First Women’s Health test on Wednesday = lots of coffee and way too many peanut butter cups today and tomorrow.
Nursing school: where I learn how to take care of other people yet can’t take care of myself. 😉
So last Tuesday I had my first OB clinical and fortunately my clinical group got to rotate through L&D first (we take turns in L&D, antepartum, postpartum, and high-risk triage/NICU/child-life services, and newborn nursery).
It was beyond amazing. I know I will probably not ever be interested in being a mother-baby nurse in any form, but I am SO incredibly grateful I got the experience that I had on Tuesday and I’m looking forward to what the next 5 clinicals hold!
So we arrived at Parkland at 0545, changed into Parkland scrubs on the L&D floor, and were ready to go by 0630. My clinical instructor asked us who REALLY wanted to see a delivery that morning and myself and 2 other gals raised our hands quickly. Of course I wanted to see a delivery!
My clinical instructor then took me into the patient’s room. I introduced myself, and since the patient was currently resting I logged into the computer and started filling in some of the pertinent info on my clinical paperwork for the day (vital signs, rupture of membranes, uterine contraction information, fetal heart rate information, etc.). Thankfully the information wasn’t difficult to find since I use the same charting system at work.
About an hour later, just as I was finished up with what I could of my paperwork (good timing!), the certified nurse midwife (CNM) comes in and explains to the mother that because she was at 10cm and fully effaced, it was time to start pushing. Eek! The atmosphere of the room completely changed as a few more people came in to help (a medical student, an L&D nurse, and a resident). The resident wasn’t there long…just basically wanted to check on the status of the mom. The CNM really did everything during that delivery – just another awesome role that nurses can play. The medical student and myself held the mom’s legs while she pushed, and the L&D nurse helped her count during contractions and monitored the fetal heart rate and the timing/intensity of the contractions.
The delivery didn’t take long…and soon the baby was born!! I didn’t think the delivery would really effect me since I’ve seen deliveries via video tape before, but it was really a miracle. I mean…to have no baby in front of you, and then, with some hard work on the part of the mom, a baby is brought into the world…WOW. I just can’t explain the feeling. I definitely cried. AND, I GOT TO CUT THE CORD!!
After the delivery I watched the pediatric nurse practitioner and the newborn nurse do the initial assessments of the baby, I watched the CNM massage the mother’s uterus and fundus to help deliver the placenta & help the uterus firm up, I played with the placenta, watched the CNM and medical student stitch the mother’s episiotomy up, and watched the mother and father’s interaction with their newborn. It was an AWESOME morning.
After we had all helped clean the mother and baby up and get the new little family settled, I left the room to finish my paperwork on the delivery. At that point, my clinical instructor found me and asked if I wanted to watch a cesarean section…YES!!!
She led me to a different L&D floor and to my new patient’s room. Again, much the same way as that morning, I walked in, introduced myself, and started my clinical paperwork on that patient. There was a lot more down time between when I met the patient and when her C-section was scheduled; because the patient wasn’t English speaking and seemed to only want to rest, as soon as I did what I could with my paperwork I left her alone and went to lunch with a few of my classmates.
About an hour or so after my lunch break, and after peppering my patient’s nurse with tons of questions (she was awesome!), we went back into the OR to deliver the baby via C-section.
Before I go on, I do have to say that I loved that the L&D nurse that was taking care of this patient was able to go into the OR with her and automatically become the circulating nurse in the OR. And, since I’ve never been in an OR it was fantastic to be able to witness exactly what a circulating nurse and a scrub nurse’s roles are. I don’t think I could ever become a scrub nurse…but I did have to sit there and consider how awesome it would be to have a job as a circulating nurse in an OR! (More options for me to consider.)
After all the prep was done on the patient and in the operating room itself, the circulating nurse called the surgeons in and everything began. The c-section began with a calm, smooth cut…but soon I was amazed at just how rough this particular surgery is. It is NOT like how it is seen in the TV shows where the surgeons make one deep cut and then pull the baby out…instead it is more like hundreds of cuts through adipose tissue, connective tissue, muscle, fascia, and finally through the uterus, all the while the surgeons are pulling, squeezing, and practically manhandling the tissues in the abdomen in order to manipulate the tissue to move the way they want it to so they can get to where they want to go. And then, after all that cutting and cauterizing, one of the surgeons reached their hands elbow deep in lengthwise through the abdomen to reach the baby and slide it out. WOAH!
And again, after the baby was born I watched the pediatric nurse practitioner and newborn nurse do the assessments and give penicillin G, clean the baby up, and then hold the baby in front of mom’s face so she could connect for a few minutes while the surgeons began the process of putting her back together.
All in all I was in the operating room for about 2 hours before my instructor came and found me (around 1530) so we could all go to post-conference and get out of clinical a bit early. But I had SUCH a great time and was thoroughly enjoying watching the surgeons sew the mother back up and observing the OR routine and rhythm that I was disappointed when it was time to go. But hopefully next L&D clinical I will get another chance to observe a c-section – and let me tell you I will thoroughly enjoy it!
One thing that I truly realized while in clinical on Tuesday…L&D nursing is completely different from med-surg nursing. For one thing you aren’t taking care of sick patients, per se (for the most part, anyway), and so it just has a very different tone and atmosphere to it. That, in my opinion, was pretty cool. Secondly, L&D nurses have to be able to be flexible and thrive on spontaneity…there really is no set schedule on when a baby will decide it wants to be born! So assessments must be made and meds must be given on a time schedule completely dependent on what’s going on with mom and baby at the time.
I am so thrilled about what I was able to witness and experience in clinical on Tuesday and cannot wait until my next L&D clinical!!!
As per my usual…today’s Saturday so I’m updating. I don’t mean to only post once a week, but this week has been absolutely hectic and even though I wanted to post on Tuesday evening about my OB clinical, I was just too tired and instead sat in front of the TV for the evening. 😉 Not a good idea, mind you, but awesome nonetheless.
My week in a quick nutshell:
Saturday & Sunday: spent the time completing my first research assignment, which took almost all day on Saturday; two quizzes; a discussion board post with 2 replies to other posts; and my OB pre-clinical paperwork (which took FOREVER!).
Monday: worked a 12 hour shift, then came home and ate a quick dinner, made sure I was ready for my first OB clinical the next day, and went to bed (around 2145).
Tuesday: got up at 0345 for my first OB clinical at Parkland!! AND IT WAS AWESOME! (Details to come in my next post.) We were there until 1700, and then began the long trek home with all of us carpoolers. I didn’t get home until 1830. And as I said before, I didn’t do anything that night besides watch some mindless TV and veg.
Wednesday: got up late for class because I really wanted the extra sleep – even if it meant getting to school later than usual, not having a place to park, and having to rush to print the day’s lecture powerpoints. Was at school from 0800-1800, and then went to work from 1900-2300. Came home and collapsed in bed.
Thursday: woke up and rolled out of bed around 0600 in order to be at a friend/classmate’s house by 0700 – so we could carpool together to THR Denton and give flu shots in their employee health fair!! It was SUCH GREAT EXPERIENCE!! I probably gave upwards of 30-35 IM shots that morning. I even gave a shot to a PCT there who happened to be in nursing school as well…and she told me that she was a senior 2 at UTA and STILL HAD NOT GIVEN AN IM SHOT! Woah. Then my classmate and I stayed afterward to pick out our patient for the next morning’s Adult 1 clinical. Came home afterward and did all my pre-clinical paperwork (took about 3 hours), and then watched the 2-hour season premiere of Grey’s Anatomy. So glad it’s back on!!! (And afterward went to bed, of course. Too tired to do anything else that night!)
Friday: Got up around 0400 for Adult 1 clinical. Clinical was great; albeit a bit slow, attended post-conference, and headed home. Arrived home around 1600, realized I was locked out of my house, and sat on my front porch for an hour waiting for the hubby to get home. And then around 1900 met up with 7 other classmates so we could all go out to dinner and freak ourselves out at a haunted house. It was my first haunted house ever and I had a blast!! 😀 Unfortunately we were out until 0100 in the morning and by the time I got home it was a little past 0200.
This morning: The hubby woke me up around 0800 so we could go get breakfast together since we’ve not seen each other hardly at all this week and he has to work today. I am so sleep deprived that I was barely able to pull myself together and keep my eyes open during breakfast. We stopped at Starbucks on the way home and I got myself more coffee – a cinnamon dulce latte (my fav) – and I proceeded to try not to fall asleep again once we got back home as he was getting ready for work. And I’m pretty sure I did dose off there for a couple of minutes…but then finished my coffee and I’m feeling MUCH MORE AWAKE NOW.
Unfortunately, last week since my life turned into a whirlwind of pre- and post-clinical paperwork, clinicals, work, and classes, I did not do any studying or reading for anything. And I have my first OB test next week on Wednesday! So, here’s what I have to do today:
I have to work tomorrow, and I have school for half of the day on Monday, so that really only leaves the rest of today and all of Tuesday to hopefully cram as much OB in my head as I can for the test. I’m crossing my fingers that I can pull it off.
And to everybody reading this, my one piece of advice is….
LEARN HOW TO MANAGE YOUR TIME NOW. AND DO NOT PROCRASTINATE!!!
Wish me luck on this test! 🙂
First of all, let me just tell you that it is currently 62 degrees outside here in DFW, and I am so giddy about it that I actually woke up EARLY this morning (on a Saturday!) just to enjoy the weather!!
Yesterday we had our J2 math test and our adult 1 lab simulation. The lab simulation was a ton of fun and I really felt way more confident during this one than I did when we had our first lab simulation last semester.
So the morning started out with our math test – a ten question test covering a few concepts from last semester and then the IV concepts from this semester. I felt pretty confident; I’m great with math and I had covered all the modules that we were supposed to review with ease. So myself and some classmates got to school about 0700 to have time to do some practice problems and we got through them just fine…and then we gave ourselves a pat on the back, sucked in a deep breath, and walked into the classroom.
We’re supposed to pass our math tests with a 90% and we have three chances to take the math test and pass. If we don’t get at least a 90% during any one of those three times, then we are kicked from the program. Honestly I walked in there expecting to get a 100% but I walked out with a 90%. Which is fine by me because I passed! A few of my other classmates weren’t so lucky. So they will have to take the retake and hope that it goes better next time.
Then we started our “clinical” day in the lab right after that. For the first hour, we had to get report for our patient and then make a quick care-map on him. (I will tell you right now that I like the care-map format better than the care plans we were doing last semester!). Afterwards, we had an hour spent in the skills lab reviewing oxygen therapy and pushing IV meds. I was one of the lucky two who was made to demonstrate pushing IV lasix in front of my other classmates! 😉 But it was AWESOME. I can’t wait until I’m doing this for real in the hospital.
After our skills lab we were then given the go-ahead to take care of our “patient.” We walked into the high-fidelity lab and were introduced to our patient, who was currently in respiratory distress due to the fact that he had congestive heart failure and had not been taking his “water pills” (lasix) for the past few days. His shortness of breath was what landed him in the hospital and we were there to get his condition back under control.
We had orders for a nasal cannula at 2-5 LPM until his O2 sats were higher than 90, and if his O2 sats didn’t improve with that we were to call the doctor. When we first walked into his room his sats were at 86, so we immediately put the cannula on him and watched for any results. Nada.
As one of my classmates went to the pyxis to get his mornings meds, I ended up calling the doctor to ask what she wanted done about our patients O2 sats. She basically told me to give the patient his meds and gave me an oral order to push 40mg IV lasix. I repeated the order back to her and then hung up, relaying that information to my other classmate getting the meds.
All the while, the patient is complaining that he can’t breath and isn’t comfortable and we’re trying to calm him down, while I have another classmate studying the patient’s labs and making sure that he is ok to take the meds he’s been prescribed (his potassium value was ok, so he could take his digoxin and lasix).
We ended up giving him all of his meds and his lasix; we noted his O2 sats come up and his tachycardia and hypertension resolve due to the ACE inhibitor and beta blocker. We thought we were doing great until his O2 sats dropped below 90 again and when he urinated he only gave us an output of 200ml.
So we called the doctor again and asked her if we could put him on a simple rebreather mask and give him another dose of lasix. She agreed with us so we put on the simple rebreather mask at 8 LPM and gave the patient 80mg IV lasix. After the slow 4-minute push, within half an hour the patient urinated 500ml and his O2 sats finally were up to 98. He was no longer cyanotic and he was thanking us profusely for making him feel better!
So yeah. We rocked that simulation and our instructor was practically beaming when she came to get us (our simulations are all being seen through cameras in the ceiling). She was so excited about our performance and only had a few constructive tips to give (don’t handle the urinal without gloves on!!).
Soooooo AFTER our simulation we then had to demonstrate patient discharge teaching. Taking turns, we each had to be the patient and the nurse giving the discharge teaching. The fun part about all this? We were being TAPED. Our instructor is going to end up pulling the best one and showing it to us in class. EEEK!
And then we were done! And it was an awesome day at school. Our next simulation is in L&D next month and I’m super excited about that one too. I’m sure it’ll be hilarious! 😉
Whelp, I took my first Adult 1 test this morning! I walked into the test probably WAY less nervous than I should’ve been, and walked out of the test feeling nothing but relief that it was done. At that point I seriously didn’t even care how I did. That’s how bad my apathy towards this first test of the semester was.
I knew that if I’d gotten a bad grade – or a grade that was below my expectations – that I deserved it. I literally spent a few hours on Saturday and some on Sunday studying for this test. I worked Monday, and then I had orientation for my Women’s class at Parkland all day yesterday (Tuesday). Of course I came home last night and studied as much as I could…but really, for the amount of time and effort that I put into studying for this test I really wasn’t expecting a lot.
I actually did discover something amazing last night while I was studying though…I was on YouTube trying to find a good video that would help me better understand arterial blood gases and in the process stumbled onto a GOLD MINE of videos for nursing students! The username is “Simple Nursing” and I probably ended up watching about 10 videos last night (yes, while I was supposed to be studying) on ABGs and cardiac meds. I understand the RAAS so much better now, and therefore clearly understand ACE inhibitors and ARBs! And I watched videos on beta blockers, calcium channel blockers, and diuretics that made these meds so simple to me. And in actuality, I feel like because I watched these videos I was able to do better on my test today.
So last night I was up until about 0100 studying (more like last-minute cramming. Not a good idea…really, it’s not.) and then woke up at 0400 so I could get a shower in and get to school early and continue studying.
Well I don’t know what I did but something paid off, because I got a 92 on my test!
Before I started nursing school, I didn’t think there was any way I could ever NOT want to be in nursing school. I was just so ready to be IN nursing school that I didn’t acknowledge that the reality would someday mean that I was sick and tired and ready to be done.
Don’t get me wrong; I really enjoy learning and increasing my nursing knowledge. I also realize that the learning is going to happen for the rest of my life.
However, nursing school is exhausting. Taking 16 credit hours of intense nursing courses in one semester is exhausting. Knowing that I still have this semester and then two more after that is exhausting. Knowing that this semester is supposed to be the easiest semester is exhausting.
I can’t help anymore but to constantly look forward to that day when I graduate and all my hard work will have paid off in the form of a beautiful piece of paper. I can’t wait until I can take the boards and become a registered nurse. I can’t wait until I am actually putting all of this nursing school theory into actual practice with my very own patients.
Until then…I leave you with pictures of my week.
Yesterday I took some time out of my morning to volunteer at Children’s. It’s not my usual day to go, but due to work and school issues over the past month I’ve missed out on several of my regular Thursday shifts.
Well instead of helping out as a sitter yesterday, I was placed in the renovated Center for Cancer & Blood Disorders to be able to help direct patients and their families around the new environment.
There were several things I noticed just in the few short hours I was there that really intrigued me:
I’ve said recently and felt pretty confident that I don’t want to be a pediatric nurse. But being in the CCBD yesterday definitely pulled at my heart strings…I could maybe see myself as a heme/onc pediatric nurse…maybe… 😉
It’s Saturday which means I have a little (little!) time to relax and breathe this morning before getting back to it. This past week was busy, but awesome and I’m feeling less stressed and much more thankful that I have the opportunity to be in nursing school and heading towards my BSN. I just needed a little perspective to push me back on the right track!
Monday – I worked and was floated to the medical ICU to sit with a patient on suicide precautions. It was heartbreaking to say the least but while I was sitting with the patient – who was mostly sleeping on and off – it gave me some time to think about why I want to be a nurse, what kind of nurse I want to be, and what kind of patient population I want to work with. It helped clear my mind of the stress and re-focus me on my goals and mission in life, and when I went home I felt ready to tackle this week. And later, I’ll make a post about my thoughts during sitting (but no time now!).
Tuesday – AWESOME! I was at school all day for a skills lab/breastfeeding lecture. The skills labs were in the morning, and we learned how to assess a newborn and a postpartum woman, start IVs, we practiced (again) putting in foley catheters (but this time in a female), and then we learned how to hang IV fluids and piggy backs. We also learned how to calculate IV drip rates and calculations. Too great for words! I guess I am a very very hands on, technical person…and it all just thrilled me. Also, I’ve noticed that J2 seems to be so much more laid back as far as the nursing skills go than my J1 semester. The professors want us to do it correctly, true, but there’s not so much pressure about doing it in the lab since they know we’ll be doing it on the floor and they’ll be there to talk us through it.
And then we had our breastfeeding/latch lecture after lunch, and I’ll just say one thing about it: I had NO IDEA there was such an art to getting a babe to breastfeed and doing it correctly! The end. (Also…it’s really hard to watch videos/talk about babies for 3 hours and then not go home wanting one so badly that you DREAM about having babies. Uh-oh.)
Wednesday – We had Adult 1 lecture in the morning, and Women’s lecture in the afternoon. I studied afterward in the library for a couple of hours before going to work, and in the process of studying I had to watch a video on Aging for my Aging class…and it made me cry. Right there in the library! I am learning as I work and as I progress through nursing school that I ABSOLUTELY LOVE older/elderly adults.
Thursday – But, as much as I love older adults, I love children and babies too!! Always have, always will. I’m just not sure yet if I could be a pediatric nurse. But I do enjoy going to Children’s to volunteer, which I did this Thursday morning (first time in a month because life has been so busy!) and for the first 2 hours I had the privilege of rocking a 22-week-old to sleep and cuddling with them as they slept in my arms. Heaven! There are a lot of cons in my mind towards becoming a pediatric nurse, though, so at this point in time I don’t foresee it in my future. I’ll get into that list at a later date…
Then, after volunteering, I went over to a classmate’s house so we could finish up on an assignment that was due Friday by 1700. We finished rather quickly, joked around for a bit, and then I stopped by Walgreens on my way home to get my Flu shot. Crazy that my doctor’s office didn’t have them in yet! But we’re required to have them by the 13th or else we’re dropped from our clinical classes, and I didn’t want to chance it so I just got it done. I think the pharmacist went to high up on my arm though, because when he stuck me it HURT! And then it was sore for the rest of the evening as I worked on a bunch of practice problems for IV calculations and then read a bit (but not as much as I would’ve liked).
Friday – I finished up with some discussion board posts, and then literally spent the rest of the day doing MORE IV calculations, until the hubby came home and we decided on pizza and a movie for our evening entertainment. I was so tired of sitting at my desk working on math that I didn’t even care that I was throwing the evening away to watch a movie. Which was FANTASTIC, by the way – we watched “Now You See Me” and I loved every second of it. Definitely would watch it again and again, although since it’s a movie about magic once you’ve seen the ending it can never be the same.
And now it’s Saturday morning and I have a ton of work to get done this weekend before I go to work Sunday night. Crossing my fingers that I can get a majority of it done!
I always try to not let my posts get too wordy, and then I look at what I’ve written and realize that I’ve done just that. Oh well…if you read all of it then kudos to you! If not…that’s quite alright. I’ll leave you with some pictures of the past two weeks. 🙂
Ok, so I didn’t get around to writing this post on Friday night. That’s because I decided to sleep Friday night, stay up all day Saturday, and then go into work Saturday night without having slept beforehand. Not sure that was a good choice…this morning I came home, slept from about 0900-1200, and then got up and tried to get some reading/assignments done, but ended up falling back asleep on the hubby’s lap while we watched Avengers. And I have yet to get anything school-related done; but maybe that’s ok. Maybe I was meant to just de-stress from the past week today.
First week of the second semester of nursing school = done! Maybe it wasn’t completed super successfully but it’s behind me now and I’m in the throes of trying to get caught up and organized for the rest of the 15 weeks ahead of me. I’m feeling a bit freaked about this semester already and I think it’s because I just don’t feel like I got off on the right foot.
First of all, I wasn’t able to complete any of the required reading before Monday, and I’ve heard that it’s a GOOD idea to read for my OB and especially Adult 1 classes – usually nursing students can get away with either not reading or just skimming the chapters. And my first Adult 1 test is now in 2 weeks, and I’m so behind on the reading (as in, I should have had several chapters read by now) that is stressing me out and giving me headaches. Seriously.
Secondly, there are so many assignments due within the first few weeks that I don’t even know where to begin on them. I sit here and think about what needs to be done and then I end up so overwhelmed that all I want to do is sleep. Eek! So I really need to just take it all with baby steps so at least I’m accomplishing SOMETHING and not just sitting on the couch like a zombie… (which I pretty much did once getting home from class every single day this week. Another reason I’m feeling like I got off on the wrong foot).
Third, I knew that I had to work last night, which meant a little less time this weekend to study and complete assignments, but I knew I could work around that since I had today (after a nap) and Monday free to be able to get some stuff done. Well I looked at my schedule on Thursday and realized quite belatedly that I also have to work tomorrow (Monday). So now I’m freaking out because I’m just wondering how I’m going to be able to get it all done. I want to be a great student this semester, I really do…but I’ve never worked AND gone to school at the same time before and I know it’ll be quite an adjustment until I get used to it. So hopefully I don’t screw myself in the process.
Especially since I was SUPPOSED to get some stuff done today and I’ll I’ve managed to do is sit around and chill.
Sooo…moving on and hoping this week is a bit on the stronger side for me. At least we get to learn how to start IVs this week!! 🙂
P.S.: I almost got to start an IV at work yesterday on one of my co-workers. She totally would’ve let me do it, except we got swamped and ran out of time. 😦 Maybe next time I work with her.