I thought a CABG was a vegetable!

Well, I have officially finished patho! Actually, I still have the final, but I have finished sitting in the patho classroom taking notes. It's pretty surreal. And a little scary. Scary? Yes, indeed. It means that all the checks are in the box. Nothing now stands in the way between myself and nursing school. There's no hiding now. Nursing school is looming large. I'm terrified and SO excited!

So, when you're a nurse, there are a million different abbreviations you have to know. Wait for it... Since we have to know them, we have to test over them, naturally. Not so bad, right? Well, it wouldn't be...if you didn't have to make an 80% on the test or FAIL the class. And if you saw the list of abbreviations, you would find your knees trembling. Here are a few examples: ESRF=End Stage Renal Failure. HS= hour of sleep= bedtime. NPO= Nothing Per Os= Nothing by mouth. LOC=Level of consciousness OR Laxative of Choice. (Not to be used interchangeably.) VDRL= Venereal Disease Research Lab. I can now write whole sentences without actually using any words. Four short semesters, and you could too! Anyways, we took the test, and I did fine. But it was hard work, and I know I'm going to have to keep studying because I do NOT need to brain dump these! Do you want your nurse coming into your room and telling you your chart says "muscular dystrophy" when in reality, it just says "medical doctor"? I think not. So, next time you visit your friendly neighborhood doctor, make sure you take the time to thank your nurse for learning those abbreviations. I mean, if I need a VDRL (and I DON'T!), I don't want her wondering what in the world that is!

So, now we head into finals week. My gameplan is to finish studying for P-cubed this week so that next week can be devoted to patho. I'll, um, let you know how that goes. After finals, there's a cruise to Alaska in my future!, painting of my family room (so long blue!), and then summer skills class! I hope you find your summer blessed, and I'll talk to you again in a few days.

The Gender-Ambiguous Plastic Dragon

Hey Everyone!

Okay, now about simulation. I wrote that last post just before simulation, and then I navigated away from the website err I could post it.(As an aside, I find it ironic that 'navigate' is the appropriate word in this instance since I did anything BUT navigate. Really, I more 'drifted without an oar' to the other webpage.) I, um, did not like that. So, it's taken me until now to work up the gumption to write it all out again, only to realize that the whole thing was saved as a draft. Anyways, um, enjoy.

This semester has been so different from my previous semesters. I remember sitting in class on the first day this year and thinking how very long it would be (and how many projects were due!) before we were out for the summer...and on to actual nursing school! However, yesterday was the last academic day before Dead Week. (Dead Week is HU's term for the week before exams.) I awoke this morning to the realization that in less than 2 weeks, this semester will be behind me. Whoa! And so much has happened!

A couple of weeks ago we finished up our clinical rotation. I learned so much about caring for patients during that time. However, we knew that once we finished clinical, SIMULATION was looming large. Gulp! What's simulation, you may ask? Well, I'll tell you. Simulation is this final 'test of skills' for gullible nursing students. (Said with love.) In my mind, I liken it to the medical equivalent of a knight's dragon-slaying festival. Except in the end instead of getting to kiss a, um, er, prince, we get to SURVIVE. To the next phase of nursing school. So anyways, we had simulation. Basically, this is a five-station test of abilities. When I arrived, I was sent to a table with all these cards lying face-down. Cue cold sweat. I drew one with trembling hand, and it said "Sterile Gloves, sterile field." Sweet! As you may have deduced, at this station, we each had to draw a card and then perform whatever skill it said on the back. I was THRILLED to get the one I did. A girl next to me pulled Soap Suds Enema. You do the math. So, I set up my sterile field (an activity which I rather enjoy anyway), and all was well. Got a 100% on that part. Yipee! First dragon down, four to go.

Next, I went to do my 'bedside assessment.' Okay, you have to understand that this assessment is on a plastic, gender-neutral manaquin who, if 'he' were to be a real person, would be dead from all the things wrong with 'him'. This guy has a section of abdomen that pulls right out of his stomach. He has 'interchangeable' genitalia...you never know what you're going to get. One eye is permanantely rolled off to the side...a sign of SEVERE brain damage. His arm sometimes gets stuck in the "up" position. No bueno. So, here I am doing this bedside assessment on a dude(?) who has no heartbeat, lung sounds, or bowel sounds. I fought the urge to giggle as I declared him positive for PERRLA (a check of the eyes/neuro), since, well, his pupils had zero function. At any rate, he survived my thorough bedside check. Agent Bedpan was the 'checker' on that one. She is so funny, yet scary at the same time. When I finished (and we only had 10 minutes), she said, "Are you SURE there's not something else you want to check?" Fortunately for me, some of the older students had tipped me off that she would do this and that it didn't mean anything. I told her "yes" with a smile. Two dragons down, 3 to go.

After the bedside assessment, I went over to this little curtained cubicle where there was a 'plastic patient' surrounded by tons of nursing errors. We had ten minutes to write down ten errors, along with rationale for why these errors were aggregious. I started by looking at his chart, which was a good thing because the bulk of the errors were in nurses'not following the doctor's orders. (I don't know what people did who didn't check the chart until the end. Gulp!) For instance, he was allergic to dairy, but on his table was cereal covered in milk. He couldn't have penicillin, but someone had left a vial of penicillin by his bed. Double whammy!! He was on a lo cal diet, but his breakfast consisted of eggs, bacon, cereal, banana, apple, toast, coffee, and...pound cake. Umkay. Anyways, I found 10 things. No problemo. Three dragons down, two to go.

Now, came the dosage calculation test. I was, I admit, a little nervous about this one. We had done a dosage test earlier in the semester that you had to get a 90% on, and I rocked it. (Lot's of good that's going to do me now, right?) I hadn't spent much time on dosage before simulation, so in the back of my mind I was worried that this was not going to go well. However, I found that my mind worked fine. No absent seizures. Nothing like that. I did well, and felt good. Four dragons down, only one to go!

So far, everything's been great! I'm starting to think I might actually make a skilled nurse someday. Then, I went to the fifth and final station. The Scare Plan. I, uh, mean Care Plan. I was prepared to diagnose 'acute pain' or 'risk for immobility.' Good to go. Yet, when I flipped my little 'case scenario' card over, I had pulled a middle age man who was obviously clinically depressed. His wife had died and he wanted to die too. Simple, right? Uh, no. I could not remember if nurses could diagnose depression. (We have this list called the NANDA which tells us all the possible nursing diagnoses. Nurses can't diagnose, say, renal failure. We diagnose things that renal failure might do, such as skin integrity breakdowns or immobilaztion.) So, I sat there racking my brain trying to figure out if depression is on the NANDA or not. At some point, I managed to remember that Loneliness is on the NANDA, so I went with it. Ick. It went fine, but I was frustrated because I felt that my care plan didn't accurately reflect my abilities. Sheesh. I'll say four and a half dragons down, one-half left on the court. Oh well. Can't change it now.

The next day in class, we got our results back. I did great overall, but I did lament the lost care plan points. Now, the hardest stuff for the semester is behind us. I took that make-up patho test yesterday, so it's off to finals here in a week. Yay!

I hadn't planned on going to school this summer, but now Junior Skills is being offered over the summer, and I need to do that. It will make my fall semester a billion times better. So, stay tuned. Things should get interesting.

Craziness!

Things have been really good lately. Last week, I finished up the P-cubed clinical. It turned out to be a very positive experience. What I learned: I really don't mind giving bed baths and changing bed pans. However, I do long for the day when the ratio of a.m. care to non-a.m. care is tipped in the favor of the "non". I want to be a nurse who is willing to get her hands dirty...but I really enjoy the 'thinking' part of nursing more. When we gave meds, for instance, I loved the process of all the checks we have to do. There's this thing called the Six Rights: Drug, patient, dose, route, time, and circumstance. For every medication you give, you MUST ensure that all Six Rights are met. Or it's a no-go. That was fun for me, as was checking all my dosages. Even more than that, I love looking at lab values and trying to figure out why the numbers are off. Or, if one number is off, what other numbers are likely to be off with it. It's like figuring out a puzzle. Sweet! In other news, Nurse Rockstar has left us. She's NOT dead...just post-op. Ergo, we now have another teacher, whom I really love. Nurse Rockstar's shoes would be difficult (and intimidating) for anyone to fill, but our new teacher fills them well. I'm very happy about this. Very. We have our last non-final-exam patho test tomorrow, but I have a fever, so I think I'll probably ending up taking the make-up exam next Friday. Thursday, we have the biggest day of the semester. Drum roll please...SIMULATION. And I will tell you about it in the next post. I know you'll be on the edge of your seat. Try to stay calm. That rapid heart rate isn't good for your vascular system.