Wednesday, April 22, 2009

ugh...

With 7 days of the semester left, I'm seriously dying.

I am no longer able to spell normal, non-medical words; I no longer have a spine that will stay in an upright, erect position; I'm starting to fall asleep sitting up; my shoulders "crunch" when I move them; I managed to wake up at 0600 today and not have a single bite to eat until 1700; and I've had a perma-headache for 1 month straight.

Am I a nurse yet?? Please??

Saturday, April 18, 2009

Update!

I know it's been a while so here's a brief synopsis of what's happened lately:
We moved into our new apartment, and we love it here! It's a great little apartment community in the middle of nowhere and it's so quiet and our neighbors are all around our age too!

My classes are slowing down, but clinicals are picking up! I've only got 2 weeks left until finals, and I cannot wait! I seriously need a break!

My patient this week was a very sweet old man who was in an amazing amount of pain (gangrene on R foot and osteomyelitis) and I felt awful for him! I've never had a patient that was in that much pain before (and he kept refusing pain meds), so I was pretty nervous. I actually felt like I didn't know what I was doing! My nurse said that I was doing everything well, but I don't know...

I kept forgetting to do part of my assessment, and I lost track of the order I was going in, and I kept having to go back in to him. At least this week my patient actually needed me. I was forgetting the simple things and that's what was bothering me. The main thing that I kept forgetting was to put on gloves! He was in contact isolation because he has MRSA and I kept forgetting that! I'm not terribly worried, he was on vancomycin IVPB for 3 days already. But still... My instructor didn't say anything to me, which is a good thing because she WILL let you know if there is something you need to work on. She actually pretty much leaves me alone on clinicals, and will just pop her head in maybe twice and say "are you doing ok?" I assume that's a good sign that she trusts me, now if only I could trust myself...

But for now, I'm going to enjoy the first day of 70+ degree weather since October. I'm actually sitting outside on my balcony typing this, feeling like quite the yuppie!

And careplans were created by the devil. My first one took me about 15 hours to do! Ugh... I should probably start on the one for this week soon...

Have a wonderful weekend everyone!

Saturday, April 4, 2009

My Patient Survived! Huzzah!!

I finally got a patient this week!

At the start of our day, the instructor, Nurse D., took us to the nurses station to start gathering info on our patients. She noticed my patient had the physician in with him and she told me to go stand by the door and listen. The nurse that was in with my patient noticed me and asked if I was assigned to this room. The Doc peeked his head from around the curtain and said "Ah! A student! Come in! Come in!" The Doc was my patient's surgeon and was changing the whole trach set up on my pt. The first thing I noticed was a HUGE surgical incision extending from the trach up to the left ear. Then I focused back to what the Doc was doing... As he was teaching all of us what the extra strings were for I was mentally preparing myself to see an open trach. I've never seen what it looks like without a trach in it! Ya know what? It looks like a wad of Bazooka Joe bubblegum! Very pink and fleshy, but no blood or drainage. I spent the next 20 minutes or so with my pt teaching him how to take care of his trach, and how to plug it off if so desired.

The only problem was, the doc gave him the okay to go home. When I told Nurse D, she said "no, they haven't ordered to d/c the foley yet." I knew that the urologist was on his way in to see the patient but I didn't tell her that.

I tried to get as much of my assessment done as possible, but since they were working on discharging, every time I turned around, another Doc was in checking him out... I was doing the best I could, and I finally got an opening to do the abdominal assessment! I ran in and when I exposed his abdomen, I found a very large dressing covering 70% of the abdomen. I went back to the chart... As far as I knew, the pt had CA of the tongue with metatstasis to the neck, had the mass and lymph nodes removed and a trach put in. I was TOTALLY confused by the dressing on the abd!

I soon was able to decipher the heiroglyphics of the docs handwriting and learned they also put in a PEG tube for later use during chemo. I thought "cool! I can change the dressing!" Wrong! It was still the original surgical dressing, the Doc hadn't changed it yet... So, that screwed up my whole abdominal assessment too...

Nurse D came up to me and told me that my pt was in fact going home, and his nurse was going to let me pull the foley! I was oddly excited! Yes! I get to do something!!!

Nope, wrong again. The urologist decided to send him home with the foley and have the home nurse take it out the next day.

I did however get to do some teaching, and help him get ready to go home, which was nice! But I hope that next time I get a patient who is going to stay put. Nurse D said she'll give me "a challenge" next time.

On the upside, I am getting pretty good at reading charts and the lab results... only because that's what I spent most of my day doing...

Now it's off to write the care plan... yipee.