After MANY sleepless nights for the past few weeks, victory has finally come!! Got a 93 on my cardiac exam!! Possibly one of..if not THE..highest grades in the class! I know no one got an A..and I just missed an A by 1 question. Remember, at my crazy school a C is 80-85, a B is 86-93 and an A is anything above a 94. So, I'm right on the cusp..and that is A-ok with me!
Last Friday, I was at the library from about 6:30pm until 2am! I had to have security escort me to my car! And then Saturday, I went over to "Candace"'s house to study with her and guess what time we stopped studying..6:15am! Yes...AM!! Craziness!
But, it was well worth it and I can't stop smiling :) Cardiac is definitely where I want to be and I'm glad that I can atleast not be scared of the information. No, I don't know EVERYTHING but I'm hoping I have a good foundation!
So, now, I'm going to go to bed...after mindless playing of my SIMS game! :)
Monday, January 24, 2011
Thursday, January 20, 2011
Craziness in the CCU
First week in CCU and it was a tad bit overwhelming. Since I was in the burn unit last week and clinical was cancelled the 2nd day, this week was my first week there.
Yesterday, we didn't do much. Just assessments and "tubbies" as our instructor calls them (light bedbaths). Our patient was in his 90s (he didn't even look like he was that old) and basically "dead on the bed" as our instructor called it. He had been shocked like 10 times from the time EMS brought him in until the day before he was admitted (we got him on day 2 of admission). He takes Nitro to relieve chest pain with angina but apparently, it wasn't working on that day and he collapsed at home. So, he was brought in..yadda yadda ya. He is vented (meaning he's on a ventilator that is essentially breathing for him) with an ETT (endotracheal tube), has a NG (Nasogastric -- goes from the nose to the tummy) tube for feedings, 2 IV lines (one that he was receiving meds in and another one was a saline lock).
We are paired up in CCU with a partner and this week "Morgan" and I were paired up with him. We had some good times with him...like tonight when we tried to give him a "tubbie" and were attempting to change the sheets from underneath him (remember "Morgan" and I's first bedbath?!?! Took us FOREVER and now we're pros..lol). Well, he's literally dead weight..he aint helping us to move at all! So, we're trying to log roll him and all and the vent machine is beeping all loud, alarms ringing from the monitor. We're like..what in the world! Yeah, we know he's probably at the end of his life and all..but we're not trying to get him there any quicker! So, we got like half the new sheet and padding up under him while rolled towards me but when he's rolled towards "Morgan" to get the old sheet and padding out and straighten out the new ones, alarms are going off and all. This happens AGAIN (I mean, I couldn't get the darn sheet and padding out for nothing -- all the while I'm thinking I'm about to pull all his tubes and all out. So, the nurse comes in (she was really nice with this patient and another one) and is like (in a joking manner) "What are you guys doing in here? Trying to kill my patient? I got alarms going off on the other side and I'm like the nursing students are killing my patient" LOL! We're like..not entirely. As we explain to her what we're trying to do, she's like..He's not going to like it..you're moving him around but ya gotta do what ya gotta do. It's going to alarm..hit that button there and keep it moving. So, that's what we do..I'm like..let's go, "Morgan"..pull him towards you and I'm yanking this stuff out. Which I do. And he lived on. Amen. LOL.
Trying to get acclimated after a semester of babies, and mamas and crazies was a little trying. I hadn't hung or given any medications in FOREVER! So, it was a little crazy, hanging meds, attaching stuff, especially since our nurse was quizzing and joking and rushing us (not really rushing us..we were just slow..and slow..lol). It will take a little more getting used to but I'm definitely enjoying the experience. Cardiac and ICU are definitely the places I want to be :)
So, I'm suppose to spend the next two clinical weeks in the ER as a rotation but I'm switching with another student so I can spend more time in the CCU and less time on the med/surg floor from the beginning of nursing school.
5 more months, ya'll! :D But, first I gotta get through this cardiac exam on Monday..ugh...lol
Yesterday, we didn't do much. Just assessments and "tubbies" as our instructor calls them (light bedbaths). Our patient was in his 90s (he didn't even look like he was that old) and basically "dead on the bed" as our instructor called it. He had been shocked like 10 times from the time EMS brought him in until the day before he was admitted (we got him on day 2 of admission). He takes Nitro to relieve chest pain with angina but apparently, it wasn't working on that day and he collapsed at home. So, he was brought in..yadda yadda ya. He is vented (meaning he's on a ventilator that is essentially breathing for him) with an ETT (endotracheal tube), has a NG (Nasogastric -- goes from the nose to the tummy) tube for feedings, 2 IV lines (one that he was receiving meds in and another one was a saline lock).
We are paired up in CCU with a partner and this week "Morgan" and I were paired up with him. We had some good times with him...like tonight when we tried to give him a "tubbie" and were attempting to change the sheets from underneath him (remember "Morgan" and I's first bedbath?!?! Took us FOREVER and now we're pros..lol). Well, he's literally dead weight..he aint helping us to move at all! So, we're trying to log roll him and all and the vent machine is beeping all loud, alarms ringing from the monitor. We're like..what in the world! Yeah, we know he's probably at the end of his life and all..but we're not trying to get him there any quicker! So, we got like half the new sheet and padding up under him while rolled towards me but when he's rolled towards "Morgan" to get the old sheet and padding out and straighten out the new ones, alarms are going off and all. This happens AGAIN (I mean, I couldn't get the darn sheet and padding out for nothing -- all the while I'm thinking I'm about to pull all his tubes and all out. So, the nurse comes in (she was really nice with this patient and another one) and is like (in a joking manner) "What are you guys doing in here? Trying to kill my patient? I got alarms going off on the other side and I'm like the nursing students are killing my patient" LOL! We're like..not entirely. As we explain to her what we're trying to do, she's like..He's not going to like it..you're moving him around but ya gotta do what ya gotta do. It's going to alarm..hit that button there and keep it moving. So, that's what we do..I'm like..let's go, "Morgan"..pull him towards you and I'm yanking this stuff out. Which I do. And he lived on. Amen. LOL.
Trying to get acclimated after a semester of babies, and mamas and crazies was a little trying. I hadn't hung or given any medications in FOREVER! So, it was a little crazy, hanging meds, attaching stuff, especially since our nurse was quizzing and joking and rushing us (not really rushing us..we were just slow..and slow..lol). It will take a little more getting used to but I'm definitely enjoying the experience. Cardiac and ICU are definitely the places I want to be :)
So, I'm suppose to spend the next two clinical weeks in the ER as a rotation but I'm switching with another student so I can spend more time in the CCU and less time on the med/surg floor from the beginning of nursing school.
5 more months, ya'll! :D But, first I gotta get through this cardiac exam on Monday..ugh...lol
Thursday, January 13, 2011
Fire is not our friend!
So, on Tuesday of this week, I spent the day at a Burn Center, not far from where I live. The nurse educator had come to our school the week before to talk about burns and the nursing treatment of them, what happens when they come in to the ER, how the skin is affected, etc. She was really good so I was looking forward to visiting and spending the day there. Even if I had to be up at the crack of dawn.
The majority of the day was spent in the "Tank Room" where hydrotherapy was done for various patients. The patient is put onto a bed similar to this one:
They are fully wrapped in white gauze and cloths to prevent infection. Infection is a HUGE problem for burn victims so everyone is in full protection: gown, gloves, mask and head covering. We (another fellow nursing student and I) didn't have to wear gloves but we did have on a gown and head covering. Once, we also put on a mask when we got close enough to a patient.
So, the patient is brought in (or in the case of a 9 y/o patient, walked in) on the bed and is stripped of all the dressings. This allows the nurse and doctors to see the burns and how they are healing. It can be very painful for the patients so they are usually medicated. This is also the time that they are washed down and cleaned. One of the patients was a 9 year old kid who was burned all on his abdomen and on his back and arms. We weren't quite sure how he was burned so the tech that was washing him, asked him and I believe he was reaching over a candle and his shirt caught on fire. He was so young at 9 but some of the youngest I heard about were 2 and 6 days old! The only thing you should be doing is eating, sleeping and pooping at that age, not getting burned! But, apparently hot formula and loose caps on bottles don't go together.
There was another patient who hadn't even been there for 24 hours -- a firefighter who came in the previous afternoon. He was sooo badly burned. Even his face was burned. Eyelids, back, butt, thighs, legs, fingers. His face was so swollen. One of the biggest problems with burns is the massive fluid loss. As a consequence, one of the first symptoms of a burn is decreased blood volume leading to hypoperfusion or shock. So, the most important immediate treatment is for shock. Fluids will be administered and for this guy, there were liters and liters of fluid given to him. They weigh the patients every day and not even 24 hours later, when they weighed him, he weighed 50 lbs more! When they were done with him, there were bits of skin that were peeling from him on the floor.
The burn unit was definitely interesting but not so sure if I would be interested in working there. Here are some pics of other burn patients:
Wednesday, January 5, 2011
Sleep deprived!
So, we have finally hit the ground..and more than running..we're more like flying! This week, we have officially started our 4th and final semester! *insert applause and loud cheers*
This is going to be a ROUGH semester. Even as I type this, I am yawning and so sleep deprived! So, Monday (2 days ago), was our orientation/school party and beginning of the cardiac segment for us evening students. It was good to see people again but it was like we just left them. Which we did, about 2 weeks prior!
We have a lot going on this sections. We start out in cardiac and even though we started the basics in cardiac 2nd semester, now we are building even more on it, for the critically-ill patient. So, we're talking disorder of the SA node, dysrhythmias, disorders of the ventricles, arrhythmias, MIs, coronary disease..the works. Then we move on to patients with acute alteration in oxygenation, which means those with ARDS (Adult Respiratory Distress Syndrome), acute asthma, pulmonary embolism and working with endotracheal tubes, ventilators, yadda yadda ya. Then we throw in there acute renal failure, renal transplant HIV. Next, people with GI problems, liver failure, endocrine problems (DKA, HHNK, Hypoglycemia, Thyroid Storm, etc.). And finally some burns and neuro problems. ALL from now until April...we are some busy bees!
Clinical will also be interesting. Sooooo, they have STILL split up me and my Nurseketeers...the nerve! While "Morgan" and I are back together, poor "Candace" is out in the other clinical group. I keep assuring her she'll be fine and I think the idea is settling in, but we'll see how it goes after next week. She's great in clinical so I know she'll be fine.
We'll spend have the semester in the CCU of one hospital and then the other half on a med/surg floor (the same one we started with first semester of school). I'm really looking forward to the CCU portion of the rotation but unfortunately, I'll be missing like half of it because of the extra rotations. We ALL (whole class) spends a day on the Burn Unit of yet another hospital and a day viewing open-heart surgery at the same hospital I had my original OR rotation. While the burn unit should be interesting (turns out we'll just be viewing the patients during hydrotherapy, where they essentially are using water to treat the burns and to remove the dead skin -- and is essentially painful), I'm really looking forward to the open-heart surgery. 2 representatives from each of those units came and spoke to our class today and both were really interesting. I have both of those rotations next week so I will definitely be updating ya.
Starting out in cardiac (which is probably going to be one of the hardest, if not THE hardest section of this semester) with one of the hardest instructors, is mind-blowing. The last hour of the first class Monday night, I honestly didn't even know what she was talking about. Crazy! But, I hit the books that very night and started working on my notes and reading. The first exam is literally in 3 weeks. She keeps saying the work is hard and difficult. She even had the nerve to say the first class, "Wait until you see my exam." Excuse me?!?! Um..ok...so, I'm adhering to her warning..and also asking her lots of questions!
Which brings me back to my original statement -- I'm so sleep deprived already..and it's only been the 3rd day! Working full-time and going to school full-time is NOT fun..but I only have a few more months and it will be all worth it!
This is going to be a ROUGH semester. Even as I type this, I am yawning and so sleep deprived! So, Monday (2 days ago), was our orientation/school party and beginning of the cardiac segment for us evening students. It was good to see people again but it was like we just left them. Which we did, about 2 weeks prior!
We have a lot going on this sections. We start out in cardiac and even though we started the basics in cardiac 2nd semester, now we are building even more on it, for the critically-ill patient. So, we're talking disorder of the SA node, dysrhythmias, disorders of the ventricles, arrhythmias, MIs, coronary disease..the works. Then we move on to patients with acute alteration in oxygenation, which means those with ARDS (Adult Respiratory Distress Syndrome), acute asthma, pulmonary embolism and working with endotracheal tubes, ventilators, yadda yadda ya. Then we throw in there acute renal failure, renal transplant HIV. Next, people with GI problems, liver failure, endocrine problems (DKA, HHNK, Hypoglycemia, Thyroid Storm, etc.). And finally some burns and neuro problems. ALL from now until April...we are some busy bees!
Clinical will also be interesting. Sooooo, they have STILL split up me and my Nurseketeers...the nerve! While "Morgan" and I are back together, poor "Candace" is out in the other clinical group. I keep assuring her she'll be fine and I think the idea is settling in, but we'll see how it goes after next week. She's great in clinical so I know she'll be fine.
We'll spend have the semester in the CCU of one hospital and then the other half on a med/surg floor (the same one we started with first semester of school). I'm really looking forward to the CCU portion of the rotation but unfortunately, I'll be missing like half of it because of the extra rotations. We ALL (whole class) spends a day on the Burn Unit of yet another hospital and a day viewing open-heart surgery at the same hospital I had my original OR rotation. While the burn unit should be interesting (turns out we'll just be viewing the patients during hydrotherapy, where they essentially are using water to treat the burns and to remove the dead skin -- and is essentially painful), I'm really looking forward to the open-heart surgery. 2 representatives from each of those units came and spoke to our class today and both were really interesting. I have both of those rotations next week so I will definitely be updating ya.
Starting out in cardiac (which is probably going to be one of the hardest, if not THE hardest section of this semester) with one of the hardest instructors, is mind-blowing. The last hour of the first class Monday night, I honestly didn't even know what she was talking about. Crazy! But, I hit the books that very night and started working on my notes and reading. The first exam is literally in 3 weeks. She keeps saying the work is hard and difficult. She even had the nerve to say the first class, "Wait until you see my exam." Excuse me?!?! Um..ok...so, I'm adhering to her warning..and also asking her lots of questions!
Which brings me back to my original statement -- I'm so sleep deprived already..and it's only been the 3rd day! Working full-time and going to school full-time is NOT fun..but I only have a few more months and it will be all worth it!
Saturday, January 1, 2011
Happy New Year!!
First, let me say Happy New Year to you! May 2011 be filled with peace, love and joy!
Ok...I know I've been SOOO bad! I can't believe I haven't posted since September! Bad, bad, BAD nursing student!! Lol! I can't even remember all that happened last semester but that's because it's been uneventful. LOL! After OB, I had my Psych rotation. I had a great clinical instructor that was really good at what she did.
There really is a thin line between sanity and insanity! I learned so much about depression, OCD, phobia, panic disorder, PTSD (Post-Traumatic Stress Disorder) and many other psychiatric diseases. We may joke about them but they are serious mental illnesses that not only affect the patient but also their families. It was so sad to see how mothers, fathers, children, grandchildren...were all affected by their loved ones disease. And medication helps, but doesn't cure them. In church, a lot of times we say we are grateful that we woke up in our right mind...just don't know how grateful we need to be!
Peds was rather boring. LOL. Maybe it was because my clinical group couldn't do ANYTHING..no medications or anything. Just vital signs and lots and lots of paperwork. BO-RING. And the clinical instructor wasn't the best. Kids are cute and everything..but, I think I'll leave them to other people. LOL.
We did get a chance to spend time in the PICU (Pediatric Intensive Care Unit) and the Pediatric ER. THOSE days were fun..maybe because I work in the ER now as a tech (did I tell you? Yes, your girl has been promoted from wiping butts on the cardiac floor to drawing blood in the ER! lol! I LOVE working in the ER as a patient care tech. I get to see a lot and the nurses show me a lot. I don't know about working in the ER as a nurse - I don't know if I like the treat 'em-and-street 'em philosophy of the ER..I like following up with a patient -- see how they progress but we'll see). I liked the fast-paced of the ER and the intensity of the PICU. Man, if you have children in your life, whether yours or just those around you..be grateful for their health. What may seem like a little headache can be something so very more serious. Trust me..I've seen it.
Well, it's the first of the year -- graduation is in a little over 5 months!! Can you believe it?!?! My, time has flown BY! This semester is going to be a hard one -- back to med/surg..mainly the ICU. I'm looking to apply for nurse internships -- which are transition programs for graduate nurses -- help us go from student nurse to registered nurse. Things are vastly different between school and the real world. So, I'm applying to various ones. AND I'm looking to move to Texas. YES, TEXAS! Opportunities are a little bit better down there than up where I live (even though I would hope that I had a good chance at the hospital I work out..hopefully!). I'm just ready to leave Jersey and be on my way!
So, my new year's resolution (among other personal ones) is to complete school and land a great nurse internship in Texas! Guess those really aren't "resolutions" but I do promise to write more consistently! I'm sure I'll have lots to vent about! :)
Ok...I know I've been SOOO bad! I can't believe I haven't posted since September! Bad, bad, BAD nursing student!! Lol! I can't even remember all that happened last semester but that's because it's been uneventful. LOL! After OB, I had my Psych rotation. I had a great clinical instructor that was really good at what she did.
There really is a thin line between sanity and insanity! I learned so much about depression, OCD, phobia, panic disorder, PTSD (Post-Traumatic Stress Disorder) and many other psychiatric diseases. We may joke about them but they are serious mental illnesses that not only affect the patient but also their families. It was so sad to see how mothers, fathers, children, grandchildren...were all affected by their loved ones disease. And medication helps, but doesn't cure them. In church, a lot of times we say we are grateful that we woke up in our right mind...just don't know how grateful we need to be!
Peds was rather boring. LOL. Maybe it was because my clinical group couldn't do ANYTHING..no medications or anything. Just vital signs and lots and lots of paperwork. BO-RING. And the clinical instructor wasn't the best. Kids are cute and everything..but, I think I'll leave them to other people. LOL.
We did get a chance to spend time in the PICU (Pediatric Intensive Care Unit) and the Pediatric ER. THOSE days were fun..maybe because I work in the ER now as a tech (did I tell you? Yes, your girl has been promoted from wiping butts on the cardiac floor to drawing blood in the ER! lol! I LOVE working in the ER as a patient care tech. I get to see a lot and the nurses show me a lot. I don't know about working in the ER as a nurse - I don't know if I like the treat 'em-and-street 'em philosophy of the ER..I like following up with a patient -- see how they progress but we'll see). I liked the fast-paced of the ER and the intensity of the PICU. Man, if you have children in your life, whether yours or just those around you..be grateful for their health. What may seem like a little headache can be something so very more serious. Trust me..I've seen it.
Well, it's the first of the year -- graduation is in a little over 5 months!! Can you believe it?!?! My, time has flown BY! This semester is going to be a hard one -- back to med/surg..mainly the ICU. I'm looking to apply for nurse internships -- which are transition programs for graduate nurses -- help us go from student nurse to registered nurse. Things are vastly different between school and the real world. So, I'm applying to various ones. AND I'm looking to move to Texas. YES, TEXAS! Opportunities are a little bit better down there than up where I live (even though I would hope that I had a good chance at the hospital I work out..hopefully!). I'm just ready to leave Jersey and be on my way!
So, my new year's resolution (among other personal ones) is to complete school and land a great nurse internship in Texas! Guess those really aren't "resolutions" but I do promise to write more consistently! I'm sure I'll have lots to vent about! :)
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