Entering Week 12

It’s the start of week 12 already!!! In a little under 5 weeks I will be graduating!! (And just in case you’re wondering, only 29 days until my last final and only 32 days until pinning!!!)

I’ve had some changes with my CCI schedule…in the middle of October I got an email stating that I was no longer allowed in the ED at the VA due to them taking precautions with potential Ebola situations, so I was given a new preceptor and a new floor – a med-surg floor. Honestly I wasn’t thrilled, for several reasons. I had grown to love being in the ED and I knew what was expected of me, I LOVED my preceptor and we got along really well, and I was scheduled to be done with my shifts on Halloween. Due to the timing of when I was able to get ahold of my new preceptor and begin shifts with her, plus the fact that she works 8hr shifts instead of 12hr shifts, meant that my CCI shifts were stretched out a bit further into November. Instead of only having 4 (12hr) shifts left to complete, I now had 6 (8hr) shifts to complete.

I also thought that I wouldn’t enjoy this new change due to the fact that I’d be on a med-surg floor, but honestly I’ve really had a good time with my new preceptor and on this floor with these patients!! I’ve done a TON more charting and medication administration, as well as looking at lab trends and looking into the H&P of these patients, which I really didn’t do in the ED because our patients were with us for such a short amount of time. At this point I’ve taken up to 3 patients, I’ve given report on 3 patients at the end of the shift (not very successfully, but thankfully the nurse I was giving report to was kind and gave me tips for how to do it better next time), and I should be taking 4 patients on my next and last shift which is this upcoming Wednesday. I can’t believe my VERY LAST CLINICAL IN NURSING SCHOOL is this Wednesday!!!

Tomorrow after our leadership and management test, our entire class is going to be taking a class picture for our pinning ceremony, so we get to wear our scrubs but actually look pretty in them for once, being that we can wear our hair down and wear makeup. Everything is wrapping up so quickly now that I feel like I can’t keep track of it all! I can’t believe that we are so close to being done.

A couple of days ago I bought my graduation announcements, all my honor cords that I will be wearing at graduation, bought my diploma frame (it’s gorgeous!) and registered with Pearson Vue to take the NCLEX. AHHHH.

I took my exit HESI about two weeks ago but I made a 904 on it (which converted to an 83%) so I’m going to re-take it. I don’t feel like I NEED to retake it since I made over an 850, however I figured it’d be good practice, plus I BARELY have a chance at making an A in CCI with that score so if I can get a better score the second time around, then my chances of making an A are much higher (they take the higher of the two scores – they don’t average them out, thankfully!).

So here’s what’s left in this semester and then I’m DONE!

  • 2 tests (L&M tomorrow, Communities next Monday)
  • 2 quizzes (Communities quizzes before each exam)
  • 2 projects (One in Communities, one in CCI)
  • 1 clinical (last one on WEDNESDAY!)
  • 1 clinical log (for Communities)
  • 1 HESI
  • 2 finals

I can’t believe it! I’m so close it’s insane!!

Emergency Department Thoughts

My clinicals in the ED for CCI have been AWESOME. So far I’ve completed 5, and will have the other five completed before November 1st. Whoop! That’ll open up even more time for me to work on projects and prepare myself for finishing up this last semester of nursing school.

My preceptor in the ED is a former TWU grad herself and she has been so amazing with me. She has a lot of patience but she tells me exactly as it is and I so I don’t have to wonder what she’s thinking or if I’m doing something that will ultimately hurt my patient. She allows me to be independent but she’s right there if I need her. Even when she’s super busy (as happens often in the ED) if I have a question or am nervous about doing something then she will patiently guide me through it.

I’m to the point now that I’m taking one patient completely on my own (well as much as I’m able to…I can’t get into the pyxis so she still has to get the meds for me) and then helping her out wherever I can with her patients. This means that I’m doing the initial assessment on the patient, getting them hooked up to monitors to take vitals, documenting in their medical record, and then carrying out the doctor’s orders on my patient while they are in the ED. It’s SO fun but it’s also quite exhausting. The ED moves at a weird pace…you’ll have moments where you are not busy at all and sometimes that can last for a couple of hours. For example, we have patients in each one of our beds, we’ve done all orders, and now we’re just waiting on what the doctor wants to do – are the patients going to be admitted or discharged from the ED? And then we’ll have hours that are SWAMPED. We’ll receive one patient just as we discharge another, and then receive another in his place…and you feel like you’ll never get caught up with the initial assessment & documentation as well as carrying out orders for each of your patients. I’ve never had 12 hours go by in such a manner…it’s a long 12 hours but at least I’m having fun while I’m there!

I’m really glad I’ve had the opportunity to be in the ED while in nursing school, for several reasons. First, it’s been great to know exactly how emergency departments work and the flow of how they run. I have the perspective of nursing from an emergency nurse’s eyes now. Second, I’m glad to have had this experience so that I can rule out ever wanting to work in the ED in my nursing career. I thought that it’d be a great place to work as a nurse but I’m discovering that it’s REALLY not for me. Not in a bad way – I think that all nurses have a “niche” and the ED just isn’t mine. Why don’t I like it? Well there’s a much more limited contact with the patients in ED. Even if they are with you for hours, they are generally NOT in a mood to be talked to. Most of them try to sleep their day away, in actuality. But most patients aren’t even with you that long. Either they get admitted up to the floor pretty quickly or they are released back to the street pretty quickly. There’s just no satisfaction of seeing a patient coming in really sick and then watching them get better over time, because once they are admitted you never get to know how they’re doing later. And then, and I’m sure I’m NOT correct in my assumptions, I feel like when we “treat” a patient in the ED they really aren’t getting better. We have  patients come in for a pain in their back, and we can’t find anything wrong with them, so we give them pain meds and street them and I’m left to wonder “well what happens when their pain comes back??” (And no I don’t think they’re just drug seekers.) And so on and so forth. A lot of patients that we see are “treated” and then sent right back out but I’m wondering if they were really helped at all. And so with that I get very little satisfaction.

That’s not to say that all the patients we see are that way. We have had some truly emergent cases come through our doors that have been admitted to ICU, all the while we were crossing our fingers that they wouldn’t crash and burn right there in the ED. Those types of patients are definitely rare though.

But I have had a great experience in the fact that I’ve had the opportunity to practice a TON of skills and see some really cool things as well. I’ve:

  • Inserted more IVs than I can count
  • Inserted two male foley catheters and one female foley catheter
  • Inserted an NG tube
  • Drawn blood cultures (my least favorite skill, I think; it’s extremely tedious)
  • Done several butterfly sticks into the veins to draw blood
  • Hung IV meds, IV fluids, given IVP meds, PO meds, IM tetanus vaccine
  • Drawn, labeled, and sent blood to the lab
  • Performed EKGs
  • Seen a STEMI on an EKG of a patient going through a heart attack at that moment
  • Watched a urologist irrigate a foley catheter for almost an hour to pull out clots so that the urine could drain
  • Watched a plastic surgeon sew up a DEEP hand laceration
  • Listed as a mentally altered patient screamed obscenities for about an hour before his meds kicked in and he fell asleep
  • Seen a BAD case of ascites
  • Had a patient that we nearly had to intubate due to a COPD exacerbation and resulting respiratory acidosis
  • Seen a hypochondriac throw themselves on the ground in an attempt to get someone to pay attention before they stormed out of the ED and were brought back in by police
  • Watched as the VA had a medical disaster drill and taught their staff how to respond in that type of situation (they had tents set up and were wearing HAZMAT suits and everything!)

Another awesome thing about being there for clinicals is the fact that there’s one doctor in the ED who LOVES to teach. Whenever he has the opportunity, he will teach you about what’s going on with his patient even if it’s not your patient. I’ve learned a lot just from listening to him!

All in all I’m SUPER SUPER thankful that I have had this opportunity. I can’t believe I’m already half-way done though! Clinicals go by SOOOO fast when you’re in charge of scheduling them when you want!

HESI For the Win

I really should not be advocating not studying as much as I have in my blog. But I am trying to paint an honest picture of my journey through nursing school, and as it stands right now I am SUCH a slacker when it comes to studying. Typically I cram two days before the test and hope for the best. Definitely not the best method but somehow it’s working – and since this semester I really don’t have much time to study during the week it’s really my only option.

Took my HESI a couple of days ago (Tuesday). Too bad it is only worth 5% of my Adult 2 grade because I KILLED IT. And I did NO studying for it whatsoever. In fact, I read an entire novel this past weekend before the test. Oops. But, something can be said about how thoroughly TWU teaches us because I felt like I really knew all the information the HESI presented to me, even without studying and “brushing up.”

I ended up making an 1146, which is higher than both my J1 (1116) and my J2 (925) HESI. Converted, I made a 99.99% and was in the 93rd percentile.

I told my best friend that I wish we were in S2 and that had been my grade for HESI – because in S2 the HESI is worth 30% of your grade!

Speaking of S2, we received our “preference sheet” on Tuesday before our HESI. It had a ton of options on it for instructor led clinicals, preceptor led clinicals, and then of course our community health clinicals. For our Critical Competency Integration class (CCI) I chose preceptor-led clinicals and my #1 spot was the VA, followed by Parkland and Methodist Dallas. We shall see what happens, but I’m pretty sure I’ll get the VA this time. I already turned my preference sheet in; because the VA has to start a background check so early on those who will be “working” there then I should hear back pretty soon.

So what classes do I have next semester? I have CCI, community health, and leadership and management. CCI is the “big” one. This is where we have either instructor-led or preceptor-led (if you’re lucky) clinicals, and have to complete 120 hrs of clinical. We will be reviewing everything we have learned the past 3 semesters in the CCI lectures in order to prepare us for the exit HESI and then NCLEX. This class is worth 6 credit hours but I hear it’s tons of fun.

Community health is just what it sounds like – community health. We will be doing a couple rounds of school nursing, homeless shelters, possibly home health and hospice nursing, etc. I’ve heard that the projects in community health are a beat-down but I’m actually quite excited about this class. Especially because at one time in my college career I was contemplating getting my Masters in Public Health (MPH). We’ll see if this class revives that desire or not. (More school?? Don’t know if I can right away).

Leadership and Management is an online class mostly, with a couple of class days and I believe tests are on campus as well. I’ve heard this class is difficult but doable.

I’ve heard from several S2 classmates that this next semester is SO much better than S1. As a general rule you have a LOT more time on your hands and the content isn’t as overwhelming. I’m so ready for that! Especially because I know we’ll all be trying to apply for jobs and handles any interviews that come our way (hopefully – crossing fingers!). I also know that dealing with senioritis is going to be a huge hurdle – because I’m already feeling it! It’s really going to be hard to come back from an awesome summer off and then go into our last semester. But I’m sure it’s also much easier knowing that it’s the last semester and graduation is literally right around the corner. The thought is mind-blowing!

Well I guess I’ve rambled on quite enough now. I have a test this upcoming Monday that I’m supposed to be studying for and obviously I’m procrastinating by writing a blog post. 😉 This test – child health – is the last one before finals! Tomorrow I have my last child health clinical (last clinical for this semester, period), and next Friday I have my last simulation for this semester. Then finals. AHHH it’s all wrapping up so nicely with a neat little bow. Can’t wait!!

April Showers

April showers bring May flowers? Is that how that saying goes? Regardless of the saying, I think it can be well understood that all I have to do is get through April and May will bring beauty and rest to my soul.

I’ve actually been doing quite well since spring break. Surprisingly, I’ve had more motivation to just sit down and “do it” and I’ve been able to stay on top of my assignments and studying without feeling the immense pressure that I did before spring break. And I say that it’s “surprising” because usually after spring break I’m all done in!

Last week marked the end of my mental health clinical (yay!!) and yesterday (Thursday) marked the end of my adult health 2 clinical!! I only have one more child health clinical – next Friday – and then I’ll be done aside from a simulation later in the month on campus. That simulation will be awesome, I think, because it’s the same one I did as a J1 with the S1’s, except now I’m the S1 and I’m sure I’ll be criticized by the J1’s…all in good fun. It’ll be neat to see the other side of the same coin. At least I know what I didn’t like about the S1’s that I was with that semester and hopefully won’t do the same things as an S1 myself.

This semester I’ve had some really great patients, some super sick patients, and have discovered that although I could’ve sworn I would never want to work in peds that it’s definitely a fun place to be. (I still want to do adult ICU – but I’m not opposed to applying for peds ICU). I’ve also learned that med-surg nurses are not “less competent” or any less/worse of a nurse just because they work in med-surg. They are SUPER busy and definitely just as smart and they really do make a difference for their patients.

Since spring break, I’ve taken three tests – child health was bright and early the Monday morning we got back to school – and I’ve done pretty well in each. In child health I made an 88%, which is great considered how very little I studied (it was spring break!!). In mental health I made a 93.75% (the highest grade this semester!), and in adult health, which I just took this past week, I made an 88%. Those grades have me sitting so far with an A in mental health, a B in child health, and a B in adult health. YAY! I’m just hoping I can keep it up, especially in adult health, because I don’t want any Cs!

What’s left for me in these last 4 weeks (how’d I get to this point?!):

  • We find out next Tuesday what next semester will be like, and will get to apply for preceptorship. YAY.
  • My adult health 2 HESI is next Tuesday as well. Hopefully I can study some this weekend before taking it!
  • Next Friday is my last child health clinical, and because it’s on Good Friday we will be getting out at 1230 instead of 1530. Score!
  • Child health exam 3
  • Poster project presentation (will give me 2 points toward my overall final adult health 2 grade!)
  • Adult health simulation with the J1’s
  • New student orientation for incoming J1 nursing students
  • FINALS! My first final is on a Saturday, boo…and then I finish them off on Monday and Tuesday, May 5th & 6th – and then I will be DONE!

You know you’re close when you can put everything you have left to do in a bullet point list! YEE-HAW. I’m ready.

 

And Spring Break has Begun

My peds clinical instructor is sick, which means I have no peds clinical this morning…which means I’m officially on spring break! Of course we have to make up our clinical at a later date, but that doesn’t even bother me because I would’ve rather had an extra day right before spring break anyway. 🙂

I’m sure this is an oft-repeated phrase in my blog, but I’m going to state it again anyway because it’s true. I can’t believe I’m halfway through this semester already!!

I was in the CVICU again yesterday at my adult clinical and I just can’t believe how excited and thrilled I am every time I’m in the ICU setting. I know I belong there and I hope I’d make a great nurse there, too. Of course there’s a huge part of me that really wants to be done with school and be on my way to learning how to function as an independent nurse, however there’s also a huge part of me that is literally terrified. I feel like I don’t know ANYTHING! How do they just expect us to graduate, get a job, and – even with the residency positions – be ready to function as a REAL nurse only 4-6 months later?!

Anyway…those are my thoughts for today. Short and sweet, I know. 😉 This spring break is going to fly by soooo fast – especially because I have SO much to do!!

An S1 Update

North Texas weather has been so fickle! Yesterday it was in the 80s. Today, in the 20s with freezing rain. As a result, delayed opening for school tomorrow – until noon. As a result of that: no child health class (because it’s from 0800-1100) which means I get a whole day off to study for my 2nd adult health exam on Tuesday morning! YAY!

So I haven’t updated in awhile…but these past few weeks have been SO insane! I’m constantly going somewhere and doing something, which doesn’t give me much time to get any studying done. So any extra time I have I’m either studying or taking a break. Most likely taking a break. 😉

But in the midst of this crazy semester, I have learned one thing for sure. I have learned where my nursing passion lies. I have had that “AHA!” moment where I felt a pull towards the area that I want to do nursing in. Any guesses???

If you guessed the ICU, you were correct!! I have come to find out that I am SO passionate about this field of nursing that I just cannot wait for my next clinical day in the ICU. I excitedly look forward to being there and learning new things, taking care of the sickest of the sick. I am loving learning about the critical care content in lecture that we’re being tested over on Tuesday…ABGs, ventilators, shock, hemodynamic monitoring, etc. I feel like I just can’t get enough. I feel like I have been re-awakened and no longer am I just trying to “survive.” Now I feel like I have something I’m striving towards again.

I just have to make it through the next 10 weeks and I’ll be done with this, the hardest of semesters. And then next semester, I get to start applying for my dream job – the ICU!

Countdown Begins

2 weeks to go until the start of my S1 semester! As much as part of me is terrified of the upcoming semester, I am also feeling the first quivers of excitement and eagerness. A new start of the semester has always been one of my favorite events. It’s always fun for me to learn what the upcoming semester holds and to know that I will come out on the other side more knowledgeable and that much closer to being done.

Everyone at work keeps asking me how much longer I have before I’m graduated. I guess it’s an awesome feeling, but then again at the same time I don’t know if they’re asking because they’re tired of my haphazard schedule (due to school) or if they think I’d be a great addition to their nursing family. I often wonder if they are trying to imagine me as a nurse on their team and how I’m standing up to their expectations. And then I often wonder myself whether or not I would accept a job on my unit if I was offered one. I enjoy my unit and the nurses I work with, and I feel a deep loyalty to my boss and my supervisor (who are so willing to work around my school schedule) that I think it’d be hard to turn down an offer (should I get one). But at the same time I have to make sure it is something I want to do and will be happy with, especially because I really feel that I’d enjoy the ED. But I really need to get some more ED experience first!!

And speaking of haphazard schedule, here’s my schedule for the upcoming semester. It’s a doozy!

  • Mondays: Children’s Health Lecture from 0800-1100. Then volunteering at Children’s Medical Center from 1300-1700.
  • Tuesdays: Adult Health 2 Lecture from 0900-1200. And then Mental Health lecture from 1300-1600.
  • Wednesdays: Mental Health Clinical from 0800-1430.
  • Thursdays: Adult Health 2 Clinical from 0645-1400.
  • Fridays: Child Health Clinical from 0600-1600. Then work (as a desk secretary) from 1900-2300.
  • Saturdays: work from 1900-2300.
  • Sundays: My day off!! (And I’m sure it’ll be a hardcore study day!)

And somewhere in that schedule I will be tutoring the Concepts class for a two-hour period in the evening…I just haven’t worked that out with the peer tutor coordinator yet so I’m not sure when that will be. I’m assuming it’ll occur on either Monday, Tuesday, or Wednesday evenings.

So that’s my upcoming semester. It sounds pretty cut and dry on paper but I’m afraid it won’t be once we’re in the thick of things!

This week in the countdown I will be attempting to become as organized as possible for my next semester. I need to clean out my office, organize my documents for the nursing student association, make sure my home documents are all filed, and yada yada yada…and then next week I will be teaching CPR classes Monday-Thursday, working from 1900-2300 those same nights, and then hopefully enjoying my Friday-Sunday with friends and family. And then S1 SEMESTER BEGINS!

Only two more weeks!

Semester’s End

Well, I’M DONE!!

I have successfully completed my J2 semester. I made it out of my Women’s Health test – even though it was a crazy hard test – with an 88, which gave me a solid B in the class. I’ll accept that with glee! So that means that this semester, I made 4 As and 1 B.

I’d like to say that I’ve been relaxing ever since then…

But I really haven’t. I have been going going going since finishing a week ago and I’m afraid I’m going to just keep going in that manner until school starts again. I had no idea running an organization was so time and labor intensive. It’s been good though so far, especially since I feel like I’ve learned SO MUCH in such a short amount of time about nonprofit organizations and everything involved in keeping one smoothly running.

I woke up this morning to an email that let us know that our clinical sections had been uploaded to Blackboard. I’m so excited about where I ended up:

For Child Health Competencies I’m at Children’s Medical Center

CMC

 

And then for Adult 2 I’m at St. Paul University Hospital, which is one of the UTSW hospitals.

coats-stpaul-large

 

For Mental Health I’m at a place in Arlington I’ve never heard about before. I’m sure it’ll be a great rotation though!

 

And there you have it; that’s my nursing school news for now. Hopefully here in the next few days when I’m not working or volunteering or trying to wrap my head around this organization, I can relax and enjoy some of the Christmas Cheer going around.

Merry Christmas!!!!!!

J2.9

I’m getting very un-creative with my post titles. But yay for the fact that I’m done with my 9th week! I now have only 6 more weeks of actual coursework left. Crazy.

This week I actually get quite a few days off in a row where  don’t have to be anywhere school related!! Yesterday (Thursday) I ended up getting all my homework done for the weekend, and then completed ALL quizzes for another one of my online classes (groups). Now I’m done with all the quizzes for aging and for groups. I would’ve done all my research quizzes also, but we aren’t allowed to complete those early.

Today I’m going to try and finish all the case studies and pre-clinical paperwork for the remaining two women’s health clinicals…and maybe, for once, I’ll be able to completely enjoy my Saturday tomorrow without ANY schoolwork to do. That’ll be heavenly.

This past Wednesday the Senior 1 faculty came into our women’s health class to give us a “preview” of our Senior 1 schedule. And next Wednesday they’ll come in and give us the paperwork to fill our our clinical preferences for next semester. Which is all cool and exciting, it is, but what I’m really stunned by is the fact that I’M GOING TO BE A SENIOR NEXT SEMESTER. Whaaa??? I mean, I knew it was coming, but to actually get paperwork with the header “Senior 1” on it is just SO UNREAL.

senior

 

J2.7

Well I’ve made it through the seventh week of J2! Which means I’m approximately 43% finished with this semester. Whoop!

I’m going to bullet point this update so that it doesn’t end up being too long:

  • I made an 86 on my first Women’s Health test last week. Not bad, especially considering I studied maybe one full day.
  • I was in the Women’s ER at Parkland this week for OB clinical. It was such an awesome experience. According to the nurses it’s not quite as crazy as Parkland’s main ER, but it did open my eyes up to the possibility of working in the ER and I have to say I can truly see myself enjoying it.
  • In the above-mentioned Women’s ER, I got to start my first IV!! It wasn’t a complete IV start since I hit a valve and the nurse had to re-start the IV in the wrist (the woman was severely dehydrated) – however I did get blood return and was actually able to draw blood from the vein for labs so I still consider it an IV start. It is just really difficult for me to coordinate my hand movements as I put in an IV…I never thought it would be so hard! It definitely requires hand dexterity.
  • I know I haven’t written anything about it yet, but my Adult 1 clinicals are going well. I am taking care of two patients this semester every week, and while it’s a bit more of a challenge as far as time management, I’m still not able to practice within the full scope of a nurse so I find myself with a lot of down time on my hands. I end up talking to my patients quite a bit which is awesome, but I’m really wanting to get some more skills experiences! Next week though I shadow in the OR so I’m pretty excited about that.
  • I am running for the presidential position of my nursing student association at TWU, and because I am running uncontested, I have unofficially gotten the position! It will be official on the 21st; I’m super thrilled about it. 😀
  • The Mayo Clinic Summer III summer externship applications open on the 15th and I will definitely be applying! I’m afraid to get my hopes up for the job but at the same time I’m REALLY REALLY hoping that I’m one of the 100 chosen. I will have to write a couple of really great essays!!
  • I will also be applying for the UTSW summer externship and the VA Residency externship for next summer as well. If you couldn’t tell, I really want a summer nursing externship! I know they are great opportunities to get much more experience and I want to do everything possible to have an edge up before I graduate as a new nurse.
  • I have my second Adult 1 test on Wednesday…so I guess it’s time to start studying. Especially since I work on Monday so there’s one less day that I have. We’re covering Diabetes, Respiratory, and Neuro though so I’m not feeling tooooo worried. Hopefully that doesn’t come back to bite me!