Gotta Get Through This...

clinical today left me flustered.

My last two patients haven't had many issues (ok-one had issues). What I really mean is that my last two patients weren't heavy with tubes or meds.

this poor person had 3 or 4 meds this morning. Which I know is not a lot. but for me, I struggled. I couldn't answer questions today (a DO was asking me, why are we giving NaCL bolus? what does the stomach produce?....swear to you, I couldn't say what the stomach produced. I kept thinking, "cholr...cholr...cholrid....?? damn HCl Acid). The entire day I was 'off.'

It started with blowing a vial of nexium...honestly. the needle popped off the syrine and the vial poured out onto the counter.

Even my instructor said to me, "Relax. take a deep breath. I'm not mad. Do I look mad? I'm not mad. Now, tomorrow if you don't know this, then I'll be mad."

Great.

Here's a list of things I learned today in clinical (out of order):

1. how to send orders to the pharmacy for missing doses. Or for wasting a vial of nexium.
2. dilaudid. inject over 2mg over 2-3 minutes. so if patient gets 1 mg, push over one minute.
3. how to give lovenox.
4. how to give meds IV push (although still not 100% on this, even though I know it's ridiculously easy)
5. those needless syringe systems? there is an extra cap on there that I didn't know about and I spent quite a few minutes trying to screw the syringe into the IV port before instructor told me that the cap was still on.
6. draining and measuring NG tube suction stuff. not sure what exactly that is called (output), but it reeked. oh my goodness did it reek.
7. the nurse actually flushed the NG tube for me. Hopefully I will do it tomorrow.
8. fetanyl patches
9. that I'm not sure what I'm doing there.
10. and I learned that I'm 1/2 way done with this semester's clinical. 5 more days!

Steady...Steady....

clinical patient tomorrow has nasogastric tube.

Not sure if I should be giddy with excitement or dreading the day...

stories to come :)

4 Down, 6 to Go..

but not that I'm really counting how many more days are left in clinical. :)

I've survived the first two weeks, but I know it will get worse.

why? Because my first two patients were tube free. no chest tubes, no nasogastric tubes, etc. (all of my classmates in my clinical group have had tubes...somehow I've had none of it).

First day of clinical included orientation and I came home and wept. The teacher, who I've dealt with before, completely stressed me out. She's quick and pretty tough, but not all that organized, which naturally made me nervous. there was so much that i didn't know, and up to a point, I was so confused and stressed that I knew I had questions, but I didn't know what to ask.

At the end of the our orientation at the hospital, we received our assignments and I copied down everything I could. That night I reviewed dressing changes, meds, vitals, assessments, etc.

I didn't sleep well that night.

and on Tuesday, I found my patient (pt) had been moved to a new room due to an infection. Lovely.

I wish I could tell you what the pt's deal was, but I also don't want to post information that shouldn't be posted. Let's just say that my instructor wouldn't allow me to change my pt's wound dressings because of the pt's general behavior. and my instructor replaced that pt with another for the clinical group that meets later in the week. I did get to inject insulin though-twice!

This week was interesting: when I went to pick up my pt info on monday afternoon, I found out that the pt went to surgery and "may or may not return to the floor" and that I wouldn't know until 6:00ish that night. That doesn't leave a lot of time to prepare for the next morning (we begin at 6:30am). Long story, but I was reassigned to a pt who didn't have any tubes or dressing or anything! But there were IVs, and the pt was incredibly patient and kind. The past two days were somewhat uneventful due to the fact that it was all IVs and not much else. The night nurse even changed the sheets while he showered that morning, just before I came on shift!

I have made some silly mistakes though: I would forget to do parts of an assessment...or leave the the roller clamp of the IV down (which meant the IV wasn't running, even if the pump/computer said it was)...I can go on and on...

But I can guarantee that next week will be a killer for me. My teacher is either going to give me two patients and/or give me one (or 2) 'heavy' patients, meaning lots of tubes, dressing changes, etc.

Keep your fingers crossed....hopefully it goes well!

butterflies

I start clinical tomorrow.

Nervous doesn't even begin to explain how I feel right now.

send some good vibes my way please...

Survived...

the wicked spring semester of nursing school! Final breakdown:

Pharm: A
Med Surg 1: A-
Med Surg 2: B+
Psych: A-
Maternity: A-
Communities: A-

When looking at those grades in black and white, I think, "wow. how did that happen?" That NEVER happened with my first degree. How much of it actually stuck?

Taking some of those finals made me realize I still have a lot more to learn. Midway through the final for Med Surg 2, I thought, "what am I doing here?" Each test question had answer choices of:
a) Inadequate
b) You are inadequate
c) Still inadequate...
d) Can you not take the hint? You're all inadequate!

And yet, despit the horrible experience, I ended up with a half way decent grade on the final. Just don't ask me to set up chest tubes or administer meds to a person in v fib without a 10 minute refresher.

Monday I start my summer classes and....CLINICAL.

Clinical scare me. There will be no plastic patients or robots/simulators. These people will be breathing. I will have to touch and help care for real people.

Our clinical instructor has helped us out a bit and provided a heads up list of things we need to be prepared to do for the next five weeks....and I hate to say this, but I think I'll be working with poop for the next 5 weeks.

ick.

It's all motivation for me to keep running, biking, walking, and increasing my fiber intake. Wish me luck!

Aye, Que Rico!

Thanks to gorgeous gal pal Traci & my brother for making this past weekend so enjoyable! After a rough week of finals, I flew home to south Florida.

My brother & his girlfriend picked me up in Ft. Lauderdale and he didn't flinch once when I asked him to drive along Ft. Lauderdale Beach.

So he flinched a little bit. Camera shy maybe?

We didn't get out to go anywhere in Ft. Lauderdale. something to do with my brother's wardrobe. Don't ask. Just be warned...if you're picking me up at the airport, be dressed to GO OUT!

17th St Causeway & A1A. I miss palm trees. and neon.

After the mini-road trip that night was a stop at Pollo Tropical for a Tropi Chop (or chop chop). Essentially black beans and rice (white) with chopped grilled chicken. You're supposed to eat them with plantains, which you order on the side, but mix with the rice, beans, and chicken. Except Pollo was out of plantains....which is like McDonald's being out of fries. Very disappointing, but the rice, beans and chicken were delicious.

Saturday morning I got my brother out of his place by 8:45am...unheard of for him. First stop? A nearby cuban restaurant for a cortadito...1/2 cuban coffee, 1/2 steamed milk. then a bagel (hehe, I hit both of my cultures). Then a trip to my old house and neighborhood plus a visit with my childhood friend Liz and her beautiful daughter Ella.

Afterwards my brother and I shopped for his place...then I met up with Traci!

That night was filled with good food, shopping, and Sex & the City. We started off at a favorite restaurant, where I had bistec empanizado (breaded steak) with moro (black beans and rice that are mixed in while cooking). Followed by dessert.

The best flan ever. I will have to try making this again...without spilling it on the floor...

Then it was off to Lincoln Rd on Miami Beach to see Sex & the City. Snapshots of the city...notice the pink sidewalks of Miami Beach. I was thinking of these pink sidewalks during my final exam on Friday afternoon....

The movie was hilarious. We laughed so much in those 2 1/2 hours! After the movie we walked Lincoln Rd which was just as I remembered it: young, old, gay, straight, English, Spanish, South American, all with their dogs.

Sunday we had breakfast at the News Cafe & walked along either Washington of Collins Ave...I forget which one. Then a trip to Merrick Park where we gawked at the art inside Neiman Marcus. I found a couple of Dolce & Gabbana dresses that I had to have. Then Dadeland...where I am still mad at myself for not getting the shoes I saw marked down to 80something.

More Miami Beach....I spy tourists, even if I played (and dressed) like one...

Finally, we met my brother & his girlfriend for dinner at a Miami staple. Versailles. No, not french food, but more cuban food. You've all seen this place on the news...the minute something happens in Cuba, the newscasters head to Versailles to interview the cubans who are sipping their coffee. This is a restaurant where you will see people dining in baseball caps and tee shirts next to people in tuxs & gowns, dressed to the nines.

I had arroz con pollo (chicken and rice...even though I make that a lot). and for dessert, Tres Leches. !que rico! then it was time for the cafecito at the window.

Un cafecito & dos cortaditos, por favor...

Then it was time for a photo shoot!