8 posts tagged “laura”

I passed Integrated Skills yesterday. Basically, you're given a scenario and you have 15 minutes to prepare (look up your drugs, make some notes, etc.). Then you go into the room where the mannequin is set up and do your thing.

My scenario was a man with Prostate Cancer who had a TURP the day before. He was on continuous bladder irrigation (CBI) and had dime size blood clots in the tubing with no urine outflow.

This tells me that he needs manual irrigation (which he had orders for). Crap. I had heard that we wouldn't have to do open irrigation since we didn't have much instruction on it, so that was something at least.

Except it wasn't true.

I did closed irrigation and the instructor says "It wasn't successful. Now what?" I said that I would do it again. "Okay, still didn't work. Now what?" Sigh... "I would get an order for open irrigation." "You got it. Go ahead."

Ah, shit.

I actually did the procedure perfectly. I also had to do a central line dressing change and give medications. The instructor told me I got a 100% (although it's really pass/fail). I hit all the points they wanted me to. Woohoo!

Today was my final. I did some studying with Laura Tuesday night and then yesterday I went over and studied with her and 3 other people. Then I came home and reviewed the power points online. I felt well prepared.

The good news is I got a 91% on my final!
The bad news is I got a 90% for my class participation grade which gives me a final average of 89.45. I hope my teacher rounds up or something because I REALLY WANT THE 'A', DAMMIT! I'm going to be pissed if I get a B.

Either way though, I am done for almost 4 months! And there was a sign-up sheet posted to select your clinical site for next semester so Laura and I signed up for the same one (Palms West, days. Not that close to my house, but I'd rather that than St. Mary's.)

Tonight is the Dolphins Banquet which would be more exciting if I didn't have to work tomorrow. Ah well...

Laura was supposed to call me when she got done at Skills Lab and then come over so we could study. She had an appointment at 10, I think, but she was going to try to get in at 8 and see if they could squeeze her in early. Well, it's 12 noon now and her phone must be off because it's going straight to voicemail. And for some reason I can't seem to motivate enough to start on my own (although I did print out the review transcript).

What I really want to do is take a nap. My eyelids keep drooping. And hey, I only have to get a 55% on the final to get a B in the class (I need an 89% to get an A. This is preferable.)

Naaaaaaaap.

I got a call today from the HR Director at the hospital. Apparently my paperwork came back a-ok with no 'discrepancies', which is what they call it when a date is off by a couple months for whatever reason, things like that. Nancy was excited that we didn't have to deal with that. The only thing is for some reason my high school records were going to take awhile to come back (come on! I didn't graduate that long ago!) so the background check agency wanted me to fax them my diploma. Fortunately I actually know where it is, and it's not buried in storage. I faxed it today but when I spoke to Nancy she said to bring her a copy when I come in so we don't have to wait.

I have to attend an orientation within 90 days of starting. JCAHO fines the hospital $2,500 for each day an employee works past 90 days without attending. Damn! The next one is April 16-17, which is M-T and I have clinicals those days. She said I could attend the one at the end of May since I will be out of school by then. I do have to go to an ethics class within 30 days. That is also on the 17th and starts at 1pm, I believe. So I have to ask my clinical instructor if I can leave at 12 that day. Hopefully that will be okay, she knows I've been hired for this job and she wrote me a really nice recommendation for it.

So! I have an appointment tomorrow at 9am with Nancy to finalize everything so hopefully I can start next week! 

I had a test this morning. Got a little better in the procrastination, but I still had some stuff to cover this morning. Anyway, I got an 82% but I should get credit added for one more question. The program tells you the questions you missed when you are finished, plus the correct answer.

The question doesn't really matter, but for the answer I put:
- Have patient ambulate as soon as possible
- Encourage coughing and deep breathing

The test program says:

WRONG
Correct answer:
- Have patient ambulate as soon as possible
- Encourage coughing and deep breathing

Hello! I called the proctor over and she told me to write down the question and my answer on my signature sheet before I turned it in. I talked to Laura and the same thing happened to her.

Exciting things in skills:
My brother let me start an IV on him on Sunday! I didn't actually hook him up to the IV line because I had used it in practice so it wasn't sterile. I did have sterile venipuncture needles so I just used those to practice hitting the vein. On the first try I missed. Since he said I wasn't hurting him, I started moving the needle around to try and get the vein. Still couldn't. That was my last needle of that type, so I had to use a butterfly needle next. With that one I hit it dead on and got a nice flash back! I was so excited! I feel good that I was able to do it that time, but now I know that IV starts might not be as easy as I thought.

In clinical on Monday I got to discontinue a Foley Catheter. Not much to it, but I think I did well and my teacher told me I did also. It's always exciting to get to do new skills!

I went to Laura's house last night to study and got home at 5am. Yes, that's right. And somehow I still couldn't get to sleep until 6. My alarm goes off at 7, at which point I left a message on my boss's voicemail asking if she could do without me. I left her my cell and told her to call me if she really needed me to come in, and she didn't. I slept until 12:30 or so and have been studying off and on all day. I put in a lot of good work last night, but at this point my brain has just checked out. I'm too tired to retain anything at this point.

I'll probably still forced some more pharm down my throat later and then rejoice tomorrow when THIS CRAP IS BEHIND ME.

(PS I'm going to Disneyworld with Alex and Taylor sometime in the next couple weeks! Yay!)

You know, I had this whole blog post planned out where I told you my sorry grade, but rationalized it by saying that at least I passed the class.

Maybe I'll use that one tomorrow.

Because today, I got an 87% on my Nursing Lecture final!  Awoohoo!

What's especially nice about that is I only studied Sunday night and then yesterday for it because I've been so focused on studying for Pharm.

Laura's Columbian coffee FTW! I've always been able to drink coffee right before bed. Not so with this stuff. It is crack in a cup.

I got an 87%!

Who cares that I am subsisting on a diet of coffee and cigarettes? Who cares that I am getting 5 hours of sleep a night and am so exhausted I can barely move?

87!

Well, there's ups and downs I guess.  Last week we had another Pharm test and I knew the first 6 chapters like the back of my hand...it was the 7th that kicked my ass and got me a 76 on the test.  It went up to a 82 later, because some of the questions told you to choose all that applied, but would only let you pick one answer.  So, anyway, screw the nervous system.  Receptor this and agonist that.  Bleh.

Today was my second nursing lecture exam.  It was only 3 chapters, but one of them (physical assessments) was 100 pages long.  I did okay, I guess.  I got an 84%, which is a B.  I guess I should be happy with that, but I missed two because I couldn't remember which was diastolic and which was systolic.  I hate missing questions for something stupid like that.  And I missed one because I changed my answer.  I knew I was going to regret it and I did it anyway. Dammit.  Oh well, it's still better than the last test, right?

Yesterday was our first clinical day where we had patients.  Laura and I were partnered up like we asked.  We had a blind guy in his 30s who needed total care.  I mean, he could move somewhat, but not too much.  He had one of those pressurized beds.  Nice because you don't have to tuck the sheets in and mitre the corners.  His nurse wasn't very nice to him (I have my theory on why, but in the interest of HIPPA paranoia, I'll keep it to myself.)  She told us on the way out, "Don't take any of his crap.  I told him the first day hear what a grouch he is."  Well lady, you get what you give, because this guy was nothing but nice to us, even when we had to position him in ways that made him hurt.  We gave him a bed bath, which went pretty well except that we weren't doing it exactly the way we were taught.  Laura and I kept looking at each other from across the bed and saying "Oh wait, we forgot to do..."  "Oh, right!" and then we'd do whatever it was we forgot.  Our patient had Sportscenter on to listen to and I asked him if he liked football.

"Yeah, I like football."
"You like the Dolphins?"
"Nah."
"Well did you grow up down here?"
"Yeah"
"Then what do you mean you don't like the Dolphins?  You're supposed to root for the home team, A!  I know there's not too much to root for sometimes, but come on!"
He laughed and told me he liked the Cowboys.  It was a good icebreaker and after that I wasn't nervous anymore.  It's nice to find some common ground.

Anyhow, we were doing the bath still when the wound care specialist came in to check on him.  He needed to be rolled over onto his side for her to check it, which worked out nice because we hadn't done his back yet anyway.  Our instructor came in at this point too, which really worked out well, because she cleaned up the tush area for us.  I was on the opposite side, but from what I could tell, it wasn't too pretty.  Yay for our clinical instructor.  Love that woman to death.  She's over there talking about cleaning up the 'poop-a-roni's'.  She finished up and went to leave and I told her we hadn't done the 'hmm-hmm' area yet.  Yes, these are the technical terms.  She told me to go ahead and do it while she and Laura went somewhere (don't remember where.)

This part wasn't as awkward as I would have thought either.  When you're taking care of someone who is sick, it just doesn't seem to matter as much.  I told him I was going to clean his groin area and around the catheter real quick, and he said okay.  I went around with the washcloth, but I probably didn't do too good of a job around the catheter because while I know I wouldn't be able to pull it out, I still don't want to yank on the thing.  I wouldn't imagine that feels too good. 

We were going to do his mouth care and shave him (oh man, I would have been so nervous about that) but his nurse came in to do vitals and feed him and we had to go to postconference, so I told him that we had to leave and thanked him for being such a great patient.  Sometimes when I'm studying for tests until I can't see straight, I really wonder if this is going to be worth it.  But after putting my knowledge and skills so far to use, I definitely know that this is what I want to do.  It's a great feeling.

I don't think I will ever forget my first patient. 

Hmm..let's see what's to report. 

We are just about done with frontloading.  Yesterday we were instructed and checked off on handwashing (you might think that's a no-brainer, but unless you're in the medical field, I can pretty much guarantee you're doing it wrong).  We also learned about the DHAT we have to fill out for each patient we have during clinicals.  DHAT stands for...Daily Holistic Assessment Tool?  It's basically a history, and a brief assessment of why they are in the hospital at the moment.  We also have to analyze why they are on what meds, and why they were sent for what tests. 

Next Monday we are being checked off on all of our frontloading skills.  Eek!  I need to buy a blood pressure cuff, because I'm not that good at taking BPs right now.  Laura, Jacob and I practiced bedmaking (occupied) and bathing after class Monday.  We got those bedcorners sharp, man!  The hardest part to me is not really the skill itself, but remembering all of the steps involved, especially introducing yourself to the patient, washing hands, etc.  Seems like it would be easier to remember those things when you're actually doing it, as opposed to talking to a crazy-eyed mannequin.  Then, Tuesday is our first day at the hospital, but it's just orientation.  We will begin patient care the week after that.  I am super nervous about that.

Yesterday we also took our Semester One ProCalc exam.  It's a math test based on dosage calculations, focused on knowing conversions (1 tsp = 5mL, 1gr = 60mg).  We had to get an 80% on it or be removed from the program (although I think you can take it again if you don't do well on the first try.)  I studied for it the night before and got 100%.  Wo0t!

When I got home I had to choose an article to critique for Pharm.  Not too clear on the due date though...sometime in October.  Seriously not digging the online experience.

Today...I have the 14 chapter beast of a test.  I'm not too happy with my online instructor, because she screwed up when she told us what chapters would be on the test, and I read two chapters that I didn't even need!  We should not be at such a disadvantage because we're taking lecture online.  Thank God I have friends that take it on campus and I can compare with them.

 I'm not really as ready for this test as I should be.  Laura and I studied after skills lab yesterday, and I'm pretty sure that I've read everything I'm supposed to, but I don't know how much I've retained.  Or the level of depth they are going for on the test.  That's why the first test of the year kind of sucks.  You don't really know what to expect.  Anyhow, I'm going to try to get a little bit of review in during lunch, and then head out of here around 2pm so I can get to campus a bit before the 3pm test and cram with Laura.

It's funny...when I'm reading all of the chapters at home, I do wonder what I got myself into.  But when I go to skills lab, and I'm learning how to nurse, I really know that's what I want to do, where I want to be.  And that's a pretty good feeling.