One month in, and I could not be enjoying Mayo Clinic any more. I feel like I have finally settled into a routine here in Rochester. I am now (fairly) familiar with how to get around downtown, have grown closer to my roommates and other externs, and feel my nursing care improving with each day. At the beginning of the internship, I observed a lot in order to get a sense of the pace and routine of my unit. Now, I try to take action wherever I can and participate in as much of the patient care process as possible. The Summer III externs have a slightly different scope of practice than we do as student nurses due to liability reasons. However, I still try to plan and prioritize as if I were the nurse. For example, even though I cannot administer medications, I still make sure I write each medication down in the morning, reviewing its mechanism of action, and ensuring it doesn’t interact with any allergies or other medications the patient may have. Going through these motions helps me get the most out of my time here, even though I may not be able to perform the physical skill.
At Mayo, nurses and other staff have the option to work 8 hour shifts instead of 12, which is a very different schedule than what most other hospitals offer. I work 40-hour weeks Monday through Friday from 7am to 3pm. Though I know my schedule will not always be this ideal when I begin my career, this schedule has allowed me to visualize the transition from being a student nurse to a full-time caregiver. With more hours comes more experience; I have gotten to see the hospital process come full circle, whether it be admission, discharges or transfers. I have gotten to see patients as they make their way to recovery and also observed protocol for declining patient situations. One of my favorite parts of being so immersed in the hospital environment is being able to see the same patients multiple days in a row. Being reassigned to a patient creates continuity of care and really facilitates the nurse-patient relationship.
After being on the orthopedics unit for a few weeks now, I feel much more confident in my ability to care for the patients on this floor. After an orthopedic surgery, whether it be hip, knee, or shoulder, neuromuscular assessments are crucial. When we receive a patient coming from surgery, we first do vitals and a head-to-toe assessment, but we pay special attention to the neuromuscular integrity of the surgical extremity. We use the CWMS tool to conduct our focused assessment, looking at the color, warmth, movement, and sensation of the surgical limb in comparison to the nonsurgical limb. Upon completing these assessments, I also learned the importance of understanding your patient’s baseline. Many of the people we see on this unit have had numbness and tingling for years prior to surgery; as a nurse, it is important to take this information into account in order to find out if these abnormalities are acute problematic changes or are well established in the patient’s history.
This past week, the hospital has been extremely busy and as a result, our orthopedics unit received many overflow patients coming from a range of different services. This was a wonderful opportunity to interact with different types of patients and diagnoses. During these days, I participated in dressing changes for dermatological patients, drain care for a post-mastectomy patient, and finally, discussing end-of-life options for an oncology patient. These experiences really attest to the importance of being able to tailor your nursing care to meet the needs of your patient. Every patient at the hospital – even if they’re undergoing the same procedure for the same diagnosis – has a different story, and it is one of the nurse’s many responsibilities to provide individualized and unconditional care to each patient.
Last week, I also had the unique experience of hearing from a specialty care team at Mayo Clinic: The Mayo One Flight Crew. Mayo One is the clinic’s helicopter that transports patients to and from the hospital. I learned all about what it takes to become a Mayo One crew member. To even apply for the position, a person must have a few years of ICU experience and preferably hold certain licenses. Once they have been accepted into the program, a rigorous orientation begins, consisting of drills, simulations, survival training, and ride-along observation shifts with other experienced crew members. Flight nursing was something that I previously did not know much about, but after hearing some experiences from the crew members, I have so much respect for this specialty. We got to tour the helicopter, flight deck, and maintenance hangar which was an incredible opportunity. Seeing everything in person made me appreciate the sheer intensity that this profession often endures. Taking care of a critical patient is challenging enough before you add in factors such as turbulence, a constricted work space, full body jump suits and communication via radio.
When I am not working at the hospital, I try to explore. Rochester is a great mix of a downtown scene that retains some quiet and quaint traditions. Every Saturday morning, there is a farmer’s market within walking distance from my apartment. It has everything from flowers to fresh meat and dairy to homegrown vegetables all from local farms. Rochester also hosts “Thursdays on 1st” which is a weekly festival where vendors come and set up tents selling handcrafted items and fair food. There is a lot of life in this town, as well as a lot of diversity. People come from all over the world to receive care from Mayo and often stay in the area a while, depending on the intensity of their treatments. Last weekend, I ventured out beyond Rochester to the great twin cities of Minneapolis and St. Paul. There, I went to Target Field to watch the Twins play the Rangers (Texas won!), pedal-boated on Lake Calhoun, and shopped at Mall of America.
I cannot believe how fast my time here is flying by; I feel like I just arrived! I am looking forward to my experiences on the unit in my coming weeks and hope that I can take in everything that Minnesota and Mayo Clinic have to offer.