One of my favorite things about nursing is that I’m always learning. On my floor, things sometimes come in groups – one time I’ll go in, and most or all of my patients will have the same type of stroke, the same type of brain tumor, or the same kind of surgery. Another time, the patients will all be radically different and have different needs.

On a recent night shift, I had a complex patient with a type of drainage tube that we rarely see on our floor. In fact, we have lumbar drains (which drain cerebrospinal fluid from a spot in the patient’s lower back) and several different types of drains coming out of patients’ heads all the time, and are quite comfortable with those. Stick a drain in another part of their bodies, though – say, a drain that replaces their bladder, or one leading to a wound vac (which is probably as gross as it sounds, but it serves a purpose), something like that, and sometimes we can get a little twitchy.

When we see unfamiliar drains, there’s a website on our hospital intranet with nursing skills. We can look up the procedures for taking care of pretty much anything. Many times, we’re advised not to touch these unfamiliar drains at all – a special team may handle it, or perhaps the patient will take care of it if it’s something they’re already accustomed to living with.

If it’s something we’re nervous about touching without knowing more, we can call our Clinical Support staff, a couple of experienced nurses who know how to handle just about anything. Sometimes they’ll come to the floor to help you, or they may be able to answer a question over the phone.

I was caring for a patient attached to a tube that I’d seen only a couple of times since nursing school, and the set-up was unlike anything I’d ever seen. The outgoing nurse explained what I was looking at, and then I was on my own.

I had a good shift. I felt like I was able to make a difference in my patients’ nights. I had time to be a resource to a less experienced nurse, and a help to the other nurse in the room. And all night, the drain did what it was supposed to do.

My patient’s drain was hooked up to suction, and when the surgical team came through that morning, just before the day shift came on, they took the suction section of the tube and ripped it out of the wall. Just ripped it. Doctors like to do things with authority.

But it changed the set-up I’d grown comfortable with, and the quick verbal order the doctor gave me for the new set-up wasn’t even in my language. The doctors were from a different service than the primary team that visits our floor. I rarely deal with them.

I paused for a beat as the team moved towards the door, digesting the unfamiliar words the doctor had thrown in my direction. While we were at the bedside, I’d provided helpful information that had conveyed my competence and helped the doctors make the decision to pull the plug on the suction.

I was about to risk looking stupid, but I had to do it.

“Tell me again what you mean about when I should plug the drain back to suction.” I asked of the doctor who had given the order. She turned around and repeated herself, providing a little more detail. I clarified what I’d heard with her, and the group left.

Then I called Clinical Support to make sure everything was OK. The nurse gave me a brusque pep talk. I went back and checked the drain, entered the order, and finished some documentation.

Then, the day nurse came in and I started to give report. There’s a familiar look when you’re giving report and you tell the oncoming nurse that the patient you’re giving them has an unusual or unfamiliar condition or piece of equipment.

It’s trepidation, mixed with concern.

But I’d had a really good night, and I was feeling confident. Many other times, I’d given report to this same nurse. She isn’t unfriendly, but isn’t very warm, either. She’s impassive, and projects confidence and skill. While I’m exhausted and ready to go home, she comes in, fresh and resigned. Any perceived failures on my part seem to just pile on the sense that she’s going to have another terribly busy day fixing everything I wasn’t able to take care of on the night shift, which begins to feel like everything that matters.

When I was a new nurse, there was one nurse we dreaded giving report to in the morning. She was a lifelong nurse on our floor with many years’ experience, and she asked endless, detailed questions and expected the nurse who gave report to have memorized lab results for the patients’ entire stay, and have a familiarity with the patient’s medical history dating back to their birth and including the most innocuous events (bee sting at age seven, broken arm at 16, etc.). This is back when we had paper charts and it wasn’t easy to just pull the information up.

She was so tightly wound that it was hard to take her style personally. Whenever I saw I’d be giving report to her, I’d silently tell myself, “like water on a duck’s back.” Instead of making excuses, when she invariably asked me a question I couldn’t answer (and she nearly always did), I would just shrug and say I didn’t know, then move on with report. No one was her equal, so there was no point in trying to be.

This other nurse? Well, I would like to be her equal. And while she isn’t terribly amicable, she’s a good nurse. So it’s harder to feel like I can’t answer her questions than it was with this older nurse (who has since retired.)

We walked over to the patient’s bedside together, and I showed her the drain. I showed her how it had been set up before the doctor unplugged it, so she’d know what to do if it had to be plugged in again. And we looked at the drainage site together.

We admired the system together. Another team (the one we usually work with on our floor) was examining the patient and checking to see if some of the symptoms that had resulted in the drainage tube being placed had resolved.

I hadn’t checked for one symptom myself because I believed it had resolved before the patient came to us, and it’s something we basically never see. I didn’t even know what to look for.

If this sounds strange, this is the life of a nurse. There are classic, but rare, things we learn about in nursing school but practice for years as nurses without seeing them “in the field.” And this symptom was one of those things.

But as I saw the doctors checking her, I immediately knew what they were looking for. We spoke briefly with the doctors about the plan for the patient’s care. I took the lead, the doctors acted on my recommendations, and left.

Then the other nurse and I looked at each other and walked over to the patient. She checked for the symptom, then I did.

Neither of us had ever experienced it outside of a textbook, and here we were, seeing it in real life for the first time together.

I don’t think she had a kumbaya moment about it. But I kind of did. There was definitely a shared awe as we looked down at the patient and admired the fascinating presentation.

There is something truly amazing about every system in the human body, and the way they all work together to keep us going. The way our bodies tell us something is wrong is equally amazing. As a nurse, I’m privileged to experience the miracle of the human body, and better yet, on mornings like that one, to share in the wonder with someone else.

Wondering what the patient thought of all of us prodding? Well, eccentric is one way to describe the person, also, accommodating. While the tube may have been the worst of the patient’s problems, the symptom wasn’t too bad, as far as symptoms go. Checking for it wasn’t invasive or painful.

Also, the book at the top? My dad’s mom was a nurse, and I inherited her medical textbooks. This is one of them.