Wednesday, December 30, 2009

Pedi in a nutshell

I finished pediatrics with flying colors! I think that rotation confirmed that I like kids and I want to work with them. They are small (to better lift you with my dear), compact (to better bathe you and change your sheets my dear), and they have a support/babysitting team right there at all times (to better have all of your basic needs taken care of my dear). It's a good deal.

The rotation at the hospital was fun even though they made no indication of what our role was. I gave a few medications, helped do a few procedures, and changed lots of beds, but not a lot other than that. I did a rotation in the IMC and PICU which was really interesting. They never let us do that stuff with adults for some reason. I worked with mostly young nurses but also a few seasoned ones. I never felt like an intruder like I sometimes did at all of the adult facilities.

I did do a rotation at a clinic in Cedar Park. That was merely OK. My preceptor had apparently had a horrible student the rotation previous to mine so she was a little jaded. The student had, according to her:
1. Spent the whole time texting and playing on her phone
2. Told the preceptor that she didn't need to do any of the work because she was planning on going into critical care
3. Sat in the doctor's chair/work space area and didn't take hints that she needed to move
4. Taken a two hour lunch
5. Done about a million other appalling things I couldn't believe.
The preceptor was so pissed that she talked to the student's instructor for 45 minutes and asked that the student not return for day 2 of the rotation. Damn. That is one overdeveloped sense of entitlement.

This made it easy for me, of course. All I had to do was take initiative and act interested in the work. I had it made. The second day I had a preceptor that was too busy calling her lawyer and spying on her soon to be ex husband online to care too much about what I was doing. I practiced drawing blood in the lab and gave about 15 Tdap shots. Yes, ladies and gentlemen, it doesn't get much better than this.

After that we had a rotation doing school nursing. My preceptor was extremely nice and easy to get along with. She was a PICU nurse for 17 years and then had kids, so she decided to do school nursing. Shifted gears a little, you could say. One of the kids came in like three times in two days, so we had to call his mom. The teacher who had sent him apologized profusely. "I didn't know he had already seen you today," he said. "Kids are such whiners these days. When I was a kid, going home was a punishment. You were on a god damn lock down in the house. No games, no TV, no nothing. If I was too sick to go to school, I was too sick to do anything but lie in bed. Damned wussy kids." He was, needless to say, awesome.

The last semester of undergrad is upon us! I feel old.

Also, I never thought I'd say this, but I HATE lying around and not feeling productive. It's really hard.

Tuesday, October 20, 2009

Opportunity?

Does this look cool at all?

http://www.kff.org/minorityhealth/bjscholars/index.cfm

Definitely thinking about it.

Piss and Vinegar.

There are few things in this world that are more awful than orientation. Humans just aren't built for a whole day of lecture. It's not right.

So far, we have had five orientations since the beginning of nursing school in Fall of 2008. I remember the first one. The instructor assigned to lecture our class would trail off about her daughter's (Star Wars themed) wedding. This was for three straight days. Gag me with a blender.

This past orientation wasn't much better. We had a two hour lecture on child abuse today, complete with pictures. It was necessary, but really, really sad. Then we had a hour about what we talked about yesterday, school and community health. 30 minutes with the PICC team, 30 minutes with child life, and then 2 hours reviewing skills. It made me want to cry, honestly.

I really hope the pedi rotation is better than maternity. I am still awaiting my evaluation for that class. I hope I did well, because I feel like I really busted my ass trying to look busy all the time. I felt totally shortchanged and left out by that clinical. Other people saw multiple c sections, vaginal births, and interesting post partum patients. Not to mention they actually got to go to the nursery to bathe and play with babies. My turn comes and all of the sudden we're going home early. I'm not bitter or anything.

Sorry this is a huge rant. I'm just sort of pissed about nursing school in general.

Tuesday, October 13, 2009

No more...

Today was the last day of Maternity. Just as we were getting comfortable with the unit and the topics, we're done. My instructor decided that today we would just do our presentations and go home. Too bad it was my day to go to the nursery and play with babies. Awesome.

Thinking back on the whole thing just kind of makes me wince a little bit. More than half the time there were no patients, but when there were, we weren't allowed to do much with them. No giving meds, doing assessments, starting IVs, or anything else for that matter. Either the nurses didn't want us to do any skills or the patient didn't want us to do it. That and every thinking process I had was wrong because none of the patients were sick, they were just giving birth.

Everything is different in Maternity. They don't use the same abbreviations. They have strange flow sheets and charting. They only have 1 or 2 patients. They are really open about talking about their vaginas, poop, sex lives, etc. It's a whole other world in there that I'm pretty sure I don't want to be a part of.

Also, is it just me or are L&D nurses extremely opinionated?

Monday, September 21, 2009

Labor and Delivery

So far, Labor and Delivery has pretty much been a big snore. I have had exactly one patient who almost gave birth. The other few days have been filled with stories and explanations and endless amounts of droning about the finer points of L&D. I mean, it's not the instructor's fault that there were no patients the last two days in labor. However, wouldn't some sort of plan in case of this very situation comes up be extremely helpful? I think so.

I'm pretty sure L&D isn't my thing. It's a lot of waiting and watching. And vagina tearing. Being in lecture makes me cringe and squirm in my seat sometimes from all we talk about. It's not pleasant.

I hope it gets better soon. I don't want to be doomed to another few weeks of hating 2/7 of my week!

Thursday, August 27, 2009

It's not gangrenous if you were born that way.

Funniest chief complaint yesterday...

"Penis is black"

The child was African American. Grandma was worried.

Wednesday, August 26, 2009

Waste not?

Well, I guess it's a rather utilitarian way to go about it...

Most China transplants from prisoners: state media

Tuesday, August 25, 2009

Partial credit for participation...?

A while back...

ME: OK, she weighs 60 pounds
CHILD'S MOTHER: Is that normal?
ME: Let me plot it on the growth chart real quick
CHILD'S MOTHER: You know, because I don't want her to become obeast.
ME: I'm sorry?
CHILD'S MOTHER: I don't want her to become obeast and have health problems.
ME: Oh, I see. Well it looks like she's a pretty normal weight.
CHILD'S MOTHER: Well thank goodness for that.

Tomorrow, Tomorrow...

Wow, I have forgotten about my blog. Sorry.

Tomorrow is the first day back to class. I'm starting the lovefest that is maternity this semester. I'm not sure whether to be scared or excited, but I now know for sure that I'll have material to scare my little sister for years. She's afraid of female genitalia.

I guess it's better than my very first semester of nursing school. I remember my orientation very well. It was excruciating. I don't know if they do this in other majors, but they really like to give speeches about professionalism in nursing.

"When you're in nursing, you're not just a nurse. You're a professional. This means you are to act as a professional. Why, when I was in nursing school and we had to wear white dresses and caps, no imperfection was tolerated. In fact, I cried every day on my way to school. I peed my pants in clinical on a regular basis. Luckily, this gave me practice in dealing with incontinent adults! You will all exude professionalism OR ELSE."

It is quite tiresome. Top Chef is a lot like nursing: Everyone takes him or herself very, very seriously.

Wednesday, June 24, 2009

Apple cider vinegar

Today wasn't very exciting. I pale in comparison to the other exciting blogs. Working in primary care over the summer has its rewards, though. I feel like I'm part of the solution (prevention).

I guess I could tell a story about my experience as a student so far.

I did my rotation at a level II trauma center in the heart of the downtown area in which I live. I got to see a lot of cool post op trauma patients -- and a lot of homeless patients. It's the charity hospital, so they admitted pretty much everyone.

I was preparing for clinical the night before. We got to pick our patients, so I picked a guy with a gambit of medical problems, was a little bit crazy, and, you guessed it, homeless. He was nice enough when I talked to him, so I decided he would be a good candidate for the teaching project I had to implement that day.

I picked hypertension as my educational topic (it pretty much was the root cause of all his problems). I prepared a presentation, made a brochure for him, and told him I would be teaching him about hypertension the next day. My instructor came in to watch my do my teaching project.

ME: Mr. Jones, I'm here to talk to you about high blood pressure like we discussed yesterday. Is now a good time?
MR JONES: You mean I'm here to talk to YOU about high blood pressure, right?
ME: (laughs) Sure, I guess you can look at it that way. I was going to start by telling you a little about what causes high blood pressure.
MR JONES: (staring intently at the television) I already know that.
ME: Well, then consider it review. What causes high blood pressure is a mixture of family inheritance, sedentary lifestyle, and obesity. Part of what makes high blood pressure so hard to treat is--
MR JONES: I know what high blood pressure is! And I know how to cure it. I take apple cider vinegar. One time my blood pressure went up so high I took the vinegar and I passed out. I never let my blood pressure get up that high again. I take my medication for it every day. The lady at the jail took my medication away from me.
INSTRUCTOR: (confused look)
ME: Would you like to talk about your medications?
MR JONES: I know about my pills. I don't need to talk about my pills.
ME: Well, as motivation to take your pills I'm going to tell you a few things that happen when high blood pressure is uncontrolled.
MR JONES: I already KNOW. You pass out. That's why I take apple cider vinegar.
ME: Some other things that can happen is stroke, heart attack, and kidney failure.
MR JONES: Girl, you are tellin' me what's UP. You don't let a guy just sit around thinkin' he's OK until one day he has a stroke and BAM he's dead. You tell a guy what's up. You know what's up.
INSTRUCTOR: (wtf? look)
ME: Yes, that's why I'm here, to tell you what can happen if you aren't able to control high blood pressure. Here's a brochure I wrote up for you.
MR JONES: (looking at it in awe) YOU wrote this for ME?
ME: Yes, I did.
MR JONES: Wow, this is the SHIT. (Starts reading it aloud).
ME: Well, I'm glad you like it.

Weirdest shit ever. Oh well, he gave my professor a rave review even though he didn't seem to like me at all. He had his foot hanging out of the bed (had an ulcer on it) and I ran into it a few times. When I suggested we put the foot back into the bed, he flipped out.

Why do I always get the psych/medical patients?

Sunday, June 21, 2009

Lazy summer

Wow, it's been a long time since I've posted.

Well, I survived my second semester of nursing school. Now for the summer I get to endure three days a week up at the clinic.

I'm taking a class this summer called Complex Issues in Children. Most Depressing Shit Ever is a more apt title. We have to debate about whether parents' spiritual beliefs should have any bearing on medical decision making for their children (absolutely not, in my opinion), what should be in the curriculum for sex ed (everything), and dying babies in the NICU. Very uplifting. Oh well, I'm about halfway through so I guess it can't be all bad.

I wish I had something more exciting for you, but I guess that's reserved for HawthoRNe (You can't arrest ME, I'm a NURSE!! AHHHHH!!!!)

Wednesday, May 6, 2009

OK, so now there will be 9 morons instead of just 5.

I work at a pediatrician's office. It's fun most of the time, but all too often I feel like I need to scratch my eyes out or beat my head against the wall just for some clarity. Take yesterday for example.

Lady walks in with her 14-year-old daughter. Daughter just had a baby. "I don't know how it happened, but all of my daughters are pregnant at once!" Now, don't be fooled. That exclaimation mark wasn't in anger or disappointment. It was in delight, people. DELIGHT. Her four daughters range in age from 14 to 19 years old.

My co-worker was in the exam room taking a history. She got to the family diseases part and said "Are there any illnesses or diseases on either side of the family? That means your side and the father's side." The girl goes, "Oh, I'm not sure about the father. It could be two or three guys, I'm not really sure." The Mom chuckles and makes the comment "Oh, boy. I guess it's just going to be really tough to get a history!"

WHAT. THE. FUCK.

That abstinence only sex education is really working out for this state. I am here to prove it.

Monday, May 4, 2009

Already?

The birds are chirping, rainbows are sprouting out of the ground, flowers are blooming...it's the last day of clinical! I can't believe I made it, nonetheless with flying colors. No more waking up early and interrupting my precious, fragile sleep schedule on which I thrive.

I guess I'm ready to move on to S1. I just don't think I'm very good at skills at all. It's just a practice thing I guess.

One class down, four more to go.

Tuesday, April 28, 2009

Big Bad Bitch of the West

Today was a giant waste of time at psych clinical. We had a debriefing (read: recruiting session) at the state hospital. It was interesting. They must be really hard up for nurses if they're talking about health care benefits and paid leave to a bunch of nursing students. Anyway, they wanted to know what we thought about their fine hospital, the good and the bad. We went around the table first to say good things about the hospital, and everyone had something to say. I mentioned a few nurses that helped me out personally.

Then, however, they wanted to know about things that were "not so helpful or pleasant about the hospital." The room was dead silent. Crickets were chirping. I spoke up. "I thought a particular nurse, Jane, wasn't very helpful. She snapped at me and the other nursing student and didn't seem to want us there." Another girl said that the staff went through report way too fast, but other than that, I was the only one who said anything.

I couldn't believe it. People complained and complained until their mouths were dry and their faces turned blue when the administrators of the hospital weren't there, but as soon as they get the opportunity to voice their concerns, they act like it was the best experience of their lives to do clinical at this facility. This just pisses me off. Not only do I end up looking like a huge bitch for saying anything at all about my displeasure, but it's compounded by the fact that it seemed like no one else had a problem with anything. What was I supposed to do? She treated me crappy and I had no power to confront her about it, and they asked.

I don't know why I feel so bad. I just hate feeling like I'm the bad guy because I said my opinion.

Anyway, we then went on a tour of a private psychiatric hospital that also tried to recruit us. I guess psych nurses are in short supply. I haven't decided what type of nursing I want to do, so their recruiting was pretty much lost on me.

Monday, April 27, 2009

Day Number 29 of My Captivity

Today was a pretty eventful clinical day. There was so much doom and gloom, I can't believe none of my patients coded. Flash! Tornado watch! Swine flu! Mexican earthquakes! While I wouldn't go as far as to say it was exciting, I was on my feet pretty much all day.

Dentures Lady started to have some strange hypotension and dizziness, so I got to do an assessment and bolus her It was pretty cool that I pretty much figured out on my own what needed to be done. I need to be better about data collection, though, because I was asked all of these questions about labs about which I had no idea. I was just concerned about the 70s systolic blood pressure.

LIHB was having a very emotional day and her primary nurse wasn't doing much at all to help. She was having a lot of pain and a ton of anxiety about her discharge planning. The nurse just sort of blew her off and didn't talk to her at all even when she got tearful. Remind me to switch careers if I ever get to that point. I got to do blood cultures, though. That was an interesting process, but I don't know if I'll do it right next time I'm asked because the nurse had her "own way" of doing things. I wish she would have at least taught me the right way seeing as how I'm a student.

I get somewhat annoyed when some of these nurses take shortcuts and I'm unaware that they are, in fact, shortcuts. I do procedures and skills the way the nurse taught me at the hospital and my instructor gets upset when she sees what I'm doing. All I can say is that that's how the primary nurse does it, and that's how I thought it was done. Confusing.

Anyway, I got a compliment from one of the nurses on the floor about my confidence and how I'm going to be great at my job some day. Then, my patient complimented me on the way I drew blood because he was a hard stick. Then, my other patient complimented me on my blood drawing skills because she was a hard stick as well (history of IV drug abuse). People were giving me so many compliments it was a wonder my head could fit out the door.

Overall, a success. No one died (on my floor, anyway. That's quite a story for later on), no tornadoes decided to strike our little (big) hospital, no one had swine flu, and, best of all, we don't live in a 100 mile radius of Mexico city.

Sunday, April 26, 2009

Three?

Tomorrow I'm taking three patients on the Med/Surg floor at clinical. Can I handle it? I think so. Here's the lineup:

1. Lady I've Had Before. LIHB is pretty easy. She's got scheduled 'round the clock pain meds and IV antibiotics and a PICC line. Shouldn't be too hard just as long as she doesn't have another anxiety attack. Bring it on, LIHB.
2. Conversion Disorder Dude. The docs aren't quite sure what's going on with him. He came in for chest pain, but the EKG was negative. Now he's on a suicide watch. I love the built in babysitters! Easy meds and I will get to practice my Spanish. Oh, and don't forget, no silverware.
3. Dentures Lady. I walked in to introduce myself to DL and she said "There's something rather important that I forgot as we were heading out to go the hospital." I had no idea I would end up running over to HEB with her five dollars to buy denture glue. She should be pretty all right, she's just a little pathetic with her knee replacement and CHF. If denture glue will make DL happy, then gosh darn it, I will oblige her.

How does that sound? It can't get any worse than last week when I had Homeless Apple Cider Vinegar Dude. But that's a different story for a different time.