Sorry to my followers, if any, for being gone so long. Alot has happened since my last post. First of all, I didn't get the OB internship and that kinda bummed me out so I stopped blogging. But, alot has changed. I just graduated nursing school and have recently passed the NCLEX-RN and I now work in a surgical unit. Last week I took my first patient. I was so scared but I had a very successful day. Tomorrow will be my second day as a brand new RN so I will keep everyone informed of my transition from student to nurse..Check back soon :)
Sunday, July 11, 2010
Sunday, July 26, 2009
Okay, so I am not sure if ICU is for me...it was interesting to see that part of the hospital and what their role is in patient health care. I learned about the different "drips" and I also learned that alot of people are non compliant with keeping their blood sugar down. Every day I was there, there was a patient who was in for DKA..diabetic ketoacidosis. Most were frequent flyers, LOL. I did see alot of patients intubated and even had a hand in popping in NG tubes. I also learned about "art" lines and what purpose they have. An arterial line is usually inserted in the radial, brachial, femoral or dorsalis pedis artery. This is an invasive way of measuring one's TRUE blood pressure. Most blood pressure cuffs are designed to read blood pressure in a healthy individual and you would be surprised how wrong they actually are in measuring a sick patient. Dr. "R" was very student friendly and if I am ever in ICU, I want him to be my Doc, lol.
I also got to do chest compressions again. This time I was all up in the bed doing them. Poor guy didn't make it anyways. I don't really have much to write about this time. Certainly wasn't as interesting as ER or OB, but I did learn a few things. Co-workers were great also.
I am off for the next 2 weeks, but I did get an internship in the OB dept!! yeah!! not sure of my hours yet. Check back soon for my next post.
Thursday, July 9, 2009
Let me just start off by saying ER was extremely awesome! It really had me rethinking my choice to be an OB nurse. I was nervous at first but once I figured out where things were located and established rapport with the ER nurses and docs, things were great. I had to toss my fear of IV insertion out the window cuz I really didn't have much choice, LOl. I just had to go in there and get it done. I wasn't successful at every attempt, but I am no longer as scared. I can also pop in a Foley quickly and without a nurse there to guide me through it.
I did get to insert my first NG tube. That was cool. The guy was really dreading it cuz he had one before and knew it wasn't fun to have a tube stuck up your nose and down your throat. His family was in the room and when I was introduced as the student who would be performing this skill, the teenager in the room said in a condescending way.."Umm, just what kind of grades does she make in school, I don't know if I want her to do this or not..."LOl. needless to say, I acted like I had done this a couple hundred times and they never knew the difference.
Here is the part were things get interesting. It was a Wednesday and it was day #3. I had just gotten to work and things were quiet. All of a sudden someone is trying to get into the back where the ambulances come through. A few of the nurses go see what is going on and guess what, it's a trauma.. a real trauma. A man in his fifites was laying fence according to his friend that brought him. A 2 1/2 in steel pipe had landed on his head (not sure how though) and he was bleeding out his head really bad. He was pale and diaphoretic and shaking. He was complaining of neck pain so we got him onto the stretcher and immoblized his neck. Further inspection showed a huge laceration to the back of the head. CT comfirmed a skull fracture, and fractures to the neck and spine. We flighted him out an hour later so he could visit the neurosurgeon. When he left he was still able to wiggle his toes.
The rest of the day was filled with the usual clinic cases...toothache, arm pain, abdominal pain, fever..mostly drug seekers wanting pain meds. Sad, but reality.
The next day was my day in triage. That was kinda cool. By lunchtime I had gotten the hang of it. That evening I got to take part in a sexual assault exam on a little girl the same age as my daughter. It hit home and I really didn't know what to do with myself and my thoughts once I got home. I didn't realize how much this happens in my community. It is heartbreaking and I'll try to post on that at a later date, but for now, lets continue with my ER experience.
Friday was exciting. I was discharging a patient when it happened. The one thing that Iwas still afraid of.....A CODE BLUE...My heart started racing and I went to check it out. 85 yr old male came into the ER with shortness of breath, then he stopped breathing and a code was called. Doctors and nurses were cramped in a little exam room (not the normal trauma room) and I just kinda hung back in the corner watching and not wanting to get in the way. All of a sudden I was called upon to help with chest compressions..OMG, that was craaazy. His chest felt like one of those stress balls, you know the ones the you squeeze. His whole chest wall had caved in and ribs were broken. I couldn't quite go as fast as the other nurses, but thank goodness for that respiratory tech, he guided me through. I gave out pretty easily and someone relieved me. WOW, my first time to do chest compressions and I was actually apart of saving someones life. We got him stable enough to move him to the big trauma room. We had him on the ventilator and I was helping a nurse clean him up. He was an alcoholic and he had vomit all over him so we needed to get things straightened up for the family. He had a sister and niece and that was it. When we rolled him over, he started bleeding out his mouth. We suctioned and suctioned and he just kept bleeding so we got on order to hang blood. His family didn't want him to recieve blood after we had it started. We had no documention stating his wishes but they did at home. We couldn't stop the blood until they brought us legal documents. He would die without that blood. Just a little bit of an ethical decision to be made. He was alive when I left but he did pass on the next day.
Monday was exciting too. ER was busy. People were waiting in the lobby for 5-6 hours and they were unhappy. Can't please everyone, but when your here for your daily drug fix and we have people being brought through the back by ambulance, tough s**t. It is hard to be sympathetic when you see the same person 3 times that week for the same damn toothache. This is the ER, not a dentist office. We did have 2 more codes and they happened at the same time. In the same room. One made it and the other didn't. While this was happening we had someone having a stroke and we were trying to get them flighted off to the stroke center. 3 codes for me two days in a row. Chest compressions twice. I talked to a nurse over the weekend who has been one for over 20 years and she has never done CPR. Such a good learning experience I have had this summer.
I wrapped up my rotation with some grossness. 19 year old presented to ER with complaints of vaginal discharge after sex this am. Okay, that's just great. Doc does a pelvic and guess what he finds......a month old tampon. She was horrifed and I bout fell over from the smell. How does that happen? Guess it happens alot. Needless to say, her boyfriend was a little angry.
I will leave you with that and I am off to ICU next.
Sunday, June 21, 2009
Well, I wasn't too excited about this rotation. I felt that I was mainly in the way and kept myself busy by helping the aides. Like I've said before...I'm comfortable with that role. I did alot of DC'ing (Discontinuing) IV's and couple of IV starts which apparently Im not so great at. It was easier on OB cause those women were young and had good veins. Older and sicker people are more dehydrated and that makes it harder to stick. I only got 1 out of 5. I have got to get the hang of it and SOON!
I didn't get to do anything crazy but I did change a colostomy, remove sutures, discharge teaching, wound vac dressing change on a stage 4 pressure ulcer, a couple of other dressing changes that were minor, a couple of admission databases, discharge teaching, and I learned that I will NEVER be snooty to nurse externs when Im in charge (LOL).
Tomorrow starts my ER rotation. Kim said she liked it so Im excited to see some action. I hope I don't make a fool of myself though :-)
Check back soon for my ER post!
Sunday, June 14, 2009
OMG...I definitely want to be a labor nurse. I even like the postpartum and babynursing. I have never been more enthused about coming to work and working for 12 hrs. I did get to see quite a lot during this rotation. I worked with some excellent nurses too.
My first day on the floor was kinda crazy. I was taking a mom and her baby out the door to go home and while I was fumbling with the car seat they called for an emergency c-section. When I got back to my floor there was nobody to be found. When I finally got the go ahead to go back to the section things were still not looking good. Baby was out but it wasn't breathing. It had been nearly 3 min. I felt like a knot on a log because I didn't know how I could help. They sent me to find the other nurse who stayed on the floor with the rest of the patients and had me get some Narcan. When I got back with the med, baby was doing fine. Whew! I did not want to experience death my first day. Whe we took the baby back to the nursery we had to suction so I got to insert the NG tube and suction. The nurses had to draw ABG's which wasn't easy. It took 4 nurses to get the job done. The baby was a level 2 baby so we kept him in the nursery for the rest of my shift.
The rest of the day went smoothly. I got to "babynurse" a few babies. For those of you who don't know what that is it is when the baby is delivered it has its own nurse who does all of the stimulating and warming. They also do all of the measuring and weighing and the APGAR's at 1 and 5 min. The baby will also get its first meds.
During this rotation I got to see circs, sections, natural labor, vacuuming, a 15 yr old giving birth, and sadly a fetal demise. I also got to hear my first heart murmur. I become proficient at inserting Foley's, I started 2 IV's, did initial assessments, and triaged a couple of ROL's. I did all of this with a nurse by my side of course. I also got to bathe a newborn and help a mom push for 2 hrs. This was by far the best clinical experience I have ever had even though it wasn't a clincial day. I talked with the person in charge and hopefully I will get to stay on OB when my summer extern program is through. She said that due to the budget she will only have room for 1 or 2. I sure hope I get it because this is definitely the spot for me.
This week I am scheduled for a much dreaded med-surg floor. I am not as excited but I am sure I will learn alot.
Sunday, May 31, 2009
Tomorrow is my day of orientation for the nurse extern program. I am so excited to get back into the swing of things. Tuesday is my very first official day in Labor and Delivery and I could not be more excited. I am definitely looking forward to having a patient that is not elderly (no offense, I am just looking for a change and I LOVE babies!) I feel like this is a mile stone in my career as I didn't get into anything maternal in my previous experience in LPN school. That was my main reason for going into the healthcare field in the first place. When I graduated high school, I was a computer major....how freaking boring is that! I ended up quiting school and having a baby and decided to return to school as a practical nursing student. I quit that after a year (i was almost finished lacking 3 mo.) and had another child. That along with other circumstances which I will not divulge into on here kept me away from my dream. To make a LONG story short, I had one more child, moved, changed the way I lived and started my journey to becoming an RN. It has been a long time coming.
Posted by future RN at 9:03 PM
Saturday, May 16, 2009
I just wanted to say few things about my grandmother. She passed away on Mother's Day evening. I will miss her wittiness and her kindness. She was a very special woman and she was the only one who really understood me. I couldn't get anything past her. She knew exactly what was going on in this crazy head of mine. I am thankful for the last 6 months that I have had with her. My kids got to know her and will have some good memories of her. R.I.P Nene, I will always love you.
Posted by future RN at 10:27 AM