It's been a while

...but I have been busy. I have given up all of my favorite shows. I have lost site of everything except for December 12th, the day of my last final.

We have finally migrated away from the nursing home and into the "real" world of nursing...the HOSPITAL! I am doing rotations in a telemetry unit and boy have I learned a bunch. Shall I just go ahead and make a list! Well of course, as it may be much easier to follow!

-a telemetry unit (from what I understand) is just a step down from ICU. At this particular hospital it is called hi-obs, or high observation.
-My patient that I was assigned to this last week suffers from liver failure due to years of alcohol abuse. The result of this is that poor nutrition, colectomy, PICC, PEG, mechanical ventilation through a Tracheostomy, and audible rhonchi. It was amazing to see just how by the second day that I was there how his condition improved.

Now on with my list of learning/things that I saw:
-I got to administer glycopyrrolate through a PEG tube
-finger stick blood sugars (boring)
-dialysis! These poor people! Take care of your kidneys please!! It is a sad demise.
-learned from speech language pathologist that when a patient is going back on solid foods, starting with clear liquids, they are fed applesauce with blue dye. If any of the blue dye is found in their canister (that holds all the yucky crud that is suctioned from their lungs) then they are still at risk for aspiration and should not be started on their new diet. Interesting, right?!?
-witnessed an ABG, or arterial blood gas withdrawal. This blood is drawn from the artery which is deeper than veins. It is rich in oxygen. In this case the COPD patient was being monitored to see if she was releasing CO2 was being adequately released from her body. If it isn't she could become could have acidosis which is not good. But that's next semester :)
-the dialysis patient had what is called a graft, where the artery and vein are essentially sewn together so as to allow constant hookups for dialysis. It is quite an interesting procedure and a hose actually flows into a sink excreting what I call pseudo-urine. So with a graft you can hear "thrills" with your stethoscope and that sounds like ocean waves.
-bored yet?!?
-I performed a wound care dressing change to a surgical site. Quite easy and I did well.
-lucky for me on day one there was an awesome respiratory therapist there who was more than willing to teach and share his knowledge. I told him he was a wealth of knowledge!
-I have to learn at some point that my patient is not going to break. I have got to get past the awkwardness and being able to lift that gown and get up under there and do what I need to do! It is my job after all! Still awkward!
-the RN on duty told me that nursing is 95% documentation and 5% basic skills. I think I believe her!
-there is a lot of sitting around in nursing. I have a strong work ethic and like to at least look like I am doing something
-unlike the nursing home, these CNA's are fabulous!! They are lickety split! Fast as a tornado and very skilled. Very nice ladies. I like to help out where I can.
-the charge nurse told me that when I speak to her, I must address her by name before speaking. Attitudes, I swear. Whatever.
-my patient was on full contact precautions so I was gowned, gloved, and masked! I felt silly but safe, right?!?
-the RN told me I seemed very confident. I totally didn't feel that way. I have a long way to go been though I have come so far.
-saw wind care vac.
-maybe more later...

***update on the people I should not even be wasting my carpal tunnel risk on***
They are still mean. The meanest of the meanies was gone Tuesday. When we came in the hospital she said to my friend "I missed some of y'all". Implying that I wasn't missed. I am so butt-hurt, let me tell ya!
I am still tired of the drama, thankful to be away from the nursing home and looking forward to more challenges!!

More later!! I am tired!