10 posts tagged “skills”

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...

I went to school for my CBI checkoff at 1:30. My clinical instructor, Jessica, was there so she said that she would take me. I told her that I am less comfortable with this skill than any other skill this semester. So she did a demonstration of all three types of bladder irrigation for me. Now this was good because after the demonstration I realized that I had no idea what was expected of me for that skill. This was bad because if you get a demonstration from an instructor, you can't be checked off that same day. I had to sign up for another time on Thursday morning before the final review. That's okay, I guess.

I came home and took a nap for an hour or so. I decided to get Taylor when I woke up at 4:45 because I didn't want to have to get up again to pick her up before 6. On the way home I checked my voice mail and I had one from Jessica asking me to call her about my CARP assignment. She said that it had to be emailed today or else I would have an incomplete for my clinical course. Sigh...I had planned on doing it tonight or tomorrow, although I knew I really should send it in today. So when I got home, instead of going back to sleep I sat down and did my paper. It's not my best work, but I'm pretty happy with it.

I've also done some HESI modules to prepare for the HESI exam tomorrow morning. I'm going to do a few more after I figure out what to make for dinner.

I really, really need a nap. Although I took one yesterday, I went to bed pretty late last night and have more or less been awake since 6:45 this morning (I slept in between hitting the snooze bar until 7:45 or so). I had my Final Evaluation for Clinicals this morning at 8:20. I passed, of course, and my instructor had some very nice things to say about me. The only weakness she mentioned was PIE charting, as I (and most of my class) forget to document the evaluation part if it's only something like 'patient understood instruction' blah blah.

Anyway. At 1:30 I have a checkoff in skills lab for Continuous Bladder Irrigation, which is why I'm not sleeping right now. I still have to read/learn it right quick before I go.

Also today I have to study for my HESI exam tomorrow and I really should write my IPR that is kinda due today (kinda in that the prof said to turn it in "next week" last Tuesday, but my syllabus says it's due a week after you go to CARP). Whatever. I just want to nap.

I am so freaking tired! I know, this is nothing new for me but I've actually been getting a good amount of sleep this week. Tuesday night I got 12+ hours, Wed I got...maybe 6 or so (which is less than I prefer) but then last night I got 8 so I don't know why I feel like my head is about to fall onto my keyboard.

Except perhaps that I've been sick for a week. I don't know if I've continued to run a fever because I haven't taken my temp since Tuesday AM when it was 101F. I'm just not giving my body enough chance to recharge, I suppose, and I won't in the near future either. I would love to go home tonight and just go right to bed but I have too much stuff to get done.

I have a test on Wednesday and we have to show proof that we've completed half of the course requirements in the HESI and MedsPub modules or else they don't even let you take the test. HESI I can deal with. They say, complete 8 modules. MedsPub says, "Complete 90 minutes in this section", which is stupid. Last night I signed on and then let the annoying voiced lady talk while I cleaned up the computer room (which is such a welcome improvement. It was a shithole.). When she finished one page, I'd click to the next, and in that way I got a lot of the required time out of the way. I still need to study for the actual test too.

This weekend is going to be busy.
Saturday:
8:30-11:30am Skills Lab Class (and check off on CVL flushing and dressing change which I have to study for tonight)
1:30pm-?? My grandmother's 80th birthday party
7:30pm-?? Monster truck show at the stadium (I'm excited! Alex got the tickets free from work and I've never been to one before so it should be fun!)

Sunday Alex has his motorcycle class from 7am-3pm I think, so I shall sleep, study, and go see my grammie somewhere in there since she is selling her condo and they close on Wednesday. :( Oh and I also have to do my paperwork for clinicals on Monday.

I just. need. to SLEEEEEEEEEP.

Seriously. I feel like I'm going to fall over.

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 procrastinate so much I procrastinated writing this entry.

The semester is almost over. I am very stressed, although not as bad as I was this time last week.

Last Thursday I got a 72 on my Pharm test, bringing my test average to 79. I have to have a 75% to pass. I emailed my teacher asking for help or advice and she said she would review my test and get back to me. Well, now it's WEDNESDAY and my next test is TOMORROW so when exactly was she planning on getting back to me? I freaked out for about an hour after that test. I cannot fail that class. It will set me back an entire semester. Come to find out though, I am the only sucker in the class not using the book for the online test.

I had a shitload of stuff to get checked off on in skills lab, but I got all of that done on Saturday except catheters, which I did on Monday. So I am all done with skills lab. That was a HUGE weight off of my shoulders.

I also had to meet with my mentor to get them to sign off on some form we have to complete part of every semester. Basically we have to give them our unofficial transcript and they make sure we are where we need to be credit-wise. I did that yesterday after my clinical final evaluation (went fine, done with that class too!) and she said she wasn't sure that my art history class counts for my humanities credit. Oh, it better. I didn't sit through that suck ass class for nothing.

So now all I have to stress over is my finals next week. And now I think I have to end this here, because the screen looks a bit swirly and I'm afraid that means I have a migraine coming on.

Today I have a Pharm test which I have to study for when I get home. I have a case study due tomorrow.

Next Thursday I have another Pharm test.

The Thursday after that is my Pharm final, PLUS my HESI exam.

The Tuesday before my Pharm final is my Nursing Lecture final.

And somewhere in there I have to get checked off on my skills like catheter insertion, NG tubes, bandaging a head wound (which my sorry teacher hasn't even TAUGHT US YET).

On the bright side I have two weeks off from school after that (and one of those I think I will take off of work as well). Also, the day after my final is probably the Dolphins Christmas Party. And the day after that, me and my clinical classmates are going out together to drink away this semester. If I make it that far.

Camping was excellent!

Today I had to do a simulation in the skills lab which pretty much sucked, except the VitaSim mannequin is pretty neat. I also got checked off on injections, so now I can give them to real live people. Well, guess I better go study for Thursday's test now.

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.

That's basically what I've been doing so far.  I think I mentioned during the first 3 weeks of clinicals, they are going to teach us basic patient care before they unleash us on the unsuspecting public.  (Actually, all patients will know we are nursing students and will have given their consent before hand.  From what they've told us, most of them love it because they are our only patient so they basically have a private nurse.)

Anyhow, the first day they put us into groups with our clinical instructor, and I found out that I will be doing my clinicals at JFK, which is oh, 10 minutes from my house.  I actually pass it on the way to campus.  Awesome!  I really like my instructor so far as well.  She seems really nice, and very down to earth.  I asked her if our first hospital day will begin at 7:30 and she said, "Oh no...I think 9am sounds better. What do you guys think?"  Schweet.

In our groups, we went around to 9 stations, each staffed by a different instructor to teach us a skill.  The first day we learned how to give bed baths (sponge baths, basically) and how to place a bedpan (fun!) and assist with using a urinal.  Mmm.  We also learned how to brush patients' teeth, remove dentures and clean those, and how to shave male patients.  We practiced that on balloons, but we left the blade guard on so I don't know how much good that does.  Without my schedule in front of me, I can't think if we did anything else that day.  I did pick a 'partner' though!  Her name is Laura and she's a single mom like me.

Somehow I feel like I already wrote about this stuff.

We missed the next day because Ernesto was on it's way. *eyeroll*  Not to say I didn't enjoy hanging out at Alex's for a couple days, but I was actually bummed about missing class.  Now our first hospital day is on Sept 19th instead of the 18th so we can make up our frontloading day.

We also only had one class this week because of Labor Day.  Yesterday we had to dress out in our uniforms so they could check them.  The pants aren't as uncomfortable as I thought they were.  I think I need some insoles for the shoes though.  Anyhow, we learned how to make beds (both occupied and unoccupied) and we also learned about restraints; when and how to apply them.  Rowr.

As for my online classes, I have a 6 chapter Pharm test tomorrow that I feel pretty ready for.  I'm going to do the workbook review tonight, and then take the test tomorrow before the Dolphins/Steelers game.  My cousin and I have an interesting bet on the game.  Next Wednesday I have my first test for Nursing Lecture.  It's on...14 chapters?  I've read 6 of them and I need to review the hell out of them.  I really couldn't give a crap about the history of nursing, or the nursing theorists, and that makes it hard to retain the info.

I'm going to have to make my peace with having no life soon...