NURSING STUDENT STORY - MEDICAL TERMINOLOGY

First semester nursing students have a lot of stresses as they begin their journey towards becoming a registered nurse. One of the main stresses is to perform a practical examination. That is the “make believe” portion of nursing school although we try to make the situations and equipment as real as possible. These examinations are performed in make believe hospital rooms complete with hospital beds, call lights, bedside tables, and various types of mannequins used for different skill check-offs. Not only are the nursing students stressed about getting graded on a pass or fail system, they have to verbalize back to the instructor what they are doing and why they are doing it. The students are responsible for knowing basic physical assessment of all of the body systems but are accountable for two systems during their practical examination. They have to pick these systems from folded pieces of paper in a cup. The unknown can also be very stressful.  

During the physical practical examination first semester nursing students needed to memorize how to examine selected body systems as well as begin to learn and pronounce medical terminology. This was always not that easy since many medical terms are quite lengthy and oddly spelled. This can make for some interesting pronunciations of medical terms as the student are performing their exams.

Kelly was a young 22-year-old who had always wanted to be a nurse. Her partner Cindy was a little older and 35-years-old with the same goal. They were going to perform their physical assessment on each other to get checked off either pass or fail. I had the cup with the folded pieces of paper in my hand. I explained to both they were responsible for two body systems. “Who wants to go first,” I said. They both looked at each other. Neither wanted to go first but knew it was a 50/50 shot. Finally after 15 seconds Cindy volunteered. “I may as well get it over with now,” she tells Kelly and me. I held the cup for her to pick out her first body system. She looked briefly at the sizes of some of the pieces of paper. Some were irregularly shaped compared to others. There were six pieces of paper. I knew the logic for some of the students would be the smaller piece of paper would be the easiest system to assess and get graded on. She picked the smaller piece of paper and opened it up to see what system she would need to assess. “I picked the respiratory system,” Cindy said with a sigh. “That is one of my least favorite,” she tells Kelly and me. I got the grading sheet ready and stood at the bedside table. “Okay. You can begin,” I told her. She looked at me like she wanted to cry.

She stood in front of Kelly. “Can you sit on the bed?” she asked Kelly. Trying to be the good partner Kelly sat on the bed with good posture. She knew it would be easier for Cindy to assess the respiratory system if she sat straight. “Okay first I am going to watch her breaths,” said Cindy. “I will watch for 30 seconds and multiply by 2,” she says. Then there was silence. Kelly was motioning downward with her eyes trying to give Cindy some clues. I knew she was stuck already. I waited a few more seconds before giving her a little push. “I will need to listen for bowel sounds,” says Cindy. “No, we are doing the respiratory system,” I told her. She slaps her hand to her head. “I know. I am nervous,” she replied. “I know. Just take your time. Think it through,” I told her. There was more silence. I knew she probably was praying to get the abdomen for one of her check-offs. The bowel sounds gave me the clue. “What are you looking for when you are watching somebody breath?” I asked. “You have to look at the systimitry,” said Cindy. “Do you mean symmetry?” I ask. “Oh yeah. Symmitry,” she replied. She was close enough. Cindy stood in front of Kelly and with her hands motioned out and in. “Ummm. Well… Abdomen?” she asks. “She liked the abdomen,” I thought to myself. I proceeded to prompt her a little more to get her to say rate, depth, accessory muscle usage but it took a while. She was not as prepared as she should have been.

It was time for Cindy to auscultate (listen) the lungs. “I am going to listen for the appacal,” said Cindy. “You mean apical?” I asked. “Oh yeah. Appical,” she replied. It wasn’t part of the check-off for respiratory but I did not want to confuse her anymore than she was. She finally started to listen to the lungs. “Tell me what sounds you are supposed to hear where,” I said. “You will have brachial sounds here,” as she puts the diaphragm on one side of Kelly’s neck. “Do you mean bronchial sounds?” I asked. “Oh yeah. Branchial,” she replied. “Close enough,” I thought to myself. Cindy put the stethoscope on Kelly’s chest. “You should hear branchialvoscular sounds here,” she said. “Do you mean bronchovesicular?” I ask. “Oh yeah. Branchoviscular.” I knew the terms would come with time.

After Cindy was done with auscultating the lungs I asked her what abnormal sounds she may hear. She stood there for a while with the ear piece of her stethoscope still in her ears. I motioned to take the ear pieces out of her ears so she could hear. She did. I asked her again what abnormal sounds she may hear. She stood there for a while. “What if you have a cold or are an asthmatic?” I prompted her. “Oh. You can hear weezles,” she said. “Do you mean wheezes?” I asked. “Oh yeah. Wheezes,” she replied. We were done. Now it was Kelly’s turn. I made a mental note. “Work on medical terms with Cindy.”

Kelly looked at the cup with the remaining pieces of paper. There were five left. I knew she was thinking if Cindy picked a small piece and got what she did not want, she would pick one of the larger ones. She slowly opened up the paper and looked. I looked over her shoulder. She picked head and skin. I heard a small sigh. I prepared another grading sheet. “Okay. Begin,” I said. “Can you sit on the bed?” she asked Cindy. Cindy complied and was happy she was done with one of her assessments. “Well, you look at the face sysmetry and the color,” she said as she placed her hands on Cindy’s face feeling her skin. “Do you mean symmetry? I asked. “Oh. I made the same mistake as Cindy huh?” she replied. “That’s okay. Just keep going. You’re doing well,” I responded. She continued to look at Cindy’s face. “I need to check her popples,” she said. “Do you mean pupils?” I asked. “Yeah. Popples,” she replied. Kelly had a little of an accent. Maybe that was as close as she could get. “She’s not paler,” said Kelly. I stood there for a while. “Do you mean pale?” I asked. “Yes. Pale. She’s not,” she responded.

Kelly continued to work her way down Cindy’s face and skin on her body. “What are you looking for when you are looking at the skin?” I asked. I knew she was stuck. “Well, you would look for cuts and bumps and migules,” she responded. “It’s okay if you called them moles for now until you get used to the term. They are called macules if they are flat and papules if they are raised,” I said. “Ok.” She continued feeling Cindy’s skin and naming every little bump and moles she had on her legs. Then we were done. Now it was time for Cindy to assess her second system and repeat it with Kelly. There were 26 students left. It was going to be a long morning. Cindy picked neuro for her next assessment.