? Can I maintain the professional persona, or will I melt into a blithering idiot?
I have to do what I told my LPN students when I first took them into a clinical: “You have done all of this in lab, just go in there and pretend you have done it a million times already, just act professional and you will feel professional.” Ha!, Those words are haunting me now!
A few weeks ago (my excuse for this story is that it happened early in the clinical rotation, I never panic now…….really, never) I got a patient with a presenting complaint of high fever for several days, recorded around 103+ by Mom. I knocked on the exam room door with my stethoscope draped around my neck and Miss Brightlight clutched in my hand, and entered. The mom was sitting in the chair with her three-year-old across her lap. He looked very pale, his eyes were closed, and there was no reaction to me entering the room and introducing myself. Mom and Dad looked at me expectantly. The child was limp, his arms and legs just dangled, his head hung over his mom’s arm. “He has been so sick! He hasn’t eaten or had anything to drink all day. We are so worried.” The child didn’t move. I panicked.
“I’ll be right back,” I told them and got my preceptor. “This kid is really sick! He just lays there, he is pale and looks terrible.” My preceptor asked me “Did you try to wake him up?”……….Oh………..Duh.
Needless to say, I went back in and asked mom to put the child on the table. He woke right up and was actually fine. Had a simple strep throat. I felt pretty stupid. My preceptor is an angel, she did not say a word, didn’t even smirk. I love her.
I poke them a bit before panicking now.