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.

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....

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.

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.

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.

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!

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.

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.

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.

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.