Hallelujah !!!!!! Whooohoooo!!!!! Yipeeeeeee!!!!!

I PASSED!! What a glorious feeling.

I did great on my clinical exam. Missed only one very small thing. After I did my initial focused assessment on the patient (a mannequin) I had to go prepare an IM injection and administer that. Well, I had already identified my patient and had him state his name and checked his ID wristband BUT when I came back to give the IM injection I was supposed to check his ID wristband again. I did not. *ugh* It was not something that prevented me from passing but just protocol. My instructor reminded us that if we do that next semester with a patient in the hospital it is grounds for an 'educational contract' because it is something that is mandatory. But I know exactly why I did it...because the facility we are doing our clinicals at now is very technologically advanced. Patients wear ID bands that have bar-codes on them, meds have bar-codes on them, student/employee's ID's have bar-codes on them and meds are listed in a computer thereby forcing you to scan all three things before ANY meds can be given. It is GREAT for patient safety but a bad habit because most facilities do not have this system.

My 'patient' was an 85 y/o with pneumonia and a history of Type I diabetes (NIDDM) and Parkinson's Disease. He had copious amounts of sputum and a right lateral leg wound proximal to the ankle bone. Upon entering the room I immediately noticed his oxygen was not on and the head of his bed was not raised (extremely unsafe patient safety issues). I did my focused lung assessment and the patient was complaining of pain 7/10 on the pain scale. The patients current medication record did not include a back-up pain med. Therefore, a call to the Dr. to get a new med was needed. After receiving a phone order from the physician I needed to prepare and give the mixed IM injection (which included the math calculations on the dosages). After that I had to reevaluate the pain level and proceed with a sterile dressing change on his wound. I managed to do that all within sterile technique. Then I had to give a mock oral report on my 'day' and write a nursing note on the dressing change. It was over in 45 minutes, all under the watchful eye of my instructor. This is pass/fail system, no letter grades.

My med/surg theory final exam was not such a breeze but my overall class grade (a combination of 20% weight based on a Peds final we had earlier in the year and this med/surg final with all other mid-term and quiz scores at an 80% weight) this enabled me to pass with the required percentage.

Now I can focus on the holidays, my family and resting a bit before we get back to classes mid-January. I may post some random thoughts between now and then ...or not ...depending on my mood. ;o)