Pass the drugs

Last night I got to pass medication for the first time..yay!! :D For some stupid reason, I thought we would just get the medication from the nurse and pass it to the patient..um, no. After checking the MAR (Medication Administration Record) for my patient, I had to get the medication from the password-protected medication cart (each patient has their own drawer on the cart)..do the 5 Rights (right medication, right dose, right patient, right time, and right route)..and watch her take it (it being metformin). Not bad! I got to also give her Alphagan, which is an eye drop. Pretty cool! Next week, we'll be practicing giving IM (intramuscular) injections and shortly after, will be giving insulin. Things are rolling right along.

One thing that you will see a LOT are decubitus ulcers (pressure ulcers/sores/wounds)..which is quite sad. I've seen so many of them! They occur over skin that breaks down when you stay in one position for too long without shifting your weight. They are a big problem for people who use wheelchairs or are bedridden, even for a short period of time. The constant pressure against the skin reduces the blood supply to that area, and the tissue dies. It starts as reddened skin but gets progressively worse, first a blister, then an open sore, and finally a crater. Literally a crater. The most common places for these ulcers are over bony prominences (bones close to the skin) like the elbow, heels, hips, ankles, shoulders, back, and the back of the head. A lot of the ones I've seen are the ones over the sacrum. Last night we had 2 patients that had horrible sores..1 of them you could literally stick your whole fist inside. And the other patient had them all over her body! She literally SCREAMED the entire time we tried to reposition her. Her skin was so dry and scaly, it literally flaked off. The hospital staff was suspecting elderly abuse..which is exactly what it is if it results in a pressure sore.

Here are some pics:

So you see why it's sooo important to turn your patients or even family members that are bedridden or in wheelchairs. Nursing homes are NOTORIOUS for bed sores/pressure ulcers..it's soo sad! Even sadder is that it's PREVENTABLE!! Just another thing healthcare workers have to deal with and are serious about...*sigh*

Now that I've ruined your breakfast/lunch/dinner..I'm off to go study! :)

Another A...

YAY!!!

2nd exam and I'm on a ROLL!! I gots to keep this up..wanna make Dean's list and score externships & scholarships. Ya'll know the deal!!

Ok...that's it! Time to study some more! Got the math exam on Wednesday and the next exam will be here before we know it!!

The only thing constant in life....

is change. And there are changes going on every day! The biggest one is early this week, I found out that they are closing my nursing school. Without going into to many details, the hospital the school is associated with has decided there essentially isn't any need for diploma schools. While diploma schools were the entry way into nursing years and years ago, times are a' changing and now there is a strong push for the BSN (Bachelors of Nursing) to be the entry level into nursing. I've noticed since I've entered school for nursing, that there is this underlying need for nurses to feel "validated" as far as their educational background..as if they aren't professionals. So, maybe this is where this is all coming from. While I am totally for advancing your education within your field (I myself will be pursing a Master's in Nursing), I know a lot of diploma-prepared nurses that RUN CIRCLES around BSN nurses. I experienced that first hand while working at a city hospital years ago. I personally chose my program because of all of the clinical hours that we receive. But, that will all end with my class -- the last class of this school. The school will be taken over by a local college who doesn't have a nursing school. A bunch of BS to me..but whatever. As long as I stay on top of my studies during these 2 years (which will ultimately fly by), I will be good.

So, I'm off to studying again. MAJOR test tomorrow evening. And the math quiz had been postponed to this week..so I'll have that to overcome on Wednesday!

My job as a nursing assistant is going well. I like my manager and the nurses there. Time will be coming up soon when I'll be applying to externships and I plan on talking to my nurse manager in getting an externship in one of the ICUs since she's over all of them.

Back to studying I go! :)

Just Keep Swimming...

Well, things are rolling right along with school..work..and life in general. I have now been totally acclimated to my nursing assistant job at the hospital. I only had 2 days of orientation with a preceptor (who was phenomenal!) and then the 3rd day, I was on alone..on a Saturday! My partner was not the best and not helpful at all..but I'm pretty independent anyway so I wasn't really affected by it. Working the 7am-3pm shift reminded me of the summer clinicals I had during the nursing assistant course, especially how much I HATE waking up early..but I'm getting used to it again. Somewhat.

I really like my floor. I'm working on the telemetry (cardiac) floor and we're right in the middle of SICU (Surgical Intensive Care Unit), MICU (Medical Intensive Care Unit) and CICU (Cardiac Intensive Care Unit). It's pretty cool. All of the nurses are pretty chill as well, except for 1. I had heard about her before I got to the floor but in reality, her bark is worse than her bite. I joke with her a lot so we're getting along fine..for now. Plus, some people are just the way they are and you have no choice but to accept it.

The patients are pretty funny. We had 1 patient (who I've had ever since I started). Apparently "Mr. Italiano" is a mobster..lol. One of the other nursing assitants claims she heard one day he was talking to his son (he's been a previous patient before) and the son told him that someone owed them $150,000. "Mr. Italiano" said that if that person didn't pay them soon..they would be "eaten by the fishes." Now, I don't know how true this story is..but it's pretty funny to hear this about a man who needs me to wipe his butt when he has a bowel movement. And those code browns, or rather in his case code "mushy black stuff" are NOT what's up..in the least way.

The hospital has a lot of patients that are up in the 80s and 90s (I do clinicals for school here as well). So, it's interesting to see how they view getting older and life in general. Around that time, people have lost many, many friends and family members and it's kinda lonely. Their children and grandchildren are busy making doing their lives as well.

Today, I had 2 patients, that were actually roommates, with a somewhat similar out view..but expressed it differently. My one patient (who was 90) expressed how she was 90 and how her sister lived to be like 96..but she didn't want to live that old. She noted how her children had their lives and she generally just reflected on her life. I asked her how long her parents lived and that just opened up a bunch of other stuff that I won't post. But, in general, it kind of was like a woe-is-me outlook. Her roommate on the other hand (which she actually spoke about when talking about life in general) was ready to die (which is what she told the first lady!). I was helping lady #2 (who I'm not sure how old she is but she looked older than the 90 y/o lady #1) get dressed because she was being discharged to a nursing home and she seemed really frustrated that she couldn't help me get her pants on. She was kind of hard of hearing and I could tell she was getting frustrated. She finally threw up her hands and said "Don't get old!" I was like..well, I want to get old! I don't want to die young! She just rolled her eyes! Then, when I finally got her pants up and was putting her little cover up jacket over her..she got frustrated with trying to put her arms in the hole. She then exclaims "I wish I would just croak!". LOL! The subject is not funny but the way she just said it..I started to laugh and was kinda like "No, you don't!" But, apparently she does if she even told her roommate! The things old people say...

With all that fun at the hospital, all is still going well at school. I got a 100% on my Pharm. quiz. Even though it was "just a quiz", it's worth 35% of my final grade! Exam #2 is like in 2 weeks and I need to get the ball on studying! We also had to do a Loss and Grief presentation on different type of losses. I chose the Loss of a neonate, infant or child. With all the experience I have with that (not personal but through family members and friends), I'm surprised I didn't breakdown! Even though I did tear up at the end of the presentation when the "In Remembrance" page came up with the list of my "angel babies."

We also had a Math Lab..OMG! I really dislike math!! It's all "nursing" math..converting milligrams to grams..how many milliliters are in a ounce..how many pills to give without killing anyone. It was crazy. Each question that had anything to do with digoxin, I was like killing the patient. I think you're only suppose to give like 1 or 2..and I was giving like 5. Nice. Anyway, the math test is next Wednesday. You have to get a 100% on it to give out medications (yikes! Hopefully, no digoxin!) and you only get 3 tries. I'll let you know if I pass the "How Well Can You Deal Drugs?" test! :)