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! :)
Thursday, September 9, 2010
Babies, babies and more babies!
So far, my OB rotation has been going well. Each night, 2 of us go to L&D (Labor and Delivery) and 2 go to the NICU (Neonatal Intensive Care Unit) to observe and follow a nurse. With my last name being the first on the list, I got to go first, with another classmate.
My night in L&D was great...got to see 2 births! I was in the delivery room with a close friend of mine when she delivered her stillborn but that wasn't a happy occasion so that really didn't count as a delivery room experience. This time..we had reason to celebrate!
I followed "Amy" for the first half (since I go to clinical at night from 4-11, I am there during the shift change. Shifts are mainly 7a-7p and 7p-7a) of clinical. She was in the recovery room (there are operating and recovery rooms right there on the floor for the C-sections), recovering a recent C-section. This patient was 41 and also had a tubal ligation (got her tubes tied). I guess she figured at 41 with 2 kids now, the store was CLOSED! The baby had already been taken to the nursery but she had to recover first before being transferred to the mother/baby unit. I can't remember how many weeks of gestation (how may weeks pregnant) the baby was but I'm pretty sure he was born a full-term baby (born between 38 and 42 weeks). Otherwise, the NICU might have received him if he was a preterm (born before 37 weeks) baby, just to make sure everything was ok.
"Amy" assessed the mom to make sure her vital signs were ok and that she could move her extremities (legs) after the wear off of the anesthesia. After everything looked good, instead of waiting for the tech to bring mom over, we just took her to the mother/baby or postpartum (after birth) unit. Her family was all waiting by the nursery, which you have to pass to get to the rooms. Her parents and other family members were there to kiss and greet her. She was also able to see her baby for the first time, which is always a good feeling. Once we got that mom settled in her room and "Amy" gave report to the new nurse that would be taking care of mom, we headed back to L&D.
Overall, it ended up being a good night. I got to see 2 births, vaginally! The first one, I came in about 10 minutes before the baby was born. The mom had already started pushing and while she glanced over at me after I entered the room with "Amy", she was not paying any attention - she was concentrating on pushing that baby out. At one point, the doctor had to give her an episiotomy, which is an incision through the perineum made to enlarge the vagina to help with getting that baby out. Man..when I saw the doctor lift up those scissors, my toes curled. And that lady screamed..even though I'm not sure whether she had an epidural or was going totally natural. Lord help her if she was going natural. But, it's better that the doctor cut her than she tear naturally. But, the "best" part was when after the baby had came out and the baby (a girl) was on the mom's chest and she was now laughing instead of screaming...a gush of fluid rushed out of her! I don't know if all the amniotic fluid, or "bag of waters", hadn't emptied out by then or what..but it was like a hydrant had been opened in her nether region. Even the doctor commented that he almost drowned.
My 2nd birth was a little bit more "civilized". I was able to see it from start to finish, per se. From the first time she started to push (even held her leg) to when the baby boy came out. This mom actually was a bit early (at 34 weeks) so the NICU team came down to be there when he was born. The funniest part was the dad did not move from the head of the bed. He stroked and comforted his wife the entire time..even cracking jokes between contractions. But, did he want to see the head as it crowned...or cut the cord? No way..as he stated "I'm good!" LOL! It's amazing..some guys want nothing to do with that area when it's exposed and pushing out a baby..and others are all up in there with a video camera!
Overall, good experience in the L&D. I also got to see an epidural being put in. While I don't really have a pull to be in L&D like a lot of nursing students..it's definitely an option I wouldn't turn down.
I also had a night in the NICU. It's funny....before I went into nursing school, I always said I wanted to work in the NICU. But, as I started school and worked at the hospital, I became fascinated with other departments like cardiac and the ER. But, last night in the NICU...I am back to being interested in it!
The babies were so small...and sooo sick! A lot of them were born at 25, 26 weeks! Imagine going into labor and delivering that early! There are a lot of multiples in the NICU. A lot of twins..and I got to see one set of triplet girls...so cute! Some of the babies were on CPAP machines to help them with their breathing because a lot of babies are born with respiratory problems. I even saw a baby with an ileostomy! It's no biggie to seen an adult with one..but a baby?!? Hopefully, it won't be permanent and her little bowels will be fixed.
Now for the rest of my time in OB, I'll be in the mother/baby unit..which involves a lot of teaching....boring! LOL! But, I'll enjoy my easy time there for now. Because in a few weeks, things will get really crazy....literally! Psych rotation starts next month!
My night in L&D was great...got to see 2 births! I was in the delivery room with a close friend of mine when she delivered her stillborn but that wasn't a happy occasion so that really didn't count as a delivery room experience. This time..we had reason to celebrate!
I followed "Amy" for the first half (since I go to clinical at night from 4-11, I am there during the shift change. Shifts are mainly 7a-7p and 7p-7a) of clinical. She was in the recovery room (there are operating and recovery rooms right there on the floor for the C-sections), recovering a recent C-section. This patient was 41 and also had a tubal ligation (got her tubes tied). I guess she figured at 41 with 2 kids now, the store was CLOSED! The baby had already been taken to the nursery but she had to recover first before being transferred to the mother/baby unit. I can't remember how many weeks of gestation (how may weeks pregnant) the baby was but I'm pretty sure he was born a full-term baby (born between 38 and 42 weeks). Otherwise, the NICU might have received him if he was a preterm (born before 37 weeks) baby, just to make sure everything was ok.
"Amy" assessed the mom to make sure her vital signs were ok and that she could move her extremities (legs) after the wear off of the anesthesia. After everything looked good, instead of waiting for the tech to bring mom over, we just took her to the mother/baby or postpartum (after birth) unit. Her family was all waiting by the nursery, which you have to pass to get to the rooms. Her parents and other family members were there to kiss and greet her. She was also able to see her baby for the first time, which is always a good feeling. Once we got that mom settled in her room and "Amy" gave report to the new nurse that would be taking care of mom, we headed back to L&D.
Overall, it ended up being a good night. I got to see 2 births, vaginally! The first one, I came in about 10 minutes before the baby was born. The mom had already started pushing and while she glanced over at me after I entered the room with "Amy", she was not paying any attention - she was concentrating on pushing that baby out. At one point, the doctor had to give her an episiotomy, which is an incision through the perineum made to enlarge the vagina to help with getting that baby out. Man..when I saw the doctor lift up those scissors, my toes curled. And that lady screamed..even though I'm not sure whether she had an epidural or was going totally natural. Lord help her if she was going natural. But, it's better that the doctor cut her than she tear naturally. But, the "best" part was when after the baby had came out and the baby (a girl) was on the mom's chest and she was now laughing instead of screaming...a gush of fluid rushed out of her! I don't know if all the amniotic fluid, or "bag of waters", hadn't emptied out by then or what..but it was like a hydrant had been opened in her nether region. Even the doctor commented that he almost drowned.
My 2nd birth was a little bit more "civilized". I was able to see it from start to finish, per se. From the first time she started to push (even held her leg) to when the baby boy came out. This mom actually was a bit early (at 34 weeks) so the NICU team came down to be there when he was born. The funniest part was the dad did not move from the head of the bed. He stroked and comforted his wife the entire time..even cracking jokes between contractions. But, did he want to see the head as it crowned...or cut the cord? No way..as he stated "I'm good!" LOL! It's amazing..some guys want nothing to do with that area when it's exposed and pushing out a baby..and others are all up in there with a video camera!
Overall, good experience in the L&D. I also got to see an epidural being put in. While I don't really have a pull to be in L&D like a lot of nursing students..it's definitely an option I wouldn't turn down.
I also had a night in the NICU. It's funny....before I went into nursing school, I always said I wanted to work in the NICU. But, as I started school and worked at the hospital, I became fascinated with other departments like cardiac and the ER. But, last night in the NICU...I am back to being interested in it!
The babies were so small...and sooo sick! A lot of them were born at 25, 26 weeks! Imagine going into labor and delivering that early! There are a lot of multiples in the NICU. A lot of twins..and I got to see one set of triplet girls...so cute! Some of the babies were on CPAP machines to help them with their breathing because a lot of babies are born with respiratory problems. I even saw a baby with an ileostomy! It's no biggie to seen an adult with one..but a baby?!? Hopefully, it won't be permanent and her little bowels will be fixed.
Now for the rest of my time in OB, I'll be in the mother/baby unit..which involves a lot of teaching....boring! LOL! But, I'll enjoy my easy time there for now. Because in a few weeks, things will get really crazy....literally! Psych rotation starts next month!
Wednesday, September 1, 2010
I want a baby!
Well, no..not really..not exactly. Tonight was my 1st OB (Obstetrics) rotation and it was really cool. When we first got there, we had to get buzzed in by the security guard outside of the floor section -- gotta make sure no one tries to swipe a baby! When we got to the conference room, we each received a packet from the clinical instructor - "Mrs. P" about our rotation, newborn assessment and other things. That's when I found out that this rotation, I'm paired up with another student to have an evening following a L&D nurse and then the next clinical, following a NICU nurse. Hopefully, we won't be following the same nurse!
Then we took a little tour of the floor. We got to see the different rooms such as the delivery room (which were SOO nice! The rooms were huge..had huge bathrooms and showers). We even got to see a room with a jacuzzi for those that want a bathtub to either sit in, deliver in or both. I'm interested in having a water birth or atleast a tub to sit in before I deliver..but we shall see!
Then we watched 2 videos on newborn assessments and then it was off to the nursery! The babies were so cute..and little! There were 2 sets of twins that I ended up seeing during the night. A set of boy twins and a set of girl twins. We got to see "Mrs. P" do a newborn assessment and then we were paired up either with 1 or 2 other students and did our own assessments. Since "Morgan" and "Candace" are not in my clinical group, my other friend "Bianca" and I decided before school started that whatever we had to do in pairs, we would be each other's partners..and that started tonight!
The newborn assessment is really thorough..things you wouldn't even think of checking but would be really important to know! Some of the babies weren't really feeling us assessing them..and they were hungry! When we went to assess their sucking reflex, they were not happy at all to discover that what they thought was a nipple, was actually our gloved fingers! But, they were so cute. We also got to learn how to weigh them, take their measurement and change that lovely diaper full of first stool - meconium!
You know I have to cry atleast once a semester and today almost was that day! There was a first-time dad in the nursery and when his family came up, he went out to greet them and the woman who was clearly his mom was just in pure joyful tears. It's amazing how the life cycle continues and she was seeing her "baby" having his first baby. Brought tears to my eyes..almost! LOL! There was also a baby there that had literally just been born. He was breeched (entering the birth canal with his bottom or feet first, instead of the normal head first) so Mom had come in to have her abdomen externally rotated so to encourage that the baby switch positions. However, during that time, the baby became distressed and an emergency C-section was held. So emergent that the mom was put under general anesthesia (not conscious at all) and the baby delivered. Luckily, the baby was alread at 36 weeks so while he first scored a 5 on the Apgar scale (method to quickly and summarily assess the health of newborn children immediately after childbirth - different criteria given a score of 0, 1 or 2, adding all to total between 0 -10) a minute after birth, luckily he went up to an 8, 5 minutes later.
Speaking of the nursery, we were warned by our teacher and a nurse that no matter what we are discussing about in the nursery, since there are windows all around and families almost always there, just keep on smiling. Imagine looking at all these nursing students surrounding YOUR baby and all of their faces are looking grim, sad or shocking while surrounding YOUR baby! The windows are soundproof so you'll have no idea of why they are looking like that. Same goes for making faces while trying not to laugh at the baby's conehead. Just keep a smile on!
So, the first night in OB was great. I'll keep you posted on any fun things -- like a birth! OB seems cool but I can't see myself doing it, especially in postpartum. I need sick patients! And I'm sure there are different situations and I'm still interested in the NICU. But, for now, not too interested in little people that only eat, sleep and poop the whole time. Then again...add 80 years and that's the other population in the hospital! ;-)
Then we took a little tour of the floor. We got to see the different rooms such as the delivery room (which were SOO nice! The rooms were huge..had huge bathrooms and showers). We even got to see a room with a jacuzzi for those that want a bathtub to either sit in, deliver in or both. I'm interested in having a water birth or atleast a tub to sit in before I deliver..but we shall see!
Then we watched 2 videos on newborn assessments and then it was off to the nursery! The babies were so cute..and little! There were 2 sets of twins that I ended up seeing during the night. A set of boy twins and a set of girl twins. We got to see "Mrs. P" do a newborn assessment and then we were paired up either with 1 or 2 other students and did our own assessments. Since "Morgan" and "Candace" are not in my clinical group, my other friend "Bianca" and I decided before school started that whatever we had to do in pairs, we would be each other's partners..and that started tonight!
The newborn assessment is really thorough..things you wouldn't even think of checking but would be really important to know! Some of the babies weren't really feeling us assessing them..and they were hungry! When we went to assess their sucking reflex, they were not happy at all to discover that what they thought was a nipple, was actually our gloved fingers! But, they were so cute. We also got to learn how to weigh them, take their measurement and change that lovely diaper full of first stool - meconium!
You know I have to cry atleast once a semester and today almost was that day! There was a first-time dad in the nursery and when his family came up, he went out to greet them and the woman who was clearly his mom was just in pure joyful tears. It's amazing how the life cycle continues and she was seeing her "baby" having his first baby. Brought tears to my eyes..almost! LOL! There was also a baby there that had literally just been born. He was breeched (entering the birth canal with his bottom or feet first, instead of the normal head first) so Mom had come in to have her abdomen externally rotated so to encourage that the baby switch positions. However, during that time, the baby became distressed and an emergency C-section was held. So emergent that the mom was put under general anesthesia (not conscious at all) and the baby delivered. Luckily, the baby was alread at 36 weeks so while he first scored a 5 on the Apgar scale (method to quickly and summarily assess the health of newborn children immediately after childbirth - different criteria given a score of 0, 1 or 2, adding all to total between 0 -10) a minute after birth, luckily he went up to an 8, 5 minutes later.
Speaking of the nursery, we were warned by our teacher and a nurse that no matter what we are discussing about in the nursery, since there are windows all around and families almost always there, just keep on smiling. Imagine looking at all these nursing students surrounding YOUR baby and all of their faces are looking grim, sad or shocking while surrounding YOUR baby! The windows are soundproof so you'll have no idea of why they are looking like that. Same goes for making faces while trying not to laugh at the baby's conehead. Just keep a smile on!
So, the first night in OB was great. I'll keep you posted on any fun things -- like a birth! OB seems cool but I can't see myself doing it, especially in postpartum. I need sick patients! And I'm sure there are different situations and I'm still interested in the NICU. But, for now, not too interested in little people that only eat, sleep and poop the whole time. Then again...add 80 years and that's the other population in the hospital! ;-)
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