New blog

Whew.... long time no post!! I completely forgot I had this blog until I was trying to answer a question about my NCLEX study habits... And then I had to jailbreak myself back into this blog. Anyway... 

I am blogging over on Tumblr now about nursing and have been since I graduated almost four years ago!! Come join me there! There's lots to read and you can ask me questions! 

Come find me at Adventures in Traumaland! 

Fall semester - SENIORITIS

This fall I took:

- Critical Care Nursing and clinicals
- Community Nursing and clinicals
- Informatics
- Leadership/Management and clinicals
- Ethics

Critical Care nursing was a beast of a class with a TON of information covered and much more in depth than previous classes. I had to go back to a bunch of my old pathophysiology stuff to understand some of critical care. Our clinicals were on a medicine floor, which could be considered slightly more acute than the other floors, more like a step down or progressive care unit which this hospital didn't have.

The best part of these clinicals were that we got to go on 4 observation days to the ICU, CCU, ER and Trauma/Neuro ICU. I didn't get to go to CCU, and instead went to the ICU twice. But that was fine with me because I am really not a cardiac nurse!

I was shocked to discover that I REALLY LIKED critical care!! I loved ICU as the first place I went and I love Truama/Neuro ICU even better. I already knew I liked the ER and I liked it again, but critical care nursing in an ICU is so much different from other nursing. I could definitely see myself doing trauma or neuro ICU in the future. It definitely is hard and you truly have to think on your feet and be a great nurse, but there are great rewards.

Skills performed:
- Med administration including oral, IV and IM
- Head to toe assessments
- Charting
- 4 catheters and 2 IV starts in the ER
- Bed baths

Community Nursing was not my favorite class. This class required us to drive to sites all over the city to take parts in different types of community nursing. I went to or followed around: a home health care nurse, a free clinic, a soup kitchen, diabetes educators, in hospital navigators, cancer center nurses, an acupuncture provider, a school nurse and a couple of other ones. My favorite was definitely the free clinic where I had actually volunteered before. They provided a much needed service to their community and it was super interesting to help out there for a day. Could I ever do community nursing? Maybe eventually. When I'm tired of working in a hospital.

Informatics was only a didactic class. It was boring, boring, boring. I understand why technology and computers are important to nurses but this class was a yawn.

Ethics was actually a sort of interesting class. Sadly I didn't have much time to devote to it with community and crit care. But it was at least applicable to being a nurse. I enjoyed some of the writing we got to do on topics of our choice and I researched and wrote about the ethics of fertility treatments.

My leadership/management clinicals were in the Trauma/Neuro ICU and I really enjoyed them, even though I was on nights which was pretty hard to do when I had other stuff to do during the day the rest of the week. I got to see some great things, interesting cases and I came to understand what managers and charge nurses truly do. Which is put out fires, help out the nurses and work to satisfy a variety of employees from housekeepers to doctors.

I really like the trauma and neuro side of ICU. I find the brain fascinating and its interesting to see what happens when there is trauma, strokes, brain tumors, etc. The trauma was just pretty horrible, but interesting all the same. Car, moped and bike accidents, falls from heights, tractor accidents, etc.

All in all it was a tough semester but I think it was worth it. It was pretty awesome to finally see and find some nursing that I really liked and could want to do for a while. In the end I still feel somewhat unprepared to be a nurse, but I know that you come out nursing school with just the basic skills to be a nurse. The rest you learn on orientation and by doing your job hands on.

Now that I'm done I've started the never-ending loop of looking for and applying for jobs, polishing my resume and writing cover letters. Hopefully there are jobs out there and hopefully I get offered one I like.

Now to study for the NCLEX and pass that sucker.

GRADUATION!!

I'M DONE! I'M DONE I'M DONE I'M DONE!!!!

I finished my last final this morning at 8 am!! Then I went out to breakfast with some friends from school.

I took my critical care final last friday and got a B. Critical Care was the one I was stressing about the most because it was a cumulative final and there was soooo much information on it! But I made a 56 page study guide and studied my butt off!

Then Ethics was monday, but that was easy-peasy.

I had my last leadership clinical last week and left at midnight from there. I didn't really even think about the fact that it would be the last time I was leaving the hospital from a clinical. But it is bittersweet. It will be weird not heading to the hospital every week for clinical.

I still don't think it's set in. That I'm actually done.

Pinning is tonight. WOOHOO!

I'll officially have my BSN!

A more updated post is coming on how my last semester went and what's going on now. As well as my NCLEX study plan.

What jobs am I going to apply for??

Here with less than a month left of nursing school and I'm still not decided on where I want to work. People keep asking... and I still have NO IDEA.

This is not great..

Places I know I do not want to work:
- Geriatrics, nursing homes, rehab hospitals
- Ortho
- NICU
- Anything cardiac
- Really any floor nursing

Places I might like to work:
- Trauma/Neuro ICU
- ER/ED
- Labor and Delivery (in the right hospital)
- PICU (Mybe?? I never got to observe here and now I'm wishing I had)
- High risk OB
- Medical ICU (or other. NOT Cardiac)
- Progressive care unit
- PACU (not likely to happen due to no ICU experience)
- Peds?? (I thought I was over peds.. but then I was thinking about infant/toddler the other day...)

So what jobs am I going to apply for? People keep telling me, apply for everything. Get your experience and then go wherever you want. The problem is I don't know if I can stick it out for 1-2 years in a job I hate! So... I don't know. Maybe we'll see how desperate I get.

I'm actually still really leaning towards ER. I'll get lots of skills practice. Lots of assessment. See lots of different stuff. Less wiping butts/bed baths. People are only there for a couple of hours. It's fast paced, etc. I would love to do ICU but I'm still super scared of how much I have to learn to do it. Plus it may be super hard to find a new grad ICU job.

What jobs did you apply for straight out of nursing school? Where did you end up?

Where have all the nursing jobs gone??

Where have all the nursing jobs gone?!?

I don't know if it's some horrible combination of the economy, the affordable care act, general panic or what... but the hospitals around here are just plain not hiring. Or at the very least not hiring new grads.

I don't know if this is widespread but in my, large midwestern, city there are few RN jobs to be had for new grads. The hospitals have been laying off nurses for months now. They're rarely posting new jobs and the ones they do post are not for new grads.

When I got into nursing school everyone assured me there would always be jobs! "Oh you're going into a career where you'll always have a job!" "Oh there's always a shortage of nurses!" HAH. Yeah, sure.

Until now apparently.

Veteran nurses, my instructors, and pretty much everyone keeps saying, "Don't worry. It'll turn back around. Nursing does this all the time. They try something new. It doesn't work. They'll hire more nurses again. It'll only take 12-18 months."

12-18 MONTHS! Because I just have that kind of time to sit around unemployed.

Needless to say I'm quite perturbed. I got into nursing, yes because I actually like it, but also because... they always need nurses! Always! You can't get rid of us. And yet...

I'm hoping that the situation is not as dismal as it looks. I'm hoping that things will turn around by the time I take the NCLEX and start looking for jobs.

In the meantime I'm considering moving to other states, doing some certifications to make myself look more appealing... and well.. praying.

How long did it take you to get a nursing job after you graduated? Does the nursing job market suck everywhere??

Critical Care?!

I never expected to like critical care... I came into this program assuming that I would graduate and get a job in Labor and Delivery. Interesting thing is, turns out I didn't much like L&D in the hospital.
And then along came my final semester of nursing school with critical care nursing. Our clinicals are on a basic medical floor, but with slightly sicker patients than med surg. More like a progressive care unit.. kind of.

But this clinical involves observations in the ICU, Trauma/Neuro ICU, Cardiovascular ICU and ER. ICU was my first observation of the semester. I really liked it.

I like that you have to think on your feet. That you have to be clued in to your patients and watching for small changes in their conditions that may mean big problems. I like that you have use your brain. This is also what scares me about ICU. You are the one that is responsible for this perhaps VERY SICK patient. So you have to HAVE A BRAIN.

Lately I'm struggling with feeling like I can't do this job. I'm in my last semester, you'd think that I would have most of this figured out. You'd think that I'd feel more secure in my choice and in my role as a nurse. NOPE. In some ways.. maybe. Some things aren't as hard as they used to be. Things like bed baths (although I'm still not great at them..), vitals, head to toe assessments.

But I've only gotten one blood draw and I've attempted four now. I've started one IV out of two. Not horrible odds... BUT ONE IV START?? Really? I've done one in and out cath on a woman after childbirth. One patient with an ostomy. I've done IV push meds and given oral meds, crushed up meds, etc. No NG tubes, no drains (although I've seen some). No big clinical procedures!

But the vast amount of SHIT I DON'T KNOW scares me. My first day on the unit for this semester I royally screwed up a lot of the charting I did. On ONE patient. What about when I have 2-6??
What about when I graduate in.. oh, LESS THAN TWO MONTHS and try to go find a job somewhere.

How can I convince someone that I am worth hiring when I'm feeling hopelessly stupid?

This is not even to consider the beast that is the NCLEX and how I don't feel ready for that. That at least I have time to study for after I graduate. Once I get out of school, I feel like I'm supposed to actually know some shit. And lately I just don't feel like I do.

Is this normal? This impostor syndrome when you get close to the end of school? Will it get better?

This was supposed to be a post about how I learned I love critical care... and yet somehow it morphed into a word vomit of feelings on nursing school in general.

Regardless, I do love critical care now. I spent a day on the Trauma/Neuro ICU and LOVED IT. I could see myself working there. If only I could get over this feeling that I can't do any type of nursing.

But alas, jobs are hard to come by in this area so I may be taking any nursing job I can get for now.

Did you feel like this at the end of nursing school?? Did you feel better when you actually got a job and started settling in?

Summer Part 2: Pediatrics!

Pediatrics was my only clinical of the last 7 weeks of summer!

Well Peds has been over for a couple of weeks but I only had 4 days off in between my summer and fall semesters so I feel like I'm still playing catch up.

We did our clinicals on a general pediatric floor with kids of all ages and diagnoses. I worked with a 2 week old, 1 year old, 10 year old and 11 month old on my weeks there. They were all in for various diagnoses like fever, seizures, short gut, etc.

Procedures accomplished:
- Vitals
- Med administration
- Swab/culture on newborn

Care plans:
Still required. These ones were better than others. They required less info overall, although more about cognitive and developmental stages obviously. I did my three early on so I was done with them.

Observations:
Pediatric Clinic
I observed in the peds clinic run by the hospital where they see all the kids that don't have insurance or are on the state insurance. It was a pretty routine doctor's office routine. Bring kids back, get vitals, height, weight and then get them in a room. I did watch them do a couple lead tests, other blood tests and vaccinations. Super cute kids, but I think I would be bored working there.

Pediatric ER
I really enjoyed my pediatric ER observation. They weren't super busy while I was there but I got to observe them triage, assess, treat, etc. They attempted to put an IV in a 6 month old who was actually diagnoses with an intussusception (which I had just learned about so that was cool). It was interesting to see how the child life specialist helps the nurses by trying to distract/entertain the child.

Overall Peds was fine... although nothing spectacular. When I was younger I always though I wanted to be a pediatric nurse but I don't really think I do. I could possibly do Peds ER, but not floor work probably. It's just like doing procedures on adults, but they're smaller and they scream more. Also most children come with parents.

Where do you wanna work?

RN on the neuro unit towards the end of our clincials: So, do you know where you wanna work?
Me (in my head): NOT HERE!
Me (out loud): Well I know where I don't want to work. Ortho was definitely not my favorite. I'm not really sure.

I could see how med surg would give you tons of clinical and time management skills. There's also a huge variety so you probably wouldn't get bored. Of course that also means you have know a lot about a bunch of different disease processes.

Ortho was just incredibly boring for me and I am definitely not an ortho nurse!

Neuro was actually more interesting as I look back. I enjoy the knowledge behind neuro and brain/cognitive stuff is more interesting to me than a lot of other things. Neuro exams are kind of interesting, but I'm not sure I would do neuro long term because sometimes the patient's are just screwing with you... and that's annoying.

Labor and delivery was obviously my true love, which I hoped it would be. It has just enough excitement and down time (usually) that I don't think I would be bored or exhausted constantly. There's all sorts of new skills to learn with reading fetal monitoring strips and participating in c-sections all that jazz.

Mental health is hard for me. I really liked some of it and I reaaallly didn't like other parts. I liked being on the youth unit and sitting in on outpatient adolescent groups, so I could see myself working with adolescents, especially teen girls. But I think that if I were going to do mental health I'd really rather be a NP that does counseling or therapy. But I'm not going to go to school for that... so that's kind of a moot point. Regardless, there are people with mental illness everywhere so mental health will be useful in any nursing.

I'm excited to do an ER observation this fall because I'm also super interested in working in the ER.

Peds is pretty interesting and I think it would be good from the aspect that I like kids, but unfortunately kids come with their own parents and sometimes they're hard to deal with. Also, IV starts on kids freak me out.

So the current answer... I STILL HAVE NO FREAKING CLUE.
I'll let you know.

Still fairly organized!

I just wanted to write and check in on my organization strategies! Midway through the third semester and they're still working pretty darn well!

I'm still using my ical for the majority of my due dates/etc. Then I plug them into my paper planner.

Monthly view

Weekly view

I'm also still using checklists for what's due each week (with due dates)

I'm still doing pretty good with submitting things on time! Only missed a few and that's mostly because I think my brain is just completely fried!!

What organization strategies do you use??

Summer Semester Part 1 Labor and Delivery and Mental Health!

Whew! Summer's on its way to being over and I never wrote about the first half of my summer semester!! (Or the end of spring for that matter).

From the middle of May to the end of June I was in my Maternity and Mental Health clinicals!

I only had about 5 weeks of each sadly (well sad about L&D being short, not so much about mental health).

Labor and Delivery:

I sadly only got to spend about 2 full days in L&D which sucked because I LOVED it, like I was pretty sure I would. The hospital we had clinicals at is considered a large trauma center so there is a high risk OB unit and therefore much more high risk L&D than other smaller hospitals. There are about 15 L&D rooms and 2 ORs.

I saw two inductions, both with epidurals. I didn't get to see the delivery on my first mom. The second mom I got to witness her vaginal delivery (in four pushes none the less!).

I saw two c-sections when I was doing my NICU observation and pretty much all I can say about c-sections is... UGH violent. They just seem so, brutal the way they rip the mom's apart, cut them, everything.

Procedures accomplished:
- Immediate assessment on baby
- Baby bath
- New baby shots
- Antibiotic ointment in baby's eyes
- In and out catheter on mom
- PP assessment on mom
- Fetal monitor interpretation
- Vitals on baby
- Footprinting baby

Postpartum:
We spent 3 days on the postpartum unit which is definitely a much different pace. Much slower, and more boring in my opinion. Tons of time to work on breastfeeding with moms though, which I did enjoy. You do get a chance to do lots of assessments on babies, though which I didn't have any experience with before. It broke my heart to see the babies being sent to the nursery though. I'd say that it was split about 50/50 on mom's rooming in vs sending their kids to the nursery. The ones that basically lived in the nursery because mom was "tired" pulled at my heart strings. I'm like.. but its this brand new, squishy baby! So that was hard as well.

Procedures accomplished:
- Breastfeeding assistance
- Multiple assessments on newborns
- Change diapers
- Post circumcision care

Observation in the NICU and ultrasounds:
- I got to follow around two different nurses who were called to c-sections where they perceived that baby may have some difficulty. I loved this part of the NICU nurses job, and I think it'd be awesome. But then we took one baby up and the nurse basically became the baby's nurse and she was attempting to start an IV on the baby and that part of a NICU nurse's job is NOT FOR ME. They are so tiny.. and I don't know. Just not my thing. I also watched a PICC line inserted into a baby which was kind weird.

My other observation was with the ultrasound techs in the clinic. So I basically just watched them perform ultrasounds all morning. It was sort of interesting, but also kind of boring to me. Interesting to find out that their job is HARD though, they are the ones who may find out if there has been a fetal demise, if there are anomalies, etc, etc. So it is not all happiness and rainbows.

Mental Health:
Mental health, mental health. I'm still not sure how I feel about this clinical. At times I really liked it and found it very interesting and at other times it was SO BORING and I felt like it was pointless. We did see some interesting cases like mania, schizophrenia, psychosis, etc. So I did enjoy that, because the human brain and mental illness fascinates me.

Our clinicals basically consisted of being assigned a patient, reading their usually 2-3 inch thick hard chart to get information for our care plans and then sitting down to talk with the patients. We were practicing our therapeutic communication (which I found SUPER HARD in the beginning, but it does get easier), and allow the patient to tell their story to someone. I think a lot of students didn't like it because they felt that we weren't "helping them", but I don't know, I hope maybe we helped a little. Or at least we broke up the monotony.

After we accomplished that some of the students would sit around with the patients. One day we colored with a woman who was actively having auditory and visual hallucinations, so that was interesting to see. And another day we did a puzzle with a woman.

I also got to spend one day on the youth unit with two teenage girls which I found quite interesting and another day observing outpatient groups of teens. I definitely feel that if I were going to be a psych nurse I would want it to be with adolescents, because I enjoyed that much more than adults.

Procedures accomplished:
- Vitals
- Mental status exams
(Yeah, that's it)

Care plans:
OH DEAR GOODNESS they were so long for this class. Like 14-20 pages. We were required to do a care plan, mental status exam and a couple of process recordings. The process recordings I felt were incredibly hard because in them you basically write down, verbatim what you said, what they said and what therapeutic techniques you were using (or not using). Sooooo much writing and paperwork.


Overall, I loooooved going to the hospital for L&D each morning, and pretty much dreaded mental health, although I usually ended up enjoying it at least a little bit.

I loved finally being in the setting I could see myself working in (L&D) but was sad that I had such little time to spend and that we couldn't do more.

I do think that the therapeutic communication techniques we learned in mental health will be invaluable in any sort of nursing because communicating with patient is a huge part of a nurse's job. Not to mention that people with mental illnesses are everywhere, in every type of nursing, so it's good to have exposure to that.

Have you already done mental health or L&D? What did you think??

Take a peek inside my clinicals bag!

Take a look inside my clinicals bag!  (so that i can procrastinate on studying)

left to right

- purple clipboard that I can store stuff in (care plans, paperwork, etc)

- notebook

- striped pencil case

- stethoscope

- bag of random lab goodies (tourniquets and other stuff that i don’t use)

- drug reference book!

- my pocket notebook to write down important info

-  my gloves that i accidentally left in there yesterday

- kleenex, pretezels

- nu skin (awesome liquid bandaid)

- extra batteries for my pen light 

- pen light (crappy white one and expensive but actually usable black one)

- pen

- chapstick, watch, gum

- bandage scissors

What do you keep in your bag? What should I add to mine?

Med surg 1 - Ortho

Well my clincials for Med surg 1 are over! We were on the ortho unit at the hospital for four weeks and my general feeling about ortho is that it's not for me.

I guess if you really like learning about ortho procedures and assisting patients with PT it might be fun. Just not my favorite. Most of the patients are simply post-op and therefore not especially "sick", so there's not a whole lot of things to do.

Procedures accomplished:

- Med adminstration
- Charting
- Head to Toe assessments
- Pain assessments
- Safety checks
- Bed baths
- Linen changes
- Physical therapy assistance

Procedures witnessed:
- Fellow student put in a foley catheter
- Assessment on a patient that appeared to have possibly had a stroke.

Care Plans:

They're still annoying but they seemed easier this time. I knew what was expected of me and it seemed easier to express my thoughts. It also helped that my instructor didn't want pages and pages of care plans. Short and sweet is much easier.

OR observation:

I got to do a day of OR observation this 8 weeks which was fun. I've observed in an OR before but I got to see a craniotomy this time which was really neat. I like being in the OR but I don't think that I'd want to be a nurse in the OR, honestly they don't get to do very much. Being a scrub nurse might be fun, but both times I've observed in the OR there have been surgical techs instead of scrub nurses. Being a circulating nurse is just kinda boring to me. I was amazed at how fast the nurse put the patient's foley in. It was amazing!

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.

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?

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?

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

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. 

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!

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!