wham bam thank ya ma'am!

I have some great news concerning my nursing program. It appears that our discussion with our instructor paid off and they will be making changes! The changes will be taking place next semester even! They're working it out so that one of the primary RNs on the floor will make the patient assignments, and we'll be given 2 patients. It is gong to be based on readiness, so they're taking that into account, which I think is great. It's awesome when you take part in effecting change that is for the positive.

In other news we finished our med/surg rotation. Our care plans were due Wednesday and the instructor grades them the night they're due. (We still haven't received our graded care plans from the previous rotation--in fact no one has, even from the beginning of the semester. That's really the only downside to that particular instructor. It's easy to swallow though considering what you gain from her. You don't mind waiting for your care plan, at least not so much.) I did swimmingly well on both my care plan and my evaluation, with 99s on both. I would have gotten a 100 % on my care plan except I left out past surgical history. I really can't remember there being any and in going over the paperwork I had didn't find any, but I didn't state that either. Oh well, one point isn't going to send me into respiratory alkalosis or anything.

Four weeks until finals!!

It's so unbelievable how it feels to be able to say that and to know that unless I really F things up between now and then I'll survive what is our hardest semester!

Next week we start our OB/newborn rotation. My whole group is incredibly excited to get our hands on those babies. We know it's not always fun though. One of our classmates witnessed a fetal demise the other day, and sadly he knew the family. I've been waiting all semester for this, because it is one area I've felt a draw toward. So, I am full of anticipation for experience as a whole.

STBTF

Something to be thankful for...

I am extremely grateful that we only have 4 more regular Mondays (which are preceded by a hellish weekend spent studying) until finals week!

suppozin' I should mention...

Thanks to all who have chimed in on clinicals. It was very enlightening.

I should have mentioned what we do do during our fourth semester, so that we don't look as unfortunate as I might have made us out to look like. We do an advanced med/surg rotation, which includes leadership building, as well as a 3 week preceptorship. We'll have clinicals all the way through up until our preceptorship at which time we will become a RNs right hand woman or man. I look forward to this as I think it will be the most valuable experience of all, up to that point.

I'm off to health assessment class this morning. Tuesdays are usually our fun days. Another student and I, whom I've become close friends with, may as well be called Lucy and Ethel. We have a blast.



Last week we got a great laugh when she went to carry one of the mannequins off the bed we needed to use for practicing respiratory assessments on each other. Up she pulls Sheman and plop!! right out onto the bed falls Sheman's unmentionables. It was just so unexpected we found it pretty comical.

Oh well, if you can't keep your sense of humor through nursing school you may as well throw in the proverbial white towel!

brainstorming to battle hindrances

Yesterday we spent some down time during clinicals talking to our clinical instructor about other possible clinical opportunities. Our program is very limited in the opportunities we have. First semester we do nothing clinically speaking, other than lab learning. Second semester we spend 6 weeks (maybe it's 8 weeks, dont quite remember), at a long-term care facility. Third semester we do med/surg/ortho/tele, OB/newborn, and we're supposed to do an observation-only Peds rotation at a local practice. Because of H1N1, those of us that are supposed to be going during the latter part of this semester have been prohibited from going. There is also a time period during this semester where each group has been "orphaned". We do not have enough clinical instructors in our local, small community hospital, and there are no contracts out for any of the larger hospitals or medical centers in the region. (Let's not forget I live in the DC/Northern VA region where there is a plethora of all that is medical.)

The other two community college's programs go to vast medical centers for their clinical experiences, and oh, you might have heard me mention in the past one of those programs is also sharing our local, small community hospital. It's not an extremely large group invading our territory; however, their instructor has asked one of our two instructors if they can take the one floor that one of our groups was supposed to have! From what I heard our instructor (our group wasn't with her at this point in time) conceded!!!!

I digress; so when we're orphaned, we go to other clinical experiences, which are usually observation-only or very limited hands-on experiences. They've been overall wonderful opportunities. Most everyone's enjoyed going to interventional radiology, the infusion center, wound care center, a local same day surgery center, staff development, ICU, (no, we don't get that as a regular rotation), etc. It's usually only been one day here or there.

In our bigger rotations (med/surg/ortho/tele, OB/newborn) we are only given one patient at a time. For instance, my patient yesterday was admitted with a GI bleed with anemia. He was completely independent, so all I did was vital signs, get his cup of ice chips (he was NPO as they were waiting on GI to get in to consult, and send him down for a procedure--didn't happen on my time), straighten up his bed (he'd been admitted the night before), and do his assessment, I&O and flow chart.

We're talking lots of down time. We bent our instructor's ear something fierce, because we want better opportunities next semester, and for future students. The program is being overhauled and this is a major need. Our instructor had spent some time earlier in the morning talking with the other program's instructor (OPI). The OPI informed our instructor of all the things they do clinically and that by their third semester they're taking on at least 2 patients.

Our mental health rotation is incorporated in as part of our LTC rotation because we work with patient's with dementia. We do have a mental health facility within 40 minutes--which in this area 40 minutes is nothing. All 5+1 (we had an orphan for the day) of us sitting there voiced that we would be willing to drive to other locations, at a distance, to be given better learning opportunities.

Bottom line is we want to feel somewhat comfortable when we're interviewing for our first nursing jobs that we we'll be a little more comfortable taking on our responsibilities. We know that we'll be oriented to the facility. We know that you really don't have your true nursing groove until you've been at it for at least 6 months. We just want the same opportunities as others.

I'm wondering: what clinical opportunities were you or are you being given as a student nurse?

she told us so

Yep. In fact she wasn't the only one to forewarn us, several others did as well. "Third semester is the hardest" she said, and do we ever agree now! "She" would be our instructor and the others would be those who went before us. The sad reality is this is the semester that can make or break you. Evidently we've lost two already. One withdrew from the program by choice as her grades weren't so hot and she had differences with our instructor. The other has, I don't even want to say it, but she's failed out, and at this point it is too late. So she has gone into audit status. It's heartwrenching; no, it's gutwrenching. There were only 26 of us at the beginning of this semester. The first student I mentioned was an LPN transtion, so she didn't start with us from the beginning of this journey, the other one did. We're bound to lose others as well. It's hard with such a small group.

Some of us are choosing to think positively and have even started discussing certain things about next semester, and have even gotten bold enough to talk about preparations for graduation. With the way time is flying we can't help but look forward.

First things first. As of right now we have 5 more exams before our finals. My clinical group has one care plan left to do, and then a clinical evaluation work-up for our OB rotation which we have the last four weeks (minus the week of Thanksgiving). We have one assignment left for our health assessment class and one for our OB/peds class. We also have med/surg practice ATI tests we're required to take, and pass with at least the benchmark, of 65, for a grade. Five tests equal 50 points. Those 50 points could go a long way toward making the grade. We then have the OB/newborn and child health ATI proctored exams we have to pass. It seems like a lot left to do, and is in a way. That being said, it's not insurmountable.

Two clinical days left for this week, and then it's five weeks until finals.

I've been thinking about how things have changed over the past year and a few months. Nursing school is such an evolutionary process. I've changed, not entirely, but a little. I look at certain things differently. I've grown. I still have my doubts,fears and insecurities, but I'm also more comfortable with a lot of things that I feared concerning nursing.

I can remember that young medic who thought it was an unattainable dream. One thing I learned long ago though is, if there's a will, there's a way!

Certain things may get in your way, but they're just speed bumps on your road to success. You just need to slow down, cross the hurdle, and press on.

Last year, when I had the time to post nearly daily I did something I called "STBTF", something to be thankful for, in honor of Thanksgiving. I don't have the time to give thanks everyday (at least in blog form), but today I am thankful for the opportunity I've been given and the support of those who've stood alongside me, whether in person or from afar.

I'd also like to thank scrubsmag.com for listing me as one of the blogs they like! What an honor!

six weeks and that which drives me bonkers

We have six weeks left int his semester. I believe that's six weeks until finals week, but am not sure though. Whatever...the time is coming nearer and nearer with each expediently passing day!

In the midst of all my eating, sleeping and breathing nursing school certain areas of my life have suffered. My house is, second to my family, the biggest area that's suffered the most.



This would be a Hibiscus plant, one of two, that we've brought in from outside. It's just sad. I'm going to have to cut it back to rejuvenate it. I'll feed the flowers to Irwin. He loves him some Hibiscus flowers!



dust...need I say more?



This is an attic fan that has been taking up space forever. It needs to be installed and we were going to have it done a few months ago. The electrician, who happens to be an acquaintance, said he'd rather not install it in the heat. It was June-July time frame--defintiely hot! Attics and heat are just not compatible!



Oh, the clutter! Not to mention this is my scrapbooking table. It has become a we-have-no-where-else-to-put-it-so-put-it-here spot. ugh!



This is our bills and mail basket, which I usually go through periodically. Ahem. It hasn't happened in a while. Can ya tell?



Being that tomorrow's Halloween I find this one kind of funny. You really can't see it for it's full effect as the picture doesn't do it justice. Who needs to decorate for the holidays (which I have not had time to do) when you have live-in, or should I say "live-out" decorators?



Lastly, this is one of my bone's of contention. Coupons. If we didn't save so much money using them I wouldn't! If I go to the commissary they help to save a bundle and if we go to one of the local chains they often offer doubel coupons. What's terrible is when I leave them until they become a monster, and several of them have expired already.

So here I sit, multi-tasking, as I post, I'm clipping. Now that I type that it sounds impossible. I should clarify, every couple of minutes I got through a few and then I type. The computer timed out a bit, so that's when I took advantage of the freeze up. I need to go shopping today, and should really go to the commissary, but it's military payday, so that means it will be crowded. Many people in the military live paycheck to paycheck, so they have to wait until payday to do their grocery shopping. I could go on about that, but it could be it's own separate post.

I'll leave it until some other time...for now I'm going to finish up my coupon clipping and head out and head in to combat. I think I'll take advantage of the drive and take some photos along the way. I might try and match up to some of the ones I took last year to see what's changed. I thought I'd posted a photo collage of them, but can't seem to find it. Found it!

I'll try and sneak in a post some time soon about clinicals.

Have a Happy Halloween!

really miss ya much

It's quite evident by my infrequent blogging as of late that I don't have much time. I miss reading everyone's blogs like I used to. I try to catch them here and there, but am not able to keep up with them like before.

This week was great, aside from failing yet another test and having a mini mental breakdown thanks to that dreadful 74. Thanks to the support of my classmates I wiped away the tears, went back in to class and sucked it up. Tuesday we had fun in our health assessment class. We did musculoskeletal assessments. Wednesday and Thursday we started our new clinical rotation. My patient was an elderly person who had fallen and had a large supraorbital hematoma and compression fractures to her thoracic spine. The first day, prior to her surgical repair of her T-spine she identified with me as her student nurse. The next day I was her granddaughter for part of the morning, and then with her exit out of the sedative effects of anesthesia she knew who I was...then I left. However...! Before, or during, whatever.....I did do my first Foley catheter placement!


Do you have anything that you are thoroughly, without a doubt nervous about? For me it was inserting a Foley in a man. I did pretty good for a first time, and walked out proud.

Foley catheter placement-check!

H1N1 vaccine-check!

I was also given the opportunity to receive the H1N1 vaccine (mist form) while at clinicals on Thursday. I've been on the fence, but decided I don't have time to get sick, so better try and prevent it. As for the boys, I'm still on the fence. They've been exposed I'm quite certain as our public schools have been running rampant with illness. According to LB 198 people were absent yesterday. He said that if 250 are absent they shut the school down. I don't know how accurate his information is, but I do know there are plans in place for such occurences as excessive numbers of students being absent with possible H1N1. Many of the cases I've heard of have either been flu-like, or have been strep throat. Putting it simply, our county is ill!

slopes and slaloms

Have you ever climbed a mountain? You're standing at the base looking up and it seems like you could never, ever possibly make it to the top. You decide, "What the heck! I'll never know unless I try!" So you start that ominous climb. All the way up you might be thinking to yourself, "What have I gotten myself into? I want to give up!" Or maybe you just have someone pushing you. Sometimes that's what it takes.

That picture is from the Cinque terre. It literally means, "five lands". It's five villages along the Italian Riviera that you may take a ferry to each place, you can drive from one place to the next (although it may be more difficult in some areas), or you can hike it. We hiked it. We hiked it when I was pushing 250, or so, lbs. We started at the bottom town, Riomaggiore making our way up to the second to the last town, Vernazza. The boys were about 6 and 9 years old. Of course they're running ahead like it's nothing, and in certain places it's very steep and very seemingly treacherous.

I struggled, but I made it.

I've climbed a couple of other mountains, certainly ones a little higher than the five lands of Cinque terre. I've climbed a part of Pikes Peak, or somewhere up in the Rockies.

I'm climbing one right now, and have finally made it to the top. I never thought I'd make it here. I'm climbing it with a group of people and we're on the downhill side. There are days it still seems like we may never finish this feat.

Nursing school.

We're half way through our third semester and everyday--everyday--is a struggle. The past 8 weeks seem to have gone by fast. (It must be the altitude.) I'm hoping, we're hoping, the time continues to rush by expediently.

Like that day in Italy, when I reached the end of the hike, I know it'll feel good to have accomplished what I thought I'd never accomplish.

It may even feel like we dominated Mount Everest.

little bitty

I like that song by Alan Jackson.


Alan Jackson-little bitty

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I'm hoping there's little bitty chance to do extremely well on the exam on Monday. Two of the four chapters we're being tested on are on the endocrine system (bleck) and the other two are on nutrition. Deja vu...didn't I just study this same stuff this past summer? One would think I'd do extremely well...then one must consider theinstructor and her tests. The advantage of doing well on this exam gives cushion for future exams. But really, future exams have at the most 5 chapters on them. There's nothing really going on over the next few weeks, except for the homecoming game next Friday, that I feel interested in taking part in. Depending on how this week goes as far as studying will decide whether I'll take a bit of a break and go to the game, otherwise I'll not go. Sacrifices, for the most part (unless they have to do with my kids) have become a lot easier to make.

This coming week will be our last with our current instructor, the end of this rotation. The five of us in my group are going to be extremely sad to leave our instructor behind because she is just that awesome! I am excited to move on to another rotation. I don't feel like I've gotten a lot of technical experience as far as doing anything other than vitals, documenting, assessment, and basic patient care. I'd like to do some catheters (gulp--that's one of my intimidators), IVs, dressing changes, stoma care, basically the stuff I haven't done on a real patient in many, many years, if ever. I am thankful going into this next rotation that I am more comfortable with assessments and documentation on this hospital's computer system. Our next instructor is the former Army nurse. Need I say more?

That's my itty bitty update. I could go on about tons of stuff, but need to get upstairs and hit the books.

near despair

more like near desperate.

Yeah, so...you remember that great decision I made to stick with this nursing program. (BTW--I do not care to hear any "I told you so"s--you did, but what's done is done. I still feel the need to bitch.)

I'll keep this brief as I have a care plan to work on and chapters to read.

Last week was (hopefully) the hardest week we'll have this semester. We had 8 chapters of OB to study and 2 discussion board assignments (debacles) to participate in. That's along with working on care plans, critical evaluations or whatever the rotation you are on requires. I failed the exam Monday because I didn't study as much as I should have. I know where I went wrong. It doesn't help that there was just so much to read and study about. We went from the whole birth process to include normal deliveries and everything else that can be thrown at you to the postpartum period and everything that can be thrown at you there. That's a lot of material to cover in one week.

When the teacher doesn't teach and you're pretty much teaching yourself, or learning in study groups, it makes it even more difficult. Hence the feelings of regret. We have one instructor for second year. One. We have no choice. Do you see the problem here? I think I'll be ok. I'm swimming on the surface and not drowning. I can't say the same for my whole class. There are people who dream about becoming nurses and their dreams are being ripped out from under them.

All this and life has its own drama. On my way to buy groceries the other day. (I decided, like an idiot, not to go to Quantico, but rather to try out the new Harris Teeter.) This was stupid, for one, because I spent more than I normally would--not withstanding the normal reduced prices you pay at the commissary, but there's a way better selection of new and different items. One reason I chose to go there was because of my time constraints. I figured going 15 minutes away versus 45 would help even out some of the extra money spent.

WRONG!!!

There was a huge car accident that included two fatalities. It apparently happened sometime before 7 a.m. and I went through around 8:45 and it was still backed up. Let's put it this way, when I saw the one car that had been involved I wanted to bawl. I knew it meant someone had died. That and the fact that they don't normally close high traffic roads unless there are fatalities. By the time I went through it had opened back up. A young father, who spent the night before up with his 5 day old, fell asleep at the wheel and T-boned a young mother. She was a graduate from our LPN program a couple of years ago. She left behind her 9 year old son.

Moving forward I took AW and his friends to the sakteboarding event on Saturday and they had an awesome time. I enjoyed watching it, although I'd awakened that morning with a severe headache.

Sunday was uneventful.

Monday I woke up with a migraine and had to skip the first class. I ended up taking acetaminophen and ibuprofen and was able to shower then drive myself to my local Rite Aid to have my Relpax Rx refilled. I headed to school for the exam. That's when I found out about the nurse who died in the above mentioned accident having been a graduate of our LPN program. There was a bit of sadness in the air.

Last night, here at home, I heard sirens, and at the same time was beckoning for my children to come in. LB informed me by text message that there was fire trucks and ambulances up our street. Being the nosey neighbor I am, and unable to focus on my care plan or anything else other than the local drama, I headed outside. Apparently one of our neighbors passed away after having a heart attack. What I gathered from another neighbor is the deceased drank heavily and had been in liver failure.

Today at clinicals we had near endless excitement. One of my classmates' patients threw up over 1000ml of blood and the rapid response team was called because she was going downhill PDQ. The RRT was called off after the doc got in there and assessed her.

Then about an hour or so (times could be off as I have no concept of time right now) later we actually had a code blue. The patient was resusciated. Then we could overhear one of the docs calling to notify the family and we overhear the doc saying someting to the effect of "You don't want him on the ventilator?" As the team was pulling the patient out of the room, to go to ICU, they then had to push him back in. Then evidently the family member decided the patient could be put on the ventilator temporarily. Off he went to ICU.

We got out early today so our instructor could attend the funeral for the deceased nurse. Oh yeah, during our morning session I had to step out of the room when the instructor notified us about the funeral and we talked about the accident. Come to find out the car I saw belonged to the nurse. I lost it.

Can we say madness? This is all not to mention the extreme wind blowing right now. It wouldn't be so bad but it's too nice for the A/C to be on, so our windows are open.

Ok, so this didn't turn out as brief as I'd originally intended, but now I am finished blathering at the mouth. Or should that be the keyboard?

Here's hoping for some calm...