I am happy to announce that I have sucessfully passes my 4th quarter of nursing school. I have worked so hard, had sleepless nights and tried so hard to pass this class. I got exactly what I neede for my final grade to pass the class. Afterward, they tossed out 2 questions, which raised my grade. I want to thank all the prayers on my behalf. I have such supportive family and friends. Not to mention my husband who is so supportive to me. He does whatever it takes for me to be successful. What a prize he is!
Now, I can "relax" this winter break until I go back in January. Unfortunately, I need to memorize about 30 IV meds and all the components that each med has (class, indications, rate, side effects, compatibility...etc). So my break won't be as much of a break as I'd like, but at least I can take a few days off until I'm at it again.
Monday, December 8, 2008
Sunday, October 26, 2008
My favorite rotation - THE ED
The ED you ask? Well, that's short for the Emergency department. I spent Thursday evening there and loved every minute of it. Here are a few of the things I did and observed.
1. I had the opportunity to perform two IV starts. The first patient I started her IV the first try and was successful. The second patient I started the IV on didn’t take the first time. The RN had difficulty getting it started too. She tried two times until she was successful.
2. I assisted the RN in prepping an analscope for a rectal exam. After we prepped everything, the physician entered the room and stated, "Well, I just figured out how to do this procedure, I saw a how-to video on You-Tube." I busted up laughing, but the patient sure didn't, I think she was in too much pain. He ended up having to do a digital rectal exam on her...still not the most pleasant thing, but I guess thats what happens when you state you have rectal bleeding upon admitting to the ED.
3. I performed an assessment on a dementia patient that was admitted for eating a sponge with paint on it. Yes, she ate a sponge with paint on it. She checked out okay. When I asked her to open her mouth to assess her airway, she opened and smiled. All I saw was red stains in between her teeth. It was actually quite funny.
4. I observed a trauma case in which the patient fell 14 feet and crushed his ankle. The patient was put under conscious sedation and the physician re-aligned, and re-set his ankle. I could hear the bones cracking as he re-set it. It was so cool!
5. Another patient came in with a femoral artery stent with an aneurysm. She was yelling out in pain. The surgeon was there applying pressure for almost an hour, waiting for the OR to be prepped.
6. Another patient admitted claiming to be 4-5 months pregnant with numbness and tingling on her left lower extremities. The physician performed an assessment and urine culture. He later determined her to not be pregnant, and with his experience, knew she did in fact have feeling in her lower left extremities and she has mental issues. His exact words were, “c-r-a-z-y, with a capital C.” She also had a journal open on the counter. I read a few excerpts from it and after reading it, I can honestly say, she definitely was CRAZY.
I really enjoyed my ED experience. I liked the pace, the physicians that were always around, paper charting, helping the patients in their urgent state. Most of all, I like the fact that everyone in the ED helps each other out when the work load is too much for one or someone needs to take a break. I think this is definitely a field of nursing I am interested in.
1. I had the opportunity to perform two IV starts. The first patient I started her IV the first try and was successful. The second patient I started the IV on didn’t take the first time. The RN had difficulty getting it started too. She tried two times until she was successful.
2. I assisted the RN in prepping an analscope for a rectal exam. After we prepped everything, the physician entered the room and stated, "Well, I just figured out how to do this procedure, I saw a how-to video on You-Tube." I busted up laughing, but the patient sure didn't, I think she was in too much pain. He ended up having to do a digital rectal exam on her...still not the most pleasant thing, but I guess thats what happens when you state you have rectal bleeding upon admitting to the ED.
3. I performed an assessment on a dementia patient that was admitted for eating a sponge with paint on it. Yes, she ate a sponge with paint on it. She checked out okay. When I asked her to open her mouth to assess her airway, she opened and smiled. All I saw was red stains in between her teeth. It was actually quite funny.
4. I observed a trauma case in which the patient fell 14 feet and crushed his ankle. The patient was put under conscious sedation and the physician re-aligned, and re-set his ankle. I could hear the bones cracking as he re-set it. It was so cool!
5. Another patient came in with a femoral artery stent with an aneurysm. She was yelling out in pain. The surgeon was there applying pressure for almost an hour, waiting for the OR to be prepped.
6. Another patient admitted claiming to be 4-5 months pregnant with numbness and tingling on her left lower extremities. The physician performed an assessment and urine culture. He later determined her to not be pregnant, and with his experience, knew she did in fact have feeling in her lower left extremities and she has mental issues. His exact words were, “c-r-a-z-y, with a capital C.” She also had a journal open on the counter. I read a few excerpts from it and after reading it, I can honestly say, she definitely was CRAZY.
I really enjoyed my ED experience. I liked the pace, the physicians that were always around, paper charting, helping the patients in their urgent state. Most of all, I like the fact that everyone in the ED helps each other out when the work load is too much for one or someone needs to take a break. I think this is definitely a field of nursing I am interested in.
ICU rotation
This past week, I had a rotation in the ICU. I was assigned to a primary RN and assisted her with one of her patients. The patient I had was a post-op patient who's vitals rapidly decreased and was tranferred to the ICU. He was a contact isolation patient, meaning I had to gown and glove each time upon entering his room. In the ICU, he was diagnosed with sepsis, with respiratory acidosis as a complication. During the shift, he had 6 liters of NS 0.9% infused with only 200ml of urine output. He also had 5 other IV’s with other medications infusing with the NS. The physician inserted a CVP line to monitor his venous pressure. It was so interesting being in the ICU. I couldn't believe how much work and time one patient took. I love the fact that nurses only do paper charting, as compared to computer charting on other floors. I loved every minute of it. This is definitely an area that I am interested in and maybe the ICU might be in my future.
Friday, October 17, 2008
Clinicals - Week 2
This week I took 2 patients. I wasn't going to be advantageous and take three when my instructor has not forced me yet. After all, I am free labor and I am paying to work at the hospital. It was nice though with two patients to have a little bit of time figuring out my evening routine, meds, charting, patient care and learning new skills. It's wonderful that there is always a learning opportunity, whether it be the patient and their current diagnosis and how to effectively treat it; or learning a new skill by working with IV pumps, and other skills.
Both days this week I had both the same patients. It is nice to have continuity of care and for the patient to see a familiar face. One patient was in for cellulitis on his lower left leg. It was pretty grody to look at, luckily he was all bandaged up. That was the extent of the complications of that patient, besides previous heart problems.
My other patient has had quite a history of events recently that unfortunately she now permanently is mentally impaired. She has history of bipolar and which she took Lithium (a mood stabilizer). It as effective for a long time, but unfortunately it has a small therapeutic range from 0.5-1.3. She collapsed last month and was unconscious for quite a while, leading to oxygen & blood loss to her brain. In the ER her Lithium level was 3.7 and potassium was elevated (which leads to cardiac arrhythmia's). She fractured her femur when she fell, but they were only able to stabilize her femur in traction for a week while she recovered in ICU. She went to surgery and was admitted to my floor. She was anxious, confused and talked incoherently. She called me Sharon. During my shift, she fell on the floor because she was anxious and moving around so much, eventually wiggling out of bed. I was with my other patient, so I didn't see it, nor was I responsible for it. She had wrist restraints placed and closely monitored. I had to feed her and change 2 loose BMs. Not my favorite thing to do, but I breathed out of my mouth to get through it.
I went over my patient with my instructor expressing my concern for her and her state of confusion. I wanted to help her and "fix" her. He taught me a good lesson, that sometimes we can't fix patients. We can only treat them and monitor them and hope they improve.
I was able to assist with a blood transfusion, set up the tubing, spike the blood bag and go through the numerous safety checks for delivering blood. I monitored the patient closely for signs of transfusion reactions. It went a-okay.
Stay tuned. Next week, I will be in the ICU & ER. I am sure I will have stories to tell about that.
Both days this week I had both the same patients. It is nice to have continuity of care and for the patient to see a familiar face. One patient was in for cellulitis on his lower left leg. It was pretty grody to look at, luckily he was all bandaged up. That was the extent of the complications of that patient, besides previous heart problems.
My other patient has had quite a history of events recently that unfortunately she now permanently is mentally impaired. She has history of bipolar and which she took Lithium (a mood stabilizer). It as effective for a long time, but unfortunately it has a small therapeutic range from 0.5-1.3. She collapsed last month and was unconscious for quite a while, leading to oxygen & blood loss to her brain. In the ER her Lithium level was 3.7 and potassium was elevated (which leads to cardiac arrhythmia's). She fractured her femur when she fell, but they were only able to stabilize her femur in traction for a week while she recovered in ICU. She went to surgery and was admitted to my floor. She was anxious, confused and talked incoherently. She called me Sharon. During my shift, she fell on the floor because she was anxious and moving around so much, eventually wiggling out of bed. I was with my other patient, so I didn't see it, nor was I responsible for it. She had wrist restraints placed and closely monitored. I had to feed her and change 2 loose BMs. Not my favorite thing to do, but I breathed out of my mouth to get through it.
I went over my patient with my instructor expressing my concern for her and her state of confusion. I wanted to help her and "fix" her. He taught me a good lesson, that sometimes we can't fix patients. We can only treat them and monitor them and hope they improve.
I was able to assist with a blood transfusion, set up the tubing, spike the blood bag and go through the numerous safety checks for delivering blood. I monitored the patient closely for signs of transfusion reactions. It went a-okay.
Stay tuned. Next week, I will be in the ICU & ER. I am sure I will have stories to tell about that.
Saturday, October 11, 2008
One Flew Over the Coo Coo's Nest
Have you ever seen One Flew Over the Coo Coo's Nest? This week I was at the Hospital for 2 days for my mental health rotation. It was not quite as bad as the movie, but it was pretty darn close. I picked a patient to focus on, which I'm writing my research paper on. She has Schizoaffective Disorder, Bipolar Type. The voices in her head were "talking" to her. She has serious issues, just as every other patient in there.
Here are some of the interesting things that went on:
Here are some of the interesting things that went on:
- An almost comatose, delusional patient wrote on a paper for me that she "is responsible for the E.Coli outbreak."
- A sweet lady with severe dementia was "missing". The entire staff was looking for her.I found her hiding in a bathroom. She was facing the wall and when I turned the corner she was right in front of me and scared me. :)
- A homeless man tried to interrogate me about being married, how many kids I had, and how "pretty I was". He was inappropriate to all the female staff.
- A young girl with severe depression got mad at me because I didn't wake her for breakfast. Well it didn't matter because she's bulimic and she threw it up anyway.
It was an easy rotation. I went to group meetings with numerous counselors. I learned how to increase my self esteem, how to effectively cope, and how to effectively break bad habits. I'm on my way to a better me!
First Day of Clinical
This week, I started my first day of clinicals. I am working 1 1/2 hours away at St. Joseph Hospital in Bellingham. It went as good as could be expected for having the entire summer off. I was a little rusty. I haven't worked evening shift so I had to figure out my evening and my tasks to be done at certain times. Also, I had to figure out the computer system to do all my charting.
I had the chance to start an IV on a new admit patient. I was able to get the IV in successfully the first time. It's a good thing I did, because I only had one chance to poke the patient. The IV catheter had two ports. The nurse told me to unscrew it to flush the IV. The IV had two ports. I was a bit confused and I unscrewed one of the ports and blood gushed out. Luckily the patient didn't see the blood and I was able to catch it all in my glove. I soon then realized she meant unscrew the cap off the saline and screw it into the IV port to flush. Well, I guess it can't go smoothly all the time...especially my first time on a patient.
I had the chance to start an IV on a new admit patient. I was able to get the IV in successfully the first time. It's a good thing I did, because I only had one chance to poke the patient. The IV catheter had two ports. The nurse told me to unscrew it to flush the IV. The IV had two ports. I was a bit confused and I unscrewed one of the ports and blood gushed out. Luckily the patient didn't see the blood and I was able to catch it all in my glove. I soon then realized she meant unscrew the cap off the saline and screw it into the IV port to flush. Well, I guess it can't go smoothly all the time...especially my first time on a patient.
Saturday, October 4, 2008
Starting my first IV
Last week, my clinical group was required to start IV's. I was a little nervous going into it, just like when I gave my first shot. I graciously let other students go ahead of me. Some made it on their first try, others it took up to 3 tries.
I finally got the nerve to do it, and my friend volunteered to be my guinea pig. With good coaching, good fine motor skills, and conficence (which I lacked a bit), I was able to start her IV on the first try. It is a little tricky, getting it into the vein, but it was easier than I thought, but she did have good veins. Next time it will be on a patient, so I will be more confidence and will have to hide any doubt in myself.
I (reluctantly) volunteered to be someone's guinea pig. My instructor helped the student find a good vein to use. Fortunately for me in this situation, I don't have good veins and my instructor wouldn't let her poke me.
I finally got the nerve to do it, and my friend volunteered to be my guinea pig. With good coaching, good fine motor skills, and conficence (which I lacked a bit), I was able to start her IV on the first try. It is a little tricky, getting it into the vein, but it was easier than I thought, but she did have good veins. Next time it will be on a patient, so I will be more confidence and will have to hide any doubt in myself.
Another test down
My exam yesterday covered mental health, cardiac and pediatric respiratory. I put a lot of study hours and it paid off. The test was taken on a computer, a change from last year. They are preparing us for state boards, which are taken on a computer. I was nervous going into it, worried that taking the test on the computer might negatively impact my test scores. I set high standards for myself to get 90%. I did not attain that score, but 88% will do just fine. There was a problem on the test I did not answer correctly, which surprised me. Apparently the number one mental health disease in the US is not depression, schizophrenia, or psychosis, but substance abuse topped the list. What is wrong with people?
Two tests down, 4 more to go!
Two tests down, 4 more to go!
Friday, September 26, 2008
Do you like-a-de-peppa?
Today at school, we had the opportunity to help decontaminate, transport and take vitals for Police Academy students. They were pepper-sprayed directly in the face, then they were required to fight an "assailant" (their partner) for a full 1-minute, handcuff them, put them into the squat car and radio for medic help. My job was to decontaminate them by assisting them to sumberge and rinse their face in water. Then after about 10 minutes of rinsing, while it feels like their flesh is burning, they are then transported to a medical room at school. A fellow student was so excited when she was chosen to drive the ambulance. After the first half of the students were taken away, I then did ambulatory care. I helped transport the student, take vitals and encourage them. Their pain was so intense, that it seemed like nursing school was a breeze. At least for now. Next Wednesday, I will be starting an IV on a student, and then I will be the guinea pig. I'm not looking forward to an inexperienced student poking me and placing a catheter in my vein.
I passed my math test today. I had to get 100%, and I only have 3 tries or I'm out. I stressed over it a bit more than I should have. Now I can focus my attention on reading my oodles of chapters for cardiac, mental health and pediatric respiratory. There goes my weekend!
My first post with photos from school!
Tuesday, September 23, 2008
More than half done
Officially I am more than half done with school. Yesterday was my first day of my second year of my RN nursing program. I have a good feeling about my teachers and hope that this is a good quarter. I am already behind in my reading. I have to drive to Bellingham 2 days this week for computer training. I have a math test on Friday I haven't studied for yet. Wow, I'm off to a good start! I am looking forward to my clinical adventures this quarter, although I am not looking forward to the 3 hour round-trip drive.
Friday, September 19, 2008
My clinical assignment
I have been placed to do my clinicals at St. Joe's Hospital in Bellingham. I was dreading this assignment because it is a 3 hour drive round trip. Luckily it is in the evenings and I can put the girls on the bus, so I don't have to pay for care in the morning. I hope that my clinicals goes by super fast this quarter and pray that I get Skagit Valley Hospital in Mount Vernon for the winter quarter.
School starts on Monday. I am looking forward to getting this year over with, but I am not looking forward to all the work that comes along with it. It's only 9 months of school, then I will be officially an RN...after I pass the state boards. :)
Don't you just love the music? I watched it on Scrubs a few seasons ago, and although it is a little crude, I thought it was very fitting for my nursing blog. Hopefully it makes you laugh as much as it made me.
School starts on Monday. I am looking forward to getting this year over with, but I am not looking forward to all the work that comes along with it. It's only 9 months of school, then I will be officially an RN...after I pass the state boards. :)
Don't you just love the music? I watched it on Scrubs a few seasons ago, and although it is a little crude, I thought it was very fitting for my nursing blog. Hopefully it makes you laugh as much as it made me.
Sunday, September 7, 2008
I've been accepted
I finally found out that I have been accepted into Everett's Nursing Program. I had an interview this summer. It went well, but my voice was completely gone. I managed to get through it, and within a few days I was notified that I had been accepted. Unfortunately, because of the course syllabus provided of my previous courses, they did not match up entirely to their program. They stated that they would place me in second quarter, or if I take a test and score well, then I would be placed in third quarter. That won't help me much, because I have already completed three quarters of nursing school. I have decided it wouldn't serve my interests to transfer and basically repeat a quarter, so I should stay where I am at and complete my nursing program as scheduled. I am anticipating this next year and hope it goes by fast and I am able to be successful.
Sunday, June 29, 2008
The first year behind me
I finally finished my 3rd quarter and now my first year is behind me. I studied hard for the final, between 4-8 hours a day for over 1 week. After I finished the final, I wasn't sure which way that would go. It would be okay or really, really bad. I finished the final at 10:30 am, and I wasn't able to check my score until 3:30pm. In the meantime, I was completely sick to my stomach. When I saw the score, I got above average, and it boosted my grade by 3%. Whoo hoo! The first year felt like an eternity. Although looking back it was a quick 9 months. I have an application into another school to start their second year nursing program. It is closer to home and would be more convienent. We'll see closer to September when school starts again. In the meantime, I will be relaxing and spending much needed time with my family. Goodbye until September.
Wednesday, May 28, 2008
In the home stretch
I am so excited knowing that I have less than 2 weeks left of my first year of nursing school. My last day of clinicals was on Friday. I had 3 clinical days back to back. It was the best week of clinicals by far. I continued caring for 2 patients and I felt really good about the whole experience, except for those few times I had to wipe one of my patients butt. Other than that stinky experience, I really enjoyed it. I was organized with my meds, assessments, labs, feeding, discharging, I&O's, charting & documenting. I was on FIRE!!! Yeah baby!
On Friday I had another "almost passing out" experience. Bear in mind, I ate at 5:30am, and it was 10am when I was asked to go into another patients room to watch a chest tube insertion. I really didn't know where the chest tube went and what it went into. Well, I soon found out. The surgeon cut a 1-inch incision between the 8th & 9th rib. She moved the tissue apart and then clamped a tube and inserted the tube into the left lower lobe. When she punctured the lung, I heard a loud burst of air come out of the lung. That's when it hit me. I started to feel funny and kind-of nauseous. I stepped out of the room heading straight for the break room. I downed a granola bar and a cup of orange juice. After 2-3 minutes I was fine and went back into the room. At that time the surgeon was taping and securing the tube and the procedure was just about done. The pt. was giving me a hard time for feeling woozy while he was awake for the entire thing! Next time I'll try to eat something before I watch something of that caliber.
On Friday I had another "almost passing out" experience. Bear in mind, I ate at 5:30am, and it was 10am when I was asked to go into another patients room to watch a chest tube insertion. I really didn't know where the chest tube went and what it went into. Well, I soon found out. The surgeon cut a 1-inch incision between the 8th & 9th rib. She moved the tissue apart and then clamped a tube and inserted the tube into the left lower lobe. When she punctured the lung, I heard a loud burst of air come out of the lung. That's when it hit me. I started to feel funny and kind-of nauseous. I stepped out of the room heading straight for the break room. I downed a granola bar and a cup of orange juice. After 2-3 minutes I was fine and went back into the room. At that time the surgeon was taping and securing the tube and the procedure was just about done. The pt. was giving me a hard time for feeling woozy while he was awake for the entire thing! Next time I'll try to eat something before I watch something of that caliber.
Sunday, May 11, 2008
Endoscopy
I had a one-day rotation at Endoscopy. I was able to watch many procedures. Some were interesting, some were not. That day, I watched 5 colonoscopies, 3 esophogealgastroduodenoscopies and one bronchoscopy.
I learned one thing: If you've seen one colonoscopy you've seen them all. They all look so similar...except for the one patient who didn't prep their bowels very well. There was sticky yellow feces that attached to the colon wall so the MD couldn't visualize any abnormalities in the bowel lining. I did see one pt. with diverticulitis. I did my research paper on diverticula disease and it was great to see it live on the screen. There were many pts. who had polyps and they were removed for lab testing to determine if it is cancerous. After standing on my feet all day I was ready to go home. Endoscopy is definitely not an area I am interested in. On to the next one....
I learned one thing: If you've seen one colonoscopy you've seen them all. They all look so similar...except for the one patient who didn't prep their bowels very well. There was sticky yellow feces that attached to the colon wall so the MD couldn't visualize any abnormalities in the bowel lining. I did see one pt. with diverticulitis. I did my research paper on diverticula disease and it was great to see it live on the screen. There were many pts. who had polyps and they were removed for lab testing to determine if it is cancerous. After standing on my feet all day I was ready to go home. Endoscopy is definitely not an area I am interested in. On to the next one....
My patient with the rod
It has been a while since posting last. I have been super busy. On the floor I worked on, most of my patients were post-op orthopedics, with hip replacements, knee replacements...etc. Nothing real interesting. Well after being on that floor for 4 weeks, I moved to another floor where patients with more needs were. The day prior, I had two patients. My instructor encouraged me to take 3 patients. Before I left I chose a patient with a diagnosis of "Urinary foreign obstruction". Before digging into his file I just thought he was passing stones through his urethra. Well, I was a little naive. My patient was an older middle-age man who had a friend insert an aluminum rod into his urethra and went into his bladder. It got stuck and had to be surgically removed.
He was being discharged the day I had him and I had to teach him how to care for his foley catheter for the week after he went home until his appt. with the urologist. He was a sick and perverted man. He was also rude to me and I just couldn't wait until he was discharged. I worked as hard as I could but he had no ride home for over 3 hours. I think he was going through some sort of alcohol or drug withdrawl, which could explain his rudeness. I don't think I'll be seeing another man ike that...or at least I hope not.
He was being discharged the day I had him and I had to teach him how to care for his foley catheter for the week after he went home until his appt. with the urologist. He was a sick and perverted man. He was also rude to me and I just couldn't wait until he was discharged. I worked as hard as I could but he had no ride home for over 3 hours. I think he was going through some sort of alcohol or drug withdrawl, which could explain his rudeness. I don't think I'll be seeing another man ike that...or at least I hope not.
Friday, March 21, 2008
My clinical assignment
I just found out my clinical assignment. Luckily, I will remain in Mount Vernon and not have to drive 3 hours going to Bellingham. Hooray! I am applying to a closer school in Everett as an advance placement transfer for my second year. I am hoping they will accept me. It will be closer and I think better all around. Application deadline is mid-April. We'll see very soon.
Tuesday, March 18, 2008
I PASSED!
This quarter has finally come to an end after another long 11 weeks. I took my final today and I was so nervous to get my grade to determine whether I can move forward in nursing school.
I was ecstatic when I saw my final grade... I PASSED!!!! I am so happy to move on to next quarter. It is amazing how much I have learned so far. I hope to retain at least 1/2 of what I have learned...but I think that might be wishful thinking.
I am looking forward to taking 1 1/2 weeks off to spend time with my family and catching up on all the things I have set aside and neglected (ie: cleaning house, organizing my kitchen and the kids craft cabinet, and sorting/organizing the kids clothes.
I start next quarter on April 1. I am unsure where my clinicals will be at this quarter. They will be in Mount Vernon (1hour away) or in Bellingham (1 1/2 hours away). I am not looking forward to driving 3 hours round trip for my clinicals. Two hours is bad enough. Think good thoughts for me because I would prefer to stay closer to home (although Mount Vernon is not very close at all).
I hope to not wait as long to post my next posting. My schedule has been so busy and hectic these past few weeks. Now I can relax for a little over a week until my schedule gets crazy again. I apologize to all my family for putting up with me. I am sorry to my friends for being so anti-social. This is really hard for me. But come summer, it's party time! I can't wait to kick back and relax in June.
I was ecstatic when I saw my final grade... I PASSED!!!! I am so happy to move on to next quarter. It is amazing how much I have learned so far. I hope to retain at least 1/2 of what I have learned...but I think that might be wishful thinking.
I am looking forward to taking 1 1/2 weeks off to spend time with my family and catching up on all the things I have set aside and neglected (ie: cleaning house, organizing my kitchen and the kids craft cabinet, and sorting/organizing the kids clothes.
I start next quarter on April 1. I am unsure where my clinicals will be at this quarter. They will be in Mount Vernon (1hour away) or in Bellingham (1 1/2 hours away). I am not looking forward to driving 3 hours round trip for my clinicals. Two hours is bad enough. Think good thoughts for me because I would prefer to stay closer to home (although Mount Vernon is not very close at all).
I hope to not wait as long to post my next posting. My schedule has been so busy and hectic these past few weeks. Now I can relax for a little over a week until my schedule gets crazy again. I apologize to all my family for putting up with me. I am sorry to my friends for being so anti-social. This is really hard for me. But come summer, it's party time! I can't wait to kick back and relax in June.
Sunday, March 2, 2008
In the OR
On Friday I did my rotation in the Operating Room (OR). I observed 5 surgeries. One was a rotator cuff arthroplasty. Aother was a pacemaker insertion. I watched 2 hysteroscopies. The surgeon was looking to find out why the post-menopausal women were having bleeding. She found polyps in both of the women. On those surgeries I was able to watch both on the screen.
I was able to scrub in on the final surgery. It was a pancrectomy and splenectomy. I was right next to the surgeon when she made the first incision. She cautorized the skin and the adipost tissue (fat). Then I watched her cut the abdomen. I saw her internal organs, the liver, small & large intestines, stomach, pancreas & liver. It was awesome! The best part of all was when the surgeon took my had and put it inside the woman's abdominal cavity. I felt her spleen & pancreas!!!!! WOW!
She removed her spleen & pancreas and her splenic vein. I've never seen a vein cut and sutured, nor have I seen , any internal organs, other than on TV. It was the most interesting thing I've seen!
It was an uncommon surgery at that hospital, and I feel very privliged to have been present at that surgery. Being an OR nurse is definitely an option now. It was a wonderful day!
I was able to scrub in on the final surgery. It was a pancrectomy and splenectomy. I was right next to the surgeon when she made the first incision. She cautorized the skin and the adipost tissue (fat). Then I watched her cut the abdomen. I saw her internal organs, the liver, small & large intestines, stomach, pancreas & liver. It was awesome! The best part of all was when the surgeon took my had and put it inside the woman's abdominal cavity. I felt her spleen & pancreas!!!!! WOW!
She removed her spleen & pancreas and her splenic vein. I've never seen a vein cut and sutured, nor have I seen , any internal organs, other than on TV. It was the most interesting thing I've seen!
It was an uncommon surgery at that hospital, and I feel very privliged to have been present at that surgery. Being an OR nurse is definitely an option now. It was a wonderful day!
My RT rotation
This last week I did my Respiratory Therapy rotation. My day was a bit interesting. I tagged along with the therapist while he did his many nebulizing treatments to patients with various respiratory problems. Some had COPD and pneumonia. I helped comfort a 14mo. boy who had pneumonia while getting his treatments. The best part of the day was when I attended a bronchoscopy. There was a tube with a camera going through the nose, down the trachea and into the bronchus of the lungs. All of this was viewed on a screen. It was so interesting to see the inside of the lungs. The doctor was extracting polups that were in the bronchioles for testing. I was looking on the screen , and the pieces looked large, but when they came out, they were less than 3mm in size. It was so cool to watch the procedure on a big screen.
Wednesday, February 20, 2008
Flesh eating disease anyone?
It has been a while since my last post. Not too much has happned by way of clinicals. Last week I had a patient had necrotizing fasciitis (flesh eating disease). It was very interesting. He was also a quadraplegic. He was very nice, but after being in the hospital for over 2 months, he was bored. To keep himself entertained he would be inappropriate with the nurses. I was a bit nervous and my instructor thought it would be a good idea for her to be present when I went into his room. I had to do the whole gown and glove procedure when entering his room. He was actually very nice and for the most part wasn't inappropriate.
There was an instance where he wanted to get a good reaction out of me. It didn't work. First, he was on a special water bed that was heated, and constantly moving the water. It was too warm for him, so he opted not to wear a gown, and just covered his twig & berries with a bed sheet. When I approached him and announced he was getting a bed bath, without hesitation he ripped off his sheet revealing himself entirely. I calmy stated that I will get to that part of the body last, so we could cover it back up. I did so, and didn't give him the satisfaction of making me feel uncomfortable.
I only have 4 weeks left, and counting down the days. I had my 4th test today and I am doing well overall. No complaints from me. I just have to study hard these next two weeks as we cover Neuro problems. A lot of problems, a lot of drugs and a whole lot of reading to do.
There was an instance where he wanted to get a good reaction out of me. It didn't work. First, he was on a special water bed that was heated, and constantly moving the water. It was too warm for him, so he opted not to wear a gown, and just covered his twig & berries with a bed sheet. When I approached him and announced he was getting a bed bath, without hesitation he ripped off his sheet revealing himself entirely. I calmy stated that I will get to that part of the body last, so we could cover it back up. I did so, and didn't give him the satisfaction of making me feel uncomfortable.
I only have 4 weeks left, and counting down the days. I had my 4th test today and I am doing well overall. No complaints from me. I just have to study hard these next two weeks as we cover Neuro problems. A lot of problems, a lot of drugs and a whole lot of reading to do.
Saturday, January 26, 2008
I almost passed out!
This week at the hospital I did my rotation in Day surgery. It is not exactly what it sounds like. I did not see any surgeries. That will be my OR rotation. Day surgery is pre-op and post-op. I admitted the patients, went through their history, got them squared away with their gowns and warming blankets. The blanks are so cool, it's an inflatable blanket that continually blows warm air on the patient. One of the patients I admitted was getting a colonectomy (a part of his colon removed b/c of colon cancer), and I was able to go with the anesthesiologist and watch him administer an epidural. I was excited b/c I never received an epidural with my 3 kids, and only saw one from a far. I thought I was in for a treat.
I must preface this experience, in that I had to be there at 5:45am, which meant I had to wake up at 4am to get there. I ate a light breakfast, because it's hard to eat that early in the morning. It had been about 5 hours since I ate anything when I went with the patient for his epidural. I was standing and watching for about 15 minutes as the anesthesiologist tried not once, but 5 times to get the epidural in the right spot. I was amazed at how far the needle went into his spine. I swear, it almost touched his belly button! :) Well, after the 5th time, I started getting light headed and sick to my stomach and my pupils started to constrict. I sat down and I began getting cold sweats. The nurse with the patient had to call another nurse to assist me to the break room. When she saw me, she could see how pale I was and walked me ever so gingerly to get some crackers and juice. I was greeted by surgeons, nurses, a nurse anesthetist, and a fellow nursing student. Embarassing!!! They all smiled because they've all been there. They gave me a few good words of advice. EAT!!! I will make sure to eat often when I am in the OR next month.
I must preface this experience, in that I had to be there at 5:45am, which meant I had to wake up at 4am to get there. I ate a light breakfast, because it's hard to eat that early in the morning. It had been about 5 hours since I ate anything when I went with the patient for his epidural. I was standing and watching for about 15 minutes as the anesthesiologist tried not once, but 5 times to get the epidural in the right spot. I was amazed at how far the needle went into his spine. I swear, it almost touched his belly button! :) Well, after the 5th time, I started getting light headed and sick to my stomach and my pupils started to constrict. I sat down and I began getting cold sweats. The nurse with the patient had to call another nurse to assist me to the break room. When she saw me, she could see how pale I was and walked me ever so gingerly to get some crackers and juice. I was greeted by surgeons, nurses, a nurse anesthetist, and a fellow nursing student. Embarassing!!! They all smiled because they've all been there. They gave me a few good words of advice. EAT!!! I will make sure to eat often when I am in the OR next month.
Friday, January 18, 2008
Quarter 2, Week 3
Today was my first clinical experience at the hospital. I was in the Progressive Care Center taking care of a patient for end of life care. He had a tripple bypass surgery and was not in good shape. He was having such a hard time breathing, and his irregular heart rate didn't help. Aside from his complications, he was very pleasant. Today he said, I want to go". I tried to clarify what he was meaning. He then stated, "I just want to go to the promise land." I felt so sorry for him, and his wife sitting next to him tried to quiet him up because she didn't want to hear any sort of talk like that. It was interesting seeing that side of nursing today. I wonder what next week will be like when I get a new patient.
Thursday, January 10, 2008
Quarter Two - Week 1
I am so excited for this quarter. I am focusing on Medical-Surgical and Pediatrics. I will be able to be in the OR for surgery. I am so excited for that! This is one department I have been seriously considering joining after graduation. After this quarter I'll have a better idea if it is still what I want to do. We will doing pre-, intra-, and post-operative care.
I will be going to Head Start and assessing the toddlers there. I will be very comfortable working with toddlers, especially beacuse I have one! I think I will enjoy it and I am looking forward to it!
I will be going to Head Start and assessing the toddlers there. I will be very comfortable working with toddlers, especially beacuse I have one! I think I will enjoy it and I am looking forward to it!
The catheterization that went so very wrong
While working last quarter in the nursing home I had many experiences that helped me grow as a nursing student. One of which was the catheterization that I had to perform. The woman had severe MS and her legs would not open very wide. Because of which, the CNA's did not perform adequate perineal care. When I did peri-care for her, I had to do a lot of "clean up" so to say. The smells were atrocious and almost unbearable. After I cleaned her, I set up my sterile field. I prepped her with betadine to sterilize her, and I thought I was good to go. I tried to insert the catheter, but what I thought was the appropriate spot, apparently was not. I had to have the two other students who were holding her legs open to also hold flashlights. I spent about 10-15 minutes or so with no luck. My instructor came to the rescue and assisted with finding the urethra, which still took some fishing and hunting around for it.
The catheter finally went into the right hole. Unfortunately, the catheter that I used was not like the one I was used to in the practice lab. The caths in the lab already had the collection bag attached. I forgot to attach the catheter to the bag. Soon I had urine coming out onto her bed. I quickly fixed that problem and was able to collect the urine in the bag. I then had to blow up the balloon in the catheter with 10ml of water. The syringe had 30, so I had to stop at 10ml. I pushed in the 10ml of water and had difficulty getting the syringe off with the same hand that was holding the catheter in place. Another student nurse that assisted me helped take it off. Unfortunately, I was still putting pressure on the syringe as to not lose water out of the balloon. I ended up squirting the patient with water all over her legs. This is exactly what not to do when performing a catheterization!!!!
I got her all cleaned up and went to measure her urine from her old bag. As I drained it, I became nauseous from the putrid odor of her urine. My spirits were down and I felt very unqualified to perform another one. Comforting or not my instructor said that was the hardest cath-job she’s ever seen, because her anatomical orifices were not in the correct location, which made it hard to find the urethra. I was finally done 50 minutes later!!!
As luck would have it, I was able to perform another catheterization. This time it went off without a hitch. I performed it from start to finish in 10 minutes and my instructor was very pleased, and boy, my confidence level came back.
I look forward to more fun and interesting events during school.
The catheter finally went into the right hole. Unfortunately, the catheter that I used was not like the one I was used to in the practice lab. The caths in the lab already had the collection bag attached. I forgot to attach the catheter to the bag. Soon I had urine coming out onto her bed. I quickly fixed that problem and was able to collect the urine in the bag. I then had to blow up the balloon in the catheter with 10ml of water. The syringe had 30, so I had to stop at 10ml. I pushed in the 10ml of water and had difficulty getting the syringe off with the same hand that was holding the catheter in place. Another student nurse that assisted me helped take it off. Unfortunately, I was still putting pressure on the syringe as to not lose water out of the balloon. I ended up squirting the patient with water all over her legs. This is exactly what not to do when performing a catheterization!!!!
I got her all cleaned up and went to measure her urine from her old bag. As I drained it, I became nauseous from the putrid odor of her urine. My spirits were down and I felt very unqualified to perform another one. Comforting or not my instructor said that was the hardest cath-job she’s ever seen, because her anatomical orifices were not in the correct location, which made it hard to find the urethra. I was finally done 50 minutes later!!!
As luck would have it, I was able to perform another catheterization. This time it went off without a hitch. I performed it from start to finish in 10 minutes and my instructor was very pleased, and boy, my confidence level came back.
I look forward to more fun and interesting events during school.
End of First Quater Nursing School
Well, I am happy to say that first quater of Nursing School has come to an end...finally! It has been such a hard quarter but it was worth it, because I did well and passed. It may not be a large feat, but I have to take one quarter at a time.
Two weeks ago I received a package from my parents (it is pictured below). When I opened it up I started to cry. You see, when I was about 12 years old, I attended a Tony Robbins convention, yes that's right, Tony Robbins. I learned how to put mind over matter, and that night, I WALKED ON FIRE! , As I walked on fire, I repeated in my head, "Cool Moss". I walked away with no burns. It was an awsome experience, and my dad said if I can walk on fire, then I can do anything. Afer my experience, I used a beading loom and beaded this necklace. A few weeks ago my parents found it and now I can look at it every day for inspiration.
Here are a few things I have learned about myself and other things while in school.1. I have a new appreciation for the beauty of sunrises2. My kids really are hard to wake up and get going in the morning3. I am starting to become a better test taker4. My husband is so awesome, and the best in the world! I couldn't have gotten to this point if it weren't for his loving support5. I missed making dinners and yummy desserts for my family6. I missed talking to my friends and having our girls night out
Quarter One - Week 9
I can't believe I have only 2 weeks left. I have been busy with studying, writing a paper, going to clinicals, and doing my 10 pages of clinical assignments. I am working at a Long-term facility. I have a patient with multiple problems, including both legs amputated due to diabetes, and one arm tramatically amputated, and on top of that he has a pressure ulcer (open wound) from sitting in his wheelchair all day. He actually has it better than some there. While working there I have taken so many blood sugar tests and given so many insulin injections, I can't count them all. I have given showers and bed baths to patients, administered many different forms of medication (eye drops, oral, topical, subQ and IM). The one I am most proud of is a PEG tube medication administration. A woman has a tube in her stomach where she has tube feedings. I administered her medication in the tube. Fun stuff! I have so much on my plate that I have been a bit stressed. As a result I broke out in one of my typical-fashion stress-induced cold sores. Thank goodness I will be done in 2 weeks and on relaxing on our cruise in 3 weeks!
Quarter One - Week 6
Today ends week 6 of nursing school. The time has flown by quickly, and I can't believe I am over 1/2 done with the quarter.I did something very fun and interesting on Wednesday. I gave Flu shots! We administered them at the local hospital to employees. I was a little nervous to give them because we had practiced injections into little fluid-filled bags. Obviously, human skin, tissue & muscles are much different than the bags we practiced on.I was nervous doing the first one, and my hands were shaking a bit. After the first, I felt comfortable and excited to do another one. I was also able to give a TB shot, which is intradermal (just below the dermis of the skin). I gave it to a sweet, little old lady, who was so patient. My instructor was very pleased with my work. Whoohoo!!As students we were allowed to receive the flu shot as well. One of my fellow students administered my shot . I had a little bit of anxiety, and I started breaking out in cold sweats. At that moment, I realized something. I don't like to be on the receiving end of injections. I much prefer and enjoy giving shots. Anyone want me to practice on them? Ha Ha.
Quarter One - Week One Nursing School
This ends my first week of nursing school. It was a crazy week. The kids have started adjusting to their new schedule of early mornings and getting to bed early. I'm not quite there yet with late nights of studying and early morning schedules. Drew enjoys going to Sue's house, and going to preschool everyday makes him happy. On Wed. he came home with a paper with cut-out people in a circle. He proceeds to tell everyone that it is his "circle of friends". How cute is he! In school I learned about vitals and I was able to correctly take an accurate blood pressure the first day! Whooho! I have so much work to do it is crazy, but Jeff has been so wonderful helping out at home. When I come home he takes care of so much of the "domestic" work and he encourages me to hide in the office and study. I'm so lucky to have such a supportive husband.
Why it is my daily dose
After visiting with my sister-in-law, Marissa, she convinced me to start a blog dedicated to just my fun and interesting nursing school experiences. I was giving her a detailed account of a catheterization job that went terribly wrong, and she said I needed to write them all down. I agreed and with the help of my sister, Heather, she came up with this wonderful and very appropriate name.
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