I'M A THIRD SEMESTER NURSING STUDENT!!!!

Well it's been a rough semester! There were days I wasn't sure I'd make it. There were days at work where I questioned myself, if I was doing the right thing.  Those bad days are behind me!  As mad as I was earlier this semester when an instructor told me I should drop the one course since I was failing, telling me I'd be much happier 'part time'!  I have to say THANK YOU! Because I was determined to prove her wrong and I did.  I passed the semester (at one point it was by the skin of my teeth, but thankfully not quite that bad at the end). No, I'm not seeing A's like I did before I started the clinical portion but I've come to realize that that is ok. I'll survive with C's. Yes, I'd love to get A's & B's but I'll live with C's. Now I am going to take time to get ready for Christmas (I just knocked over the Christmas tree while putting my window display up) and not 'think' about school for a few weeks.

Wishing you all a wonderful Christmas and Happy New Year!

I AM DOING THIS!!

Well, the title says is. I am doing this! 

I passed my two exams (last Thursday and the week before). It's been very stressful to say the least. I've been attending every possible opportunity to get help. Something that is offered to students is called 'SIP-N'. It's a peer tutoring type session. Former graduates from our program who are working full time as RN's come in to try and help us understand what we are learning (or reinforce what we are learning). These sessions have been very helpful. They also have sample NCLEX questions to help us to 'think like a nurse'! It has become evident that the questions are getting harder each time.

I have also been blessed with another scholarship! This is the third scholarship I've been awarded! So very happy as this takes a bit of the burden off trying to figure out how to pay for school and bills, etc.

There are two exams left (one in each course) and I must do well on those. I would love to bring my average up but I'm striving to pass right now and the letter grade is not as important.

I've been working two days a week at the hospital. I really enjoy all that I'm getting to do there helping those who are trying to get back home following either strokes, joint replacements, brain or spinal injuries. It was nice to have the same patients several times as I would get to really see improvement in them. Had a really stressful night one shift and was very overwhelmed but thankfully the next day was much more manageable.

I will be back in a few weeks to update you on the end of the semester. I am very much looking forward to a break (even though it is only a few weeks), it is a very needed break.

Discouragement & Encouragement

As several have asked, where's my blog . . .   I am finally getting a chance. I love blogging about what I am learning and doing but finding the time to do it as regularly as I'd like is not always an option. So when I last posted I was preparing for my next exam. I did pass that, thank you Jesus, but not with as high of a grade as I would have liked. I had heard from previous students that the diabetes test was the most difficult. Having not done well on the first exam for this course this semester, I was very stressed. I studied so much on the diabetes that I didn't focus enough on the stroke of peripheral vascular disease portions. I did pass but as I mentioned not by much. Due to this, at the half way point for the med-surg portion of this semester I was not passing. I was 'strongly' encouraged by one of my instructors to drop out of the course and continue part time this semester with the maternity and peds course and then retake the med-surg course next semester (thus still as part time). She told me I'd be much 'happier' part time. Mind you, I just lost my full time job (stress), my son had a seizure just before my first med-surg exam (stress), started a new (very part time) job (stress)! How would I be happier part time??

You cannot go on to the 'next level' until both of these courses are done. I was heartbroken. I have been working towards this since May of 2010 and I was not ready to throw in the towel. Today I learned that this same instructor told another student who is not passing at the moment that she is trying to 'dig herself out of a box!' What a way to tell someone buckle down and get it done, NOT! 

I spoke with another adviser and she keeps statistics on students and the pass/fail at each point. With her encouragement and my determination, I am NOT withdrawing and going to do everything I can to get my grade up and pass this course.

I have every possible thing on my calendar. I am attending weekly 'Sipn' (tutoring type of sessions) for each of the courses (some are twice a week), I am attending all test reviews to see where my mistakes are made and hopefully understand why I chose the answer I did. I am working two days a week at the hospital and two days of clinical at the hospital and still trying to find something to fill the BIG gap in the pay. All of this fills up the ENTIRE calendar. There are only three days this month that something is not on the calendar (and they are devoted to studying most of the day). It's crazy, but I'm taking advantage of every opportunity that I have to do better and get a better grade and learn more.

So, just a bit from last update . . .

While on my maternity rotation I was able to observe a baby being born via c-section. I was initially disappointed that I was not seeing a vaginal birth but watching the team of doctors PULL this baby from it's mother was such an amazing experience! (I was concerned since I didn't care for my OR observation day last semester). I also did a clinical day in the NICU. I am thankful that I live in an area with such an amazing teaching hospital that allows us students to see first hand so many amazing experiences.

This coming Monday I will have my first clinical absence. I hate to have to miss a clinical day (and may have an advisement due to it) but I MUST take my new employee orientation for the hospital. I didn't get to take it last month due to my maternity rotation so I HAVE to take it Monday. Bummed as I really am enjoying my med-surg clinical instructor so much more than my first rotation earlier this semester.

Also for my job at the hospital, I have had to take two other courses; one was on patient and employee safety (not getting hurt while helping a patient) and the other was a self-defense course. I was a bit blown away at learning some of these things as I did not realize how easily a situation could turn bad. Granted most of the employees in that course work in the ED or Psych unit but thankfully I know what to do if something happens (just hope my brain remembers it).

SO MUCH HAPPENING ALL THE TIME

I can't believe it's been a couple weeks again. I have been working for two weeks at the hospital and go back in tomorrow and Sunday from 3-11:30. I truly am enjoying what I'm doing at the hospital. As for school, the past few weeks have been in maternity. We had one evening in Labor & Delivery where I was able to 'assist' with a newborn assessment. We will be back in Labor & Delivery Monday afternoon/evening and I truly hope I get to see a birth. On Tuesday I'll be in the NICU unit.

While on the maternity floor, I had the privilege of taking care of several new moms the past few weeks along with their newborns (even a set of twins!). I've demonstrated bathing newborns for the new parents and have administered the babies HepB shot. I have had brand new young moms (18 years old) to older (experienced) moms. I really have enjoyed this rotation and wish we could spend more time here. The instructor this rotation has made learning very enjoyable.

I didn't do well on my last exam. It was on Altered Immunity and Infection; Alterations in the GI system and Alterations in Nutritional Metabolism; Alteration of the Endocrine System, Fractures and Osteoporosis. I am studying very hard for the next exam in this area, many on Diabetes, Stroke; Peripheral Vascular Disease and Cardiac Deficits.  LOTS of information.

In between all this, Dale & I participated in the Philadelphia 3-Day for the Cure with 1500 other friends!  We truly are committed to the fight against breast cancer. Seeing young women in their 20's being diagnosed with this breaks my  heart! These women should be planning their futures, not making chemo and radiation appointments.

This photo is of my 'cousin' Shannon and I at the mile 59 marker (one mile to closing)!!! I walked with Shannon in Boston in July! After walking Philly the first weekend of October, she turned around and went to DC and walked that 3-Day in the pouring rain!!! She is awesome!

  

  

A QUICK UPDATE!!

I have been so busy that I've not had time to stay on top of this. I finished working at the real estate office last Friday. To celebrate, my boss took his wife, Dale and I, along with our agent and his wife to a very nice dinner. We had a wonderful evening and some very fine food.  We finished up our rotation at the med-surg unit last week. We were in the brand new unit those two days. I had a patient who was suffering from multiple pulmonary embolism. My patient was very young to be experiencing this. I was able to administer IV meds via a pump.

This week we started our maternity rotation. Monday was spent working on our community collaborative project. My team will be presenting 'Safe Sleep' to expecting and new parents later this month. Safe Sleep is to enforce that parents put their babies to sleep on their backs, not their sides or tummys. Tuesday we started our day with a tour at a local birthing center and then went onto the maternity unit at the hospital.

Today I started my new job as a patient care tech (PCT). It is a casual position so I only get four shifts every two weeks (and it pays a great deal less than I was making) but hoping it gets my foot in the door. I had a great day and am looking forward to all that I can learn in this position.

I will be back at the hospital tomorrow and then it's on to the Philadelphia 3-Day for the Cure! I'm going to be running on steam but so looking forward to this weekend. I will truly listen to my body as I need my feet for clinical on Monday afternoon and evening!  

TWO WEEKS IN ONE

I've been meaning to update but time has so easily gotten away. With the new semester under way and clinical in full swing (and still training for the 3-day for the cure) there is not a lot of 'down time' to update. So I'll try and bring you up to date from the past two weeks.

Our first real clinical day with a patient was September 9th. We were partnered up with a classmate for this afternoon and the next day as we were still acclimating to the setting and finding things. Our patient this week had something called 'hemoglobin c'; this is something neither myself, my classmate nor our instructor had heard of. In addition to this, our patient was very anemic, so we were able to observe a blood transfusion.  But the blood needed to be heated first. The nurse administering this was using this device for only the second time so there was confusion on how it actually worked. It was good to know that nurses are always still learning. We were able to have this same patient again the next evening after this patient returned from surgery. We were glad to be of some comfort to our patient as they became aware of the surroundings and their family was not close by. Our patient recognized us from the previous night and I believe relieved to 'know' someone since they woke up in recovery and all these faces were new.  It was a pretty uneventful first two clinical nights but that is ok.

The hospital we are doing this clinical rotation in has been undergoing a major renovation. The unit we are assigned to was moved this past week. We were in the unit on Monday and had our own patient. I had a very interesting patient who happened to go unresponsive in the middle of an episode of throwing up. I could not awaken my patient and immediately asked (a little loudly) for assistance. One of the RN's that was right outside my patients room entered (along with a half dozen others) and perform a sternal rub and my patient was alerted.  My patient at that point had no idea where they were (which hospital) or even which year it was. The entire rapid response team and physician entered the room and performed various tests. Before I left for the evening my patient was sent for a CT scan. 

The next evening due to our unit moving we were assigned to another unit (just for this day). I was a bit disappointed as I wanted to know how my patient was but they were no longer my responsibility and I would have to wait until we return to our brand new unit to see if I can get an update. So this evening we were again partnered up (since we didn't know where things were and were only going to be here the one night). My partner and I were able to provide care for our patient and during our 'down time' we were able to work on our assignment from the previous night. I did learn to use a bladder scan on my patient this evening and I also had to straight cath my patient (place a catheter to drain their bladder)! I was so nervous as I had not done this since lab last semester (I did get to assist an RN with one but I mostly observed), so with the guidance of the RN assigned to my patient, I was able to do this.  I always wonder how I will do when I do a new task that I've not done before and I still amaze myself that I did fine! I handled the situation providing dignity and as little discomfort as possible to my patient.  I DID IT!!! 

In the meantime my job is quickly coming to a close. This coming week will be my last week there. I have been offered a 'part time/temporary' position in the hospital. I am jumping at the chance to get my foot in the door and hoping that bigger and better things will come from this.

This coming week will be the end of this rotation and then we are on to maternity! I am really looking forward to that! I will truly try and update at the end of next week.

OH WAIT!!! We had our first exam this week and I got a B!!! I was so relieved as I always stress myself out! I had so much going on this past week. Our son, Tyler had a seizure last weekend (out of the blue) and there has been a lot of doctors appointments and getting him to and from his job and school since he is unable to drive right now. Praying that he is given a clean bill of health when he sees the neurologist next month.

So Much Going On Already

Well, I'm already behind on updating.  Last week was a LOT of craziness!  On Monday, September 3rd (mine and Dale's 30th wedding anniversary and my first clinical day of the semester), my employer informed me that he would be closing business at the end of the month. Shock cannot describe how I felt! I got so upset that I actually hyperventilated. So now the search for another job that will provide me with the flexibility to continue this journey and STILL pay our bills. I'm hoping to get into one of the local hospitals, but that is not going to be full time and certainly will not be even close to what I am currently making. I've had a wonderful time in my position here and a boss that has been so accomodating to allow me to alter my schedule each semester enabling me to start college for the first time in my life and then to actually keep this up as started into the clinical portion of the nursing program. I'm definitely going to miss this.  

So in the meantime after getting this news I had to head to the hospital for my first clinical day. This day was strictly orientation with the unit we will spend this rotation on. Unfortunately our unit is moving to a brand new location with the same hospital during this rotation. As soon as we figure out where things are we will have to do it all over again. We didn't have any patient contact last week as it was only one day (due to holiday on Monday) on site.

My clinical group started in the regular 'med-surg' area so we had to show that we were still able to do the skills we had learned last semester. I spent two afternoons in the lab going over things to make sure it was all still up 'there'! I had an issue with one of the 'Sim' dummies, I was not hearing any bowel sounds and we have to differentiate between, present or absent, hypo, normal or hyper. I was doing well on blood pressure, heart sounds, lung sounds but just could not hear the bowel sounds (and was freaking out).  Turns out that the Sim I was working on was NOT working properly!!! Thankfully when it was time to do my assessment, I passed with no problems.

Later in the week we had an IV lab where we had to learn how to hang various IV's (regular IV, secondary bag and also syringe pump). I was so glad I paid attention to the lecture as it really did go fairly smooth (I just always second guess myself and have to stop that).

I'll definitely be back the end of this week to update all that we were learning this week. Thank you again for following along on this journey.

BACK AT IT!!

Dale and I got to enjoy a wonderful week at Disney earlier this month before all the craziness started back up. This was taken on our Wild Africa Trek at the Animal Kingdom. See the hippo in the water.

Well school started up this past week. The crazy schedules are already starting, the extended work hours to make up for the time I am taking off for school has started. The reading, the lectures, the seminars and quizzes have already started! Wow, it all happened so fast! It seemed summer was just going by slowly while we were waiting for our vacation and BAM, it was over and back at school. As crazy as life is getting, I'm so excited for this new semester.  

This semester will bring a rotation in med-surg (this is continuation and more in-depth of what we were doing last semester in the hospital setting); a rotation in maternity (labor and delivery) and pediatrics! No waiting to get into the hospital setting this semester.  Clinical start this Tuesday (my 30th wedding anniversary)! I'll be starting in the med-surg (general hospital floor) for four weeks before I move on to maternity. We are already learning about IV medications, with more calculations and how to administer the meds. We will actually have an IV lab this week where we will get the hands on practice we need. The following week we will have our childbearing lab. Now I've given birth to three children but never watched someone else give birth. I'm am so excited for this portion of the course.

So while I am watching lectures, reading chapters, going to classes, clinical, seminars and working, I am also still training for the Philadelphia 3-Day for the Cure! In just over one month, I'll be walking 60 miles in one weekend to raise awareness and funds to fight breast cancer.  I walked the Boston 3-Day for the Cure back in July and had such an amazing time, meeting so many new people in the Pink Family.  This weekend I am leading three - ten mile training walks!  Next weekend for anyone who is up to getting some miles in, we will be doing 18 miles on Saturday (and probably 12 on Sunday)!  

I hope to update my blog weekly like last semester.  So check back often to see what is new.

Where Is The Summer Going???

Well I figured I was going to take the summer off from blogging for the most part, but well I have some news I needed to share. Since school has been off (May 9th), I have truly not looked at my nursing stuff, other than to pack it neatly in a box and get all my supplies put away (so they weren't out in the middle of everything). So as most who know me know that last summer we lost our pug Abbey. Abbey was MY baby and I was more than heartbroken when she crossed the Rainbow Bridge. I could not think about another dog at all. We had Jade (our bulldog) and Mona (our cat) and I was fine with that. Well, once school was done and my time wasn't consumed 150% with clinical or lectures or studying, I started to LOOK, just look for a new pug to join our home. I really was just looking. Then I came across a Petfinder ad for a little black pug named Bella who had been in the foster home for more than six months. She was in a pug rescue in New Jersey and they do not typically adopt out of NJ but since she'd been in the system for so long they extended the borders and DE was included.  

This was the day we brought Bella home! I'm so in love with this adorable furbaby. She has no way replaced my Abbey (and in the beginning I called her Abbey often) but she's another baby who loves me. I am so blessed that I get to take her to work one day a week. She is such a good dog and sits so quietly all day (unless someone comes in and she begs for attention). So, Bella and Jade and Mona have all adapted to life together.

So as summer is flying by, I received a letter from my college a few weeks back. This was the very first time I hadn't received a letter from the dean congratulating me on my grades (I really struggled with that this semester), so I wondered what in the world was I getting from school at this time.

I was shocked and very surprised to see that I had been awarded another scholarship!!! The college has an alumni scholarship and I applied a long time ago because our son, Dale-Ross, graduated from the same college. This scholarship was open to any family member of a graduate (sibling, child, parent). So I am pleased to say that a good portion of my tuition this fall will be paid for!!!  So blessed!

I've spent most of the summer training for the Boston 3-Day for the Cure. Next weekend, July 26-28, I'll be in Boston walking 60 miles to bring awareness and funds to find a cure for breast cancer. I am so excited to be meeting so many new people that I've only known online. The pink family is truly a close knit family and only once you've been involved can you truly grasp the depth of this.

Just a week after returning from Boston, Dale and I are going to celebrate our 30th anniversary (a few weeks early) with a trip to Disney World! So excited to go to our 'happy place'. Then just a couple weeks later school will be starting up. I'm excited and nervous for the next adventure on this journey. I will definitely share it with all of you who have been following along. 

It's Official!!!! I Passed My First Semester!!!

This was a difficult week. All semester as we had exams they were always one week apart making it a little easier to concentrate on what material we were being tested on. I had planned to spend all weekend studying, BUT, Sunday was the Broad Street Run (this is held the first Sunday in May each year). For those not familiar with this, it's the largest 10-miler in the US. People come from EVERY state (and other countries) to run this race. It's a fast race since it is virtually flat (with a gradual down hill slope most of the way). This would be my fifth Broad Street Run, but the first I would be running without properly training. School has taking a bite out of my time to train for running, so I was not sure at all how I would do, but I was determined to give it a shot. Aubre and I left home just after 5:30 Sunday am to head to Philly.  

We joined 40,000 (yes, 40-thousand) other runners and most of them had on red socks in support of Boston. A notice had gone after the Boston Marathon to wear red socks for the Broad Street to show your support for Boston. It was a task finding those red socks, but I did and joined the ranks of red socks all around us. In addition to the red socks, we had stickers we wore over our hearts that read "From Philly to Boston with Love".

It was a difficult race since I was not prepared but I did finish my fifth Broad Street Run and am proud to say it was NOT my slowest time!!!

So back to the real reason for my blog. . . So after getting home from our race (and two hours sitting in traffic to get home), I finally started back in on my studying. Came home from work on Monday and started right back in. Tuesday, I had taken the day off so I could study for several hours before I had to go to school to take my exam. The stress, the anxiety, it was awful. There were times I thought I was having a heart attack (panic attack most likely). I then repeated this same process Wednesday and today, Thursday for the last exam of the semester.

So as disappointed as I was on Tuesday to get a C for the semester in my one course, today I was elated to get that same C.  I was so very afraid that I just wouldn't make it.  I'd heard many of times that 60% of the students fail this exam. If I scored really poorly, it was possible that I would not be able to go on. No matter all the other things I learned and did well on, bottom line is the exams.    

I never in my life thought I would be pleased to get a C, but I've been told again and again that "C's get degrees" and I'm beginning to realize that.

So as this semester officially ends, I am now a 'second semester' nursing student. Classes start up the end of August with clinical starting the very next week. So excited to be moving on to mother-baby nursing (in addition to more 'med-surg'). I can't wait to learn some more. 

I plan on taking the summer to 'relax' a little and to read up on what I learned this semester to keep my brain working. I will try and do some updates throughout the summer if there is anything special to report. Oh wait, there will be!!!  I am going to Boston the end of July to walk the 3-Day for the Cure there (in addition to the Philly 3-Day in October). I am looking forward to meeting some other amazing 'Pink Family' people!!!

Thank you for following along on this journey. I hope to continue this throughout the remaining semesters.

  

Last Week of Clinical of First Semester

I didn't get a chance to update after clinical since we had a group project to do and then completely immersed myself into studying for my final two exams!

This was supposed to be our last week at the nursing home but due to an outbreak of a virus we were unable to go there. We did get to return to the hospital for our final two clinical days (I loved doing our clinical in the hospital so that was a bonus). It was nice to get to see (and have dinner) with the other half of our evening clinical group.

Monday night I was assigned to a patient who was blind and hard of hearing. My patient was not doing well at home where their spouse was no longer able to take care of them. I was able to use the therapeutic touch and speaking to communicate with my patient. As long as I was able to let my patient know when I was there, my gently touching their arm, and speaking very closely letting my patient know exactly what I was going to do.

When I arrived Tuesday, my patient had a visit from their spouse who has able to give me some ideas of what food I might be able to entice my patient to eat. Finding out that someone likes pudding or ice cream was an added bonus. My patient did not eat well the first night so I was really happy that they did eat for me that second night.  

A few of the things I was able to do this week at clinical were dealing with my patient and their Foley catheter; recording I&O's (intake and output) to make sure my patient is staying hydrated; providing music (via the tv) for my patient to have something to calm them during their stay.  For the most part I had no issues with my patient but occasionally my patient was agitated.  Just before leaving for the evening my patient pulled out their IV so I was able to observe when the IV team came down to replace it.  

I was sad when we had to leave the hospital since I truly enjoyed each thing I was able to do there. I look forward to heading back in the fall but in different areas of the hospital.

After finishing up the clinical part of the semester we had a group project we had to finish and present to the other first semester nursing students. Our subject was Healthcare Acquired Infections. Our group wasn't the best at 'working together' but when all was said and done we got our project done! Here is our clinical group! These are the people I have spent the last four months with.

I finished up this week with major studying. Up next the final two exams of the semester!

From the Operating Room to Public Speaking

Well we are really getting down to the wire here. Only two more weeks of school left. Two more nights of clinical and then two exams and one group project.  Hard to believe we are almost at the end of the semester.  This will be the first year I am not taking a summer course since starting this journey three years ago.

So this week started with my OR (operating room) observation. I was hoping for some 'good' surgery to observe but unfortunately my 'day' I was assigned was 'joint' day at the hospital. I arrived just before our designated time (I am always early for school and clinical and was freaking out that I was going to be late) and found that another student was already there and shortly after I arrived the third student assigned to this same day arrived. We were met by an OR nurse who then took us to the locker rooms where we changed into hospital scrubs and 'geared' up for the OR. We were each in separate OR's watching 'similar' surgeries. I was with Speedy Gonzales. This surgeon was already on his second surgery at 8:30 am. I arrived in the room where surgery number three would take place. I watched as the scrub nurse prepared a LOT of equipment. I was going to see a left knee replacement. It was amazing all the tools needed. Soon they brought the patient in and I found out quickly that they are not put under general anesthesia for this but more of a spinal block and then a twilight or light sedation. Was a little creepy when the patient was coughing and gagging. (Too much TV surgeries where everyone is out cold, haha). So I watched as the cut into the knee and the sawed and pulled and hammered and I started to get 'hot'. I didn't feel sick but got worried I might have an issue so I was able to sit and watch and then I was fine. I certainly did NOT want to pass out and contaminate the entire sterile field (or hurt myself, haha). As soon as the surgeon was done with this patient, the Physicians Assistant stepped in to close the surgical site while the surgeon moved to the next surgery. After this patient was done we wheeled them off to the recovery area and it was back to the same operating room where it was already being prepared for the next surgery. It was amazing to see how much of a TEAM these group of medical professional are. The next surgery I was able to observe about 3/4 of it was a total hip replacement, but soon it was the OR nurse calling for us to prepare to leave.  Our 'shift' was over. It was truly an amazing experience and I hope to get to do it again (only a 'cooler' surgery would be good)!

After I finished at the hospital it was off to the school where I needed to finish up some mandatory lab hours. Shortly thereafter I get a call from one of my fellow students from my clinical group telling me that they were sent home from clinical this day due to a virus going through the nursing home. Wow, I certainly don't want to catch whatever is going around, so I am very happy that the school takes our health into consideration at times too.

On Tuesday since we were still unable to return to the nursing home, we had our clinical time in the lab at school. We had several simulations set up where we had to assess our patient or provide care for another patient, we practiced would care, diabetic testing and insulin shots and 'comfort' care for an elderly 'patient' who suffering from Alzheimer's. After I did this simulation, my instructor told me she felt my 'calling' was possibly for hospice or nursing home area. I told her I wasn't so sure, as I get 'attached' to my patients (in a matter of minutes)! We did get to work on SimMan again. It's crazy how 'life like' he can be. His eyes react to the light when you are checking PERRAL (pupils, equal, round, react to light and accommodation). He also had various lung sounds, pulse rates, blood pressure, you name he can probably do it.

We had a good afternoon of clinical and it was good to go over some things we learned much earlier in the semester. Always good to review.  

Well, today was a luncheon I had been invited too. It was in coordination with the scholarship I received a few weeks ago. The school likes to bring the donors and recipients together to see how the donors money is making a difference.  I was looking forward to this luncheon UNTIL I got a call earlier in the week asking if I would speak at the luncheon. I was told, just something short to give my 'story'; why I chose this school and how this scholarship will help me.  SURE, I said, no problem. And then I started to freak! I am not one who like to speak in front of people. I love to talk, but 'having' to talk is not the same thing. 

I had stressed about this 'speech'. I initially thought, I'll just 'read' my thank you letter that I wrote to the organization that awarded me my scholarship. Then a friend said 'don't read' just put bullets down and go from there so I tried that but found I was adding to much to my bullets. So today about an hour before leaving when a co-worker asked if I was 'ready or nervous' and thought oh no, I don't really have anything 'ready'. So I grabbed my note card and looked at my thank you letter and threw it all away. I put three one line notes on a 3x5 card.  

So I arrived about 10 minutes before the start time, got my name tag and was told what table I seated at. I then went into the conference center and found my 'place' at the table (there was a card with MY name on it!). I looked at the program that was laid at each place setting and FREAKED OUT!

My name was right there, I really was going to be speaking to this group (thankfully a smaller group of about 50 people). I got very nervous, my hands were shaking, my insides were shaking. Little by little everyone arrived and we started the luncheon. It was nice to just have 'normal' conversation while eating and getting to know the other people at my table. There were two other students at my table along with one donor and three faculty members.  We shared a little about who we were, what we were doing and enjoyed not thinking about that speech. So then it was time. The VP was up first. He recognized all the donors in attendance and the students. It was then time for the other student to get up and talk (thank goodness he was before me)!  He seemed all confident but was nervous too. He pretty much read his speech and told the audience he was doing that to make sure he didn't forget anything. Then it was my turn. Oh my gosh, deep breath, again, breathe!!!!

I walked up to the podium. I introduced myself and pretty much let it roll. I told them that I love to talk, but I don't love to 'have' to talk and that I was truly shaking! I explained how I worked in a small Christian school for many years and got to 'play nurse' since we didn't have one. I finally decided when I 'grew up' what I wanted to do. I explained that I chose this college due to the wonderful things I'd heard about the program I am involved in. I made people laugh when I mentioned how I attended an 'Nursing Information Session' roughly three years ago and thought NO WAY could I do that, it will take forever to get into the program. But I registered in May of 2010 for my very first college course. I tackled each one and just this past January I started the clinical portion of the program!

I went on to tell them that this scholarship meant so much to me. I actually cried when I received the call that I was awarded this scholarship. I teared up at this point and so did a few of the ladies there. I explained that my husband works two jobs and I work almost full time and we truly live paycheck to paycheck (like so many others). I told them how I had to take a student loan this semester. I hated the fact that I had to do that, but $1200 in book store charges alone this semester were far greater than the financial aid I had received. I told them that I hoped this scholarship would enable me to attend the fall semester without having to take another loan. I thanked the donors who have made so much possible for so many students and I think I looked down at my 3x5 card and said 'out loud' 'Well I guess I covered everything'!!  

I was told over and over by many in attendance that I should never underestimate myself, I am a wonderful public speaker. The Dean came over to congratulate me along with several other 'high up there' school officials, each saying how well I did, how my 'story' was touching.  The student who spoke before me asked 'Hey, I thought you couldn't talk in front of people, did you practice that?' to which I replied, NOPE!  I just let it roll. I was able to finish my lunch and then it was time to head back to work. I don't think I actually stopped shaking until I was back at my office!

I will have  just a few more updates before taking a little break for the summer. I pray that these last few weeks go smoothly and that all the information I am learning stays up in my brain where I need it!

Failing - Not An Option

I've been receiving information for that past two years from about Phi Theta Kappa Honor Society.  It's a Honor Society specifically for Community Colleges.  I finally bit the bullet and joined.  I've had a good GPA since starting this journey, but worry about the required GPA to continue as a member during these difficult two years of clinical.  This will hopefully encourage me to keep my grades up (and not just 'passing').  So, I am officially a member The Alpha Epsilon Zeta Chapter of the Phi Theta Kappa Honor Society.   Now I just have to keep my grades at the required GPA to continue in it.  I've not had a chance to attend a meeting but will get to one in a few weeks before classes are over for the semester.

At the very start of our shift we received notice of the bombing at the Boston Marathon.  It was scary, as the alerts came in via phones and tv's around the hospital.  So it was with a heavy heart that I started my last week of hospital clinicals.

So this was our last week doing clinical work at the hospital.  I was bummed as I really enjoyed this time.  And due to scheduling, I wasn't going to have a patient this week.  Monday was my turn as the Team Leader.  In that role, we shadowed our instructor, got reports on each patient that our students had and assisted where needed.  I didn't think I would enjoy this but I really did.  I liked being able to help others.  Last week we worked on parenteral meds so each of the students in my group would have to give an injection this week since we are no longer able to provide medications at the nursing home we will be doing our final two clinical weeks with.  So as Team Leader I accompanied the instructor and the student nurse to the patients room where the student nurse gave the injection.  Those that went before me all had to do insulin injections with the insulin pens.  So there isn't to much to mess up.  When it was my turn, I was shocked that I had to give a heparin shot (this is a blood thinner that helps prevent blood clots in patients who aren't able to ambulate).  So thankfully, my instructor, allowed me to review all the steps in giving this shot.  She tried to trick me up by handing me two different syringes.  I was smart enough to know that (after checking the patients medication administration record) my patient to receive 5000 units or 1 mL of heparin.  The one syringe my instructor gave me would only hold .5 mL so I knew right off that wouldn't work.  We were taught exactly what to do the previous week in lab, so I knew that I had to inject 1 mL of air into the vial of medication and then withdraw 1 mL of heparin.  I was to inject this in to the patients abdomen.  Since the patient had gotten their injection that morning in the lower right quadrant I was to inject in the patients lower right quadrant.  I was very nervous at first, but did as I was taught and BAM, it was over!  I did it and I the patient didn't flinch, so I guess I didn't hurt them.  I was on cloud nine that I had done something else that I'd been taught!

The next day, I was on IV observation.  Our hospital has their own team of IV nurses that go all over the hospital starting IV's, assessing those that had been started earlier (or elsewhere), changing the locations as a problem arose.  I'll tell you these nurses move.  We got called to the ER to only get there and find out the patient had been sent to radiology so we were off to another unit at the very opposite part of the hospital.  This went on the entire time so it's obvious these nurses move all shift long.  We got a short break for dinner and then I was able to follow another team of IV nurses that had to start a PICC line.  This IV is inserted through a vein in the arm and threaded up the arm, into the superior vena cava (near the heart).  This procedure took a lot longer than a 'normal' IV and is done under sterile asepsis.  I was so glad I had the opportunity to observe this and the other procedures this night.  It was a great last night at the hospital. 

I was sad as we left knowing we won't be back until the fall but we will get back there.

So today was my sixth exam of the semester, the third of this course and I failed my exam.  I've not failed anything since starting this journey and I was heart broken and ashamed.  I was not going to share this as I am embarrassed that I didn't' do well on this exam, but I have to say I have worked my bottom off for the past three years  next month and failure is NOT an option!  I will work this much harder so that hopefully this never happens again.  I'm very nervous as it has been rumored that 60% of all students FAIL the final exam in this one course!  I thought surely this can't be true but now I'm beginning to wonder.  I know several others who also failed this exam and they also have never gotten a grade this low.  I have to say my failure was a 70, passing is a 75.  I still have a B average for this course but I truly want to makes sure I don't drop any further.  The last two exams of this semester are both in less than three weeks.  Our exams are usually a week apart but not the final two, we have them both in the same week.  And the material in both of these courses is much more difficult.

So I end this week with lots of studying to do this coming weekend.  I have a motorcycle ride with Dale on Saturday and I'm going to spend some quality time with him as we don't see each other to often these days.  On Monday I will get my turn in the Operating Room for observation!  I've heard all kinds of reports from students who have already done this and the only complaint has been the 'smell' of burning flesh.  I'll see how that goes and will update you next week.

Learning Your Patient Isn't Going to Make It

Well, a week off from school flew by!  I had planned to spend a lot of time studying but the week was over before I knew it.  

The week started off with sad news.  Bridget had passed away the Thursday before. It broke my heart that this woman did not make it to her 30th birthday. This was her goal for so long.  So many, many sad tears were shed and again as I write this.  My heart still hurts.  29 year old women should NOT die from breast cancer. This is why I walk, this is why I fight, this is why my husband stands beside me in this fight (he crews for the walkers)!!

So back to the real reason I blog . . .

I was excited to get back to the hospital again Monday and Tuesday. We also had lab twice this week. On Wednesday, we learned about administering parenteral medications. These medications are given my injection. So when we go back to the hospital this coming week we will get to give injections!!  Nervous and exciting. Today we learned about nasogastric tube. How to insert them, remove them and irrigate them. Not a pleasant experience for the patient but some times the patient is not able to get nutrition through the mouth so it is sent down this tube directly into the stomach.

But onto the 'real' stuff. So Monday we were back in the hospital. For anyone who lives nearby, you know that Monday it was absolutely gorgeous out. Just a week ago, it was cold, rainy and even snowed one day. But summer hit Monday (and it's gone again). It was just beautiful walking into the hospital. So we get to our meeting spot and are handed our patient assignments and begin to review the information. At that point I realize, DARN, my glasses are in the car. I'm not sure if I mentioned this before, but the student parking area is about a 10 minute walk to the hospital lobby. The unit I'm assigned on is a little further away. Thankfully one of my classmates read my patient info for me to make sure there was nothing dire that I needed to know for when our instructor asks us questions before going to the assigned rooms. As soon as we were dismissed, I booked out to my car to get my glasses. Thankfully I've been trying to get my training runs in for the Broad Street Run, so my walk is much faster than it used to be. As soon as I got back to my assigned area the nurse going off duty was ready to give report to the nurse coming on.  My patient this evening had MS and had had a fall but had just been released to go to rehab. I only assisted with this patient for a little bit. Assisted the patient with getting dressed in street clothes (they did not want to go on the transfer in the hospital gown). Shortly after that the team arrived to transfer my patient to the new facility. After dinner I was able to assist other students as needed since I would not get a new patient for the short time after our dinner break.

On Tuesday I was given a new patient. The patient was just returning to the room from receiving some therapy. As soon as we started to transfer the patient back to bed it was apparent they needed to use the bedside commode. I jumped right in to assist my patient (funny how things that might of 'bothered me' before were not an issue at all now). Shortly after getting my patient back to bed, I began getting their vital signs and starting with the full body assessment. My patient was very tired so I left them to nap a bit while I documented my findings in my paperwork and the hospital computer system.  We get to document certain things in the electronic medical records here. I love when I have to sign my name to the paper chart and put "SN" after it for 'Student Nurse'! So while I was working on the computer another doctor went in to see my patient. A short time later the doctor came out asking where my patients nurse was. She was assisting another patient and I explained I was this patients student nurse for the day, could I help with anything with. At that point, this doctor told me that my patient was just told that there was not much time left. The disease this patient had was not responding to the aggressive treatment. Due to the other medical conditions this patient had, once they discontinued certain things the end would be imminent. I was heartbroken again. Granted I'd only just met my patient, but I would have the rest of the evening to assist them and wasn't sure how I would do. I initially went back to my patients room and 'acting' as if I knew nothing different.  I was able to assist my patient with their dinner tray and finished my assessment. It was our dinner break at that point, so I told my patient I'd be back in a little bit. After dinner when we returned to the floor my patients own doctor was in to discuss 'options' with them and to explain information over the phone to the family members. At that time, my instructor came by. She visits each of us throughout the day to check out some things on our patient.  She's one to just 'knock and enter'. As she was walking into the room, I grabbed her and told her to wait. Explained what was going on. That's when it really hit me. This person was going to die soon. Shortly after that the doctor came out asking the nurse to get something for the patient. This patient was trying desperately to not throw up while the doctor was talking to them. The nurse was explaining that it was too soon to give the next dose of what was administered earlier. At this point the doctor went into 'overdrive'. Her patient was suffering and she wanted something done NOW. So an order was provided for some fast acting meds. I n the meantime I went into the room and was hit with the thing I'd been dreading. I've dealt with all kinds of bodily fluids but I do not do well when someone vomits. When the kids were little, I would call Dale at work as I could not clean up the vomit when one of the kids threw up.  My patient had thrown up on them-self. I went right to work, got an emesis (vomit) basin and started to clean up my patient. The nurse then came in and administered the meds and soon my patient was started to feel better! As the evening wrapped up and I had gotten my patient all freshened up it would soon be time to leave. I spent some quiet time with my patient where we just talked. My patient was not scared of what was coming and told me that with my care and compassion that I will make a great nurse.

I was sad leaving the hospital. 

Yesterday was our third exam for the one course and this coming Thursday is the third for the other course.  I got a C.  I was bummed but accepted that I passed and that is what is most important.  We always get a chance to review our exams to see what we got wrong and what the correct answer was.  I had changed my response on FOUR questions!!!  Four questions would have given me a solid B in this course!  I will NOT second guess my answers on the rest of my exams!

Today I had my interim evaluation (from my time at the nursing home) and received a great review.  I am truly enjoying EVERYTHING I am learning!

From Ecstatic To Sorrow ~ All In A Few Hours

I received a phone call today from one of the nursing counselors at my school.  She proceeded to tell me that the scholarship (the first and only scholarship I ever applied for) had been awarded to ME!!!  To me, really???  This is a nursing scholarship from a local church in memory of their late reverend and his wife.  I applied only because it was sent to me in an email by the nursing office.  I never in my life thought I would get it but I did!  This will be a nice amount towards my fall semester!  Hoping with this I will not have to take out a student loan (which I had to do this semester).  I was so happy I actually cried!  I called Dale right away and then posted my great news to Facebook since that's the way to tell the world :)

Then, just a few hours later, I see a post on Facebook about one of the people who I told many about this past winter.  Her name is Bridget.  Bridget spoke at the 2010 3 Day for the Cure.  This link will take you to the YouTube video. It is less than 10 minutes.  If you have the time, go and listen.

Bridget Spence Speaking at 3 Day for the Cure 2010

Bridget was diagnosed at the age of 21!  YES 21!!!!  She had just graduated college. She discovered the lump six months prior but multiple medical personnel told her that it couldn't be cancer, she was too young, she had no family history, she would be ok.  Well, six months later she was told she had STAGE FOUR cancer!  At the age of 21, just when she was starting her life.  Well Bridget was determined to do what she could and make the most of her life.  She married her 'Big Guy' (what she always called her husband) and she fought and she fought and she fought.  On December 26th, Bridget wrote her last blog entry, saying 'goodbye' to her followers.  She had given up the fight and was going to spend what little time she had left with her husband.  

Today I learned that the end is very near.  Bridget's time on this earth is coming to an end.  My heart breaks for this woman who will not see her 30th birthday, who will never have her own family all the things that I've done since turning 30!  My heart breaks for this woman.  Please pray that Bridget's passing will be painless and swift as she has suffered far too long.

Bridget is just one of the reasons I fight!

SPRING BREAK!!!!

It's officially SPRING BREAK!!!! 

We had a 'Mentoring Lab' on Thursday of last week, where fourth semester students (those graduating in May) mentored us.  It was a laid back lab where we went over some basic skills and got to ask them questions, pretty much any question we wanted.  I was relieved to learn that several of these people have juggled their full time or some two part time jobs along with passing (and some of them even have small kids!).  I was glad to know that yes, others have done this.  I've been discouraged as so often I'm told by advisers (and even other students) that you just 'cannot work and do this program'!  This is not an option for me.  Dale and I both work a lot to keep afloat.  Yes we take trips to Disney or cruises but they aren't on a whim, they are well planned out and done far in advance so we can make little payments at a time.  So back to the lab.  We were divided into five groups (of three students each).  I over heard some not very kind comments coming into the lab about the upper level students talking 'down' to us 'newbies'!  I did NOT experience any of that, thankfully.  Each gal I worked with (our class has one of the largest ratio of male student nurses than any class before, still out  numbered by the female students) were very kind, supportive, gave tips on what they have seen, how they have tackled certain tasks or courses.  Lots of encouragement.  I was really glad we had the chance to experience this.

So back to nursing.  This week, one of the student nurses in my clinical group lost her father, another student in the same evening group but on the opposite schedule (we are divided in 1/2 so while we are at the nursing home the other 1/2 is at the hospital and we flip back) dropped out of the program this week.  Another student I knew from one of the day clinical groups dropped out a couple weeks ago.  It gets scary when you see people dropping.

This was my last week at the nursing home until later this semester.  After spring break, I'll be back at the hospital for two weeks and then back to the nursing home for two weeks (and then school is just about over for the semester!!!).  This week, I had patient whom I thoroughly enjoyed working with.  My patient was open to having a student nurse and assisted me when possible with their own care.  I was able to also assist others students with their patients when they needed help (and at times others assisted me).  It's great that we are able to help each other out.  Nothing like getting into the room to assist your patient with something and running out of supplies or forgetting to bring all that was needed into the room.  Thankfully there is usually another student close by to give you a hand.

Also this week, we had a lab on catheterization.  I have been fortunate to have actually observed a straight cath earlier this semester at the hospital.  This week we learned about the different types of catheters and when they are used and how to insert and remove them.  Not something I'm looking forward to doing but know the time will come that I will need to do this and I hopefully will remember to use all the skills I've been taught and to treat my patient with the dignity and respect they should have when having this procedure (or any other for that matter).  

I'm excited to get back to the hospital setting as I seem to enjoy the faster pace (less down time) there.  In the meantime, I'm trying to catch up on all the lectures I've put off the past two weeks since I've just been wiped out.  Thankfully with a week of no classes or clinical I can come home from work each day and work on school work in the evening.

There will be no update next week since there is no school.  I'll be back in two weeks (and hopefully get this blog out earlier in the week).

Many of you know that I'm very involved with the 3 Day for the Cure.  Since I was able to raise all the money I needed to walk Philly this coming October, I decided I would try and raise it over again and walk a second city!  I registered to walk the Boston 3 Day for the Cure which is later in July.  I've already raised over $500 towards that.  A friend made me this map.  I am trying to get a $20 donation from every state.  So far I have 15 states accounted for (therefore pink).  For each donation I am carrying the name of either the person who donates or the name of the loved one they want me to carry.  If you would like to help me out, please consider making a donation.    If you would like to donate, you can click this link My 3 Day for the Cure page

Short and Sweet

Well this segment will be pretty short and sweet.  I have no photos to share this time.  And I already updated you on my exams last week so this week wasn't a lot of 'new' things.

I did learn that I hope to not have to go to a nursing home when I get older.  It is sad that so many of the residents have no one who really visits them.  Either they have outlived their family or their family is not local.  

This week we arrived at clinical and were told we would have our 'own' patient (this isn't new since we did have our own patients when we were in the hospital).  Only difference here is that there are not a lot or 'others' around to assist you if you need help.  Many of those in the nursing home need assistance with getting out of bed, repositioning in bed, going to the bathroom or being provided with incontinent care.  No matter what, most of these things need two people.  Due to all the SAFETY things we've been taught, you do NOT want to injure yourself, especially your back, by doing something that requires two people to do safely.  But, thankfully, this week, my patient was relatively independent.  My patient would need assistance to the bathroom and on occasion needed incontinent care.  My patient was able to eat dinner in the dining room unassisted so at that time, I assisted another patient who was not able to feed themself.  I love being able to help someone.  It is especially hard if they aren't all 'there' and can't let you know if they are hungry or full or thirsty.  

Since my patient was more 'with it', it was pretty easy to communicate and assess their health.  As much as I don't care for the 'atmosphere' in the nursing home.  I do enjoy bringing a little light to someones day.  I did do a lot of running around though.  I found that in this smaller setting they run out of things.  So it requires trips to other supply areas where something you find what you need and sometimes you don't.  Kind of hard to believe that a facility could run out of 'wipes', really??  Not a single pack of wipes available the one day, so we went back to the day of wash clothes and soap for providing incontinent care.  

I did have the opportunity to observe the wound team on their rounds to assess various wounds that patients had and how they were or were not healing.  I helped another patient load phone numbers in to the brand new iPhone that he was provided to keep in touch with those not within the facility.  (never thought my iPhone would actually be beneficial for a patient.  

So I will end with the fact that if you have a loved one in a facility, take the time to visit them.

Two Exams and a Nursing Home

Well it's been more than a week since I updated.  It's getting harder to update after my two very long back to back clinical days.  I get up 5am to go to the Y, get to work before 8am and to clinical by 2:15 pm.  This rotation started our nursing home clinical setting.  We have not gotten out before 9:30 either night!  By the time I get home it is after 10pm and I have at least an hour (or two) of homework for clinical that has to be completed before I can go to bed (as it has to be turned in at the start of clinical the next day).  Since I work in the morning that means I have to finish in order to go to bed.  So this week was a long one! 

Last Thursday I had my second exam in NUR 141 and got a C.  I would normally be disappointed but I felt really bad leaving that exam I was very glad I passed.  Today was my second exam in NUR 142 and I got a B!  

So back to this weeks clinical!  So Monday we started at our new location, a retirement/rehab facility.  It was my first time in one of these in a very long time. We spent the first 1/2 of Monday getting oriented to the facility, their regulations and policies.  At 5pm we went to the dining room and assisted an elderly patient with their dinner (some are not able to feed themselves, some just need assistance cutting things up, some just needed to be reminded to eat).  After that we took our dinner break before we were assigned our 'patient'.  We were teamed up with another student.  

Our patient had been ill earlier so when we arrived at the room we thought it was best to give our patient a bed bath, provide incontinence care and attend to a pressure ulcer.  Our patient is not able to communicate but does understand and can nod a response (when they want to).  All in all, a good first day.

Tuesday we arrived back to the facility and were assigned our same patient (and team) from Monday night.  Thankfully the student who I was working with really wanted to improve our patients spirits.  So we decided we were going to get our patient out of bed into the wheelchair and down to the dining room.  I accompanied our patient to dinner and provided feeding assistance.  While we were there, the other student was doing a complete bed change on our patients bed.  That way when our patient turned in for the evening the sheets, pillow, blankets were all fresh. Our patient had taken a short nap in the wheelchair after dinner and was difficult to awaken.  I was concerned and contacted our instructor who came right to the room and got right down in front of our patient and 'loudly' called the patient by name telling them it was time to wake up!  BAM!!!  The eyes opened and our patients entire demeanor had changed.  Our patient was very cooperative and let us do our head to toe assessment.  We provided wound care, and continent care and prepared our patient for bed.  We were done by 8pm so we worked on paper work and assisting other students until it was time to leave.

All in all it was a good two days.  The other student and myself felt very connected to our patient and hate that Monday we will go back and get a new patient (and I believe we will be on our own then).

Today was a sad day.  It was eleven years ago that my sister, Susan, passed away. Susan (I mentioned her several weeks back) was hospitalized after a fall and acquired a health care associated infection.  This is something I've learned more about and sadly these can often be prevent with proper asepsis techniques.  This was my sister Susan with my mom.  I believe this was the Christmas before her fall.

Well, tonight I am 'relaxing' and taking a few hours off from school.  Have lots of lectures to watch this weekend.  We started on pharmacology last week and are finishing up the 'nursing process' this week.  

Thank you again for following along on my journey.

Health Assessments

I cannot believe another week has gone by and I really don't want to miss updating those that have been following along on my journey.  This was my third week at the hospital.  The next three weeks will be spent at a nursing/rehab facility.

Each week I would drive into the hospital passing by a memorial that the Loving Arms Support group has set for those that lost their babies, whether be miscarriage, pre-term labor, still birth or even shortly after birth.  It's a support group for parents who have had a heartache that no one should ever have to experience.  This week I decided to stop and 'visit' our angel babies.  See, Dale and I lost three babies to early miscarriage in 1997 and our final angel in 2002 (ectopic).  So we have two memorials at the hospital.  I stopped this past week because it was beautiful out, the temp was nice, the sun was shining, but mostly because I had a little time before I needed to be inside the hospital.  Here are our babies memorials.

So, now, back to this nursing thing!!!

It's been a great week!  I had the same patient both of my clinical days.  This made things a tiny bit easier as I had basic info on my patient and I had already met them and helped with their care the previous day.  So my patient this week, was an older person who was admitted for respiratory issues but also being treated for wounds that were not healing.  The first afternoon when I received the report from my nurse, I was told they had trouble getting my patients temperature.  Other vitals were ok but temp wasn't registering.  After being moved to another bed, I was able to go in and assess my patient and get their vitals.  I was able to get his temp but it was in Fahrenheit and I had to convert it to Celsius.  Oh, no, what was that calculation!!!  I am so glad I put it into my brain a few years ago and it actually is there when I needed it. I already new my patients temperature was very low but after converting and charting it I let the nurse assigned to my patient know.  At that point a Bair Hugger was order.  (granted that's spelled right but sounds like bear).  And that was in hopes of upping my patients temp.  I had never seen one and only heard of one a week before.  So with my instructors assistance we were able to get this on my patient.  The next afternoon when I was able to get vitals I was glad to see that the temperature had come up, it was almost normal (it was still pretty low, but not dangerously low).  It was good to see how this device worked.  I was also able to watch as the specialist assessed the open wounds and (taught those shadowing him) decided on their plan of action.

I was bummed leaving the hospital on Tuesday night knowing I won't be back there for four weeks.  I thoroughly enjoyed my time there and all the things I've learned.  At the end of the evening we were given our interim evaluations and I did very well.  (It's basically either you get satisfactory or not).  

Today I was testing on my general health assessment.  We were taught exactly how to do this over the past few weeks.  Each student was testing individually.  When I arrived at my patients bed (this is a 'sim person so I can tell you all about her!!!) I was given her scenario.  My patient suffered a fall and dislocated her hip.  She also had her trachea caught on the blade of another ice skater (so assuming she fell while ice skating), thereby she now had a tracheotomy.  

So typical head to toe assessment her vitals were already done so we start with her general appearance.  My patient, Ms. Smith, had blue hair, swelling to her right jaw line and some yellowing of her skin.  She had no offensive body odors and no obvious piercings or tattoos.  So then we move to her head.  Now you have to realize that every time we practiced this on the simpeople, they have normal heads, flat stomachs, no piercings (some do have tattoos), so I was quite alarmed that my patient had a head that appeared a little to large in proportion to her body (just something we do note, not that a big head is a bad thing), she also had a scar on her nose and one above her lip, documented her blue, thick hair. I checker her eyes, making sure PERRLA (pupils, equal, round, react to light and accommodation), no drainage, conjunctiva pink; moved on to ears, appear proportionate in size and symmetry; moved to her nose which was clear and no issues breathing; her mouth was fine.  Then we move down to the  neck, since Ms. Smith had a trach I couldn't do all that I would need to do but did check her lymph nodes.  Next we moved down to the thorax (chest area) and at that point I remembered that I forgot to do the 'whisper test' while at her ears so I explained to Ms. Smith that I forgot to test her hearing and went back to that before proceeding (this was a major SAVE on my part!), so back to her thorax.  I first checked turgor here (a little pinch to the clavicle area).  Her chest seemed rather thicker front to back than side to side and that was noted.  I listed to her heart in the APETM spots (aorta, pulmonic; Erbs point, tricuspid and mitral areas) and then onto her lung sounds.  All good so far, moving down to her stomach, well darn, it was not flat!!!  It was distended.  I inspected first, then listened to her bowel sounds and then palpated the area checking for any pain.  It was firm in the center where it was swollen.  Going along good when we are told FIVE MINUTES oh no, this is strictly timed and I am taking my good ol time assessing my patient.  So now I move onto her extremities.  There was no issues with joint pain in her upper extremities and her radial pulse was good, her strength was good, so I moved onto her legs.  She had good pedal pulses and strength in her left leg but weakness in her right (due to her dislocated hip, see I remembered, that was part of the test too)!  One last think I had to check was her lung sounds on her back (and the skin on her back).  With the instructors help, we sat my patient up and listened to the six points we were instructed.  (at which point my instructor said 'great job in placement'!!!)

That was it, I did it and passed with no prompting from the instructor and no lab referrals to come back and be tested again!  I can breathe.  I am now studying for my next exam (tomorrow morning) so I will end here.

Thank you for following along with my journey.