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.

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.

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.

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.

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

Under Where?

Our classrooms have wireless internet access, so it stands to reason that you can do a little internet surfing during those boring class times.

Note to self: Don't shop for intimate apparel during nursing classes unless you are in the back row where no one can see your screen. I'm just saying.

This One's For You Woodworking Man

Woodworking Man = My Father in Law

Woodworking Man is a Type II diabetic who has very strong opinions about the location of a finger stick when testing blood sugar. I have heard on more than one occasion that it drives him nuts when healthcare workers take his sugar, they poke the pad of his finger and not the side.

Last time it came up I promised him that if they didn't allow me to do the side poke while in school that once I was out of school, I would do it his way.

He will really like my instructors, because during our blood sugar testing lab today, they told us to use the side of the finger.

"Victory for Woodworking Man"

You like me, You really like me

I think I was channeling my inner Sally Fields at orientation the other day. Walking in I was thinking "No one will want me to sit by them, no one will want to talk to me." It's like all the fears of Jr. High came back with a vengeance.

I'm such a dork. I found a place to sit by people who I really like and I spent a lot of time catching up with many of my classmates.

I am such a ninny.

2nd Semester Orientation

It really should have been called "How to scare the shit out of a room full of adults." Ok - maybe we weren't scared, but definitely overwhelmed.

I'm really excited about this semester since we will be learning about chronic diseases. Most importantly is that our time in class to clinical gets better, it will now be a 1:2 ratio (class to clinical).

Gearing it back up

Break time is over.... it was sure fun while it lasted. I can't believe a whole month has gone by.

Thursday is our orientation day and then next Monday we are off to the races. IV's, Trach care, bladder irrigation here I come!

We have a scavenger hunt that we need to do before showing up on Thursday and I thought, "Oh - I'll just pump this out and get it over with" late yesterday afternoon. WRONG. It turned out to be WAYYY more detailed that I expected. I can live with it because I found that our 16 page clinical write up form we had to do last semester has been replaced with a 4 page form. I expect it will be the last time I will ever see paperwork reduction in this field.

Clinicals Are Over!

This week I finished my first clinical rotation and turned in the last of my paperwork. Yahoo! Now I am studying for the final which is little over a week away.

I loved the second part of clinicals this semester. We were at a local VA rehab facility and I got to see some interesting things and work with some really nice people. Also, I LOVED my clinical instructor. She is a great teacher and no matter what dumb things I did, she was always encouraging, yet correcting me at the same time.

So now I am trying something different while studying for the final, I am actually working in a study group. I have always been against them because I felt that the quality of study wasn't worth it. However, I think with all the time I have available, I am more open to it because I can study with them and then do some on my own. Yesterday was our first session and I think it went well. I also found out a bunch of gossip about things I was completely in the dark on. In fact, one of my classmates said, "Wow, you never seem to be in the middle of this stuff." I told her it's because I completely out of the loop and have no idea of what has been going on.

Oh, funny thing while studying yesterday... the question that was read was about how you insert a tympanic thermometer in an ear correctly. One of the choices was read incorrectly, but nearly had us all on the floor. One of the possible answers was "Move the penis to get into the ear canal." It should have been pinna, but I liked the first choice the best.

The Home Stretch

We only have 4 weeks left for this semester! We have finished all the lectures and labs so all that is left is clinicals, tests and projects.

I had my midterm clinical evaluation. It went well so now we are on to the next clinical site with a different instructor.

Last week we got to go to a local long term care center (the new politically correct term for nursing home) and give flu shots to the residents. I did fine and no old people were maimed. I did feel like an idiot when my instructor pointed out that I couldn't understand my client not because of her stroke, but because she was speaking Spanish. So I said "Hola, como esta?" and wanted to say more, but realized the only other thing I knew to say was to order a margarita.

Vital Signs Clinical

We had our first clinical this week. My group is at a nursing home and we were each assigned a rehab resident to take vital signs on. I was assigned to a cute little old gentleman who kept thanking me for taking his blood pressure. Let's just say he wasn't quite oriented x3, but he was nice and appreciative.

My favorite moment was while I was waiting for my instructor in the breakfast room with the other residents of the nursing home. One gentleman said something about all the different colors of pills he has to take and another lady said, "Yeah - we even burp in Technicolor."