Happy Holidays

Twas the night before Christmas.., and all thru the floor
Lasix was given, filling the foleys galore.
Stockings were worn to prevent emboli,
they came in two sizes, knee and thigh high.

The patients were nestled half-assed in their beds,
while visions of stool softeners danced in their heads.
We in our scrubs, and they in their gowns,
Fashions created to hide extra pounds.

When down in the ER it became such a zoo,
they called with admissions for me and for you.
They're coming, they're going, and they're all looking the same.
My patience for patients is starting to wane.

Now call lights are ringing, the patient 400 pounds, says-"
Didn't get my pericare, now send my nurse down."
And now delegation seems the best plan,
We try to send others, to the needs of this man.

When what to my wondering eyes should appear,
But Santa himself and 8 tiny reindeer.
He says he comes from Central Supply.
To bring us LR,NS, & D5.

The doctors then scribbled what no one could read,
Orders on patients, to measure their pee.
We try to decipher illegible words,
orders for patients, to guiac their turds.

The new shift arriving, our day is now through,
How did stool & emesis get in my shoe?
We give them report and pass on the facts,
and tell them of duoderm lining the cracks.

And the nurses exclaim as they limp out of sight,
"Ativan to them all, and to all good night.!!!"

One Step Closer

The end of another semester! I celebrated this very successful term by taking the family to Disney World for 6 days. After this past year I know they have missed out on a lot of the one on one time they so deserve.

Only one more semester left!!!! Or to be more exact only one more 8 week class then Preceptor! It seems like I spent forever on the waiting list just to get in an now this program has just flown by.

Cardiac, ECGs, Dysrhythmias oh my!

So there isn't much of a purpose to today's post. Just wanted to share some links I have come across that may help in this portion of the class.




Some NCLEX cardiac questions:
nclex-style-practice-questions/

Powerpoint reviews:
cardiovascularsystem.htm

ECG Exercises

Then test your skills with a quiz!
The Second ECG Simulator

Add your favorite study tips below if you want to share :)

Pump your Blood

Going old school for a moment here. Figured since we are studying the structure of the heart and all, might as well add it to a tune.

Let's bow our heads

Dear Lord:

I know we go through this every day, but please give me the knowledge as to why I actually wanted to go to nursing school.

Lord, give me the strength to make it through those boring three hour lectures without falling asleep.

Lord, please give me the patience to make it through clinicals with instructors who can't just give you the right answer. On the same note, give the floor nurses the ability to remember what it was like to be a student and give us just a little more respect.

Lord, give me the endurance to read all the assigned readings and be able to remember it when I am taking a weekly quiz or a test with 4 right answers.

Lord, give my family and friends the ability to realize I really am on the edge of insanity.

Finally, Lord, give me the vision to see that one day I will be a real nurse and I will never have to wear this ugly uniform again.

Amen

A few lessons learned...

Wow, okay. So it has been a little over 3 months since the last post...figured it was time to grace the internet with my presence again.

Yes, I am still in the program. Not much has changed in the way of school... still busy as heck. We just finished up Ob/Peds by taking the HESI yesterday. By some miracle I actually got an A in the class!

The next class: Adults II, which started with clinicals today. With these clinicals we are being introduced to the great skills of Trach care and suctioning (yummy!), starting an IV (along with caring for it, med pushes, issuing blood products and starting piggy backs). Theory for this class will be focusing on the Cardiac/Pulmonary systems.

So, the realization has come, that we only have 16 weeks left of classroom time!!! Of course there is still preceptor time, but that is far more interesting then sitting in a classroom. (and a lot harder to fail!) Making end of the insanity more of a reality, we were told to apply for graduation today! (We have to apply the semester before we graduate.)

So here are a few things I have learned so far:

1. Some instructors are crazy! Just smile, do your job, and pray that the crazy isn't contagious.

2. Pediatrics is boring! I am sadden by this fact, I thought Peds was the reason I joined nursing school! Oh how I wanted to find an extra bed and partake in designated nap time when the lights were lowered on the floor! However, I did really enjoy the day spent in the Pediatric ER...guess that will still be a consideration in preceptor location choice.

3. Psychiatric nursing is one of those love hate things, and I loved to hate it! Something about being in a locked ward didn't sit well with the claustrophobic side of me. Or maybe I identified a little to well?

4. I like my new dysfunctional family (aka classmates, or sometimes they are called friends too). They are the only ones who fully understand the chaos that nursing school entails. It makes the daily monotony a bit more bearable, I care about their success as much as my own.

5. Mistakes happen, take note of them, laugh at them, and move on. Or even better...tell your classmates so they can get a good laugh out of the deal too!

6. If you get beat up by a confused patient, be prepared to get teased by your clinical instructor, who is secretly glad she was standing out of arms reach.

7. Sometimes the exams you take in the class have nothing to do with what you have learned, or in fact the correct answer was really the opposite to what you were told in class.

8. Just like the military there is a lot of "hurry up to wait" and there is a lot of time wasted! Today for instance could have been over before noon; however, we were there until 1530. I have learned to always have extra reading material on hand.

9. Nothing in this program is worth raising your anxiety level....take a deep breath and say "goosefraba". This is only temporary.

10. Patient safety is a must; however, restraints are around for a reason!
Okay, I am there is much more I could add to this list. But my head hurts and I have some chapters to read....first quiz is on Friday!

One more month!

We are officially (as of yesterday) one month out of being able to check off another completed semester. If I make it to the end has yet to be seen, I have struggled a little bit on the last exams in both classes. Thankfully, I am not to the point were I must get a certain grade on the final...but if I don't shake things up soon I will be looking for a new major.

In light of everything here is a bit of humor...

Stages of Life in Bottles

(Thanks Tracey)

Nanda Nursing Diagnoses

Top 10 Diagnoses for nursing students…

10. Fluid volume deficit related to dehydrating effects of caffeine as evidenced by increased student sightings at coffee bars.

9. Impaired social interactions related to inappropriate topics of conversation as evidenced by excessively detailed discussions of bowel and bladder functions.

8. Sexual dysfunction related to time constraints and stress-induced impotence as evidenced by increased irritability of nursing students and their significant others.

7. Functional constipation related to lack of time to go to the bathroom as evidenced by moving at the speed of light and still not getting everything done.

6. Impaired skin integrity related to increased intake of fat, chocolate, and alcohol as evidenced by the return of adolescent facial breakouts.

5. Anticipatory grieving related to impending midterms and final exams as evidenced by fits of crying and social withdrawal in October, December, March, and May.

4. Maturational enuresis related to trauma-induced regression to childhood as evidenced by frequent changing of linens.

3. Ineffective individual coping: obsessive compulsive behaviors related to high demand of nursing school as evidenced by the continual checking and rechecking of calendars, date books, course syllabi, and other nursing students to reassure that one is not forgetting assignments.

2. Altered thought processes: caffeine-induced psychosis and paranoia related to increased coffee consumption as evidenced by the overwhelming feeling that all the instructors are out to fail you from the program.

1. Self-care deficit related to being a nursing student as evidenced by weight loss/gain, insomnia, and mediocre household cleanliness.

Confession...okay more of a gripe

So I confess...I am not a very good blogger. However, I am a fairly good student, which explains my lack of blogging here lately. Maybe I should rename the blog from "chronicles of" to the "occasional rantings of an allusive student nurse." Hmmm, I think it's kinda of catchy :)

A few other blogs I read occasionally just stop at random points, and I wonder if they are in the same boat as me? Or are they not posting because they are no longer on the student nurse to registered nurse path? Rest assured my loyal readers (all 10 of you) I am still trudging away, just busy as all hell!

I can't believe how much work there is actually to do! Three weeks ago I wrote all the assignments due for each class in my weekly planner, color coded to match each class...yup, I still have a migraine from it!

I feel it is taking everything I can offer just to try and keep my head above water. There is this overwhelming sense of overall disappointment, looming over my household. I feel guilty "hiding" in my room behind a mountain of books instead of crawling around outside intriguing the young minds of my kiddos. Or when I do take some time off of school the work, it is always in my brain that I should have a book in hand. Any other task, not involving nursing, never really gets my full undivided attention.

Something has to give, I am crossing my fingers and toes hoping it wont be my sanity! There are still 11 more months to graduation and pinning! I find it befitting that we are studying hypertension this week. I think I need to re-review the signs and symptoms of prehypertension for a little self diagnosis.

Alright this has completely veered off the intended topic and I end the complaining here. Back to the books...I have to find someway to cram all the information required to pass two exams on Monday, into a already nearly necrotic brain.

No Longer A Nurseling

Today brought in a brand new semester of Nursing. We have now progressed to Adult Health I and Mental Health. If it is possible, even though it was only an orientation day, I am already feeling the stress. There is this overwhelming dread as I look over the two syllabus'. I wonder how it is even possible that we are going to be able to meet so many objectives. Seems impossible for a normal semester, but this is summer and there is a month less to cram in the same amount of material?!? Oy vey. Sleep is going to be a distant memory! Have I mentioned how much I love coffee?

I am very sad to confess... I think I have killed a small forest today and quite possible a few more will be cleared in my name before the end of these 12 weeks. The notes need to only cover the information for the first test in both classes is unbelievable. I think I am going to have to go buy a bigger binder tonight! We had it so easy last semester....

Tomorrow is a clinical day, without the benefit of having at least having one theory class. Nothing like being tossed into the fire. My first three weeks (2x a week) will be spend doing my Mental Health rotation. I was told the hospital I am going to still practices electric shock therapy. I thought they did way with that in the 70's....hmmm. Promises to be a learning experience like no other. The Clinical instructor said we will mostly be on a woman's floor but we will also be making rounds on the Children's floor as well. I thought Peds was going to be hard to see sick kids, the mental health aspect of illness never even crossed my mind. Don't know how those days are going to go

Alright, I am off...I need to go locate where this hospital actually is before early morning rolls around.

Nurse's Appreciation Week

In honor of Nurse's Appreciation Week a few prayers to help you through your day:

A Nurses Prayer

Give me strength and wisdom
When others need my touch;
A soothing word to speak to them,
Their hearts yearn for so much.

Give me joy and laughter,
To lift a weary soul;
Pour in me compassion,
To make the broken whole.

Give me gentle, healing hands,
For those left in my care;
A blessing to those who need me,
This a Nurse's prayer.

Copyright 1995 Allison Chambers Coxsey

Also for you certified nurses aides:

A Nurses-Aides Prayer

Lord, before I leave for work today,
I need to take the time to pray.
I want to serve You faithfully,
And perform my tasks with dignity.
When I 'counter moments of stress,
I pray for help to do my best.

While assisting cares for a resident,
I heard her whisper a prayer lament.
If a resident is upset with me,
I ask him to forgive, I plea.

Residents suffer, expressing fears,
Others grumble of aging years.
Some residents glow from faith inside,
Where dignity rules their hearts of pride.

Some residents feel they live in despair,
When in the "Home"their destined there.
"Resident Rights" are a vital must,
For quality care to us they entrust.

Grant me compassion O' Lord I pray,
as You guide me through my working day.
by Linda Fisher Adams, CNA

HESI

It stands for Health Education Systems, Inc. For some schools this is the type of exam you take to even enroll in Nursing School, until recently my school used the NLN to enter the program(though I hear that is changing to the HESI.)

Once you are in the nursing program it becomes another dreaded exam you have to take prior to the final. The people that created this test believe that how well you do on this exam is directly proportional on how well you would do when it comes to take the state licensing exam after graduation...NCLEX.

It covers everything you should have learned during the semester. I say should have, because there were some questions on the one I took today that was clearly not from anything we covered in the past three months. However, I know they will be covered in Mental Health or Adult...which does come next semester. Maybe they were just testing our critical thinking skills with our limited knowledge base? HA

From the beginning of classes convening we knew we had to achieve a numerical score of 850 or have to do a remediation plan. Not a lot of fun when you have other class assignments to be concerned about. Last week the Nursing Department sent out an email stating: If you receive a conversion score greater then 80% you can opt out of taking the Final Exam. No added pressure or anything.

I know quite a few people that devoted countless hours studying for this. And I will most likely be hated for admitting...but I didn't study one bit. I didn't know what I should study or where to focus my time. So instead of wasting the time all together, I gave my undivided attention to things going on at home. (My son sure did enjoy his 4th Birthday, without mommy being buried behind a mountain of books.)

Isn't he cute!

Alright, enough playing around. Turns out I will not be taking a final for this class! I received a numerical score of 1017 which converted to a 92%. (Don't ask me how they convert it because I don't have any clue!) So all that is remaining for this semester is: one case study that must be finished tonight and a unit exam on Thursday! Sadly I still will have to take a Chemistry final as well.

You know you are nursing student if.....

1. You open the refrigerator door and notice that the already opened milk jug has been dated and timed and has your initials on it.

2. You keep the sterile field even when you cook dinner.

3. You have used restraints...and it was not a sexual experience.

4. Your family has filed missing person reports on you during finals week.

5. You shake a person's hand and you find yourself feeling for a vein to decide which size IV catheter you would use.

6. You discuss the consistency of your patients' poop on your lunch break..and that's not weird to you.

7. Your normal friends all graduated in business or mass comm.

8. You've canceled your gym membership once you realized your Pediatrics book can double as a 10 lb weight.

9. You are determined to figure out how to administer caffeine through an IV line before finals week.

10. You know that the correct answer is not on the test and you will argue to the death for those 2 points.

*****

About Number 4. that explains my lack of posting. We are now on our down hill slide to the end of the semester. We did our last clinical day this past Tuesday. Tomorrow the HESI. Next Thursday one more unit test and the following Monday and Tuesday Finals!!!! I am going to try and post tomorrow, today's class was way to much fun not to :)

Let the shit talk begin

That line was actually spoken as the theory instructor walked into the room on Friday.

For good reason, topic of the day: Bowel elimination (deification or even poop if you prefer) this topic also included flatulence and hemorrhoids. So, yes, there was literally a whole lot of shit talk. I may never think of chocolate in the same way again. Just in case the Bristol Stool Form Scale doesn't do the trick in determine if your own poop is good or bad...Milk Duds (Type 1) BAD, chocolate milk shake (Type 7) BAD, the goal of each deification to match a Baby Ruth consistency(Type 3 or even sometimes 4). Good thing I am on a diet kick. I mean, who really needs to eat chocolate ever again anyway, right?

Okay this class wasn't a fun as the topic alluded to, oh well. Maybe next week things will perk up a little, the next topic will be Pain Management....Narcotics! That may be good for a story or two.

Lesson of the day:
Proper fluid and fiber intake, plus a little exercise is all that is needed to prevent things from backing up!

In case you missed this when it first played on Scrubs (the funniest nearly medical like show out there!!!) a few years ago...I present you the POO SONG! (this pretty much sums up the lesson, well we didn't doing the song and dance...guess my class just isn't that cool!:)

Crazy insane week

So much for actually resting up on Spring Break. For only working three days total last month to working five shifts in a week; wow, I am worn out. Think I need to take a vacation from my "vacation." I guess for now I will have to be content with vacationing at my home away from home...AKA school. I spent a huge portion in the green and white uniform at school this week. Practice Practice Practice!

This past Saturday I got the not so wonderful news that I would have to re-tape my catheter insertion. My sterile gloves that came with the catheter kit were ridiculously too big; the tips of the finger tips could be folded back into my palm! At some point during the insertion my Edward Scissorhands touched my trash bag without my knowledge, poof my sterile hands were now dirty and I contaminated my patient. Instant fail! Lesson learned, I rerecorded today with much smaller gloves this time around. Hopefully there will be much better results!

We didn't have clinals this week; instead we spent the day in the school's lab. Where we were checked off on our last remaining skill set. Wound Care, more specifically I had to perform a sterile Wet to Dry dressing change. (Could have had a Montgomery Strap with a drain instead.) Things went well, short of my q-tip that I was using for packing snapping. Thankfully that happened at a point I could continue the task using the broken part. The completion of that skill brought on the conclusion of Lab testing days, the remainder of the semester will be spent at the hospital and there are only three remaining days of those!

The theory test went well, got my first 'A' on a this this semester! I quite happily will give up the 84% trend to keep this new one going. The only remaining exams are one regular test pertaining to the last four topics yet to be covered, the final (comprehensive of course), and the HESI (the true test to see if we absorbed anything from the entire semester!)

Let's see, I registered for next semester. Because I made myself stay awake until the online registration opened, I did get my first choice in classes. A few friends made it in there with me, its always great to have familiar faces around! This schedule filled up so quickly, many of my other classmates will be elsewhere. Kind of sad, I love the dynamics of this particular class. For the most part we all worked pretty well together. I suppose there is always another semester to try and get into the same classes!

Alright this is getting rather long and I think I prefer to have today's theory discussion in its own little post....but that will wait until tomorrow.

Feeling the Strain

I am sorry for not updating sooner, it has been (and will continue to be) a incredibly busy week.

Call it a welcome back from Spring Break....Now its time to bust your butts and catch up for the week you slacked off gift.

Tomorrow there's a theory test I am quite sure I am no where ready for but I don't ever think I am ready as I should be! I promise to up date the past week after the exam is done and over with!

Look for posts next week!

I pee when I sneeze

All you mommies out there know
what I am talking about....
Stress Urinary Incontinence!

Topic of Discussion in today's theory class: Urinary Elimination

Good news for those that suffer from Stress Incontinence there is relief that can be found in medications or if you like the flair for dramatics there is a surgical option. With any route you will be able to sneeze without fear of leakage again.

As you can see I really don't much to post about, just felt this overwhelming desire to tell you about pee. Alright that is all.

Lesson of the Day:

One word: KEGLES!

In other non-nursing news...
As of today, I have a graduation date; May 8th!!!! Well okay before I parade across that stage, I need pass Chemistry and some stupid exit math test required by the state. All and all, I guess that is easy enough. I am very excited to have something to show for the past year and a half that I spent on the schools RN program waiting list!

Ouch!

Okay that hurt, a lot. Ramifications from that Chemistry class I skipped last week have been felt; like a big painful smack across the face.

Within the one hour we are allotted to be lectured to death daily, the professor managed to cover nearly an entire chapter. Of course I reviewed the information I missed and made the determination that there wasn't much material he would really be able to test for. That's what I get for thinking!

Today was exam day, and it was very very painful. If I had to put a number to it; 80% of that test consisted of material from that one stupid chapter I considered to be irrelevant. After looking at the first page of questions, my confidence quickly diminished and I let my mind wonder for the remainder of the test. Thankfully, unlike the last exam, this one was a multiple guess (or choice if you prefer) . Meaning there is still a 1 in 5 chance that all the blanks I randomly filled in when the 5 min. was called could be correct. Here's to wishful thinking....I will update this post later this afternoon once grades are posted.

Lesson of day:
There is a reason that attendance is highly recommended for Chemistry classes.

**********UPDATE***********

Apparently I have someone looking out for me, or at least guiding my hand in writing down the answers. There is no way I could have randomly guess 15-20 questions enough to actually pass on my own. While I didn't do as well as I normally would, I got a 76%!!! Now, there is only 1 remaining exam plus a final. I can see graduation on the horizon!!

Anything you can do,

I can do better.
I can do anything,
Better than you.

Riding high on new knowledge, it’s funny how something or someone so small can make you feel as though your newly found skills are, well, rather insignificant.

This is borrowed from a friend, a mother, and a fellow nursing student:

“I have the knowledge to do patient care including emptying bulb drains, dc'ing foleys, emptying them, changing wound dressings, emptying ostomy bags and changing them but none of that matters to my son. I tried to take off his band-aid and he told me "You don't know how, only daddy does!" Kids can really knock their moms off pedestals real fast.”

(Thanks for allowing me to share that Liza!)

My bug was in the ER last night were they had to start an IV on him.All went well; however, he may have developed a lifelong fear of nurses now.This morning as I asked him if I can take the bandage off he told me “No, want grandma to do it!” Toddlers…sigh.

Reality Check of the Day:

Just remember when you think you are good; remember,

there is someone out there who is even better!

(Even if it is simply Daddy or Grandma!)

Don't want to know

You can learn a lot about a person from information that randomly spews out of the mouth. Sadly, while in nursing school you come to learn more about a person then you may ever wish to.

I don't know it's because we are in that medical type setting, but I have noticed people talking about what should be a privet health history. People talk about medications and procedures they or family members have taken or undergone in the past like it's not that big of a deal. Well now that we have more of an understanding of medication and what it's used for the more I just want to say "I know what you have been doing, Tisk Tisk!"

For instance, today while talking about Dermatological Drugs the topic of how over the counter (OTC) anitfungal cream to treat tinea pedis can also be used to treat tinea as well. Okay sorry, just had to take the opportunity to sound smart for a change. Basically the creams for athlete's foot will also work on ring worm. A male student's voice pipes up from the back of the room "Yeah, but they don't work so well on jock itch which is a fungus as well." (Class trying hard not to burst out laughing.) Wish I remembered what the instructor said, but I am sure it was funny....those fighting back the laughter weren't able to contain to for long.

The point of this blog post? Guess I felt to need to reintegrate that there are some things I can go through my day without ever knowing about my classmates!

Interesting day

So I was on my way to Chemistry class, when suddenly in front of me cars just start swerving every which way. As I approach the intersection, there is an older guy laying in the middle of it!

With cars still trying to drive around him. I approached and positioned my car as to block both lanes of course also got out of the car to assist. Running up, I see a bike in the medium not far from the man...deductive reasoning man was on bike got hit by car.

I am in my school nursing uniform and a man on cell with 911 says "oh good, there is a nurse here." I turn his direction; surely, he's not talking about me. The color in my face is slowing starting to drain.... "NO, STUUUUUDENT NURSE!!! STUDENT!!!" I may have also mumbled "I know just enough to be dangerous!"

Alright, I wasn't as freaked out as much I am implying. I was able to provide an initial assessment, respiration, and pulse rate for EMS. Moreover I like to think I was able to provide that man some comfort and encouragement. Just maybe the primitive skills I have or simply just being there at that one moment in time, prevented shock or even further injury.

There is one thing I know for sure, I don't doubt for one moment I am working towards the right profession for me :)

Clinical Roles

This semester the Intro students are also known as Guinea Pigs. My school is piloting a new approach to what the students will learn and take away from the clinical experiences starting with my semester. If all goes as expected this will become the new standard practice. From what I read on other nursing blogs, this isn't a new idea for nursing students...just new to this school.

Previously we would go to the hospital as a group of 10 and our instructor would take 8 patients and "assign" them a student for the day leaving 2 left over to assist the main student caregiver as needed. Each person would do everything during an 8 hour shift that their patient required for direct patient care. (Bath, Meds, ect...)

Now, we are taking turns in roles that are designed to encourage independent thinking. Now there are only 4 patients on a floor that will be assigned to students. So there are only 4 caregivers. The extra students would be in one of the following positions Team Leader (have 2 care givers under them), 2 Safety Nurses and 2 Resource Nurses (1 each per team). This is the schools way of exposing us to different expectations of nursing before being tossed into the fire once we do finally get our license. All of those are roles that an single RN does at any one point of a shift, these will to be expected of us by the time the program is over.

Today I had the opportunity, due to manning issues (yes as students you can face that too) to be in the position of safety and resource nurse for 3 patients. A LOT of paperwork to fill out....fall risk assessments, pressure sore risk assessments, assessment of manifestations, figuring out patient safety goals and then a Larger Health Care System Safety Goal. As you can see all very important topics but no direct patient care. Meaning not really that much to talk about, sorry.

Next week I get to be Team Leader, bring on the delegation! ha

Sleep

Per my Introduction to Nursing book "on average a preschooler sleeps about 12 hours of sleep a night." I think someone failed to inform my children of this! I wonder if it is to late to do so now? I am lucky if the almost 4 year old sleeps 6-10 hours a day! This includes nap time!

In case you haven't guessed it, one of the topics for the next test is Sleep. The others include Skin Integrity and Wound Care (at last theory behind a skill we covered about a month ago), Urinary Elimination, Fluids, Electrolytes and Acid Base Balance, oh and Altered Nutrition. For a grand total of 14 chapters from a combination of 3 different books to read, 10 chapters worth of workbook stuff, 24 DVD procedures to watch, 5 online case studies, and an assignment or 2 thrown in for good measure...

So much for taking bit of time to do something else on Spring Break!

Only an hour...

But I miss it and want it back! It has me (and especially the children) all out of sorts.

I put in sometime at work this weekend. Thanks to the stomach virus that is going around this town, I put in a little more hours then I had originally planned my homework around. To make up for falling behind on my assigned readings, I skipped my chemistry class today. Funny how steep of a gradient there is when dealing with a slippery slope. I don't foresee any ramifications from missing this one little class, but who knows for sure!

I think this is also the week I have to video record a insertion of a catheter, urine specimen collection from the properly inserted catheter, and then discontinuation of a catheter for my skills check off....Guess I should find some time to go and practice that!

Sigh, its going to be another busy week, really could have used that hour!

Student Nurse Brain Stimulator:

Grades, Grades, & more Grades

Got a whole mess of grades back today, Mid Terms!

The Tally: 3 A's, 1 B :(

Thanks to the school posting the mid-term grades by a certain date, our instructor wanted to include yesterdays test in the midterm grade. Meaning we didn't have to wait in agony for the usual week for the results for the nursing theory test to be posted.....84%! I am beginning to believe that is my number. So far we have taken 3 exams and all three I have gotten and 84% on each of them.Not bad, but defiantly not good either.

In Nursing School world a 80% is a 'C'! Yes, I know in the grand scheme of things a 'C' will get me pinned in the same way an 'A' would, but would like to remain Phi Theta Kappa eligible, if only to keep options open as I continue on my educational journey.

Okay, done with that rant for now....might retouch on the subject when the term ends :)

Rapid loss of age

I believe this hospital has the fountain of youth posing as a beautiful decoration in the Lobby.

In our little class conference to receive my assignment, I was told I was going to be in the caregiver roll this time around (more on the different rolls next week). My RN instructor said I would have a 77 year old male patient. By the time I made it to my said room to do my first assessment and take vital signs I found my patient in bed wearing Dora the Explorer socks....Oh and he was 19 years old. All I could say is "wow, you lost 60 something years overnight!" Clearly my nurse was working off an old census when she gave the assignments; my new patient was just admitted about 3 hours prior to our arrival.

Over all, that first day was pretty uneventful. He was a sweet patient, who sadly has seen more hospital time then I ever have. There wasn't much I could do for him or that he wanted me to do for that matter; he was still ambulatory, didn't have bandages, and all his medication was passed via I.V. (a no-no for Intro students to change). My direct patient care consisted of my assessment, vitals x 2, bringing blankets, and just popping my smiling face in the door every 2 hours...just in case he forgot who I was. :) Indirectly there was documentation (charting) and filling out my school assignment forms which consisted of a Head-to-Toe assessment and creating a nursing diagnoses x2 and matching care plans (interventions/teaching) to go with the diagnoses.

Coming up with nursing diagnoses and care plan was a bit difficult for me with this particular patient. Outwardly he appeared great, no obvious signs of illness. Leaving me to turn to the chart to try and make head from tails of the labs results from blood draws taken upon his admission. Very challenging when you really don't know what the heck you are looking at, but overall a GREAT learning experience. By the time is was all said and done I must have done something correctly, I received a perfect score on the graded portion of the nursing care plan.

I look forward to see what role I will be in next week. Alright, time to start studying for a test in theory that we are taking tomorrow!

Made it to the Midway point!

We have reached the midterm of the semester and my sanity is still intact, house is still standing, and for the most part the children are happy. But I swear, it feels like weeks are getting longer now!

It is quite possible I have become brain dead just from over exerting those poor little neurons. Then of course you toss in a few nights worth of minimal sleep into the mix it's a wonder I am still functioning enough to type this. I know if I can make it a few more weeks without being locked in a padded room, I will be okay. Spring Break is at the end of the month, plenty of time to recuperate then!

Let's see....as for the big long to-do list I posted about last week: Drug card got done ahead of time, I am ready to burn them now! Case study's got done. The chemistry test helped contribute to some of this mental fog I have been experiencing; but it's all good in the end, I actually did quite well on it. Best part, there won't be another one of those tests for a few weeks!

Of course there were a few events I didn't plan on, okay so I knew about them...I just spaced about it! Today was the dosage and solution test in the theory class. The math for it isn't that complicated if you have the equations and conversions down. But there is a intimidation element of having to score above a 90% or have to start looking for new career choice outside of a medical field that puts a damper on things.

In another surprise for today (as if having a test wasn't enough)I had a class end for the semester. It was one of those work at your own pace....yea, I thought I had all semester to do it. I really need to pay attention when I register for classes. Needless to say when I checked my school email to find it was ending today I freaked, as I hadn't done a single thing (it was going to be the spring break project)! Thankfully it was only a one credit easy class that I was able to complete start to finish (4 assignments, 4 tests) in just under 3 hours and I even ended up with an 'A'.

That leads me to what didn't get done from the to-do list....reading, lots and lots of reading. (and the workbook corresponding to said reading). I am pretty excited I didn't pick up any shifts for this weekend, leaving me with ample time to read.

The first day in the hospital was pretty uneventful, dare I say even down right boring. There was no direct patient care, it was more of an orientation day where we received computer training for the charting and got a chance to tour the floor we will be assigned to for the next 6 weeks. This coming Tuesday is the real deal though.

Alright, I really believe should head to bed now before this becomes more senseless rambling...so I leave you with the oxygenation lesson of the week....

When having trouble breathing,
Remember:
Turn, Cough, and then take a Deep Breath

(Well of course unless you are choking then there is a whole set of other issues to be concerned about.)

Good night all :)

The Student Nurse's Prayer

Forgot to add this...

So I am talking to my half torso practice mannequin, pretending that that HE is a real patient as we would in the hospital. I pull back the sheet to expose the wound dressing I need to change only to find that my male torso is in fact a female, with all her feminine glory exposed to the whole room.

So one of my partners kindly offered up "if you really want to make it a male, I saw a whole box of penises back there, it made me giggle..."

Lesson of the day....never assume someones gender, mannequin or not!

Hope you had your pain meds...

because this is going to hurt! (a lot)

Topic of discussion/demonstration of today's lab: wound care, including irrigation, debridement, culturing, and dressing change.

After lunch, focus completely changed to inserting/removing a urinary catheter and collecting a sterile urine specimen. We all got sent home with "practice kits" for these two main activities. I can soooo see people lining up for me to cath them now!
Today was also the last simulated labs for a while, watch out local hospitals Intro to Nursing students are in the building! Minus one more lab day in April to get checked of on our wound dressing skills, we will be in our assigned hospitals for the remainder of the semester. Should be fun or good for a interesting story or two. :)

I have ten or so of assigned chapters to read (with of course the corresponding workbook pages for said chapters), drug cards to finish, and two case studies to work on before next week, plus I think I also have a chemistry test to prepare for. Guess what I am saying, is don't look for posts anytime soon....unless something really interesting happens.

Dreams Don't Lie (Much)

In anticipation for last weeks theory test grade being posted today, I dreamed about logging on to the computer to find out the results of test two last night.

Of course I am going to dream that I passed; specifically, the dream said I got an 85% on it. Pretty darn good! Had I actually thought about it at the time, with the questions being 2 points apiece and partial credit not given, an 85% is mathematically impossible. Oh well, I did get finally get some great restful sleep from that point on!

In reality, I got on 84% on it. Still not bad; I am quite ecstatic with the results. After the reviewing a correctly graded test last week, I was sure I had a whole lot more wrong...I actually lost count of how many I thought I answered incorrectly. This will be the one and only situation where I am happy to admit I am mistaken.

There is a mini break for the remainder of the week; school is closed today and tomorrow for some faculty and all college day thing. Fine by me.

I realized today, just how drastic my expectation on home cleanliness has changed since the nursing classes have started. While we're not living in a health risk situation, there is lots and lots of clutter.

Seriously how did we accumulate so much stuff, we have lived here less than two years!?! Things are just shoved where they could fit out of the kiddo's reach. Let's not even mention the toys! Yeah, I don't do clutter so well.

So the plan for today and possibly tomorrow is to organize, recycle, and donate! All I can hope is the cleanliness lasts until Spring Break! I wonder if upon noticing how much I cleaned today, my husband would feel compelled to take the Christmas lights off the second story of the house tonight? :)

Digressing

This is going so far off the original focus of this blog but trust me it all does tie in together somehow.

It has been a pretty rough last few days. School, family, friends, LIFE has encompassed every area of my brain; leaving little room for the information required for my nursing class.

We always hear, never leave things undone or what needs to be said unsaid; life is unpredictable you never know what can happen next. I, like most people, really don't follow that action to well. In fact, I have over a dozen unanswered emails sitting in my inbox right now. Priorities right? I always reply to my friends deployed to the "sandbox" rather promptly, who knows what can happen over there. For my friends at home, on safer ground, I run about a week behind in my responses back.

Sadly, there was one message I never had the chance to respond to. This past Thursday I found out that a friend I was stationed with a few years ago died as a result of a car accident. So many things left unsaid; life is very much unpredictable. Had I know last week what I know today, I would have said thank you for being such a great friend. That I thought you were doing a amazing job raising your boys, that they carry your spirit and passion for life, and will continue to do so as they grow into men. You are truly going to be missed by all.

To add to an already emotional roller coaster of a week, my three year old son had an appointment, of what I assume to be the first of many, to screen for Autism. Most see him as an incredibly bright child (which he is don't get me wrong), but when one is so advanced in some areas you tend to lag behind in others. At three years old, this boy of mine can read, write, and in his own words "spell complex words." Clearly very high functioning; however, he does have many of the Asperger's syndrome symptoms that requires further investigation prior to starting Pre-K this fall.

He has a referral out for further tests on 4 of the 5 areas of development. However, the lady conducting the tests said she couldn't really figure out if he was just being suborn and refusing to do the task or he really couldn’t do it (when things don't go his way he tends to shut down.) Just to be safe she put out a referral for us to meet with someone else. Only time and many more assessments and tests will reflect the true extent of what we are dealing with for now and the future hurtles we have to overcome.

What all this is leading up the test I took last week. While the test grade is still not posted, I have this strong feeling I didn’t do as well as I would have like do. My mind was of course elsewhere during the entire duration of the test; and I will have to accept the consequences of diverting my attention.

As a nurse you have leave your problems at the "time clock."
But I am not that nurse;
yet.....

Passing Meds Already!

Wow, this week has disappeared on me; so incredibility busy it's unreal.

For one lesson alone we were assigned 9 glorious chapters to read in the Pharmacology book! Sad to say, it's still not done. Oh, and the theory test on said 9 chapters plus another 6 more is tomorrow afternoon...yup, I do realize it's a little to late to freak out now.

This week in Lab is the first time I slightly felt like a real nurse, instead of a glorified aide. We are leaning to pass medications and give injections. In fact we even signed off on the Intramuscular (painful shot into the Deltoid) and the Intradermal (think TB tests).

Next Tuesday will be the practicum on Med. passes and a subcutaneous injection (insulin injections). A little alarmed that my instructor felt the overwhelming desire to share with us that last semester she only had 3 people pass those skill first time around. I am not liking the classes' odds here. We do have an opportunity to retake, but it is done on our own time. Well, I really don't have the time to spare as it is....so I think it will be much easier on me to pass the first time around.

That being said, I can really use someone to practice on....

any takers?

Wear Red Day

In the essence of spreading the word, here is the reminder that tomorrow is wear red day.

Woman for so long many of us have been putting our own self and health on the back burner. Taking care of you first should be the first priority!

HEART DISEASE IS THE NUMBER ONE KILLER OF WOMAN!

It also kills more people in the USA than cancer does. Heart disease is often called the silent killer; but heart disease does not usually occur spontaneously, but after a gradual build up. All the risk factors: high cholesterol, hypertension, obesity, and diabetes can gradually damage the heart.

Get empowered with the facts, a few simple changes in daily lifestyle can lower that statistic for us! For example... make healthy changes to your diet and exercise, assess your risk factors for heart disease and get those regular checkups.

Post It Note Tuesday

Okay so I saw this post it note Tuesday on a friends page, since I didn't have much to say today figured a post it will do nicely. :)

Whining (Hey, I warned you)

So my two children started daycare when I had to start day classes nearly a month ago. I knew they will now be exposed to everything and would possibly be sick all the time. So it makes perfect sense (note sarcasm here) that I would be the one who is nearly on the deathbed now... while those two happy, healthy, noisy little critters slam things around the house.

Don't misunderstand me, I am happy and maybe a little grateful that other then a slight cold they are okay. But do they have to be so darn noisy, come on my head in going to explode here! I don't even think I would wish a sinus infection on my worst enemy.

Sigh, I have that practicum tomorrow, that when I was in great heath I signed up to do first thing in the morning (0700). Hopefully some of this pressure in my head will subside by then and I can regain the full range of hearing....because as of right now I am having a hard time hearing the low tones. (AKA the apical pulse) GREAT!

Alright, I am done whining...seriously considering smothering myself with a hot towel.

Ramblings

Knock Knock

"Hi, I am Tiffany"
"I am going to be your student nurse today"
(worried patient now eyeballs the door)

"No, don't you worry..."
"I am going to take great care of you!"

I have been told that "practice doesn't make you perfect in the world of nursing, but it does make you confident." That is what is all about ladies and gentleman, confidence. Good thing I have enough of it to go around, or at the least I know how to fake it very well.

Alright really, I love that I am lucky enough have a place I can go to get the extra practice I need. And even more thankful that I know some coworkers who wouldn't mind having an extra day off this weekend. Yes, I am really calling and begging to take your shift on Saturday, so go and enjoy your unexpected day off already!

This coming Tuesday we have a practicum exam, which is a little more serious then the skills check off we did two weeks ago. Half of it I am comfortable doing as I have done it countless times before as a nurse's aide; however, the other half is now starting into things that only RN's can do. Well, I haven't ever been an RN before so I NEED all the practice I can get to help gain some insight. (Hence why I volunteer to work on weekends!) I am really thankful that I work with some wonderful nurses, that if time permitting, don't mind if I follow them around like a puppy dog starring over their shoulder. If I am really lucky there will be some new admits so I can see the skill I really need to be reviewing this week...Head to Toe assessment.

Alright better get back to the books, I have a million and one things vying for my attention this week to come and no clue where to even start. Hope you all have a great stress free weekend.

Simulation

Wow, am I bad at this blog thing. In fairness there is nothing really interesting to talk about as of yet.

One more month and we will get out of the lab and away from simulations to our "hands dirty" in the hospital! Today I had my first simulation lab. Basically, machines (as opposed to other nursing students) are our patients but they can talk and can do all the things to them you would do to a normal patient with diagnostic testing, medications, etc. We even have one simulator gives birth to a machine baby, but that will be a topic for OB/Pediatrics class. Our Sims instructor mentioned how she doesn't like to be at the school after dark, as the machines become really creepy. Honestly, I was totally freaked out when our "patient" just started this loud heavy breathing, it sounded just like the bad guy from every cheap horror movie created. With the bad comes the good, this is a beneficial tool to learn how not to kill someone. There is no reset button in the hospital.

The test grades came out online this morning and I did about how well I expected I would, but something seemed off. Pretty much the entire class complained how they thought they did better than the scores reflected. So now we are going to re-review them tomorrow. Possibly, we will find the error in the scantron and 90% of our grades will improve from the grade book version. In the theory portion of this week we are trucking right along. Today started the Pharmacology; very soon we will be passing medications and giving shots!

Therory Test One

Funny, when I was in the military and taking a promotion exam, we used to joke that when you get stuck on a question 'C' your way out. Of course not a fool proof plan but any answer is better than leaving a blank, right? So imagine my dismay when taking my first Intro test, answer after answer kept coming up with the infamous 'C'. Must be a mistake right? Pondering that question had me re-reviewing my test three times, burning up a good 45 minutes of time. Statistically it didn't make sense that so many answers would wind up similar in a row, the instructor had to be messing with us right?

Oh well, time was running out of time so I stuck with my first instinct, which turned out to work in my favor. As we waited for everyone to finish up, all the discussion was about the statistical anomaly and how "Christmas treeing it, wouldn't have cut it!" While we did get to overlook the answers briefly, I don't know for sure how I did on the exam. I will find out grade book results next week. But I know I passed it! So with that I take a deep breath, let out a grateful sigh of relief, and now I must prepare to move on to the next hurtle....Chemistry test on Monday!

KISS

No I don't want one; nor, do I think you would want a germ infested one from me. I am referring to the mnemonic aide KISS
It is so easy to over think the situations that we are being presented with in our simulations. I know it's hard to believe; but yes, sometimes the answer is the obvious! ABC's, Safety, and check for a doctor's order...seems easy enough. Well, that is until you have an RN firing questions at you, 29 pairs of eyes critiquing every your every move, and still have to maintain enough composure to complete the skill you set out to master in the first place. (Of course you must be able to do everything without becoming a babbling fool.) Short, direct, to the point answers just might convince people that you actually know what you are talking about. Sorry for this rant, but I think I needed it, if only for a reference point to utilize later. I do have my first theory test this week after all.

Well, with the conclusion of a very long lab day, I have been deemed "safe" and allowed to practice the skills that I signed off on today on real people! Yes, I did over think everything and I am pretty sure I missed a step or two along the way but I maintained patient safety and privacy. I suppose in the end that is what matters most for now.

Location Location Location

If you haven't already, I believe now is a good time to invest in Starbucks. Call it an inside tip, but their stock is about to rise big time. My study group decided to start meeting there. Because I lack self control, some much some needed sleep, and I cant seem to locate anywhere that currently sells it in intravenous form, I predict I will down cup after hot delicious cup of this black gold!

Study group at Starbucks? Are you kidding me? I have very few vices I haven't managed to gain an upper hand on yet, one being coffee and the other bookstores. I can't seem to EVER walk out of a book store empty handed, regardless of the fact I know I don't have any time left to enjoy a non nursing related book. But we are going to study at a Starbucks inside Barns and Noble? Ha ha ha, yeah right!

A quick perusal around the shelves and a Venti cup later, I was ready to devote my attention to postural abnormalities, antihyperensive medications, range of motion, or what ever the topic was going to be first. It went pretty well, eventually you can tune out the distractions. I do however pity the innocent people sitting near enough to hear our conversation...I am really really sorry, I am sure you didn't want to hear what an infected wound looks like while enjoying your coffee.

So this afternoon I have discovered my fate for the next year... coffee and books. A quick look around at the other tables and I begin to recognize some faces, or at least the covers of the books that the faces are buried behind...other nursing students in the semesters before ours. Maybe I will find a way to ingest my coffee it in IV form before the semester is out after all.

Important lessons

So my time management skills are a little less then desirable, sad that it has taken all these years to figure this out. Yes I have always gotten tasks done on time, but pushing them to last moment just doesn't work in the way they did in previous class. I have my first set of skills to check of on Tuesday and my first theory test on Thursday. Properly didn't devote as much time as I should have to studying, but figured I would have a nice, kid-free, three day weekend to fully devote my brain...

KARMA!

Ricky woke up with a fever yesterday morning, and has been a have to sit right on top of mommy and give me all your attention mess since then. Don't get me wrong I do love all the hugs and kisses, but the effects of stress are slowly creeping up. Thankfully I don't look like this cartoon depiction of stressed out nurse yet... but I do feel an eye twitch coming on.

Until yesterday I believe I was a little over confident, I thought I had the 12 skills I signing off on are in the bag. After all, with the exception of charting I have been "practicing" for this day ever since I started working as a CNA over a year ago. While I haven't counted I have properly given over 1000 bed baths and I won’t even estimate how many transfers I have done. Yet somewhere somehow the negativity crept in, yes I know how to do it, but do I know the "nursing way"? There it is, the question that has me pouring over my books until the pre-dawn hours of the night. Guess I need to stop thinking.

As for the theory test, I think I have resolved to the fact I just might not pass it. Let’s put it this way: Thursday evening I attended a 3 1/2 hour workshop on critical thinking and test taking strategies, designed specifically for first term nursing students. Friday afternoon in class the instructor is telling us about her policy to meet with students if they don't score an 80% or above on the second test; "I don't worry about the first one as much, no one really passes it!" NICE! Of course I am not going just take it, as I am not one to give up to easily and I have a GPA to maintain, but I guess I won’t be too hard on myself if the inevitable does happen.

Ricky is giving me I am going to puke on you and your laptop if you don't pay attention to me now face, so I am signing off. Will try to update again with the results soon....

So I survived day one

Just for future reference triple check the time you need to be somewhere if it is that important! So, I am sitting at a red light on my way towards the schools direction when I decided to check my schedule. Yeah, not the brightest of times to do so... It was 12:48, funny it said my class starts at 1300. I swore the thing said 1330 yesterday. That’s not even the best part; the kids were still in the car!

So yes, I was late to the first day of class (way to place a target on my head from the get go.) I fully expected to get tossed from class but thanks to my lead foot I ran in there huffing and puffing just right at the five minute cut off. Things will be much easier once the kiddos start full time daycare on Monday but still.

Okay back to the class. Not much fun today, just the typical go over the syllabus, rules, expectations….fun fun fun. Again we heard the warning that there will be no social life for the next 17 months. No biggie I lost mine four years ago, I have learned to cope. Tomorrow we will be “hitting the ground running” covering medical asepsis and infection control.

Oh, one highlight of the day we chose which hospital we wanted to do our clinicals at, I did get my first choice. I know for a fact there is a Starbucks in this hospital.

Just a few days away

New uniforms with shoes… $89
New stethoscope… $105
A semesters worth of books… $724
Feeling like you are actually ready for Nursing school…Priceless

While I may have all the required items, the required reading mostly done, and even a jump start on some of the assignments for this first week that priceless feeling is quickly replaced by the “what the heck did you get yourself into now feeling.” Is there any way to actually feel ready for what will be the greatest challenge of my life?

It’s a good thing I like a challenge! Watch out nursing school (and future patients in my clinical rounds)…here I come.