I loved my two OR experiences. LOVED them! I know for sure I don't want to work in one...at least, not right now. But the experience was so rewarding.
Last week I got to see a surgeon hunting for a bullet that had been lodged for 2 years in the guts of my dear, sweet patient. The doc hunted for that thing like an easter egg before giving up and repairing the damage it had done to his parts so he could look forward to a "normal life." I met the patient before the surgery, watched his insides get rebuilt for several hours, and then stayed with him in the PACU for a couple more hours since he had nobody there to hold his hand, except his two prison guards. We had a good talk about his hopes and dreams and I didn't leave his side until I was made to go.
Did I mention he was a prisoner?
I wish I could share how much this case touched my heart and reminded me of why I wanted to be a nurse in the first place, but...there are privacy laws. Let me just say that I hope I never forget him. The other students watched as I fed him his ice chips and stayed close so he wouldn't be afraid and declared that if they are ever in the hospital, they want ME as their nurse!
Aw...shucks.
Today was my final day in the O.R. rotation and I faced another fear. The fear of watching the gore that is an orthopedic joint surgery. Why is this my fear? Because I had four surgeries to rebuild my humpty-dumpty left arm not so long ago, and have some titanium in there to prove it. Since I'll be facing more of such surgeries in the future (for maintenance) -- I just wasn't sure I was up to seeing up and bloody close just what goes on in there!
Meh. No big deal. I was glued to the procedure the whole time. I orbited all around the table to make sure I saw every drill, wire and bolt. It was disgusting and fascinating. I loved it.
What I do NOT love about the O.R....
The fashion. Really, the only way to express oneself is by way of eye makeup. (Designers like to express themselves.) It's kind of like a Burka-Situation. The puffy blue hats are as far away from sexy as possible. And you can think some guy could be good looking under all the layers of blue...and yet be disappointed when the patient is rolled away and the guy lowers his mask.... I'm just saying.
It's a meat locker. If you are perpetually cold, like me, this environment is unacepptably frigid. Good for patients because bacteria like warm places to grow. Bad for me. The menopausal ones around me LOVE it.
The lead. If you are going to work in an orthopedic OR, they will ask you if you are wearing lead. You may think about the uncomfortable underwire bra for a second, and then say no. And then they will wrap you in an apron of lead down to your knees and you'll stagger away under its weight. They take lots of x-rays while they drill holes in bones. You will consider your pre-osteoporotic bones, and of the discs of your spine crushing in on themselves under the weight of this new torture device. You will wonder why you didn't drink more milk and if you will be two inches shorter by the end of the day. Bad enough that you will be standing on your feet for four hours in a meat locker, but now you are also shrinking.
And then the surgery will be over and you will take off the lead...
And you will float away!!!
Tuesday, April 10, 2012
Friday, March 30, 2012
Friday...Glorious Friday
It isn't uncommon for me to feel like I "crash land" into Friday at the end of every week while in nursing school - however this week is more like a meteor plummeting from space. This is because last night marked the first night that I (among a small group of hearty souls) pulled an all-nighter before our exam this morning.
Now I remember why I don't do that anymore.
The grades aren't where I'd like them to be this term. I had anticipated this coming into it because of the heavier class load, however, I'm not thrilled that I was proven right. I don't mind the grades dipping, since I never started out with the idea of being an A student. I want to be a balanced student. However I'm especially displeased that I'm missing points this term simply due to Operator Error! I failed my first exam in my life this term -- which was extremely puzzling since I knew I had prepared at LEAST enough to PASS. Well in the post-mortem, it turns out I marked an answer on the answer sheet on the wrong line, and that made the subsequent five (correct) answers, also wrong! Doh! I don't mind missing points for answers I had no clue about, but it does chap my hide to miss them because I didn't bother to go back and check that I'd filled them out correctly!
Still, the poor grade is a black mark on this term's grade-book for me, and is in part why I decided to cram all night for today's exam, on which I did admirably - but still not up to my usual standard.
I think I've just identified the theme for this term: Not Up To My Usual Standard.
How very underwhelming.
We are two weeks away from finishing term 3 and yes, that theme just about sums it up. As promised, the term was incredibly hard academically (and the beatings are far from over). I found myself hitting new lows in every area: emotionally, academically, endurance, nutrition, exercise...and personal hygiene.
An older gentleman stopped me as I was leaving my favorite diner/study spot this weekend, put his hand on my arm and said, "good luck in nursing school -- it's the hardest thing you'll ever do." (I was wearing my school sweatshirt.) I said, "You a nurse?" He smiled and said yes. I wanted to throw myself into his arms and cry, but instead I gave him a wobbly smile and said, "It IS hard, in fact...it's kicking my ass!" And we both laughed.
It has been kicking my ass, I'm not going to lie.
And in the middle of the "fog of war" -- I'm amazed at the things that can occupy my mind and interrupt my thoughts. All of them seem oriented around the bottom of Maslow's Hierarchy of Needs. The following list are random thoughts I have had during lectures about gangrene, osteoporosis, amputations, etc:
[I am estimating I will fall a few points in terms of your respect for me now...]
"I wonder when I last washed my hair?"
"Did I wear these clothes yesterday?"
"When did I last eat?"
"I wonder if I have any money."
"I wonder if the cafeteria has pie."
"Mmm...I put clean sheets on my bed. Man, I want to be in my bed right now." {I actually yearn for my bed like a lover on most days.}
"How can I write this Care Map and still watch Idol tonight?"
"Did I go pee yet?"
"OMG -- am I out of BUTTER? How can I make popcorn and study all night without BUTTER?!"
Yes -- lofty thoughts, those. Oh sure, other stuff breaks through now and then. Things like world peace and the fallen state of man, n' such. But don't be surprised if you call me one day and say...what about those elections? And I say...what elections?
It's that bad.
Now I remember why I don't do that anymore.
The grades aren't where I'd like them to be this term. I had anticipated this coming into it because of the heavier class load, however, I'm not thrilled that I was proven right. I don't mind the grades dipping, since I never started out with the idea of being an A student. I want to be a balanced student. However I'm especially displeased that I'm missing points this term simply due to Operator Error! I failed my first exam in my life this term -- which was extremely puzzling since I knew I had prepared at LEAST enough to PASS. Well in the post-mortem, it turns out I marked an answer on the answer sheet on the wrong line, and that made the subsequent five (correct) answers, also wrong! Doh! I don't mind missing points for answers I had no clue about, but it does chap my hide to miss them because I didn't bother to go back and check that I'd filled them out correctly!
Still, the poor grade is a black mark on this term's grade-book for me, and is in part why I decided to cram all night for today's exam, on which I did admirably - but still not up to my usual standard.
I think I've just identified the theme for this term: Not Up To My Usual Standard.
How very underwhelming.
We are two weeks away from finishing term 3 and yes, that theme just about sums it up. As promised, the term was incredibly hard academically (and the beatings are far from over). I found myself hitting new lows in every area: emotionally, academically, endurance, nutrition, exercise...and personal hygiene.
An older gentleman stopped me as I was leaving my favorite diner/study spot this weekend, put his hand on my arm and said, "good luck in nursing school -- it's the hardest thing you'll ever do." (I was wearing my school sweatshirt.) I said, "You a nurse?" He smiled and said yes. I wanted to throw myself into his arms and cry, but instead I gave him a wobbly smile and said, "It IS hard, in fact...it's kicking my ass!" And we both laughed.
It has been kicking my ass, I'm not going to lie.
And in the middle of the "fog of war" -- I'm amazed at the things that can occupy my mind and interrupt my thoughts. All of them seem oriented around the bottom of Maslow's Hierarchy of Needs. The following list are random thoughts I have had during lectures about gangrene, osteoporosis, amputations, etc:
[I am estimating I will fall a few points in terms of your respect for me now...]
"I wonder when I last washed my hair?"
"Did I wear these clothes yesterday?"
"When did I last eat?"
"I wonder if I have any money."
"I wonder if the cafeteria has pie."
"Mmm...I put clean sheets on my bed. Man, I want to be in my bed right now." {I actually yearn for my bed like a lover on most days.}
"How can I write this Care Map and still watch Idol tonight?"
"Did I go pee yet?"
"OMG -- am I out of BUTTER? How can I make popcorn and study all night without BUTTER?!"
Yes -- lofty thoughts, those. Oh sure, other stuff breaks through now and then. Things like world peace and the fallen state of man, n' such. But don't be surprised if you call me one day and say...what about those elections? And I say...what elections?
It's that bad.
Tuesday, March 13, 2012
Gag-O-Meter
I have rejoined the living after the busy day at clinicals, thanks to my three hour power nap. I still have much to do and its already rounding on midnight, so instead of getting started on all that...of course I'll blog.
First of all, I kind of smirk when I type: "busy day at clinicals." At this point, I really think the words "busy day at" should just be implied. I think I have a really high tolerance for change on the fly. Heck, I ran a design studio for years, full of creative and brilliant lunatics. There existed no linear process of A to B. I honestly don't know how folks could enter the medical profession if they were wired to expect to make a "plan" and then "follow it" to the letter. Still, even I am constantly adjusting to the whole new world of crazy that is the hospital floor. As we are learning in school, there is the "ideal outcome" for any given situation, and then...there's what really happens. Reconciling how far apart those two things really are is always surprising for me. And I'm a Type B! Lord help all those Type A nurses out there!
One incident today (among several less interesting things) shot my best laid plans all to hell. It also makes for an interesting story, although those of you with a delicate constitution may like to skip it and go back to whatever it was you were doing.
THE HEMOVAC.
Sometimes when you have surgery you'll wake up attached to a circular accordion-like vessel which is about the size of a saucer. The surgeon will squish down this plastic device, which is attached to a tube inside your surgical site, and which will then provide a bit of suction and a place for that nasty stuff to collect outside your body. This is a Hemovac, and today my knee-surgery patient had that snaking out of his tidy full-leg bandages on his first morning post-op. Of course I was excited to see it, since it would be something new for me to experience. He also had a couple of wires sticking out of his tush, a nerve block that kept his whole leg blessedly numb. In other words, he had a lot of lines which could potentially detach from him and ruin both of our days.
Of course that's exactly what happened...and how I discovered the presence of my Gag-O-Meter.
Man, we were SO close to the end of my time with him and everything before that had gone swimmingly well. I even got to give him his mid-day IV push medication. Afterwards my instructor had gone over how I would empty his drain, as it was now expanded about two inches full of blood, and courtesy suggests we don't leave these messy tasks for the next shift...we take care of them before we go. She trustingly left me to do this solo and went to deal with another patient. However, for moral support, I snagged another student who had just completed this task and was willing to talk me through it. Since it was essentially a bag of blood, I figured a mistake could easily ruin both my stark white outfit, AND my reputation!
So my patient was tucked neatly into the freshly made bed (which I had just finished making up while he was at PT) and was starting on his lunch of rubber turkey and powdered mashed potatoes when we approached to deal with the Hemovac. I flipped back the crisp white covers and instead of the cleanly bandaged leg resting on clean white sheets -- he was laying in a bed of gore! Bright red blood was leaking through his thick bandages, beneath him on the bed pad and all over the covers! (My bed!) His drain, and its now detached tube were lying impotently beside him. Since his leg was fully numb, he couldn't even sense the wetness he was lying on.
Rather calmly, the other student and I began to deal with the situation. She went to get a nurse, while I remained with the patient. The male nurse came in, glanced at the bed full of gore and diagnosed blandly, "Drain's out." (Clearly this was a "no-DUH" moment, but I repressed it.) The patient stated that he felt a little tug about 30 minutes ago, and we deduced that shifting around in bed had pulled the tube out. (I realize this isn't exactly rocket science.)
The nurse and I then emptied the drain out of the patient's line of sight, thankfully. I held the measuring cup and he squeezed. The thing is, it's blood. It doesn't just drain right out when you open the valve (say, like urine would.) I hadn't really thought about that fact ahead of time and I was already somewhat steeled to participate in this gross task. (You just never know what event is going to cause you to toss your cookies.)
If you can picture me on a television screen this whole time, down at the bottom of my screen would pop an animated meter - my Gag-O-Meter, which goes from zero to ten.
It was at zero when I entered the room. And I am proud to report that it didn't really twitch when we flipped back the covers to see the bloody mess. When I held the cup and felt the warmth of the blood filling it, the meter moved up to a 1. No big deal. But it wasn't until the nurse began to squeeze the drain, and this long, dark clot just hung there suspended, and then slowly began to snake, quiver and coil its way into my warm cup that the Gag-O-Meter moved up a couple more points. I realized that if I had been: pregnant, hungover, or was just getting a stomach flu, I probably would have hurled. I couldn't tear my eyes off of the seemingly endless clot, and kept worrying that the nurse would squeeze a bit too hard to force it through and maybe spray us both, thereby soiling my outfit -- (at which point, I very well may have soiled the floor.)
I think the Gag-O-Meter got to about a 3 today. I'm betting at a 5, I would actually gag. At a 10, that's when somebody would be holding back my hair. I periodically wonder when/if these events will happen for me personally. Perhaps it will be in a couple of weeks during my OR rotation. If not, I have a sneaking suspicion that another body fluid may send me over the edge when I start to suction tracheal tubes in the ICU...
Phlegm.
First of all, I kind of smirk when I type: "busy day at clinicals." At this point, I really think the words "busy day at" should just be implied. I think I have a really high tolerance for change on the fly. Heck, I ran a design studio for years, full of creative and brilliant lunatics. There existed no linear process of A to B. I honestly don't know how folks could enter the medical profession if they were wired to expect to make a "plan" and then "follow it" to the letter. Still, even I am constantly adjusting to the whole new world of crazy that is the hospital floor. As we are learning in school, there is the "ideal outcome" for any given situation, and then...there's what really happens. Reconciling how far apart those two things really are is always surprising for me. And I'm a Type B! Lord help all those Type A nurses out there!
One incident today (among several less interesting things) shot my best laid plans all to hell. It also makes for an interesting story, although those of you with a delicate constitution may like to skip it and go back to whatever it was you were doing.
THE HEMOVAC.
Sometimes when you have surgery you'll wake up attached to a circular accordion-like vessel which is about the size of a saucer. The surgeon will squish down this plastic device, which is attached to a tube inside your surgical site, and which will then provide a bit of suction and a place for that nasty stuff to collect outside your body. This is a Hemovac, and today my knee-surgery patient had that snaking out of his tidy full-leg bandages on his first morning post-op. Of course I was excited to see it, since it would be something new for me to experience. He also had a couple of wires sticking out of his tush, a nerve block that kept his whole leg blessedly numb. In other words, he had a lot of lines which could potentially detach from him and ruin both of our days.
Of course that's exactly what happened...and how I discovered the presence of my Gag-O-Meter.
Man, we were SO close to the end of my time with him and everything before that had gone swimmingly well. I even got to give him his mid-day IV push medication. Afterwards my instructor had gone over how I would empty his drain, as it was now expanded about two inches full of blood, and courtesy suggests we don't leave these messy tasks for the next shift...we take care of them before we go. She trustingly left me to do this solo and went to deal with another patient. However, for moral support, I snagged another student who had just completed this task and was willing to talk me through it. Since it was essentially a bag of blood, I figured a mistake could easily ruin both my stark white outfit, AND my reputation!
So my patient was tucked neatly into the freshly made bed (which I had just finished making up while he was at PT) and was starting on his lunch of rubber turkey and powdered mashed potatoes when we approached to deal with the Hemovac. I flipped back the crisp white covers and instead of the cleanly bandaged leg resting on clean white sheets -- he was laying in a bed of gore! Bright red blood was leaking through his thick bandages, beneath him on the bed pad and all over the covers! (My bed!) His drain, and its now detached tube were lying impotently beside him. Since his leg was fully numb, he couldn't even sense the wetness he was lying on.
Rather calmly, the other student and I began to deal with the situation. She went to get a nurse, while I remained with the patient. The male nurse came in, glanced at the bed full of gore and diagnosed blandly, "Drain's out." (Clearly this was a "no-DUH" moment, but I repressed it.) The patient stated that he felt a little tug about 30 minutes ago, and we deduced that shifting around in bed had pulled the tube out. (I realize this isn't exactly rocket science.)
The nurse and I then emptied the drain out of the patient's line of sight, thankfully. I held the measuring cup and he squeezed. The thing is, it's blood. It doesn't just drain right out when you open the valve (say, like urine would.) I hadn't really thought about that fact ahead of time and I was already somewhat steeled to participate in this gross task. (You just never know what event is going to cause you to toss your cookies.)
If you can picture me on a television screen this whole time, down at the bottom of my screen would pop an animated meter - my Gag-O-Meter, which goes from zero to ten.
It was at zero when I entered the room. And I am proud to report that it didn't really twitch when we flipped back the covers to see the bloody mess. When I held the cup and felt the warmth of the blood filling it, the meter moved up to a 1. No big deal. But it wasn't until the nurse began to squeeze the drain, and this long, dark clot just hung there suspended, and then slowly began to snake, quiver and coil its way into my warm cup that the Gag-O-Meter moved up a couple more points. I realized that if I had been: pregnant, hungover, or was just getting a stomach flu, I probably would have hurled. I couldn't tear my eyes off of the seemingly endless clot, and kept worrying that the nurse would squeeze a bit too hard to force it through and maybe spray us both, thereby soiling my outfit -- (at which point, I very well may have soiled the floor.)
I think the Gag-O-Meter got to about a 3 today. I'm betting at a 5, I would actually gag. At a 10, that's when somebody would be holding back my hair. I periodically wonder when/if these events will happen for me personally. Perhaps it will be in a couple of weeks during my OR rotation. If not, I have a sneaking suspicion that another body fluid may send me over the edge when I start to suction tracheal tubes in the ICU...
Phlegm.
Saturday, March 10, 2012
How to Look Like a Dumbass in Nursing School
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!
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 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.
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