excitement | Nursing Student Chronicles

That’s right. A little less hand holding.
This was a great last couple of weeks for clinicals.

Last week, I had an adorable client who reminded me of my great-grandmother. I really start to feel like a full-fledged nurse for the first time because I got to advocate for my patient. I set up consults to address stressors outside of the hospital and really built up a rapport over the two days. It was awesome to hear that she was disappointed I wouldn’t be back for a third day. I really accomplished a lot!

This week, the leash was loosened a bit. My instructor really likes for you to take the opportunity to spread your wings if you fell ready because Ortho is a floor where you can do that. You see a lot of the same things (oh, if I see another hip….) which may be boring to some people. I thought it would be boring at first. But then, I realized what an advantage it is to get used to a particular clientele. You really get to test yourself and work faster and add on responsibilities.
For this week, I got a patient on Day 1, did his care, and discharged him home on Day 2. It was awesome! I got to do so many skills by myself- very exciting. My instructor said I was at the level I’m supposed to be at and that I could go in on my own. We would talk it over first…for example the dressing change. She would make sure I was competent and then let me go do it. It was fine since I had already performed all of these skills before.
So, this week I took out a foley catheter, took out an IV, did a dressing change, and administered meds- all on my own! My coassigned nurse peeked her head in while I was doing the dressing change so that she could note it for her own assessment and told me that my dressing change was awesome.
My patient and his spouse both told me I did a great job and how I must have been a straight A student (I wish).
I talked with my instructor about adding on to my assignment- possibly having two patients?? Next week, I’m team lead which is like being Charge Nurse…so I won’t be able to do it then. But the week after is my last week of clinical and she said that would be fine.

She also said how she liked that I was really maximizing my clinical experience because some people in the group were not. And then there were some people in the group not ready to handle that patient load. But she thought that I was more than ready to handle it.

HOO-RAH!
I’m floating on Cloud 9.

Lucky

My husband is adorable. Can I just say that? I think I will.
In fact, I am so impressed by him on this particular day that I’ve decided to write a whole post about him to stash away in the corners of my blog/journal.
We’ve had a few arguments the last couple of weeks. Not a lot. But more than normal for us.
To be honest, any argument over one in the span of a month (every now and then a week) is pretty rare for us. But we had a few. And as a result we were both in a funk. Cause we hate arguing. It messes up our whole day. It makes me introverted and I don’t particularly like being that way. Any day I can’t share wholeheartedly with my husband is a day wasted in my book.
So, he’s the type of guy that doesn’t consider the matter 100% resolved until we’ve seen each other in person and you can see the resolution on the other’s face.
And today, he called me and said, let’s take our lunch at the same time so that we can play chess. We like to play chess with each other through our iPhones. I readily agreed.
Two nurses were sitting behind me chattering away about their day nonstop. I sat with my hummus, pita bread, and phone chatting in between moves to my husband.
About 20 minutes into our game, I heard the nurses stop and one of them said “awww”. Curious, I looked up.

Standing right over me, was Ishaq.
Ishaq, who I had assumed was in the break room at his own job 15 minutes away, was reaching for my hand- pulling me away from the hummus and the pita.
He told me he could only stay for 2 or 3 minutes but he wanted to see me so that we could make up. I walked him outside with a huge grin on my face.

I adore my husband. He lit up my days and continuously lights up my life.
I’m so lucky.

Feel-Good Moment

How scary is it to be admitted to a hospital? I don’t know. Knock on wood, I’ve never been.
I had a patient who had to go to surgery for a cyst and is pregnant. Terrified she was- and with good reason!
I was talking with my schoolmate about babies today and was reminded of her.
She had the prettiest hair that kept falling in her face that I would push aside for her. We talked about her becoming a first time mother and how she wanted the sex of the baby to remain a surprise. I tried to calm her and keep her company until her doctor arrived.
She was trying to hold it in, the nerves that is, but she kept asking if her baby was okay. The doctor came in with the monitor to listen to the heartbeat and turned it on.
He pressed it against her belly and we heard the whooshing sound of the placenta and nothing else.
After a couple of minutes of this, the doctor reassured her that the lack of heartbeat didn’t mean anything bad, he just hadn’t found it yet. He was moving slowly trying to make sure he didn’t miss it.
The tears started to fall and after another minute that stretched on like an hour….a tiny heartbeat fluttered in our ears.
And it grew louder. And stronger.
Until a full, healthy heartbeat blared through the monitor.

Relief swept over all of us. I hadn’t realized I had been holding my breath until that moment. She cried tears of joy and relief and laid her head back, running her hands through her hair.

I got her cleaned up and some ice chips and then transferred her to the Ambulatory Care Unit where she would get changed and go home.

That was one of those feel-good moments that keeps pushing me forward to get through the program. It’s a reminder of why I’m going to school to become a nurse. Corny? Maybe. But it’s true nevertheless.

PACU.

It’s official. I am in love with the PACU. Post anesthesia care unit, that is.

Basically, this unit a is fast paced, on your toes, better know your P’s and Q’s kind of place. That’s where I went today with two other classmates. It was amazing.

Here’s how it works. There are 12 beds open. Today, they were short a nurse so we were working 8 beds. Patients roll in from the Operating Room to the PACU because that is the recovery room. Each nurse gets two beds. The first patient goes to bed 1, second patient goes to bed 3, then 5, and 7. After each nurse gets their first patient, it goes around again on the even numbers.
PACU patients are ideally there for an hour or so before being transferred out, although they are often in the unit longer for various reasons.
Patients that go home same day may go the ambulatory care area to meet with family and finish getting things settled before leaving. Patients going to the floor may have to wait in PACU until they get a bed. The other reason for the longer wait time is if the patient is unstable.
Vital signs are checked every 15 minutes and your assessments better be spot on. You also have to maintain fluids going in and make sure the dressings from surgery are dry and intact. If there is too much oozing or bleeding, you’ve got to notify the right people and potentially roll them back. Depending on what kind of surgery they had, your assessment focus changes. For example, a patient with back surgery, you want to make sure they can move their legs and still have sensation while a heart patient, you’re monitoring their rhythm strips. Those are some basic examples.

The neat thing about PACU is that it starts off slow where you’re doing nothing. Well, that bit is the only dull bit. As soon as the first surgery rolls in, you hit the ground running. The patient rolls in and you jump in. Someone is charting while someone else is hooking up their leads to the monitor while someone else is hooking up the oxygen. The level of teamwork is amazing.
The PACU nurses are unbelievable. They’ll be taking report from the CRNA (certified registered nurse anesthetist) and listening to the various people calling out data and charting it all at the same time. They can listen to the breath sounds to see if they’re clear or wheezing, crackling, etc while counting how many breaths they take in a minute at the same time. A task a lot easier than it sounds.

“Pt X came in a for an inguinal hernia repair this morning and is under general anesthesia. There-”
“36.4 is temp!”
“- estimated blood loss is 5ml and-”
“12 respirations, clear and equal!”
“they’re on 8L of oxygen non-rebreather mask. They”
“BP 134/83 and there’s an 18 gauge needle in the left hand!”
” have a history of smoking and asthma. Their pre-op BP was 145/95 and they”
“Dressings dry and intact.”
“were given Ancef 1gm at 0850″

That’s just an example of a report from CRNA and call-outs from the ones assessing all happening at the same time. And it all happens in about five minutes. Then you follow it up with a more in-depth look and then reassess every 15 minutes. Plus, you could have another patient to tend to at the same time.

The other thing is that when you wheel a patient out, you could come back to another one rolling in. So fast paced! I adore the fast paced environment. And everyone is so knowledgeable there. You’re always learning and seeing new surgeries or new doctors who do the surgeries in different ways. Truly fascinating.

What else is fascinating? The way people respond to anesthesia. HILARIOUS. That’s a post for another day though.

Today was busy and I got to do more today clinically than ever before. We’re taking it to a new level and today, I finally started feeling like more of a nurse and less of a NA (nursing assisstant).
I did a straight catheter for the first time on a male (human, not a dummy), an Accucheck to test glucose, prime the tubing on a drip (medication that flows through an IV), change the tubing on a drip already hung, and learned how to/successfully put on EKG leads. And then, of course, all the normal assessment things.
I also saw some neat drains that you only see straight out of surgery. There’s one drain that pulls blood out and once it’s full, you flip it and retransfuse it back into them. So awesome.

I’m back there tomorrow starting late!! The other nice thing about PACU, they are the latest starting clinicals. I don’t have to arrive until 7.30 so that I can change into my scrubs and be on the floor at 8. Hello, luxury.

ZOMG, 20!

look at the cake with all them candles. his brothers ended up blowing them out

Happy birthday my love!!
He is 20 now and no longer a teenager. How old!
I was waiting to post this until I had a picture to go with it. We rang in Ishaq’s birthday at midnight on the dot. I hyped him up for it telling him that his birthday gift was going to be the best ever.
It was a video camera- something he’s been wanting forever. It’s really nice. We met in a filmmaking class, so it was kind of sentimental as well. He’s forever got ideas for movies and that is one of his greatest creative outlets. We can’t wait until it’s sunny again so the movie making can begin! His brothers are just as into cinematography as he is, so we’ll see!

We slept in and woke up around 12:30. We had lunch at an Indian food restaurant in Chapel Hill (our favorite one in the Triangle) and went to the planetarium. Unfortuanately, it was closed. They’re forced to close at 3pm now because of the budget cuts. There were two other couples trying to go at the same time we did. So that was disappointing. Well, for me, not for Ishaq. I love my optimistic husband. He was still thrilled about the camera and Indian food. And, he said he was excited just because I remembered he loved astronomy.
So we went to the movie theater (cliche, but the wind and rain had ruined all of my other plans) and decided to see Watchmen. We were an hour early, so we spent the whole time playing video games which was actually really fun. The movie was only okay. But we had a good time regardless.
Afterwards, we went and saw his family before going home and continuing on our Naruto series. That’s an anime show we watch online that is SUPER good. Mmhmm.

The verdict: He says it was his best birthday ever. Seriously. (Even if it was Friday the 13th! -_-)

"It's a tradition of excellence…"

Today was the first day of classes. The first half of it, I had this anxious feeling gnawing away at my chest as the anticipation grew and grew.

The day started off with introductions from around the room. All fifty of us. Then we got student handbooks, heard speeches from the security and health offices of the hospital we’ll be doing our clinicals at, along with speeches from the school organizations.

We got a speech from the head of our school in which I could myself swelling with pride as Dr. W explained how our school is big on reputation. “It’s a tradition of excellence…” I could see my good friend Bee swelling up with pride next to me as well.

The Student Government Association said that we’ll be holding elections for class officer within the first two weeks. I am considering running for one of the offices. I think it will be a good way to get involved and go ahead and get started on the leadership path since I know I’ll need to get used to it if I ever want to advance. I’m excited!

Well, for now. I’m pretty sure in a few weeks my blog will have turned mopey and depressed about the lack of free time, haha.

So, after lunch, we got our books and uniforms and that was it! One half of the class stayed today to get their uniforms inspected. My group goes on Wednesday. Our shoes are supposed to be 100% white. I found silver today outlining the N on the New Balances. I swear they looked all white in the store. Isaac didn’t notice either.

I hope I don’t have to take them back. They’re sooooo comfortable. *pouts* See??

new-balances

They feel like blanket-slippers on my poor aching feet. Ah well. I also found out that I’m going to have to change out my nose ring for a clear one. Drats.

But, overall, I would say today is a success!! I’m super stoked and ready to start learning! Apparently, there’s a lot to learn. All my books don’t fit in my backpack…

And so it begins.

Three Days.

Nursing School starts in three days. I am terrified and excited. Wow.

I bought my all white lace-up shoes for school today. Some ridiculously comfy New Balances. My mom got me an awesome digital watch with a second counter for Christmas which has been saving my life at work. I also got a nifty tape recorder for my lectures. I can synch it up to my computer and make podcasts also. I’m very excited.

I have my stethoscope which was a present when I left my last job and I get my uniform on Monday. I can’t believe it is almost time to start.

I’ve been learning a lot at work lately. I’m trying to utilize my resources now that I think I want to work PICU. That may change later on, but that’s the course I’m on right now.

I’ve been learning more about ECMO which is extracorporeal membrane oxynegenation. It is a fascinating machine that acts as your heart and lungs. When someone’s heart is weak or their lungs are diseased, ECMO is used as a last resort. Basically, the person is hooked up to a machine and there are all these tubes that wind around so that blood goes in and out as the machine pumps. Meds like heparin are also used to reduce and, ideally, eliminate blood clotting.

I also learned, yesterday, about the paralytic drugs Vecuronium and Rocuronium. I’m telling you, this stuff fascinates me! When I talk like this to my non-nursing-school-friends (NNSFs), they stare at me blankly and their mouths start crinkling on one side in distaste. Ah well.

Oh! And on December 22nd, I became officially certified in Healthcare Providing CPR and AED machine use. The AED machine is the portable machine with the pads that stick on your chest to deliver shocks. I am super proud and excited about my new knowledge. Hopefully no one collapses in front of me while I’m out and about. But if they do, I can save them! Reassuring, no?

Happy New Year!!

2009 is looking up.

New look and such.

So, as you can see, the blog has a new look and title and such.
Why?

I got my nursing school schedule, email, passwords, etc. in the mail today which means my journey is really beginning. School starts in two weeks and two days. Im a bit nervous though to be honest. But so excited!!