Friday, January 29, 2021

Diploma Nursing Students Learned Procedures the Hard Way


Needles could turn a smile into a grimace, lickety split

Procedures were the alpha and omega of diploma nursing programs and the ultimate way of measuring a student's progress. Like just about any other trade school, academic accomplishment took a back seat to providing a free source of  hospital labor. Procedures performed without concern for remuneration on unsuspecting patients were the currency used to pay for  "free" books, housing, uniforms, and food. There was no such thing as a free lunch.

Student nurses' mindsets were carefully groomed  to maintain a calm, confident, omniscient  bedside demeanor despite the fact that this was our virginal attempt at thrusting a 2 inch Imferon needle into a fellow human's vulnerable flesh. We were acutely aware that the procedure was likely inhumane and excruciatingly painful. Student nurses also carried the burdensome  knowledge that any flaw in their Z tract injection technique would be visibly advertised by that ugly, dark brown Imferon staining the surrounding subcutaneous tissue. An ear beating public  dress down from my favorite instructor, Miss Bruiser was sure to follow. I found it ironic that her name reflected the very nature of the Imferon staining complication, a big old brown contusion that looked a mess.

As a general rule of thumb, any procedure performed above the waist line, was done to a fellow student, affectionately known as a procedure pals. This relationship always reminded me of a cat vs. groundhog fight, one minute the cat is chasing the ground hog and the next minute the rodent is baring his formidable front teeth at the feline. The nurse and the victim patient in subsititutus  had to be very wary when dealing with  one another, she who injects and skedaddles  might live to inject another day, or the next minute, become the hapless recipient. Like so many other aspects of nursing, a classic no win situation.

 Performing painful treatments on each other was thought to be a vital component of nursing education, a real boon to developing empathy and the proper "attitude," what ever that was. Thank heaven we were not studying neuro surgery.  I shudder to think about the mess a bunch of first time amateur  craniotomies would look like.

When it came to performing uncomfortable downright painful procedures there were two student nurse  personality types involved. The most dangerous, in my humble opinion, was the eager beaver, overly enthusiastic student who would stop at nothing to be the first one administering the tormenting treatment. 

These were the novice nurses who thought the blood dripping from their fingers after a botched venipuncture was a badge of honor or that  it was appropriate to celebrate doing post mortem care for the first time. Miss Bruiser usually was able to take the wind out of their sails by insisting the eager students "volunteer" for her to insert a NG tube down their dainty little porboscus. Her ram rodding technique combined with her "demonstration" of a sulcus at the base of the tongue would humble anyone. The manipulation of the tube at the level of the epiglottis was guaranteed to provoke a hacking, gagging fit that would turn one's stomach while simultaneously bring tears flowing like a fire hydrant. A memorable experience that was sure to temper the gusto of the most aggressive eager beaver.

At the other end of the student nurse spectrum were the reluctant, overly sensitive types who were preoccupied with the uncomfortable nature of their ministrations. I was, without a doubt, a member of this tribe and frequently found myself biting my cheek when it came time to do just about anything associated with inflicting pain.

Mrs. Viotto was the kindly, grandmotherly nurse that was assigned to us who were not so eager beavers when learning painful procedures. Her constant reassuring smile resembled the exaggerated expression a pantomimist would use. Her typical discourse followed the theme  that we were there to help patients recover and in order to accomplish the end goal we would sometimes have to do things that were "uncomfortable." Pain was not part of her vocabulary. Everything from dressing changes on burn patients to bicillin injections were just "uncomfortable."

There was a reassuring smoothness in the way Mrs. Viotto conducted herself when demonstrating procedures. Rather than the stabbing and jabbing of the over eager student nurse clan, she stressed gliding a needle into position or threading a catheter in place. I learned more from her than any other instructor.

There was a very short window of opportunity for student nurses to master procedures and if by junior year a deficit was identified big trouble ensued. That dreaded yellow dismissal form with the dream shattering message, "unsuited for the practice of nursing," would soon find it's way to your mail box

. It was like an amputation in the days before anesthesia; painful and irreversible. Although, sometimes, the students who persevered envied the one's who left, especially when the ex-students would return to nursing school for a visit with tales of menial jobs paying more than a nurse could ever  hope to earn.


  1. I'm convinced the student nurse experience was universal back in the old days OFRN! It would have been unendurable except for the camerarderie of other nurses and the odd kind supervising Sister who encouraged us to keep going no matter how horrible it all seemed.

    I recently had the experience of coming to the aid of a young, sobbing student nurse who had been failed in a prac and was ready to give up. I had her smiling by the end of our chat - she was a kind hearted lass and I hope she continues her training - I'm feeling a bit like an old mother hen these days!

    I hope you are doing OK over there! Cheers from Sue

    1. Sue, Novice nurses today need all the encouragement they can get in these trying times. Whippersnapperns have a much more difficult time than I had back when everything was so much simpler. Aside from the lack of remuneration, old school nursing was a joyous experience compared to the problems facing contemporary nurses. It must feel like a lamb being led off to slaughter to face COVID day in and day out.

      I'm doing fine and am just laying low until I can get vaccinated.

    2. She was a sweet little thing OFRN - and I remember how easily I could be discouraged as a new young nursing student... she just needed a few kind words - I was in the hospital cafe and she was sitting there alone crying into her coffee - so I went over and told her I had been a nurse and could I help her - and she sat there and sobbed... by the end she had a smile on her face and was brighter... I went away feeling glad I had helped one brand new little nurse... they don't have the other students living around them like we used to in the nurses' home - I think they miss that camerarderie that kept us going.

      It was so good to see her brighten up after a chat! Cheers and you stay safe! Sue

    3. So kind of you to boost her spirits. Dorm living did have the advantage of someone always available to chat.

  2. Hi OFRN, I did leave a comment some time ago here but it seems to have vanished (probably an error at my end).
    I think all we old school nurses suffered in similar ways did't we - world wide! Your nursing school sounds just like mine. Great memories! Cheers, Sue.

  3. I know I have said it before, but it absolutely bears repeating. Reading your blog brings me peace when very few other things can. I initially voraciously read your blog in reverse order like a glutton, but have tried to pace myself as I reached more recent posts.
    I hope life is treating you well, OFRN; after your physical health deteriorated, you still found a way to touch lives and contribute. You were and are an amazing nurse and I am grateful to have found your blog.

    1. Thanks so much for your kind words, Kathy. That means so much to me. I try to ignore my health issues as much as possible and just keep on keeping on. When I was working as a nurse, I sometimes would write my own return to duty documents long after the MDs told me to go on disability. Stupid, I know, but I had this delusion that I would die if I could not work as a nurse. I was wrong about that one and have lived decades after departing from the work I loved. It's nice to have so many good memories of the folks I tried to help over the years, not that I was such a good nurse, but at least I was there when patients needed help.