Nearly-Flying Colors

For crying out loud people, OCCLUDE THE TUBING when giving an IV push medication!!!

Today was my medication administration CPE.  Goodness - four weeks into the semester and we're already having one of our most major practical exams!  How many times did I go over the requirements of that CPE?  A lot!  I even highlighted the little things I was afraid to forget because I was so focused on the medications...

When giving an IV push medication into a primary tubing, you should always occlude the upsteam tubing so the medication goes directly into the vein instead of back up into the tubing.  That is why it is ordered IV push NOW instead of infusion over a certain time period.  This little bullet point was indeed one I had highlighted...and still forgot.  But I bet I don't forget it again!

Luckily, there were critical skills that, if missed, would result in complete failure of the CPE.  Occluding the tubing was not one of those critical elements (although it probably should be).  I still passed my exam - did everything else exactly right!  WHEW!

So relieved to be finished with that.  And I have officially been declared safe to administer medications to patients.

On a totally unrelated note, the season premiere of Grey's Anatomy is tonight!!!!  Therefore, I will be glued to the television for an hour with no thoughts of studying for any of my classes.

Yep, I'm an addict.

Role Models

There are many reasons I chose to go back to school and to pursue a career as a nurse.  Today, I would like to give a shout-out to a couple of people who have been very influential and encouraging to me on this journey.

I worked with these two nurses at the cancer center where I was employed prior to starting school.  To me, these two women epitomize nursing as a combination of art and science.  Not only are they incredibly smart, skilled and educated, but they are two of the most caring and approachable people I have ever met.  They are my role models - in patient care, in work ethic, in teamwork and collaboration (and on a side note, in future parenthood!).  These two women have been so kind and encouraging to me in the process of applying to school and pursuing my career. 

I only hope that someday I can be half the nurse they are!

These pictures were taken at my going away party!

I was very sad to be leaving this group of people...

There are many other people that have influenced me in my journey as a future nurse - the doctors, nurse practitioners, nurses, pharmacists and other professionals I have worked with - not to mention my wonderful friends and family!  Still, when I think of the examples that I would pattern my practice after, Susan and Leesa are those examples. 

Thank you I love you guys!

You are in charge of your feelings, beliefs, and actions. And you
teach others how to behave toward you.  While you cannot
change other people, you can influence them through your
own behaviors and actions.  By being a living role model of what
you want to receive from others, you create more of
what you want in your life.

Eric Allenbaugh

You've got to be careful whom you pattern yourself after
because you're likely to become just like them.

Rich Mayo

Time MISmanagement

As I have probably mentioned in earlier posts, I have very poor time-management skills.  It's not because I haven't been educated on the subject, it is simply because I am easily distracted and if there is something slightly more interesting than the task at hand, I WILL PROCRASTINATE!  There are a myriad of things that occupy my attention ahead of learning classes of antibiotics (e.g. the cooking channel, my various crafts and creative projects, my FACEBOOK addiction...)  Then there are two "things" that can occupy more time than any of these. One you have already met, and that is my Faithful Fluffy Friend, Lena, who insists on being outside every two hours while I am awake.  The other is this guy.

Luckily for me and my time management, he has been in the mountains hunting elk for the last week.  I had weekly exams in both Fundamentals and Pharmacology, then Thursday I have a pass/fail medication administration practical exam.  STRESSFUL!  It has been much easier to study with him out of the apartment for a few days, as he can be quite entertaining and therefore distracting when he is here.

I do miss him though.

Clinical Insights

Today was day number two of our two-day clinical placement for Fundamentals.  My group was placed at University of Colorado Hospital on the Neuroscience floor.  I LOVED IT!  Even though we were doing the work of a CNA (which I am quite familiar with) we got to see patient care, medication administration and procedures from the viewpoint of an RN.  We had a lovely and smart clinical instructor originally from Belarus who challenged us to be very involved and allowed us to work closely with our patients and the staff of the unit.  We were able to observe a tracheostomy tube being removed by a respiratory therapist, and we got to feel a man's brain through his scalp because a section of his skull had been removed to relieve pressure after a head trauma. 

I DID have to remove my nose piercing as per clinical policy, and I decided that maybe it was time to just get rid of the thing and move on instead of trying to put it back in.  It feels so strange after seven years!

I think that hole might be there a while!

**Also, I will never leave the house in my black CU scrubs without a lint roller to remove the white dog fluff that seems to surround me constantly.

We were each required to do a physical assessment of our patient, and since it was a neuroscience floor and all of our patients had varying degrees of neurological injuries, we had to include a neuro assessment.  I was nervous, since I hadn't practiced assessment since last semester, AND had never practiced on a real patient.  Now I was expected to do one of the longest and most complicated physical assessments off the top of my head?? 

Well it went fine.  I remembered all but one thing, and was even commended by my instructor for what a thorough job I did assessing and communicating with my patient.  She actually said that if she had had time to bring the rest of the class into our patient's room, she would have asked them to observe my assessment because it was exactly what she was looking for.  I don't mean to boast, but her kind words made me feel very good and boosted my confidence in my skills so far.  I know that I am a good communicator, and I am blessed with a good memory which is incredibly useful in certain situations, but it always feels good for that to be reinforced.

It also reinforces my feelings that I am exactly where I'm meant to be.  I love working with patients.  The theory and practice of nursing that we learn in class and in lab is very interesting to me, but it is the patient care that I love.  My patient was a very interesting man who allowed me to be a part of his life for just a little while - just long enough to know part of his story and for him to become part of my lifelong learning experience.  However, for that little slice of life I am grateful, because it is the patients and the human-ness of this profession that make me want to be a nurse!

P.S.  Being on that unit for two days in the midst of nurses, medical residents, pharmacists and pharmacy techs, attending physicians, nurses, CNAs, respiratory therapists, and a myriad of other healthcare professionals, I realized just how important the role of a nurse is in the treatment and daily care of patients.  Everyone relies on cooperation and input from the nurses, but perhaps none so much as the residents and physicians!

After two days in the hospital, I took a turn for the nurse.  ~W.C. Fields

Thoughtful Uncertainty

The pharmacology exam went well - very well, in fact.  I only missed one answer (who knew that cocaine has a medical use and is not a schedule 1 controlled substance??), and I got full credit for a five-point extra credit answer.  Yay!  Dr. Sampson assured us, however, that it was his "getting to know you" exam and that the next one would be much more challenging.  Yay. 

I can't wait until we have to start memorizing drugs (she said sarcastically complete with eye-roll).  Some of my classmates already have drug books that look like porcupines with colored tabs to mark important pages.  Over-achievers!  I don't even know what is important yet!  I have however begun a very meaningful relationship with this pretty little book that can be used as a reference during exams, complete with abbreviations, brand and generic names, and measurement conversions.

Ta-da!!!

Since I survived the Pharmacology exam, it's time to move on and prepare for tomorrow's Fundamentals lab.  It's a FIVE HOUR LAB starting at 7:00 AM and drilling us with the different skills we will need to torture...I mean, treat...our patients.  We are required to wear our black "nurse-of-death" scrubs (as described by one of my classmates) embroidered with the CU emblem and properly identifying us as STUDENT nurses.  We practice different clinical scenarios and stick needles into self-healing gel pads in hopes that it will be something like the real thing.

As simple as this sounds, there is quite a lot of required reading in preparation for class, and so far has demanded most of my study time, which has really become the equivalent hours of a full-time job.  My fluffly little friend, Lena, is less-than-enthusiastic about my class and study schedule, as she thinks we should be spending this time together running and playing outside.

Please go outside with me.

Are we going outside?

Bored.

Bored.

Only a year to go, my love!

I realize that I can get as much education out of my time in the nursing program as I choose to take from it.  I am trying to take advantage of that and really take my studying seriously, but as you know, I am really good at distracting myself and procrastinating.  I hope that by using this blog to reflect on my studies and to remind myself of my responsibility in this, that I will stay motivated and focused on the goal - to be an educated, professional nurse with the ability to think critically and provide the very best care for my patients.  I know I won't be an expert right away, but I know that I can arm myself with the tools I need to be successful in the future.

Education is man's going forward from cocksure ignorance to thoughtful uncertainty.

Kenneth G. Johnson (1922-2002) American educator, semanticist.

Pharmacoholic

“Nurses dispense comfort, compassion, and caring without even a prescription.”

– Val Saintsbury

Tomorrow brings my first Pharmacology exam/weekly quiz.  And despite the sentiments in the inspirational verse above, Dr. Sampson has assured us that we will need to know pharmacology and the prescription process very intimately before we enter the workforce as nurses.  Therefore, today is devoted to the study of Pharmacology.  I have a sneaking suspicion that much of this semster will be devoted to the same.

My newest friend.

Does anyone have tips for making drug cards?  It was recommended to us by our professors, but I wonder what information will be most useful to squeeze onto a 3x5 reference tool?

Procrastination Party!

I hate housework.  But it's amazing how many things that I find HAVE TO BE DONE before I can start my homework or studying.  I should have taken advantage of yesterday and today to review my notes from classes...but instead I did laundry and dishes and cleaned the kitchen and ironed some things and organized some things and watched a John Wayne movie that I've seen a thousand times.

I just started my second semester of five in a BSN program.  At the end of my first week back after summer break, the procrastination has already begun.  The weather has been GORGEOUS here in Denver for the last couple of days and I have just found things other than Pharmacology, Nursing Research and Fundamentals of Nursing to keep me occupied.  I don't think I will get away with it much longer.  My semester is about to get much more involved I think.

Only a week in, we've already plunged into the material!  After drilling us about patient safety, medication errors and recent Institute of Medicine reports on both, we've already learned the rules of medication administration and practiced (on inanimate objects) giving subcutaneous and intramuscular injections.  Fun!  However, I am really not a fan of needles myself, and it makes me really nervous to think about sticking one into someone else!  I want to be helping people, not hurting them!  I guess in the long-run, that is the outcome.  Besides, I'm sure the pain of a routine vaccination is nothing compared to starting an IV, which is the next skill we learn.  The IOM reports also make me worry about the frequency of medication errors, and I think it must be really easy to do - but I don't want to be one of those statistics!  So much to keep in mind...

Back To School

When I was little, I wanted to be a veterenarian.  I was always attracted to what it was about the practice of medicine (in animals or humans) that combined art with science - two of my favorite things!  As I grew in age, I also began to grow out of my shyness, which allowed me to enjoy meeting and working with members of the same species.  I realized that animals could not tell you what was wrong or what was hurting, and I could only imagine feeling frustrated and helpless in that career path.  So I decided to be a doctor - a MD - a human practitioner. 

After graduating with my first Baccalaureate degree in Biology, I decided that I really needed some experience before I could make that decision.  I worked in a small outpatient oncology clinic for over four years.  It was there that I found what I believe to be my calling.  I found a couple of nurses there who were terrific mentors to me and really opened up my eyes about patient advocacy, patient safetly, and quality patient care.  I realized that having that hands-on interaction with the patient is really what I desired, not just to be the one prescribing their medications.  Please don't get me wrong...that is not all I think about physicians (especially oncologists!) but I have oversimplified to make a point.

So here I am, five years after my first college degree, in school again for my second Baccalaureate - this time in nursing.  It took me a long time to get here, and each day that we learn a new skill I am not without doubts and reservations about whether I will good enough for my patients, but I finally feel like I am in the right place - like this is something I could do for the rest of my life.

Life is a succession of lessons which must be lived to be understood.

-Ralph Waldo Emerson

Be well.

First Blog Ever!

In the process of designing my new blog, I asked myself more than once why anyone would want to read whatever I write here.  The purpose of this blog is to be a record of my journey and the lessons gathered from my latest challenge - nursing school, as well as being a self-discovery tool as I am at the point in my life where some crucial decisions will have to be made.  I think that I am not alone in these processes and challenges, and therefore might have someone with which to share my experiences, or with at least to commiserate.

So anyway, here are my random ramblings.

So long, be well.