Posts Tagged ‘ nursing student ’

It’s Cold In Here

Nope, the title isn’t a reference to the temperature outside. It is actually a patient quote.
Let me explain.

This is a flashback to the PACU floor. At school the other day, we were having a conversation about our very first catheter insertion on a real live, breathing person.
Mine was in the PACU. My patient was super distended, in lots of pain, and asking if there was anything we could do to make him void since it was so uncomfortable.

“Sure!”, my instructor said. “What would you do in this situation?”

I assessed his stomach and found he was extremely distended. I gave him the urinal to try once more on his own and of course closed the curtain for privacy.
Nothing.

Straight cath was the next option. His MD happened to stroll in and checked him out. He reached the same conclusion and gave the go-ahead.

I was nervous, feeling ill prepared. I hadn’t expected to do any catheters here and hadn’t reviewed.

“Calm down,” Mrs. D said. We reviewed the steps. Easy.

So, I get to work. As I’m wiping with Betadine, my patient- still groggy from anesthesia- decides it is a good idea to start talking to me.

“Hey, just so you know, it’s really cold in here,” he said with eyes half-mast.

“Oh. Uh-huh,” I nervously reply with an awkward chuckle. I mean, what do you say to that?
I insert the catheter and am having trouble getting it past the prostate. My coassigned nurse comes over and teaches me how to “walk the catheter in” because it keeps popping back out the second I let go.

“Yeah, it’s just cold in here. Just so everyone knows,” my patient states again.
More nervous laughter.

My coassigned and I finally get the catheter in and he leaves me to drain it. It was slow going. 800ml slowly drained. (Note: never drain more than 1000ml at a time!)
And while it drained, my patient decides to triple check and make sure I knew the temperature of the room.
Hint: it was not warm.

Thanks male patient. Long story short, I successfully completed my first straight cath and it was incredibly awkward.
Any good stories from you guys?

Love,
Laney

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Lab Values

Hey everyone!

Snow day is over and it’s back to the nurse-y posts. At least for a little while…

Anyways, this has saved my life in clinicals. My coassigned on the oncology floor showed it to me and I haven’t taken a second glance back since.
Apparently, this is the way MDs write lab values, which I had never seen/heard of before. It’s called different things including fish scales and a basic lab values worksheet. There may be other ways to write it, but this is how I learned it. I looked up some samples online and the consensus seems to be the same.
Hopefully this will be helpful to someone else down the road!

This is a chem 7 basic metabolic panel.

So you’ve got:
Sodium, Chloride, BUN
Potasium, Bicarb, Creatine
with Glucose.

And then for your CBC stuff:

White Blood Cells
Hemoglobin
Hematocrit
Platelets

I love it. And, as mentioned in the comments section on a previous post, I like to put the abnormals in red. It makes it real simple. Anything else I need to add (calcium occasionally…) I put on the side, but this usually keeps me covered.

Love,
Laney

M-isms

On poor dosage test grades: “That’s the problem with y’all. I give you this nice good book and you don’t even use it. Shameful.”

On getting the class quiet: “Really! Hush up! Y’all couldn’t not talk to save your own lives.”

And Then My Head Exploded.

So there’s this girl I work with. And she’s in nursing school.
Before I begin, let me tell you- she’s a bit dim.
She thinks she knows it all…but, nevertheless, there’s some empty space up there. And I’m not trying to be mean by any means. Please don’t think that.

It’s just that this really topped the cake. Fresh icing. So, I will talk about it here. Because I don’t want to be catty and talk about it to people who actually know her.
Once again, she’s in nursing school also. She’s already got a degree so she is completing the two years for nursing stuff.
I asked her this morning how school was going.
Everything was going good apparently. Great!

Then she told me she’s only been in school 3 weeks and already has an exam on fluids and electrolytes.
Reasonable, I thought.
But then she said she didn’t think it was soon enough to have a test yet and what could they possibly test on??
Confused, I thought…well, you could have a whole test on just fluids and electrolytes. That’s a lot of information right there.

Before I could say anything, she continued.
“Yeah, and you know my health assessment class is kinda slow. I don’t feel like I’m learning anything. We learned how to give a bath and make a bed.”
I explained how the first semester is usually Nursing Aide stuff and it can be slow when you want to learn a bunch of skills. But you still have assessing to learn anyways.
To which she replied: “Oh yeah, they spend a lot of time on assessing. I mean, our end of the semester exam has a full head-to-toe assessment.”
I told her our school had that for a check-off at the end of the first semester also.

But THEN she said:
“It just seems like a waste of time. I mean, do nurses even assess anyways?”

And my head exploded.
Do they even assess anyways?! I don’t have enough font or capitals or colors to reasonably express, without being annoying, how far my jaw dropped to the floor. Do nurses assess? Really. Seriously.
Do you even know what you are going to school to learn how to do? What, exactly, do you think nurses do all day?

I stammered and quickly recovered.
Yes! Nurses assess! That drives everything. It’s the very basis of our care. We assess without realizing it. But you have to know how to do full head-to-toe so that if you know what’s normal, you can find what is abnormal. You assess even when you’re just talking to a patient and seeing their LOC (level of consciousness).Yada, yada, yada.

She responded:
“Oh. Really? Like assessing skin when giving a bed bath. I get it. Huh. I really thought it was, like, the nurse practitioner’s who assessed.”

Whatever else could explode, did. Little blood vessels I think.

“Yeah, but that’s that. But I was watching [insert name of night nurse] get out the blood and put it in the little bottles to send to the lab and I was like, man! I wish I could be doing that! You know, instead of boring head-to-toe assessments.”

There was nothing left of me, but a little puddle of shock.

I just…I don’t even know how to finish this post.

Love,
Laney

M-isms #10

On some women not liking diaphragms/cervical caps: “You gotta ask though because some women won’t like it- they get freaky about touching themselves.”

Clinicals + Lasagna = Sleepy

That’s right. It was a short shift of not a whole lot. I just tried to fill the time.
We talked about policies and procedures for 30 minutes.
I wanted to curl up in the fetal position and just sleep.

Now I’m home. Ate some lasagna.
YUM.

Now, I’m exhausted. Clinicals always makes me hungry and sleepy. I’ll probably go nap now.
So, this isn’t too exciting. Sorry for that.
I’ll post more this weekend.

Tonight:
Dress shopping with Britt
Birthday dinner for HK.

Happy Thursday to everyone!

Love,
Laney

Fundus Buddies?

NO!

My instructor wants to us to be fundus buddies on the postpartum (PP) floor. After today, I can confidently say that I do not find the fun in fundus (aka the top of the uterus that you can feel during pregnancy).
I’m so bored!

Granted, I think it’s awesome their are nurses who do PP, but tain’t for me.
It’s just a bunch of boobs, butts, and vahoohahs.
And when I feel like I’m not doing a whole lot, time slows. Today was slow. It took FOREVER. I thought I would never leave!
We arrived at 0700. Started the morning off by going through floor orientation and then started the unit tour. Then a classmate from another rotation came in.
“Howdy T! What are you doing here?”
“Oh well, I’m meeting so-and-so for my community rotation,” T replied.
“Oh okay, cool.”
“Yeah,” he continued. “Have you seen so-and-so? I was supposed to meet her at 0830.”

My head exploded. What?! It’s not even 0830 yet? Are you kidding me? I thought it was almost lunch time!
I checked my watch in a slight panic, pushing up my jacket sleeve.
If it were a movie, there would be horror music as it zoomed in to the bright digital numbers that screamed 08:18.

My day went on in that fashion until 1530. I thought the day was done, it was 1000. I thought I had graduated school, it was only lunchtime. I thought I had already had babies of my own, it was only time for a lactation consultant meeting that dragged for TWO HOURS.

Now, this is nothing against the unit. Some students liked it. I just like a faster pace.

Here’s how to remember your focused assessment: Bubble He.

B- breasts [engorgement, cracked nipples, no clogged milk ducts]
U- uterus [firmness, fundus, is it at the umbilicus?]
B- bowel movement [have they had one, stool softener after 2-3 days]
B- bladder [emptying it?]
L- lochia [bloody, mucousy, discharge…what color is it?]
E- episiotomy [check sutures, bruising, tearing, hemorrhoids]
H- Homan’s sign [dorsiflex to check calves for blood clots]
E- emotional [PP depression, appropriateness]

And that’s it. Ugh. Not my cup of tea.
I’m team lead tomorrow aka charge nurse. Which is fine, I like charging.

Oh, and it’s a short day. Due to floor/curriculum changes, we got split into shifts for this rotation. Either 0700-1100 or 1100-1500. Luckily, we all got the shifts we wanted and I am happily on the 1100-1500 shift. I’m not trying to be up super early.
Only three more days (one tomorrow and two shifts next week) and then I can move on to Labor and Delivery. Until tomorrow…

Love,
Laney