WARNING: This is a Poopy Post

You know you are in the right field when at the end of the day you are psyched because your complete bedrest patient pooped! I know, I know. ;D   BUT, when your patient hasn't had a bowel movement in two weeks, it's a pretty big deal! And folks, it's not like I enjoy assisting with the bedpan and such, but it feels good to be part of helping my patient be successful--even with pooping! And my co-assigned nurse actually said to me at the end of the day, "Good job today, I think you being there for her today really helped her overcome her fears and enabled her to go".  Awww!  hahah.

Also, she's young...and has been away from the comforts of home and away from her friends for over two weeks, so I knew she needed some encouragement and to laugh a little--even if she was laughing at me. I didn't care. She needed a good day. And I think that while she wouldn't admit to being excited about pooping-- it was a big accomplishment for a bedrest patient and I know she's relieved that they won't have to do an enema tonight.

Later,
Joy

Incentive Spirometer

I love incentive spirometers...it really is positive reinforcement for our bedrest or post-operative clients.

I found this video on proper use of the Incentive Spirometer very helpful. Only wish we had opportunity to have video demonstrations avaiable for our clients in the hospital. I know that PT/OT provide training initially, but nurses do need to reinforce correct usage.

Four More?

I think it's possible that I only have 4 more WCP's left to do this semester. Woot! The hospital where I have my clinicals is doing their big electronic records switchover in March, so the week that it goes live, our clinical instructors have decided that we need to be "out of the way" as much as possible as the nursing staff will have an added stress of the new software. So they've told us...no care plans that week, no patient care...so as I understand it we'll be doing our big health history and head to toe assessment that week. It's only supposed to take us one shift to complete it, so not sure what we'll do with our other clinical day. Hopefully they won't cancel and then make us make it up in April. We already have one clinical day to make up in April since our clinical instructors had to go for intensive training on the new software earlier this semester.  We're not sure when we, the students, will get our software training, but probably after spring break--which means another clinical day not doing patient care. huh. At least it's not up to me to figure it out. Our program has to abide by what the Virginia State Board of Nursing requires of our program. So it will all work out.

But it's hard to believe that Spring Break is just two weeks away! I have no plans at this point. I hope it's on the warm side. Maybe I'll get out and rescue my plants outside and get some planting done. Although by then my allergies will probably be in full swing. Last year was awful. I think I figured out that it's the pine trees that I'm surrounded by. Good reminder to start up my Allegra now and make sure it's at peak levels when peak pine hits.  I have a couple other things that need to be done--oil change, interior car cleaning, VA taxes, and some other misc. things. Nothing too terribly fun planned at this point. I'll probably have some catch up reading to do for school. All my friends will be working that week, so maybe I'll just make evening/weekend plans and save my days for errands and projects...maybe throw in a lunch with friends too. Hmm? 

Later,

Joy

Good Start So Far...

Well, this week has started of pretty well.

• Took my first lecture exam for NUR 112 (50 multiple choice questions) and got an 88. Which is very consistent with how I performed last semester. I was so relieved! 
• Got my second SATISFACTORY on my Working Care Plans. Two for two. Feels good. Now pressure is off a bit. We still have to evaluate our interventions/treatment/care and drugs we administer...but they won't be "grading it".
• Today is Tuesday, so that means I spend all day/night creating a Working Care Plan for my assigned patient on Wednesday. I started at 12:30pm and finished up at 8pm. Last week I finished up at midnight, so this is a vast improvement. Large part had to deal with only a few new meds (and much fewer!)...plus I think I'm just getting hang of it.

Still wondering/considering what I should do to occupy my time this summer. I've thought about shadowing opportunities, with local hospice & jail. Maybe also ask to shadow in the embalming room at local funeral home (if its even permitted). I'd love to get connected with group in Haiti or somewhere where I can get loads experience with inserting IVs and so forth.  I think opportunities for paid employment are going to be few and far between since I'd only be available for 3 months. Maybe I can get some pet-sitting jobs. Would be nice to earn something, but at the same time, I know that I will be glad NOT to have a heavy committment. 20 hours a week would be nice. Would be nice to get in nursing experience and make money, but that's not likely since I'm not licensed to do anything (even CNA work).  I'll just keep praying for wisdom, direction and for the Lord to provide for my needs. I'm okay financially if there are no emergencies or big auto repairs and if I don't take any big trips to Haiti! ha! 

Until Later,

Joy

5 Weeks Down

Here's the gist of Week 5 of Semester 3:

I was selected as one of two students to give meds at clinical on Wednesday. That was a great learning experience! Thankfully I got much more sleep the night before--compared to my first WCP clinical day. I'll learn on Tuesday if I got another "S". Sure hope so.  My patient care felt very rush/disorganized because I was selected to give meds (and my instructor sits down with us and quizzes us on ALL the drugs our client is taking (even ones I'm not giving) and about how to administer and big side effects. So that took about 45 minutes. Then immediately after receiving meds, my patient had to leave the unit for x-ray, which took about an hour. So things felt very jammed up at the end and I didn't get to do 1-2 skills that I had hoped to do because we simply ran out of time and it was time for us to leave the floor.  But giving meds was fun and a great learning experience. I was nervous about being selected to give meds, not knowing how intense my instructor was going to be...but since I could tell her about the drugs/rationales, it went well. There were two things that I needed correction on, but unlikely that I will do them again the next time. :D

Pleased with results on my Pharm exam that I took on Thursday. It was challenging, and with the ones I got wrong, those were the ones that I probably read too much into the question and wavered back/forth about. But since I took the "I will not change my answer pledge" last summer, I didn't change my answers. Bleh.

Yesterday's (Friday) clinical went great.  Very pleasant and cooperative patient. Felt like I was much more organized and efficient--at least compared to Wednesday.

Also, yesterday's  weather was just amazing. It was mid 70's when I left clinical around 2:30 pm. I came home from clinical and changed clothes and grabbed lounge chair from the garage and a few blankets and went out to my back patio and watched the sun set. I was sooo sleepy from being up at 4:30 am and about 4 hours of sleep the night before, that I realized that I was simply not going to get much studying done. So I ended up joining some friends for dinner downtown (including SweetFrogs) and then went back to their place to play games. I was pretty sleepy and loopy. My brain was just not functioning very well at all--so playing large group "Catch Phrase" or whatever it was...was an exercise in futility for me. I simply could not come up with words at all...to describe my catch phrase or even to guess with my team. We also did Telephone Pictionary which my brain was better suited for at the moment (no time limits). Then played Dutch Blitz (like Nertz), which was also challenging since my motor/visual skills were struggling to keep up with the fast pace. But laughing all evening--was such good medicine! I was a bit loopy in my exhausted state...at least I got home safely! 

Waking up this morning after 8 hours, I felt a little hung-over in my loopy state. It's taken me a little bit to wake up and get moving. I need to spend the day studying for my Nursing 112 exam which is on Monday and need to make decisions about what worship service to attend tomorrow to get maximum study time in. There's a congregational dinner/meeting at church tomorrow night that I'd really like to go to, so I need to make a plan for which worship service to attend and how to maximize studying this weekend to make that possible. I also obviously need to get sufficient rest this weekend, so that I'm rested going into next week. Unlikely that I will do SOSI therapy (Sunshine. Oxygen. Social Interaction) this weekend...just not enough time. Plus I think Game Night probably covered the Oxygen and Social Interactions parts.  AND did get some sunshine absorption yesterday afternoon on the patio... 

Well, off to make lunch and get some studying done. 

Blessings.

I don't share many photos on this blog...simply for lack of time.  However this year, I am posting a picture a day on Facebook. Here's link to my "2011 in Pictures".

Happy Valentine's Day

I dunno what's gotten into me, but I'm feeling optimistic today. Even on Valentine's Day--when I typically just wander around annoyed at all the red and pink happiness. So I'm going to chalk it up to 3 things: Sunshine. Oxygen. Social Interaction (outside of nursing school).

Last week I posted my hope/desire/plans to attempt to get out and get some exercise on Sunday afternoons. My friend Elizabeth, who I've only recently gotten to know through my Bible study group, responded to my blog post and we made plans. I am not very good at initiating--but I will definitely respond if someone initiates/pursues (and I've got the time). We headed out to the Monticello Parkway/Trail and enjoyed mid-50 temps with full sunshine and full cardiac benefits. It was wonderful. It was so nice to be out and about and not thinking about school or even talking about it (okay, maybe I did mention it a little towards the end, but my recollection is that it was minimal). There were other much more interesting topics to be discussed!

I honestly think the Sunshine, Oxygen. and Social Interaction (SOSI) are very much responsible for my elevated mood and outlook. This is going to be a challenging week- no kidding. But I feel like the SOSI "therapy" has in a sense, been a reset button. Coping skills intact.

In the coming seven days, in addition to normal lecture readings for Pharm and Nursing II and clinical stuff, I'm also taking my first tests in Pharm and Nursing II. Today our Pharm instructor (online course) invited students to attend an hour long in-person test-prep session--basically giving us a better sense of what we need to review/study for the test. I left much more optimistic and much less anxious. Our instructor was very reassuring. 

Tomorrow is our all-day prep for clinical on Wednesday. I'm really hoping to get to bed at a decent hour tomorrow night. There's always the chance that I will be giving medications, so I really need to be well-rested and have solidly reviewed the meds and med administration skills applicable to my assigned patient for the hours I will be there on Wed.

In March, everything about clinical will be turned-upside down as my hospital is moving to a more fully integrated electronic records system. With our current record system (on computer), we have the ability to print off the Patient Treatment Plan and all the ordered treatments, meds etc...  It is my understanding that once the new system goes live in March...there won't be any reports that we can print.  I'm trying not to think about it and realize that every single nursing student is going to be in the same boat. Our clinical instructors are also going to be somewhat inconvenienced too... so flexibility is going to be key to our sanity. We are hoping for a thorough training day on the software...but we're not sure when that will be.   I just need to focus on getting my 2nd Satisfactory (on WCP) before the new software hits... that should take some of the pressure off.

(Click on image to enlarge)

Well, I'm going to go take a 20 minute nap and then jump on studying for my pharmacology test.

Cheers...and Happy Valentine's Day!

Ups and Downs

Yesterday I was on campus for lecture and swung by the nursing faculty offices to ask question of my online Pharm instructor. While there I bumped into my clinical instructor and without me asking, she excitedly told me that I got an "S" on last week's Working Care Plan (WCP). An "S" is for satisfactory, of course. That's very good. It means that I met expectations and there was nothing wrong with it. I was shocked. I worked long and hard on it last Tuesday --maybe for 12 hours? --and then turned around and worked hard on it again on Thursday night to turn in on Friday morning. The reality is that we have to have everything done/completed (as if we were turning it in) by Wednesday at start of clinical, but the instructors do not collect them, because they want us to USE them (makes sense) for our clinical day on Wednesday. Then we take them home and evaluate our interventions (from our 3 care plans) and our patient's response...we can also proof read or finalize anything else that needs work and then we turn them in on Friday (our second clinical day of the week). We're not to be changing our care plans, but rather evaluating them and then adding a few sentences to the bottom about what revisions we'd make for the next day of care.

The requirements for our WCP have increased since last semester (+patho, +medication data sheet) and so I just assumed that with a new clinical instructor (who has been labeled TOUGH) that there was no way that I was going to get an "S".  Even as I was working on my evaluations, I thought of a higher priority nursing diagnosis that I should've used...so I really wasn't all that hopeful. But when she told me that she had given me an "S", I was so excited and relieved! We have to earn two S's out of the eight or so WCP's that we will do this semester, so it's good to have one "S" out of the way. Once I get my second "S", I won't be required to  turn my WCP's in for grading on Friday. I still have to complete them, but they won't be turned in to be graded.

Today, being Tuesday, is the day that all first year nursing students are feverishly putting together our WCP's for tomorrow's clinical. But tomorrow I am scheduled for my OR observation day, so I don't have to do a WCP. Yeehaw! I still have to get up at 4:30 and hit the road before 6:00 to park and catch the bus to the hospital, but this time, I won't be sleep deprived!  And I think it's possible that I won't actually get plugged into the OR stuff until 8:30ish. I'm really looking forward to it. I've already seen some heart cath procedures so I hope they put me in something very different--abdominal, transplant, ortho, lung, etc...  I think that we'll only be observing in elective or non-emergency surgical procedures.

Last week was just crazy all around. I felt like I was never able to catch up. However, I realized on Monday that part of my problem last week was that I worked 4 hours on Monday and on Wednesday evening as a standardized patient and therefore lost some good study time. Good money, but it did make finding time to do readings and study much more challenging. By the end of the week I was feeling pretty resentful that nursing school was consuming all my time and not really allowing for any "me" time. But with realization that I'm not normally going to be working--that helped to ease my heart/mind. A couple good things happened on Monday that lifted my spirits, so this week I've been in a better state of mind.

But I can totally see how I will have to regularly fight the sense of resentfulness towards school. I struggle with procrastination, but even if it takes all night, I will not do a sloppy job. I will kill myself to do it right-whatever I'm working on.  For example, I could've totally been slack with my first WCP thinking there was no way I was going to get an S, so why bother killing myself the first week? But no, I worked LONG and HARD on that WCP ending with very little sleep before having to get up for clinical the next day. I won't say how little.. but it's SCARY how little. But I HATE turning in slack work. It's just not me. I think it's a loyalty thing. See my Myers-Brigg profile ISTJ/ESTJ.

I just need to make time for myself. Hopefully something other than going for dental appt, eye exam, annual physical or to donate platelets...(ALL of which I took the time to make appointments for yesterday).  I think as semester goes on, these WCP's will become easier, as cutting and pasting with minor tweaking will be more of an option (especially for medications). I will also learn to relax my presentation standards for the first go around on Wednesday and then clean it up for final submission on Friday.

I'm also really frustrated because I thought was going to have a bit more time to exercise this semester since I'm only on campus for class one day a week. Perhaps it would just be better to plan a couple hour activity on Saturday morning or Sunday after church to get some exercise and catch up with a friend or two in the process. One day a week is not enough (especially since I want to drop some pounds), but it would help my mental outlook to get out into the sunshine and breathe fresh air. I REALLY miss the days when I was only working 9-5 and had my evenings and weekends free and I could go off hiking with friends for 5 hours or spend the day luxury reading. That seems forever ago. I've been doing school or school + work for the past few years and I'm tired of deadlines! Ha ha. I've just got to figure out how to find the time to take care of me. Life will never get any easier or any less busy. AND I still have two more semesters after this one...so I NEED to figure out how to take care of myself in the midst of meeting everyone else's expectations. At least I will have this summer to enjoy. I'm still wondering what I am going to do with those 12 wonderful weeks. Make money? Travel? Mission trip? Get married? (haha just kidding on that last one!)

It's hard to believe that I will be turning 38 when I graduate from nursing school in May 2012. Where did my 30's go? Oh yeh, Liberia + nursing school are the themes for my 30's. I'm not complaining... Liberia was an awesome experience that I feel very fortunate to have had. And going back to school after many years to pursue a career is something not everyone gets to do. And actually, going back to school --without having to work--is also something most people can't do. If I had a spouse/family/mortgage, going back to school would probably be the last thing on my mind and perhaps even an impossibility. I do know I'm blessed. Very blessed.

Well, I'm rambling now and it's time for me to head to bed. This might be the ONLY Tuesday where I will get 7-8 hours of sleep.

Joy