Wednesday, September 28, 2011

Positive/not so positive clinical day...

Update on first clinical day: started at the nursing home with gait belt training. Aching back, aching feet, aching brain, aching morals. Observational Experiences today: bed bath, wound care for sacral decubitus. Hands on experience: head to toe assessment...

And now for the moral dilemma: a fellow nursing student commenting aloud about how bad a patient's breath smelled. A patient whose upper extremities were contracted, no ROM, oriented x1. It wasn't until after I left and was telling my husband about my day until I realized how wrong what she said was. I told him if I became a whistle blower I would suffer the consequences because it was only me and one other student in there with her. Hubby pointed out that it is the patient who has no voice, and nurses are the advocate/voice for the patient. This same person, when went to another room to observe held her nose, breathed heavily, and grimaced at the smell. I think it was very immature. She wasn't overdoing it or anything but it was definitely noticeable to me...what dO I do??

So earlier that morning our small clinical group of 7 students was divided into 3 groups. Hmm that doesn't divide evenly so there must be an odd man out, right? Well, have I mentioned before that Faux has a group aptly named "Team Awesome"? Well yes she does! And there are about 10-12 of her little puppets in the group. Let me describe the two puppets that are in my clinical group:
Puppet#1-the same girl who made the breath remark, know-it-all attitude, very early 20's, (and maybe even deficient in people skills, but I digress)
Puppet#2-fun loving, witty, all the teachers think she is great, running for our class 2nd VP position, can't think of anything else positive to say...

So today #1 was obviously disgruntled because she got stuck with me and my other classmate I will call J. #1 was standing by us and then #2 said "hey #1, whose group are you in?". She said "I am in their group" pointing to me and J. #2 looked at means then looked back at #1 and rolled her eyes!! How dare she?!? She is also made this lip smacking sound that 5 year olds make when things don't go their way.
Why am I getting all this abuse?? What has Faux said about me and why is this happening? I can't prove it. I feel powerless. So throughout the day #2 was very short with me IF she talked to me at all.

Need advice! Need the right advice! I am beating a dead horse.


Tuesday, September 27, 2011

"Pre" Assesssment of my first clinical day

So tomorrow at 0700 is the day I have been working for for over three years now. Yes, tomorrow my hard work and dedication is going to begin with the placement of a bedpan under someone's bum. For My first clinical day I thought it would be fun to make some predictions... A Pre-assessment of sorts. I have dreaded this day for 7 weeks now, mainly because I do not know what to expect. Here are my predictions:

1. I will be on time to my clinical site. (Not a bad prediction at all!)
2. I will change my first adult brief. (I must do it to get over the fear!)
3. I better not have to do a Foley on the first day!
4. I will be assigned to my client who is angry and combative, and male.
5. I will palpate some lymph nodes, read some charts, and hopefully fly under my instructor's radar!
6. I will survive the day. I can do this!! I have so much to learn!!

Today we were given all of our clinical documents. This is a major pile of work added onto our already high workload. It consists of patient data sheets, nursing diagnoses sheets, more patient sheets and then another patient data sheet that has to be turned into the university. Luckily, because I have a vast amount of experience with medical records, filling out all this paperwork will not be too time consuming. We also have to list all the daily Meds and ony the PRN Meds that the client actually takes. Because they are in a nursing home they have a huge list of PRN Meds. I have some major organizing to do after clinical tomorrow. I have a test Monday over something (can't remember what) and I must start preparing. Dr. Abrasive will have lots of questions on there. She is fierce!

Post assessment tomorrow!!

Friday, September 16, 2011

What I have learned about nursing school thus far...

Disclaimer: Please do not let my words come back to bite me in the butt. These are JUST little observations that I have made...nothing set in stone! Now, let's move forward with my post...

So I have learned that NS isn't really that hard.  Am I right?  Sure, they pile on the work and try to make your mind go in a million different directions.  All of that is great because I am a good multitasker.  I like to make lists and check things off as I go (Hi, Kelsy).  The content however, isn't really all that mind boggling.  Sure I know what a wheelchair is.  I know crutches, indications for the use of a nebulizer, how to round a decimal to the tenths place, etc.  So where is the hard part?  Where is the need for me to lose my social life and study non-stop?  Is it coming soon?  Is it just around the corner?  Please refer back to my disclaimer!

So, five whole weeks of nursing school down the drain. Or should I say "under my belt". Before I say anything else I must copy and paste an email I sent to my Bestie, "Amy" from Tuesday. I must warn you that it is unedited and full of raw emotion. I even had to use A curse word (but I was nice enough to place special characters even in the midst of my anger). Yes, this email was as raw as a field reporter coming live from a battle zone. Here goes

"so I had my Foley cath skills check today.  I did everything perfectly except for my sterile glove touched my unsterile field so that made me fail the whole thing.  When I was done and the instructor began telling me that I failed because of ...I realized the $%&* was next to me.  She was so distracted by paying attention to my failure she had a little smirk on her face.  I wanted to drop dead.  It would have been fine if she hadnt been all up in my business.  I am also mad at the instructor for not being more discreet.  So i had to stand there in shame while he filled out my "Lab Remediation" sheet and tell me about the retesting procedure.  It was all I could do to walk back in the classroom and pack up the supplies that I had just totally failed on knowing how much instant satisfaction it had just given someone.

I walked outside and tried so hard to hold back my tears.  It didn't work.  I was and still am so sad...this sounds like a blog post huh?"

Yep, totally raw. The good news is that I went back later that night and did my "remedial" practice followed by my last chance romance with the Foley. It was amazing. I passed. I figured I wouldn't since I was trying so hard. The next day on Wednesday I had my PEG tube check off and I did great! The most important part was stressing to my patient that their bed must remain 30-45 for thirty minutes to an hour. This is important. So they want die by drowning in their own vomit. Oh yeah, and the formula was also important too. Because without the feeding of formula they wouldn't aspirate. I did realize after it was all over that I never put on the gloves which should have failed me. My instructor luckily did not notice.
Rewind to Monday, September 12, I had another test. I didn't do so swell. I made an 83. I keep making the dumbest mistakes. One question was "what does RUQ refer to?". Right upper quadrant right?? Well this girl wasn't paying attention and I chose Right Under Quadrant. Ugh! Shame on them for putting that on there to screw me up! Haha

So Monday is my first Pharmacology exam. Then Tuesday is our PO med check off and also simple dressing change check off. In a week and a half we will be taking all of our learned skills on our clinical rotation through the local long term care facility. I think that starts on on the 26th. I am pretty excited but nervous about what it will be like!

Thursday, September 8, 2011

Made it through 4 weeks...

So...I passed my skills assessment for safe entry/safe exit, BP, lymph nodes, oral mucosa, radial pulse, and respiration counts. It was fairly easy but so nerve racking. I hate talking to these stupid dummies. Then, I get so nervous that I stumble over my words like a lunatic. A funny story to share...while doing the dummy's apical pulse, I could not locate the sound of the heartbeat! I thought I was going to puke. I kept telling my instructor who was grading my performance that the dummy must be powered off. He looked at me all confused and then came over and twisted the tubing on my Littmann! I was so embarrassed. He did well at assuring me that I had no reason to be nervous; that he had been in my position at one time as well!! I think technically I should have failed. Also, the day before when I was testing for my safe entry, I forgot to "pull the curtain for privacy". That should have failed me. My instructor let me pass. It was my partner that told me what I had missed.

So next week I am testing on health assessment for general survey, health history, and HEENT. I am studying my PowerPoint slides and my NCLEX book for that one. The tests seem pretty straight forward. You basically have to eliminate answers, as with any multiple choice exam. They are set up like the NCLEX ((I suppose, as I have never taken it I have assured myself that I can do this. I just need to breathe deeply and take one question at a time.

This week has been much less stressful than last. I think I am finally getting all of my ducks in a row as far as routine goes. I have not been able to watch any TV, which is fine, but I have been watching my Big Brother shows because they are a family favorite. It is the only show where the whole family sits down to cheer on their favorite players!!

Tuesday I have my foley catheter lab test. I am so nervous about that one. I have to maintain my sterile field and it is nerve racking. Maybe this time I can remember to pull that curtain!!

Friday, September 2, 2011

3 weeks under my belt and first exam!

So I spent the week cramming. Well, not really but I should have! Today I took my first exam for nursing. The class name is Professional Clinical Nursing. It covered infection control, safety, and vital signs. The tests are okay. I wish I could say they were easy but since I did not score 100 I guess it wasn't too easy. They ask you a question, for example,

"if you have a patient that has just received a positive diagnosis for MRSA, what would be your first priority.

A. place him in a semi-private room with a man who has an open wound
B. Place him in a room with a lung cancer patient
C. Place him in a private room with his family at his bedside
D. Put him in a semi-private room and wear a mask when you enter

Seriously? I laughed out loud when I read this question. I thought it was just a hoot! Then there were several other questions that I had the correct answer to but I changed the darned things and got them wrong. I was so peeved with myself!! I have got to quit second guessing myself. I get all screwed up in the end.
So...if anyone out there needs their fecal impactions taken care of, needs a new colostomy bag placed or just needs it cleaned out and swished with water, if you need a Foley catheter placed (male or female), or if you need some nutrition via the nasogastric, nasoduodenal, or nasojestunem tube, I am your woman!!
This has been quite a week! I have learned a bunch of stuff and I still seem to be retaining all of the information. It is coming naturally to me. Next Tuesday I have my first skills check which will include safe entry/safe exit, blood pressure, apical pulse, radial pulse, brachial occlusion, palpating and naming lymph nodes, and also examination and dictation of finding in the oral mucosa. Whew! That sounds like a bunch, right? Well, it really isn't that bad. I get three chances on each of them. Hopefully I will only use one each. I just have to remember to lower that bed and place the call button for Mr. Sim!! That is what everyone seems to miss. When I took my HESI nurse entrance exam, it said I was a kinesthetic learner. I am finding that to be true. I learn by doing.

Anyone want an update on Faux? Well she sat in front of me today for the test. When the score popped up upon her completion, I saw she missed only one and she raised both of her arms in victory as if to say "hooray". Gag. Me. With. A. Spoon.

Have a lovely Labor Day weekend!! I know I won't!!