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.

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:

• 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.

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 (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!

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!

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.

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.

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.

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.