Monday, December 13, 2010
YAHOO...
I have officially made it through my second semester of nursing school. I am no longer a freshman!!!
Classes were way harder this semester but I do believe I am pulling off all A's which is an achievement. I think my favorite class this semester was Bro. Atwood's Psychiatric nursing class. He is a very nice, funny, and reasonable teacher. I actually wanted to go to his class (unlike my other nursing classes).
Christmas is almost here!!!
I get to go home on Thursday... no homework for 2.5 weeks.
Monday, December 6, 2010
State Hospital South...
All in all it was a good experience but I most likely will never work as a psych nurse.
Monday, November 29, 2010
Almost done...
Clinicals are going well. I finished my last day of med/surg. YAHOO! I do not like taking care of older people. I want to work in pediatrics or neonatal. For my last three clinicals I get to go to State Hospital South in Blackfoot, which is a Psych hospital. I am a little scared. People with these kind of mental issues give me the heebee jeebees.
Only 2.5 weeks to go till the end of the semester
Only 9 more test to go.
Then I will no longer be a freshmen
I will be a Sophomore
Saturday, November 13, 2010
AH...
School is going well, I am offically done with one nursing class. I took the final today and actually got a decent grade. I was very very happy.
Now this is the teacher that has been causing every one grief with her tests. I swear no matter how hard I study for them and even if I memorized the power points word for word, I still wouldn't do well. and it frustrated me so much, so with much sadness I will be recieveing my first B+ in my entire life. :(
I have one last 5th floor clinical for this semester! I am so excited! I do not like 5th floor really at all. Mostly it is filled with old old sick people. I am not to fond of old old sick people. I would rather work on pediatrics or even with people more my age, not these 70+ year olds. After I am finished with this rotation I get to go to a Psych hospital. (not looking forward to this) perhaps because I have been tainted with all the media telling me these people are... well there isn't a word for it really. I am concerned...
Scenario is on friday! AH!!!!!!!!!!!!!
I am so very happy for Thanksgiving. I get to see my family. Then after that there is only 3 more weeks of school and then I am home for 3 weeks with no homework! YIPEE. I am so very sick of homework and tests. I take more tests in a week than most people take for one class over the whole semester.
My life is crazy!
Monday, October 18, 2010
Long time...
Skills day:
So I participated in skills day on the 8 of October. I was hoping to get NG tube insertion, foley catheter insertion, something like that but not IV fluid stuff. Well guess which one I got. IV fluids. Now this skill isn't difficult at all, but I however, recived a not so great score because I forgot one thing... a right. In nursing we do this thing called the 5 rights: right patient, route, time, amout, and med. This 5 rights is supposed to be 3 times. I did the first two outside the room but I forgot to do the 3rd check, so I was docked big time (even though the patient wouldn't have gotten the wrong fluids). Ticks me off just a little bit!
So the whole skill goes like this: I walk into the room, introduce myself, check their name band, and wash my hands. Second I tell the patient that IV fluids are ordered, so I check the EMAR or MAR (medication administration record) against their wristband to make sure it matches, then I check the meds against it. If all are correct I can continue. Next thing I would do is to check the IV saline lock (which is just a fancy name for an IV line in the arm/hand that doesn't have fluids attached). I would flush the line to check for patency. I would then get my fluids and prime my tubing. (priming is filing the lines with the solution). If everything we well I would then attach the fluids to the IV in the hand/arm.
Now that skill doesn't seem difficult now does it, but let me tell you it gets a whole lot harder when a person in a white coat is watches, when you know you are being graded and when it is timed. I just got so flustered that I forgot one thing and it was killer on my grade. Grrr....
OR:
The OR is awesome!!!!I quite enjoy it.
I have had the opportunity to watch hernia repairs, cholecystectomys, appendix removal, hysterectomies with bilateral salipingoopherectomy(ovaries and tubes removed). Awesome! I also had the opportunity to scrub in and help with one the hysterectomies. The one down side to OR is that my back tends to hurt a lot.
Another thing that interests me is being a Nurse Anesthetist. I find that being anesthetist would be a good job. I wouldn't mind being that, however, it is a lot more schooling.
School:
School is going well, most of the classes aren't too hard. I am pulling decent grades. I may not receive all A's this semester. The one class has some of the most ridiculous tests I could go insane. I learn a lot in her class but her tests really don't have much to do with what we learned.
Still no man in my life... no like I time for one anyway.
Saturday, October 2, 2010
Resource Nurse...
We started off the day checking every floor to make sure things we going as expected for 0730 in the morning. We were in the ICU when the Code Blue rang out and guess what.... the resource nurse goes to code blues. So off we rushed down to the ER. Now a resource nurse does whatever is needed when a code is called (ie. start lines, chest compressions, give meds...) and because he had me with him, I was able to participate in the code. I performed chest compression on the man. Holy cow! that makes a person really tired really fast. I felt such a rush of adrenline. It was intense. However, once it was over I was shaking so bad. I couldn't believe that I just experienced a code. I just helped save a life. Then another man came into the ER and a code was called (I didn't do anything there). After that man was stable enough we moved him up to the ICU where the MD was going to put a central line in. When all of the sudden he coded again. Everyone rushed in and he was back.
So in summary I was able to participate in 1 code and witness 2 others. WOW! all these codes happened before 1000. So my day was packed full of excitment. However, I am not sure if I could do that day after day. Guess it's a good thing that I want to be a NICU nurse and not an ER nurse.
P.S. I am really sore from doing those compression. Yes I may be a little out of shape, but that man was huge and I had to push down far and really hard.
Monday, September 27, 2010
Oh the things...
I think that teachers think that their class is the only thing we students have the whole semester, so they just pile on all the homework. Read this, read that, take this quiz, then go take this test. It just goes on and on and on. It's never going to end!
Ah thank you for reading all my venting. I feel much better now.
Clinical are going great. Sometimes I wish I didn't have two in a week, but the more time I spend actually practicing my skills the better nurse I will be when I actually graduate. EIRMC isn't as bad as I expected. Things just run a little differently, especially the computer system which, in my opinion, was written by a robot. Using the mouse isn't really an option, I have to use all the F function buttons, and it only likes to read capital letters for some odd reason. I also have two different clincial instructors, one for Monday and the other for Friday. I like Friday's instructor better. I have been told I need to practice my documentation more. I need to right in more detail and leave out certain words that really don't need to be in there. If I can get that down, hopefully I can get a decent clincal grade.
Still no man in my life. Apparently I look to well put together. I know my major and I am going for it. These factors seem to repel men. I was told this in high school and I was told this the other day by my roommate.
P.S. If you have any questions about nursing things feel free to leave me a comment and I will answer to the best of my knowledge. (which means I will mostly likely go look it up in a book).
Monday, September 13, 2010
IV's...
School...
Now if you saw my schedule this semester, you would be like "how cow, how in the world does she have any time to do anything?" My answer would be that I really don't have a lot of time to do things. Now for the dreaded schedule:
Monday
-0600 to 1300 Clinical
Tuesday
- 0900 to 1045 Nursing 104
- 1130 to 1230 Family Foundations
- 1245 to 1345 Middle East
- 1515 to 1645 Child Development
Wednesday- Absolutely nothing. (except on the occasion we do something or I go to the dialysis center)
Thursday
- 0730 to 0845 Nursing 103
- 0900 to 1045 Nursing 104
- 1130 to 1230 Family Foundations
- 1245 to 1345 Middle East
- 1515 to 1645 Child Development
Friday
- 0600 to 1300 Clinical
HOLY COW!!!
Monday, September 6, 2010
Moving...
I am not fond of sleeping in hotel rooms. I never seem to get any sleep. Mom, Nicole, and I stayed in the Motel 8 down the street from my apartment. We thought the room had two beds, when it in fact only had one and a pull out bed in the couch. I decided to sleep on the couch, then decided to pull out the bed. I layed there for about two hours when I concluded that the pull out bed wasn't comfy. I then got up and put the couch back together. Now this couch was soft and comfy and I should have stayed there in the first place. I might have gotten a better night sleep if I would have, because I woke up without fail almost every three hours. Around 5:45 I decided that I wasn't going to get any more sleep, I got ready, ate breakfast, and headed to my apt. I arrived at my apt ready to check-in at 7, to bad check-in's didn't start until 8. So I waited. Now you may ask why in the world would I be there that early? Well my dear person reading this, I wanted the exact same room back that I had the previous semesters. I know a little crazy, but I wanted it. I was the first one in the apt about and hour, so I really didn't need to be there that early.
Now the agenda for the next few days is going to the Kimball and then going to the MC to buy all my lovely textbooks that I need for this next semester. Classes this next semester are going to be tons of fun (not really). All my classes are on Tuesday and Thursday with clinicals on Monday and Friday. I go to class from 7:30 in the morning till 4:30 at night. I am nuts!
Posts will becoming regularly now (I hope). I will actually have something to really talk about, instead of this random stuff.
Monday, August 16, 2010
Nothing new...
I am enjoying my break, well sort of.
Working 9 hour days can get a little tedious, but it's the price I have to pay for money for school.
School starts in less then 4 weeks. It's crazy!!!
Tuesday, July 27, 2010
Sad...
So once again i am jobless for the next school semester.
Thursday, July 22, 2010
Monday, July 12, 2010
Almost...
Now only 3 more semesters to go.
I have loved learning everything. Actually being in a program has made me realize how much I really want to be a nurse.
Wednesday, July 7, 2010
So...
I feel kind of bad for those poor students who failed skills day. Failing according to the nursing program is anything below a 75. The things that sucks about failing skills day, or anything for that factor in lab, is the remediation part of it all.
Remediation is going back into lab practicing the skill that was failed and practicing the other skills with a lab tutor. I am not exactly sure how long or how many times this has to be done. After the practicing part, the student who failed must go back in and perform the failed skill and another randomly chosen skill for the instructor, and document everything. So two skills, to documentations, one grade. Lots more pressure.
That sounds like loads of work, that I really don't have time for.
SO DID I PASS OR FAIL???
?
?
?
?
?
I PASSED!!! with a 99/100 wohoo!!!
p.s. I really don't understand how they failed any skill, they weren't difficult.
Wednesday, June 30, 2010
Skills day...
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...
Monday, June 21, 2010
Answer...
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!!!
Tuesday, June 15, 2010
Would you rather...
No cheating people just answer the question.
Answer will be in the next post.
Friday, June 11, 2010
Wednesday, June 9, 2010
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.
Tuesday, June 1, 2010
Monday, May 24, 2010
Did you know...
Before meeting a patient for the first time, check to see what IV is flowing and what the rate is BEFORE going into their room.
After introducing yourself check the IV bag to make sure the correct fluid is running and that it is flowing at the correct rate.
I was at Clincial on friday and went into my patients room introduced myself, and then I checked the IV. The IV that was listed to run was Lactated Ringers. I came to find that the solution that was actually running was D5 1/4 NS. (5% Dextrose 1/4 Normal Saline) I finished up my assessment and went and told my nurse of the discovery that I had made.
We check the eMAR (medication list) and then we check the MD orders. Both said the IV was suppossed to be Lactated Ringers. Now this wouldn't be such a problem for any other patient, however this was bad for mine. He was a diabetic.
So what does this mean?
You never give a Dextrose IV to a diabetic becasue it's SUGAR!!!
So an incident report was filled out.
And I saved the day!!!
Thursday, May 13, 2010
Scenario...
Passing scenario is a requirement to stay in the nursing program. No pressure!
There were three parts to this scenario.
Part 1: Head to Toe assessment.
My patient was a 84 year old Caucasian female with pneumonia and dyspnea if she layed flat in bed. I took her vital signs and found out that her O2 saturation was at 82%. In case you don't know that is bad! A person should have their sats 90% or higher, but not to high because you can over oxygenate a person. Because I found out her O2 sats were 82% I administered O2 to her at a rate of 4 L/min. I then went on to do a focus assessment on her respiratory system. Upon completion I continued on with the Head to Toe assessment. I finally finished barely within the allotted time.
Part 2: Documentation
Now documenting seems easy right? WRONG! It is very hard to get the hang of. Everything needs to be documented. Everything! If the nurse doesn't document everything he or she does she could end up in a court of law or get fired or get a talking to from the higher ups. Back to documentation... Everything has to be in a nice neat order. Starting with Neurological, Respiratory, Gastrointestinal, Genitourinary, and finally Musculoskeletal. Now if everything is not charted correctly in scenario you get dinged!
Part 3: Nursing diagnosis and Care Plan
First, who knew that a nurse had to figure out a diagnosis for a patient. I always thought the nurse just took care of the patient. WRONG! Nurses figure out another diagnosis that realtes to the medical diagnosis.
My patient had pneumonia. With in typical pneumonia patients crackles can be heard in the lower lobes of their lungs. Som my nursing diagnosis was Impaired Gas Exchange r/t imparied alveoli gas exchange secondary to pneumonia AMB: crackles in lower lobes of lungs, dyspnea, and increased respiration rate of 24 (normal is 12-20).
Then the care plan consists of: first, a short term goal and a long term goal the patient will accomplish. Second, Assess, Do, Teach (three things to asses with this patient, three things to do to the patient, and three things to teach the patient). Third, Rationale for doing everything, however we haven't learned that part yet. And fourth, evaluation of the goals that were set. Met or not met.
Whew! that was a lot to accomplish.
You may wonder how long did I have for all of this?
Well you are just going to have to suffer because I am not going to tell you! Ha!
Wednesday, May 5, 2010
Assesments...
First Step: Meet the Patient
Knock , perform hand hygiene, introduce self, check the name band on the patient, ask how he or she would be like to be addressed, see if they are alert, oriented x3 (person, place, time), ask about the pain level and when last pain medications were given, check IV site and tubing along with the solution, rate at which it is flowing (usually in mL), check the oxygen, check any other tubes or drains, perform vital signs (blood pressure, pulse, respiration, O2 sats, pain, and temp), safety check(bed in lowest position, breaks on, side rails x2, call light in reach).
Whew! and that was just the first step.
Next check the system that involves the patient's medical diagnosis.
Then comes the Head to Toe. which means that you check every single part of the body and I mean every single part. Leave nothing out! From the head to the toe literally. You also ask the uncomfortable questions. No one ever wants to ask those questions.
After all that the assessing is done.
Saturday, May 1, 2010
Tuesday, April 27, 2010
Vital Signs...
Vital signs consist of temperature, pulse, respirations, blood pressure, O2 saturation, and pain.
Normal temperature range for an adult is 96.8 - 100.4
Normal pulse range for an adult is 60-100 beats per min
Normal respirations for an adult is 12-20 breaths per min. So you can never tell a person that you are taking their resps because they will change their breathing pattern. Try it!
Blood pressure for an adult needs to be less than 120 over less than 80. The sound that a nurse is listening for while taking blood pressure is called Karkaroff sounds. (Reminds me of Harry Potter). It's really hard to hear the sounds with lots of talking going on. Some peoples Karkaroff sounds are really loud and some are very soft. Sometimes a nurse can't even here the sounds. NEVER look at the needle bobbing for a blood pressure reading.
Oxygen saturation (which means, for all those out there who don't know what the heck I am talking about, how much O2 is attached to the hemoglobin the in the blood) needs to be 90% or higher. Preferably in the high 90s.
Pain 0-10 0 being no pain and 10 being the worst pain a person has ever felt. A fellow nursing student ask a guy what his pain was for the day and he answered 6. When she asked why he was in such pain he told her that his girlfriend just broke up with him. I thought that would have hurt a lot more!
Ya so that is all I have for now. sorry it's so boring, but that is all I have learned thus far.
Monday, April 26, 2010
Things I have learned...
Relasing Info knowingly: One year in jail and a $50,000 fine
Accessing health info under false pretenses: Five years in jail and a $100,000 fine.
Selling info with harmful intent: Ten years in jail and a $ 250,000 fine.
WOW!!!
Never want to violate HIPAA.
Wednesday, April 21, 2010
Overwhelmed...
Nursing 100A: This class doesn't seem that hard. I can retake the exams as many times as I want. Love that!
Nursing 100: Now this class is harder. So much material covered in class. Exams every week. Have to remember everything from this class forever. No pressure!
Nursing Lab: Wow! So many skills. Covered this week: bed pans, bed baths, catheters, hand washing, oral care, occupied bed making, peri care, PPE, and precautions.
Math 108: Assignments due every class period. Quizzes due after every class period. 5 exams
Psych 111: Quizzes due every Friday. 4 exams.
Rel 122: Reading journal due every class period. Research paper.
I am going to have absolutely no time for anything whatsoever. Eat, sleep, school is going to be my new motto.
My life is really over now.
Thursday, April 15, 2010
Long...
Now why do you ask was I sitting in a 4 hour class bored out of my mind? According to the Nursing department I needed to have American Heart "Health Care Provider" CPR instead of Red Cross. Well let me tell you something Nursing Department, CPR is the same everywhere! All the programs are the same. So why on earth did you make me pay money to take a class on things that I already knew? Why couldn't Red Cross be okay? Oh the frustration.
This monday I get to sit in another meeting, however, this meeting is going to be 6 hours long. It's a good thing that I have no idea what they (whoever they are) are going to be talking about. It's a mighty good thing I don't know.
So on to better and brighter things...
Ya I got nothing.
Sunday, April 11, 2010
Beginnings...
Waiting for something is the biggest pain in the world. I was told when I turned in my nursing application in October 2009 that I would know if I was in or not by the end of February beginning of March 2010. Well the end of February rolled around and I still didn't know then the 15 of March passed and I still hadn't received a phone call or anything in the mail. I was getting really impatient (mom was too). So I concluded that I would just give up on waiting. I was telling my mother the next morning my conclusion and I am not kidding just like 5 minutes later after I stopped talking to her I got a call from the nursing office. They told me to come and get a letter. I finished getting ready then rushed over to the office. I was in!!!
However, that was not all there was too it. First: I had to fill out an acceptance letter, second: I had to get American Heart CPR certified, third: they needed a copy of my vaccinations and fourth: I had to have a medical history form filled out with a check-up to the doctor. This was a lot easier said then done. Good thing I was going home.
2 weeks later I got another call, I had to go pick up another packet and it happened to be raining that day also. I didn't take an umbrella because the wind was blowing so hard there was no point in taking one. The walk to and from the Clarke was really long, very cold, and very wet. This second packet was full of information about which classes I needed to take to graduate and info on all the ridiculous amounts of money that I would be spending on books for class and my scrubs for clinicals. Who would have thought that books cost almost $1000 and scrubs cost around $200. Not me!
My life is offically over...