Clinicals

Clinicals were very stressful. It was like living in your own little world for about 2-3 days a week because you have all of this information to write down and put in your head for quick retrieval. It gave me horrible hand cramps from all the writing. In fact, our first year, we had to literally write out each drug card. Not typed, not pre-printed, but hand-written. It sucked, especially when I had a patient like patient 1 below. We prayed for the patients with only like 5 medications. But I also learned those medications very well because of it. In our second year, which is exampled below, we were allowed to type up the drug cards or use the pre-printed ones if we had them. Most of us didn’t, we just typed and printed them ourselves. One day, in our first year, I had a patient with anemia. Instructor wants me to write up ALL the anemias. I could have died. Do you know how many there are??? My hand cramped for like 3 days after that because we had to hand write those too. She was a tough one, but I respect her for it, even today. Ok, so you want to know what it was like in my clinical experience? Read below.
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Here is an example excerpt from my clinical experience:
Day 1: Attend lecture. Get patient assignment for the next day, which will be 2 patients.
Patient 1:
Diagnosis: Pneumonia. Patient history includes: HTN, DM, COPD, CHF, Hypothyroidism, AFib, GERD, CAD, CABG (2005), Bilateral Fem-Pop (2003, 2006), Smoker.
Med List: Protonix 40 mg, Atenolol 25 mg, Lisinopril 40 mg, Diovan 80 mg, Reglan 10 mg, Digoxin 0.125 mg, ASA 81 mg, Glucophage 1000 mg, Glucotrol 5 mg, Levothyroxine 100 mcg, Pravachol 20 mg, Lasix 20 mg, Aldactone 25 mg, Coumadin 2 mg, Novolog Sliding Scale, Lantus 40 units, Multivitamin, Zosyn 3.35 grams, Solumedrol 60 mg, Levaquin 500 mg, Xopenex/Atrovent nebs, Advair, Spiriva, Nitropaste ½ inch, Nicotine patch 21 mg, Ativan 0.25 mg, Gabapentin 600 mg, Hydrocodone 5/500 mg prn moderate to severe pain, Tylenol 650 mg prn mild pain, temp > 101.
Treatments: Blood sugar glucometers AC/HS, O2@3L per NC, Nebs q6 hours, Daily PT/INR, daily weight
Patient 2:
Diagnosis: Acute Pancreatitis. Patient history includes: GERD, ETOH abuse, Smoker, Cholecystectomy (2000), Appendectomy
Med List: Protonix drip 8 mg/hr, Demerol 50 mg, NS with MVI, Thiamine and Folic Acid to each liter @ 80 cc/hr, TPN @ 60 cc/hr, Lipids @ 10 cc/hr [total 150 cc/hr IVF], Nicotine patch 21 mg, Novolog Sliding Scale, Ativan 1 mg prn, Librium 50 mg prn.
Treatments: Blood sugar glucometers q 6 hours, Central line, Neuro checks q shift and prn, NGT to LIS with 30 cc irrigation q shift, bilateral soft wrist restraints

With assignments in hand, off to the facility (45 min away) for chart information to include: H&P, lab data, and any other information pertinent to the preparation tool and treatments scheduled. This takes 2 hours of writing stuff down and then 1 hour to drive home.
Get home. Make sure uniform is clean and ironed, if not , throw it in washer stat. Order pizza. Kids love you for ordering pizza. Send kids in other room to watch whatever they want. Kids love you more because they can watch Spongebob, Sportscenter, videos all evening as long as they get their homework done. Hole yourself up at computer or desk or kitchen table with all your Med-Surg, Drug, Lab, and Care Plan books. Write up the main medical diagnosis and one additional diagnosis for each patient – complete disease pathology plus anything else the book has in it so nothing is missed. Make a list of nursing diagnoses and care plan interventions expected for each patient. List all abnormal and pertinent normal laboratory data with explanations of each and why abnormal. Write or type up each medication listed on index cards to include: name, action, dose and route, contraindications, administration information, side effects, and nursing implications. Make sure kids are bathed and tucked in by 10 pm. You finally get to bed at 1 am.

Day 2: Alarm goes off at 4 am. Shower. Iron uniform if not already done. Pack bag with all needed nursing supplies, paperwork, and whatnots. Leave house by 5:15 am. Get to facility at 6:20 am and on the floor by 6:30 am for pre-conference. Discuss expectations of patients and their diagnoses. Get report from floor nurses. And off to the floor to begin your patient care. You are selected to give medications today on both patients. You have to do all patient care to include toileting, baths, linen changes, meals, etc. Also reviewing drug cards so that when quizzed by the instructor, you know these medications and why they are being given. You also have to find time to write your notes and assessments for review by the instructor. She would like to have these by 10 am. Continue throughout day until 3:30 pm when you break for post-conference. Leave facility by 4:30 pm. Get home by 5:45 pm. Plop on couch. Nap for 30 minutes until kids wake you up. Take youngest child to basketball practice. Bring sandwiches to eat on the way for dinner. Get home at 9 pm. Put uniform in washer again. Review paperwork for tomorrow and make any needed changes. Iron uniform tonight. All in bed by 11 pm.
Day 3: Alarm goes off at 4 am again. Get up at 4:30 and shower. Bag still packed from yesterday. Enjoy extra 15 minutes of coffee. Get to facility by 6:15 am and repeat yesterday all over again. Leave facility by 3:30 pm today as instructor will do post-conference in class tomorrow after the test. Get home and finish up clinical paperwork due tomorrow. Fix a real dinner tonight and get kids to help with clean up. Gather books and notes to study for test tomorrow. Get to bed by midnight.
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How the day went in the hospital depended largely on the patient. If you had a lot of extensive things going on, like above, it would be so hard to get everything done, but you did it. You knew your drugs. You knew their medical diagnoses in and out and could spew off tidbits of information at the drop of a hat. When the instructor asked you about the most obscure medication on the list and you didn’t know it, she would let you look it up and then tell her about it. One thing about clinical is that your fellow students were usually there to help if needed. And your instructor was always available. It was a team work environment. But I am so glad it is over :)

yeah.. it's official!!

so i took the leap and took the nclex this past tuesday. never before have i ever been to the almost panic level of anxiety, but i was almost there on monday night! i couldn't even stay to watch my youngest son's final season baseball game because i was so nervous. amazing how one test will do this to you. arrived at the testing center early.... sure didn't want to be late! lol.
went through the entire ordeal of security measures to enter the testing room... took the test. it cut off at 75 questions and then came several days of nausea, nervousness, lack of concentration, etc until i finally gave in and called the bon to see my results....... i was prepared for the bad news, but they told me that i PASSED! i literally cried lol. cried from relief of all the anxiety i had been feeling the past few days. my nausea instantly disappeared. i felt 100 feet tall. how dare them make me feel like that LOL!

i just find it also amazing that 75 questions determines a person's competency to be a nurse. the questions i had were... well HARD as hell. no doubt about it. i felt like an idiot when i left that place. i had medication questions for drugs i wasn't even sure were in the drug book :) lord knows i had never heard of them.. how was i supposed to tell the nclex people what side effects or interventions to look for/do?? but it is all water under the bridge now. i no longer have to sign my name with RN-A (A = applicant) anymore! i can push forward in my preceptorship toward my goal of working the ICU. I externed in there for 9 months, and was hoping to get a job in there after school, but unfortunately, my manager, and probably wisely so, does not hire new graduates to work in the unit. so i will do my time in med-surg. learn my time management, charting, and so on, so that i can move my career forward. i owe them at least 6 months on the floor until i can change positions, but if i do have give my employer 1 year for certain.

i would entertain the possibility of working in the ER, but there are some things that just simply gross me out... like protruding eyeballs for one lol. but other than that, i know i would do much better with a faster paced environment. so we will see where the future takes me. i just know that there are several places i would entertain the thought of working and some places i have absolutely no interest in working. now that i am officially an RN, i hope many doors open for me wherever i choose to land.

I rock @ shock

Just wanted to post some bragging rights here... :) we had our test on shock, code management, acute resp failure & ards this week and oh yeah.. got a 98!! i was flying high on that grade, especially after doing so bad on the previous test. Sure did make me feel great!

Final exam is next week... I just cannot believe that it is almost over, still. Planning on taking a little vacation over the next 2 weeks. Grades are due by May 10, so am hopefully expecting my ATT sometime in the week of May 15. I am scared to death of scheduling for the nclex, taking the nclex, failing the nclex. All i can do is prepare, prepare, prepare. Do my best. Pray to god for a passing score. All I can do.

I had meant to share more of my clinical stories this semester and some more of my work stories, but between taking 3 classes this semester and working, it was all i could do just to manage that, let alone the kids and their extracurricular activities. Hopefully, one of these days I will be able to put more of these stories together. Well, off on a studying/reviewing journey I go.

58 down, 2 to go

I can't believe that there are only 2 more weeks left of my nursing classes and I AM DONE. Finished. Of course, this is assuming that I am going to pass the class :) After the horrid test we took today, I am so very, very thankful I had a great average with some cushion. Just need to rock the next test and the final exam and I will a-ok.

I hope that the college sends the transcripts soon to the board of nursing. I am really hoping to schedule my test in the beginning of june. I am scared to death of taking the nclex. completely. totally. scared. I guess this is normal to have this anxiety about it. I mean after all the work and time and life-changing events/priorities, I would just die if I don't pass. I honestly don't know what to think or do.

On another note, I interviewed at another local hospital last week for a position in ob and er. I felt that the interview went well, but truth be told, I really wanted a position in the icu, for which I am interviewing for this coming wednesday. the problem is that this hospital does not pay as well as the one I currently work, so it just makes the decision even harder. I guess I have to actually be offered the position first - duh - but in case that happens, i want to be prepared of what I am actually planning on doing. I do hate not knowing what I am planning on doing. I have just been too indecisive on this. Guess I will just see how things go and then make a decision from there. Gotta get my pros/cons list out right away though and formulate some questions to ask in the interview.

guess i really need to catch some zzzzz's. first tuesday in awhile that i don't have to get up before dawn and go to clinicals *grin*

One step closer

tomorrow and wednesday will my LAST clinicals forever :) unless of course i continue on to pursue my BSN, which I am planning on doing soon in the future. but i am just so excited to be that much closer to finishing. Finally got the monster of a community assessment finished and turned in.. phew. hated that project with a passion! put in an application at another hospital.. want to keep my options open. not to mention that will be a greater opportunity for learning experiences at this other hospital if i can get the job :) keeping fingers crossed. the downside is that it will require some commuting, so they will have to offer a comparable package to the one in which i have already been offered.

i can't wait to have a normal life again. i have felt bound to textbooks and interventions and rationale for the past 2 years and now i just want some free time, me time, and most of all, put some real order back into this house, which has books and books and books all over, wherever i plan on working that night lol.

ok, enough rambling for now. i must go get some sleep. alarm comes early in the morning.

Indecisions

I have been officially offered a job where I work. Not in the ICU like I had hoped, mostly because there aren't any open positions in there at the moment. The job is on the medical/telemetry floor, full time nights. My indecision comes from a potential desire to work somewhere else. I am just not sure if I am making the right decision, although it is possible that I am. At the other hospital where we do our clinicals, there are openings in the ICU, and I really enjoyed my experience in that unit as well as the way that hospital handles things a bit differently. I wonder do all students go through the same indecision as I am about where to work when they are finished, or do they know exactly where they want to work and there is really no other option for them.

We have 5 weeks left of school. 5 long weeks. But only 2 more weeks of clincal left :) I am so excited to be thisclose to being finished. Although the next 5 weeks is going to be full of tests, ATI tests mostly. I think we have at least 7 of them to take. I have mailed my application for licensure to the board of nursing and paid my nclex examination fee. Now just waiting for classes to be done, transcripts to be sent, and receiving my att so that I can schedule my exam. My nerves are shot... shot to hell. I have to finish writing up my part of this huge community assessment that we have had to do this semester (hate all aspects of this project, btw). Have to finish my portfolio for leadership, and study, study, study. In the meanwhile, my oldest son is on the JV baseball team at school, youth league baseball has started and I am only one person able to be in one place at one time. I can't feel more pulled in different directions than I do right now. Will it ever end? I know it will, but what will I do when it does?

I am sure that I will want to catch up on a couple years of lost sleep lol.

it's just a little different now...

well the nurse manager where i work has decided to fill the open positions in the ICU, so it seems as though I will most likely be starting out on the tele/med-surg unit. Actually, it is quite ok with me. I love working in the ICU, but I am not stupid to think that I shouldn't get good floor experience before moving into a specialized area. It is a bit of a relief because now I don't have to rush to take ACLS or anything like that before moving into there. :)

We got the papers to fill out our official application to sit for the nclex exam after graduation. Just having the papers and the book makes me nervous lol. Just thinking about filling it out makes me nervous. What if I make a mistake? I guess I will really have to review it before filling it out to make sure it is all right when I hand it in. Nervous.

Ahh well, am sure things will work out in the end as they are supposed to be. I won't spend a lot of time worrying about the little stuff because I have too many other things to do and other things to worry about, such as my test coming up on Monday and my other classes as well.

Ok off I go to review a bit before getting ready for work.

weight a minute

Last week, I had a really great learning experience. This week, my assigned patient (Yes, we were supposed to have 2 this week. Unfortunately, census was down so we only had 1.) Anyhow, my assigned patient was admitted over the weekend with a change in mental status. Try writing that up for clinical prep – shoot there are so dang many things that contribute to a change in mental status. It is difficult to know which direction to effectively write up without knowing any further history. But I got it done. Arrive at the clinical hospital 0630, ready to go. Get report on my patient, learn some things important, like there was a right subclavian portacath. (immediately knew that she was most likely a cancer patient, since they tend to have these for chemo medications). She was s/p breast ca and a left radical mastectomy. She became seriously confused, was admitted, and had a raging UTI.

It’s no secret that a UTI will cause a confused presentation in the elderly. Much documentation has been done on that subject alone. Heck, Pope John Paul the III died from a UTI that progressed to sepsis. But this woman was only 50. Hmm.. ok, I thought. Also learn that she has a positive history for diabetes and hypertension. Pretty common these days, especially together. But I was not prepared for her. Not by any means. You see, I walk in to greet her, and find out she was the size of the hospital bed itself. Literally. They had ordered the special bed for her, but it had yet to come in. So in the meantime, she is packed into the regular bed on an air mattress. She couldn’t turn or move because there was no room. None. She is 530 lbs. And full of fluid.

She has widespread anasarca, which is now weeping and causing skin breakdown. Everywhere. Straie were puffy and full of fluid, looking like they would bust at any moment. Left lower leg is dusky and her toes are almost black. Her skin is literally sloughing off from the fluid overload. But that wasn’t even her main problem. Nope.
Although that in itself is pretty horrible to see, it must be even more horrible to experience.

Her main problem, however, was pancytopenia from the chemo. Her WBC count… normally 5-10, were 0.9. Hgb was 7.9 after a unit of prbc’s and procrit. Most seriously though… her platelets were 6, when normally 150-450. There was petechiae everywhere and purpura over her left leg as well. DIC was a formidable risk, and ever present in the mind. Sure she had open sores where her skin was tearing to let the excess fluid out. DIC, on the other hand, could be a potentially fatal complication. Yes, she had received some irradiated platelets, but still her numbers only went up to 12. She was on vitamin k. Her bleeding times were well out of whack.. as to be expected.

She was really a nice woman struck by cancer and now all of these complications. She was concerned that she was dying, and chose to ask me instead of her primary physician about her prognosis. (of course, I told her what I knew, that her blood counts were really low and her circulation was disrupted from her edema, but it was not my place for talking about a prognosis). Luckily, the second day, she had received her special bed and we were able to move her around in the bed to the best of our ability. Most of all, I felt sad for her situation. There was nothing as a nurse that I could do to really help her other than continue to try to keep her as comfortable as possible and monitor for any acute bleeding and pain. Couldn’t even dress the wounds properly as her skin was just too moist to have anything adhere to it. She was a completely different patient than I had last week, but still, extremely sick nonetheless. I guess that next week I will get my walkie-talkie :)

Toot Toot from the trainwreck

Each week, we are required to fill out a self-evaluation of our progress in lecture and in the clinical setting. We all stress out, hoping that our performance was satisfactory in our instructor's eyes. Since I had a difficult patient last week that I had felt I did pretty good with.. I gave myself all S (satisfactory) in all of the categories. I didn't make any mistakes, and did the best that I could with a dying patient (who passed over last weekend). We give this "tool" as well as a myriad of other paperwork for our clinical prep to our instructor to review and comment upon.

Now to toot my own horn :) I got my self-evaluation back with not 1, not 2, but 3 E's (for excellent). Yeah, I think I just grew about 3 inches lol. No one has ever mentioned getting an excellent in clinicals before, so maybe they were just afraid to say anything, like me. Some students can be so touchy when others do better, sometimes it is just easier to play things off. But to know that I did excellent in critical thinking, prioritizing care, and discussing scientfic rationales for treatment and planned medical care made my damn week.

Oh and I was sure to thank my ICU cohorts for all of their assistance and teaching so that I was able to competently care for that patient. They deserve huge kudos for contributing to my educational efforts :)

trainwreck approaching.... choo choo

We attend clinicals twice a week, and luckily, I survived our first 2 back in quite some time. So did my patient. Yes, that would be one patient. It was supposed to ease us back into real clinicals again. (Not that OB/Peds/Psych aren't real clinicals, but totally NOT the same as med-surg patients). However, when I got to the floor Tuesday morning, my previously assigned patient had checked out (probably transferred to a higher level cardiac facility d/t an acute MI). So low and behold, the charge nurse was more than happy to assign me my new patient. Beware when they say.. oh she is a good patient (HA). I should have seen the warning signs... heard the upcoming choo choo.. chug a chug a chug a chug. I didn't but it wasn't long before I was hit by it like a mack truck.

Let me first preface this by saying that under no circumstances should this patient have been on the floor... but should have been in the ICU. She was a full code and in acute heart failure. Her BP sucked and was falling. She was in atrial fib paced rhythm (dual lead pacemaker) with episodes of RVR. She continued to get all of her cardiac meds because the physician said that the benefit outweighed the risks. It didn't matter she was vasodilated in every inch of her cachetic body. Her heart required it. She was on a 100% nrb. She couldn't take but one bite of food before becoming breathless. Her veins sucked. She continued to infiltrate IV site after IV site. So much so that her arms were edematous from the infiltrations. She could not tolerate fluids. Her wbc count was 30.5 but not septic yet (blood cultures were negative, however, it would probably not be long). Thus, she had to have an IV to run her antibiotics. Central line attempts were unsuccessful and would send her into runs of vtach. Her blood sugars were consistently below 60; she refused to eat more than one or two bites. She had pneumonia and pulmonary congestion from the heart failure. Her hgb was 9.5; but had already received 4 units of prbc's earlier in her admission. Now she didn't even have an IV site appropriate to run blood. That is the picture of my two days in clinical. yeah, fun... all I can say for myself is that I am very lucky to work as an extern in the ICU at my hospital or I may have freaked completely out. (my instructor told me more than once that she was impressed with how I handled this patient).

On the upside, I did have the rare opportunity to see the cardiologist start a peripheral IV. I am assured by many nurses that this usually does not happen, ever. He is also the one who was talking to the family when we left about her code status. (I can tell you that I prayed and prayed that she did not code on me while I was there). It was a clinical of balancing on the tightrope, hoping that one small reposition didn't vagal her into oblivion. I also learned a lot. I learned that acute hf patients get their cardiac meds even with bp's as low as they can tolerate. Meds can be changed every hour. Orders written and rewritten every 30 minutes. Vegitation means to look for potential clots (not growing potatoes in the heart as I jested to my classmates hehe). Seriously, I knew it had to be something, I just didn't know what it was.

Next week, I take on two patients. Let them be stable. Hell, self-care would be wonderful even. I know that I am ready to jump back on the bandwagon and take on more than 1 patient, but not more than 1 like I had this week.. our supposed "ease back into the swing of things" week. I think that my clinical instructor would also like the same. Nah, no thinking.. I am sure she is hoping for the same!

delegation made into an official paper

curiously, i have worked on this delegation assignment for about 2 weeks, really. our list of very sick sample patients is comparable to what you might actually see in the hospital. i have searched the nursing journals forwards and back looking for good reference articles, which is actually quite a chore because i haven't been able to find that one really good article that sums it up perfectly. of course, there are thousands of articles on diseases, and i really think that may be my next step in searching. my biggest problem is deciding who gets which patients. surely, it is based upon complexity of care. the rn gets the more complex patients, but not all of them at one time, either. the lpn, according to our book, can take care of the stable patients but not the complex ones?? something must be wrong with where i work then... either the charge nurses aren't dividing up the patients correctly, or the lpns have a broader scope of practice than is presented in my leadership book.

now i have to put most of this together into an apa style paper. we have to use references on why we chose each patient for a particular nurse. to me, that is the most difficult part, because i have stated above, the literature just isn't actually available with specific references. not that i have found, and i have searched long and hard for it. somehow i know i will get it finished. i don't mind having to think critically but it sure does put a lot of things into perspective. it makes me consider how they divy assignments at the hospital where i work. there are plenty of lpns who have been there a really long time who are more than capable of working with a complex patient. yet, i don't think i should base my delegation assignment on what my experience tells me, but more along the lines of just how my book states it.

off to ovid i go.... hunting and searching for the next perfect article. wish me luck!

Odd Duck

I have come to the realization that I just don't really fit in with my co-students. I am not sure why it is.. I get along with most everyone ok.. other than a few things that have happened here and there. But I don't think the same as they do, and I just feel like an odd duck when I am around them. Perhaps it is because I didn't grow up in this area? I dunno really. Maybe I am just a little more laid back than they are? I can't quite put my finger on it.

I know many people form good friendships with their co-students while in nursing school. I just can't imagine really ever talking to these people ever again once we are finished. As of now, I don't really talk to any of them outside of class unless I see them out somewhere. Maybe I am just dysfunctional, after all? Most of the time I don't have a problem forming friendships, but these people are all wound up so tight, one pinprick and I think they would float away to the Atlantic ocean or something.

We gained a student this semester from another campus. I wonder what she thinks of our class? I know we have a completely different aura than the class that she had previously been with. I know it must be hard for her to have to assimilate into our own little strange co-existence that we all have with each other.
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On another note, today we began our discussion of ekg rhythms/rhythm strips and such. and on the subject of conduction... our teacher reinforced it with how they say "clear" with defibrillation. I posed the question... "I wonder how long it took them to figure out that they had to clear before proceeding with the shock?" Seriously though. Who was the unlucky soul(s) who suffered a great shock while attempting to save the life of another? What did that first code team think when one of them dropped to the floor because they didn't clear and thus were shocked as well? Interesting to consider and sure am glad that it wasn't me. So, the instructor said that she wondered who discovered that certain rhythms were indeed shockable.

After doing a bit of reading, I have determined that this discovery was made by two scientists from Switzerland in 1899. However, perfection of the testing was done by Carl Wiggers, from Ohio, done on animal models. (Remember this was in the 1930's and 40's and so no unlucky person I suppose, only the unlucky animal). The first life to be saved by shocking VFib was done by Claude Beck in 1947 in Cleveland. Now you just learned something new today :)

Have a great night.. I have some statistics to work on and I continuously find myself deviating from that subject. Heh.

Yeah!

Finally, this semester is really, really over! Passed my final exam with flying colors and am now ready to finish the last 15 weeks of the program. I cannot begin to tell you just exactly how excited I am to be that much closer to my degree :)) Graduation day is May 15 and coming up soon! *pats self on back for a job well done!*

last class!!

Finally! Our last class of the semester was today. Too bad I was too tired to enjoy it. Our final tests are on Monday with finals on Thursday :) I am soooo happy to finally be done. Now just one more semester before graduation and I cannot even begin to relate the load that is slowly coming off of my back. Woot! :))

Hoping to have more time to post some stories and stuff and get this blog completely updated over break. See you very soon. Gonna be a busy weekend with work and studying :)

goodness, time just flies by

well we finished our fall break without incident, for sure. just have one more test this semester, ati, and then our final exam. i am so excited to be just almost finished with just one more long semester to go. unfortunately it is going to be filled with nothing but med-surg, and i have already been forewarned of just how difficult it is. i just want to be done, but moving ahead slowly but surely. this semester has seemed to just simply fly by. i can remember our first clinical in the psych hospital, and now of course, we are finished with clinicals for this semester. having gone through all of the OB stuff has been really exciting. it will be difficult to go back to the other stuff and have to relearn and review it all over again in even more detail than before.

work has still been crazy with the census fluctuating from shift to shift it seems. we have been blessed with warmer than normal weather lately and people just aren't really sick yet. i have a feeling that when they finally do succumb, we will be getting slammed. i am ready for all the learning experience i can get in the icu over this winter and spring so that when i graduate, i am ready to work. i will probably have to work on the floor to begin with, but i still hold out the possibility of working in the unit when i graduate. that is why they are spending the time with me to work in there, because that is where they are planning for me to work if there is a spot open.

A break!

well finally we have reached our fall break (or thanksgiving break really). i am so excited not to have to look at anything for a whole week... well if that were exactly true it would be nice. we will have our second peds test when we come back, so i plan on reviewing so i don't have to cram it all in at the last minute. i hate cramming for a test. 3 more weeks before our final exam an then a glorious 15 weeks left of school before i graduate. i am getting so burned out on studying that the day cannot come soon enough for me. unfortunately, i am scheduled to work for most of my break, so no real vacation for me. it would be nice, but my kids want to play youth basketball, so have to earn the money for that! :)

Random Ramblings

I am so happy to be almost finished with OB. We have our last lecture on it today with our testing on Monday. Not that it wasn't a fun and interesting rotation. I actually loved it. But it is another milestone conquered in the happenings of nursing school. We are left with Peds for the rest of the semester, and I am so very thankful to have completed that clinical rotation. We all know that caring for sick children can be very demanding. In fact, it is probably the parents that can make the experience even more difficult. I just know that I am not cut out to be a Peds nurse at all, ever.

Census is still down at the hospital, so it seems on the weekends anyhow. Or at least there haven't been too darn many critical patients. In a good, perfect world, that is really is a GOOD thing, right? But man does it ever make my paycheck stink. I need people to be sick enough to be in the ICU so that I can work and learn, don't they know this? It is times like this when I wish that I would have just stayed out on the floor instead of being a little hot shot and transferring over to the unit. I know I made the right decision for myself, just perhaps not my paycheck. I love working in the unit though, and I wouldn't trade the experience for the world.

What do you say to a fellow student who thinks that she is the know all to everthing, talks over you in clinicals, interrupts when the instructor is asking questions to answer the question that was asked of you? Do you just let her go on and make a fool of herself because she doesn't know when to shut up? What do you tell her when you are going to do some patient education, and it is her wish to follow you, knowing when she gets in there, she will take over and mark it down as her accomplishment? Well I let her talk over me in front of the instructor so that the instructor could see what she was doing, but when it came to my patient, I politely told her, "I think I am going to do this one by myself, thanks." Yeah, it pissed her off pretty good. She won't talk to me, heck she won't even barely look at me. I don't see how this is my problem anymore :) I know she is sensitive to matters like that, and I am sure that she took it personally when I said I wanted to deal with my patient by myself, but that is what we are supposed to do! I certainly didn't follow her into her room and interrupt her whole educational session with her patient. I know she just wanted everyone around to know that she knows everything. Well, now she can go bother someone else because I am sure she won't bother me anymore.

have to run to class in a few to get our last OB lecture. ciao.

a mini vacation...

census is down and i did not have to work ALL weekend long. i cannot even begin to tell you just exactly how much i needed these days off to recover from lost sleep and whatnot. it was beautiful. really. so did i get to work on the project due at the end of the month? nope. did i review my study notes from the lectures? nope. haven't cracked a book or looked at anything to do with nursing in 3 whole days. i feel like a new person though! i feel like i might actually be able to concentrate in class tomorrow. i am refreshed. renewed. ready to finish out the rest of the semester. i try not to think of next semester when we have med-surg II. i have heard the horror stories. i have heard just exactly how hard it is. i don't want to go back to hard, but i don't have a choice, do i? although i am more comfortable with the knowledge that we get with med-surg. it is more focused upon the stuff we will really see in the hospital. i love ob and i love the newborns, but in my area, there is no hope for a job there. those people just never leave. they stay in that unit for years and years and years. i will have to move if i have ob aspirations. even in the icu, the same goes for in there as well. another unit where people aren't inclined to leave or even transfer out. i will have to move if i plan on having a job in that area. although there is one possibility of a person leaving, i just have to hope that they hold out til may or close to it. but i will probably have to chose the med-surg/tele mixed floor where the unit director wants me to start until they have an icu position open up. i want options! i want to make the decision for myself. i don't want to feel pushed into accepting a position that i might not want. sure i still have several months before this arrives, but they are already discussing it, without me, of course. and still, people ask my opinion, where do i want to work when i graduate? i always answer the same and tell them that i don't know. i don't know what will be open when i do. somewhere in there, they aren't getting the options message. i suppose i just need to lay it out for them and tell them that i don't want to commit yet. that this is a decision i need to make on my own. will they listen? nah. i doubt it. all they see is a potential person to fill that open slot on nights. sigh. i know new grads often have to work nights because days gets the more experienced nurses. i even don't mind working nights. but that is still them making the decision for me. i will figure it out. soon.

been awhile...

well it has been awhile since I have had the time to update. I didn't imagine that it would take quite this long for me to get back into the swing of things, but it has. This semester in school has really taken a toll, and it is supposed to be the easiest semester out of them all. I might disagree. Although the subject matter might be a little easier, we have had projects out of the wazoo to do which takes up a good amount of time.

Our Psych rotation came and went without an ordeal. I wish that we would have been able to have our clinicals at an acute Psych facility, but on the other hand, I am glad for the bit of experience that we did get. It was enough for me to know that is so not the field that I want to go into at all! Now we have started OB and Pediatrics. I have finished my Peds rotation, thank goodness. Another field that I know I do not want to go into. :) Not that there is anything wrong with kids, but it is just not my thing. I have had the opportunity to work a few more shifts up in the OB unit at work along with my clinical experience, and I do still really enjoy that. I don't know if that is what I want to do or if I want to stick with the hopes of being in the ICU. It will all depend upon what is open when I graduate. But I love, love newborn babies! In addition to the hospital clinicals this semester, we also have to do clinicals in the health department and in two schools. I dunno what I think of that yet as mine do not come up until November.

That's all I have right now for a little update. Nothing really significant or exciting has happened lately. Census has been down a bit at the hospital, as is expected, but I know things will pick up soon with the colder weather moving in.

truth takes time

you see, during my entire first year of school we focused upon support of each other. and then the support turned into expectations and lots of taking but no giving. i am all for supporting other students who are having problems... but not when it is taken for granted. these type of things can be deceiving for a long time, and many people do not see it in their desire to please everyone. however, there comes a time when you should see it for what it really is... and thus is why, truth takes time.


picture is from an episode of alias... where indeed, though unclear at the moment, the truth behind a situation is revealed eventually. my problem is that i cut off those people who were taking advantage of my helpfulness... i couldn't understand why i should work my tail off and they shouldn't have to.. only to be able to use the work i did.. such as all the work i did for our final in health assessment.. these people expected me to send them my notes.. didn't even bother working on it beforehand, just expected it. after that, i was finished. i was not going to do the work for several people.. i have my own self to worry about. i don't think i am being selfish, but how can people expect to pass nursing school riding on the coattails of others. well, truth be told.... several didn't pass into the second year, but there are a couple left in our program. but if you cannot bother to learn (not memorize!) the information, how can you expect to become a respected nurse and make responsible decisions and use any type of critical thinking? i just don't get it. anyhow, so this group that is left has banded together.. and made me the bad guy in the whole ordeal. because i refuse to let people walk all over me. because i had the courage to tell them that they really needed to do the work on their own and stop asking everyone else to do it for them. i am not trying to get the best grade in the class. i am trying to learn everything i can, including from my mistakes, so that i can pass the nclex and be a competent nurse. i don't have the time to play the silly mind games of classmates that are meant to drag a person down. i just don't have the time.

i know this is a downer post. nursing school is difficult enough without the interferences of teenage acting middle age women. i can only hope that there are others out there who may be going through the same dilemma. i just learned to say no. and it is telling when people stop talking to you or whatever because you decide not to carry them through anymore. i thought i had lost some good friends, but i guess they really aren't friends. the truth just took some time is all. ok.. i really must get to studying since we have another test next week. ciao!