Skills day...

I was scared out of my mind for skills day! (which happened today)

I have always hated doing things in front of people that actually know how to do what I am doing. It makes me nervous having people watch me.

During this semester we have learned an assortment of skills that are done everyday in the hospital. Every skill has steps and certain focus assessments and teachings that must be done. That is a lot of things to remember for each skill.

The ones the lab teachers told us to focus on for skills day were: NG tube placement and maintenance, central line dressing change, blood glucose and insulin administration, IM and Sub Q injection, nasopharyngeal suction, getting a patient up for the first time, and sterile dressing change. The drugs we had to know were Demerol, Morphine, and Dilaudid (pain killers); Phenergan, Visteril, and Zofran (anti-nausea meds) Humulin R and Humulin N, Lantus (insulin) and Heparin (anti-coagulant).

Once I got there at 9 am I picked a card with a color and a number, those corresponded to the skill I was assigned to perform. I got 5 minutes to check the MD orders, 20 minutes to actually perform the skill, and 10 minutes to document what I did.

My skill was central line dressing change. Now what is a central line? Hopefully all of you know what an IV is, a Central line is an IV that is inserted into the right subclavian artery and into the ascending aorta. (inserted into an artery in the shoulder and into the heart). And for those who don't know that is a sterile technique. What is sterile technique you say? Well it's kind of hard to explain. There are certain gloves I have to wear, certain kits I have to use to change that dressing, everything must remain sterile as I do the skill or I have to start all over again. Sterile technique is what is used in the operation room, so if you watch the medical shows, that is what sterile technique is (if they do it correctly, I watched one day and they contaminated the field, naughty!) If you want google central line and see what it actually looks like.

I felt a little rushed but everything worked out in the end. My instructor said that I did very well.

P.S. there are like 20+ steps for a central line dressing change.



Now I have to wait...

Answer...

You would want a 24 gauge needle.

The bigger the number the smaller the needle. It's completely backwards from what you thought it would be huh!

A 12 gauge needle is huge!!! that would hurt so so so bad. It would be like sticking a normal size drill bit into your subq tissue or a muscle. OUCH!!!

Would you rather...

Would you rather get a shot with an 12 gauge needle or a 24 gauge needle?



No cheating people just answer the question.



Answer will be in the next post.

???

Does anyone read this?

Drawing up...

Do you hate shots? I sometimes do, especially when the solution they are injecting is really thick.

Some people love getting shots (they get this crazy look in their eyes, creeps me out just a bit).

I, however, LOVE GIVING shots!!!

It takes lots of practice not as easy as I would have liked. When giving an injection with a needle many things need to happen. First the nurse needs to check the eMAR with the Kardex, and if they don't match up, the nurse then goes to the MD orders (the MD orders are always correct). Then the nurse will go to the medication room and retrieve all the medications needed while doing the 5 Rights. Right dose, right patient, right medication, right time, and right route. This needs to be done twice or more.

Wow that was a lot.

Drawing up medication in a syringe is not easy. Orders can come in many different types, like mL, mg, units, etc... Lots of calculation goes into this, so nurses better know their stuff. I hate math. :( After figuring out how much is needed then nurse must then keep everything sterile and I mean everything. Plus there can be NO air bubbles. If air bubbles are inside a flick of the syringe is needed until the bubble is gone. Why? bubbles can go in anything and travel to the heart, lungs, or brain and that my dear person reading this blog is BAD!!!

Finally after all the medication is ready to give, the nurse then goes into the patients room and does the 5 rghts one more time (would be very very very bad if a nurse gave the wrong meds to a patient, lots of problems). If everyhing is correct the nurse then may give the injections.

Failure...

I just failed my second test.