Sunday, June 24, 2018

Teaching Student Nurses - That'll Learn Ya

"The next time Miss Bruiser gives me the
business, I'm gonna let her have it."
Crime and Punishment was more than a great Russian work of literature. To a lowly diploma school nursing student it was an integral component of the educational  training process. Mishaps, oversights and downright mistakes were all dealt with by mean spirited instructors out to teach a lesson that usually incorporated humiliation and the infliction of discomfort if not outright pain.

A bulletin board in the lobby of our nursing school was referred to as the wailing wall or the wall of shame. It publicly proclaimed the scores on NLN proficiency exams with the less than stellar results underlined in red and accompanied by cryptic notations to see Miss Bruiser for further review or report to so and so for remediation. The "reviews" were not pleasant and "remedial" usually meant painful and/or humiliating of the highest order.

My scores in obstetric nursing were not up to snuff and as a shy, 19 year old male I was ordered to teach a post partum mother's class. "Fool," Miss Bruiser intoned in her most somber voice, "I've got something special in mind just for you. You  are going to teach new mothers how to care for their infants." It was as if Bozo the Clown had been put in charge of a manned spaceflight to Mars.  I had to demonstrate with a baby doll how to bathe and care for a new born infant. My "students" were all experienced multigravadas that did more laughing and chuckling at my ham fisted, clumsy attempts than an audience at the Comedy Club. I think it was probably the most embarrassing episode in my entire life and I have a special knack for putting myself in embarrassing situations.

My procedure pal Janess was very busy with passing meds and was late turning one of her patients. Miss Bruiser caught her in the act of being 20 minutes behind the turn schedule and had that look in her eye that shivered our timbers to the core. We knew something was up the next day when a bed from the nursing practice lab had been wheeled front and center in the nursing school  auditorium. Before the day's lectures began, Miss Bruiser ordered Janess to hop into the bed and with her usual brusque mannerisms proceeded to "position" Janess with the entire class as a captive audience. When all the bending and twisting of extremities was completed, Janess found herself in a side lying knee-chest position with her head canted at such an acute angle that  her mandible was parallel to her clavicle. "You will remain in that position for the duration of today's lectures," barked Miss Bruiser as she ram-rodded  the siderail up with enough force to elevate the entire bed. The entire class witnessed Janess's contortionist like  punishment  that went on for nearly 4 hours. When she was released from the surly bonds of the bed she could barely walk and all she ever wanted out of life was to be a nurse.

Thankfully, the operating rooms were out of bounds for Miss Bruiser, but Alice, my favorite nursing supervisor was a perfect stand in with a bag of punishments  honed over decades of service. She had a real obsession with finger nail length and would approach nurses at the scrub sink with her millimeter ruler at the ready. One millimeter was the specified nail length and any deviations were treated with a subungal curettage with the business end of a mosquito hemostat. I learned the hard way that the subungal space is highly innervated when Alice began carving away on me while I was a novice OR nurse. I learned how to shave  my nails to half a millimeter length  for an extra margin of safety.

Alice had a thing about tucked in scrub shirts because she claimed leaving them out provided an escape for sub-axillary micrcocci which she affectionately termed "pit fallout" not to be confused with perineal fallout. She  also claimed that lose dangling scrub tops were at risk for inadvertently contacting a sterile field. Alice's cure for untucked scrub tops was an aggressive manual tuck in followed by a practiced upward yank of the scrub pants. I believe the street name for such a maneuver is a "wedgie" and it was something to be avoided at all cost.  I always carefully tucked in my scrub top to avoid this pitfall..

Getting caught wearing gloves for anything but a sterile procedure was a serious deviation from accepted hospital practice. The punishment for wearing gloves was usually a cleaning assignment that involved hospital beds encrusted with a variety of dried on excrements and don't even think about donning gloves.

In the old days things were done in a different way. Nurses scraping by on a subsistent wage faced a wild, chaotic hospital work environment where there were few cures for some very dark illnesses. In this entropy rich culture rigid rules and their subsequent enforcement provided a twisted sense of security to hardened old nurses. Of course, things are different today...I hope.


  1. When I finished laughing WITH your post, I immediately thanked the universe for granting me non-mentally and emotionally abusive instructors throughout my training.
    My favorite was the one who always added, "But in the real world..." {And we all know the 'real world' of nursing is completely different from school!}
    Second one was she who almost always prefaced her lectures with "When Flo and I were in school..."
    Instructors who could make me laugh always commanded MUCH more respect from me than those who tried to intimidate.
    I'm glad you survived!

  2. This sounds like Catholic grade school in the 50s and 60s.

  3. Officer Cynical and bobbie, I always enjoy hearing from both of you. I missed out on the Catholic school experience, but nursing school made up for it.

    Bobbie, nursing instructors were a colorful cast of characters. One of my favorites could not remember all the girl's names so she called them all "Trudy." Unfortunately for me being the only male, she always got my name correct.

  4. Your story of what was done to poor Janess is mind-boggling. I wonder if she finished her training? I'd have walked...

    I was fortunate to train when something like that would have resulted in legal action - but verbal and emotional abuse from senior staff to juniors was rife. At the time I started training a drop out rate of 50% was the norm, and bullying had a lot to do with those figures.

    I'm sure bullying still goes on, it just has to be subtler than your Miss Bruiser or Alice! S.

  5. Janess was a very tenacious young lady. We both started working in the OR together after graduation. She was great with coming up with some real zingers to surgeon's verbal abuse. I remember one occasion while working with a surgeon we called "The Mumbler," she told him she could only "listen so loud" when he screamed at her to "LISTEN."

  6. Good for Janess! I'm glad that she and you both made it though OK!

    Interesting how attitudes have changed... I remember corporal punishment being the norm when I was a kid at primary school - boys got the cane across their behind or a ruler whipped over their hands - I absolutely hated any kind of violence and reckon I was traumatised from watching boys being beaten/caned up until I was about 12 years old and then went to an all girls high school where it didn't happen. I don't know when it was abolished in our schools but it's unthinkable now! Girls could be slapped across the face by women teachers. One teacher scared me so much I fainted when I saw her in the school grounds!