Reading vs. Napping | the ever-present conflict

Heading into the 3rd week of the semester, and it's just been so hard to get motivated to do readings and study guides. Not sure what it is. Hoping I can shake it, otherwise this is going to be a miserable semester!  Maybe it's that I've not been alone in the house for the most part since before Christmas with the coming/going of the homeowners. I enjoy having them here, for sure, but I'm not used to studying when other people are around. Next weekend they leave, I'll be back to living alone and hopefully I'll find some sense of normalcy and pattern. I also think warmer temps will help. I think the fewer blankets I need to sit comfortably while studying--the better. Right now, I start reading and then all I want to do is curl up for a nap! ack.

Also, every morning in the waking hours (6-9 am) when I'm still in bed and trying to snooze, I find that I am basically dreaming/thinking about care plans and patient care. It's not real patients or real situations--I think it's really that I am subconsciously stressed. I don't really think about it much during the day, it's just when my mind is so relaxed...that it gets to pick the topic. This happened during the first part of last semester, and eventually I chilled out and was okay. I personally wish my mind would focus on something much more pleasant and relaxing, like vacationing in a log-cabin in the mountains during spring or fall.

This coming week we'll be doing our first full Working Care Plan for this semester. I'll go to the hospital on Tuesday morning and find out my patient assignment and then basically spend an hour or so reading the patient's chart and door-side chart. Then I'll come home and work on the following:

• One page pathophysiology of the patient's primary medical diagnosis.
• General Assessment (from data collected from charts)
• Med Chart --have to go through each drug patient is on and explain why they are on it, possible side/adverse effects, along with dosage, route of admin and nursing assessments (monitoring) needed. This semester, two students (each clinical day) will administer their patient's meds and have to be prepared to know what drugs are for and how to administer them
• Lab/Diagnostic Chart--basically we have to note any abnormals and explain why they are abnormal in our patient and nursing assessments needed.
• Select 3 nursing diagnoses based on above assessments each with one realistic, desirable Patient Outcome for our patient care day.
• For each Nsg Dx/ Outcome will then need to determine multiple nursing interventions (assessments, meds, treatment, teaching...) that are realistic and directly linked to the Outcome Statement.
• Then we are to create a "to do" list for each clinical day so that we don't forget any aspect of patient care.
• ...and a couple more bits and pieces that won't make sense to anyone reading this.

That's the paperwork we'll be doing. However, we'll still have to review the patient's treatment plan (current orders) to see if there are any skills that we will need to perform (IV, wound care, catheters, etc...) and review those so we'll be ready if opportunity arises. We are basically doing ALL patient care (bath/oral care, linen changes, all assessments, and do all treatments except meds (unless our day to administer meds) for our patient.

Then after clinical we'll come home and have to evaluate and revise our Care Plan (did client meet desired outcome? if not, why and then revise. Then on our 2nd clinical day of the week we'll turn it ALL in for our instructor to review/grade and continue with same patient (if patient has not been discharged). We'll be doing 8 or 9 full Working Care Plans this semester (total of 16 days of patient care) and we have to get a Satisfactory on 2 of them. 

We also will be doing another Nurse-Client Interaction (documentation of therapeutic communication) this semester. That has to be done before Spring Break. We'll also be doing a full history & physical assessment of one of our clients (without prompts/documents).  I need to start preparing for this, but I'm not really sure how. This will definitely produce anxiety-induced dreams in the coming months, I'm sure.

Not this coming week, but the next, I am scheduled for my OR day. I'm so excited. Not all sure what they have planned for us. Not sure exactly what it will look like, but hope I'll get to see something I've never seen before (how about a transplant!!! :) ).  When I was in one of my anatomy/physiology courses, we got to pick a Learning Experience type of thing and I connected with a friend of mine who worked in the Heart Cath lab...so I got to see a couple oblation procedures...so I'd really like something different from that! But as far as I know, we don't really get to choose what we see. It's all pretty much whatever the hospital coordinators are able to schedule us for. We have a written assignment that we have to submit for that.

This clinical prep and patient care is on top of the weekly lecture/reading components and also my Pharmacology class. It's overwhelming, but I'm trying to keep reminding myself:

1. Take it one day at a time. Breathe.

2. You are a student--you are not expected to know everything or be "experienced" yet.

3. These are all learning experiences--take full advantage of them!

4. You are smart, you can do this...heck, thousands of students graduate from nursing school each year and pass the NCLEX.

Well, I guess I'd better get back to my readings (even though I don't want to).

Cheers.