37:20:07:56

Unbelievable. I just completed my last clinical prep of nursing school! It totally didn't register until I finished it. While we still have one more clinical day next week, we will show up and do our prep on-site! So no clinical prep day next week! Woot! No more clinical prep days ever! (or at least this go-around with school!). My eyes got a little misty thinking about it! I mean, I've worked my tail off for the past five semesters and the end always seemed so far off and distant. But today marks the beginning of the end of my nursing school career!

And to top it off, I finished my Peds care plan in record time! Last week my clinical instructor decided to change things up a bit and introduced a new way of doing our care plan. I far prefer the care map method! Much less work, but same results! I'm sure some folks aren't thrilled with the change, but I LIKE it! And next week for our on-site prep, we'll also be doing care maps.

So needless to say, I am in a great mood! What I wouldn't give to just relax and enjoy a Redbox movie! But no, I gotta pull it together and take advantage of this gift of four to five extra hours (from finishing clinical prep early) and get some course reading done! This weekend is probably going to be quite the emotional roller coaster, so I need to get as much school stuff done for this week and next before the weekend. Thankfully no tests next week.

Only 37 days and 20 hours until pinning/graduation. But only 30 days and 22 hours until final exams are over!

The end is near. But I'm afraid that when it does arrive, I won't know what to do with myself!

Relieved

Okay, so my last post was full of whining and complaining (probably a bit of PMS)...but I am happy to report that I did NOT receive two patients to prep for. Other folks in my clinical did. Now I'm wondering if she'll try to throw two patients at me next week (our last clinical day). Hopefully not as we ALL really want to have an easy day that includes leaving floor early and enjoying lunch as a clinical group (tradition). I think tomorrow we are going to revisit next week's lunch plans with our clinical instructor.

Anyways, I'm REALLY hoping and expecting to get to bed at a decent hour tonight! Yes!

Still Hanging In

Things are crazy right now, that's why I haven't posted lately. Written assignments, tests and more written assignments are keeping me busy. But there is a light at the end of the tunnel.

Only two med-surg clinical days left. Actually, I should say, two clinical PREP days left -one of which is tomorrow. Prep days are the worse. Caring for patients...so much more enjoyable then prepping for them. Last week I was assigned two patients. The prep was ugly and I got about an hour of sleep. Not fun. Not right. But it's over. Or so we thought. Everyone in my clinical has been assigned two patients (half one week, half the other). Last week my clinical instructor told us she'd be randomly assigning double patients to some of us (again). NONE of us want it the first time, because NONE of us want the extra paperwork and the sleep deprivation and the repercussions of no sleep that continue to affect us (or at least me) even two days later. The stupid part about all of this is... that having two patients was apparently not required, but my clinical instructor REQUIRED it. And we were also told that our two patients would be non-complicated. Yeh, right. I'm on a cardio-thoracic post-surgical floor. Of course they are going to be complicated! The course coordinator even told her clinical group to let her know if they wanted two patients and doesn't seem like she will be requiring her group to do two patients. Well, I'm pretty sure our clinical group is NOT the envy of anyone else. It sucks.  Last week, caring for two patients wasn't a big deal and even having to give meds for one of them wasn't a big deal...but doing the prep just made me want to shout obscenities and to whine and complain. But I didn't. I sucked it up and was a big girl -- despite wanting to complain endlessly.  But if I get assigned two patients tomorrow, I think I might just have to go to my clinical instructor and say, "I'm sorry, I respectfully decline. I simply cannot have another night of no sleep. Last week's sleep deprivation made it difficult to prepare adequately for my other classes and do my other classwork. Two patients are not being required of any other clinical groups, and if it looks poorly on me that I'm requesting to prep for only one patient, then so be it. There's also the "do no harm" aspect. I'm not sure I can properly care for my patients on one hour of sleep."  Thank you very much.

Don't get me wrong. I am NOT trying to wiggle of extra clinical work. I don't mind caring for two patients. It is all about losing sleep b/c I'm up prepping for two patients. I have learned so much from my clinical instructor this semester. She really knows her stuff...and that's what I WANT in a clinical instructor. But requiring us to do extra when none of the other clinical groups are being required, really is unfair. And not right. Those folks are more rested going into clinical. They have the energy to do homework and prepare for lecture the next day, they might even go to the gym.  On Tuesdays I get up about 5:30, get my crap together and go to the gym before lecture...then I'm up all night prepping...then head to clinical with maybe an hour of sleep. I am wasted come 2:30 when we leave clinical. Let's see, how many hours have I been up? Maybe 33 hours with one hour of shut-eye. Who can manage to go read a text book after that? Mercy. I end up crashing for a couple hours, then get up and evaluate my careplans and meds and do self-evaluation of my day for a few hours...and then back to bed. Last week I even slept through my alarm for my Thursday morning aquatic class. Boo!

So needless to say, I'm not going to be happy if she assigns me two patients tomorrow. And it will take everything within me to not go to her and attempt to decline. I really wonder what her response would be if I ask her to only assign one patient. The struggle is that I actually LIKE this unit (compared to my other clinical experiences) and might consider applying to work there and in that case, it would only make sense that I ask her to be a reference. But I'm completely TORN. How can I decline second patient and still maintain my clinical instructors "respect" to get  a good recommendation/reference - at least as much as is possible for a nursing student.

Tomorrow I will get last week's paperwork returned, so we'll see by her grading if she's ticked off at those of us who followed the course coordinator's instructions for prepping for second patient). Last week she wasn't particularly happy with us -- but perhaps she's since gone back to the coordinator to get clarification. If had done as she'd asked, I'd still not have finished-and would not have gotten that one hour of "sleep".

Tomorrow will be a long day regardless of whether I'm assigned two patients or not. I'm considering skipping my aquatic class to go vote. Otherwise I have to get up extra early to vote. Sigh.

In good news... I got a 98 on my my most recent test. I have no idea how that happened. Honestly did not even hope for that. I was hoping for low A, high B.

So the REALLY good news is, that I only have to survive Med-Surg clinical prep and clinical this week and next and then that will be over. I only have two Psych clinicals left (last one is the Monday before Thanksgiving). It's always REALLY nice to have clinicals done and to be able to focus on studying for Test 3 and Final Exams. Getting close.

One last gripe. Typically on the last clinical day of the semester, each clinical group with their instructors will head out early and go out to eat for lunch. It's been this way for every clinical I've had. However when we mentioned this to my Med-Surg clinical instructor (who is a first-time clinical instructor for my program) did not seem like she was aware of this tradition or else does not support this. It was like she plans for our last clinical day to be like every other clinical day. She said we could possibly bring lunch to the unit. Um, yeh. NOT! Are you kidding me? I think she was more concerned with the fact that she is planning to work the 3-11 shift AFTER our clinical. In my head, I'm thinking, "um, this is NOT about you...it's about us, about celebrating survival of another clinical semester! It's about being social and enjoying spending time outside the clinical setting."  She graduated from our nursing program about 5-7 years ago, you'd think she'd remember what it was like? I dunno. I think there's some pride issues going on and a desire to prove how bad-ass she is.    It doesn't help that she's a clinical instructor for us on the same unit that she works everyday (although in other ways that IS a benefit!)  I really wish she'd let down her hair, so that we aren't always pulling out our hair.

Okay, enough said.

Probably said too much.

But I'm venting.

You get that, right?

It's That Time of the Semester

Things are crazy busy and I think that's going to be the general theme until Thanksgiving (clinicals will end). Not sure I'll be writing much here due to needing to stick to priorities.

On the good side. I've remained sick-free despite a house guest who got strep while she was with me, AND last week the twins of my artist boss were home sick with the vomits. However, I did accidentally tear/rip off fingernail right at the top near cuticle. It's red and sore! Thank goodness my mom gave me some antibiotic ointment for it (that expired in 2008). Hopefully my finger won't fall off.

My second Nurse-Client Interaction is due this Monday (Psych clinical). HATE writing these up. Then Psych Test on Tuesday. And on Tuesday, I'll be prepping for not one, but two patients for Wednesday's clinical. Think it will be good to have two patients. Challenging for sure! But the paperwork might just kill me, if we have to do double paperwork. It already takes me 8-9 hours to prep for one patient (believe me, it's a ton of work), but how do you find another 8 hours and still get sleep? Bleh. Not looking forward to Tuesday.

And in other news... right now it's snowing about an hour from here. Tonight driving home from campus, I'm pretty sure that I saw flakes mixed in with the rain. Crazy early to be having snow! Wow. But I love the idea...even if we aren't getting any accumulations. I'm hoping for a lot of snow this winter, but only during my holiday break!!!

Cheers.

Unexpected

For the past two weeks in my psych clinic, I have been talking with a woman who has been homeless since 2004. "According to the Substance Abuse and Mental Health Services Administration, 20 to 25% of the homeless population in the United States suffers from some form of severe mental illness. In comparison, only 6% of Americans are severely mentally ill." (Link to data here). So far this semester, I have struggled in my psych clinicals to feel any sense of calling to that population in an intentional way. We have been reminded several times that wherever we go as nurses, in whatever field we chose, there will ALWAYS be patients that we will come across with mental health disorders... OB/GYN, Peds, Surgical, General Medicine, Cardiac, Home Health, Schools, Public Health, etc... So it IS important for nursing students to have this experience. It's usually the least favorite clinical, but I think for me, it has served it's purpose of opening my eyes to the plight of those who suffer from mental illness. And it makes me especially grateful for my stress and trauma-free childhood and adolescence years and for my parent's loving attention as they taught me how to live and cope with what life throws my way.

Today, my client's story really got to me. While her mental illness does significantly complicate things for her, I was struck by the plight of the homeless...and even more so, the homeless with mental illness.  Imagine losing your home. Imagine not having any family or friends that can provide shelter or assistance. Imagine sleeping on park benches in DC. Imagine having your belongings stolen as you sleep. Imagine having your ID lost or stolen. Imagine not being able to change your circumstances (with a job or schooling) because you don't have any way of proving your identity or education. Imagine being physically and sexually assaulted. Imagine living on the streets alone having hallucinations or delusions or paranoia due to a psychiatric disorder. Imagine not having any personal means to feed yourself, buy medicines, or get a shower.  Imagine not having a mailing address (which is important for any paperwork or government assistance - most of which require proof of domicile).  

Today I asked my client to list out some positives of staying at the psychiatric hospital (most of them want to leave!).  While she does not want to be there, she listed the following as positives, in order of importance to her):

1. Soft bed!!!
2. Inside protected from elements and extreme temperatures.
3. BINGO (chance to win good, useful prizes - like calling cards, personal care items, snacks...)
4. Three solid meals a day
5. Getting a chance to talk to people (other patients) and freedom to voice my opinion
6. Safe.
7. Fresh air (occasionally going outside--not common at the jail where she came from)
8. Access to medications.

Telling huh? Certainly all things that I take for granted on a daily basis!

Anyways, her story left me wondering what I could do as a nurse for the homeless population? What would it look like to be a nurse that primarily serves that population?  Would it be something I could do full-time? or is it more as a volunteer?  What programs exist in the major cities (with large numbers of the homeless) that utilize RNs in their list of services/programs?

I was kinda shocked when I started having thoughts like this while talking to her. Does this mean I should be considering psychiatric nursing as a field to pursue? I'm not sure. I still don't feel called to psychiatric nursing in general, but perhaps there's something here that I need to continue thinking about and researching. There are certainly opportunities to work with the homeless in my community now. And while I can't really add volunteer work during the semester, perhaps I can do some shadowing or exploring of opportunities over Christmas break.  I always have lofty goals of shadowing, but they rarely seem to come to fruition. I still haven't gotten to the jail/detention center yet or to the funeral home to witness embalming.  :( However, EVENTUALLY, it will happen!  Maybe I am just am too optimistic when it comes to my time?

Torture Tuesdays

Well, my sister is married (yay!) and now it's back to reality of being a student nurse.

Last week was really hard. It was my first week of my Adv Med-Surg clinical (on Wed). But prep the night (Tuesday) before was BRUTAL. This semester we have lecture in the morning and then head over to the hospital to get our patient assignment for the following day and begin our work of gathering assessments, lab work, meds, & medical, family and social histories from the charts to be able to form our working care plan for our patient. I started my prep work at home around 4pm...and I worked all night. I think I got about 90 minutes sleep (!) before getting up to head back to the hospital. I was perky and alert for clinical, but started fading dramatically in post-conference! I skipped going to the gym as that seemed impossible. I went home and piddled around hoping I might get a second wind (yeh, right!) but I think it was about 5:30 and I decided to take a short nap...that short-nap lasted 10 hours! Woke at 3:30am, completely disoriented with date/time. I also found I had been sleeping with my bedside lamp on! So tired. I got up about 4 am and worked on my evaluations of my expected outcomes and cleaned up some of my working care plan-- all of which was due by 3pm on Thursday afternoon. Realized about 30 minutes before I was to leave for lecture that I had not done my clinical evaluation (of self)...so I decided to wait and do that AFTER lecture since I would have plenty of time.  

After all that, I ran home, packed bags for what I'd need for the wedding weekend and then headed over the mountain to get started on last minute wedding stuff. Silly me, I stayed up until 4am (!) working on our unique table identifiers for our guests. Then Friday morning I was up again early to head over to wedding site to continue working on getting stuff done in time for rehearsal. I was feeling pretty nasty as I had not had a shower since Tuesday morning (prep day) when I had showered after my aquatic class before lecture. I'm embarrassed to say that I never got a chance to shower or change before the rehearsal. I was so disgusting!! Stayed up late Friday night too working on lighting project for the dance floor, and then got up early to drive back to Charlottesville and back (about 90 minutes) with wedding clothes (yes, left them behind!) just to meet up with nephews and brother-in-law to set up chairs at the ceremony site. I did find a window of time to get my first shower on Saturday morning and wonderfully I got to take a second shower an hour before the wedding! Whew.

EVERYTHING went really well and came together in some cool, even unexpected ways! It turned out to be a BEAUTIFUL day (as planned, of course)! Two weeks prior we were looking at the possibility of two hurricanes...but one hurricane dumped early (all week) and the other went out to sea.

I focused really hard to get some good sleep the last couple nights. Made it to the gym this afternoon after Psych clinical...and now I'm preparing for another prep day tomorrow :(  Not looking forward to it. REALLY hoping that things will go much faster this week. I CANNOT afford to be a zombie the rest of the week, as next week I've got tests in both my lecture classes and will be needing to study all weekend, rather than sleeping!

If I'm going to get up and go to the gym in the morning (aquatic class) I had better get to bed!

Cheers.

Cardiac + Thoracic + Surgery = My Unit

Today we had a two hour orientation for our Med-Surg clinical. I'm on the TCV surgical unit. That's Thoracic & Cardiovascular. Very sick patients. Also on our unit is a 9 bed Thoracic Surgery Intermediate Care Unit (TIMU), which we'll  hopefully get assigned to towards the end of the semester.

From what I can gather from the hospital's website, the patients I'll be working with will be recovering from conditions or treatments/surgeries related to:

Cardiac - Aortic, Mitral, Tricuspid & Pulmonary Valve Surgeries, Coronary Artery Bypass, Aortic Dissection & Aortic Aneurysms, Atrial Fibrillation, Heart Failure Surgery/Transplant.

General Thoracic - Lung Cancer, Esophageal Cancer, Hiatal Hernia & GERD, Achalasia, Malignant Mesothelioma & Other Pleural Diseases, Emphysema & Lung Volume Reduction Surgery, Mediastinal Tumors, Hyperhidrosis, Indeterminant Lung Nodules, Airway Diseases (Tracheal or Bronchial), Lung Transplantation.

Definitely a lot of very interesting, very complex conditions which will hopefully provide many, many learning experiences! We'll only spend eight clinical days on the unit, plus one in ICU for this rotation/clinical. Very different from last semester where we were on the unit twice a week. I don't think there will be time to be bored...and I'm expecting Tuesday nights are going to be terribly long, but hopefully interesting. Last semester I got so bored doing careplan after careplan for knee replacements!

I think of all the units I could have been put on, and I am so glad to be one of the few students to be assigned to this unit.  Even though this cardiac & lung stuff scares me, I know it's a great environment in which to overcome my fear and it will help cement the theory I'm learning as I will be applying and experiencing it in the clinical setting! *BUT hopefully no one I know will be a patient there!!

My clinical instructor works on this unit, so she knows the staff and this population of patients well. She'll know where things are and know the protocols and the routine on the unit. And because she knows these types of patients well, she will be able to challenge us more than someone who doesn't normally work with cardio-thoracic patients.

Today after clinical orientation I decided it would be in my best interest to try to log on to EPIC (electronic medical records system) and see if I remembered my log-on info. Well, turns out my password had expired, so I had to call the help desk to get it reset. Then when I logged in, I had to search/add my instructor as co-signer, then needed to change unit preferences to this new unit and not last semester's unit. It took me about 30 minutes to get it all straight, but now I'll be ready to go when I go in for clinical prep next Tuesday. Only one other person from my clinical stayed and made effort to log-in and get things straight. While I typically enjoy helping people figure things out on the computer, I am going to be really annoyed next Tuesday if someone asks me how to access EPIC (when they see that I'm able to log-in). I don't think it's fair for them to steal my prep time (or any other prepared person's time), when they could have easily stayed after clinical today to resolve this for themselves. I just have a feeling that most stduents will be surprised that they will have issues logging in next Tuesday.

If you are a fellow student, and you are reading this, I HIGHLY suggest that you go early to your unit on your prep day (right after lecture) and attempt to log-in and get everything sorted out. This way when assignments are posted, you can get started right away.

• Chances are you will need to call the Help Desk (# is on the computer desktop) to get them to update your password. Be sure you have your user ID to give them. 
• Once you initially log-in to EPIC, you will have to search/select your unit. Use search tab...you can search "2 East" or "6 Central" etc... and hopefully it will pop up for you to select. 
• Then you will need to search/select a new co-assign. Last semester this was my clinical instructor. Thankfully my new clinical instructor is in the system because she works at the hospital. MAKE SURE YOU KNOW HOW TO SPELL THEIR NAME!
• Once you are into the guts of EPIC, you will realize that you need to change your preferences so that it will bring up your unit's patients. When I got in, mine still had my last semester's unit. It took a little "playing around" and coaxing from the deep far recesses of my brain to figure out how to do this. It was about 5 months ago since we learned to do this in our EPIC training. I don't remember the exact folder to look in, but there is one folder in the sidebar that will contain what you need. If you find your unit listed, you just need to click and drag it up and drop it into the "My Unit" folder (that was set up last semester). After you put your new unit in, you can delete your old unit. If you have a "My Patient" folder, just delete whatever patient (Mr. Jones) may still be in there from last semester, but DO NOT delete the "My Patient" folder. Once we have our patient assignment, you can drag that patient into that folder. 
• If you can't figure out how to change your unit, you will need to ask one of the unit nurses or PCA/PCT's. . .and hopefully they'll have time to help you.

I think I might be smart to write these directions down (with specific folder names) in the event that I'm at this same hospital next semester and have to figure this out again! I REALLY wish that the hospital had provided us with a written summary of our EPIC training that we can consult afterwards. But no. :(

Theme Song for Second Year

"Here Goes" was been my theme song for my first year of nursing school. It was my "fight song" or the "Rocky tune" that I played as I was driving into clinicals. It's been such a great song that I'm carrying it into my second year. Thought I would post again.



While I find it to be easily applicable to nursing school, I also like it as a reminder for other areas of my life and the goals I've made. Although I still find it hard to apply to "never loved anyone with playing it safe."

Next Semester

UPDATE:  Looks like they've modified next fall's lecture schedule...

Tuesday:  Psych Lecture

Thursday: Adv Med/Surg Lecture

We won't know until later this summer which day we'll have WHAT clinical. All we know is clinicals will be on Wednesday and Friday (with patient prep on Tuesday/Thursday), but not sure which day will be Psych and which day will be Med/Surg.

I'm looking forward to our Psych clinical. I think it will be interesting! I kinda hope that I'll end up doing clinicals at the mental hospital over the mountain. A distance to travel, but I'd really like to have a clinical experience beyond our local university hospital. And the other local hospital won't be able to host our clinicals next year because they are MOVING to a new location across town. After this semester of having to deal with change to new medical record software--I am very happy that they won't have us mixed up with the move to a new hospital location. Ack! What a nightmare!  My parent's live over the mountain, so getting assigned to location on other side of the mountain (hour drive from my home) wouldn't be all bad. I could plan to stay at my folk's house the night before clinical which would cut significant travel time (although maybe they'd be a distraction?)

Clinical #2 Completed

Feels great to have clinical behind me and to now be able to focus on the theory (book work) for the remaining 3.5 weeks. I was looking at the work for Pharm this evening (not studying, just looking) and realized that our next test (end of this month) will cover 17 chapters and my Med-Surg lecture test will cover 16 chapters.  Fun Fun.

In clinical today, we quizzed our clinical instructor for what she could tell us about our fall classes and if she had any recommendations for us. We haven't even finished this semester and we are already fretting over next semester (in the fall). We'll have Advanced Med-Surg and Psych --both include a lecture and a clinical. Because of how time consuming clinical prep was THIS semester...we are wondering how we are going to manage to do two lectures, two clinical days and two prep days. There's also rumor that lectures and prep will be on the same days... It's really looking like my weekends will be consumed with readings for both classes. It really is HARD to come home after a long clinical day and find energy and willpower to do the assigned readings for lecture. I'm not sure how successful I will be, but now I'm wondering if maybe I should plan to do the majority of my readings this summer, take notes with the expectation that I'll only need to review my notes/readings when assigned in class. I'm wondering/hoping that I can talk a second-year student into sharing syllabus/course assignment information with me so that I can have an idea how to pace my readings. If I do get another scholarship for the 2011-2012 school year--they might let me go ahead and buy my books early (this summer), otherwise I'd have to buy them out of pocket and not be able to utilize scholarship for fall text books.

Yes, it's much too early to start stressing over fall semester or even planning to do readings during the summer (yuck!) It's the natural "planner" in me wanting to jump ahead (and a little control-freak mixed in).

What I DO think is a good idea, that a few of my peers are open to, is to plan to meet once a week during the summer and spend a few hours working through an NCLEX review book together. Not only will working together as a group help us stay accountable, but also each of us brings a different perspective or understanding to the material. If one of us is struggling to remember the information...we can work together to help create ways to remember/memorize. And very possibly, just talking through questions with them will help  increase retention of rationales.

I also have hopes to find and make two new recipes a week. I'll start first with basics that anyone should know how to cook (turkey, pot roast, etc.). Guess I may have to start inviting people over for dinner. Not sure if it's even realistic to think that I can pull it off--plus it might prove to be too expensive of a venture. I'm also really hoping to earn some money this summer. A part-time job would be all I would want I think--but not at all sure about the feasibility. Haiti is taking a chunk of my savings and now I'm wondering if I may end up having to get a new or refurbished transmission for my car (it's not happy at the moment). I have a handful of other things I'm considering, but really need to find time to sit down and think things through. Would be nice to have a "plan" for after I get back from Haiti--so that I don't just spin my wheels when I get back and waste the remainder of May.

Well, I'm sleepy and Survivor is over...so I'm heading for bed. Plenty to do tomorrow that is for THIS semester. :D

It's a Wrap - Almost!

The painful part of clinical is over...the prep work. Can't believe I got it done before 7:30 pm. I started later than normal and finished earlier than normal--five hours! I remember that first one took FOREVER!! I think it's largely due to the fact that I've gotten the hang of these working care plans...but also thanks to the fact that this is probably my third care plan for a knee replacement. I'm so ready for something more interesting...BUT I will have to wait 5 months for that. Remind me then when I start to complain.

So tonight, in celebration of finishing my WCP early and that tomorrow is our last day of clinical... I am going to go watch the Dogwood Festival fireworks tonight. Silly I know... but hey, I haven't gotten to do a lot of other stuff this semester that I've wanted to...so I think it'll be fun. Too bad the weather is not 80 degrees like it was on Monday night at 9pm. I think it'll be a cool 48 degrees. lol.

And in honor of the last day of clinical tomorrow... I will AGAIN include my theme song for clinical (which was originally just for last semester, but I guess I just carried it over).  I wonder if this will end up being THE theme song for my entire nursing school career, or if I'll find another good one for next year when I'm working with psych patients, children and new moms. Hmm?

Bebo Norman's "Here Goes"



Just realized that I'm going to have to change out of my pajamas to go to the fireworks tonight...PJ's are my absolute required attire for working on careplans. :D

Semester Three Clinicals Wrapping Up

The end is near. Very near. Last clinical day for this semester is tomorrow. Today I will spend my afternoon/evening writing up my working care plan for my patient. I am really hoping to get some solid sleep tonight.

Funny story, in the wee hours of the morning we had some pretty big storms, enough to wake me up and disorient me. I fell back asleep only to have my alarms go off (I have two) at 6:30ish. On days like this when I don't have a specific time to be at the hospital, I take full advantage of the snooze button. At this point I'd been snoozing for about 15 minutes (3-5 minute cycles) and then I awoke at 0655 and almost panicked thinking it was Wednesday (clinical day) and I was late, VERY late, with no way possible to redeem it. I thought, you've got to be kidding me, my LAST clinical day and I'm going to screw it up and have to come back on Friday??? I took a deep breath and I guess the oxygen kicked in and I realized that no, tomorrow is clinical. Whew. Well, needless to say, I was relieved and then proceeded to snooze for about another 10 cycles (yeh, it's a problem).

Well, if I don't want to be up until midnight working on my CP's, I better get off here and venture to the hospital.

Oh, one more thing. I discovered recently that the Nurse Manager for my unit is a new member at my church. Haven't officially met him yet. Then this past Sunday at church I bumped into one of the physical/occupational therapists (not sure which) from my unit and introduced myself. My church is big...so it's no surprise that it's taken me this long to notice these folks.

Okay... gotta go.

A Unique Privilege

This morning, when I went in to meet my patient, it was obvious my patient was still processing the accident he'd be in the day before (there had been a casualty in the other car). He clearly needed to talk about it. That's what's wonderful about being a nursing student...you get to spend TIME with your patients and hear their stories. So I let him talk while I gave him my full attention. Through his description of the accident, it became very apparent to me that the man was a man of faith and probably a Christian. To be sure, I asked a few questions to assess that my instincts were correct (asking whether he had a faith community, etc) and then was able to smile and say "I'm a believer too, would you like for me to pray with you?" He got this very relieved/contented look on his face (even with 10/10 pain rating) and he extended his hand toward me, I grabbed it and we prayed together. It was such a wonderful experience! An experience I've been looking forward to since I started nursing school. What a privilege it is to pray for a patient--a stranger--and yet not a stranger, but a Brother in Christ!  A unique privilege for sure.

Clinical Countdown...

While working on my working care plan for my assigned patient tomorrow, I realized that after today, I will only have ONE more full care plan to do this semester! Next Wednesday is supposed to be our last clinical day, however the faculty have yet to notify us if there's need for us to make up a clinical day that was cancelled earlier this semester. Would be nice if they could tell us before next week. :)  But if we do have to make it up, it will be next Friday --and it won't require us doing another care plan...woot!  

Once clinicals are over, I will have three days/week of my life back! No more all day patient prep (care plans) on Tuesdays and no more waking at 0415 on Wed/Fri.  I will definitely need those 3 "extra" days a week to start preparing for final exams. Plus there will certainly be things I have to do to prepare for my trip to Haiti (doctor's appointments, running errands etc...).

I am involved with helping with the funeral for the young man in our church b/c the worship staff are in St Louis this week putting on a conference for Bifrost Arts. There was need for someone to step in and coordinate the A/V needs so I volunteered. Thankfully I spent many of the past dozen years assisting with funeral details and A/V stuff at my church, so while it requires time, it's not a big stressor. This is something I CAN do in the midst of this tragedy to support the family and my church family. Thankfully the service is on Thursday (my day off from classes/clinicals). I will lose a significant chunk of reading time though and I also have a HUGE clinical write up due on Friday (and it's probably 60% done at this point) and I've got LOTS of readings to do before Sunday/Monday deadlines. So I may not be getting much sleep this week. I'm very grateful that my hormones are back in line this week and the Haiti craziness of paperwork and tickets was completed last week!

Better get back to work...I want to get to bed at a decent hour tonight. It seems earlier than it is...thanks to Daylight Savings Time.

Later.

Feedback

Today, the nurse who had my assigned patient last night was giving report to my co-assigned day nurse (for my assigned patient today). The night nurse remembered me from last week (the same nurse who gave me verbal pat-on-the-back mentioned in my "Poopy Post") and she introduced me to the day nurse as "This is Joy, your nursing student" and then something like "she's really on the ball" or "she's got it together." Something like that.  Wow, how awesome is that?! This is a nurse that some of the other nursing students (and even PCA's) think it kinda "snippy"...but somehow I've earned her respect (as a nursing student) and she's passing that info on to other nurses.

THEN, this afternoon, my co-assigned nurse said to me..."really great job today."  Some nursing students complain that their co-assigned nurses aren't really nice or compassionate to nursing students or helpful. But that has NOT been my experience. I have had some really great interactions with a number of the RN's and PCA's on my floor. Sure some are much more oriented to explaining things than others. Stopping to explain something to a nursing student takes time out of their patient care time. Understandable! But I totally appreciate it when they do take the time to talk something through with me. My goal is to do my job as quietly and efficiently as possible and to consult my co-assigned nurse only when there's a problem or to update them on the status of my patient. I've only got one patient to care for...they've got six--including mine, that they are legally responsible for. 

I definitely feel like my biggest challenge is being organized in my care. I've learned so much in clinicals this semester and last, but still feel like a bumbling idiot sometimes in planning care. Some days I do well...other days when there are interruptions or other issues pop up...it can be challenging to feel organized, efficient and thorough. It's a learning process. But it will come.

Nursing is a field where positive feedback is almost non-existent (at least from higher-ups, peers etc..) ...so it's nice to get this feedback (as a "lowly" nursing student) that someone thinks that I'm doing a good job. It totally inspires me to do better.  So the lesson here is... you inspire others by giving good feedback! 

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".