Wow. Wow, wow, wow, wow, and wow.

Folks, I really do, and I mean REALLY DO think I've figured out what I want to be when I grow up. And I'm just on the cusp of 33 years old.

The week began with learning about what a nursing assistant actually is and the limits of the certification. But that shouldn't sound trivial because quite often, the CNA can spend more time with a patient than any other member of the health care team. As you can imagine, a wealth of ethical issues immediately leap to mind. Ethical, legal, moral, and a host of other "soft" issues are going to come into play the moment you step into the room of a patient.

I suppose in many ways I'd already been tossing that kind of thinking around in my mind. Patient comfort and quality care take not only physical skills, they demand mental jumping jacks at a frantic pace. Well, frantic but organized. As with any patient focused task, there are a million soft boundaries in every direction. It's up to me to decide how to see them, when they need to be avoided, and how to deal with them in every situation.

My head is in the right place. I know that. I'm good under pressure and I'm an excellent communicator, at least, I've been told that repeatedly in the past. What's brand spankin' new for me is the limits on what I'll be able to do and the host of legal issues surrounding healthcare.

And jeez did we cover that ground this week. A lot of it.

We learned a mind-boggling array of acronyms. HIPPA, OBRA, HFAP, JCAHO, IDPH and a number of others that have new meaning to me. Years of nursing, advances in technology, and the generally litigious society that we live in has laid down a thick layer of protections for patients, staff, and health care systems. Waters that may be crystalline one moment can turn murky in an instant. We're just scratching the surface on how to navigate them.

Our instructors are great, and each of them, in their own way, has said a similar thing to us many times. To paraphrase; You can teach skills, but you can't teach morals and ethics. If there is anything I'm afraid of, or maybe I should say wary of, it's exactly those two things: morals and ethics.

Many shades of grey when dealing with morality and ethics.

So with an armful of regulatory information, a healthy discourse on elder care, the places we could be working as CNAs, a little bit about recording, a little bit about charting, and a great (if not scary) workshop on hand washing and infection control dress-up, we dove into safety issues on our last day this week.

I was tied to a bed.

No, it wasn't some kinky role-play. It was a serious exercise to demonstrate, generally, how to use restraints and tie quick-release knots, but the unspoken part of the lesson allowed us to experience one-millionth of what it feels like to be restrained. There was lots of good humor as we partnered up and bound each other to the training beds, but every single student, myself included, had that eerie and uncomfortable deer-in-the-headlights look when fully restrained.

Logically I know restraints have their place and I understand the serious nature of using them, but I know it will be difficult to see someone tied up. Somehow I'll deal with that when the time comes, but there'll be no shaking that helpless feeling for quite sometime, even if it only lasted a few seconds.

There's a ton of review I have to do this weekend and 10+ chapters to read for next week. I'm calling it Spa Week because we'll be learning lots about various grooming and bathing techniques as well as transfer procedures. I've spied the word massage on the syllabus and honestly, I can't wait to be on the receiving end of a practice massage.

I just hope it doesn't happen after lunch because either I'll be gassy or sleepy. Or God forbid, both...