Friday, December 21, 2012

Clinicals

Since I'm in an accelerated program, my first clinicals took place this last semester. We had 5 weeks of clinical in the lab at school and then 3 weeks in the hospital (twice a week). Mostly the stuff at the lab was pretty boring, but we did learn how to do all the basic skills: bed baths, changing an occupied bed, vital signs, ROM, assessments, giving meds (not IV or IM), etc.

The check off's were nerve wracking... but I passed them all. I know that you have to learn the things somehow, but it seemed like things were so different in the hospital that I'm not sure how useful it all was.  There's only certain things you can learn by pretending to do them on a fake patient..

My clinicals were on a general med-surg floor that also included some renal and trauma patients. Overall most of the nurses that I interacted with were really nice. Some of them were more willing than others to teach, let us in on cool procedures and take the time to help us out. The most recent graduates seemed to be the most willing to help us out and teach us, since they were just in school not that long ago. Mostly the nurses were grateful to have another set of hands, since we were basically the ones taking care of our one patient.

It seemed to me that clinicals (for fundamentals at least) pretty much consist of getting your feet wet, getting used to going into patient's rooms and talking to them. You try to see what else is going on on the floor to see if there's something interesting to see, but otherwise you feel like you're in your patient's room or stuck in the hall trying to find something to occupy yourself. The worst was that there was literally no place we could go that was out of the way, where we could sit or chart if we had free time. This was sort of okay for a 5 hour clinical but it may kill me when we start 12 hour clinicals the second 8 weeks of the spring semester. Ugh.

Procedures accomplished

- Bed baths. Managed to get lucky on my first two patients and they were ambulating and didn't need help bathing, but I helped a fellow student with a bed bath on her patient the second week and that was just plain tiring because the woman basically couldn't help  us at all. My third week I had a partial paralysis guy who didn't do much of anything for himself so I had to give him two full bed baths, luckily with help from fellow students. He was also a complete gem in the fact that he was so out of it. I couldn't figure out if he had dementia (he was being treated for it), was trying to be funny, or was just that inappropriate. Whatever the reason, he was a challenging patient.

- Flushed an NG tube on a patient

- Passed oral and transdermal patch meds to my patient the last week. Not super hard... but I got to use the Pyxis so I guess that was exciting

- Sort of assisted my instructor with an ostomy. We didn't put the new one on because the ostomy nurse was called for it.

- Vital signs twice a day on each of my patients.


Procedures witnessed

- Nurse pulled a foley catheter on a woman after I got to deflate the balloon.

- Watched the nurse give IV and IM meds, give meds in the NG tube

- Watched my instructor empty a J-P drain.

- Changing out an ostomy which the ostomy nurse did (after my patient's ostomy bag exploded all over the floor while I was with her. Twice. Have I mentioned I'm a figurative and literal shit magnet?)

Care plans

Yup, they suck. They're an epic waste of time in my opinion. But they're apparently a necessary evil in nursing school and perhaps after. The hospital we're at actually has nurses doing a sort of care plan for their patients. Really they're just stating nursing goals and interventions and that stuff...

Care plans are just time consuming and boring. But whatever, they must be done and so I do them.

Saturday, December 15, 2012

Creating a schedule

I commented in my first semester survival post about time management and getting organized. Here are some of the ways I managed my time this semester. 


My weekly planner. In the beginning of the semester I sat down and wrote out all of my due dates for each week. I ended up not using this as much as I thought I would. I ended up using my weekly to do lists and the schedules for each class that I had printed out.


My monthly calendar was more useful. This allowed me to see what was going on each day at a glance. I knew when I was working and when I had clinicals, a test, etc. For the most part I put all of the dates into ical first and then transferred to my planner. This was because pretty much all my stuff came from emails, my online classes, etc so I was already on the computer. Below is a screenshot of my ical from November. I've got days I'm on call, tests, clinicals, study groups, everything that I need to remember and can't seem to keep in my brain.


The time map that I talked about I kept for the first couple of weeks of the semester. This just allowed me to see how much time I was using for what. This can help if you have a super busy schedule and are trying to find times to squeeze in studying around school, work, family, etc.


Here's a copy of my weekly to do list. I would sit down at the beginning of the week and go through each class's syllabus/schedule and write down what was supposed to be completed or was due that week. This helped me prioritize and I got to cross things off so I felt like I was actually accomplishing something. Not everything got done for each week... but at least I could carry it over to the next week's to do list.


Here's another example of my monthly calendar view,  from November (or hell month as I called it.)


So there ya go! What helps you get organized? Do you have a system so that you don't forget things?

First semester survival tips

My first semester:


1st 8 weeks:
- Human Nutrition
- Professional Nursing Concepts
- Abnormal Psychology

- Professional Nursing Concepts
2nd 8 weeks:
- Fundamentals of Nursing clinical
- Dosage Calculations
All Semester:
- Pathophysiology
- Pharmacology


Time management, time management, time management. 
Figure out what works for you and do it. I read before I started school that learning how to manage your time is actually one of the hardest things to do in nursing school. If you're in an accelerated program I think this is especially true. You have to keep track of 8 million due dates and figure out when you're going to read, listen to lectures, study, do assignments, prepare for lab/clinicals, have a LIFE. It sucks.... and its not really that easy. 
One way that I dealt with this in the beginning was using a time map. This lets you visually see where you are spending most of your time and it also helps you see where you have free time. I also had a calendar where I wrote down all the important things going on: tests, due dates, clinicals, etc. Mostly I would sit down at the beginning of every week and write out a to do list for that week and go off of that. I miraculously only missed one due date I think the entire semester.

Schedule relaxation time
As much as you'll hate it you do have to relax at some point. Or at least I did. There was no way it was going to be healthy for me to go full steam at this for four months. I would have lost my mind more than I already did.
Schedule time where you go to the movies, hang out with friends (if they haven't all abandoned you :D), DRINK (this one is important...), go out to dinner or just sit and read a book. Aimlessly surfing the internet is allowed too. As much as you will feel guilty for NOT STUDYING, just do it. You have to take time to take care of yourself or you will burn yourself out super fast. Know yourself, know how much time you need and what you can spare in your schedule/study load

Find a study group/ support group
*If these things help you* I mean I think everybody can benefit from a support group, but study groups are on an individual basis. I found a couple of fellow students to study with and I think it helped me. Also, its nice to be able to blow off steam and you can all relate because you're complaining about the same program! Just having someone that can talk you through an assignment, help you answer a question or simply commiserate with you is super nice. 

Know when to ask for help
Also, know where to find help. Do you need a tutor in a class? What about a study group? Ask the professor, ask your academic advisor, ask a counselor, ask your fellow students. 

Figure out how you learn best
This one was super hard for me. I'm not sure that I ever learned how to study that well in school and my previous degree. Also, the way that I studied kind of changed for each class. But experiment, figure out what works for you and what obviously doesn't. 

For example I used notecards for nutrition and pharm. I tried notecards for patho but it didn't really seem to work (although I just kind of sucked at patho all around). I used the resources that came with the textbook for fundamentals and answered al the NCLEX style questions it provided. I also did the study guides for fundamentals because her tests were exactly from her study guides (other classes not so much). 

Honestly it's never to early to start working on NCLEX prep or NCLEX style questions. All of my fundamentals test were nclex style... and a lot of people struggled with them. If you've got access to Kaplan use it. Although it sucks because it will look like you don't know anything (you dont! it's your first semester), it can be helpful. 

The thing I kept in mind most of the semester was: I will get through this. Every other nurse has done this and so I can too (especially the ones that don't seem particularly bright...). I would also remind myself that this will be so worth it in the end, when I graduate and get the job that I want. 

What are your first semester survival tips? How did you make it through?


Tuesday, December 4, 2012

Update

Hello!

I know I've neglected this poor blog... I've got lots of partial blog entries and ideas jotted down that I'm hoping to get blogged after finals next week. I've got all kinds of fun stuff coming, so stick around!

Good luck to all the other students taking finals!! May the odds be ever in your favor!

What finals do you have this month?

Wednesday, August 22, 2012

Nursing Image in the Media

This is a short little paper I wrote for my professional roles class, but I think that the discussion about nursing portrayal in the media is interesting, so here its.

There has been a good bit of backlash from both the entertainment community and the nursing community about Nurse Jackie. The nursing community doesn't really like that Jackie (and to discuss another medical show Dr. House) has an addiction to painkillers. 

She also bends the rules when it comes to many ethical concerns. While this makes for dramatic TV it would be pretty hard to do the things that Jackie does and still have a job. I understand these points, but I think that Jackie's actions on the show bring up many great topics for discussion in the medical community. Nurses are faced with similar moral and ethical decisions every day!

What are your thoughts? Do you watch Nurse Jackie or any other medical shows?


The image of a nurse that is portrayed in the media is very important factor in how people think of nurses. This image may be a healthy American’s main interaction with nursing and what a nurse does. When people watch TV and movies and see certain negative or positive portrayals of nurses this will be what they are thinking of when they interact with nurses at the hospital or doctor’s office. One recent portrayal of nursing on television is on the Showtime show, Nurse Jackie.
On Nurse Jackie the main character is Jackie Peyton a veteran Emergency Department nurse. From the first episode it is evident to viewers that Jackie is a very good nurse with questionable ethics and it is also evident that Jackie has a drug addiction to painkillers. Jackie often skirts hospital rules in order to do what she feels is best for the patient. Scenarios include Jackie forging an organ donor card, stealing money from a man who assaulted a prostitute, helping a man with lymphoma find marijuana, and helping a patient that was an illegal immigrant leave the hospital so he won’t be arrested (Truth about Nursing, May 24, 2009). While the things that Jackie is doing are unethical and in many cases illegal, her actions allow a commentary between viewers about the ethical dilemmas and challenges that nurses face on a daily basis. From Sorrell (2009),
Nurses’ comments on blogs have noted that Jackie speaks out candidly about injustices in a way that they wish they could. Many nurses can relate to the irony of the hospital administrator warning Jackie about the hazardous effects on patients of working double shifts, and then her being asked to stay for a second shift.”
Perhaps by viewing episodes of Nurse Jackie the general public can begin to understand how difficult a nurse’s job can be and that it encompasses so much more than following orders or babysitting a patient.
 Another important aspect to discuss is Jackie’s portrayal as a nurse in the media. Unlike many older TV shows that had nurses as main characters, Jackie is not seen as subservient, meek, or docile. From “The Henchman of God”, “But nothing else here reinforces the stereotypes that have led the public to undervalue nursing. Jackie is deeply flawed, like real people, but she is not a brainless physician helper, a naughty nurse, or an angel…” (2009). In many episodes Jackie stands up for what she believes is in the patient’s best interests and fights against anyone that stands in her way, whether it be a physician or the nursing administrator. She knows what she she thinks is best and will do everything she can to make sure the patient gets what they need. From Contemporary Nursing, “Nursing is first and foremost ‘knowledge work’. Knowledge workers are people who require specialized education to do work that requires judgment.” (p 35, 2011). With many media portrayals of nurses, it may not be evident that nurses are autonomous individuals who use critical thinking constantly to keep their patients safe. On many shows nurses are seen to take orders from doctors and perhaps hold a patient’s hand to comfort them. While this is true of real life nurses to some degree, nursing encompasses so much more than simple care giving actions. When nurses are not seen as ‘knowledge workers’ their full value as competent healthcare providers cannot be understood by the general population.
If nursing as a profession is to be fully understood and taken seriously, then we must change the way nursing is portrayed on TV and in the media at large. A show like Nurse Jackie is a good start in the right direction. While Jackie has many flaws as a person and as a nurse, there are many good aspects of her too. She shows viewers that nurses can and do think for themselves and make critical decisions to help their patients. The more exposure the general population gets to intelligent, passionate nurses the better their understanding of what nurses do in their professional lives.

References
Cherry, B. & Jacob, S. R. (2011). Contemporary Nursing: Issues, trends and management. St. Louis, Missouri: Mosby, Inc.
Sorrell, J.M., (July 22, 2009) "Ethics: The Value of Nursing Ethics: What about Nurse Jackie?" OJIN: The Online Journal of Issues in Nursing Vol. 14 No. 3. DOI: 10.3912/OJIN.Vol14No03EthCol01
Summers, S. (2009, June 8). The Henchman of God. Retrieved from http://www.truthaboutnursing.org/news/2009/jun/08_jackie.html
Unknown Author. (2009, May 24). Summer 2009 TV Preview. Retrieved from http://www.truthaboutnursing.org/news/2009/may/24_summer_tv.html

Thursday, August 9, 2012

Gearing up for fall

I can't believe its already August. It's scary how close I am to starting my actual nursing classes. 

I went to registration for my nursing classes and bought all of my millions of textbooks for this semester. I got my nursing tote in the mail which is all of my medical supplies like IV tubing, fake meds, foley catheter kit, etc. I'm pretty excited about it. But I won't get to use any of it until October when my fundamentals class starts. I'm not looking forward to how many classes I'll be taking this fall. It's going to be a lot of work.

The way my program works, all of my classes are online and I only go up to the nursing center for clinicals or to take proctored tests for my classes. Which is good because the nursing center is like 45 minutes away from me. :( 


My schedule this fall:
1st 8 weeks:
- Human Nutrition
- Professional Nursing Concepts
- Abnormal Psychology
- Professional Nursing Concepts
2nd 8 weeks:
- Fundamentals of Nursing clinical
- Dosage Calculations
All Semester:
- Pathophysiology
- Pharmacology

I haven't even started to collect all of the school supplies I need for this fall. I don't know exactly what I'm going to want or use. I guess I'm just gonna get into my classes and see what I want to use. It's bugging me though because I would like to have everything ready already. 

Tuesday, July 24, 2012

Conditionally Admitted

I've been conditionally admitted to my Online Accelerated BSN program. My admission is dependent on getting a B or above in my physiology class. But I've got an A in it right now so I'm not super worried!

Things I've been doing since I got admitted:
- Bought my scrubs and polo for school. I need to get khakis and all white shoes (right now I'm hoping for some cheap danskos)
- Working on Physiology!

Things I'm going to do:
- going to register for classes this week.
- I need to call the bookstore and get a list of books for this first semester so I can order them online

Thursday, June 7, 2012

The Waiting

I did it. I submitted my nursing school application last week. Now the waiting starts. I got an email saying they will be mailing out decisions on July 9th. I'm trying not to think about the fact that thats only like a month away. I mean I want to know.. but I'm also like... what if I don't get in??  (Okay I know the answer to this.. I'll go out and get my nose pierced and then figure out what to do afterwards.. :D)

I have the required C+ or higher in all of my required pre-reqs... I only got a C+ in intro to microbio.. so I guess if I don't get in I'll try to retake that because I could probably get a better grade now...

I'm trying to think positively and in some ways it seems like I've basically already been admitted... I keep feeling like I'll DEFINITELY be in nursing school in the fall. It just feels like thats the reality... But I guess we'll see.

I'm hoping that I won't have to be up at the nursing campus all the time because I really want to still be able to work. I want to be able to attend births and I don't wan't to be up at the nursing campus all the time because its like 45 minutes both ways from my house.. :(

So I got all of my login info for my physiology course online that starts in a week or so. I've ordered my textbook so I can go ahead and start skimming at least. Since this is an online class we're just supposed to use the etextbook but I HATE online textbooks so I went ahead and ordered a copy of it. I don't understand how anyone can like etextbooks. Otherwise I'm just waiting for all the info to show up in my course so I can find out what all I'll be doing this summer. I need to go get a binder to put my printoffs and stuff in. Ahh school supplies shopping!

Anyway thats all for now!

Tuesday, May 29, 2012

My Pre-Req Journey

Ahh nursing school pre-reqs... So many classes, so little fun. I mean I suppose if you absolutely adore science and math classes you might consider them fun. But I would imagine the majority of pre-nursing students struggle through some of their pre-reqs. This seems especially true if anatomy and/or physiology is specifically designed to weed out people for the nursing program. :(

The pre-requisites that were required for my admission to the online accelerated BSN program I will be doing:
- Intro Microbiology
- Human Anatomy
- Human Physiology
- Gen/Bio Chemistry
- Statistics
-Various Humanities (fulfilled by my previous Bachelor's)
-Theology (It's a Catholic university. Some of this is fulfilled by my previous religion minor.)

I've completed all of my pre-reqs except physio which I'm taking this summer online.

Co-requisites (I completed for admission to a different program.. not required to gain admission for this program)

- Human Growth and Development

My favorite pre-reqs were definitely my humanities classes from my undergrad! I also enjoyed Human Growth and Development since its technically a psychology class and I found it interesting.

Stats was... okay. I'm really not big on math and I forced myself to take college algebra my last semester of my first bachelor's degree because I knew I wanted to go back for a nursing degree and some schools require college algebra or subsequent classes. I'm glad I went ahead and took college algebra because I think it helped prepare me for stats.
In my opinion stats was frustrating and time consuming. I took a 300 level (basically intro) stats class. I won't say that the concepts were beyond hard, they just took lots of practice problems and a lot of time. As with most math classes there was a lot of required online homework and it was just incredibly time consuming. But I ended up with a B in the class and I'm happy with that.
My suggestions: Take some preparatory math classes before you take stats, especially if math isn't your strong suit. Talk with an advisor or someone from the math department and ask them what classes they recommend you take to do well in stats. Spend the time studying and doing the problems from the book. Take advantage of ANY extra credit available to you. Also, if you can't find an explanation for something GOOGLE it! I found a lot of tutorials this way.

Intro to Microbiology was definitely not a great class for me. I attended every class, even though all my professor did was read from her prepared powerpoint slides that she gave us ahead of time. This also had a lab component which I found okay, mainly because it was explained really well and had a good lab manual.
I did horribly on the first test (and second too I think) I then realized that maybe I should make notecards for all of the things I was having trouble keeping track of. This helped a bit and I did better on the last two tests. My saving grace in this class was the unknowns we did in lab and a few other worksheets that were easy grades. I managed a C+ (albeit by the skin of my teeth) and this is all I needed for the class to qualify for my program. I was just happy to be done with this thing and not have to take it over.
My suggestions: Don't wait 6 years in between your first college level bio class with a lab and your next one! It definitely makes things harder. Find a study system that works for you. I used notecards, but they're not for everyone.

Anatomy was my most hated/dreaded class. I ended up taking it twice at the other university I was at (where I took the majority of my science pre-reqs). There was SO much information covered in our anatomy class and even after taking the class (and accompanying lab) twice, I still don't think I truly understand/know a fraction of it.
My major problem with this class was that I feel that it was considered a weed-out class at the huge state university I took it at. It was a required pre-req for pretty much any healthcare related major and they used it to see who was really committed to their program. It was totally normal to hear someone say this was their second or third time retaking anatomy (Heck I was obviously one of these people!).
At the university there were only two professors that taught it and they had profoundly different teaching styles. My sister had taken the class before with one teacher and told me she thought she had discovered how to do well in the class. He gave out study guides and she said if you filled them out and studied them the same information would be on the test. I attempted this but was overwhelmed by the serious amounts of information and the study guides for each test would literally be 20 pages long (typed). I ended up with a C- in the class my first time around.
I took it again this spring with the other professor and I found that I liked his lecture style and way of running the class much better. He offered extra credit for one thing! He really did want to help his students learn the material and pass the class. I studied my butt off this semester (although really i felt like I studied my butt off the first time too..) and I ended up with a B- in the class. I wanted to cry with happiness when I finally got my grade.
My suggestions: Find out a way of studying anatomy that works for you. The first semester I tried to fill out pages and pages of study guides by listening to lectures again and bringing the study guides to lecture to fill out. This worked in some ways... I had a good idea of what was going to be on the test, but there was so much information covered by each test that I couldn't find a way to remember it all.

The second time around I had the compendium that went along with our textbook and also the lab manual (both of which were turned in for points/extra credit). The compendium was sort of a bullet points, here's the important stuff outline. I went through and highlighted info I know I needed and added my own basic drawings in the margins. A mentor suggested if you can draw it, you'll hopefully understand it (I think this drawing was more beneficial for lab rather than lecture tests). There were also practice tests that I went through in the compendium for each section.
Example of a compendium page:

For lab: I went to every lab (even though I hated it and my teacher wasn't great). I worked on the lab exercise and tried to use the models. A lot of people took photos of the models so that they could study them at home. We also had our histology slides available to us and I printed these off and would bring them to each lab so that when my teacher went over them on the overhead I could write down things she pointed out and slides she went over (these were the ones that would likely be on the lab exam).
After the first lab exam (which I did horribly on FYI) I came up with some new study methods. I took all of the printed out histo slides and cut them out. I circled areas on them and pasted the photo onto an index card. On the back I wrote down what each section was and what the slide was showing. I think this helped me a TON.
See example:

Front of a Histo note card: 

Back of a Histo note card:
I also went through my lab manual and when there was drawing or photo of something I knew we would be tested on I covered up the labels with post it notes so I could quiz myself.  This also helped a ton for labeling models on lab exams.
See example:
Example of my lab manual. Notice the highlighted lines for each thing I needed to know:
For my chemistry class I knew about 3 weeks in I was going to need help to pass this mother. I found a tutor through my school's tutor matching system and I paid her 25 bucks per session to help me pass. I realized that in the long run, paying for a tutor would be way cheaper than having to retake the class if I didn't make the grade I needed.
I took the easiest possible chem class (that still qualified) which was a 101 level class. My main complaint about this class was that I felt (and many of my fellow students said the same thing) that this class was wayyy too hard for an intro level chem class. One girl even said she had taken organic chemistry before and was having trouble in this class!!

Regardless, I studied as much as possible, met with my tutor, did practice problems, made notecards of elements, compounds, ion, rules, etc. My teacher gave us practice problems and practice tests before each test and I did all of them (100's of questions) at least once and sometimes twice. I'm fairly certain that having a tutor got me the B in lecture and A- in lab that I ended up with.

My recommendations: For goodness sakes, GET A TUTOR if you can afford it. They are invaluable resources if you have a good one (Look at it like I did.. its either pay a tutor or pay to take the class again. Which is more expensive?). Study as often as you can bear. Do any practice problems (from the book, online, etc) or practice tests that you are given. Print them out, work out the problems, correct your answers, then print them out and do them again. Make flashcards for any small bits of info: element info, compounds, ions, etc.

I'll have to let you know about physiology since I haven't started it yet... I'm also a little scared of the online format... but I've taken online classes before and liked them so I'm hoping that it will be okay.

I hope I've helped some by showing you my struggles in my classes. Leave me a comment if you got specific questions or study methods that you LOVE!

Welcome!

Hey there!

Welcome to my first blog post! I just wanted to share a little bit about myself and where I'm at in my journey to earning my Bachelor's of Science in Nursing!

Who I am: An anonymous nursing student. I'll go by M. :)
Where I live: The midwest.
Background: I have a previous Bachelor's Degree in Women's Studies. I have always been interested in nursing but I thought that it wouldn't be possible for me to become a nurse because I wasn't great at math and science (kind of key subjects for nursing..).
After I finished my first Bachelor's Degree and discovered I couldn't get ANY jobs with it... I decided to return to school to take my pre-requisites for nursing school. (I say returned to school but I had decided in my last semester of BA to get my nursing degree so I had a grand total of 2 weeks after graduation before I started Human Growth and Development online!)

My goals: To graduate in December of 2013 with a BSN, to sit for the NCLEX and pass it! Then to find a job in a hospital. Right now my interests are Labor and Deliver or Emergency.. but that may change.

What I'll most likely blog about: My life as a nursing student, classes, clinicals, healthcare/medicine articles I find interesting, books and study methods I've used, and who knows what else?

Where I'm at right this very minute in the process of applying to nursing school: I have finished all my pre-reqs except physiology which I am signed up to take June through August online.
I have finished my application for nursing school and will be delivering this week to the office.
I will get an admission decision in mid July, I'll be admitted conditionally since I'll still be taking physio at that point... I'll sign up for classes and then start school in August!

Any questions? How did you find your way to my blog? Are you considering nursing school? Are you already in nursing school? Leave me a comment!