Swinging Door

Its just a damn shame when folks get too busy doing their job to think about the patient. This is not the fry line at McDonald's.

This week my patient was readmitted to the hospital with c/o coffee ground emesis less than 24 hrs of being discharged for the same problem.

I started my shift with instructions from my nurse to d/c my pts NG tube. I completed this and assisted the pt in ordering the 1st real food in about a week.

As things go, dietary had not yet rec'd the chg from a clear liquid diet. 3 hours later as I am about to d/c the IV, the tray comes. I ask dietary to wait to bring in the tray so I can get the IV out.

No problem except that my instructor is nowhere to be found. Another 40 minutes and the IV is finally out.

My patient is eating (finally) and the nurse comes in to go over discharge instructions (because her students were "nowhere to be found"-did u try the pts room?)

Within 20 minutes my pt is showered and out the door.

Progress notes state that "pt tolerated diet chg well." Really? AEB what? I wouldn't be surprised if the pt left their meal on the dashbooard of the car on the way home.

This nurse discharged 2 patients in a span of 20 minutes. The other pt had to come back because a script was not in her paperwork.

I guess it seems to me that another person will be placed in the room as soon as it is emptied so what is the point of pushing the pt out the door before they are ready? It's not like u serve ur 5th pt so now u get to go home.

Am I just too new? When will we stop pushing pts out the door?

Attitudes

This week in clinical one of my fellow students had a newborn w/respiratory distress. The parents were 16 and 17 & the grandparents who were arguing over custody were also in & out.

My classmate walked around all day with a wrinkled nose, snide comments and so many deep sighs I thought they might hyperventilate at any second.

When they say in class to leave your attitude at the door, that's exactly what it sounds like it means. What they should say is leave it at home. It shows in the hallway, at the nurse's station and in the med room. It effects everyone around and is transferred from one shift to the next. Though I wasn't in the room, I can't believe it didn't show in the care provided.

Is it any wonder that people act the way everyone expects them to? Teenage parents are still teenagers. They still act like the world revolves around them though they look like adults. If I don't even know if that is my child then how am I supposed to know how to act?

Even worse I'm a teenage father (maybe) and there is something wrong with this little tiny thing that I am supposed to take care of. I may even be afraid to pick the baby up. Many grown men have that very same fear.

As my child's nurse shouldn't you be teaching me how to do these things (since you are doing my child's ADLs anyway)? Can't you involve me in giving the baby a bath? or Teach me how to hold my baby while giving a bottle?

I even found some patient ed materials to give the mom & dad. The student took the materials, wadded them up & put them in their pocket, and said that dad was too busy sleeping and mom was nowhere to be found. Uh - maybe baby is in the hospital and mom and dad are exhausted (Duh!)?

I really wanted to say something but wasn't sure what. Am I overreacting?

5th Quarter - Peds

Gotta admit I'm a little apprehensive about this quarter. Pediatrics is probably not going to be my specialty but I am trying to keep an open mind.

We toured the unit where I will be for the next 8 weeks and I am looking at vent and trach kids. Not a picker-upper for sure. I am definitely going to review my suctioning skills and see what I can find out about CF.

We'll see how it goes... 2 more quarters after this one (!?!)

Med Surg - Quarter 2 done!

Finished my second med surg quarter and I gotta say - it wasn't bad at all. As a matter of fact, I would say I was blessed to have had the instructor everyone dreaded. Really, if you were on top of your routine, she was very pleasant to work with. I'm glad I didn't let the rumor mill do any more than scare me (warn me)?

Don't get me wrong -all that paperwork took forever! But I think I will be able to function much faster than other students just because of all the preplanning she made us do. She also used the Socratic method where she quizzed you and put you on the spot right in front of the patient. (whew!) I don't know which was harder answering the question she asked or figuring out the answer she was looking for. The questions were so vague!

I am really glad I got to work with her.

Getting ready for Finals

I have to say: after last quarters constant barrage of paperwork, I feel really weird right now. There should be something due soon. Am I missing something? Usually when I get this feeling there is something looming ahead.

Right now I am studying for Pharm- cardiac meds, integumentary meds, etc. I have also been going over my acid-base balance stuff and some electrolyte stuff (Hyper-Hypo yadda-yadda) for theory. Everything feels like its bouncing around my head in a big buzz and I'm just waiting for something to happen to BOOM make it all settle down and fall into place. I can see the pieces of the puzzle but not the picture. Anyone have any suggestions?

Maybe the big thing looming on the horizon is the skills performance exam in 2 weeks. Pick a card - any card - and do the skills. I'm freakin' nervous about that. Good thing I'm going to the lab on Friday am to practice (probably along with everyone else).

I have clinicals today and I feel like a big "?" is floating over my head. I know some days you are "on" and some days you aren't but man! I hope I get it together before clinicals today.

Will I ever get it together? I'll keep trying - but somebody pray for me!

Med-Surg Nursing - Quarter 3

Well, I feel the shadow of the next quarter looming.

Last quarter was so stressful and busy with nursing care plans and papers and projects that by the end of the quarter, I felt like I went through a jump line for a gang tryout (you know where they line up on both sides and keep hitting you while you walk through a tunnel to the end). I nearly got my butt kicked! I honestly didn't want to hear another thing about babies, butts, boobs, perineums, lochia, late decels, or phases and stages of labor! Thank GOD thats over.

Clinicals start on Monday the 29th. I am looking forward to this quarter because it'll be something new and exciting. We are starting with perioperative nursing care and I have begun reading early because it looks like we'll be just as busy as last quarter.

The sections look interesting and I am very interested in perioperative nursing so hopefully I might even enjoy this section. I'm not ready for the death and dying section but will meet that challenge head on when the time comes. Any advice on this area would be appreciated.

For now, I will continue to work my butt off with my fellow students (those that are left) and keep pushing through.

Any advice for a full time working mom and nursing student is always appreciated.

My First C-Section from the Other Side of the Table

Yesterday I saw my first C-section as a nurse (student). There is only 1 student allowed in L&D at a time and this was my week. When I got to clinical and learned that there was a scheduled C-section planned that day for my rotation in labor and delivery I was both excited and nervous.

I was afraid I might be sick or worse, embarass myself by taking a dive. I've heard horror stories and didn't want to be "the one" this quarter. I wasn't. I watched the C-section and helped fetch suction containers and supplies. When the surgeon tied the patients tubes, he called me over so I could see a little closer.

I have to say it was the coolest thing I have seen yet.

That baby was 11lbs 4oz and was only in the 37th week as of yesterday. Talk about LGA!

I can't wait until next week, but since it was my only week in L&D, I doubt I get to see any more this quarter.