Tuesday, April 29, 2008

Looking into My Crystal Ball for my Nursing Future

Every clinical week we have a post clinical conference (PCC) where our clinical group sits around talking about our experiences. A few weeks ago I was in the OR, so I had instructor Y (as in Why oh Why does she want me to feel like an incompetent ass) lead our PCC. One of her topics was to talk about the areas where we have interest.

Before this discussion I've made it quite well known that I am interested in Critical Care, especially Coronary Critical Care. After instructor Y made me feel like Jerry Lewis in the PACU, I began to question if that is the best place for me. But, after a few weeks of looking back on the experience and realizing that it wasn't a true test of my abilities, since I still AM IN SCHOOL, I will cut myself some slack and go forward with the plan to be ultimately a CCU nurse.

My summer externship will play an important part of my decision making when I get the chance to see first hand what cardiac nurses do and if it suits my personality.

Side note: Instructor Y has made it very clear that she doesn't like cardiac and considering how polar opposite we are in many aspects, I take it as a good sign that I will like it.

Saturday, April 26, 2008

Matters of the Heart

I got a call yesterday offering me a summer PNA (Professional Nursing Assistant) externship in cardiology. This means I will be spending my summer on the telemetry floor being a nursing assistant, but also being mentored by one specific nurse on that floor. I will work their hours and be their NA.

Cardiac medicine was my first choice because I am interested in it post graduation and figured this was a great way to find out if I really wanted to do it. Plus, it is one of the major reasons why I got into nursing in the first place. When my dad had his aortic valve replacement/CABG (coronary artery bypass graft) a few years back he spend some time in the CCU of his hospital. He had an AWESOME nurse named Pauline who took care of him for the two days he was in there. I looked at what she did and how she did it and thought, "Self, you could totally do this." Plus, I loved how she took care of my dad and took care of me by telling me what I could do for him and explained everything that was hooked to him. I thought she was a goddess when Dad was ready to be extubated and it was taking respiratory forever to come and do it. She shooed Mom and I out of the room and did it. Now I know that it was within her scope of practice, but to me it meant a lot for Dad not to have to be intubated for another 1/2 hour while we waited for RT.

I can't wait. Now where did I put my NA study manual??? I'm scheduled to take the test the day after my school final - great timing. But at least I will get a week off before starting the program.

Tuesday, April 22, 2008

Group Project Theater

Every semester we are assigned at least two group projects to submit to our instructors. Last semester and this one seem to have a theme... you have 1 case study and 1 project with a different theme, but that is geared towards the elderly (last semester it was prescription drugs, this semester it is nutrition).

So last night I finished the elderly nutrition project (I already completed the case study) and there was much rejoicing in the house. I HATE HATE HATE HATE HATE group projects. Our instructors say we do these things in groups "to help us learn to work as a team together" but I think it is so they only have to grade 6-7 projects and not 35.

Here's the type of exchange I wish would take place so that I knew ahead of time who would do their work and who would expect me to do their work for them.

Student Nurse Theater

Me, "OK, so I will do the 15 page patho on Acrocephalosyndactylia, Student Nurse Alpha agrees do the write up on the nursing process and Student Nurse Beta will come up with a teaching plan based on the nursing process. Let's plan to have this done a week ahead of time to give ourselves some breathing room."

Student Nurse Alpha, " OK, I will promise to do my section, but in reality I am going to ignore it for the entire working period and then two days before the final due date post something completely half-assed. Naturally, the whole time I will be claiming some family emergency is occurring so that you don't get too mad at me."

Student Nurse Beta, "Alpha, that's a great plan because I am going to agree to do the teaching plan, but will constantly bitch that you are holding me up. So finally when you get around to doing the work, I am going to claim I had a previous commitment that I claim I told you all about (but that no one remembers) and I expect someone else to do my work for me."

Me," I appreciate you letting me know that I will need to play janitor on this project. Now I can just do all the work up front and not have to get all of it done in 12 hours."

The End

Monday, April 21, 2008

Changing Lives, One Needle at a Time

I can't take credit for the title quote, that goes to a nurse on the medical floor I did clinicals on earlier this semester. It still makes me giggle, so I have to share it with the internet.

Tuesday, April 15, 2008

Jerry Lewis in PACU

This semester we have to spend two days in PACU (formerly called the Recovery Room). The course coordinator for this semester is a PACU queen, so naturally she oversee's the experience.

Instructor Y sets us (normally three students are in PACU, but my rotation only had 2) up in a bay and we take a client. At least that is how it is supposed to work. Our first day went relatively smoothly. All thumbs here needs to work on anything skills oriented so doing new things like putting on ECG leads quickly was entertaining to observe.

The second day started off slow, so Y decides that she will give each of us a client. As I am helping the other student, my client rolls in. What seemed like a routine situation ended up being an all day affair. The client came in complaining of nausea and pain. No problem, that's why there is Phenergan and Dilaudid. Then a problem arises, the client has a Morphine allergy, but has been able to take Dilaudid. Until now. Yes, she started itching and now gets to add Dilaudid to her list of no no's. So the anesthesiologist is called and Zantac and Benadryl are ordered to help relieve the itching. The pain relief is now switched to Fentanyl via PCA and we think we are in the home stretch.

Oh wait, the foley has come undone and urine is now all over the bed. Let's clean that up, deal with her allergic reaction, pain, nausea and remember to look at her O2 Sats! At this point I felt like Jerry Lewis that whenever Y asked me a question I would want to stammer and say, " Duh, well.." At one point she asked me an easy med math question that I couldn't do in my head in the midst of all of this and so the client answered for me. I thanked her for doing my homework for me. Man I was embarrassed.

This very nice client was about to be discharged from PACU around lunchtime but had to stay around for a fluid bolus and by then I got some help from other students. I went to lunch and when I came back found out that the VAST team (they put in the IV's) was there and had to stick her twice in order to get another access for the albumin she was getting. It was then one more fluid bolus, the family coming in and she was off to her room.

I was certain my evaluation was going to include statements like " Are you sure Jerry Lewis isn't your father?" or "I've never seen anyone tangle up IV lines like that before." Instead I got all S's (Satisfactory) on my objectives and the advice to manage the client's medical problems and not concentrate so much on the emotional issues.

Monday, April 14, 2008

Favoritism

The course coordinator for 2nd semester is a very matter of fact, no nonsense kind of person. I came into the semester all excited because I thought she was going to be the kind of instructor I would love. WRONG.

What I didn't know is that rampant favoritism is also one of her attributes. We have several people in my class who love to inspect our instructors tonsils by using an anal entry. I know this and expect it within any classroom setting. What I hate is when the instructors fawn all over these students. I have a BA in education, I have spent time in the classroom as a teacher and a student. There is a way to keep a balance between your favorite students and the rest of the class. Instructor Y either doesn't know how to keep the balance or doesn't care if one even exists. On top of that all of her favorites happen to be the shallow, appearance matters types of people.

I really, really tried to keep an open mind about this situation but a couple of weeks ago a seemingly benign comment snapped that open mind completely closed. It was in the middle of a lecture and the instructor said something to one of her favorites that I interpreted as a private joke between the two of them. Right there in the middle of class the instructor singled out a student and made an inference that only the two of them understood.

BUZZZZZ! Thanks for playing, but Cathy X. Is wants you boot you right out of the door. I have no problem with students and teachers becoming friends in the type of situation I am in. I have a BIG problem with that friendship not having limits within the classroom.

I have named this instructor Y because - Why oh Why are you such a bad judge of character.

Sunday, April 13, 2008

X Band

Our clinical schedule for this semester has us 6 weeks on either a medical or surgical floor, 3 weeks in OR/PACU/Home Health and 3 weeks on the orthopedic floor.

I had instructor X for my 6 weeks on a medical floor and I LOVED her. She was the first instructor I've had that I felt sized up her students and knew their strengths and weaknesses and tried to address them. I really liked her communication style and she didn't let people get away with things that other instructors let slide (like multiple missed clinical days).

I particular liked her because she liked me. Since starting school, I haven't felt a connection with a single instructor. I don't know if it is because I feel I don't need their approval or if it is because they are all fucking looney and my brand of crazy doesn't match theirs (note to self: do a blog entry about apparent mental illness among nursing school instructors). Instructor X is the first one that I feel could be a true mentor for me. I really didn't have that the first time around for my BA, so it is nice to have someone to go to for advice this go round.

Have I mentioned that instructor X used to be a psych nurse? Perfect fit for me.

Anyway, at the end of this semester we go through a ceremony called Black Banding. My school only recently gave up wearing the white hats and it used to be that after your second semester you would get a black band put onto your cap. Hence - "Black Banding". You would pick an RN that you want to put the band on you. Now my school gives you a pin with a black band that you wear on your uniform. I have asked instructor X to Band me. It is such a relief to know that someone who I respect so much will do this honor.

Thursday, April 10, 2008

Once Upon a Time

there was a rather large male client with a nasty mouth that needed a bed bath. "Little White Support Hose" nursing student was called upon to bathe the said client, so she bounced into the room to help. "Little White Support Hose" was eager to help and wanted to make a good impression with the big, bad client.

"Little White Support Hose" starts at the top and works her way down, just like a good student is taught. She comes to the nether regions and exclaims in her head, "Oh my, what an enormous ball sack you have!" ""Little White Support Hose" goes to town cleaning the area as best as she can with a straight face.

"Little White Support Hose" gets done and moves down to the feet. That is when the client states, "That was a good job. You weren't afraid to get down in there and scrub."

"Little White Support Hose" left the room feeling dirtier than when she went in.

The End

Wednesday, April 9, 2008

Tuesday, April 8, 2008

Yesterday's Post was a Reaction to Someone who needed a Cephalic Analectomy

Yes, I mean they have their head up their ass.

There was a post I read on the Allnurses.com forum started by someone who wondered why the nursing students at her school where so negative. This person had yet to start nursing classes, she was just finishing up her pre-req's. She wanted to know why they seemed so negative. Naturally, everything in this person's world was wonderful including her 2.8 children, husband, and pizza delivering job.

I would love to be there the first time she has a non-compliant client. 10 to 1 she will alienate them with her "life is so wonderful" shtick and then wonder why her clinical instructor jumped all over her ass.

Monday, April 7, 2008

The Real Nursing School Experience

This semester is eating me alive. The typical non-clinical day has me reading several hundred pages, reviewing notes, taking practice NCLEX questions and trying to get assignments done all the while attending lectures. Clinical days mean setting the alarm for God's wakeup call, hopping into that fabulous uniform and getting to the hospital before your clinical instructor asks where you are (because being early isn't enough). Then it is full day of either overwhelming client care or an underwhelming experience in which you need to keep yourself busy. Follow all of that up with 3 hours of paperwork so that you can put your feet up and be ready to do it all over the next day.

Yeah - I'd say that describes my week. Now I want to include the following additions:
  • The failing grade on any test is 79% and you freak out when you get an 85%
  • It is tough watching those you like struggle hard and there's only so much you can do for them
  • It's even tougher to watch those that have the intellect of a retarded sheep have their praises sung by your myopic instructor all the while ignoring the true talent in the class.
  • You spend all weekend trying to figure out why a certain instructor makes it seem that she hates your guts and then you realize... it's not just you - it is everyone who doesn't fit her "Barbie Perfect" world.
That in a nutshell is what my life is like at the moment. For all the Pollyanna's out there - yes I am being negative. This is an outlet so that I can put on the front and play nice today and not explode into a puddle of whatever is left after you explode.