ANXIETY

It's the night before a big exam that I'm not real confident about...so I'm anxiously awaiting tomorrow.

It's also a night where there is an Armageddon-like line of storms headed my way...the kind of storm system that amateur meteorologists have been "OMGOMGOMGOMG!!  This is gonna be IT, folks!!" all. week. long.  And tonight...not any better!
 
(as a side note there:  I appreciate that folks are interested in weather and learn about meteorology and all...but do you see the professional meteorologists in the media doing this kind of thing?  No?  Well maybe that's because in their training, they learned to keep a poker face on and know that freaking people out days in advance doesn't help a damn thing.  I would love to ask those people if they want their doctors and nurses to be running around their room freaking out when they get their test results?  No?  Well then use the same caution/common sense with your knowledge.  Give the info, but no need to sensationalize.  Thanks.)

So tonight?  Take my usual test anxiety, add in a lot of freaking-out storm stuff, and you get an absolute mess of a person who is exhausted but can't sleep, who needs to study but can't focus, and who has such abdominal distress that I swear I am going to puke.  I'm thankful at this point that I had only a bowl of cereal for dinner...it will be less to puke up.

Changing gears a bit to help take my mind off impending doom...

School has been keeping me busy but going fairly well.  I'm kicking butt on my busywork assignments -- journal entries for Community clinicals, nurse notes for Assessment, weekly quizzes...  I have this big TNI exam tomorrow, plus a major project due Tuesday (Finished! Just have to turn it in!) and a skills evaluation on Wednesday.  This is a big one -- medication administration.  We're hearing horror stories about this one, that no one passed it the first time last semester.  I have been running the whole scenario in my head over and over again...cementing the procedure into my memory, learning to make it second nature where I don't even have to think about it.  I so want to pass this one the first time out!  I need that confidence boost after being shaken over that first exam a few weeks ago.

Learned something new this past week (well, I learn something new just about every day, nursing-wise) -- CARE PLANS.   Oh yes.  I now have the basics on the lovely, time-consuming thing that is the Nursing Care Plan.  We have to do 1 full care plan on one of our clinical patients sometime this semester...but next semester, we do care plans like every other week.  I cannot tell you how excited I am about this!  {sarcasm off}  All that aside, they don't seem *too* horribly bad...just time consuming.  Of course I say that now...

Found out my HepB titer still showing low, so I had to get yet another HepB vax over the weekend...sporting a very sore left deltoid.  5th one over my lifetime, 3rd one since October.  They're going to have me get a 6th one in August and then do a titer check after that.  If I don't show antibodies then, I will scream.  I'm tired of being a pincushion!

That's about it for right now -- doesn't sound like much, but I swear I am constantly reading or making notes or researching or doing some kind of school something!  But my saving grace for right now is that Spring Break is in 2 more weeks.  Not going anywhere, and I'll have work to do over break, but a full week off from classes and having new stuff added to my plate sounds *heavenly*

Alrighty...weather is knocking on the door, so I'm going to sign off for now and keep a close tab on the situation.  Hoping I can get to bed soon...so I can then turn around and get back up in less than 2 hours.  I am going to be a real treat tomorrow.  Maybe someone can start me on a caffeine IV so I can somewhat resemble a human...

Have a Happy Monday.  Cheers  :-)

An eye-opening experience

I mentioned in my last entry that I was going to our town's free clinic for my Community Health clinical this week.  I was there for most of the day Thursday and really enjoyed my experience there.  They're a small clinic and are mega busy, but pretty darn efficient.  The staff that I met were great...very friendly, very receptive to a newbie observer taking up space and their time, even though they often met themselves coming and going.  The 2 RN's I met that day...well, one of our TNI lab supervisors said something once about certain skills that RN's don't typically do, but they're not below an RN's realm...yeah, the 2 RN's at the clinic that day, there were no skills that were below their realm.  They saw patients, gave shots, filled scrips, handed off meds, educated patients, took phone calls, called in scrip refills, made follow-up appointments with other providers, cleaned the rooms between patients, charted, filed files, assisted the PA...they did it all.  And unless they took a quick 5 minutes to inject some nutrients into their veins, I didn't see either of them take a lunch break.  They were ON and going the whole time I was there.

But that was not the eye-opening experience to which my title refers...

In classes...and in the news...and just about everywhere you look/hear...you'll see/hear stats about how prevalent certain medical conditions are in the US.  That our diet and sedentary lifestyle put us at risk for diseases like hypertension, hyperlipidemia, type II diabetes, and others.  I hear the stats, I see the news stories, and knowing what I know about the patho behind these diseases, I believe it.  But until Thursday, I had not really experienced it.

Going off my personal medical status and the general medical status of my family...we don't have those diseases.  Some of my elderly relatives are on HTN meds and are told to watch their cholesterol levels...but that's to be somewhat expected based on their age alone.  But myself, for example...at age 34, I'm not overweight, no HTN, no high cholesterol, no sugar issues.  I (mostly) eat right, I get out and exercise, I keep track of any health issues that pop up...essentially, I take care of myself.  Now that's not to say I NEVER have sugar or fried foods or caffeine...because I certainly do (too much of it lately, I admit).  But I recognize when I've been not-so-healthy and then I make adjustments accordingly to get back on track.  I can say the same of my husband and kiddos, my sister, my parents, and several members of my extended family.  While we're not perfect, we do take care of ourselves.

I observed the triaging of about 15 patients at the clinic on Thursday...and I was quite surprised that maybe 12-13 of the 15 were on medication for not just one, but often all 3 of the diseases I mentioned above.  Their scrip lists were populated -- Metformin, various statins, ACE inhibitors, and beta blockers, HCTZ, potassium, plus several on Proventil and Advair.  One patient was on 14 different meds!  Little naive, living-in-a-bubble me was floored.  Seeing the same drugs over and over again, patient after patient, the only difference being the start of the drug name -- -statin, -olol, -pril...-statin, -olol, -pril...-statin, -olol, -pril...changed this statin for that one, taken off metformin and put on janumet...and so on.

I know genetics plays a role in some people, that they can lead a perfect life regarding diet and lifestyle, and still require meds for "preventable" diseases...but I have a strong hunch that many of the patients I observed that day were not in that category.  They could probably reduce or eliminate the need for many of those meds if they made some lifestyle changes...but I saw no real desire to do so.  Most were overweight, most were smokers, most probably don't eat too many fresh fruits and veggies (OK, that one was an assumption...but it's based in reality).  It's easier to take a pill (or 5) than to quit smoking, eat better, exercise more...??  And like I said, I know that is common...plenty of people want a quick fix to the superficial problem instead of looking for a deeper fix for the entire issue.  People demanding antibiotics for viral illnesses, taking Tylenol for slight fevers...don't let the body take care of itself, no, throw drugs at it and fix it yesterday.  It's common...but also sad.

OK, so that got a little soapbox-ish there.  But yeah, the main crux of this entry is my being a bit surprised at my first experience with a medical reality.  I suppose I better get used to it...but at the same time, I hate having to get used to it.  Because that means that many people would rather depend on "unnecessary" medications to keep them alive and somewhat healthy and functioning, than to make some health-based changes and stay off the meds.

Welcome to the medical field, newbie.  You're in for a bumpy ride as your naivety is continually de-flowered.  :-)

Crap week followed by a good week

OK, I've had my one really crummy, horrible, no-good, very bad week for this semester.  No more.  I've met my quota.

So yeah, last week...I just want to forget about.  Just write it off, pass it by, never think about it again.  First exam in TNI...didn't do so hot (damn NCLEX format questions).  First SRAT in Health Assessment...didn't do as well as I would have liked.  Snow Wednesday night canceled Community Health clinical Thursday...had to have a make-up rescheduled.  Various issues with people...nothing major, just little things adding up.  By Friday, I was ready to hide in a corner and rock back and forth while sucking my thumb.  Or hide out in a cave for awhile while waving a white flag of surrender.  Something like that.

But this week...mostly a different story.  Not absolutely perfect, but turning out to be much, much better.  Did well on both exams this week -- first Community Health exam (92%), first med dosage calc exam (93%).  Got back first Nursing Notes assignment and she said I did very well (that coming from a very picky instructor!).  Had a good TNI lab today, learned how to prep and admin oral, subQ, and IM meds -- including various role playing scenarios with our instructors (side note: I love working with both instructors in that lab.  They are so cool and laidback, while being real and honest with us and making us think.  Plus we have a bit of fun here and there.  I hope we hang on to them the next 3 semesters!).  Actually have Community Health clinical tomorrow...my assigned site for this week is the only free clinic here in town.  Not sure what to expect, but I'm betting it will be an interesting day.  And I'm keeping on top of my To-Do list...checking off reading, online quizzes, assignments, online modules, and any other stuff that needs to be done.  I roughly know what's coming up next week, what I need to focus on, pay special attention to, remember.  I'll be damned if I let something sneak up on me this semester!


Before I sign off and go write up this week's nurse's notes...any seasoned students or former students -- do you have any tips for learning to think the proper way to be successful at answering those stupid NCLEX format questions?  Is this something that will come to me the more I practice, or because I'm struggling now, does that mean I'm doomed..?  Please...give me some hope...

Two more days, kiddies, then it's the weekend...we can do two more days!  :-)

First hospital clinical!

It went well...pretty much what I expected, and at the same time, not quite what I expected.

Because our class is larger, we're split into 2 clinical/lab groups.  My group was assigned to one of the general med units.  We made our way up with our supervisor and waited as a group in the hallway as he checked in at the nurse's station to see what we'd be doing for today.  As it turns out, we were on bath duty...which didn't really surprise me, because we gotta start somewhere!  We were all a bit nervous, so we convinced him to let us work in pairs (and some of us added a 3rd person for additional manpower) and were assigned to different patients.  The patient my partner, A, and I were assigned to was on respiration precautions, so we were required to not only wash hands and glove up, we were in gowns and masks as well.  We confidently gathered our bathing and bed-making supplies, and headed on in.

We introduced ourselves, just as we'd practiced with the dummies and each other in lab, but it was much easier talking to a real patient.  Our patient was very sweet, but also very sick.  Bless her heart, she put up with A and I pestering her for almost an hour.  It took us that long to get her bath done and her bed changed, because we had to take frequent breaks for her sake.  She never complained, but I think we wore her out.  After we were finished, we changed the TV channel for her, put her call button at her hand, and left her to take a nap.

After everyone was finished, we retreated to the unit's breakroom with our supervisor and rehashed what we'd done and seen.  I think we were all not surprised at bathing duties, but at the same time, some of us were surprised that we were allowed to work with such frail and fragile patients.

So I've been checked off on vitals, bed baths, bed changes, am learning how to do various body region assessments, and have completed 1 clinical where I had an actual patient...but yet I still feel like I'm playing dress-up when I'm wearing scrubs and my name badge and have my stethoscope around my neck.  I'm assuming that feeling will go away soon...but for now, it's totally there  :-)

So...I survived my first TNI clinical, didn't hurt anyone, or do anything so grossly wrong that I got banned from the unit.  I'd say that was a good day!

And now I get to spend the next few days studying for my Community Health exam and my 1st Med Calc quiz, both on Monday.  Nervous!  Not exactly sure what to expect for Community Health.  And Med Calc being math, and math being so much *not* my forte...yeah.  I'm going to review practice problems after reviewing practice problems, then review some more practice problems.  I have 3 chances to pass...and I want to pass the 1st one so I don't have to deal with it...at least not until next semester.

Happy Hump Day...it's all downhill to the weekend!

Procrastination at play...so here I am

So I'm really supposed to be studying for my first TNI exam on Monday.  I really *should* be studying for my first TNI exam on Monday.  But I'm not.  Just can't quite make myself get into that proper mindset yet.  Dragging feet.  So I'll yak about my week instead.

• ATI Critical Thinking test -- still not sure what this means, but we all took this test this week.  It wasn't too bad...think SAT/ACT-like questions.  We got our results immediately and out of the 6 areas, I do very well in 4, and not so well in the other 2.  I got 100% in the 4...then a 55% in inference and a 75% in explanation.  The inference I can kind of see...but explanation..?  I used to be a teacher...and I thought I'd been able to explain things fairly well...?  *shrug*

• Assessment lab -- got to do a mock skin, hair, nail, and ears assessment on my partner, complete with using an otoscope for the first time.  Our instructor went around and checked us off on blood pressure...and I passed!  

• Went through the rather dull computer training, so we can now use the computer system at the hospital to input patient info.  In theory, anyway.  Hoping my first time out I will have lots of help.

• Community clinical -- first time out.  I was at the county Health Department in the WIC offices, although I didn't end up doing much with WIC.  The nurse I was assigned to is the department's TB nurse, so I ended up seeing a lot more TB stuff than WIC.  I feel like I learned quite a bit regardless.  I also went to the Family Planning clinic to sit in with a couple appointments (one of my classmates was with them for the day and thought I needed to observe a couple procedures)...that was really interesting!  I'm assigned to the Family Planning clinic in March and I'm looking forward to going back.

I had lots of paperwork to do this week...and I'm glad to say it is all finished and ready to be turned in next week.  The only thing I have to do is study.  I've got most of tomorrow -- I have social plans during the day and later that night *squee* -- and all day Sunday.  I think I'm going to just throw in the towel and head to the local college library so I won't be tempted to watch the Super Bowl.

Alrighty...I suppose I procrastinated enough.  Guess I better do at least some studying...boooo

Happy weekend, y'all!