This morning I was greeted by an elderly woman who really needed to get out of the hospital, so she thought. When I got to the floor and finished report a sitter in one of the patients’ rooms was getting off duty and had to leave for another job. The staff nurses really had no one available to watch the patient and they finally asked me if I could stay with her for while they drew up the meds for her agitation. I was happy to oblige and ended up staying with this patient for about 45 minutes. The only way she would not try and crawl out of the bed was if I was holding her hand. After getting her sedated and the bed monitor turned on she was happily resting, but she still wanted me to hold her hand. I would try and let go, but she would awaken and get very agitated again. Eventually she was so drowsy that she just couldn’t bring herself to try and get out of bed after I let go, but I still stayed with her. Soon after she started resting, her husband came in to visit. He spoke with the staff nurse for a minute and then sat down with his wife. He spoke with me for a few minutes while he sat. Come to find out, he was going to take her to a nursing home after she was released later that day. This couple had been married for nearly years and he had taken care of her by himself for the last several months. She had fallen three times prior to her admission and he was able to catch her. The fourth time caught him off guard and she ended up in the hospital. I cannot imagine what this man had to have been going through. I could tell that he was distraught by the situation, but he was holding himself together very well for the time being.
While I was sitting with the patient, I couldn’t help but notice the resemblance to my grandmother who passed away three years ago. After I met the husband and found out that they had been married for so long, I thought about my wife and how I would feel if we were in the same situation. It is very difficult to keep your professional demeanor when you sympathize with the patients so much. I am curious to learn more about this part of nursing. How should one react to such situations? What is appropriate to say and do for your patients? When does human compassion override facility and professional duties? I think that the only real way to learn this is to be in a facility with experienced nurses who are caring, compassionate, and respected in their positions.
In addition to my early morning experience I was able to be fairly productive with my time today. I completed an assessment on my patient (barely…I forgot my cheat sheet today. I’ll try again on Thursday.), and was able to learn a lot from both staff nurses in my hall. It is really hit or miss with the staff at this hospital. Some are great teachers and others just want to get their job done without some “kid” following them around. What was my greatest achievement today? I was able to dc an indwelling catheter. I was supervised by one of the staff nurses and this time........I DIDN’T PASS OUT. Some thing to be very proud of I’m sure.
-DV
Thursday, September 30, 2010
Saturday, September 18, 2010
Knee Deep
Geez,
There just aren't enough hours in the day. I wake up early and if I'm lucky it's a MWF and I can go run for half an hour before class. If not, I'm on my way to the hospital for six hours. I find that I am spending about six hours a day studying outside of class and clinical and I am just barely staying caught up. I felt really good about the information I had learned during the first week. There was a lot of A&P review on the GI system. I feel like I know that stuff pretty well. It is the critical thinking that gets in the way. I can tell you where everything is and what it does, but when it comes to making decisions based on that information things get a little cloudy. With that in mind, I have my first exam for the semester on Wednesday. I've been able to put myself into a pretty good position for studying. My reading is not only up to date, but complete for this section. I will not have direct patient care next week in clinical due to my RT rotation, so no care plans are due. I've also completed four case studies that are due on Thursday. So what's the problem? I was called in to work this weekend and next. I've got rehearsals and concerts to get through. Now, I'm certainly not complaining about being able to make a little money, but I really want to do well on this exam. At this point it is just a matter of studying. How many NCLEX questions does it take to make an A on Exam One? 1......2.......3.......? :) I guess we'll see.
Lately, I've been contemplating my future career. I go back and forth on the decision to get a tech job somewhere. I want the experience and the opportunity to get my foot in the door. At the same time, I'm pretty swamped as it is. Also, I still don't know where I want to end up in nursing. After last weeks real life CPR training I can see why a lot of people want to go to the ED. It is pretty exciting working in an environment like that. Occasionally I think about CRNA as a future career. The pay is great of course, but will I enjoy it? I'm looking forward to seeing some of that type of work later this semester. I also think about becoming a nurse practitioner. Before going to nursing school I thought about trying to get into medical school. I still have thoughts about that once in a while, but the amount of schooling required just doesn't fit in with my family life. I really admire the people who are willing to make the sacrifice to go to medical school. It takes a lot of dedication. I'm also the tiniest bit jealous. But I am enjoying my life as it is. Now I've got to go and be the best that I can be. Time to study for about six hours before rehearsal this afternoon.
-DV
P.S. Any readers out there want to share your thoughts? Leave a comment. :)
There just aren't enough hours in the day. I wake up early and if I'm lucky it's a MWF and I can go run for half an hour before class. If not, I'm on my way to the hospital for six hours. I find that I am spending about six hours a day studying outside of class and clinical and I am just barely staying caught up. I felt really good about the information I had learned during the first week. There was a lot of A&P review on the GI system. I feel like I know that stuff pretty well. It is the critical thinking that gets in the way. I can tell you where everything is and what it does, but when it comes to making decisions based on that information things get a little cloudy. With that in mind, I have my first exam for the semester on Wednesday. I've been able to put myself into a pretty good position for studying. My reading is not only up to date, but complete for this section. I will not have direct patient care next week in clinical due to my RT rotation, so no care plans are due. I've also completed four case studies that are due on Thursday. So what's the problem? I was called in to work this weekend and next. I've got rehearsals and concerts to get through. Now, I'm certainly not complaining about being able to make a little money, but I really want to do well on this exam. At this point it is just a matter of studying. How many NCLEX questions does it take to make an A on Exam One? 1......2.......3.......? :) I guess we'll see.
Lately, I've been contemplating my future career. I go back and forth on the decision to get a tech job somewhere. I want the experience and the opportunity to get my foot in the door. At the same time, I'm pretty swamped as it is. Also, I still don't know where I want to end up in nursing. After last weeks real life CPR training I can see why a lot of people want to go to the ED. It is pretty exciting working in an environment like that. Occasionally I think about CRNA as a future career. The pay is great of course, but will I enjoy it? I'm looking forward to seeing some of that type of work later this semester. I also think about becoming a nurse practitioner. Before going to nursing school I thought about trying to get into medical school. I still have thoughts about that once in a while, but the amount of schooling required just doesn't fit in with my family life. I really admire the people who are willing to make the sacrifice to go to medical school. It takes a lot of dedication. I'm also the tiniest bit jealous. But I am enjoying my life as it is. Now I've got to go and be the best that I can be. Time to study for about six hours before rehearsal this afternoon.
-DV
P.S. Any readers out there want to share your thoughts? Leave a comment. :)
Wednesday, September 15, 2010
Oh...you're a male.
Today I was pretty excited about getting to meet the patient that I would be working with this week. I was able to get all of my preliminary work done without any problems. Going in this morning, I met the staff nurse who was nice enough, but not overly concerned that I would be around today. I also met the PCT that was on my hall as well, she was very helpful. While I was getting report the PCT had gone into my patient’s room to answer a call light. A few minutes later she stepped out and asked if someone could help her for a minute. I quickly volunteered and told her that I would be working with that patient today anyway. The PCT said that it was somewhat of a personal issue and that the patient did not like males. Apparently I had picked a patient that was not going to have anything to do with me this week. At least that is the impression I got from the PCT. So, the staff nurse goes in to help her and I am left outside to wait like a good boy. I have to admit that I was a little put out by all of this. I am a pretty likeable guy and I had to deal with this same problem last semester in Foundations. It seems that I may be confronted with this problem for the rest of my career. I was determined to go into the room and make a good impression with the patient. When the ladies finally got out, I went in and proceeded to get to work on my assessment…
I was comfortable getting my assessment done after talking to the patient for a while. I went through about 65% of what I was supposed to do for my head to toe. The other 35% was lost somewhere in my brain. It is going to take a lot more assessments for me to remember everything that needs to be checked. Later my instructor came in and went through an assessment on my patient with me. This was one of the most beneficial things that could have been done for me. Afterword we went into a room and went over the findings and discussed how to go about making sure that a complete assessment was done and how to do it well. This is the first time a clinical instructor has done this with me, and I cannot wait to go back on Thursday to try again. I feel so much more comfortable going into a patient’s room and doing my assessment. I really wish my foundations instructor had done this with me (a few times would have been nice). I would have felt a lot better about things. I also feel more comfortable about bringing in my “cheat sheet” to make sure that I have covered everything.
…by the time I had worked with my patient for a while. We were both comfortable with each other. She was beginning to talk to me about her personal issues regarding her illness when we were interrupted by the PCT for the patient’s bed bath. (There went my process recording, but I digress.) I told the PCT that I would be more than happy to help. Then I explained to my patient that I would only help if she were comfortable with my being there. (This is where I had what I like to call, one of my “Jedi Moments”.) The patient stated, “Well normally I would say don’t bother, but you might be able to help her.” I feel like I had been able to make the patient comfortable with a male nurse(ing student.) I cannot be sure if the PCT was initially uncomfortable with me or if the patient would not have been comfortable with a male nurse or if I was really able to change the patient’s perception. Either way I did what needed to be done today.
I was comfortable getting my assessment done after talking to the patient for a while. I went through about 65% of what I was supposed to do for my head to toe. The other 35% was lost somewhere in my brain. It is going to take a lot more assessments for me to remember everything that needs to be checked. Later my instructor came in and went through an assessment on my patient with me. This was one of the most beneficial things that could have been done for me. Afterword we went into a room and went over the findings and discussed how to go about making sure that a complete assessment was done and how to do it well. This is the first time a clinical instructor has done this with me, and I cannot wait to go back on Thursday to try again. I feel so much more comfortable going into a patient’s room and doing my assessment. I really wish my foundations instructor had done this with me (a few times would have been nice). I would have felt a lot better about things. I also feel more comfortable about bringing in my “cheat sheet” to make sure that I have covered everything.
…by the time I had worked with my patient for a while. We were both comfortable with each other. She was beginning to talk to me about her personal issues regarding her illness when we were interrupted by the PCT for the patient’s bed bath. (There went my process recording, but I digress.) I told the PCT that I would be more than happy to help. Then I explained to my patient that I would only help if she were comfortable with my being there. (This is where I had what I like to call, one of my “Jedi Moments”.) The patient stated, “Well normally I would say don’t bother, but you might be able to help her.” I feel like I had been able to make the patient comfortable with a male nurse(ing student.) I cannot be sure if the PCT was initially uncomfortable with me or if the patient would not have been comfortable with a male nurse or if I was really able to change the patient’s perception. Either way I did what needed to be done today.
Thursday, September 9, 2010
It Starts Again
So, I've actually been in class for two weeks now. I'm just getting back to my blog. I've studied more in the last two weeks than ever. It's going to be a crazy ride, but I LIKE IT! Here is my journal entry from today's clinical. Today was the first day to actually take care of patients for this semester. I think you'll find it interesting...
Day one – check. I had most of my pre-clinical work complete, but I was still a little insecure about the quality of the work I had done. Yesterday, I had to use another student’s log on information in order to access my patients chart. I felt rushed because I didn’t want her to have to wait for me too long. I was able to get the basics and went home hoping for the best. I could have been a little more thorough, but I suppose it was enough to get me started. I was very glad that when I got to clinical this morning, my instructor had my log on information for me. Monday will be a lot better now that I’ll be able to spend as much time with my patients chart as I need.
As always, I was a little nervous about going up to the floor today. However, I do think I am getting a little more comfortable “going to work” in the hospital setting. I’m not a total newbie. Because the students are pretty much assigned to different wings on the floor, I am pretty much on my own. That’s a good thing. It forces me to take the initiative in finding help and getting things done. I was able to get report from the staff nurse and I even gave her some information on labs and an endoscopic procedure that had been done the day before. I’m really surprised that she didn’t seem to know about the endoscopy. I was about to check out my patients chart and look for new meds and orders when a code was announced at the other end of the hall; thus started the exciting part of my day. Along with the other students, I went over to check out what was going on. I was really surprised at the organization and cooperation that was going on in a room filled with about 10 people. The nurses were giving chest compressions, calling physicians, calling family members, charting, giving meds. All of this seemed like a carefully timed act. I was standing out of the way watching when one of the nurses asked if there were any student nurses around. My immediate thought was, “Hey, I’m a student nurse….” I walked up to the door and was asked if I wanted to do compressions. “…..SURE!” I gloved up and made my way to the other side of the bed and started. The adrenaline was really pumping. All I could think was to give the compressions at the right speed and force. After a while some of the other students came in and we rotated for another 15 or 20 minutes. Then, it was all over. The physician called the time of death. Afterword there was a huge let down. The other students were visibly upset after the family arrived. I didn’t really feel sad or upset when I went back to work with my patient. It was just something that happens sometimes even when you do everything that you can to help. Tonight when I was able to sit and go over my experience with my wife is when I really felt something. I could feel the emotions begin to well up. The loss of a life, even if it is a complete stranger, is a very difficult thing to observe. I suppose my reaction can be a good sign that I can hold it together when I’m on the job when I need to be professional and giving support to patients and their families. However, I can see how this sort of thing could really be a heavy weight to deal with if you see it on a regular basis.
The rest of the day was pretty slow. :) I am going to review some assessment material this weekend so that I’ll feel more prepared next week. I do NOT feel prepared right now. It’s going to be a long weekend….
-DV
Day one – check. I had most of my pre-clinical work complete, but I was still a little insecure about the quality of the work I had done. Yesterday, I had to use another student’s log on information in order to access my patients chart. I felt rushed because I didn’t want her to have to wait for me too long. I was able to get the basics and went home hoping for the best. I could have been a little more thorough, but I suppose it was enough to get me started. I was very glad that when I got to clinical this morning, my instructor had my log on information for me. Monday will be a lot better now that I’ll be able to spend as much time with my patients chart as I need.
As always, I was a little nervous about going up to the floor today. However, I do think I am getting a little more comfortable “going to work” in the hospital setting. I’m not a total newbie. Because the students are pretty much assigned to different wings on the floor, I am pretty much on my own. That’s a good thing. It forces me to take the initiative in finding help and getting things done. I was able to get report from the staff nurse and I even gave her some information on labs and an endoscopic procedure that had been done the day before. I’m really surprised that she didn’t seem to know about the endoscopy. I was about to check out my patients chart and look for new meds and orders when a code was announced at the other end of the hall; thus started the exciting part of my day. Along with the other students, I went over to check out what was going on. I was really surprised at the organization and cooperation that was going on in a room filled with about 10 people. The nurses were giving chest compressions, calling physicians, calling family members, charting, giving meds. All of this seemed like a carefully timed act. I was standing out of the way watching when one of the nurses asked if there were any student nurses around. My immediate thought was, “Hey, I’m a student nurse….” I walked up to the door and was asked if I wanted to do compressions. “…..SURE!” I gloved up and made my way to the other side of the bed and started. The adrenaline was really pumping. All I could think was to give the compressions at the right speed and force. After a while some of the other students came in and we rotated for another 15 or 20 minutes. Then, it was all over. The physician called the time of death. Afterword there was a huge let down. The other students were visibly upset after the family arrived. I didn’t really feel sad or upset when I went back to work with my patient. It was just something that happens sometimes even when you do everything that you can to help. Tonight when I was able to sit and go over my experience with my wife is when I really felt something. I could feel the emotions begin to well up. The loss of a life, even if it is a complete stranger, is a very difficult thing to observe. I suppose my reaction can be a good sign that I can hold it together when I’m on the job when I need to be professional and giving support to patients and their families. However, I can see how this sort of thing could really be a heavy weight to deal with if you see it on a regular basis.
The rest of the day was pretty slow. :) I am going to review some assessment material this weekend so that I’ll feel more prepared next week. I do NOT feel prepared right now. It’s going to be a long weekend….
-DV
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