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.

I'm actually doing this!

The week goes by so fast that I can't believe it is time to update here.  After my post last week, we learned in lab about naso-pharyngeal suctioning.  On Thursday night the Student Nurse Association hosted an Open House at our lab so we could bring our families to the lab so they could see the Sim people we work on.  Aubre and Dale accompanied me to this and got a little peek at what I get to do.

On Friday we started on medications (we had med lectures recently and learned how to look up meds in the drug guide and obtain all the info that a nurse would need to know).  So Friday our lab was on dispensing meds.  My lab group did trans-dermal, ears/eyes/nose and we did PEG tube.  This week we'll do oral meds and go over calculations.

So clinical this week was very enjoyable (but very tiring).  My feet are just getting wet but I hope I can keep up the pace and not fall behind.

Monday, my patient was being sent for an echo-cardiogram and a vascular study just after I arrived on the unit.  I was able to accompany my patient to these procedures.  The tech doing the echo let me 'sit and watch' (out of the way); but the tech who did the other procedure was very open in letting me stay right there and watch and the tech took the time to describe what he was seeing and how it related to the patient.  

Tuesday, my patient was being sent to the OR just after I arrived in the unit. Since this wasn't a 'planned' procedure I was not permitted to accompany this patient.  I will get a day later in the semester to observe in the OR.  Since my patient was not there for a bit, I lent a hand where needed.  I was able to observe a bladder scan and a straight cath.  This is something I will actually  learn later in the semester.  

I am glad that our clinical assignments are in a real working hospital (or similar location) and for the most part we have nurses who work with us and help us to learn.

Trying to keep it short and simple, hopefully hitting on the highlights from the week.

WOW! I Can Do This!

Trying to remember where I left off from last week.  Oh, we had our first exam in NUR 142 and I got an A!  I was so happy to see that!  We are required mandatory lab hours where we work on the skills we've been taught so that we are proficient in doing them when working with REAL people!  So Saturday morning I spent a couple hours in the lab working on vitals and wound care. This is the 'old' Sim Man who we practiced our vitals on.  We had to detect his pulse, (radial, apical and pedal - in other words, wrist, heart and foot); blood pressure and respiratory rate.  He is not as 'advanced' as the newer Sim Man and I'll get a photo of him one of these days.  

So, Monday arrived and it was my first time pulling these hours.  Up just after 5am to be at the Y by 6am, workout, work by 8am and then the hospital for clinical at 2:30pm until 9:30 pm.  It was a LONG day and full of lots of information (all orientation things).  The next day we were getting our own patient (we were told before that we would 'share' a patient starting out, but our instructor does not believe in that.  So with a little apprehension we were 'on our own' the next night.  I was excited to finally be working with a real person and couldn't wait until it was time (yes, I was a little nervous too).

You all know all those HIPAA laws (those forms you sign when you go to the doctors), well because of that I can only share 'vague' information with you.  I received my patients information to review when we came on the floor.  After looking through my patients info our instructor asks us about our patient (making sure we actually read through their info).  My patient was mentally challenged.  My patient was on contact precautions (meaning I had to wear a gown and gloves whenever in the room).  

For those who have known me forever know that I had a sister who was mentally retarded (MR) as is now 'appropriate'.  Susan was my older sister.  She fell in early 2002 and was admitted to a the hospital.  She contracted a bacterial infection which eventually caused her death on March 14, 2002.  I was raised knowing that some people are different but they are all 'people'.  

I believe that God had his hand in this as it was the perfect patient for me!  I had no qualms about having this patient and had an amazing first night.  I was able to do vitals; had the opportunity to empty a colostomy; do perineal care; view pressure sores and change bedding!  I had an amazing first night!!!

In lab, doing these things on a simulated person just doesn't prepare you completely for the real thing.  Not knowing how I would honestly feel when I had to address these items, I was a little concerned, BUT, when the time came, I didn't think twice about it!  I did it and I would go back and do it again!  

I really do enjoy what I am learning!!!

Exciting Things Happening

Wow, since last week so much has happened (thus the multiple updates last week).  Will try to keep it to one post a week to not bore you with the little things that excite me.  So much though to tell you.

Our Community Group

Monday we went to a local senior center where we were we met with, interviewed and played games with various seniors there.  We toured the facility and found that there were so many options for the visitors to do.  They have different activities each day of the week along with a fitness center and gym that is available each day.  We met an older gentleman who suffers from Parkinson but thanks to a procedure where electrodes were placed in his head his symptoms are much more manageable.  We assessed those we interview for an risks of falling at their home.  Some of us played Wii Bowling with the bowling king there (no lie he gets 300's most games he plays!).  It was a lot of fun and an enjoyable morning.  Our time there ended when one of our group sang for those in attendance.  (unfortunately my video will not load)

Afterwards we went back to campus to present our Community Project.  We did very well and received 18/20 points on our presentation.

Today we were back in the lab for more hands on!  Next week I'll be in the hospital setting so this week we went over everything we'd learned so far.  I received my interim evaluation where I was told I was going a good job, demonstrating the skills I've learned and my ability to communicate with my patient what it is that I am doing to them.  

Things we worked on this week were assessing, cleaning and dressing pressure sores and various wounds (those open that needed packing and those not just needing new dressing).  We went over surgical asepsis, sterile vs clean technique, application of heat and cold and drains.  

This is one of the many 'Sim' Persons in our lab.  We had to access the really cool SimMan at one point today as he was having trouble breathing (lips turning blue), coughing and gasping.  We were able to assist him with re-positioning his bed, putting 3L of O2 (oxygen) on him (via nasal cannula).  We got his pulse ox (which was down to 89 at first), his blood pressure, pulse rate, respirations and apical pulse.   After we stabilized him we asked the instructor about our 'person'.  I asked if he could have a seizure which he promptly started having.  It's amazing the technology we have in this lab!  Next week there is an Open House in the Nursing Lab and I hope that I can bring my family in to see these amazing people that I get to work on.

Next week I should be updating after my first two days at the hospital!  I am excited and nervous at the same time.

Confusion!!!

So after looking through more information from my school site, it looks like I'll be going to the hospital for my first rotation, then I'll be going to the rehab and nursing facility I thought I was going to first.  Boy is it confusing.  Granted I've another week of regular lab time (on the Sim Dummies) before heading out to the 'real world'.  I was hoping to get some practice time in tomorrow at our lab.  In addition to the many hours of class, lecture, lab and clinical we are required independent lab and computer hours.  I've not been able to get there for extra lab time and was hoping to get an hour or so in tomorrow.  We have a storm heading this way so lab has already been closed for tomorrow.  So I'll have to stay later on Monday and Tuesday next week to get some time knocked off. 

Got a B!!!!

Well I took my first exam for Nursing 141 today.  I was a bit nervous since I've heard over and over that if you are used to getting A's in your courses to 'get over it' since they are not easily obtained in the clinical portion of the nursing program.  I am very happy to say I got a B on my exam.  We will have  a review on Tuesday to go over what we got wrong so we will know the correct things to do in various situations. 

Now to kick in the studying for next weeks exam for Nursing 142, and watched the two lectures from this week and prepare for tomorrows seminar (and the list doesn't end).  

Oh, I got my first clinical assignment.  I'll be at a nursing and rehabilitation center in the Pike Creek area.  Not sure exactly what I'll be doing but I know that starting February 18th, I'll go to work for five to six hours, then travel to this facility and do clinicals from 2:30 pm until 9:15 or 10:15 pm (then travel home and do it all again the next day), lol.  Looking forward to this hands on though.

I'll be back to update you all next week on what new things I've learned.

No photos today, sorry.  Boy has life been crazy.  Lots of family things going on to add to the stress of my first real exam this coming Thursday.  Would appreciate any prayers you can spare for this (the exam and the crazy stuff going on).

I spent most of this past weekend studying for this coming exam.  

Since I am in the 'afternoon/night' clinical rotation, I do not go to school every day.  Lectures are done in a tech room with full recording (so it's just like you are there).  So I spent hours watching those videos which we then put into use this week in lab (hands on)!

Spent the past week learning about hygiene (bed baths), how to keep your patient warm and protecting their privacy while bathing them while they are confined to a bed.  For those patients that may need oxygen, we went over oxygen therapy and when to use a nasal cannula vs a mask.  We worked on urinary and bowel incontinence along with ostomies, when these will need to be drained and when they'll actually need to be replaced and how to do that.  We went over the various ways of specimen collection.  We discussed enteral (feeding) tubes.  I actually had a student who needed to be tube fed when I worked at the small Christian school years ago.  I wasn't the 'school nurse' but that was one of the many hats I wore and helped me to decide to go into this profession.  We also did blood glucose testing (that too I had some practice with as one of our teachers and a student were diabetic) today.  With all this 'stuff' coming out of the body we went over intake and output (liquid going in vs the amount coming out).

We went to a Community Forum on Monday. We heard from AIDS Delaware, St. Francis Home Health Care and the Red Cross.  We are putting together the finishing touches on our community project from the past two weeks and will be presenting that to our class on Monday.

I'm certain there is lots more but I try and update this when I get home when it's still fresh in my mind.

Thank you for following along and hope it will get more interesting for you soon.