Archive for November, 2009

Erm.

Just working at the PICU today.
Haven’t written because of exhaustion. I’m pleased to share, however, that clinicals is done with and I’ve only got a couple of days left.
I’m working on my 33rd of 36 hours needing to be logged from Friday, Saturday, and Sunday. So, needless to say, I am not terribly coherent.

I promise to update over the Thanksgiving Break.

(PS- one of the nurses insisted on playing a radio station with Xmas music on it. It’s not even Thanksgiving yet! What the heck!?)

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A little less hand holding?!?!

That’s right. A little less hand holding.
This was a great last couple of weeks for clinicals.

Last week, I had an adorable client who reminded me of my great-grandmother. I really start to feel like a full-fledged nurse for the first time because I got to advocate for my patient. I set up consults to address stressors outside of the hospital and really built up a rapport over the two days. It was awesome to hear that she was disappointed I wouldn’t be back for a third day. I really accomplished a lot!

This week, the leash was loosened a bit. My instructor really likes for you to take the opportunity to spread your wings if you fell ready because Ortho is a floor where you can do that. You see a lot of the same things (oh, if I see another hip….) which may be boring to some people. I thought it would be boring at first. But then, I realized what an advantage it is to get used to a particular clientele. You really get to test yourself and work faster and add on responsibilities.
For this week, I got a patient on Day 1, did his care, and discharged him home on Day 2. It was awesome! I got to do so many skills by myself- very exciting. My instructor said I was at the level I’m supposed to be at and that I could go in on my own. We would talk it over first…for example the dressing change. She would make sure I was competent and then let me go do it. It was fine since I had already performed all of these skills before.
So, this week I took out a foley catheter, took out an IV, did a dressing change, and administered meds- all on my own! My coassigned nurse peeked her head in while I was doing the dressing change so that she could note it for her own assessment and told me that my dressing change was awesome.
My patient and his spouse both told me I did a great job and how I must have been a straight A student (I wish).
I talked with my instructor about adding on to my assignment- possibly having two patients?? Next week, I’m team lead which is like being Charge Nurse…so I won’t be able to do it then. But the week after is my last week of clinical and she said that would be fine.

She also said how she liked that I was really maximizing my clinical experience because some people in the group were not. And then there were some people in the group not ready to handle that patient load. But she thought that I was more than ready to handle it.

HOO-RAH!
I’m floating on Cloud 9.

Knock, Knock

How sad am I? I tried to WOW Ishaq with a hilarious joke from school today.
Let me know what you think.

In lecture:
Instructor- “So this antibiotic reduces the reliability of birth control. So remember this equation…. Tetracycline+BirthControl = BABIES!!!!”

The whole class cracked up. Myself included.

So I told this comedic gem to Ishaq and was greeted…a stare. A blank stare for 5-7 seconds. Fake laughter followed. He tried to humor me.

“You just don’t understand! This is gold. Comedic gold!” I shouted.

I called my mom a bit later and told her the joke.

“Bahahahahahaa!!!” That was a proper response.

Man, nursing school. You’re just misunderstood. I still think you’re funny. When we aren’t fighting bitterly.

Guess Who’s Back? Back Again…

Hey! Basically, we’re getting down to the wire and my attention has been thrown full throttle into projects, papers, and tests.
The last test, I didn’t do so hot on…meaning more throttling at full force.

Also, clinicals is wiping me out. Now that the specialties are over, we are doing full patient care and charting for 8 hours a day every Wednesday and Thursday.

Here is a typical clinical day (for me on an orthopedic floor which is my current rotation):
0800: arrive on floor
0815: get assignment, greet patient, fill out CPS form with history and lab values, print off nursing rounds report, print off physician orders and write down what each order is for, have all of this done and ready for group report at 0930.
0845-0900: start patient assessment, assist with breakfast if necessary, mouth care, anything else they need
0930: group report.
1000: patient assessment/medication administration/vital signs/
1030: chart assessment, chart meds
1100: chart treatments (ADLs, safety, mobility, equipment, etc)
1130: get patient up and eating lunch/medicated before physical therapy. I also seem to answer family questions at this time since this is usually when they start showing up.
1200: IV assessment, chart said IV assessmet
1215: go to lunch
1245: return from lunch, check on patient. if they are out with PT then change linens and tidy up room.
1300: get patient back in bed. bed bath if needed and dressing change
1330-1345: chart treatments again (same as before but also including dressing change/wounds now)
1400: next set of vitals and chart those
1430: report off to nurse and leave floor for the day. go downstairs for post-clinical conference.
1500: go home!!

Of course, anything else needing to be done gets squeezed in. Last week, I had to advocate for my client and set up PT/OT consults (which hadn’t been set up yet even though my client was already a day postop and this could have delayed their discharge by a day!). I also had to set up a Social Work consult since there were reluctances about going home. I adored my patient last week. She said I was really sweet and seemed genuinely disappointed that I wouldn’t be coming back after my two days with her. It was awesome to have the same patient two days in a row. It was very different…I liked it!

Anyways, back to the grind tomorrow. Teal stethoscope and all.
🙂