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Archive for September, 2009

Today was the magic day — first clinical.  This is how it was supposed to go down:

  • 12:45PM:  Meet as a group in lobby and head to computer/charting training.
  • 1:00PM-5:30PM:  Go through training on how to chart/document in the hospital.
  • 5:30PM-9:00PM:  Perhaps go to floor of hospital and orient ourselves and maybe see patients.

And this is how it actually went down:

  • 12:45PM:  Meet as a group in lobby and head to computer/charting training.  (OK, so far so good.)
  • 1:00PM:  Arrive at training room and see a room full of other students taking up every available computer.  (Uh-oh.)
  • 1:03PM:  Stand around awkwardly as instructors gather to figure out what’s going on.
  • 1:06PM:  Sit around the periphery as instructors decide that there’s some sort of scheduling snafu.  (Duh.)
  • 1:10PM:  Leave computer room and head back to building where we met.  (Nice sunshine today.)
  • 1:20PM-1:45PM:  Sit at a table and receive brief orientation to instructor’s expectations.
  • 1:45PM-1:50PM:  Walk to hospital.
  • 1:50PM-2:30PM:  Receive very brief tour of the unit we’ll be on.
  • 2:30PM:  Go home.

So yeah, so much for a big 8 hours of clinical my first day.  All in all a fairly disappointing day … but stuff happens, right?  So gotta roll with the punches.  Tomorrow will be a busy day:  4 hours of computer training and then a few hours of seeing our first patients.

The patient-seeing will entail a few things:

  1. Doing a “head-to-toe” assessment:  Basically a very thorough overall assessment of all body systems.  This is where I’ll take my vital signs and ask the patient a million questions and use my senses to assess the patient.
  2. Completing a Nursing Admission Form:  This is where I’ll ask the patient another million questions on a super-thorough form.
  3. Starting to learn how to document document document document document document document.  After that, we’ll document some more.  And then after that’s all said and done, it’ll be time to start documenting.

For the first month or so, I will get one patient to assess and follow.  After I get the hang of assessing my patient and charting everything, they’ll add in more tasks.  The instructor hopes to have us giving meds by the 4th week or so (we’re not allowed to give IV meds, I don’t think — only oral, intramuscular, and subcutaneously).  Also, each of us will have one week where we play the role of “charge nurse” in our little group, in that we’ll help schedule the tasks for our fellow students and basically oversee everything for that week.

I’m pretty nervous about tomorrow, because this will be the first time I’m actually talking to a live patient and performing nursing duties!  I’m ridiculously excited, however.  I know I’m not expected to do everything right at this point, but I’m still hoping I don’t mess up.

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… until my first clinical rotation.

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Did anyone ever tell you that you should rub something if it hurts?  If you bump your elbow, you start rubbing it, right?  This works because of something called the Gate-Control Theory of Pain, which says that, in the spinal cord, there is a “gate.”  This gate allows certain stimuli to reach the brain before other stimuli.

For example, when you bump your elbow, the sensation of sharp pain is sent to your brain.  However, when you start rubbing that elbow, the sensation of pressure is sent toward the brain, goes through the gate, and the gate closes before the sensation of sharp pain can get there.

This theory says that pressure will always reach the gate (and subsequently the brain) before sharp pain.  Makes sense, right?  When you push a button on an elevator, you sense pressure in your fingertips first.  When you kiss a loved one, you sense pressure on your lips first (among other, more beautiful sensations).  When you walk down the street, you sense pressure on the bottoms of your feet first.  And so on and so on.

It’s almost become a reflex — when you hurt something you immediately reach for it to start rubbing it — Mother Nature’s way of letting you start easing the pain.

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Shout out to Mama Cass.

Today was the first time we’ve had (almost) all our classes on Monday — next week we have all our classes meeting for the first time.  However, here was the schedule for today:

  • 8:00AM-10:50AM:  Pharmacology I
  • 11:00AM-12:00PM:  Medical Calculations (Review)
  • 2:00PM-4:50PM:  Intro to Professional Nursing

Now, I’ll admit I played hooky from the Med Calc class, because it was a review for our Final Exam tomorrow, and we weren’t required to go … so … uhh, I didn’t go, and used that time to run some errands I needed to run before the end of the day.  A nice lunch at home, and then it was right back into the classroom.

The morning session was just an introduction to pharmacology, with some discussion into pain medications.  The afternoon session dealt with effective communication and the nursing process, which we’ll apparently be using tons of once we’re in the hospital (starting Wednesday … eek!)

The point of all this hullabaloo is, however, that last night I needed to finish up an online assignment for Epidemiology (due today, but wanted to get it out of the way), so I stayed up way too late (until 1AM) to finish it.

Thus, 5 hours of sleep.

Thus, eyes involuntarily shutting during nursing process lectures.

Thus, Cranky Kenny rears his ugly head.

Thus, sense of humor gets wicked cynical.

Good times.  In any event, the best part of our Intro to Professional Nursing class is that, during every class, several people are supposed to “present” themselves to the class (ie, why they want to be a nurse, where they come from, etc).  Usually this entails a few moments of show-and-tell along with some backstory, which is usually pretty interesting.  Today’s participants were especially interesting, including:  a woman who had cervical cancer at 24 years of age and decided to become a nurse; a woman from South Africa who showed her patriotism; and of course, K (my bestest buddy from school), who detailed her journey to Tanzania and how it profoundly impacted her.  All good stories and great inspirations for successful nursing careers.

Tomorrow is only one class — Medical Calculations Final Exam — and then S.A.N.L.O.P., after which I plan on using the whole afternoon to take care of KennyStuff (haircut, errands, drop off rent check).  Then on Wednesday … first day of clinical rotations!  It’s only a computer training day, but it still counts.

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So there are about 130 people in my class, 30 of whom are in the same program I am in.  Of those 130, I’d say maybe 20 are men.  Because of this ratio, I usually find myself in small groups alone with women … or maybe, just maybe, one other guy.  So you can imagine the surroundings.

On Wednesday, we had our Lab dealing with body mechanics — how to transfer patients from bed to stretcher, how to lift a patient into a chair, etc.  So, seeing as I was the only fella in my group all morning long, this is how it all went down:

SCENARIO 1:  MOVING PATIENT FROM BED TO WHEELCHAIR

Instructor:  Ok, let’s learn how to move a patient from the bed to a chair.  [Looks around group] Hmmm, ok, how about you get in the bed and pretend to be the patient, Ken?  You’re nice and tall — that’ll present a nice little challenge.  [I proceed to get into the bed]

SCENARIO 2:  MOVING PATIENT FROM BED INTO HYDRAULIC LIFT

Instructor:  Ok, let’s practice getting the hang of this lift.  [Looks around group] Hmmm, ok, Ken, why don’t you get into the bed and we can practice putting you into the hydraulic lift?  It’ll be good to figure out how to get a really tall person with long legs and arms into the hammock.  [I proceed to get into the bed]

SCENARIO 3:  MOVING PATIENT FROM BED ONTO STRETCHER

Instructor:  Ok, here’s a skill that’ll always come in handy — we have to get patients onto a stretcher when they go for tests and such.  [Looks around group]  Hmmm, ok, this’ll be outstanding — Ken, you get into the bed, because you have exceedingly long arms and legs, and you don’t fit into the bed, and this will get us to think about what we need to do.  [I proceed to get into the bed]

So you see what’s goin’ on over here?  I jest, of course … I don’t really mind, but at this point, next time we start to learn a new task, I’m changing into my pajamas and slippers and just getting into the bed automatically.  Might as well, because they’re gonna ask me anyway.

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Today was the last day of Labs!  We had a fun scavenger hunt-type activity, where we visited 5 different rooms and tried to point out everything that was wrong about those rooms.  Some things were obvious (patient found lying on floor with his ankle broken and his gown off) and others were not so obvious (patient’s name incorrect on chart), but all mistakes were visible if we took the time to find them.  It was a fun day.

Then we were off to different rooms to be tested on our vital signs.  An instructor sat with us as we took vitals from another student:  radial pulse, apical pulse, blood pressure, and respirations.  I passed this test, and then K and I went to the Terminal Market for lunchie munchies.  Mmm …

Next week most of our other classes start, and then Wednesday/Thursday are my first 2 days in the hospital!  Exciting!  I think the first day is computer training (to learn how to chart and document everything you do), and then it’s off to the floor to meet my patients.  Cannot wait.

STAT OF THE DAY:  At this point in my education I have completed approximately 58 clinical hours!

Now I’m off to go pick up my bike and get a much-needed Slurpee.  Have a great weekend, everyone.

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Nurses and Alcoholism

In class this past Monday we viewed a very outdated video (from the mid 1980s, I believe) which contained a startling statistic:

  • Approximately 80% of all nurses come from families with at least one alcoholic member.

Does anyone know why this might be?  I think I remember it has something to do with codependence, but not really sure.  Anyone have any experience with this kind of research?  I remember seeing it onscreen and thinking, “What?!”  It’s almost unbelievable, but it’s been proven — just trying to find the clinical studies to back it up.

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