I'm sitting in a coffee shop this sunny Saturday afternoon on Walnut street after a week of exams that left me haggard and drained by Friday. Pretty sure I just failed my first test ever - the drug exam. Easy to do when failing means missing two out of 14 questions. I hate drug exams, so many data points to memorize...and admit I only gave it a half-assed effort on Thursday night prepping for it. I was already seeing double from long nights of study for the big nursing exam we also had this week.
In any case, instead of studying for the microbiology exam and lab midterm, I thought I'd blog about how stupid I felt this week during clincals. I can't wait until I know everything and will stop sticking my foot in it on the floor! First I'll share just a couple ways I made myself look like an idiot, and will end with a story one of the seniors shared with me, that makes my little faux-pas look minuscule in comparison.
THE LITTLE RED CAP:
When you disconnect an IV temporarily, you need a Little Red Cap to put on the end of the tube, to keep it clean.
I needed to send my knee-replacement patient to physical therapy on Tuesday, and knew she needed to be disconnected in order to go there. I'll admit, I'm still intimidated by IV's...even though we've been trained. The main priority I was given: (since post-op joint replacements are loathe to do this)...Get. Your. Patient. To. PT. Don't put up with their whines. It is BEST for them to be UP and MOVING. (Of course...if you attempt to do this by yourself, without help, we will knock your block off...)
So, I was stressed, since she'd been hinting all morning that getting out of bed would be, impossible. I hunted down my co-assigned nurse and told her we were all ready to go, except for disconnecting the IV. She raised her brows and said, "you up for it?" In my head I freaked and said NO WAY! But, robotically I answered, "Hell yeah!" (Because I'm a junkie for all new experiences.) She smiled like I had given the right answer, and handed me the packet which contained the Little Red Cap. (This is lucky, because I never would have remembered I needed it.) She reviewed what I was to do, and then sent me on my way. The PT assistant was in the room already, and he wasn't going to disconnect it. Not his job. But he, and the patient, were waiting for me. More stress.
I fumbled around with everything. Stopped the IV pump. Closed the clamps everywhere to make sure we weren't all about to get very wet. Wiggled, and strained to get the danged tube out of her IV port without actually pulling it out of her hand. Finally, got it! I popped that little red cap on the end coming out of her hand, and hung the end of the tube connected to the pump back up on the pole, always afraid the end would touch the floor, or anything else, and become contaminated. Since I had nothing to cover it up with, I used a clean glove, as my previous clinical instructor said would work in a pinch. It hung up there like a deflated, blue UDDER. But my patient was free, and together, the aid and I got her OOB and to PT, without any calamities and despite her protests.
SO proud of myself, I asked my clinical instructor to come in and show me how to shut off my beeping IV pump, which knew it was no longer connected to a person and was beeping it's complaints. She walked in and stopped short when she saw my blue udder hanging up there.
"Kristine...what's that?"
"Uh...I didn't want it to get dirty."
Smiling now, "That's good, but why didn't you use a cap?"
"I only had one, so it's on the patient's hand."
"You don't need one on the patient. Their end is has a valve that closes and keeps it clean. The red cap goes on THIS end." (Pointing to my blue udder.) Instantly, I remembered that detail from our training.
FAIL!
I spent the rest of the morning wondering how I could get that red cap off my patient's hand before my co-assigned nurse saw it and realized what a dumbass I am. It was just this bright red thing in the wrong place that vibrantly announced that the student nurse didn't know jack to the whole world! Turns out I didn't get to it in time. Instead I confessed as my lead nurse looked puzzled up at the blue udder. She just smiled and said she'd beat me later for it, but we had other things to do...
(I love her!)
THE BLADDER SCAN:
Later that day, with the same awesome nurse, I proved, yet again, how much of a newbie I am. She allowed me to do the bladder scan on the same patient - now back from PT and exhausted, but who also hadn't pee'd since her catheter had been removed that morning. That can be bad, so she needed a scan, and I was going to do it! After my nurse reviewed the procedure, I bared the patient's belly, got the gel on my instrument and placed it over the bladder area, gently rotating it around a bit.
"Just hold it still and point it at the bladder hon...we ain't having a baby here!"
Groan. The nurse and the patient both got a kick out of the look on my face.
In any case, these stories are helpful because I PROMISE YOU, I will never swirl the bladder scanner or misuse the Little Red Cap ever again! :)
And hopefully, any student nurses reading this never will either!
I was relaying this story to a few seniors on the porch late one night and they loved them, but one of them blew mine out of the water as she relayed what she had done in her first year on the floor:
THE ICE CHIPS:
This student nurse went to her busy clinical instructor and asked what else she could do that day, her patient was settled and resting comfortably. The instructor waved her off, busy with another student, "just go fill up the ice for every patient on the unit."
So she did.
Then she entered the room of a patient who had just passed away. She looked like she was sleeping, and the student nurse had no idea she was deceased. To the daughter who was quietly weeping, she said "would your mom like some ice chips?"
"She's GONE!" the daughter howled at her!
The student scrammed from the room.
And that's how she encountered her first dead person. She offered them ice chips!
I tell you, I think there's a book here. In nursing school, as punishing as it is, sometimes if you don't laugh...you'll cry.
Enjoy!
Saturday, March 10, 2012
Saturday, March 3, 2012
Pit Crew
It's Saturday and I'm in lazy mode. Slept in, made a late breakfast (around lunch time) and my goal is to remain in jammies all day. In other words, it's like any other Saturday!
I'm approaching the mid-point of Term 3 and it is everything I feared it would be: extremely rigorous and challenging. The weeks start out with a bang, Monday's being the absolute worst -- a full day of classes ending around 2:00. A quick change into assessment clothing, and bolting down some food before the mad dash to the hospital for pre-planning. Several hours later we return home to eat and dig in for the LONG night of paperwork.
I have yet to get more than two hours of sleep on any given Monday and this continues to frustrate me; not only because I'd like to get more rest, but primarily because I worry that it endangers my patients to have a "zombie-nurse" caring for them the next day. I keep thinking about pilots (since I was married to one) and how the FAA requires them to only work so many hours before they give them a mandatory-grounding to go get some sleep. After all, hundreds of lives are at stake and sleepy pilots are a bad thing. Same goes for nursing in my mind. So, I have begun picking the brains of the seniors around here on the subject of clinical paper work, hoping to pick up some time-saving pointers in order to get a little more rest for my clinicals on Tuesdays. Every Monday is a new chance to learn better time management, prioritization and efficiency -- and I'm determined to streamline. Somehow.
Especially since clinical days are my favorite! I love being in the hospital and I keep winning the "patient lottery" -- each one this term has been a gem. I have just finished my stint in a Telemetry unit -- mostly heart patients and now will spend several weeks back on the Orthopedics floor (which is where I was for my first term). Considering I have a titanium elbow and have had FIVE (yep, five) ortho surgeries myself; I have a great affinity for the ortho patients and can't wait to get back there to see them. Don't get me wrong, my time with the heart patients was fantastic. We actually had a pretty great happy ending there this term. Week 1 we got to listen to a man's chest who had no heart beat -- he was on a VAD (Ventricular Assistive Device), so a machine was circulating the blood continuously through his body. It was eerie feeling for his pulses and finding none, listening to his chest and only hearing a whirring sound. In any case, this young man (in his 30's) had been in the hospital for a month, waiting for a transplant and was getting pretty down, having had a couple of close calls. Well, my last day on the floor, I heard he had finally gotten a match and was at that moment in surgery and hopefully on his way to a new lease on life!
I'll spend several weeks in Ortho before finally getting my OR rotation during the last two weeks of term. I am anxiously awaiting my time in the OR, and wondering if I'll be up for the experience - the gore, the smells, and the hours and hours of standing. It will definitely be a break from the very active clinical days I have had so far.
I was discussing nursing in general with my mom and told her that I feel like I'm being trained to be on the Pit Crew for the human body. We all cruise our way down the road of life, but every once in a while, something goes wrong with our body - the human machine, with all it's electrical wiring, it's circulatory and digestive plumbing, the ambulating pieces and parts. That's where I come in. You'll pull off the road and into my hospital where we will swarm all over you; like the pit crew does for a race car.
And hopefully you'll get back out there on the highway of life, no more worse for wear.
Your welcome.
:)
I'm approaching the mid-point of Term 3 and it is everything I feared it would be: extremely rigorous and challenging. The weeks start out with a bang, Monday's being the absolute worst -- a full day of classes ending around 2:00. A quick change into assessment clothing, and bolting down some food before the mad dash to the hospital for pre-planning. Several hours later we return home to eat and dig in for the LONG night of paperwork.
I have yet to get more than two hours of sleep on any given Monday and this continues to frustrate me; not only because I'd like to get more rest, but primarily because I worry that it endangers my patients to have a "zombie-nurse" caring for them the next day. I keep thinking about pilots (since I was married to one) and how the FAA requires them to only work so many hours before they give them a mandatory-grounding to go get some sleep. After all, hundreds of lives are at stake and sleepy pilots are a bad thing. Same goes for nursing in my mind. So, I have begun picking the brains of the seniors around here on the subject of clinical paper work, hoping to pick up some time-saving pointers in order to get a little more rest for my clinicals on Tuesdays. Every Monday is a new chance to learn better time management, prioritization and efficiency -- and I'm determined to streamline. Somehow.
Especially since clinical days are my favorite! I love being in the hospital and I keep winning the "patient lottery" -- each one this term has been a gem. I have just finished my stint in a Telemetry unit -- mostly heart patients and now will spend several weeks back on the Orthopedics floor (which is where I was for my first term). Considering I have a titanium elbow and have had FIVE (yep, five) ortho surgeries myself; I have a great affinity for the ortho patients and can't wait to get back there to see them. Don't get me wrong, my time with the heart patients was fantastic. We actually had a pretty great happy ending there this term. Week 1 we got to listen to a man's chest who had no heart beat -- he was on a VAD (Ventricular Assistive Device), so a machine was circulating the blood continuously through his body. It was eerie feeling for his pulses and finding none, listening to his chest and only hearing a whirring sound. In any case, this young man (in his 30's) had been in the hospital for a month, waiting for a transplant and was getting pretty down, having had a couple of close calls. Well, my last day on the floor, I heard he had finally gotten a match and was at that moment in surgery and hopefully on his way to a new lease on life!
I'll spend several weeks in Ortho before finally getting my OR rotation during the last two weeks of term. I am anxiously awaiting my time in the OR, and wondering if I'll be up for the experience - the gore, the smells, and the hours and hours of standing. It will definitely be a break from the very active clinical days I have had so far.
I was discussing nursing in general with my mom and told her that I feel like I'm being trained to be on the Pit Crew for the human body. We all cruise our way down the road of life, but every once in a while, something goes wrong with our body - the human machine, with all it's electrical wiring, it's circulatory and digestive plumbing, the ambulating pieces and parts. That's where I come in. You'll pull off the road and into my hospital where we will swarm all over you; like the pit crew does for a race car.
And hopefully you'll get back out there on the highway of life, no more worse for wear.
Your welcome.
:)
Sunday, February 12, 2012
Snowed in with Cabin Fever
I wonder how cold it has to get before PIttsburgers consider it cold?
I'm at the diner now and chose to drive instead of walk this morning, considering it's well below freezing outside. Cold enough for me! I trudged the few blocks to the parking lot where my car is located, walked right by it and into the lot, racking my brain to remember where I parked it last. (I drive so rarely now, it takes a minute to recall.) No wonder I walked right by and missed it. It looked like every other car--buried in 5 inches in snow! I finally found mine and unburied it for the short drive to the diner. I figured it was a good idea to get the snow off today, since it's supposed to snow even more tonight and I actually have to drive to the hospital tomorrow, may as well get some of it dealt with today.
In any case, I passed the corner park thinking it would surely be deserted this morning, but of course it wasn't. The hail and hearty deck-hockey guys were out there playing in the frigid cold. It made me smile. How cold before they cancel the game?
I had a severe case of cabin fever this Sunday morning, after having been in the near-empty dorms all weekend and missed my usual friday night out when plans fell through. I consoled myself with Rom-Coms on the telly, catching up on my notes and cross-stitch. Luckily I did make it out Thursday night, unexpectedly. I was invited to karaoke night with a friend and a group of her friends from the hospital in which she works. Got to visit a cute new neighborhood and discover a nice old tavern--The Apple. Her friends were clearly all about karaoke--and I swear they were good enough singers to go professional. I love watching karaoke and singing along! Too bad I can't sing! :)
There are clear downsides to living in this old building...the fire drills being the most annoying right now. Last year they had something like 36 false alarms, but it still means we all need to leave the building and wait in the park across the street for the 3 fire trucks to come and give us the all clear. The only up-side to this exercise is gawking at the gang of cute firefighters that swarm the building! Nonetheless, I have tallied it up so far, and of the 6 or so drills we've had, I have been pretty much naked when the alarm went off for most of them; just getting out of the shower or already in bed. (I have started getting a little skittish when in the buff, thinking that I will surely hear that blasted bell at any moment.) I'm beginning to take it personally, as if it just waits for the worst moment (for me) to go off. What the alarm doesn't seem to do is go off during the daylight hours, or when I'm fully clothed, or when I'm not even home. Why?
Last night was the worst yet. I had just showered and crawled into bed at midnight when the alarm went off. I glanced at the temperature and, seeing that it was 16 degrees out and snowing, I got myself fully dressed in tall boots and warm coat among much cursing and gnashing of teeth. Other girls chose to dash right out in what they were wearing, choosing the expedient (and undoubtably safer) option, especially had it been a real fire. They later regretted it as they fought hypothermia in the park in shorts and a tee-shirt.
I'm blogging from my counter seat at the diner now that my friends (the old duffers) have finally gone. I love to discuss old cars, the golden age of big band music, the work-ethic of today's young people and various other topics with them. But when they finally go, I get to put on my head phones, dial up some Perry Como (in homage to my vintage diner and vintage friends) and get my work done. Headphones are necessary to drown out the buzz; clanging dishes, shouts of "order up!" from the kitchen, and the gabbing of the waitresses. Headphones also discourage friendly conversation from my neighbors...so I can actually get my work accomplished. Of course, the diner doesn't have WiFi, as I discovered this morning, but I guess I really didn't think it would. It's okay, I brought plenty to do.
This week we went into the Sim Lab and learned all about IV therapy. How to hook them up, the ways to hang medications, give bolus doses through the ports, how to change the tubing. How to draw blood. I was so excited about all this until my clinical instructor told me that students are restricted from putting in IV's at my particular clinical site to which I've been assigned this term! Boo! How am I supposed to practice? By the time I'm actually faced with a real patient it will have been weeks/months since I was trained! I pity my poor first patient for this reason. Because of this, I'm determined to actually take advantage of the open lab sessions they have after class every Friday, so I can at least go practice sticking rubber people...until a real human subject is made available to me. Grrr....
I'll head to Whole Foods later and plan the meal I'll make for friends tonight. Something comfort food, since it's cold outside. I'm thinking a cheesy garlic scalloped potato dish with ham. And maybe pie. Something to stick to the ribs, fill our bellies and fortify us for the coming week. Calories be damned. I really miss cooking and entertaining friends over a meal. Glad to have a friend with a kitchen so I can do so once in a while!
Like a prisoner in a cell...I like to mark off the time remaining in the term on my white board, counting down the weeks until the end, and break. Happy that one week is already behind me, and girding my loins for the remaining nine. Oh well..."It Had to be You" is playing on Pandora, and I have notes to type.
...Until We Meet Again!
Sunday, February 5, 2012
Reflections from Gate B8
Parked by the window at Seatac airport awaiting my flight back to PIT by way of Chicago. Hoping the weather all along my route will cooperate and get me back on schedule.
It's a gorgeous northwest day...blue sky acting the backdrop to our stunning Olympic Mountains in the distance. Finding it very hard to leave home...again. Clearly, my homesick blues have already set in and I haven't even squeezed myself into my teensy coach seat. (What would it be like to fly everywhere first class?!)
Tomorrow kicks off Term 3. I am dreading it entirely. Not sure one week in between terms was enough to refresh my batteries before the hard work begins again. Plus, we will all be returning to the lecture hall, minus a couple of students who didn't make it. It's a bittersweet beginning. I realize we may lose a few now at the end of every term, but saying goodbye is still hard. These are folks we go through tough things with...all-night cramming for exams, scary encounters on the clinical units, and even just the mundane sharing of crappy cafeteria food together. Inevitably...we bond.
We return to find out what clinical rotations we'll have and where. I'm looking forward to that information...very much hoping to be placed at my 1st choice...the big city hospital located nearby, and NOT the smaller, suburban hospital that's a half an hour away. I'm living on borrowed time with the little beater-car I brought here, and hoping to stretch that time by keeping long commutes to a minimum.
I'm not sure of everything we'll be learning clinically this term, but I do know we'll be getting our IV training. I am VERY excited about that! Another skill that will make us more useful on the floor. Also -- I know we'll be getting a rotation into the OR. I'm looking forward to that, but with some trepidation...hoping the experience is interesting, AND that I don't disgrace myself by wussing out when things get gross. Which they will.
Finally, I do dread how busy I will be over the next 10 weeks. Selfishly, I'm hoping my new exercise regime I began when I moved here doesn't get sidelined when the schedule gets full. Taking my runs (nearly) every day is such a mental-health break. I don't like slogging along on the elliptical in the gym when it's too cold or snowy outside, but even that is better than no movement at all. Exercise has been such a de-stressor, and a welcome escape from the dorms.
In any case -- it looks like time to pack up and board the plane. To everyone I was able to see, and to those I missed this time -- know that I love you and will see you soon.
It's a gorgeous northwest day...blue sky acting the backdrop to our stunning Olympic Mountains in the distance. Finding it very hard to leave home...again. Clearly, my homesick blues have already set in and I haven't even squeezed myself into my teensy coach seat. (What would it be like to fly everywhere first class?!)
Tomorrow kicks off Term 3. I am dreading it entirely. Not sure one week in between terms was enough to refresh my batteries before the hard work begins again. Plus, we will all be returning to the lecture hall, minus a couple of students who didn't make it. It's a bittersweet beginning. I realize we may lose a few now at the end of every term, but saying goodbye is still hard. These are folks we go through tough things with...all-night cramming for exams, scary encounters on the clinical units, and even just the mundane sharing of crappy cafeteria food together. Inevitably...we bond.
We return to find out what clinical rotations we'll have and where. I'm looking forward to that information...very much hoping to be placed at my 1st choice...the big city hospital located nearby, and NOT the smaller, suburban hospital that's a half an hour away. I'm living on borrowed time with the little beater-car I brought here, and hoping to stretch that time by keeping long commutes to a minimum.
I'm not sure of everything we'll be learning clinically this term, but I do know we'll be getting our IV training. I am VERY excited about that! Another skill that will make us more useful on the floor. Also -- I know we'll be getting a rotation into the OR. I'm looking forward to that, but with some trepidation...hoping the experience is interesting, AND that I don't disgrace myself by wussing out when things get gross. Which they will.
Finally, I do dread how busy I will be over the next 10 weeks. Selfishly, I'm hoping my new exercise regime I began when I moved here doesn't get sidelined when the schedule gets full. Taking my runs (nearly) every day is such a mental-health break. I don't like slogging along on the elliptical in the gym when it's too cold or snowy outside, but even that is better than no movement at all. Exercise has been such a de-stressor, and a welcome escape from the dorms.
In any case -- it looks like time to pack up and board the plane. To everyone I was able to see, and to those I missed this time -- know that I love you and will see you soon.
Tuesday, January 24, 2012
Win Some, Lose Some
For many, today was the low point of nursing school so far. I shall now refer to it as Black Tuesday.
Its the last week of Term 2 and we took a brutal unit test which covered (among other things) acid-base balances, fluids and electrolytes. Hello, SCIENCE! This test wasn't just going to be about concepts, it was about the details. And if you didn't spend time on memorizing a bunch of data, you weren't going to be able to reason your way to the answer. Most of that material was along the lines of, "you either know it or you don't." Many didn't.
Unfortunately, right after that we had our first Drug Exam. I had heard these were brutal, and preparing for it sure was. Again -- it was about a bunch of data; long unrecognizable drug names attached to lists —why would it be prescribed, what action does it take in the body, what contraindications might there be, what signs and symptoms would be associated with those, what nursing care is required? Lists...lists...LISTS!
Even recalling these hazy days of studying, cursing, and suffering that lead up to these two exams gives me PTSD.
For me it's the worst kind of studying. I'm terrible at it. I have a hard time concentrating because it's dry. I embark on mini-acts of rebellion and self-harm. (Like writing curse words on my notes or eating pizza both for dinner at 1:30 a.m....AND for breakfast.) Still, I've learned that I always do better than I think I will, because I have a somewhat dubious gift--I can cram through a bunch of material and the next day go write a test on it and end up with a fairly decent grade. This does NOT comfort me, although many would be happy to have this skill. All this means is I can hold the information in my head for only so long as it takes to pass an exam. Ask me next week...and I promise you, it's gone. Long gone.
I'm also a fairly decent guesser.
When taking a multiple choice test, any time I don't know the answer, I'll pick one, but I'll write a question mark next to the question. At the end of the exam...I'll know how many question marks I had and can sometimes get a pretty good idea of what my score might be. Today was the first day I had an ALARMING number of question marks at the end, and I truly thought it would the first exam I would have EVER failed. (Here at nursing school, and also in my whole life.)
I ended up passing the unit exam with a good grade, but as we went through the test, I realized that I was getting a number of my question-marked questions correct. I still don't know the material, and had no rationale behind why I picked one over the other...truly I thought I was throwing a dart and randomly just selected any answer. They just happened to be the right answers.
The drug exam was a squeaker. Two more questions wrong and I would have bombed it. Failed.
I don't like how close I came to failing that exam. It was too close for comfort. I also don't like how quite a few lucky guesses got me that decent grade on material I will admit I still don't really know or understand. We'll also be covering this same stuff for the final exam this Friday -- and I'm going into it wondering how I'll study differently so I may end up with more answers I'm certain about, and fewer question marks.
I really don't want to bank on the fact that I'm a fairly decent guesser.
Pretty sure my future patients won't want to bank on that either.
I have one last complaint before I collapse in a boozy heap and conk out from pure exhaustion. (Because NOT going out for several beers today after the blood-bath just seemed wrong!) The timing of those tests stinks. Why both on one day? Especially because of the type of material it was, they could have spread them out. Why wasn't one tomorrow? We've got nothing going on tomorrow. In fact, we didn't even have our FIRST exam this term until week 4...surely by the end of week 2 we could have gotten one exam out of the way and pushed the whole schedule up.
From my perspective, overall organization of the schedule this term needlessly left us with a bottleneck of exams at the end. I've never been one to whine...I know that at times, things will just be hard. However, I do feel that the school didn't really get to see how well this cohort would be able to perform academically had the schedule been more spread out. I raise this complaint because I heard of so many students today who either failed one or both of those exams. I had a little wiggle room in my grade to be able to afford a hit. Too many students did not. I can't help but wonder if we'd all have done markedly better if given a day or two in between such difficult exams.
I know many are taking a hard look right now and asking some tough questions. Am I up to the academic standards needed to get through nursing school? ...Can I continue to hold down one or two jobs and still do it? ...Do I need to make adjustments in my life? ...Do I need a back up plan? ...A safety net?
We all need a break!
Good thing it's a week off coming up. Time to recharge and refocus.
Onward!
Its the last week of Term 2 and we took a brutal unit test which covered (among other things) acid-base balances, fluids and electrolytes. Hello, SCIENCE! This test wasn't just going to be about concepts, it was about the details. And if you didn't spend time on memorizing a bunch of data, you weren't going to be able to reason your way to the answer. Most of that material was along the lines of, "you either know it or you don't." Many didn't.
Unfortunately, right after that we had our first Drug Exam. I had heard these were brutal, and preparing for it sure was. Again -- it was about a bunch of data; long unrecognizable drug names attached to lists —why would it be prescribed, what action does it take in the body, what contraindications might there be, what signs and symptoms would be associated with those, what nursing care is required? Lists...lists...LISTS!
Even recalling these hazy days of studying, cursing, and suffering that lead up to these two exams gives me PTSD.
For me it's the worst kind of studying. I'm terrible at it. I have a hard time concentrating because it's dry. I embark on mini-acts of rebellion and self-harm. (Like writing curse words on my notes or eating pizza both for dinner at 1:30 a.m....AND for breakfast.) Still, I've learned that I always do better than I think I will, because I have a somewhat dubious gift--I can cram through a bunch of material and the next day go write a test on it and end up with a fairly decent grade. This does NOT comfort me, although many would be happy to have this skill. All this means is I can hold the information in my head for only so long as it takes to pass an exam. Ask me next week...and I promise you, it's gone. Long gone.
I'm also a fairly decent guesser.
When taking a multiple choice test, any time I don't know the answer, I'll pick one, but I'll write a question mark next to the question. At the end of the exam...I'll know how many question marks I had and can sometimes get a pretty good idea of what my score might be. Today was the first day I had an ALARMING number of question marks at the end, and I truly thought it would the first exam I would have EVER failed. (Here at nursing school, and also in my whole life.)
I ended up passing the unit exam with a good grade, but as we went through the test, I realized that I was getting a number of my question-marked questions correct. I still don't know the material, and had no rationale behind why I picked one over the other...truly I thought I was throwing a dart and randomly just selected any answer. They just happened to be the right answers.
The drug exam was a squeaker. Two more questions wrong and I would have bombed it. Failed.
I don't like how close I came to failing that exam. It was too close for comfort. I also don't like how quite a few lucky guesses got me that decent grade on material I will admit I still don't really know or understand. We'll also be covering this same stuff for the final exam this Friday -- and I'm going into it wondering how I'll study differently so I may end up with more answers I'm certain about, and fewer question marks.
I really don't want to bank on the fact that I'm a fairly decent guesser.
Pretty sure my future patients won't want to bank on that either.
I have one last complaint before I collapse in a boozy heap and conk out from pure exhaustion. (Because NOT going out for several beers today after the blood-bath just seemed wrong!) The timing of those tests stinks. Why both on one day? Especially because of the type of material it was, they could have spread them out. Why wasn't one tomorrow? We've got nothing going on tomorrow. In fact, we didn't even have our FIRST exam this term until week 4...surely by the end of week 2 we could have gotten one exam out of the way and pushed the whole schedule up.
From my perspective, overall organization of the schedule this term needlessly left us with a bottleneck of exams at the end. I've never been one to whine...I know that at times, things will just be hard. However, I do feel that the school didn't really get to see how well this cohort would be able to perform academically had the schedule been more spread out. I raise this complaint because I heard of so many students today who either failed one or both of those exams. I had a little wiggle room in my grade to be able to afford a hit. Too many students did not. I can't help but wonder if we'd all have done markedly better if given a day or two in between such difficult exams.
I know many are taking a hard look right now and asking some tough questions. Am I up to the academic standards needed to get through nursing school? ...Can I continue to hold down one or two jobs and still do it? ...Do I need to make adjustments in my life? ...Do I need a back up plan? ...A safety net?
We all need a break!
Good thing it's a week off coming up. Time to recharge and refocus.
Onward!
Wednesday, January 11, 2012
Buzzing 'Round Here
You can tell its a test week (luckily not for me) -- the seniors have one this week. Blessedly this week my cohort doesn't have one. Then we have something like 5 tests in the next 3 weeks. You won't be hearing a peep from me after this post. Yes--it's test week. Girls in sweats and messy pony tails flopped over every couch and comfy chair on every floor of the residence. Sprawled in the halls. Smudges under their eyes.
My class was back in clinicals this week. We go on Tuesdays to take care of our assigned patient. That means we do pre-planning on Mondays. The ratio of hours spent planning to take care of our patient, to hours spent actually caring for our patient seems to be about 1:1. Mondays we throw on our "assessment clothing" (career wear) under our lab coats and invade the ward -- looking for information about our patient, usually from the chart. We need to collect about a zillion data points in order to complete our paperwork, which will be due by end of day Tuesday. By the next morning we should be very familiar with what our patient has, how to care for them, what meds they are on (and what they do, what the side effects are, etc) and anything else relevant to their care--even though we have never met them. (We are welcome to meet them and even get our head to toe assessment done the night before...but who has the time?! --Actually it has more to do with interrupting their dinner and their sleep. Plus many of them are coming back from surgery and too groggy to put up with us.)
A person could go blind reading the charts. They are easily 4 inches thick and range from handwritten gibberish, nonsensical (to me) lab results, graphs, charts, and piles and piles of forms. I expect if we laid each page of a single chart end to end, we'd easily travel to the moon. The only good thing is that after weeks of hunting through them looking for the same information, I'm getting quite familiar with where to look. I'm getting faster. But it seems just as I get comfortable with something...they ask us for even more paperwork. So the ratio never really seems to change. One hour of pre-planning for every hour of care. At least for me. But I'm old and slow. :)
The graphic designer in me is chafing at the poorly designed forms I'm forced to work with. Information design is one of my favorite topics. Its both a science and an art. The healthcare industry could truly benefit by investing in good design. Productivity and comprehension would increase. Error and eye-strain...reduced. Everybody wins! Lord, even the user interface on the "new" computerized charting systems seems pulled right from the early 90's. Nightmare!
Don't even get me started on the signage and wayfinding systems. Cringe!
Tonight I'm studying for a vocabulary quiz on elimination. There are more latin-derived words to describe pee and poo than I ever could have imagined. Speaking of poo -- I encountered my first (and long feared) diarrhea adult diaper change this week, and conquered it. Man...somebody else in my class got to insert their first catheter, while another had a wound vac...how cool is that?! (A wound vac is a machine that basically shrink-wraps draining wounds and applies suction.) And all I got this week was lousy loose stool. I was recently exposed to some pretty gnarly wounds and I just can't wait for more so I can practice my newly acquired wound-care skills.
It is really weird what nursing students think is exciting.
My class was back in clinicals this week. We go on Tuesdays to take care of our assigned patient. That means we do pre-planning on Mondays. The ratio of hours spent planning to take care of our patient, to hours spent actually caring for our patient seems to be about 1:1. Mondays we throw on our "assessment clothing" (career wear) under our lab coats and invade the ward -- looking for information about our patient, usually from the chart. We need to collect about a zillion data points in order to complete our paperwork, which will be due by end of day Tuesday. By the next morning we should be very familiar with what our patient has, how to care for them, what meds they are on (and what they do, what the side effects are, etc) and anything else relevant to their care--even though we have never met them. (We are welcome to meet them and even get our head to toe assessment done the night before...but who has the time?! --Actually it has more to do with interrupting their dinner and their sleep. Plus many of them are coming back from surgery and too groggy to put up with us.)
A person could go blind reading the charts. They are easily 4 inches thick and range from handwritten gibberish, nonsensical (to me) lab results, graphs, charts, and piles and piles of forms. I expect if we laid each page of a single chart end to end, we'd easily travel to the moon. The only good thing is that after weeks of hunting through them looking for the same information, I'm getting quite familiar with where to look. I'm getting faster. But it seems just as I get comfortable with something...they ask us for even more paperwork. So the ratio never really seems to change. One hour of pre-planning for every hour of care. At least for me. But I'm old and slow. :)
The graphic designer in me is chafing at the poorly designed forms I'm forced to work with. Information design is one of my favorite topics. Its both a science and an art. The healthcare industry could truly benefit by investing in good design. Productivity and comprehension would increase. Error and eye-strain...reduced. Everybody wins! Lord, even the user interface on the "new" computerized charting systems seems pulled right from the early 90's. Nightmare!
Don't even get me started on the signage and wayfinding systems. Cringe!
Tonight I'm studying for a vocabulary quiz on elimination. There are more latin-derived words to describe pee and poo than I ever could have imagined. Speaking of poo -- I encountered my first (and long feared) diarrhea adult diaper change this week, and conquered it. Man...somebody else in my class got to insert their first catheter, while another had a wound vac...how cool is that?! (A wound vac is a machine that basically shrink-wraps draining wounds and applies suction.) And all I got this week was lousy loose stool. I was recently exposed to some pretty gnarly wounds and I just can't wait for more so I can practice my newly acquired wound-care skills.
It is really weird what nursing students think is exciting.
Friday, December 30, 2011
Hospital Holiday
Happy New Year from the farm in Portland! I've been down here for the last week after spending my first week of holiday up in Tacoma with friends. I wised up during this trip home and did more entertaining at "my place" rather than running around town having drinks, coffees, lunches, dinners and happy hours with friends -- and thus wearing myself out. "My place" is actually my girlfriend's house and it was fun being able to cook big meals, have people over and veg in front of the fire to watch White Christmas. So happy I was able to go back to my old company and join them for their Christmas party and catch so many of the friends I have there for a quick visit.
I thought I was getting a break from hospitals for a couple of weeks, and then my 94-year old grandpa got sick and we spent Christmas Eve in the ER with him. It was actually quite heart-rending as he decided against having surgery to correct a twisted bowel, instead choosing to let "nature take it's course," meaning he would die in several days. He was moved to the ICU and I watched the doctor respectfully plan his care around grandpa's wishes, however much he believed he could "fix him." We were all so stunned by the turn of events, as we thought he'd just go in for some kind of enema (constipation being his chief complaint) -- and instead being faced with the big end-of-life decision that night. I was still wrapping presents at one in the morning on Christmas Eve...the baking we planned to do that day having been abandoned. Instead we looked around this 80-acre spread, and the spacious home where we always gather and realized it would be our last holiday here. We were all so sad.
Christmas morning we gathered and listened as dad got a surprising call from the ICU...grandpa had changed his mind and decided to FIGHT! Present-opening was postponed as mom and dad went to see him through surgery. Our moods immediately lifted and Christmas became a happier day for us.
Coming home this trip I have learned SO much. In no particular order:
I thought I was getting a break from hospitals for a couple of weeks, and then my 94-year old grandpa got sick and we spent Christmas Eve in the ER with him. It was actually quite heart-rending as he decided against having surgery to correct a twisted bowel, instead choosing to let "nature take it's course," meaning he would die in several days. He was moved to the ICU and I watched the doctor respectfully plan his care around grandpa's wishes, however much he believed he could "fix him." We were all so stunned by the turn of events, as we thought he'd just go in for some kind of enema (constipation being his chief complaint) -- and instead being faced with the big end-of-life decision that night. I was still wrapping presents at one in the morning on Christmas Eve...the baking we planned to do that day having been abandoned. Instead we looked around this 80-acre spread, and the spacious home where we always gather and realized it would be our last holiday here. We were all so sad.
Christmas morning we gathered and listened as dad got a surprising call from the ICU...grandpa had changed his mind and decided to FIGHT! Present-opening was postponed as mom and dad went to see him through surgery. Our moods immediately lifted and Christmas became a happier day for us.
Coming home this trip I have learned SO much. In no particular order:
- Once a nurse, always a nurse. It was my sister (the RN) who determined my grandpa needed to get to the hospital to be seen. She began texting me the night before as she joked, "ever given an enema?" Knowing she was being asked to administer one to grandpa...and that she was hoping I'd step up and grab this "training opportunity" -- I texted back something to the effect of; "Nope...and I know where you're going with this...I'd NEVER perform a procedure for which I hadn't been properly trained!" :D Still, the exchange was foreshadowing what came next.
- Pay attention to S&S: Signs & Symptoms. By the morning of Christmas Eve I awoke to 4 text messages from my sister describing what she saw with grandpa: huge distended belly. Hard upon palpation. Hypoactive (nearly absent) bowel sounds. Complaints of "discomfort," (grandpa has never even spoken the word "pain.") BP 30 points higher than baseline. Crackles in lungs. Labored breathing. Edema bilaterally in lower limbs. Reading all of that I remember thinking to myself...this is bad. My sister and I were both thinking it was something cardiovascular. The ER admitting nurse thought it was too.
- Respect the patient. Especially the elderly. And when it's family. Hearing grandpa say he wanted to die rather than come home with a colostomy bag...that he wasn't enjoying life anymore...that he was ready to die—this was hard to hear, but my first reaction was; this is his choice. I love him and I'm going to support how he chooses to exit this world, even though it hurts and shakes the foundations of my life. We were all relieved when he made a different decision the next day, but I would have been willing to see it through either way. However, yesterday my sister came back from seeing him in the hospital and she was miffed. The nurse's aid, several times within grandpa's hearing, called my grandpa "cute." This man is a WW2 Army Air Corps Lt. Colonel and flew with President Eisenhower. He is a hunter and a fisherman. He is a world traveler, taking trips to every exotic corner of the globe well into his 90's. A life-long farmer, he has taken legal cases on behalf of farmer's rights all the way to the Supreme Court! He. Is. NOT. Cute! Healthcare workers would do well to respect the person in the bed, as old and as sick as they may be.
Myself? I'll be heading back to Pittsburgh and nursing school. I have 4 more weeks of crazy tests and competencies left in Term 2 and then there'll be a week off before starting Term 3. This next term marks the end of my "honeymoon phase" at school--in which my schedule was much less busy than the other students, since I had brought many transfer credits in and didn't need to take the full load of courses. That all changes as I catch up with my cohort for spring term. I'll be in class or the hospital five days a week, from 7:30 a.m. until 5:00 p.m.
I'll try not to whine much, but expect to see some of that in future posts.
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