Looking Ahead

Grades posted today for our final exam. And I'm THRILLED that I scored a 94%. Huge relief! Even though I'm disappointed that I didn't get an A in the class, I am still quite happy with my B. Part of the challenge is learning to take nursing school tests that are written to help get us ready for the licensure exam. So hopefully I'm growing/progressing in this area and will do better next semester.  Although next semester does come with its own challenges. I'm going to have to dig MUCH, much deeper next semester to come out with good grades for both Nursing II (med-surg) and Pharmacology.

This next semester I will take two classes totaling 10 credit hours. Nursing II (112/med-Surg) now includes two clinical days and our care plans will be much more in-depth and comprehensive for our patients. We'll also be evaluating our goals/interventions/client's responses as part of our care-planning. I'll also be taking Pharmacology, which is a tough course in its own rite. I have decided to take it online, saving time/gas since I won't have to travel to campus (25 minutes). Plus I've done really well with online courses in the past. Our nursing program offers it both in classroom and online. At this point, it seems like the majority opted for the online version. The nice back-up is that Pharmacology will be offered again in the summer (in case we don't do as well as we'd like).

We have not received our clinical assignments yet. I think program administrators may be waiting to see who passed Nursing I  (108) before posting the schedule...as they may have to reshuffle some clinical groups. Once they post the groups, we'll know WHERE we'll be working (which site, which unit) and WHO will be in our clinical group (9-10 students per group). Will be nice to get to know another group of my classmates, but it would be nice to have at least one person that I know fairly well (like from other classes).

Next semester I really want to do better in taking advantage of PVCC's fitness center. Unfortunately, last semester I got sick during 2nd or 3rd week of the semester and it greatly disrupted the good start I had started --plus then we started doing care plans around week 5. And unfortunately, when care plans started having weekly due-dates, I lost a lot of that time that I thought I'd have. ugh. And b/c I've not be training adequately, it would be quite miserable to start back running at this time of year (outdoors in the freezing cold). I really need to get my act together! I also need to do better at mass cooking and getting soup and stuff put in the freezer for future meals. I should do a LOT of cooking during my semester break and work hard to get my freezer filled up! 

Dating, getting together with friends, going to weekly Bible study---these have all been challenging, but I'm going to keep pressing on. If I don't get out of the house and hang with friends, how am I ever going to live a balanced life rich in relationships? Let alone meet someone with mutual attraction, date and hopefully get married? I'm not getting any younger or any more charming...and I'll be 38 by the time I graduate. Too bad marriages aren't being "arranged" anymore! That would make it so much more simple!  I could focus on school while my family or church family is trying to find someone to agree to marry me. I like that idea.

While I think dating someone seriously while in school would have huge challenges (priorities, distractions, emotional energy),  I think it could also be very good. It would require things to go slow, to be intentional, the best outcome is that it would get me out of my independent, self-sufficient mode and thinking about someone else for a change! But too much thinking about the other person could be a huge disaster academically...and if the relationship did not work out...sigh, that would be double depressing.  So I just have to keep trusting the Lord with this. To keep praying for His will to be done in the midst of this chapter of my life which from the outside probably reads "she's just to busy for a relationship"...which is TOTALLY WRONG. We'll never NOT be busy. This is just a different type of busy. My only consolation is that plenty of people meet and date while in school. Oh goodness...how did I get off on this topic? Stopping now.

Well, not much more to add. Just feeling good that the semester is over and that I have a five weeks to relax  and have a little extra time on my hands to do some fun stuff. If you know me...call/email me and we can go do something!

Semester Two: Finished!

Survived my final. Think I did pretty well. Grades not expected to post until next week. Not sure if that's the exam grade or the final grade...the rumor was a little lacking in specifics. : |Glad to be done.

Headed out now to help with my niece's birthday slumber party tonight (15 or so eleven & twelve year olds???) and then will stay over to help my sister move into her new apartment.

So glad that I can relax now for a few weeks. Will work 3 days a week but that's nothin' compared to schoolwork hanging over my head!  Now what? Not to worry...there's plenty on my list to do. Some fun stuff..some not so fun...but just not school!

Cheers.

Semester Two: Almost Gone

Semester Two ends this coming Friday with the taking/passing of my final exam. Almost there. Almost. The Thanksgiving holidays definitely gave me a taste of winter break, so much so that I really did not want to come back for my tests and final exam, mostly b/c it's been SO hard to get re-motivated for the final two weeks. And it showed. I was very disappointed with my Test 3 results. I probably could have spent more time studying, but mainly I over-thought things and changed answers. If I had left them alone, I would've done much better! My score could improve if they end up throwing out a question or two that I got wrong. I can only hope.

Friday evening (after we took Test 3 that morning) we returned to campus for collaborative testing to help us get ready for our final exam next week. It was there that we saw preliminary results for Test 3 (and got to review all our tests). So I won't know Test 3 official results for a couple days I suspect. But now, there is no conceivable way for me to get an A in this course. I'm sooo bummed. But reality is...what's done is done.  Can't go back and change things...can only move forward (having learned a lesson---maybe?) Now it's time to focus on the final exam!

I think I've counted that I have about 28-35 hours this week that I can study for my exam on Friday. I work all day Monday and Tuesday (my seasonal job) and that really only permits about 3-4 hours of study those nights. I'm just hoping I can get/stay motivated to systematically work through the study schedule that I've worked out. I've basically divided up all the content onto different days, based on whether I think I'll need a little or a lot of time to review it.  Today I review/read again chapter on Fluid, Electrolytes and Acid-Base imbalances... I know I'll be needing to spend time all week on this, so I figured I'd start early and then take flash cards to work this week to use during my breaks and to review before bed. And now that I've taken this little break, it's time for me to get back to the books.

I really doubt that I'll be posting anything new this week...so all my faithful readers (all three of you) can enjoy the break.

Cheers.

Aging Populations | Something to Watch

For my Fundamental class, on our section on caring for the aging adult, we were required to watch a video produced by PBS titled "Living Old". http://www.pbs.org/wgbh/pages/frontline/livingold/view/.  It's 60 minutes long. I totally recommend it. It's not an easy watch by any means. Definitely sobering and thought-provoking. Statistics say that by 2030 (20 years away), over 20% of our population will be over 65 years of age.  I think this PBS special definitely discusses some of the relevant issues surrounding this topic. It's NOT a nursing video...it was written for the general public, but there are healthcare providers, family members and members of this aging population that were interviewed.

I'm 36 years old. My parents are in their early to mid 70's... I certainly have wondered/thought about what the next 10-15-20-25 years will look like. What is it going to look like for my parents as they age and their bodies become less efficient and less robust. My parents became vegans over 10 years ago and they certainly believe this is going to help them stay strong, healthy and help prevent chronic disease or cancers from stealing their years.  Thank God, they are strong and healthy now (they brag they are not on any prescription medications), but that doesn't protect them from the unexpected (car accident, serious fall/fractured hip, back injury...) which could potentially impact their ability to manage their ADL's (activities of daily living) and remain independent. They certainly expect they will remain independent a long time. I just pray that is the case...

Interesting statement was made in this PBS program, the gist was that if you have three or more daughters and/or daughters-in-law ---chances are that you may be able to avoid going to live in a nursing home. My parents did well to have four girls. I've always said that having children seems like a pretty good retirement plan. ;-)   At this rate, I'm WAY behind...but not much I can do about it in my single state. I suppose someone better mention to my four nieces and nephews that they may be called upon to care for their elderly parents AND their elderly aunts. I'm sure they'll be excited to hear this--seeing as none of them are in highschool yet.

Well, I really just wanted to post the link to this PBS/Frontline special.  Nothing much else to post...I'm just busy studying right now for my final two tests which I have at the end of this week. Next week I'll be studying for my final exam which is next week...nearing the finish line! woot!

The End (of the semester) Starts Here

Just finished my last clinical assignment of the semester: self -evaluation. I know I've been counting down clinical days all semester, but it's finally here. Tomorrow is our last clinical day of the semester! We're all bringing in breakfast foods and will share with the unit staff tomorrow as a 'thank you'.  Then we'll be on the floor for 3.5 hours, leaving about 11 AM. Then we're all headed to lunch together...which should be fun. Hopefully no major disasters in the morning to sober our celebrations! 

This Thursday and Friday are the last "new content" days of the semester in my lab skills and lecture classes. The timing of it all is really perfect, as this weekend I'm headed to Pittsburgh for a family wedding and since I will have entire week of Thanksgiving off (just the way my class schedule worked out), my family will end up staying an extra day or so and come back early next week. So nice not to have to worry about school stuff over the weekend or holiday week! (Some people DO have class on Monday--just NOT me!) However, I still have to go next Tuesday for my final clinical evaluation with my clinical instructor--but nothing really to prepare for that (that's what I'm turning in tomorrow).  

The Friday after Thanksgiving I will get trained for my seasonal job which will start the following Monday. Looks like I will work M/Tu for couple weeks while I finish up tests/exams in early December...but as soon as the semester ends I will work the early shift 3 days a week. Will be nice to earn a little extra cash to help pay for this upcoming trip to PA (hotel room), purchase C'mas gifts, buy much needed clothes, and throw a chunk back into my dwindling saving account!

I have already started my "to do" lists for my holiday break. I will have to be a bit more organized since I'm working, but this will be the longest break that I will have had since I started taking classes the summer of 2009. Last year I had 5-6 weeks off between semesters but I was still working full-time, so I really didn't get a break. But this time I will have 4 days off a week while I'm working and two full weeks off in January. And because I'm working the early shift, I will get all my evenings off (which tend to be my most productive hours anyways). I'll be staying in the area for C'mas--hanging out with my parents and two of my sisters, and then the rest of the family arrives for our main family event over New Years weekend. The homeowners will be home just before C'mas and we'll overlap some, especially the days I'm working, but we get along great. It's such a great arrangement. I might lose my room over New Years but since I'll be doing family celebrations at my parents, it won't really matter.

Well, off to gather my bits for clinical tomorrow. Cheers.

ABG Interpretation

This week we've been reading about Acid-Base and Arterial Blood Gases.

I just wanted to share two sites that I located that have been helpful.

For ABG interpreting practice: http://www.vectors.cx/med/apps/abg.cgi. With each set of ABG values, it will let you know if you are wrong, right or mixed in your answer...and then provide basis for answer. Seems to have UNLIMITED ABG values to analyze.

For general overview of ABG's and interpreting, here is a PDF packet: http://orlandohealth.com/pdf%20folder/Inter%20of%20Arterial%20Blood%20Gas.pdf.  This looks like it might have been a continuing ed type of thing a number of years ago...but helpful nonetheless.

There are LOTS of other sites out there, but these I've used and have found helpful.

Another Good Clinical Day

Another great clinical day. It's really nice to be "on our own" doing assessments, providing care and documenting our work. It's a great clinical day when the nurse you are working with treats you as a person and not as if they find you completely annoying and a waste of their time. I haven't worked with all the nurses on the unit, but I think once you show them that your goal is not to waste their time or ask them tons of questions, but that it's because we ARE active learners...learning to be critical thinkers, learning to be solid care givers in the midst of a lot of first time experiences, then they DO respect the learning process and you as a student nurse. Now, I'm sure there are some nurses who just hate nursing students and can't remember what it was like to be a student...but I don't think I've met one this semester. Which is a really great thing for my first clinical experience!

I love it when I can contribute (and not simply lighten up someone else's patient load), whether that's discovering some new relevant assessment data or making a connection that the abnormals are side effects to meds/procedures, or discovering something that's out of compliance and finding a way to fix it. Those little things build trust with the nurses you are working with. And I think as time goes on, we grow in our confidence, have fewer questions and ask fewer questions, our assessment skills improve, our critical thinking improves, our organization of our time improves. I remember back to our first clinical day at the hospital and everyone was so nervous and anxious about doing head to toe assessments...and now it seems across the board we have all grown in our confidence levels. Now we judge our days on whether we got to do/learn new skills! That first day EVERYTHING was new and everything was stressful...but now we actually WANT new experiences! Amazing what happens in 8 weeks time. Sure, there certainly are days with challenging patients that require so much attention and bedside care that we wonder, how in the world would a normal nurse be able to care for this patient AND 4-5 more! Is this really what I want to do? One day I'll have a day like this and then have to be ready to show up the very next day to do it all over again!

Some other students have struggled with relating with some of their nurses and I can't explain why my experiences seem to have gone better. Perhaps the student's experiences with their nurses were different than what they expected and therefore they were disappointed. Or possibly it was just a really harried, crazy day for that nurse and unfortunately the nurse took her stress out on the student nurse. Or maybe the student nurse really was asking a low priority question during a high priority moment. I dunno. All I can say is that I've had really great experiences for my first clinical and I'm SO GRATEFUL! My clinical instructor is also very good. We all really like her. She's very interested in our progress and doesn't hesitate to hold us to high standards and to push us to improve and get better. My wish is that our clinical groups were smaller in number. Most clinical groups start with ten. We started with nine and have not lost a single student. Rumor has it that some clinical groups have lost a number of people (due to poor grades, life situation, decided nursing was not for them...).

Early on, clinicals were such a mysterious thing...causing great anxiety and stress...now, perhaps because there's much less mystery, I am looking forward and wondering what next semester's clinical days will be like. Next semester we will have clinicals 2x/week. The afternoon before the first clinical, we will get our patient assignment and we have to work up a care plan without having met our patient...and then we go to our first clinical of the week, care for that patient (unless they've been discharged in the meantime) and then we have a day to evaluate our care plans and revise as needed and then we go back again for a 2nd clinical day caring for that patient (if patient is STILL there).

This coming week we don't have to turn any care plans in...but we have to turn in a self-evaluation. Then we'll be meeting one-on-one with our clinical instructor at a later date for our final evaluation. Not a big deal... but I do want to find out what she believes my strengths and weaknesses are. If they match up with my perceived strengths and weaknesses.

Next week clinical will be a half day (since we've gone over our normal 6.5 hours on a few other clinical days) and then we'll go to lunch as a group. Yay!

Well, I need to sign off here and get some reading down for my lab skills class tomorrow. Didn't get it all done at my parents house. Was having to much fun!

Personal Experience

Survived my lab skills test on drug administration this past week...even though I wasn't feeling that well. Glad to have that behind me. Only new material over the next two weeks, then a week long Thanksgiving break (thanks to having no classes on Mondays and Tuesdays)! Then all that's left is 1 lab skill test, 1 lecture test and then final comprehensive lecture exam.

I'm so proud of myself for getting the bulk of my General Assessment done today. All I have left is the three care plans, which I hope to do tomorrow afternoon after church.  Monday I'm heading over to my parent's home to stay with my dad as my mom goes to DC area to take care of my niece/nephew for a few weeks while my sister is out of town. Thursday night my dad had a severe nose bleed that even after my mom (retired nurse) packed his nose with gauze, added ice packs and called the 24/7 insurance nurse....they ended up making two trips to the ER that night...three procedures later and now he has a saline-filled balloon type thing up his nose putting pressure on things. My mom will drain the nose balloon thing tomorrow (to reduce risk of sinus infection). So hopefully things have clotted up sufficiently that he won't bleed Sunday into Monday.  He's got a ENT appt on Monday. I'm just going over there for a couple days as a precaution and to be an extra hand if he starts bleeding again. His BP was fairly high compared to his normally low baseline. So it's good that I get my Care Plan out of the way this weekend, so that when I'm at my parent's house, I can just focus on readings for lecture/lab skills--which is a lot less to haul around. With CP's I'm using lab diagnostic handbook, drug guide, nursing diagnosis book, medical dictionary and sometimes an old pathophysiology text book, PLUS my laptop.  So hopefully I can leave all that stuff behind. Since I have clinical on Wednesday, I don't know if I'll go home Tuesday night so I don't have to drive so far the next morning. Guess it will largely depend on how my dad is fairing. My other sister could conceivably spend the night if needed. And if needed I can spend the rest of the week there, coming and going for classes, if there is continued concern.  The interesting hx about this is that back when my parents were first married, they were staying with my dad's parents and my grandfather had a severe nosebleed. Physician said the nosebleed was a good thing because it prevented him from having a stroke!  So that's why my dad's elevated BP with this bloody nose is a bit disconcerting.

So for me, as a nursing student, this is interesting and will of course stick in my mind in the future. I'm also curious if the ENT will order blood labs and if there will be anything abnormal. So hopefully I'll be taking my dad's BP several times while I'm there. A little practice for me. Appropriate monitoring for him.

When my mom was first telling me about this (between ER visits on Thursday), I kept thinking...now what would my nursing dx be? What would my nursing interventions be?  I didn't get farther than thinking about it...b/c I figured my mom has a good handle on the interventions...but I'm still thinking about the nursing dx.

Resisting Temptation

Practicing drawing up meds tonight in anticipation of my skills test tomorrow. Now if only tomorrow, no bubbles would appear in my syringes. My fingernails are already mad at me. sigh.

Also, I swear it's pretty darn tempting to want to try to give myself a fake TB shot with sterile syringe and sterile water or normal saline. I really want to see if I can make that cool little bubble under the skin! But I won't. I'm smart that way. But it is tempting.

I love all the little bottles and "Demo Dose" supplies we got with our Pocket Nurse Totes that were required for skills lab. (We got WAY MORE than this!) Not that we (I) will open or use them all.

The little colored caps that come off the top of vials are particularly fun for me. You see, as a child, my mom would collect them where she worked as a nurse and then would bring them home. My mom used them as "tokens" for my younger sister and I. We'd earn them by practicing piano or doing some other dreaded activity...then we'd individually get to trade in a bunch of tokens for a prize or something that we had managed to beg my mom to buy at the store. So I anticipate that the cap of my very first injection will probably be saved for posterity's sake. Not sure what I will do with it though. I suppose I could collect a whole bunch and then make something out of them. LOL. Oh, yeh, no doubt I'm a nut. Certified.

Moving Right Along

Another great clinical day. Today wasn't that busy, but I did get to go with my patient down to radiology to watch them insert a Hohn central line (on my patient). Pretty cool. Not much going on with my patient, he was pretty independent and able to handle his ADL's for the most part. Today was the last General Assessment we have to do this semester and last care plan that we'll have to submit (after the fact). I think it's just a end-of-the-semester-I'm-so-ready-to-be-done-with-this-semester feeling. It was nice to have a pretty relaxed clinical day. I felt more organized..but granted I wasn't running my legs off either. Next week I'll probably get a patient that needs more care...but that will be okay because I won't be having to write up an extra assessments or careplans after this week. Bring on the tough stuff next week! ;P

Hard to believe we've only got two more clinical days and the last one is a mix of patient care, partying with unit staff (we bring the food) and then lunch out as a clinical group. So next week is our prime week to get some added skills experience. Haven't had the pleasure of inserting a catheter, but for many skills it usually is a matter of being in the right place at the right time with the right patient!

Tomorrow I have a skills test on drug administration. Basically administering oral, injectionable and IV meds...and paying attention to asceptic technique and being careful to observe 3 checks and 5 Rights of Medication Administration. A bit nervous since we haven't had but 1-2 weeks on the various drug admin topics...and this is pretty important stuff! Next week we'll be doing venipuncture. Woot!

One thing I wish our program offered is a pathophysiology course. It's not currently required. I think BSN programs require it...but really I think it would be soooo helpful as we work on care plans and understanding the various needs of patients with specific disease processes and conditions. Right now we are only learning about the disease processes of our patients and not across the spectrum. So I've submitted my recommendation to our student rep on the Curriculum Committee for the nursing program. One option I do have is to see if I can take Patho at UVA...but then I'd have to apply to UVA and pay big bucks to take it online at UVA.  That's just silly. But might be what I have to do.  Right now, to get by to learn about disease processes of my patients (for care planning) I have an old Patho text book that I swiped from the local recycling station. It's 12 years old...but really I'm sure that basics are pretty much the same. I might see if I can find used copy of the Patho text that UVA nursing students use...

We got grades back for our 2nd lecture test...again I scored an 88. Well, I'm consistent. I really had hoped to do better. But again, I'm not sure how I could've studied any harder. Friday we'll learn what we missed and what the majority of the class struggled with. There were a few that I knew I missed... not sure if I want them to be stupid mistake or not. So we've only got one more lecture test and then the final comprehensive exam. I really need to get high A's if I'm going to get an A in this class. Frustrating. I'm doing very well on my careplans, but we don't get grades for those ;(

Well, I think I am fighting another cold. Just a touch of a sore throat and I think a runny, stuffy nose. I just need to get through Friday. I'm supposed to donate platelets on Saturday, but I'm guessing I'm gonna have to cancel. Bummer.

Well, onto review skills videos for medication administration. Hoping I can stay awake!

Best Clinical Day Yet

Today was a great clinical day. The best yet. I think it was because we basically got to map out our day with our patient without having to worry about waiting for our clinical instructor to observe us do our assessments/vitals. 

New skills today: giving suppository (!) and changing dressing on a toe/foot wound (related to diabetic neuropathy). I totally didn't flinch--neither did my patient...my patient could not feel it. Diabetics: PLEASE TAKE CARE OF YOUR FEET!

I've got so much studying to do tonight and tomorrow, that I can't write more. But since I'm in a celebratory mood...I wanted to share.  

Only THREE clinical days left this semester.

Cheers.

Second Fundamentals Test Coming Up!

Friday we have our second fundamentals lecture/theory exam. I have not yet started studying for it.

Thankfully, I did manage to complete my lab skills readings quiz for Thursday and my lecture readings for Friday (for after the test) this past weekend and completed the General Assessment write up today...all that remains is to watch a bunch of skills videos (for skills lab), write one care plan and finish up my Nurse-Client Interaction assignment. The NCI proved very challenging last week as my patient was on isolation precautions. So no paper was allowed to go in/out of the room. So I had have to depend largely on my brain to recall the 5 minute conversation and then to evaluate the conversation and non-verbals for therapeutic and non-therapeutic conversation. And I was very busy with my patient, so it was tough to find time to recall/write down the conversation. I understand we'll get to do this again next semester and then again in our psych clinical during our 2nd year.

Not yet overwhelmed or nervous about this test...but I REALLY want to do better than last time (88). I would LOVE to get an A in this class. And the tests are where that happens. We have a quiz average that is included, but I do not see how I will score lower than 95 average on that...but really hoping for a 100 (once they drop quizzes). I anticipate I'll try to study some hours tomorrow and Wed/Thursday evenings.

I'm going camping this Friday/Saturday to celebrate the 2nd test being over and hopefully relax a bit. I'm only going to spend one night (could go for two) b/c I need to get basic life stuff done, plus probably some studying too. We've got our next lab skills test a week from Thursday...on meds administration (oral, topical, injection, IV etc...) so I do need to plan for that!  Sadly, we won't actually get to do med administration until next semester.

Oh, already have idea of next semester's schedule:  Two classes:  Nursing Fundamentals 2 and Pharmacology.  Monday morning is our Fundamentals Lecture, Tuesday morning is Pharmacology lecture, Wednesday and Fridays are our clinical days with clinical prep on Tuesday afternoon/evening. So it looks like my weekends will be eaten up with lecture prep! ACK! I will have option to take Pharmacology either in classroom or online format. I'm leaning towards the online format...simply to cut out time it takes to travel to school and sit through lecture. I really wish they could tell us if performance/grades were higher in one version than the other. sigh.

Tomorrow afternoon I am interviewing for seasonal employment at the distribution center for a local electronic retailer. They need folks from end of November through the holidays. I'd need to have reduced hours for the first couple weeks after Thanksgiving b/c of school exams, but can work plenty of hours after that through Christmas. I really don't want to work EVERY DAY during the holidays, as I am looking forward to a break. Maybe I'll just rest in January if I'm not needed to work. But the money will be nice supplement to my bank account and being able to not stress over gift-giving this year. I also probably need to figure out if I plan to go to Ohio for Christmas. But that largely depends on what my other sisters plan to do and usually they don't make plans early. New Years is when we do the full family thing (all sisters, parents, nieces/nephews)...so it's a matter of figuring out where I'll be for C'mas Day.

I probably should post an update of my expenses here soon. I keep forgetting...plus not a lot of time. We'll it's time for me to head for bed...another full day tomorrow of school assignments/studying, job interview and getting ready for clinical on Wed.

Blah Blah Blah...

Tomorrow is another clinical day. I'll be turning in three physical assessments from last week: Urinary, Bowel and then we had one of our choice and I chose Skin/Tissue. We also had to complete 3 care plans--1 per assessment. Tomorrow we'll be doing another General Assessment and a Nurse-Client Interaction (NCI) assessment. I've been dreading the NCI ever since I learned we'd be doing this. Basically documenting verbal/non-verbals on both sides... recording the therapeutic communication techniques we used with our patients and the responses...along with non-therapeutic communication that undoubtedly will slip in there. Basically a blow by blow of 5 minutes of conversation. I'm not altogether sure how this will work and am fairly nervous/confused.

We'll be getting our General Assessments back tomorrow from two weeks ago, so hopefully we'll learn from our previous mistakes so that we can write up a better Gen Assessment tomorrow. The patient that I did my first Gen. Assmt on was discharged after 3 hours. So hopefully that won't happen again--as that would possibly be problematic for completing my NCI.

I'm so glad that I will not be repeating last week's late bedtime (only 4 hours or so of sleep and HR over 100 when I went to bed!)

Last week the first care plans that we did were returned to us. I think for the most part I had a well-executed CP but instead of my nsg dx being "Impaired skin integrity..." I should have had "Risk for skin integrity..."  I can't remember now what my rationale was for choosing the full monty, but I remember I thought about it and thought about it. It was a confusing one. But since there weren't a lot of red markings, I felt pretty good about it. We'll be getting feedback about our first General Assessment tomorrow, but she already gave me feedback   from my CET (Clinical Evaluation Tool) that said I did really well with my Nsg Dx's...so gives me hope that I'm on the right track.

Hard to believe that after tomorrow, we'll only have 4 more clinical days left. For the following two clincal days (not including tomorrow) we'll be doing a General Assessment with 3 care plans. Those weeks will be heavy weeks, but then all that's left is to do is final evaluation of ourselves and then meet with our instructor for her evaluation.  I have mixed emotions about clinicals. They are anxiety producing (since this semester we don't know our patient assignment until 30 minutes before care starts) and a lot of school work. However, this is where we learn to be a nurses. Where the theoretical meets reality. I really wish I had pursued some shadowing experiences during this semester, but reality is that it's been challenging enough to get my school stuff done and still allow for some fun/balance in my life. I could probably manage to do 5-10 shadowing experiences in 5 weeks time--even with the holidays. So glad I'm not working...but I suppose that if a temp job was offered to me, I'd be foolish not to take it. Even better if the job was in healthcare field--but I don't want anything stressful!

This past week I started my "Christmas Break To Do" list. I love lists and this gives me something to look forward to--even if what I need to do/accomplish is not very fun.

Half-Way!

Hard to believe we're half-way through the semester! Yay!  And I've only got five more clinical days left! Instead of feeling panicked about what I will experience at clinical, now I'm a bit anxious about what I won't get to see/experience this semester. Funny how that is. I really would like the chance to insert a catheter, NG tube, administer an enema--uh, no, not all on the same patient-yikes!  It's really the luck of the draw what patient I am assigned to and what they are ordered on the day that I'm there.

Monday/Tuesday of next week are Fall Break, but for me, it's like any other week since my classes are Wed-Friday. So no break for me...I still have to prepare for my classes next week. We've got our 2nd lecture test coming up two weeks from today, so things will be getting K.E.R.A.Z.I.E. again. sigh. 

We'll have our last clinical day mid-November--the week before Thanksgiving,. After that all I have left is the 4th skills lab test and our 3rd lecture test...and then final on Dec. 10th.  My cousin's wedding is the weekend before Thanksgiving, so I'm very grateful for the chance to just chill out with my family that weekend and for the week of Thanksgiving and not have school stuff hanging over my head. I'll have plenty of time to study for my tests. School stuff will be finished by December and then five lovely weeks of break! Ahhhh!

All I can say is so-far so good. So far my feeling is that is the material isn't all that hard to understand. It's that we are rushing through it so fast. Kinda afraid it's gonna leak out of my brain before I have a chance to use it. I think by far the most challenging is just keeping up with all the readings and clinical assignments. 

I took the afternoon off to give my brain a break-- but I expect I'll be spending all day tomorrow working on care plans and if time, I'll start reading for classes next week. Sigh. No rest for the weary.

Room to Improve

Our first test grades were posted today. If I calculate right, I missed 6 questions...so I got a B (88). I had hoped for better, but I knew there were some that I likely got wrong.  I wish there had been more questions so that each question wasn't worth so much. That fact I didn't earn an A doesn't have me shook up. Live and learn, what's done is done. Fact is that I'm not sure if I could have studied any harder or any better and improved my results any. I DO think that if I'd had 15-20 more minutes to take it, that I would have been able to review my exam and fix dumb errors (from rushing). We only had one hour for 50 questions. I am curious to find out which questions I missed (and if these were ones the majority missed as well) and am ready to learn from my mistakes. Unfortunately, it's very possible that I made stupid errors that I will later kick myself on. But hey, like I said before, while I could get preoccupied, anxious about my grade, I really just want to learn. And sometimes we can learn best from our mistakes. Tests are all about finding out what we know/don't know (and whether we can follow instructions and understand the questions). I still have 3 more tests/exams for this class. The hard part of getting B first time around is that you have less of a cushion--in case a future test is worse. But I'm not going there...just gonna focus on the present and making my reading/studying time count.

No time to sit around though. We have our next theory test at the end of October and we've got five units worth of material to cover in 3.5 weeks. Giddy-up! Obviously, my current study methods/efforts for my weekly readings will be tweaked a bit. Not sure exactly how until I see my exam and what my trouble spots were.

An interesting side note...while I've always been the curious one with accidents, natural disasters etc... I'm finding now that I'm in nursing school, I have a new way to think about these things. A man from my church was BADLY injured in an accident---life threatening injuries. His arm was partially amputated several days after the accident because of infection that set in to open wounds. And there's still more infection and they are going to have to go in and do more surgery to try to clean out the rest of arm (debridement of the dead skin/tissue remaining) otherwise they might have to amputate more.  So now as a student nurse this has me thinking on a whole new level. Nursing Dx's, Interventions, etc... it's overwhelming to contemplate. The medical field has come a LONG way since Florence Nightingale and Doc Baker on Little House on the Prairie (one of my favorite TV shows as kid). In those days, this man would have died-from loss of blood, brain swelling/bleeding, lack of oxygen, infection, failing kidneys. He's still not out of the woods yet--they are likely working hard to prevent systemic infection. The great news is that it appears his pain response is still intact and he is able to respond to commands. It will be a LONG recovery road for him. Have mercy, Lord.

Update: Rumor has it there was only one A (or only one grade in the 90s--not sure??) for our first test. One of my friends in the program who I spent a fair amount of time with/talking to got that A...and the other woman we hang out with...also got a solid B too. So I am pleased that the three of us did really well--am grateful to have connected with other smart women!  So while I would've loved to have gotten an A...I'm still very happy with my B, as rumor is that many did not pass it. :(

My Official Clinical Theme Song | Fall 2010

Last Tuesday I decided I needed a theme song for clinicals. A song that I could play on my drive in that would be meaningful, encouraging, hopeful and give me courage. It could've been something as provoking as the Rocky theme song or some other well known tune OR just have really great lyrics.

So here's my official theme song for this semester's clinicals:

Bebo Norman  |  "Here Goes"



My sister offered the one below, which I like too (it's kinda vague):

Frou Frou  |  "Let Go"



"Here Goes" seems to meet most of my criteria. It's got a good intro, which I think Frou Frou's is kinda left wanting. I need something to ramp me up and bolster me. Clinicals can induce plenty of anxiety--especially since we know nothing about our client/patient before we walk in the door (true only for this semester).

I hope you enjoy them...

First Fundamentals Test

It's been a crazy week and it was a huge relief to be handed our exam and told "you've got one hour". There were certainly some questions on the test to make me think. A handful of questions that I was left picking between two possible answers...making the best guess and hoping I was right.

Yesterday I camped out in the library after my lab skills class (4ish) until library closed at 9:30. I had spent so much time focused on Fluids/Electrolytes this past week (and getting all the other reading and assignments done) that yesterday afternoon was my first thorough review of all the previous chapters and lab skills theory content. But when I got in to my notes and objectives to review, it was like "hey, I know this stuff!"  Which is a pretty good feeling. So for those 5 hours I went over every Study Guide's objectives and did the NCLEX questions at the end of each chapter...then reviewed lab skills readings/notes. I spent a little time on Fluids/Electrolytes before leaving the library, and knew I needed to spend some more time on it when I got home. But leaving the library and walking through the parking lot at 9:30 at night, my optimism grew and the stress just rolled away. It was such a wonderful feeling...confidence mixed with relief. 

I had the same feeling after taking the test this morning. Confidence and relief. Confidence that I did alright and while I know there are some possible wrong answers and I may not score an A... I felt like I did well. I studied hard and feel like I have a good grasp of the material. It's not all about the grade--there is something to be said for learning from mistakes!  Sure there's a scholarship on the line for me...and always the risk of not passing the class (and being dropped from the program), but I don't feel that's an issue right now...so the stress is gone (for now). There were certainly folks who were even more stressed after taking the test. Reality is that I can't do anything about it, what's done is done and I will have to wait like everyone else for the results next week. And it is possible that they may end up dropping a question or two--if they find majority missed it and it was poorly written question...

So things will calm down (only a tiny bit) for a week or so...before lab skills test. But now that we've experienced a lab skills test and now a lecture test...the mystery is gone and that takes some of the stress off. 

The big challenge for me, I think, is MAINTAINING the knowledge about Fluid and Electrolytes and connected chemical processes. We'll be tested on it again at the end of semester for the final comprehensive exam...and then again throughout the rest of my nursing school career. So I need a strategy for reviewing it and letting it sink further and further into my brain for long-term retention. It's like I need to be tested on it EVERY WEEK to keep me on my toes.

This is also challenging my brain about the A&P I learned over a year ago. How easily we forget...BUT how easily it comes back with a little effort. :D

Well, off to enjoy my weekend.

Week 6 | Preparing for First Test

This coming week is going to be a bit insane!

1. We have our first lecture test for the Nursing Fundamentals class (NUR 108) on Friday. It includes anything covered in readings and lectures for the past 5 weeks, plus anything covered in readings for skills lab (theory content)  for the first 3 weeks.  And we've probably read at least 700 pages, I would guess.
2. This first test includes Fluid & Electrolytes, which was our lecture content for this past week... F&E includes all things related to excess and deficits. It's overwelming material and with only really a week to digest and memorize the signs/symptoms, causes, etc... mercy!
3. Not only is the test this week, but we still have to prepare for the lecture that will follow the test on Friday! Believe it or not, the content subject is STRESS! haha. Thankfully we don't have a graded quiz on that material--so I wonder how many people will actually do the reading before Friday. It's possible the instructors may put up a narrated lecture online, which can help, but we are still responsible for the readings.
4. We also still have to prepare for clinical (Wednesday) and do readings for skills lab this week (Thursday).

I honestly do not know how people who have families and/or work are able to manage it all. Perhaps they don't get much sleep. But that hardly seems sustainable--and definitely not healthy. I've been sick the past two weeks with a head cold and while I feel better now, it was still very hard to push through to do my school work when my body was so tired. Glad I'm not getting sick this week...that would be AWFUL.

I studied all day yesterday (with regular breaks to capture stinkbugs that have mysteriously found their way into my house) and picked up again at noon today. Will spend all of the next two days focused on school stuff. It's sad, I have not left the house (except to walk to my mailbox) since I got home on Friday afternoon. I do need to go to the grocery store, so hopefully I will leave house before clinicals on Wednesday!  

Secondary to school, the homeowners are coming into town on Thursday (day before exam) and so I'm also thinking about cleaning bathrooms, Swiffering the kitchen/hallway floors and decluttering the downstairs. This past week I've "taken to" the kitchen table for studying. A little too close to the refrigerator, but is better than the sofa (temptation to snooze) and better than the office upstairs (warm/chair that hurts my back). Since the homeowners will be here for the next three weeks, I'll need to find another location other than the kitchen table. I enjoy having them in town, but it's really hard to get and stay focused on school when there are people around. So I may be living at the library a lot over the next three weeks! 

Here's a photo (my first for this blog, I think) of my current study setup. You'll notice that my 7.9 lb. Fundamentals textbook is supporting my laptop. So no textbook reading going on this evening...just working through an online F&E tutorial today along with focusing on normal lab values for the 6 main electrolytes (reviewing various sources).

Well, enough of my procrastination. I think I will cut off the studying for this evening. I will spend the next 20 minutes printing off school documents & assignments, then maybe take another 20 minutes to Swiffer the kitchen floor and carry up belongings from den to my bedroom...every little bit helps. And then I'll climb in bed for a little lite reading to relax me. Oh, and probably another glance at normal lab values so that my brain can be memorizing them all night long. haha.

Passed the Dosage Calculations Test!

Passed the required Dosage Calculations test...not only did I pass. I aced it. Very good feeling to have that behind me for this semester.

Today was our orientation day at the local teaching hospital. LONG DAY. Up at 0430 to catch the 0620 bus from satellite parking. Then sat around lobby for about 30 minutes before our instructor showed up at 0700. Guess I could afford to take a later bus...but the then the buses are fuller and that holds a risk too.  We ate breakfast together during pre-conference and discussion of what the day would hold. Went over a LOAD of hospital specific paperwork (terribly overwelming!) and then headed over to the ID office to get official hospital IDs...which ratchets up the reality notch a little tighter. Then headed to the unit where my clinical instructor normally works. Our instructor reserved a day room for us to use and brought in a hospital bed for a mini-skills lab (turning, positioning and transferring patients + vitals). And just as we were leave that unit, the fire alarm goes off. Thankfully not as obnoxious and painful as the ones in my elementary school. BUT, it.went.off.for.thirty.minutes! Mercy. Apparently this happens "all the time" b/c of the construction going on around the hospital (or steam from a shower). So that was somewhat exciting and then quickly pretty awful.I felt bad for the patients. If you are in the hospital you already feel like crap...why not taunt you with an alarm that would make any normal person a bit agitated?  But we got to see their procedures in action--so that was good.  Did see a couple firemen in their mega gear looking for the cause of the alarm. I think they narrowed problem down to our floor. I never thought about it, but those guys probably have to listen to their fair share of alarms.

Never heard what the culprit was as we went ahead and left the unit to head down to the until where we'll spend the next eight weeks. The fire alarm was unexpected and stole our time, so we didn't get to do the "hunt and find" exercise on the unit (where's this, where's that...), but we did get an instructor led tour of the unit so we won't be completely lost next week when we show up and have to find stuff!

Then we headed off for training on the hospital's electronic medical record/charting program. That about did me in...at one point I got so restless, fidgety that I could not focus and spent like 10 minutes reading the same page over and over and over. ugh. I was the LAST person to finish. I'm guessing a lot of people just ran through it and didn't fully comprehend everything. I really spent a long time looking at some of the documents that we printed out (that we will be using a lot). Hopefully I will be ready when times comes for me to actually DO what we were learning.

Now my brain is FRIED. But I've got to plug away for a few more hours this evening and try to get through our reading on electrolytes and fluids---probably one of the tougher concepts we have in in our fundamentals class.

For anyone who might stumble upon this post in the future and is applying to my nursing school...definitely take the Health Assessment class in the summer (along with Dosage Calculations) so that you are not taking Health Assessment (226) at the same time as Fundamentals (108). I'm so glad that's out of the way and I have those experience going into 108. Also very glad I'm not working! It's challenging WITHOUT a job and without dependents/family counting on me. I feel fortunate.

Well, I need to hang this up and hit the books. cheers.

Second Clinical + First Skills Test

Today was our second clinical day. Again at the long-term care facility. We definitely had more client interaction. Our main focus for today was to complete an aging assessment interview and to get vital signs taken and to assist with anything the CNA's need help with (within our learned skill set to date). I spent a considerable time after breakfast with my client in her PT and OT sessions--basically just observing. At times the number of nursing students seemed to equal the number of PT clients in this a fairly small room. It was all we, the nursing students, could do to stay out of the way. When it was time for my client to do OT, the number of students/clients had dwindled and it was not nearly so crowded. During OT, I realized that since the OT's were doing some group Range-Of-Motion exercises, I could do it along with them. Certainly helped the time go by and keep me alert. I really liked the OT because he didn't ignore us (the nursing students), but explained a few things and tried to open our eyes to what he was doing and why. He was helping to broaden our vision...and I applaud that he didn't just roll his eyes at us--but it felt like he saw us as future care partners.

Next week we head to the mega teaching hospital in town...we'll get our official ID badges, orientation to paperwork (by our instructor) and then attend the hospital's training for their electronic charting. It will be a longer day than normal, but since our first clinical day was canceled (due to circumstances beyond everyone's control) we still have to make up those hours...so those extra hours for hospital orientation will fill part of the those hours we need.  Our clinical instructor told us that she's going to see if she can create a mini skills-lab for us at the hospital--teaching us how to use the equipment in the rooms, where things are kept etc...so that we can be ready to roll on our first clinical at that site.

Learned from our clinical instructor that there's an opportunity for us to make up remaining clinical hours by helping with a local public school's hearing/vision screening day. That will be in early October.  I am so grateful that they are helping us find ways to make-up a clinical day, rather than tacking it on at the end (when we are studying for finals)...plus you NEVER KNOW (!) if there will be another missed clinical day (due to sickness or some other random event).

Tomorrow is our first skills lab test. We will receive an index card with three skills we have to demonstrate with our lab partner. I'm grateful it's not a percentage grade, but a Satisfactory/Unsatisfactory grade. But still I'm nervous. I hate being watched or giving oral presentations--I best get over that quickly...because that's the only way the faculty can know if we are mastering our skills.  Here are some of the skills that we can be testing on:  making bed (occupied + unoccupied), vital signs, ROM exercises, positioning/turning, bed pan/urinal, hand hygiene (self + patient), bed bath, back massage, oral care, applying/removing TED stockings, ambulation (walking and with crutches, cane, walker), transferring patient from bed to bedside commode, wheelchair/chair and so forth. There are certain things that apply to all skills that we have to demonstrate as well (review physicians orders, ID client, educate/explain what you are doing, hand hygiene, pull door/curtain etc...). My head is swimming with information. I think I just need to take my time and think it through while I'm doing it...and not get anxious and rush.

Well off to bed to get a decent night's sleep. Still sick and my brain just gets foggy after awhile.