Mindless Behavior

I have been doing some really crazy things lately.  First, and this happened a couple of weeks ago, I had went to Sam's and bought Panera Bread Cheese & Broccoli soup (YUM-O).  I brought it home and ate one whole container the very same day!  A few days went by and I had a craving for some more of that soup.  I opened fridge and could not find it!  I was not a happy camper.

So this past Saturday I was feeding one of my kidlets a nutritious meal of Chef Boyardee Beefaroni.  I opened the cabinet to pull out a sauce pan and guess what I found?  My soup.  One week old.  I can almost taste the bacteria that must have been brewing!

So this past Wednesday night, I hurried to the grocery store with one kid in tow.  I had to pick up the other from her tutoring lesson and I had less than 10 minutes to grab some milk, apples, and wheat bread.  I pondered a little too long over that bag of apples ($5.99) and decided to leave them.  They could eat a sugared up fruit for all I care at that point--but NO way was I paying that much for apples.  I grab my cart (which I affectionately call a 'buggy', but I will spare you the pain of hearing that) and run to the check out.  Except, it wasn't my cart.  I panicked and immediately thought of that poor person who was surely walking around aimlessly looking for her cart.  I hustled it back to produce, passing one guy who had a big smile on his face so I knew he had probably seen her...and yep!  He said "She's back there looking for it...".  I go to the produce section and find this little old lady with three employees trying to help her locate it.  She was really nice about.  I even explained to her how my mind was all over the place.  I am glad I didn't pay for her groceries.  I do not like Rye or Pumpernickel bread.

Yesterday, I had many assignments due.  Assignments that will not be graded in any way.  I believe this is also known as busy work.  Two full days of thrombotic-producing busy work. I am sure that as long as I sat on that couch, my venous return has to be compromised.  So enough of that.  I did laundry, OCD-cleaned my house, and ran to the commissary.  I knew it would be crowded from after-church rush, but I could handle it.  So I get there, see the crowd, and as I venture further in, it is evident that there is no food.  I am on the Lunchable/salty meat/bread isle when this lady has a conversation with me about the shelves being wiped clean.  We talk and I tell her it gets worse over on the frozen foods.  I grab my cart and go strolling along.  "Ma'am, Ma'am, excuse me..."  I turn around and it was the no-Lunchable lady and she says "You took my shopping cart!!"  I turn back to look, and sure enough, there it is--her purse and everything.  I explained to her my earlier incident from Wednesday and she was so understanding.

I am mortified.  How am I missing all of this detail?  Running away with people's buggies!  I have got to get a grip on all this thoughtlessness!

On a more positive note...

I took my first Med/Surg Exam on Monday morning and made an 87.5%!!  It covered the following: Respiratory, PICC, CAVD, Injections, Intro to PMHI, IV Therapy, Delegation, and Fluids/Electrolytes.  In the midst of my weekly clinical grief I totally forgot to post something of such utter importance.  Shame on me!

My next exam covers Cardio, Immune, and something else which I can't remember.

I still contribute my success to my MacBook.  It has been my saving grace!

Have a great weekend!!

I wanna hide under a large rock.

I have had the most horrible two days in Clinical Rotation…all you nurses reading, please advise!  Here is my scenario, and for the sake of privacy, I will be switching up my stories!

The hospital I am at has med/surg floors that deal with specific illnesses, like most hospitals do.  The type of floor I am on is not relevant I suppose, but the following information is.  My MAR indicated an IVPB of Penicillin G Potassium to be hung at 1000.  Already flowing in the primary was 20 meq potassium in NS with magnesium sulfate.  I was told by my instructor to be ready at 1000 to dispense medications.  Now keep in mind that 5 other students in my group are administering medications.  In what we call the “IDEAL” world, there is a 30 minute window to give meds.  Our instructor expects this to happen.  So here is the dialogue, listed in times incremements:

Me 1000: Meds ready, brain ready.

Her 10-1115: With other students giving meds.

Me 1116: ???

Her 1117: Ok tell me about your medications (standing in the nurses station)

Me 1117: “Ok I have this and that…and Penicillin G Potassium 100 ml/per hour, the fluids are compatible because I looked it up in the IV Compatibility book”

Her 1118: “Really?  Are you sure about that?”

Me: “Yes, because I looked in this book and there seems to be no interactions according to it.”

Her: “You sound like you are second guessing yourself.  You really aren’t sure are you?  Do you realize that you are almost 2 hours late giving this medication?  Do you understand what this means?  And now, you aren’t even sure that these medications are compatible after I have given you all this time to look them up?”

Me 1119:  <about to pass out>

Her: “You need to get on the phone with a pharmacist right now and determine if these are compatible.”

Me:  I scurry to the phone trying to look as confident as I possibly can, because after all, I HAVE just second-guessed myself.  So I call Pharmacy and get put on hold.  She is getting even more angered by the second.  She sees a Pharmacist sitting across the nurse’s station.  Tells me to hang up and go ask him.  I do.  I tell him the situation.  He writes it down and says he will get to it.  I go back and tell her.  She says “No, you need to go ask him again.”  So I go ask him again and he says that he is in the middle of writing orders and will look at it in a bit.  She is fuming!!  Tells me to get back on the phone with Pharmacy.  I call.  I hold.  Someone calls back and says the Pharmacist is unavailable because he is assisting with Chemo meds.  During this time, another nurse hears our debacle.  She shows the instructor an intranet website the hospital uses to check for compatibility.  And golly gee darn, the meds ARE compatible.   Guess what time it is?  1155.  So we head to the med box to gather the medications that should have been given almost two hours earlier.  Guess what?  The meds have already been given by the nurse who is over that room. 

I felt so cruddy about myself.  In post-conference she mentioned the situation to the group.  Said she was very disappointed in the way we prepare meds and how we do not know our drugs.  So last night I came home and was DETERMINED not to let her defeat me.  I made my own patient “brain” which is a sheet that I write all my Vitals on, medications, allergies, etc.  Basically all of the pertinent information that you really need to know at all times.  I had a plan to be very organized and informed and show her that I could rebound from the day before (which really wasn’t my fault, right??).

Wednesday:

Pre Conference begins.  She advises us that we really need to be “on it” today and know what we are doing.  Meds need to be given in a 30-minute window.  She should not have to do anything but walk up to us, and without saying anything, we need to start spouting off everything she needs to know (side effects, interactions, indications, etc.)

Remember that I had a plan to have ALL my ducks in a row.  I was giving a Beta Blocker, I need to know the Blood Pressure and Heartrate prior to administering.  Did that.  I had lab values.  I had side effects.

Her 1045 (after giving her all this premeditated knowledge):  “Really?  Hmm.  What is her diagnosis?”

Me: “She has ABC, XYZ, and JKL.  She was prescribed the blocker because of consistently high BP’s and HR for the last few days.”

Her: “No, what is her Medical History?  What is the reason she was here for before?”

Me: <Sweating, about to die>: Umm, well, this is a blank floor, so she has been treated previously for blank.  But now she is being treated for ABC, XYZ, and JKL.

Her: <Long stare, too long IMO>: “Really?  You really don’t know what she is here for do you?  You have no idea.”  She says to classmate: “Jane, do you think you could help her find out why her patient is in the hospital?” To me: “This is what we discussed in pre-conference.  I have given you all this time and you STILL are not ready.

I am on the verge of tears.  I have become resentful.  How is it that I shouldn’t be feeling some resentment? 

The weirdest part: I come home and take a nap.  I am physically and emotionally drained.  I sleep for three hours and when I wake up I realize what I have been dreaming about.  People dressed in Wendy’s costume (from the Wendy’s Commercial) who I had caught stealing medications and they tried to have them filled at the pharmacy.  I dream I am involved in a lawsuit involving those medications. I dream of an old, dear friend who had a blow up mannequin to travel with.  There is way more, but I should save some for later.

Most Awesomest!

I have the most AWESOME clinical group EVER!!  I look back and feel "shortchanged" compared to last semester.  Here is a great example of why it is the BEST:

Me: "Yes, I did live in Alaska..."
Group Members: "WOW!  What was it like?  Did you love it? etc..."
Me: "Yes"
Group: <laughing, giving feedback, etc.>

An example from last semester:

Me: <talking to myself>
Group Members: "She is such a stupid &#&$@(* B&@*$"
Group Members: <Rolling eyeballs at the sight of my existence>
Group Members: <Loud, obnoxious, hateful bullies!>
Me: <inhibited learning experiences which do not amount to the $25,000 in tuition that I am paying>

Seriously, I am done with the last semester chatter.  If you miss it, an archive is located over to the right --->

I am now focusing only on the positive experiences that are going on.  It is time to move forward!  So to start things off...yesterday we took a tour of the hospital with our instructor.  I love traveling through the internal arteries of the hospital (staff hallways).  It's funny because even though it is staff only, you always see some stray person roaming around, lost.  The HIGHLIGHT was our visit to the cooler.  Yep, upon MY suggestion we had the opportunity to possibly see a toe tag.  Lucky enough for the person who hasn't had their tag placed, there was no one home.  Now I consider it to be totally out of the nurses scope of practice to want to visit the morgue/autopsy room, but when I mentioned it my instructor lit up like the 4th of July!  She was so excited that I had asked, and in the end, so was the rest of my group.  The Autopsy room (currently vacant) was just like what you would see on TV.  Grayish/Blue in overall appearance, a table in the center with pipes leading down to the floors, drains, a fridge for organs, etc.  Definitely a cool experience, but hopefully I will never grace that place with my presence (or lack thereof).

Clinical shall begin!

Tomorrow morning at 0630 begins the new clinical rotation for spring semester.  I made it into what I am going to *predict* to be a really great group.  No bullies.  Bully is at a completely different hospital and I am very thankful for that.  So, without further delay...my predictions:
1.  Everyone in my group seems to be very adult.  Not in an adult film sort of way, but in a way that makes them not seem like a bully to the naked eye.
2.  I predict this rotation will prove to be gory.  I will be starting IV's, and may God bless the people who I perform it on. (Seriously, say a prayer for them)  The skin is truly not as tough as it looks on the outside, especially when you have an overzealous nursing student coming at it with a sharp.
3.  My skills need to be brushed up on.  I have forgotten my Head to Toe Assessment, Foley Cath insertion, PEG feedings, etc.  Again, keep these people in your prayers.
4.  My group unanimously voted to work through lunch and get out of clinical at 1330 rather than 1400.  My stomach, or what is left of it, begins speaking to me around 1100.  By 1130, I will be running on stored fat.  Not much left of that!
5.  Most of all, I anticipate the awesome patients that I will encounter.  That is really the best part of this whole nursing thing.  Sitting in class, dealing with drama, and tiptoeing around rigid instructors is nothing compared to actually being with someone in a time of need and having them eager to assist me in learning.

...So no real qualms with starting clinicals.  The nursing home and my experiences there will forever be engrained in my mind and I shall be forever grateful to be in a hospital where hand sanitizer and gloves are available for each and every patient, no matter the cost!

Back again!

These blog posts are getting WAY too far and few between!  But, at least I have a few things to ramble on about.

Bullying:  Yes, I am being bullied.  The semester has started and the Bully just cannot help herself.  My husband makes a good point about her though: "Why does she have to say and do mean things to you if she isn't happy in her own life?"  Now, dear husband, this is not the easy-way-out thought that I am looking for because I like to ponder on things.  Men are just way too simple.
~~~A little history on this bully: She called me a "B" in conversation to some other students while I am sitting right there in front of her, in clinical conversation she refuses to speak to me when I speak to her, not he last day of class she stood in front of my desk and said to another student that she hopes I do not make it back next semester because we need some "fresh faces", also in a recorded lecture (which I still have) she raised her hand in class to ask "How can I get one person out of my clinical group that I do not like?". 2012 rolls around and she is interrupting conversations I am having with others and telling them what a HORRIBLE clinical group she had last semester (she did that twice, on two separate occasions), and then on Friday she stands in the parking lot with her arms folded staring me down as I drive past.~~~
Now, I am trying to figure out what makes a person like this tick...and why is she treating me this way?  I feel powerless because short of being a tattle-tale, how do I handle this in a legal, ethical manner with the faculty, and I wonder if I should?

**Dermatologic Update: I went to the dermatologist this past Friday.  He examined me, asked 1,000,001 questions, and in the end had no clue what my condition is.  So, I guess as a troubleshooting method he put me on Doxycycline, which is a Tetracycline antibiotic with some pretty stinky side effects to include nausea, and sensitivity to sunlight.  I have also noticed such symptoms such as a generalized burning feeling in my skin, and chapped lips.  It sucks.  Also prescribed was a topical ointment called gentamycin sulfate.  Not much to report on that one.

Nursing School Update: (Because that is why I am here...)  Today I passed the following skills:
1) IV initiation & insertion
2) IV Piggyback setup
3) Subcutaneous Injection
4) Intramuscular injection
5) IV push medications

The first skill check-off went horrible!  I was just starting an IV!  Putting a needle and catheter in some dummy's arm!  Easy right?  Well, I flubbed!  I started sounding off my 7 Patient Medication Rights and was SO nervous that I could not realize that a simple IV insertion is NOT necessarily a medication.  But I passed.  I set up my Piggyback in a flawless manner and appropriately spouted off my 7 medication rights (Because a Piggyback DOES hold medication!!).  The rest are just history.  I passed them all.

I am ready to start my clinical rotations next week!  Tuesdays and Wednesdays 0630-1330.

Wow, I'm BACK!!

I thought it was time to update.  I have been putting it off for 9 days it seems.  Going this long without posting gives me many things to update on!  I will make a list and expand from there.

I had my sutures removed from the first biopsy, and last Friday January 6 I had an Ultrasound Needle Guided Biopsy.  It was no JOKE!  I went in thinking that it would be a simple needle needle stick (hence the term "fine needle aspiration) but it ended up being much more invasive.  For over an hour I was repeatedly stabbed with this "rod" jabbing in and out.  Over and over again.  At one point my local anesthesia had worn off and I felt some pain.  The doctor administered the local once again and I was fine. They were able to retrieve three good tissue samples for pathology.  I think the instrument they used was called a "core needle".  It was a loud, obnoxious tool.  Once in place it made a wretched clamping noise as it bit down on my tissue.  It hurt my feelings more than anything.  So, in summary, I had a 3 sutures complete with steri-strips, a mammogram immediately followed, and then I visited the lobby and filled out comment cards for Dr. No Bedside Manners.  I had nothing positive to say about him.  And in my current condition I didn't have many positive things to say about anything!  I still have bruising and soreness and can only sleep on my right side.

The results for that biopsy should be back tomorrow, January 13.  I also have an appointment with a dermatologist at 1540.  That should be interesting.  I'm pretty sure he doesn't get to see the likes of people like me all the time.  He should have a good day!  :-)

Monday was the first day back in nursing school.  It is now Thursday and I still feel like I am on Christmas Break.  I am totally not into it.  I could care less.  I guess I need to get past these Fluids and Electrolyte chapters and then I will be truly happy.  On a positive note, we started initiating IV's, intramuscular injections, SubQ injections, and hanging IV's with IV piggybacks this week.  I soaked the floor.  I really need practice.  That's tomorrow!

I was talking to a Psychologist early this week.  This is totally off the subject, but we were discussing why men and women cheat.  He says that men cheat because they can.  Women cheat because they are deeply hurt and are essentially signaling through infidelity that they want out of the relationship.   I thought that was pretty interesting.  Makes sense actually.

So I must sign off for now...I will post TOMORROW with biopsy results and details from the dermatology visit.