Saved by Critical Thinking

Oh, by the way, I think I forgot to mention the daily emotional roller coaster nursing school has been so far. I feel like I go between "ay caramba! I'm gonna die!" and "nailed it!" six times a day. This post reflects the latter. (I wonder if this is what pregnancy is like?!...or...gasp...Menopause!) Much to my relief, I think I'm stabilizing a bit now. And the whole, "read the boxes" concept for getting through all the 16 or so textbooks helps considerably. So, contrary to my last post, I'm now thinking: Hey, maybe I can do this! Supporting evidence below:

Exam 1 result: 92% sweet!!!

Hand hygiene, PPE (personal protective equipment), vitals, SPHM (safe pt handling & movement), ace wrap & TED hose application, O2 admin: CHECK! :)

BP checkout: killed it! (Clinical instructor comments: "good speed", meaning I released the pressure in the sphygmomanometer (BP cuff) correctly, and got the right reading.

IM admin: excellent across the board!

Blood Glucose check: nailed it!

Med. Admin.: fumble, fumble, fumble through.............pass. phew. That was a rough one. Try not to have brain farts when you're preparing meds. Aspirin is NOT acetaminophen, Einstein. That's an easy one! And furosemide does have a Brand name, and it's called Lasix®, Lanoxin® is digoxin, silly. (luckily my brain kicked in prior to actually giving it to the pt). In my defense, when you're being critiqued and your brain is on lunch break, anything could be acetaminophen! But honestly Caitlin, if you're going to give someone nitropaste, studies show it's most effective if you actually apply it to the patient, rather than just leaving it on the table. My goodness! But luckily was saved by good critical thinking skills and identified everything I did wrong and said how I would do it differently next time.

I found this rap to remind me about the 5 Rights of Medication:

Now I just have to knock the socks off Morning Care checkout & head-to-toe phys assessment.

Ooh, funny thing. This one girl's fingers were really cold and white, and she asked another girl what she would do to warm them up and improve circulation, and she answered very matter-of-factly: put them in the microwave and turn it on.

(...don't worry, she was joking).

Just for fun, I liked this video:

4th Week Masters?

Unfortunately, it's been a while since I've posted because I think the world has started spinning faster lately. Anyhow, we are now just completing week 4 of the quarter and preparing to start Clinicals. In Practicum, we've "mastered" (and by mastered, I mean bumbling through like.....):

*general assessment
*heart, lung, & bowel sounds
*vitals (BP, Pulse, Respirations, Temp)
*making an occupied/unoccupied bed:

*turning & transferring a patient from bed-chair, etc
*bed baths (clean to dirty, folks!)
*oral care, dressing a resident/client/pt, feeding a resident (it's actually harder than it looks b/c when you do it on classmates, you start laughing too much & spill the water! and trying to pull pants onto a partially paralyzed person who's sitting is super hard!)
*peri care (that means cleaning the nether regions--clean to dirty, front to back, inside to out)
*medication administration (don't forget the 6 Rights! That'd be right pt, time, drug, dose, route, documentation!)
*checking blood glucose...on a banana (b/c we're not allowed to poke our classmates, or ourselves). 1st reading looks goofy? (too low/high) recheck. 2nd reading the same? panic! no, just kidding...report to the doc, so she/he can panic...
*IM (intramuscular) injections on some sort of 'realistic' squishy pad (don't forget: IM-deltoid: 2-3 fingers widths below the acromial process, and throw it (the needle) like you're playing darts in a bar...well, not quite that hard and w/o the influence of alcohol.

And after all this learning, the confidence meter reads:
*going through all the steps in my head or on a classmate = probably 8-9
*on a resident who might be in pain, or heavy, or paralyzed, or not able to communicate well, or grumpy = 2.

Watch out folks...here we come! Well, in all honesty, we're actually doing really well. I think it will be much better when we get to our Clinical site & see what it's actually like. Then I'm sure my confidence will be at least, at least...2.5

We have head-to-toe physical assessments & Morning Care checkouts next week, so we better be 4th Week Masters by now...riiiight.

A Variation in Nursing Massage

Today in class we learned the importance of incorporating massage into patient care. Older adults (especially) in long-term care (LTC) facilities (e.g. nursing homes) don't often receive adequate physical contact, which is essentially vital to human life (not in the same way as water, but people are made to have physical contact with one another. So, a person deprived of physical touch will likely suffer some physical, mental, and emotional repercussions (maybe feelings of neglect, worthlessness, low-self esteem, loneliness, etc)

Anyhow, we're learning to give massage, and we watched this video which illustrated "proper" massage technique...

Next time you're a resident (i.e. you live there) in a Long-term Care facility...consider asking your nurse why he/she is not in a gorilla suit.

We Were Supposed to Read that too...?

So, I go to bed Sunday night feeling happier than I've been for a while b/c guess what?!? I finished all my reading and homework, and am prepared, this week, for doing a little extra studying, going for a run or two, catching up on this blog, watching Grey's, and going to bed early...

Just Kidding! Monday morning arrives and the prof says, "So, you've all read the (8 million) chapters assigned for today..." and the first thing I think is: "8 million?!?!?! I thought there were only 4 million this weekend?!?!" (looking at my syllabus) "we were supposed to read that too??? Fiddlesticks!"

So, basically, I'm coding (medical term essentially meaning you're going to die if someone doesn't hustle-up and save you). No longer on my "prepared for the week" high, I returned to dwelling in the land of "chronically behind with schoolwork"...Do they have a pill for that? hmmm...I think we start pharmacology next week, so maybe I'll ask/learn about that then. But for now, how about some ice cream...

PhD in Procrastination

Our first theory exam looms overhead (i.e. Monday), so miraculously, I've exercised, cooked, and cleaned more this weekend than I have in the past month. It all has to do with "The Art of Procrastination". I guess I don't really need to write an entry on this since anyone who's ever been a college student likely holds a PhD in Procrastination (I know I do) along with whatever degree they went to school for. However, since the saying goes "use it or lose it" (and I certainly wouldn't want to lose a PhD), I might as well delve into the world of "doing everything but...".

There are only a few simple steps to successful procrastination. Please see below:

1) Have a motto or mission statement: the motto I live by is: "you gotta do what you gotta do, to not do what you gotta do"...and the mission: "striving for procrastination excellence: putting others before oneself (demonstrating compassion and selflessness) by caring for the needs of others and ensuring the world in which we live is cleaner, tidier, and happier.

2) identify that which has to (not) be done (i.e. study for an exam, write a research paper, etc)

3) identify everything else in the world that could (and should) be done before item #2. Remember, in successful procrastination, everything is more important and more urgent than the said item #2. This includes: cleaning (can't study in filth!), exercise (in hopes of getting lood moving to the brain), napping (to ensure you're adequately rested before studying), providing "moral support" to friends in need of social interaction, organizing of any sort (your notes, dresser drawers, the kitchen cabinets...).

It appears that a few people feel the way I do, and have posted their thoughts on YouTube. Here's one:

Follow these simple steps, and subsequently begin adding the letters "PhD" after your name*

*NOTE: please do not actually write "PhD" after your name in any context where people might take this seriously, b/c I think this is actually illegal unless you have a degree from an accredited institution...now don't tell me I didn't warn you!

Homework Again!?! You Have GOT to be Kidding Me!

Week 1 of Nursing School now complete.  phew!  I'm counting this as a week of successes.  By Wednesday, I had pretty much recovered from the initial shock and stress of being told that between class and homework we would be spending almost 80 hours per week with school...and were subsequently told "remember to be good role models for your patients and eat right, sleep, exercise, and leave time to relax".  Excuse me?!?!  When are we supposed to do all that???  I know, maybe I can improve my multi-tasking: while taking a patient's vitals, I'll jog in place, while simultaneously eating a salad, and I'll invite some friends so I can relax at the same time...I'm sure my patient will understand...

Here's what I've learned so far: 

1. How'd YOU like to be called "Geriatric"?!?!  I didn't think so..."Older Adults" (O.A.'s) is the current PC term.  Somewhat contrarily (I think), the official terms for the various age groups of O.A.'s are - 65-74: young old (fair enough); 75-84: middle old (still not too bad); 85-94: old old (do we really need to say it twice?); and 95+: oldest old (a little excessive, don't you think?).  How are these supposed to make people feel better?  You might as well call them "spring chick of the old folks", "you've had better days", "really wouldn't wanna be stuck behind you in a grocery store aisle", and "haven't your organs shut down yet?"...I think I'd prefer Geriatric... And besides, it's called "Gerontology" anyway.  Not really fooling anyone the term "O.A.", or else they should call it "Olderadultentology".

2. Florence Nightingale had a hand in sabotaging the Nursing profession by allowing only women to enroll in her program.  As a result (and a lot of history and other factors later), many men are disinclined to become nurses, which is unfortunate because I'm sure all the men in Nursing are delighted by the question: "How long have you been a male nurse?" -- "Well, I've been a male since the X met the Y.  As for Nursing, I've been in the profession for ___ years."  (unless there's been a gender reassignment, in which case the format of this question may be perfectly appropriate).  The point being: no need to point out that he's a male...since anatomy is a prerequisite for Nursing, he likely already knows.

3. Using a Hydraulic Lift to move a patient from, say, a bed to a wheelchair, you don't even need to remove the lifting device for them to use the restroom because it doesn't contact the perineum!  Here's what the lift looks like.  Enjoy the music: YouTube - UNILIFT Ceiling Mounted Lift