Student Nurse, prn

Floating on cloud nine....

2006-08-09T09:34:00.000-07:00

Yesterday I received my results from the state board exam and I am elated to report that I...

PASSED!!!!!!

Each day waiting for the results (4 weeks) seemed like torture but finally the envelope arrived. Then I was afraid to open it. My daughters were home so it was exciting to have them there. It seems so surreal to finally be able to call myself a Nurse.

Ironically, it was 3 years ago this month I started my pre-requisite classes not even sure what nursing was all about but that I wanted to have a great career and a steady income.

What is next to come?

Well, I am still working at the facility (acute rehab) where I was a CNA. I moved to the nursing desk after I graduated and I am doing ward clerk type duties (processing Dr. orders, faxing the pharmacy, ordering xrays and labs in addition to other paperwork). I will continue in this capacity (slightly expanded but still no patient care) until my license (and #) arrives in the mail in another 30 days or so. Then I will begin my training on the floor. I chose to stay at this facility because they are offering a tuition reimbursement program for current employee's who move up and it will be a good to have at least a year of acute nursing experience in a med/surg environment.

So, as my instructor used to say it's time her 'nurse-lets' fly from the nest.

I do plan on going for my RN but at a slower pace I have about 6 pre-requisite classes left. I plan on taking them (mostly sciences) one night class per semester and then enroll in the upward mobility program that is 1 year full time. So, by maybe 2010 I will be an RN.

A big thank you to everyone who has read the blog. I hope maybe some information was helpful to other student nurses. My original intention was just more of a journal but the feedback has been so encouraging especially on the rough days. The medical community is certainly a great one as well as all my other faithful readers.

I have no plans to continue the blog at this time. I don't have an interest in writing about my work but I also don't like to say never. I did start another blog but I find I am not writing much there either maybe I will take a small hiatus and then reconsider. Best of luck and happiness to everyone.

with love,

Nurse Carolyn

Joke....

2006-07-23T23:14:00.000-07:00

Ok I heard this today at work ...y'all have probably heard it before but it got a laugh from me.....

Dr. says to his patient, "I have bad news and horrific news which do you want first?".

Patient replies, "I'll take the bad news first".

Doc says, " I am very sorry to tell you that you have only 24 hours to live".

Then the patient asks, "What possibly could be the the horrific news?".

Dr. tells the patient, "I forgot to call you yesterday".

ba-da-boom!

Critical thinking....

2006-07-10T19:25:00.000-07:00

That's the name of the game with NCLEX. It's not a fact based exam, oh don't get me wrong, facts are mixed into the equation but it's all about judgment and critical thinking and a dose of common sense.

Is it possible to study? Sort of. Review terms, values, anatomy, meds and diseases. Do as many NCLEX style questions you can tolerate and call it a day. You either know this stuff by now or you don't.

I have all day tomorrow to study. Then it's the day I have been preparing for for three years. (That felt odd to type did I punctuate it right? ...for for...)

Anyways, no pressure, noooo (insert sarcasm).

Results take 30 days to receive by mail after the exam.

I'm numb. Behave y'all. TTFN.

Listless and calm....

2006-06-28T13:15:00.000-07:00

I was looking for the French word in card game I used to play as a kid called "Mille Borne" it's about an auto race and I thought one of the words was Coup de --?-- (graw?) kind of meaning the grand finale but alas Google has failed me or may patience ran out. Help anyone??

So, the title of today's blog describes my current state. I can't kick it --the listless part. I work part time from 1-9pm and on my days off I veg out. I am calm about my upcoming NCLEX-PN exam on July 12th. I know I should be a crazy woman about it but I took 4 days off of work prior and that will have to suffice for crunch studying. The feedback from classmates has been varied. But both had the exam turn off at 85-90 questions. One felt good the other completely unsure. One we heard nothing from.

Oddly, I thought I had posted since the pics. Does blogger eat posts entirely?

Today is day 3 of three off. I am nursing a pulled muscle in my lower neck upper back. Can't move my chin towards my chest or lean it back. Slept in a bad position. Damn this getting older sucks.

PICTURES!!!! Can you believe it? ....I had to fend off the paparazzi

2006-06-02T23:53:00.000-07:00

The bestest folks in the world and fellow Nurses.

The entire graduating LVN Class of 2006

Me and my best buddy Brenna after the ceremony, the proud new Nurses *awwww*

Waiting patiently ....

Getting pinned by my all time favorite instructor :o)

Here I am during my 'speech ' to the crowd

This is my 'official' graduation picture with the traditional Nursing cap and all.

Me ...on a regular day

Sorry this took so long. I know I promised it long ago (I had trouble with Blogger and the pics) I hope some of you are still hanging around...

with love, Student Nurse, prn

Beep, beep back it up baby...Pinning Ceremony and Graduation

2006-05-13T11:02:00.000-07:00

Oh, how remiss of me not to blog about the pinning ceremony/graduation.

It was sureal. All that anticiption, planning, anxiety then it went by in such a flash. Not unlike a wedding. I want to rewind and do it again. Partly, I think, because I was nervous that I was speaking (I hate to call it a speech) therefore I was not able to absorb and relax about the event.
According to family and freinds I did well (do they EVER tell the truth?) ...well, actually I spoke too fast in the beginning then I calmed down, realized it (had a nice internal dialog) and slowed it down to finish quite well if I do say so.

Three students recieved awards from either one of the facilities we did clinicals at or from the faculty. And then the 4 remaining were also honored by the faculty ...because they could not agree on who deserved the award the most so we all got one!

Of course we all looked like a blast from the past in our nursing hats and white uniforms. Guess I'll use mine now to either loan out for Haloween or use for adult dress up *smirk*.

Afterwards, my family and a few friends went out for a nice dinner and I stayed out to have a few cocktails with some girlfriends. A nice way to end a great day.

The future begins.............

update: pics will be delayed a few days the ones my daughter took are all blurry, currently waiting for pics other family friends took.

Schedule for Friday....

2006-05-11T22:53:00.000-07:00

Not a damn thing :o)

(the sound you hear is the slow leak of stress from my brain and body)

oh and *pssst* pics will be up Monday and for ONLY one day, for my dear sweet regular readers

Drum Roll, please..............

2006-05-09T16:59:00.000-07:00

You are now reading the blog of a woman who has passed her last exam in the VN program!!!

Woooot!!!!

Today went well. We took the exam. Instructor ran the scantron. Informed us we all passed.

We all went to lunch (and had a surprise wedding shower during lunch for our sole male class member who is getting married during summer) and then went back to class go over the exam.

Now I have to get everything prepared for tomorrow and the pinning ceremony. Gonna start with a manicure and pedicure while reading a entertainment magazine.

Time to........ get busy living!!!

p.s. graduation/pinning ceremony pictures will be posted soon

Overwhelmed...

2006-05-07T22:16:00.000-07:00

Ever get to the point you are so frazzled that you become ineffectively frozen to the point that you almost can't operate?

Fear of failure should help me study more but it seems to just freeze me up.

*ughhhhhhhhhhhhhhhh*

My last clinical day .....

2006-05-03T21:42:00.000-07:00

I'd say I am speechless but that would be silly.

One last day (1/2 day actually) and we get to chose a unit we want to be in (I think I'll be in ER or the OR) ....and then we meet our instructor for our clinical course evaluation followed by the traditional.... 'take-the-instructor-to-lunch' gig and then clinical is DONE.
Holy Foley!!!! (<--heheh) Pray for a smooth error free day.

Imagine, the next time I will be doing patient care will be when I am licensed.

Edit: Almost forgot the disaster drill went ok. We (the students) did great if I do say so (well the hospital staff did say so!) ...but there was a big lack of communication with the incident site (airport) in regards to the number of incoming patients and whether or not the had been decontaminated from the 'nerve gas'. All this is of course gone over in the debriefing so it can be corrected next time. Overall, it was great to get a feel what a true emergency would be like and how a nurse can contribute as well as all that is involved.

Before disaster strikes...

2006-04-29T11:45:00.000-07:00

...you have a drill.

At the hospital they have a HUGE one. A county wide disaster preparedness drill.

People volunteer to participate as both professional responders (MD's Paramedics, EMT, Law enforcement, Fire fighters, Nurses) OR victims. This one, I believe, will be a biohazard situation.

So, on Wednesday of next week we get to participate as Nurses. So cool. Actually, being a victim playing the injured roll might have been more fun but this is going to be great experience from an educational point of view.

Tuesday is our very last lecture class (with a quiz on renal). The following Tuesday is our final exam. This weekend involves lots of studying....

Update: Mom...

2006-04-29T11:34:00.000-07:00

She's home, after having to stay an extra night in the hospital due to a low grade fever.

She did have a first semester nursing student (RN) assigned to her, which I thought was hilarious. I am sure she talked the guy to death. Poor fella was having a hard time just getting her BP (he couldn't manipulate the automatic machine).

Treatment plan: Rest, q 6 hour Percocet (oxycodone and acetaminophen)

The only PT she received in the hospital was she was taught how to do a log roll to get out of bed. No brace or anything else.

She seems in good spirits. Talking on the phone 24/7! Typical of my Mom. She also wanted to take a shower when she returned home but was referring to the shower as the "den of doom...where the evil happened..." --all in jest of course. I told her to get a shower chair just in case.

Distance sucks....

2006-04-26T12:57:00.000-07:00

I don't normally blog about personal stuff but this crosses the line from personal to nursing/medical ...

I just found out my Mom is in the hospital. *ugh* and My folks live 2 hours away (by car). Mom is only 60, very lively, spry, those seem like weird words to describe her let's put it this way ...she's the HIP Grandma, (as in COOL) get the picture? Totally close with my two daughters.

Well, she had the stomach flu. Was up all night before last with typical symptoms, emesis and diarrhea, etc....so yesterday she gets in the shower at 6pm-ish after my Dad had returned from some errands. He's watching the boob-tube and hears a crash. Calls out. Nothing. Gets up finds Mom in a crumpled pile in the shower (small square glass enclosure) ...not responsive, she has had a syncopal episode (passed out). He lifts her eyelids and her eyes roll back. Calls 911. Go Dad. She's unconscious for maybe total of 2 mins. Paramedic/EMT's come get her up and transferred to a gurney and to the local hospital.

Trip to the ER. Xrays, CT scan. Diagnosis: Cracked vertebrae L5 (Lumbar 5 the last one before your sacrum and coccyx) and low potassium level. Start pain meds. 11pm agree to admit to hospital. 2am in room.

Talked to her at 10:30am she had just gotten breakfast (WTF). Asked her the name of her nurse, she had no idea, no one had introduced themselves! (WTF) She's in a ton of pain and getting morphine IV and now Percocet PO (by mouth) and potassium PO. Dr. says rest you will go home tomorrow AM.

Her potassium (K+) was most likely low due to the emesis and diarrhea from the flu.

It sucks to be far enough away I can't go and give her a hug but my bro lives close and my Dad is very capable. I just can't concentrate on anything right now.

Welcome faculty, family and friends....

2006-04-26T00:08:00.000-07:00

OK it really doesn't start that way but GUESS WHAT? ............

I am going to speak at the pinning ceremony. ME. Little ol' me. A 'speech' and I volunteered to do it. My classmates do not know the content. It's a surprise. They do know I have something planned. But be assured it has lots of the word DREAMS in it and required poignant moments.

I do not think I am a good speaker. I am NOT the type to want attention. A few weeks back I was in an especially emotional state (read: PMS'ing) and decided to start writing. This was the result of my 'moment'. I hope that the passion I felt at the moment shines through in my 'speech'.

As the saying goes anything that doesn't kill us will make us stronger. I'm going to be one tough chick.

Pray for me. Please.

This could get interesting.

I am the Enema Queen....

2006-04-24T19:34:00.000-07:00

Two more weeks of clinical time left and I never had to do this. Rectal medication, yes. Enema, no. But now I can say I have the had the joy of not only administering ONE but FOUR enema's in one day.

#1 Mineral oil enema -- no results
#2 Saline enema -- no results
#3 Saline enema -- no results
#4 Warm tap water with Castile soap enema (gravity fed) -- no results

Next step? Digital disimpaction -- results, unknown, I was headed to post-clinical wrap-up and the next shift gets to handle it :o)

*whew*

Senior-itis ......

2006-04-22T15:18:00.000-07:00

I have it bad. Here is the disease process....

Super Seven Study Guide - Senioritis

Definition: Acute inability to concentrate during class

Etiology: Pending pinning ceremony/graduation

Pathophysiology: Increased levels of epinephrine and norepinephrine

Symptoms: Altered level of conscience, lack of concentration, persistent day-dreaming, tachycardia, blurred vision, restlessness, twitching, fresh manicures/pedicures

Diagnostic studies: Check blood level of euphoria, CT and MRI scans of the brain

Medical Management: Daily doses of common sense and reminders of final exam

Nursing Management: Patient education in regards to effects of not passing final exam.

Fastest week ever...

2006-04-17T14:36:00.000-07:00

Just like a vacation week to zoom by so fast.

But thinking back and I did enjoy it a lot and with tons of variety:

paid bills (ok, it HAD to get done before I left)
traveled to the SF Bay Area to visit with family for three days
saw "Ice Age; The Meltdown" and had dinner at a yummy Mexican Restaurant with a friend
lovely relaxing lunch with another friend
Sunday night dinner with family (and found out I will be an Auntie AGAIN!)
went skiing twice at Lake Tahoe resorts (discovered I am TOTALLY out of shape, once while it was sunny and once while it was snowing (in CA in April!!)
went to Easter church services on Saturday night (and volunteered for the First Aid Team)
worked two shifts, one on EASTER morning (possibly my last shift EVER as a CNA..whoohooo)

Now I am trying to get my house back in order, do some laundry and catch up on homework for tomorrow. We have lots of lecture material to finish before the end of the semester. Crunch time folks!!

SPRING BREAK ..Whoooohooo!!!

2006-04-07T22:06:00.000-07:00

I will NOT be basking in the sun at some tropical location in a bikini BUT I will relax a bit, visit with family and good friends, enjoy my kids, ski/snowboard for two days, see a movie or two, eat out, work a couple of days and most of all NOT pick up a textbook/lecture note/etc....

The weather is depressing in California. We expect rain for about a week (it's been raining non-stop lately) we have yet to have multiple days of sun. Very unusual spring.

See y'all next week.

Dress rehearsal ..."the HESI Test"....

2006-04-04T19:22:00.000-07:00

So, today we took a test on the computer called a HESI Test (we paid for this privilege in our tuition).

This test is supposed to be VERY VERY similar to the state board exam we will take after graduation. Yeah, remember, I may graduate but I can't be licensed until the great state of California says I know how-to be a nurse.

The state exam is a bit tricky. Let me explain. Firstly, it's timed but I hear you have five hours and that is MORE than enough time. Secondly, it's all on computer. Next, once you answer a question you can not go back.

Also, there are several types of questions;

1) multiple guess (ops, I mean choice)
2) choose all that apply from a list of about 5-7 possible choices
3) then a fill in the blank (either a number or word)
4) an anatomy marker (put an X on this body part, etc.).

And here is the real kicker...if you get a question wrong and for example it is a pediatrics related question, the computer says to its mighty self, "humm, Student Nurse is weak in the Peds area, HA!, let's give her more questions on Peds" (insert devilish laughs).

Can you believe it!!! That's just cruel!!!

The test then continues until the computer just shuts off. At that point you have no idea if it shut off because you were doing well or because you were doing badly. Some folks can have theirs shut off after not too much time has passed and other sit for hours. Neither knows why. The results take approximately 30 days to be mailed to you. You are not issued a grade just pass or fail.

Anyways, today's test wasn't so sophisticated but it was 160 questions long and I got an 88%. Sweeeeeet!

*doing the happy dance*

..... it gives me hope, that's all.

You DON'T want to be the interesting patient....

2006-04-02T17:55:00.000-07:00

I was in the ICU this past week and I discovered one main theme. You never want to be the Doctor's 'interesting patient'. Trust me it just = bad news. And in the case of my patient it proved to be true.

My patient -- 72, f, Diagnosis: Atrial fibrillation.

History: She came through the ER over a week ago due to general malaise "I just don't feel well". She has a big history of COPD (chronic obstructive pulmonary disease) and is on 2 liters of oxygen at home (former smoker). Her quick diagnosis in the ER was Atrial fibrillation. She was in the ER for about a week having breathing problems in addition to the heart dysrhythmia. She had an NG (nasogastic) tube for feedings. Thursday AM in Telemetry she has an exacerbation of SOB (shortness of breath) while they tried to get her to sit on the side of the bed. Her O2 SAT's (saturation) goes down below 75 and they have respiratory therapy come and get her on a bipap machine to sustain the needed O2 level of over 90. So, she comes back to the ICU. Now she is being assisted by the bipap machine (it's not a ventilator, it forces the air in via a mask without a tube).

Her in-house Doc orders a pulmonary consultation for that night which they do a bronchoscopy and can't "see much" due to some possible clots. They have to put her on a ventilator to sustain her breathing. So, they reschedule for Friday AM to repeat the procedure.

They do this procedure in the room and I got to be there. Essentially they put a tube with a camera attached down the mainstem bronchial tube to look in her lungs. Well, what they find is a fistula in the mainstem bronch that the NG tube can be seen laying in. Keep in mind the NG tube is in the esophagus and the bronchoscopy tube is in the lungs (past the epiglottis the two never shall meet). It seems the wall of her brochial tube has eroded due to a massive amount of cancer and the erosion goes into the esophagus. The Doc removes the NG tube at which point he moves the camera into the hole and looks into the esophagus! He also backs the camera up and shows the massive cancer spreading over her mainstem bronchial tube. He takes a few biopsy samples, photos from the camera and exits.

And then repeats the infamous words, "in 20 years of doing this type of procedure I have never seen this."

During the procedure many nurses from ICU and Tele are filing in for a look and I feel like I hit the student jackpot.

Unfortunately, for the patient, Doc says they can not remove her other lung because of the end stage COPD she couldn't function on one already compromised lung. This is a terminal diagnosis of lung cancer and this patient will never get off the vent besides the fact she can not eat unless a tube is placed into her stomach. Prognosis is to remove the vent and see how long until she passes.

I also got to experience her Doc tell her daughter the prognosis. It was hard to keep my composure. Friday was an interesting day.

Care plans ....

2006-03-27T17:56:00.000-08:00

We have two care plans to finish before the end of the semester.

I just finished one from on of my last weeks patient. I will do another this week, that relieves one major item to not think about over spring break.

Patient info, medical diagnosis, pathophysiology of disease, diagnostic exams, medications, assessment, patient problem, nursing diagnosis, nursing interventions, goal, evaluation, goal met.

My instructors version of the scientific nursing process called ADPIE.

The HAG yelled at me!!!!......

2006-03-25T10:26:00.000-08:00

OK, I'll calm down now. Some people have no social skills at all.

Here's the scoop...I am passing by the nursing station and the unit secretary says to me, "Patient in Room 100 needs something right now" (it's not a stat I'm dying, just a get here ASAP).

I make a quick bee line for the room. When I get in there the patient has pulled out her IV (I think her chair got caught on it) and her forearm is bleeding and the IV is spurting out saline fluid. The patient has her hand over the blood source.

I put some gloves on pronto, grabbed an unopened roll of curlex (rolled gauze) that happened to be sitting on her bedside table and placed the whole roll on her arm and then had her bend it at the elbow. Whew, priority #1 --stopped the bleeding. Then, I took the IV and placed it on the incontinence pad on the bed (I'm not allowed to touch the IV pumps yet) I did this so it wouldn't get the floor all wet. I told the patient I'd be right back and went to get the assigned RN.

She was on her break, so I get her break-nurse and we went back into the room and took care of the issues. (Stopped the IV, properly put a small dressing over the site of bleeding) then I went back to my previously scheduled whatever I was doing.

About a 1/2 hour later the assigned RN sees me at near the crowded nurses station and yells loudly at ME, "no one ever told me about my patient's bleeding!!!!!!"

Then at least 5 people in the vicinity say, "shhhhhhh", very sternly at her.

Of course, I look like a deer caught in the headlights and stammer something like, "the break-nurse (who's name I couldn't now recall) knew all about it".

The assigned RN says something unintelligible and the break nurse looks dumbfounded, shrugs and we all walk away.

I was pissed off. People now think I am an idiot for something that I did correctly. It was the responsibility of the break-nurse to report anything she did while the assigned nurse was gone.

I stewed about it. Notified my instructor. Then my instructor talked with the HAG today and she said, (and I quote) "Oh, I wasn't mad at your student I was angry at the break-nurse, I knew it wasn't your students problem"

WTF?

Drug seekers...

2006-03-23T20:14:00.000-08:00

Not sure I should have used that title after the one from a few days ago ...this blog has gone to the gutter.

But seriously that is the subject today. I had a patient the last two days with a disease called Crohn's (click on the link for a detailed description) but in a nutshell it's a very painful chronic inflammatory disease of the large bowel. She, the patient, (47 y/o, white) was in for the diagnosis of GI bleed (symptoms were massive blood in her stool). Her discharge diagnosis was listed as exacerbation of Crohn's. She has been to the hospital many times before because the disease can flare up and have increased symptoms at any time.

My RN that I was reporting to today was rather flippant that I chose her as a patient. Mumbling that there were better patients for learning experiences than a 'drug seeker'. Well, first of all when I chose her it doesn't exactly say on her chart/care plan "DRUG SEEKER". It lists her medical issues not the nurses perceived psychosocial ideas.

Now granted this chick was on massive doses of opioid drug derivatives but hey, she said she was in pain. The description of pain, we are told by our instructors, is exactly as our patients perceive it. Nothing more, nothing less. Pain is very SUBJECTIVE. And granted I may have had my doubts but I certainly didn't treat this patient any differently because of her history. I mean has my RN today ever had Crohn's? --I don't think so.

I can understand how in the ER they get fed up with folks coming in with pain issues on a constant basis but this gal was in the hospital for days with pain.

I know I have lots to learn but I hope I never get jaded like my RN was today.

Pimpin'....

2006-03-20T22:53:00.000-08:00

When you got something good, share it.

My good friend is brilliant. One of his most recent ventures is a company called VisiStat.com. Don't think medical STAT, think site visitor stats. His site is very user friendly and they send you a daily email with a re-cap of the previous day. I highly recommend it. And no he did not ask me to post this, I did it because I believe in his products.

But, of course, see for yourself here at VisiStat

Just to clear things up...

2006-03-19T20:52:00.000-08:00

I appreciate all the nice comments from my most recent post.

I blogged about this long ago (but briefly) on my career path. So, I just want to clear things up.

I will be an LVN when I am finished with my current program. For some folks they are thinking what's the difference? Other are thinking why would you do that?-- RN's make more $.

So, first I'll explain the difference to non-medical folks. RN is Registered Nurse and LVN or LPN in some states is Licensed Vocational or Licensed Practical Nurse. I can only speak for the difference in California. An LVN can do all the same stuff an RN can do when licensed except for anything IV related. We can however take an IV certification course and do some of the IV stuff. To keep it simple. An LVN can NOT inject anything directly into an IV catheter (even if certified). After certification we can hang IV fluids and blood. Again this is the simplistic version. Procedurally there are some very technical and specialized things also but as far as routine tasks that is the difference.

Now the better question is why did Student Nurse, prn choose LVN and not RN? A number of reasons. First, I am changing my career mid-life. This is primarily because I am a single parent.

I had a career before my divorce that I LOVED. It was the best job I ever had. I was a Corporate Concierge at HP in Silicon Valley. Catering to the elite HP executive guests in a high tech customer briefing center. I have always been in the travel/hospitality field and loved it. I am a people person and calm problem solver. My career path however did not pay well. Perks were off the charts--dining out comp, theatre in San Fran, wineries, you name it but I was never going to be able to raise two girls on that salary in the Bay Area.

I also knew I never be able to handle the stress of school, working and my girls at the same time. So, logically the job went bye-bye. I moved to an more affordable area of California bought a house and started my pre-requisite classes at a local community college. I had budgeted that funds would be able to last the length of the program if I got in quickly but only for the LVN program because the classes required for the RN program are more of the harder sciences and etc. I didn't have time to wait to complete them while not working.

I finished my pre-req's, worked for a while as a nursing assistant, and applied for the LVN program. I got in on the FIRST try (it's lottery based so luck is the only factor).

So, here I am ALMOST broke (haven't touched my IRA yet) and applying for a student loan to get me through the last few months but the sanity base is the equity in my house is AWESOME, gotta love CA.

Once I finish this and I am licensed I will go back and take the remaining pre-req's for the RN program --one night class at a time. And then apply for the step-up program geared for LVN who want to be RN's so I will get there someday. For now I will earn a decent salary in the field I want to be in while I get to my ultimate goal, RN.

Light at the end of the tunnel.....

2006-03-15T18:28:00.000-08:00

I can see it, it's not bright but it's there.

This week marks the 8 week mile stone until our pinning ceremony/graduation. If you factor in one week of spring break in April that leaves only 7 weeks of class time. Wow.

Tomorrow we take a class picture in our complete uniform.

I have been on the surgical floor for the last two weeks and will be this week too. I have had a several folks with the knee replacements. A back surgery. An appendix burst (19 y/o new Mom only 23 days post partum). Gastric by-pass, etc. This week should be more fun. I have two care plans to complete before the end of the semester. I think I may tackle one this week. I tend to prefer surgical floor to medical. The medical floor is like the investigation team. Lots of sick/miserable folks and not sure what they have going on, so lots of tests, labs and nausea/vomiting/febrile folks until the mystery is solved. The surgical folks on the other hand are post surgery and just in need of recovery. First most patients are still tired/loopy and sleep a lot. Second day is always better and by the third they are itching to get back home.

I also put in a request to go to the ICU, originally I said no, because I have no interest in that area of care. But I have changed my mind for two reasons. One is as a part of the continuum of care I think it's best I see that part of a patients stay. Secondly, I have been surprised in the past about what I enjoy and I promised myself to keep an open mind.

Lastly, my intentions all along were to keep my blog school related. I think I have managed to keep that goal but I have the desire to continue to blog. I find it cathartic. So, to those sweet fateful readers who maybe interested don't fret, Student Nurse, prn will resurface in another light. I will find a way to lead you to the new place while still trying to protect my anonymity.

Coming up for air.....

2006-03-14T14:05:00.000-08:00

*gasp* I am alive.

I have been immersed in studying for the past few days. I was up till 1am last night (technically that was today still) because we had our mid-term exam today.

96 multiple guess questions. One math calculation. Eight short answer essay questions.

I passed. *whew*

Tag, you are it..........

2006-03-08T17:09:00.000-08:00

Well, it turns out I've been tagged by Dustin over at Desert Imaging. So here it goes:

Four Jobs I've Had in My Life:
1. Sales at The Gap
2. Receptionist in a Hair Salon
3. Reservations/Inside Sales/Operations Supervisor for a Tour Wholesaler
4. Corporate Concierge at HP (best job I ever had!!!)

Four Movies I Could Watch Over and Over:
1. Somethings Gotta Give
2. Dirty Dancing
3. Shawshank Redeption
4. The Everlasting Lightness of Being

Four Places I Have Lived:
1. Tucson, AZ (born there)
2. Menlo Park, CA (grew up there)
3. Plano, TX
4. Lexington, KY

Four TV Shows I Love to Watch:
1. The Real World (someday I will grow up)
2. Grey's Anatomy
3. American Idol
4. ER

Four Places I Have Been on Vacation:
1. Hawaii, all islands (and more times then I can count)
2. Jamaica
3. Europe (Spain, Africa, Italy, Switzerland, France, England)
4. Lake Tahoe

Four Websites I Visit Daily:
1. my Yahoo home page
2. Dictonary.com
3. my blog
4. Craigslist.org (Sacramento)

Four of My Favorite Foods:
1. Sushi
2. Mexican
3. Ribs
4. Chocolate

Four Places I Would Rather Be Right Now:
1. Greece
2. Fiji
3. My cabin near Tahoe
4. with my niece (she's 8 months old)

Four Most Wonderful Places I've Ever Been:
1. Barcelona, Spain
2. Kona, Hawaii
3. Big Sur, CA
4. Wright's Lake, CA

Four Books I read Over and Over Again:
1. Drug Guide for Nurses
2. Diseases and Disorders, A Guide for Nurses
3. Shel Silverstein, A Light in the Attic or Where the Sidewalk Ends
4. John Steinbeck, East of Eden

Four Songs I listen to Over and Over Again:
1. Making Memories of Us, Keith Urban
2. Linger, The Cranberries
3. Kiss You All Over, Exile
4. Sunday Morning, Maroon 5

Four Reasons Why I Blog?
1. to capture for posterity my experiences as a student nurse
2. to share my experiences with other students
3. to help me think
4. to Rant and to Rave

Four people I tag to do this?
1. Mona
2. Neil
3. Monika
4. Bear

Mundane...You want mundane?...Here's is my morning....

2006-03-06T09:32:00.000-08:00

No school on Mondays...up at 8am ...wake the youngest kidlet ....tell her to get her rear in gear...get newspaper off porch...turn on heat for teapot...make the bed....turn on the Today show...plop in comfy chair...teapot boils...pour cup of tea.....sit down in chair...turn on 'puter...watch news...get distracted.....remember time...yell at kidlet to HURRY UP!!.....get out of chair ....to make oatmeal for kidlet now that she has 'NO TIME' to eat and get to school...in process of turning teapot on for the oatmeal spill entire cup of fresh tea onto counter and floor....*sigh*....finish with oatmeal, making a lunch, driving almost-late kidlet 2 BLOCKS! to school...return....fire-up teapot again...clean up entire spilled mess...SIT in comfy chair...get up......put hot water over teabag....get distracted by post-Oscars news and email, blogs....get up for tea to discover teabag leaked and now tea-leaf flakes are floating in tea....get new cup, strainer and pour tea into new cup...take that first sip of warm tea, was it not ment to be?

All I all wanted was a hot cup of tea with my newspaper and Today show before I have to study. I tried hard not to RANT but hopefully this is NOT my regular 'mundane'.

Health and Wellness Fair...

2006-03-04T16:22:00.000-08:00

I volunteered today at a Health and Wellness Fair...sponsored by a large church in my area.

I was doing blood pressure checks for folks and sitting at the First Aid station. I had a good time. Meet some nice people. There was community law enforcement (sheriff, highway patrol, search and rescue), other local agency's (SPCA, Mediators, Recovery specialists), folks promoting good health (vitamins, chiropractors, health clubs), a blood drive, speakers, and food vendors.

One thing I learned, I LOVE a MAN in UNIFORM they give me tachycardia.

My personal claim to fame for the day was I put a Cat-In-The-Hat bandaid on a two year olds finger. She had a small cut. I felt like a hero.

Hope everyone has a great weekend.

Snow day in Cally?.....

2006-03-02T17:42:00.000-08:00

I wish!!

Actually, two of my classmates had that pleasure today.

I live in area that is very unique. Two hours west of me, the sound of the ocean, one hour east of me, snow.

Our clinical location this semester (a hospital) is 30 minutes east of where I live (and where our school's campus is) ...go an additional 30 minutes east and that is where they get snow a few times a year.

Can you take a guess at what city I might live in --approximately?

Reprieve...

2006-02-28T22:46:00.000-08:00

Our quiz for today was cancelled because the instructor was ill. We still had class with our theory class with our clinical instructor substituting but it was more low-key and material that we were going to address later in the semester. Sweeeeet. This lightens the load over the coming week/weekend due to most of the work already being done for next Tuesday.

We are also off tomorrow (Wed) so I have lots of personal errands planned. I have been getting ahead with little projects we have assigned this semester. One was the A.A. meeting I attended a week or so ago. The other was we had to write a letter to some type of legislative member on an issue we feel strongly about in regards to Nursing. I wrote to the California State Board of Licensed Nursing and asked that the IV curriculum be added to our program so we don't have to take an extra class after graduation and pay more $.

Few loose ends. Hat requests ...thanks y'all for asking. I may post a picture of the hat but probably not on me. I have tried to remain anonymous to protect myself, the facilities I train at, my patients and my school due to the privacy laws in my state of California. I may put the picture up for one day for my fateful readers (you know who you are) and then remove it. Still mulling that over.

And for Mona and her request for instructions on a Foley catheter insertion. That made me laugh not only because it would be hard to explain BUT weird too. Let's just put it this way everyone's anatomy is wildly different. I did make light of it in class saying how our one male student must have an easier time inserting a female catheter because he has had a birds eye view of the female anatomy before, whereas most of us women have most likely not experienced that. He did blush a bit but with a sly smirk also :o)

Voting has began for Nursing blog for the month of February at Mediblogopathy just in case you feel the need to VOTE for a great student nursing blog you know, HINT, HINT.

I also did some cleaning of cobwebs on the blog (very minor). I am not a whiz with HTML so that's as good as it gets.

Toot....toot....

2006-02-23T18:02:00.000-08:00

I have had a great week and I wanna too my own horn.

First, my clinical instructor was lecturing on Tuesday and practically stopped mid-sentence to say to the whole class.... "Student Nurse, prn; I want to say something to you... (me getting nervous assuming I was about to be made an example of in a not-so-good way).... I want to mention how far you have come since you were in my 'Careers in Nursing' class way back when and how much you have grown, I am so pleased"

Shock!! Pick me up off the floor!!! She's not one to single folks out so blatantly. She will give students kudos for getting a question right, etc. but this was just odd, unexpected and very flattering :o)

and there is MORE!....

Lastly, during our post-clinical session on Wednesday, one of my fellow students, said she HAD to give another student kudos because an RN in the ER was just RAVING about last weeks student and how exceptionally CONFIDENT she was (<--that was ME!) in her skills and overall abilities. It was the same RN that I mentioned was so great to me.

Gasp! Knock me over with a feather!!!

Isn't it odd when other folks can see the confidence in you that you honestly don't feel that you have? Food for thought.

AA Meeting...

2006-02-23T17:18:00.000-08:00

One of our assignments this semester is to attend a local A.A. meeting. I went on Friday night last week ..... What a great experience!

I went with a friend who has been sober since summer of last year. It was an open meeting where they welcome friends, family and non-members, most of the meeting attendance was members. I had an opportunity to introduce myself during the announcements.

I learned a lot about how A.A. works for those in need an one main thing I walked away with was that the members have a huge sense of camaraderie with each other.

The ER, part deux.....

2006-02-19T23:10:00.000-08:00

......I got to go back. I was thrilled. I won't leave a long list of the types of patients we saw but needless to say it was similar to the previous week.

Best part was on Friday I got to work with an RN that is a natural teacher. She was EXCELLENT. She knew exactly just where to lead, mentor and teach. I felt at ease around her. Her confidence gave me confidence. She asked me questions without seeming overbearing or condescending. I wish I could return.

One of the LVN's said something interesting to me...he said the ER is different. Normally on a Med/Surg floor we know the treatment plan, patients diagnosis, medications, history, etc. He said the difference with the ER is they work backwards, they have to find out the diagnosis, the medications and history of a patient then they can treat them. He said you must adopt this backwards thinking before you can be effective in the ER.

Procedurally, I did a female Foley catheter, administered a suppository medication (I see you holding your hiney cheeks together!) ....and visited the special procedures room to watch a bronchoscopy (a procedure that a camera on the end of a tube is inserted into the nose or mouth and into the lungs which provides a view of the airways and lungs and to collect secretions/tissue specimens for a biopsy) and a EGD (esophagogastroduodenoscopy- an examination of the esophagus, stomach, and upper duodenum with a small camera inserted down the throat).

Next week I am on the surgical floor for several weeks on end....off to hip and knee replacement land.

Oh and lastly, we all got our hats we bought for the pinning ceremony. I sure hope I don' t look like the flying nun in this thing.

Grey's Anatomy...

2006-02-19T23:00:00.000-08:00

...the book has nothing on the ABC show.

I don't have much time for TV viewing but Sunday night is usually one where I put down the text books and stop studying to indulge in a mind numbing dose of the idiot box. I have to say this particular show, Grey's Anatomy ROCKS and not just because it's a semi-medical related show and that I grin when I understand the medical jargon.... it is just a well written drama with all the *gasps* one can muster in one hour. Love it. Keep it coming. I am hooked.

We blew it....

2006-02-15T09:52:00.000-08:00

Yesterday in class we all had the blahs... despite the beautiful day here in Cally and the tinge of love in the air, we couldn't muster any enthusiasm. We sat like bumps on a log, couldn't come up with simple information. Looked at each other like --sheesh, don't YOU KNOW THE INFORMATION?

We disappointed our instructor and made her a little pissy.

She told us we'd get senioritis but we didn't believe her.

Personally I started the day out great (thanks for the email Neil), practically whistling but once I sat in my chair I was drained of any energy. Not sure why but it happened. We need to step it up a bit.

Oh and yeah, I also messed up seems I am in the ER another week! I'm glad I was just starting to get the flow of the joint. At least when I go back I can be more efficient and effective.

The Big V

2006-02-13T21:57:00.000-08:00

Happy Valentines Day to all and their loved ones.

Emergency Department

2006-02-12T19:43:00.000-08:00

After all my teasers I feel guilty. As sometimes it is the case real life, it is not how it is portrayed on TV mostly because it would make a boring TV show. The average small hospital ER is kind of slow, dull and then an occasional excitement gets in the mix. Keep in mind I was there for about 8 hours starting at 6:30am on two weekdays.

When I arrived there is one MD working and by 11am there are two . There are usually 6 nurses (including one in triage-checking patients in and one charge nurse helping when&where he/she can).

Here are some of the down and dirty stats:

Thursday

(age, sex, chief complaint, possible diagnosis or reason- some of which I state as unknown because I was either not involved in their care or they were discharged with status as unknown)

55 M - Bladder, possible UTI
94 F - Fall, head lacerations&concussion (transferred to her primary hospital)
20 M - jaw dislocation, from altercation
9 F - headache&fever, unknown
23 M - cough, pneumonia
11 F - cough&fever, pneumonia
89 F - nausea&vomiting w/hematuresis (blood in urine), unknown
35 M - dizziness, vertigo
89 F - altered level of conscious, unknown
22 M - ear laceration, earring caught in car door (13 stitches)
5M - red eye, not conjunctivitis-unknown

Keep in mind we had a two hour stretch in the AM without ONE patient. That is known as the student syndrome. I made labels for a ear/nose/throat cart. Yipeeeeee (*not*). I am missing a few in my log as we got busy towards the end of the day. In report I heard they had a total of 51 patients for this entire day.

Friday

83 M - chest pains, admitted for observation
4 month old M - fever&red eye, unknown
50 F - bad day, psych referral
73 F - seizures or stroke, admitted to ICU for probable stroke
49 M - R wrist swollen, sprain
3 M - bloody nose, bloody nose
46 M - R hand swollen, arthritis
41 F - knee pain, unknown
38 F - pelvic pain, UTI
51 F - flank pain, unknown
41 F - cold, unknown
62 F - shortness of breath, unknown
16 F - "5150" came in with a sheriff, suicide attempt-psych referral
45 M - extremely combative brought in by Highway Patrol officers-gurney prepared with restraints, unknown
18 F - severe asthma, unknown
83 F - shortness of breath/ weakness/altered level of conscious, unknown
2 month M - shaken baby syndrome/shortness of breath-unknown
56 M - infected toes-complications of diabetes

We also had about an hour+ with no incoming patients in the AM. I missed logging several more towards the end of the shift because it got swamped with at least one patient waiting in the hallway.

To answer Neil and Chelle: nothing worth casting in Hollywood but I wouldn't have kicked a couple of them out of bed for eating crackers *grins*

From a student perspective it was a really good two days. I got to do a PPD injection, two In&Out catheters, NG tube medications, a splint, IM injection, focused assessment, one unsuccessful Foley catheter, dip several urine samples and absorb the overall environment. I was calm under the chaos when it started to get busy. I was complimented by the staff for my skills and ability to learn quickly and was told "I would do well in the ER".

Think I should join the Screen Actors Guild? or stick with my nursing career path?

Acid-base balance ...pH...HCO3, PCO2, CO2...ugh

2006-02-08T13:07:00.000-08:00

In lecture/theory this has proven to be a difficult subject. So darn confusing to figure out if a patient in congestive heart failure is in respiratory acidosis or metabolic acidosis. It is all rattling around giving me headache. I turned to the 'www' for help some good stuff out there but on a quiz I just end up thinking in circles.... *ack!.....any suggestions?

Tomorrow--off to the ER...and yes, Neil and Chelle I'll be checking out the Doc's for you both to see their Hollywood 'factor' and let you know.

The Teaser....Reality ER vs Television ER....

2006-02-03T17:20:00.000-08:00

Thought I'd set the stage a little in advance for next week in the ER, it's my only rotation in the ER and it lasts for just two days.

The ER is located in a hospital in a small mountainous Northern California town that has a population of 12,500 --according to the 2000 Census. The other two closest hospitals are 30 minutes in either direction (east and west). One of those two takes the local life fight trauma patients. They do not take life-flights at this smaller hospital. They have about 10 beds total in the ER not including the 3 they can put on gurneys in the hallways.

Today I took a tour of the place today it was suppose to last 30 minutes. It took only 15 minutes then I spent the next 15 minutes in a patient room taking vital signs of a patient with abdominal pain of 8 on a 1-10 pain scale (10 is the worst pain you can imagine).

I love procedural stuff and I multi-task well. I think I may like this experience. I am not a TRAUMA JUNKIE that lives off the adrenaline rush. So, I go into this rotation with open eyes and hope that I will enjoy it.

(and *pssst* I am not even going to mention the 'student syndrome' which is when students show up the department gets quiet and they have "the slowest days we have have in months" because that is not going to happen when I am there, not it will not)

Status check ...pulse...

2006-02-01T12:36:00.000-08:00

Yup, I have a pulse. Still adjusting to being back in the classroom and clinical site.

We are at a different clinical facility this semester. So, they have been giving us time to get adjusted to the new place. Slowly ramping up. It's kind of like waking up on the wrong side of the bed or having someone rearrange the furniture in your house. Same but different.

Clinically this semester they keep an eye on you like a hawk. One slip up and you get written up. Wash your hands, check your ID wrist bands, knock on the door, provide privacy, etc.. no room to slip up. And if you perform a skill that we have been 'checked off' for ..like inserting a foley catheter and you make an error, you get written up, regardless if you catch it.

I haven't had any exciting patients to speak of ...one needy lady in with back pain after a fall. L2 compression fracture. Hospitalized 26 times in the last 6 years. She readily admitted to me it's like family here and that she love's all the attention and people to talk to. Sad. My other patient had an 'accidental' ingestion of a toxic substance. (RV septic cleaner?) but she was already drunk on beer so RN said that probably saved her life because the ethanol alcohol and the toxic substance go for the same receptor sites in the cells and therefore her cells/organs were not so affected by the toxic substance.

I do go the the ER next week --so check back !!

In lecture theory, we go back over stuff we have already learned (and hopefully still retain) and dive deeper into each area. All with keeping in mind the final goal --graduation and passing the state board exam.

Quote.......

2006-01-25T21:09:00.000-08:00

I like this one.

"Opportunities are usually disguised as hard work, so most people don't recognize them."
--Ann Landers

Persistence...

2006-01-24T21:34:00.000-08:00

It pays to be diligent. Our instructor decided after 'further review' that those of us that missed the math problem in debate have passed (unless of course we missed more than that question).

Ya baby!

Math, scrubs and blogging...

2006-01-23T18:42:00.000-08:00

Just a lil of this and that today ...Miscellaneous thoughts, if you will.

Math... each semester we are tested on our math skills. The work/problems don't get any harder it just keeps us in check with the skill. First semester we had to pass with an 80%, second semester 90% and third semester 100%. Personally I think once you learn the few formula's needed for nursing math and some conversions etc. it's not all that bad. I am no math whiz by any means but I also don't get the same test anxiety with math as I do with other tests. Thankfully.

So, far I have passed each time EXCEPT Friday, *ugh* I missed one problem. I'm not freaked out but I felt we had a badly worded question in the bunch. The stats were; 2 students passed, 5 did not. All five missed that SAME question. I felt there were two correct answers one in grams and one in milligrams. The instructor just asked what would you waste from the syringe not specifying VOLUME. I intend to argue it in class tomorrow --wish me luck. I'll post the problem word for word later so you can judge for yourself. I just can't recall the exact wording now. I should have been concerned I was the first person done with the test. Even after I did a full re-check.

I was reading another Nursing related blog the other day and Miliner's Dream was talking about the scrubs they were issued to wear, mentioning the color (kinda a royal blue). How lucky is she!! We wear head to toe white. I have very pale skin and blonde hair this is NOT a great color next to my face especially when it is also everywhere else too! Plus they are odd, the top has a zipper from neck to bottom, the pants have a permanent pleat and the jacket is blouse with a round neck not the exam coat type. I can't wait to choose my own when I graduate.

Lastly, I got a nice comment from a fellow blogger whom I read and I mentioned what I look like. Unfortunately, because I occasionally blog about patients I have decided to remain anonymous due to the HIPAA regulations and patient privacy. Guess I will have to email a pic to Chelle. And that reminds me I need to update my links. I read way to many blogs that are not listed. :o)

Lecture tomorrow and then we get to teach the incoming RN class how to make beds and take blood pressures on Wednesday. It always amazes me that the RN student come into the program with NO HANDS on experience. Being a CNA first is a huge advantage for us LVN students at least we know the basics of patient care. I'll try and be NICE. *grins* Mostly because this is an exercise to help RN student understand how working with a TEAM is advantageous.

Week 2 of 16 .....enjoy!

I'm back!!!!.............

2006-01-17T17:16:00.000-08:00

...in classes that is.

Today was our first day of theory/lecture after the much needed winter break. We have the instructor that has been teaching for years and we love her. Tough as nails but she gets down to business by teaching what we need to know, in an orderly and concise manner.

Today wasn't too bad we chatted about our vacations, went over what to expect this semester and did some (much needed) review. My classmates and I have decided to again spilt up the objectives for each chapter and divide the work. This is a relief in itself. We are also are looking ahead to May when we actually graduate starting to imagine the pinning ceremony as a reality not just a far off dream. There is still a lot of work to be done but I feel now that I just maybe a nurse someday.

Now time for homework ......let the games begin.........

CPR and Pearly Whites....

2006-01-11T22:36:00.000-08:00

I renewed my CPR certification today. I had to sign-up for a the whole class because I let my old one expire. But the instructor was really cool and we got out 3 hours early!!! Since a bunch of us had done the same thing she fast-tracked us through because we had been certified before.

Other exciting events for today included a trip to the Dentist to have my teeth cleaned. Oh the thrilling life I lead.

I am starting to feel like a human being again. I have my energy back but I am still feeling congested.

Tomorrow bills and laundry ...whooohooo ! *rolls eyes* All in an effort to be ready for classes on the 17th.

The student nurse becomes....

2006-01-08T21:12:00.000-08:00

..'the patient'.

Nothing major, I have a miserable sore throat and it has zapped my energy level. Ugh. Been laying around all day with the intention of doing something, anything -- but no luck. I called off for my shift for Monday I don't want to compromise the recovery of my patients.

I am a cranky patient.

Yesterday was .....

2006-01-06T09:25:00.000-08:00

...not as good as the previous day.

I felt like I was behind all day. Two of my seven patients were crying. One got bad news about a good friend living out of state (her friend had brain cancer) and the second patient was so worried about her 8:15 appointment to have her back brace fitted she was beside herself ("Nurse!, does this patient have any anti-anxiety meds? because she needs them ASAP"). All this while trying to get 7 people up into wheelchair's, dressed, beds made, vital signs done, and two meals distributed and two patient showers done. Not to mention all the trips to the toilet (or incontinent brief changes).

My back hurts and I'm TIRED today. Now I remember one of the reasons why I am in nursing school I couldn't handle the physical demands of being the CNA (Nursing Assistant) for much longer.

I am thinking about a massage today (thanks for the suggestion Marcheline) I can feel the tension starting to fade away. TGIF!!!

Whistle while I work....

2006-01-04T16:34:00.000-08:00

I whistle when I am happy. Not just everyday happy but content happy. I was whistling at work today.

I enjoy the elderly. They amuse me (especially the confused ones!), they have great stories about their pasts (I wish I had more time to sit and listen) and they are appreciative.

I find in acute care the patients are so much more demanding and I don't mean in a 'you are not helping me because I am ill' way, I mean in a 'get me this' you are my servant way without any manners.

One of my ladies today said, "you are the best nurse I have had here". Then her licensed nurse told me that she is almost always grumpy and that I must have a "way with her" because she is pleasant today.

A smile and a whistle while you work attitude will always get better results or as they say in the south, "you can catch more flies with honey than with vinegar".

Happy Wednesday y'all.

Can it really be 2006?

2005-12-31T15:50:00.000-08:00

Happy New Year!!

After catching up on a few blogs that I read regularly I am very melancholy today. Can a new year really be about to begin?

Wow. Time is so intriguing . What will the next year bring? Hopefully a graduation in May for me. Followed by a graduation from the 8th grade in June for my eldest daughter. (*gasp* I can't possibly be the mother of a child in high school! Wasn't I just there myself?) Then I will tackle the CA state board exam for nursing licenseure in the early summer and then the ultimate goal getting a job in nursing. Can all this happen? It seems so long ago (Spring of 2003) that I decided to pursue another career path. Then there is my personal life which I don't blog about here but as a single gal I always wonder what life has in store for me.

All this reminds me of this very cool project I did in my Human development class in the fall of 2003. My instructor has us do a time line of our life. What you say? *ppstt* You are not dead.

Well, that was the kicker, we were to list all the major things that had happened in our lives so far. Birth, siblings births, graduation from high school, marriages, divorces, family deaths, --the big events. Then we had to continue the time line and add things that hadn't happened yet. Predict the future persay. Our graduation from college, parents deaths, children's marriages, grandchildren, remarriages, spouses deaths,, etc... you get the idea and yes, we had to decide when we were going to die. I decided I was going to die at the ripe age of 88.

When I had the project all lined up (it took three pieces of 8 1/2 x 11 paper laid end to end) I was glancing at my past and a fictional future. How very surreal.

The thing that struck me the most was how I felt I was struggling so much with the current chaos of my life. Going back to school, relocating to a new city, the recent divorce, etc. BUT when I looked at my life as a whole (all 33 inches of it on paper) and narrowed in on the very very small seemingly insignificant span that would take place while I was in school and compared to the past and future. It made me realize that this crazy time was very short and that I could handle it.

I can handle it ....I am not super woman I am just doing what I need to so that I can support my family and enjoy giving to others.

Holiday Cheer...

2005-12-20T09:21:00.000-08:00

Last year I worked in a facility over the holidays that is 1/2 long term care and 1/2 acute rehab. The rehab side where I work is for folks mostly sr. Citizens that need intensive physical rehab post surgery or stroke (cerebral vascular accident -CVA/brain attack) before they can go home or possibly their significant other/family is unable to care for them during this rehab stage. I ended up working Thanksgiving Day, Christmas Day and New Years Day. *gasp* I know what you are thinking, poor Student Nurse. But don't, due to my arrangements for shared custody with my daughters I would have been alone during those days/times anyways.

So, it was something I enjoyed a lot to be able to care for these folks during the holidays. I really get a kick out of putting a smile on someone's face or making them laugh. I have a knack for an infectious smile, if I do say so myself.

If you are looking for a feel-good holiday gift I would like to suggest to get yourself some small trinkets (candies are not recommended because of some folks dietary restrictions or swallowing precautions) and deliver them room to room with a personal greeting. Lots of these folks do not leave their room except for therapy. I nice warm holiday greeting could make their day. It would be wise to get permission/rules from the administrator of the facility first because remember for some of the long term care patients, this is their permanent home.

This year I get to spend more time with my family over the holidays due to not working during the school year. But I will go back to work on the 28th for a day of work and then some sporadic days in January.. I am looking forward to it. I miss the smiles.

I wish you all the all the joy the holiday season has to offer, may the blessings of life warm your heart

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

2005-12-15T14:10:00.000-08:00

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)

Day 0 .....

2005-12-13T16:01:00.000-08:00

Not sure what to say today.... this test was even more what difficult than I expected. I felt like I studied A LOT and was prepared.

Best comment from a classmate today at the mid-exam break was (this is a fella who is normally very quiet)..."I fell like I am going to vomit", .....enough said.

Now it's time to concentrate on tomorrow's clinical skills exam. We have 45 minutes to perform in front of our instructor. We choose one of three taped nursing reports. The one tape will include information about 2 patients. We then pick the patient with the highest priority of care and do what is needed for that patient. There are 3 skills that we may have to perform based on the taped report we chose. Either insert a Foley catheter, insert an NG tube or do a sterile dressing change. Also, there will either a mixed insulin injection or a mixed IM injection. After all is done we must do a nursing note and verbal report to the instructor.

All while not forgetting to knock on the door, introduce yourself, check the patients name, ID band, inform the patient of the procedure, provide for privacy, gather the equipment, check the room for patient safety issues, wash your hands and complete the task according to the proper technique.

Day 1 ... sigh

2005-12-12T21:25:00.000-08:00

Tomorrow is the theory med/surg final. It's almost 9:30pm and all I have dancing in my head this holiday season is drug names, disease names, lab values and terminology.

Next on my agenda is a good nights sleep and a decent breakfast in the AM (hard boiled egg , 1/2 bagel and a big cup o'tea-decaf).

We had nice study group today, so I feel like I have done my best to study the material.... I had a instructor who once said so simply; "If you know it you know it, if you don't you don't", he was emphasizing that once you know something stop studying it and go on to what you do not. At this point it's too late to cram anymore in so... sweet dreams until tomorrow

Day 2..........My signs and symptoms are ....

2005-12-11T23:12:00.000-08:00

...nausea, sleeplessness, gastritis, anorexia, irritability, drowsiness, tachycardia, hypertension, increased respirations, headache, ALOC, and diarrhea.

Question: What do I have? (scroll down)
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Answer: TEST ANXIETY!!!

Day 6 ...can you spell pneumonia?

2005-12-07T18:11:00.000-08:00

There are some words that no matter how often I write them down I can't remember the spelling. In fact I have always been a bad speller... I can spot a misspelled word in text but I couldn't tell you how to spell it correctly... and medical terms are just a accident waiting to happen. :o)

We are at 'Day 6'. Today in theory lecture the topic was supposed to be review. We did some miscellaneous stuff but got very little time for review. The good news is I did an hour + of time with my study buddy and went over Respiratory acidosis and alkalosis and I feel much better about it now. *whew*

Today was also clinical prep lab and I have two more new patients (both male) in the final week of clinical at the hospital. I'll write about them more tomorrow.

Right now I am in a combination of fear (for the final exam) and excitement (to have the semester over). I am looking forward to the 30 days off but I know it will go by like a flash with the holidays mixed in. I have a list as long as my arm of stuff I put on the back burner to focus on school.

Day 10 .....Motivational kick in the arse

2005-12-03T15:10:00.000-08:00

No study group today, gotta get up the gumption to do it on my own. Take books. Start up fireplace. Get warm beverage. STUDY.

Ohhh and before I forget a recap from Thursday ....

My female patient doing well tolerating solid foods having a few BM's, talking about going out shopping with her daughter and buying her "cute cancer scarves" for her potentially balding head. She said she is a planner and is glad that she has time to process and plan the coming weeks. I wished her luck before I headed out for post clinical.

My male patient I thought had turned the corner. His NG tube had been removed. He felt better in the AM wasn't using his PCA for pain meds any longer. He agreed to a shower and was Ok'ed to have 'sips of clear liquids'. About an hour before I was ready to head off to post clinical he complained of nausea and the RN gave him some IV meds for that. Right as his surgeon came by he immediately had copious amounts (over 200ml) of bile emesis. Sheesh, needless to say I was late to post clinical. And the MD said he wanted to do another upper GI CT scan. This fella is not outta the woods yet.

Day 12 ...and bowel obstructions

2005-12-01T19:37:00.000-08:00

So far, so good.

We did a 3 hour study session on Tuesday and one hour session Wednesday and today. We are taking off Friday because both my study buddy and I have plans that evening but we will be back to it on the weekend. I am hoping that the concentrated daily sessions will help me retain all this material.

Today was also my middle clinical day this week. I have two patients with similar diagnosis. Both have bowel obstructions. One of the small bowel and one with the large bowel.

My male patient (SBO) is a very non-compliant with his care and recovery. He has been refusing his ADL's and complains of nausea in order to get out of walking the hallway. And he wonders why he can't pass gas! Walking will wake up the GI and help restore function. Instead of telling him what he had to do today, I said, "Would you like to take your morning walk at 9am or 10am?" That doesn't give him the option to decline and makes him think he is in control. :o)

My female patient (LBO) has not been as fortunate. After her colectomy they discovered the mass was colon cancer. I was with her today when her oncologist went over what to expect the next 12 weeks or so. She will have a port-a-cath inserted so that it will be easier to administer the chemotherapy. That will start in January. It is hard to watch a normally healthy woman in her late 50's be told that she has stage 3 cancer. Her comment was I can't even say the word "cancer". I have to admit the great bedside manner of her Doc helped her absorb all this new information.

Tomorrow I pick up a total hip replacement to make a total of three patients.

The count down begins....

2005-11-29T20:30:00.000-08:00

After today we have exactly two weeks to our final exam in Med/Surg. It will be about 100 questions, multiple choice with a few short answer and a few 'fill-in-the-blanks'. The following day we have a 45 minute long clinical exam to be performed in front of a clinical instructor. >>> PANIC!! <<< Pardon the moment of sheer terror as we were given the details of the clinical exam today. Usually I am ok with clinical tasks but this is a multi-multi-step process that we have never experienced before with the watchful eyes of the instructor. Pass or fail.

I guess I am on overdrive panic. I have started a daily study session with another classmate to go over the semesters worth of information. That should help. We toss out questions to each other, grill on facts, terminology, etc.

Reflections... and dreams

2005-11-25T20:49:00.000-08:00

I find that during this Thanksgiving time I look back at how far I have come and reflect on it and give thanks that I have made this progress.

Just 3 years ago I was unsure of making a huge life change. Could I actually go back to college? Would I be able to make it in classes with 19 year olds? Could I get grades higher than a C? How would I deal with all that and a new house, town, no local family support, no job?

I have found that thankfully when things are suppose to be it just happens --falls into place. You give yourself fully, without regret. Now, I need to be able to apply the same philosophy and freedom to my feelings in other areas of life.

I still struggle each and every day with the financial sacrifice I have made to go after this goal but knowing I am doing this to better my future and the future of my daughter's --this provides me with hope. It is a good lesson to them of how important education is and to start out with that foundation so you don't have to tackle it later in life.

There is nothing more I want right now in this world than to be a NURSE. I want the stability and comfort that a career gives. Simple stuff, why does it seem like a dream still?

Go......Team work!!

2005-11-18T16:19:00.000-08:00

I was sending a reply to a fellow student at his blog and got to thinking about team work.

My Nursing class can accommodate 12 students. We started first semester with 11 (not sure why). We had two students leave the program around the 8th week (of a sixteen week semester). One student discovered Nursing wasn't what he thought it was going to be and one girl was not a good exam taker so I think she didn't pass the Pharmacology final (she knew the material but they never inform the other students why the person left). So, we ended the first semester with 9 classmates.

Second semester we started with 7 students, During the summer break we 'lost' two students. One decided that there were aspects to Nursing that she didn't care for (even tho she was in the health care field) and the other had family/personal medical issues that prevented her from continuing the semester (she will pick it up during the next fall session).

We are now holding at a tight group of 7. I am really enjoying the team work efforts of my fellow classmates. There are 6 females and one male. Our male student a loner by nature and we have come to understand that about him he tries to tolerate us very verbal women the best he can. We recently were let out of clinical early and opted to all have lunch together and even got him to join us --progress!

When I met this bunch of folks I was very ambivalent about them. Said to myself, well they are OK but I don't see myself bonding with any of them. After all this time I can say I truly have admiration and respect for each and every person in my class. We look out for each other, we help each other and we share our knowledge willingly and selflessly and it feels good to be part of tight knit group.

Two tales of life

2005-11-17T19:12:00.000-08:00

I have two patients today in clinical that are on opposite side of life's scale. I am on the surgical floor this week.

Patient #1 is a very young man (17) who has suffered major injuries to his eye. I don't want to say how to protect his privacy but let's just say he wasn't doing anything bad or in a auto wreck. He was just attention to fix something and a very stretchable cord hit him in the eye. Shattering bones below his eye. R-orbital-fx; right eye fracture. His eye is so swollen he can not open it and his other eye has suffered "sympathy" trauma for lack of a better diagnosis. It wasn't injured but he is not willing/able to open it. He is great pain and has tons of family support. Withdrawn and not willing to communicate other then the necessary yes/no responses. He is awaiting word on if surgery can be done and the status of his cornea.

Patient #2 is an older man (71) who had a fall at home and has a R-hip-fx; right hip fracture. He is one day post-op on a replacement (hemiarthroplasty). His history is Cerebral Vascular Accident x2 (CVA-Stroke), Diabetes mellitis (DM), Chronic Obstructive Pulmonary Disease (COPD), pneumonia, diverticulitis, hypertension (HTN), acid reflux disease (GERD), depression, benign prostatic hypertrophy. I have sympathy for both one young man is just starting life and is devastated by the unfortunate events in his life. The elderly gentleman has lived a long wonderful life and is certainly not ready to give it up but is not strong enough to enhance his rehabilitation.

Something to think about.

Shock and awwwwwww

2005-11-14T15:10:00.000-08:00

Ha! gotchya bet you were expecting something GOOD eh? Some juicy story, sorry no such luck *grins*

Shock-ed that anyone reads my dribble. I started this blog as a way to remember my time in Nursing school (a diary per say), to Rant, to Rave, and as most bloggers will say it was all for me --not even considering that anyone might read it.

and

*awwwwwww* but I have to admit knowing folks are reading and commenting is cool, so thanks to those who take the time...really.

Minus catchy title

2005-11-08T19:13:00.000-08:00

Not feeling creative at all it's the start of a long week. We had Med/Surg lecture today and received back the mid-term. I passed, not thrilled by my score but I passed. Tomorrow is another early and long day, followed by a quiz on Respiratory and Musculoskeletal. If it sounds like I am lethargic and blah you read correctly. Not everyday is a winner. Night-night.

2005-11-06T16:22:00.000-08:00

Student Nurse, prn

Straight cath/vaginal culture and a subQ... or two

2005-11-05T21:22:00.000-08:00

I spent Friday in clinical in an locked Alzheimer's unit. I enjoyed it; great staff, nice music and activities/GAMES! I had three patient's to administer meds to and do treatments.

One of my patients gets a M-W-F sub-Q (subcutanous) injection of Procrit (for anemia due to hepatic failure) this wasn't my first time. She had to receive two injections, thankfully, she was too tired to object. I'd done at least two other sub-Q's and this one went well. Technically it's NEVER our first time, we are told to tell patient's that because we practice in the lab on an injection pad--so technically our first time on a HUMAN is our real first time. But in this case I had done 2 other patients. My first was on an elderly gentleman with severe dementia. Unfortunately for him the force at which I 'stabbed' him in the abdomen was not enough and the needle/syringe bounced off the epidermis and he said, "ouch". I felt awful but didn't realize he gets regular abdominal injections which tends to toughen up the external layer of skin and makes it harder to inject over time.

My treatment was a dressing change on a stage two pressure ulcer on the lateral malleolus (ankle bone). That was quick and easy. A bit of cream and an underneath pad along with kerlix around the ankle/foot to keep it all in place.

Lastly, another patient was experiencing the symptoms of UTI (urinary tract infection), burning on urination, itching, etc. She is incontinent so an straight cath was ordered to obtain a urine sample for testing. This is sterile technique so my instructor had to be present. It went well, I got it in on the first try (finding the right place isn't as easy as you'd think especially on an elderly woman who doesn't want anything to do with this procedure) and I didn't break the sterile field, yipeee! After the cath a vaginal swab was done. This involves a longer q-tip like stick inserted and swabbed momentarily into the vagina and then placed into the lab vial. She didn't much care for this either.

The Alzheimer's unit is small, only 18 patients (9 rooms) ...they offer structured activities but I am told the only thing that that patient's must do is be toileted on a schedule. Everything else they do or don't do is their choice. Some participate in the group activities, some do not, some wander/pace the hall back and forth, some sleep a lot, some ask you over and over, "what should I be doing right now?". Most of the patients are pleasant and cooperative, they just are at risk for wandering.

A Love Story

2005-11-03T17:25:00.000-08:00

A Love Story

I will seek and find you . . .
I shall take you to bed and have my way with you. . . .
I will make you ache, shake & sweat until you moan & groan. . . .
I will make you beg for mercy, beg for me to stop . . . .
I will exhaust you to the point that you will be relieved when I'm finished with you. . .
And, when I am finished, you will be weak for days.

All my love,
The Flu

Now, get your mind out of the gutter and go get your flu shot !!!

Find a penny, pick it up...

2005-11-02T20:09:00.000-08:00

..all day long you'll have good luck.

I found a penny on the way into Clinical this morning and I had a great day. Coincidence or not? My classmate found a dime I'll have to ask her if she had an especially good day.

Happy Halloween

2005-10-31T19:28:00.000-08:00

For some reason, tonight reminds me that we have been asked if we will wear Traditional Nursing Caps during our pinning ceremony. What do you think?

Motivation and emesis

2005-10-30T18:14:00.000-08:00

Motivation...I know my ultimate motivation (graduation) but it's so hard to stay motivated on a day-to-day basis. I don't want fear to be my motivator because then I lock up and stuff starts flying outta my head. Food is a BAD, bad motivator unless I want to weigh 1000 lbs when I'm done. I suppose I just have to remind myself how much I love the whole learning process and motivate myself.

Emesis...vomiting...throwing up...tossing your cookies...yup that's been my weekend. Gotta love your kids when they are doing this because no one else surely will. Dr. Appointment tomorrow cuz it's been since last Tuesday (5 days) for my 10 y/o *sigh*

The mid-term studies continue although I am a bit distracted. Tuesday will be here before I know it.

Good news and SNF

2005-10-26T20:15:00.000-07:00

The good new is we heard on Tuesday the results of the Peds final. I PASSED!! *whew* The test has not been returned so I don't know my grade but it's a great sense of relief knowing I passed.

We have started our 3 weeks in a SNF (Skilled Nursing Facility), Long Term Care, whatever you prefer to call it. It rained all day and on our 1+ hour drive to/from but all is good. It's a nice home-like place and the staff is friendly. Best news is our confidence level is much better now and I think we are all ready to tackle this assignment and make the best of it. The days will be long but rewarding as we continue to strengthen our skills. Tired and more homework to do before bedtime......

Screaming kids? nope, no way, forget it ....(and a final on Tuesday)

2005-10-22T14:49:00.000-07:00

Here I go again, ever so glad to prove myself wrong. Peds; never thought in a million years I would consider it. Even told folks, what areas interested me but mentioned, "except for Peds it's too close to home I can't handle kids in pain".

Wrong. WRONG.

I spent two days in a Pediatrics clinic. Loved it. Even the injection clinic. Yup. Go figure. The LVN's are mainly procedural in this type of clinic (think: injections, ear washes, splints, wound care, hearing tests, straight caths, urine dips, suture removal, etc.)

I liked the environment, the pace, the staff, all of it. It has proven me well to keep an open mind on exactly what I want to do in the future...

Even might consider working for the state in a very long term care facility; prison. Just a thought.

Now back to Tuesday we had our Final for Peds (what a co-winkydink) and we have yet to get the results back. Patience is a VIRTUE. Wish me luck :o)

The fun continues with a quiz this Tuesday and a mid-term next Tuesday ...all with the start of 3 weeks (3 days a week) in a SNF (Skilled Nursing Facility) that's an hour away from my home, arrival at promptly 6:30am ...did I ever tell you I am NOT a morning person *ugh*

Nurse, scalpel please

2005-10-14T22:32:00.000-07:00

Two days in the OR ...Thought I'd walk away enamored but it didn't happen. Silently, I always thought the OR might be the place for me but I never was sure because I hadn't had the exposure.

I have always known I am people person. I always knew how much I loved my patients when I was CNA. ...but my best guess would have been the OR was for me, simple, interesting, skilled...

I was WRONG...

Nurses in the OR are boring...yup...boring...The doc's rule the roost (well they always do) but floor nurses have a take charge attitude.

For the last two days I observed the following:
1) Laparoscopic Cholecystectomy with a liver biopsy (gallbladder removal)
2) Take down colostomy (reversal of a section of the bowel being brought to the surface)
3) Thorocotomy and lobectomy (chest incision with removal of a portion of a lung)
4) Breast biopsy
5) Hysterectomy with salpingo-oophorectomy (uterus removal with excision of an ovary and a fallopian tube).

What did I learn? Surgeons can be very nice and cool or very obnoxiously surly and rude...OR Tech's have interesting but repetitive jobs, Anesthesiologists have scary jobs and I don't think I want to be a OR nurse.

Quizzes...

2005-10-11T21:21:00.000-07:00

RANT: Etiology, Pathophysiology, Signs/Symptoms, Medical management, Treatment, *ugh* who can keep it all straight. Pass me a hammer and then some ibuprofin.

Did someone say Foley?

2005-10-07T21:31:00.000-07:00

Well, I knew this would come up soon in clinical. The FIRST Foley catheter. OK ya, we did it in clinical lab on the mannequins fine --but real anatomy is not perfect like dear ol' mannequin gal.

My classmate had rushed over this AM to tell me about her attempts in the L&D/OR room to insert a Foley. She went through 3 kits before she had success! All the time with an audience (the OR tech, RN, Dr. etc.) but luckily the patient was anesthetized from the waist down and fully distracted by the other activities in the room.

After hearing her hilarious, yet embarrassing story, it was now my turn. Calm environment (antipartum) with a patient not in active labor, non-english speaking, a great RN (from yesterday) and my clinical instructor. I was ready both mentally and with my supplies.

I've talked before about my test anxiety but oddly enough I do not tend to get clinical anxiety at all. It's like a big calmness just comes over me and I can think clearly. Best part was I got it on the FIRST try ..and used only one kit.

My instructor seemed pleased and I was offered to shave prep the patient also. It was a super good way to end my time in L&D and post partum. Now back to the books for some more theory.

Kudos

2005-10-06T17:13:00.000-07:00

I got a compliment from an RN today. *smiles*

I was in post-partum today teamed with a really great nurse. I mean that because she is a natural teacher. Very encouraging, explains what she is doing and why, let's you watch and then let's you try. She's not overly critical either. I have a feeling she still remembers what's it's like to be a student. She also stressed that I should go forth and get my RN ..she said, "you are too smart and you will get bored as an LVN" ...gosh, a helping of 'pat-on-the-back' goes a long way with self-esteem. And to top it off my instructor is letting me do some proceedures without her being present, that is also a good sign. Today was good.

Nurse!! Nurse!!

2005-10-02T17:56:00.000-07:00

or in another language ...

"In case you may be interested, Nurse in Gaeilge (Irish) is Bánaltra and in Korean it is Kyo No Won. You can add'em to your collection." --Bear

Thanks to my buddy Bear for this interesting info.

TGIF baby

2005-09-30T15:54:00.000-07:00

What a great week in L&D!!. Score pad reads: 3 c-sections, 1 vaginal birth. *Whoohooo* and 4 happy healthy Mom's with babies (2 boys and 2 girls--an even score for the population). Two of the c-sections were early AM and planned. The vaginal was planned and AWESOME to watch (4th baby girl for the Mom) and the last c-section although un-planned was a success (breach position prompted the last minute c-sect). It was my first time being on 'the other side' of vaginal birth after having two of my own. I have to say the body continues to amaze and never more so than a baby coming through the birth canal. C-sections are so quick and efficient now I can sometimes understand why the Doc's swing that direction these days.

I have to admit though I'm a bit worried that I was too lax on my assessment paper work due to the sheer wonderment of the past two days. I have a feeling that will bite me in the butt from my instructors point of view but I just got so wrapped up in all of it not to mention that the RN's weren't proactive in explaining what they were doing and why knowing full well I was an LVN student.

I'm a bad bad blogger...

2005-09-28T18:16:00.000-07:00

Forgive me for my lack of posts..the beginning of the semester has just kicked my hiney. I have started to get my grove back but it has been tough to engage the brain. I am off the L&D (labor and delivery) for a week, followed by a week in post-partum. Possibly I will have some interesting posts in the very new future.

I can't wait ...babies!!! I don't want to have any more myself but there is nothing like holding and smelling a brand-new-fresh-out-of-the-oven newbie :)

Second week and I am alive!

2005-09-08T19:37:00.000-07:00

Great news eh? So much time has passed since my last post I thought I needed to prove I am alive. Right now I am working on care plans for my two patients this week. Highlights for the last 14 days. D/C'ed an IV and Foley, watched a colonoscopy, CAT scan and a Pulmonary Function Test. So far so good :o) ohhhh and I passed my math test with a 100% so I am allowed to pass medications this week *whoohoo*

Three days and counting...

2005-08-27T17:33:00.000-07:00

..until the fun begins *insert sarcasm here*--I mean classes of course. Oh joy. Text books, lectures, quizzes, tests, clinical, care plans, white uniforms. But alas, summer must end, and the shorter crisp days of fall will be upon us soon.

I do have to remind myself how much I enjoy the learning process, in order to keep a positive attitude. Now that there are only two more semesters to go I can sense the light at the end of the tunnel. I know it's there, I just can't see it quite yet but I feel the fresh air.

Stress and test anxiety

2005-08-02T22:07:00.000-07:00

I built up a lot of stress and test anxiety last semester. Most of it came from knowing that if I do not do well I get booted out of the program. I did fantastic in my pre-req's --I got all A's except for my CPR class so I ended up with a 3.96 average. Yeah for me! This was an amazing fact because I was never all that great of a student in HS. Average, very average. I am older and hopefully wiser now. What I do know about myself is that if I ENJOY it and WANT it, I will do well.

My primary instructor informed us on the first day of class that we should NOT expect to get all A's even if we had been an A student.. I knew the effort that I put forth before and just thought I could step it up a notch and no problem. WRONG. This nursing stuff is a whole new ballgame.

I did ok at first, some B's on quizzes. Then some horrific quiz scores that scared the pants off me. To the point that I realized this was going to be rough. I did pass the Pharmacology section with an over all B so I felt a bit more confident. Then came the M/S midterm. That knocked my butt to the curb and shook my confidence badly. We have to get a 70% or higher in each of the 3 sections to be allowed to continue. M/S is all semester long. Pharm is the first 1/2 and OB is the last 1/2 of the semester. My M/S mid-term was just a wee bit over the passing line. The panic set in. I had to do well on the final or (well I can't even type those words) ...

I passed. I am thrilled and at the same time disappointed in myself. I can do better and I know it but I let my fears and mind take over my ability to concentrate. I got the stereotypical sweaty palms during the test and felt like thoughts jumped from my brain cells. Oddly enough during clinical exams I feel alive and confident. I talk myself down and breathed calmly. This same thing happened when I took my CNA clinical exams. Almost like the sky opens up and it's all clear (I know kinda funky but that's the best I can describe it).

Bottom line is the summer has been a nice chance to calm down re-focus but I need to learn some skills to avoid this scenario next semester. Any suggestions?

Lazy and HOT summer days (and nights)

2005-07-28T01:21:00.000-07:00

I should be reading. I am not.

I did manage to get a couple of pleasure reading novels in during the first few weeks of summer vacation. In early July we received a list of the chapters associated to our syllabus so that we could 'get ahead' for the fall semester.
Insert: Instant stress. I am all about 'getting ahead' but could we just have a bit more time where we truly didn't have to think about classes?

Now, I have no good excuse not to read as the place where I work has a very low census and all the regular full-time staff are fulfilling the available shifts. Add to that my departure for a two week vacation to what I consider, heaven on earth, my families very remote and rustic cabin (with no electricity, no telephone, no TV), think: silence, the smell of pine tree's, board games, propane lights, outhouses, fishing, walks, paddling the canoe and normally a juicy novel or five. Guess I'll have to see how it all feels while reading a med/surg text.. Wish me luck.

hello (((helllo))) <---the echo

2005-07-12T21:35:00.000-07:00

Can you hear me? Mostly this blog is for me.. .. but I am curious if anyone stops by ... *yawn* not that anything exciting has gone on recently.

I did work an AM shift today ..I was placed on the Long Term Care side (not my normal gig) but I was a few minutes late due to a traffic snarl on the highway and sent over there for the day ... two people had called off for their shift ... therefore, and I ended up with 10 patients!! Eight of whom I had to get up/changed/dressed before breakfast. During all this chaos I was busting my *ss and doing my best to acclaimate when the LVN on staff peeked in at me and said she would give me a later lunch assignment because I was 'behind' (with an attitude like I wasn't proficient) and that I "couldn't take my lunch" until I had showered my two patients. OMG. I know one thing I will have much more compassion for the overworked/underpaid CNA's when I become a licensed nurse.

Comfy ol' shoe

2005-07-05T22:50:00.000-07:00

I went back and did some CNA work on the AM shift at the facility where I worked last summer/fall/winter. I worked the acute rehab side and it sure feels good to be able to go back and get right into the routine without questioning my abilities (which is the polar opposite of clinicals in the hospital). The proficiency creates a great comfort and confidence in me to think that someday I will also have that feeling with my skills as an LVN. I also really enjoy working with the patients and like to think I can put a smile on their faces. Many patients asked why they had never met me before and some (returning patients/long timers) seemed happy to see me. Doing the simple ADL's that they need assistance with can be very rewarding. Now I am exhausted but satisfied about a good days work. Sleep tight ....zzzzzzzzzzzz

So, you wanna be a Nurse, huh?

2005-06-30T21:47:00.000-07:00

People keep asking me what area of Nursing I would like to go into. I wish I could answer them but I am still waiting for something to 'grab me'. For the time being I try to be open minded about each new experience I have in the clinical environment. I do know that realistically my options are some what limited because I will be a LVN. The age old battle of RN's vs. LVN's and their roles and of course the ever present cost cutting measures that facilities struggle with. I did enjoy my time in the Long Term Care/Acute Rehab facility I spent doing my CNA work but I often wonder if that is for me.....time will tell....

2005-06-27T01:34:00.000-07:00

Student Nurse, prn

Greetings!

2005-06-26T15:13:00.000-07:00

Hang tight while I get the hang of this y'all :o)

Student Nurse, prn

Floating on cloud nine....

Joke....

Critical thinking....

Listless and calm....

PICTURES!!!! Can you believe it? ....I had to fend off the paparazzi

*Beep, beep* back it up baby...Pinning Ceremony and Graduation

Schedule for Friday....

Drum Roll, please..............

Overwhelmed...

My last clinical day .....

Before disaster strikes...

Update: Mom...

Distance sucks....

Welcome faculty, family and friends....

I am *the* Enema Queen....

Senior-itis ......

Fastest week ever...

SPRING BREAK ..Whoooohooo!!!

Dress rehearsal ..."the HESI Test"....

You DON'T want to be the interesting patient....

Care plans ....

The HAG yelled at me!!!!......

Drug seekers...

Pimpin'....

Just to clear things up...

Light at the end of the tunnel.....

Coming up for air.....

Tag, you are it..........

Mundane...You want mundane?...Here's is my morning....

Health and Wellness Fair...

Snow day in Cally?.....

Reprieve...

Toot....toot....

AA Meeting...

The ER, part deux.....

Grey's Anatomy...

We blew it....

The Big V

Emergency Department

Acid-base balance ...pH...HCO3, PCO2, CO2...*ugh*

The Teaser....Reality ER vs Television ER....

Status check ...pulse...

Quote.......

Persistence...

Math, scrubs and blogging...

I'm back!!!!.............

CPR and Pearly Whites....

The student nurse becomes....

Yesterday was .....

Whistle while I work....

Can it really be 2006?

Holiday Cheer...

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

Day 0 .....

Day 1 ... *sigh*

Day 2..........My signs and symptoms are ....

Day 6 ...can you spell pneumonia?

Day 10 .....Motivational kick in the arse

Day 12 ...and bowel obstructions

The count down begins....

Reflections... and dreams

Go......Team work!!

Two tales of life

Shock and *awwwwwww*

Minus catchy title

Straight cath/vaginal culture and a subQ... or two

A Love Story

Find a penny, pick it up...

Happy Halloween

Motivation and emesis

Good news and SNF

Screaming kids? nope, no way, forget it ....(and a final on Tuesday)

Nurse, scalpel please

Quizzes...

Did someone say Foley?

Kudos

Nurse!! Nurse!!

TGIF baby

I'm a bad bad blogger...

Beep, beep back it up baby...Pinning Ceremony and Graduation

I am the Enema Queen....

Acid-base balance ...pH...HCO3, PCO2, CO2...ugh

Day 1 ... sigh

Shock and awwwwwww