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