Countdown To Freedom

Thanksgiving at home was a dream come true. Even though I studied through about half of it. But I was home and that’s all that mattered. Flying back here this afternoon to face the next 10 days was not my cup of tea.

Then again, that means I am 10 days away from surviving my first (and most hellish) semester of nursing school, relatively unscathed. So if I MUST come back into town, at least I’ll be so busy, it’ll be over before I know it.

Here is what stands between me and Christmas decorations, boat parades, quality family time, and (of course) snuggling with S…

1. ATI Mental Health Assessment
2. ATI Pharm Assessment
3. Roles paper
4. 2 clinical shifts
5. 1 comprehensive care plan
6. Med-Surg Exam #4
7. Wound Care simulation in the lab
8. Mental Health Final
9. Pharm Final

On Thursday, December 11th, my bags will be packed and I will be RARIN’ to go!

P.S.  Nurse Teeny pauses to pat herself on the back….she passed her Foley Cath test last week! I have a tube for your bladder and I’m not afraid to use it!

Capping It All Off

In 17 days I’ll be 25% of the way to becoming an RN. That’s just freaking scary. But in the spirit of getting ahead of myself, I thought I’d begin marinating over what this semester has taught me and where I think I’m headed.

• Lesson #1: Psych is out. Even though I loved my placement and was exhilarated by the challenge of working with pukey adolescents, I’ve discovered that I love the technical aspects of nursing too much to focus on therapy at the expense of everything else that encompasses this profession. I can be therapeutic and still be hands-on.
• Lesson #2: I hate, absolutely despise, and loathe transferring/pivoting/lifting people who are bigger than me (or are my size, for that matter). Yet another reason to choose peds. A lot fewer of those floatin’ around.
• Lesson #3: The human heart fascinates me. The human brain does too, which is why I have enjoyed my Neuro rotation. But the other day I was listening to heart sounds on my patient who had had a stroke and a heart attack, and when I caught an S3 (that’s an extra heart sound that shouldn’t be there), I about jumped out of my skin with excitement.
• Lesson #4: Every experience I have had thus far, and many of my conversations, continue to lead me along the path that I have already been envisioning: pediatric end-of-life care. So much so that I am trying to finagle my way into doing my capstone (final semester rotation) at a pediatric hospice facility. I found out today that our capstones don’t necessarily have to be in the immediate geographic vicinity. Most of the coursework can be done online by that point, and if you have an interest in a particular type of nursing or location, apparently our program can help make that happen. This just opens up whole realms of possibilities for me! And if I start planning for my options now, I’ll be that much more prepared to figure out logistics.

Now if I can just pass my silly Foley Cath test, I’ll be golden. Note to self: don’t turn your back on the sterile field, Nurse Teeny!

2 Shifts To Go

And no more left before Thanksgiving!  It’s inconceivable to me that I am 5/6 of the way through my second clinical rotation and 2 1/2 weeks away from surviving my first semester of nursing school.  How in the name of everything holy did that happen so fast?

This week was flippin’ incredible too.  My patient yesterday and today was a 60-year old Vietnamese woman who spoke broken English and had suffered a pretty significant brain bleed that made her entire left side basically kaput.  Droopy face, flaccid extremities, numbness, the whole deal.  But we established great rapport and I think it’s safe to say that we pretty much adored each other by the end of the day.  And it was awesome to watch her improve in just 24 hours from being drowsy and dizzy and needing two people to help her up to the bathroom, to being playful and singing me Christmas carols and being able to pivot to the chair commode with only my assistance.  She was so proud of herself!  Even though the trauma of her stroke definitely saddened her, her resilience and spirit were truly inspiring.

I had another stroke patient this morning who also had left-sided weakness, and had had a heart attack in the ambulance on the way to the hospital.  Double trouble.   After spending a few days in Cardiac Intensive Care, he was transferred to our unit last night.  Because of his cardiac condition, he was on telemetry and I was able to auscultate irregular heart sounds, which was amazing to hear on a real human being rather than a mannequin.  He was able to get a bed on the acute rehab unit pretty quickly, so I worked him up this morning, helped with breakfast and meds, and then it was time to transport him over.  The floor’s CNA coached me through the whole process.

Speaking of coaching, I must say that we have been positively spoiled rotten by the quality of instruction we have received.  And we’re in the new building of the hospital so the facilities are pretty fancy schmancy too.  Even though we know we’ll eventually have a rotation that’s not quite so cushy, this is a great way to get broken in and build up our confidence in our abilities.

6 lectures, 2 clinicals, 3 papers, 6 exams, 1 care plan and 1 self-evaluation til Christmas break.  Time to buckle down and get there.

Stroke Rounds

Imagine walking into a room filled with ridiculously smart people, including: a neurologist who specializes in stroke care, a nurse practitioner who also specializes in stroke care, the additional stroke specialist interviewing for a job, a physical therapist, an occupational therapist, a speech therapist and the chaplain.  Not to mention your nurse, who has been at this for 6 years.

Now imagine being tasked with the responsibility of presenting your patient to this illustrious cohort.  Intimidating much?

That’s what I had to do this morning.  My patient had a hemorrhagic stroke secondary to hypertension three days ago and was just transferred from the ICU to my unit yesterday.  So this was the first day that Neuroscience “stroke rounds” (as they call this daily interdisciplinary powwow) were reviewing her case.  Stroke rounds depend in large part on the nurse, because she (or he) has the most up-to-date information.  And my nurse seemed to think I was ready to take the lead.

Boy, did it feel good.

I’m 100% positive that there is significant room for improvement.  But it was empowering and exciting to be a resource for all those other experts in the field.  Not to mention my patient was a sweetheart squared.

Nursing rocks.

Love Ya To Pieces

The past two weeks have been a whirlwind of clinicals, papers, and assignments.  We are winding down the semester, which is incredible to believe.  And I have come to one crucial conclusion…

I am exactly where I am supposed to be.

My clinical experience especially has confirmed that nursing is my calling.  I got a great evaluation from my instructor midway through the rotation, and I have enjoyed (almost) every interaction I have had with my patients.  As the staff nurses have grown more confident in our abilities, they have given us more complex patients (or made us juggle two patients on one shift).  Over the past four shifts I have done everything from take out a Foley cath to feed through a nasogastric tube.  I’ve checked blood sugar, injected insulin, and administered narcotics via IV push.  And most importantly, I feel comfortable communicating with my patients and totally in my element.  One of my patients told me at the end of shift “I love ya to pieces, hon.  Thank you for everything.”  That made my week.  No actually, it made my semester.

I know I have A LOT to learn still.  But rather than be intimidated by what I don’t know, I feel prepared and excited about the challenge. 

And boy am I ready for Christmas break!

Adaptation

I’m beginning to understand why my instructors constantly talk about flexibility being the name of the game in nursing.

We have a care plan due next week, based on the assessment and care we provide to our patient today and tomorrow.  So when I went in this week to get my patient assignment, I was intrigued and excited to get assigned to someone I knew would be there both days and required a higher level of care.   When I showed up for my shift this morning, I was ready for the challenge, pleased that my instructor thought I could handle it and incredibly nervous about the complexities of my patient’s situation.

Until I checked the electronic chart and realized my patient was GONE.

Back to the ICU for a diminished respiratory rate.  So much for 3-4 hours’ worth of preparation and research.  Flexibility Test #1.

Then I was assigned to another patient who was pre-op for cervical and lumbar surgery, scheduled for this evening.  Which means he would be there tomorrow too.  I had just wrapped up vital signs when my nurse popped her head in and said his surgery had been bumped up several hours and transport was on their way right that second.  Flexibility Test #2.  We scrambled to complete pre-op paperwork and sent him on down.

So there I was at 10:30.  No patients, no assessment completed, no way to prepare a care plan to follow through on tomorrow.  Crap.  I spent the next several hours assisting my classmate/buddy with his patient’s medication administration, straightening up my surgical patient’s room and catching up on charting.

Lo and behold, my patient from the ICU was transferred back to the floor…10 minutes before my shift was over.

So tomorrow will involve completing a full assessment, thinking through my care plan on my feet, and then following through on my goals as much as possible.

Just go with the flow, Nurse Teeny…

YES WE DID!

I’m so proud of my country right now.

Wow.

Say it with me….

PRESIDENT OBAMA