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!
Wednesday, March 27, 2013
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.
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.)
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?
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?
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.
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.
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