Field trip clinical...strange day

For our last Mental Health clinical, our instructor arranged for us to take a tour of an adult mental hospital, Western State Hospital, instead of going to the children's psych hospital here in town.  I've been looking forward to this opportunity ever since she told us, thinking a change of scenery would be nice, plus getting to see an actual psych hospital...you know, the big,imposing, grandiose brick facilities that you see on shows like Ghost Hunters and Ghost Adventures?  Yeah, that's Western State.

Western State Hospital, Hopkinsville, KY

We got there and waited in the main entry area.  I remember feeling fine, normal, not at all different (hmm, I'm giving myself away, here....read on).  We had to sign in, wait for everyone to get there, and then our instructor talked to the employee who showed us around, I'm assuming to give him an idea of what she wanted us to see/learn about the place.  As with most mental facilities, the doors between floors, units, areas, etc. are self-locking, and in the main entry/reception area, we were separated from the rest of the facility by locked doors.  As I said, I was fine, nothing out of the ordinary...but then we went through the first set of locked doors and into the actual facility...

We started out in an area that housed the offices of the social workers...an area that was once a patient unit.  As our tour guide was giving us some intro information, I started feeling...well, weird.  I can't really explain it...I was dizzy/light-headed, felt my HR increase, felt anxious and jittery, kind of hypervigilant...and almost like I was standing next to myself...or something.  Just an overall very weird vibe, strange mojo, but with a negative feeling...like something wasn't right.  I was dizzy to the point of having to make sure I was leaning against something, like a table or the wall.  I felt like this throughout the whole tour...except for when we left the main building.  When we went to a different building, I felt normal.  But once we went back into the main building, I felt odd again.  And no, no fresh paint, no new carpet, no cleaners...and no one else was having these symptoms.  Once our tour was over, I was ready to get the heck out of that building and get back into a positive area.  As soon as we stepped out of the building, I was back to normal again.  Although I felt very tired and was prone to just glazing over and thinking about nothing.

I had no pre-conceived notions about being there today.  I was actually looking forward to it.  I knew it was an old facility that had tons of stories associated with it, and as a history buff, I was wanting to hear the stories about the history of the place.  I also knew that many old hospitals like this are prone to stories of being haunted, and Western State is no different.  Our tour guide told us of various happenings that have been mentioned by staff.  While I believe that that kind of thing is possible, I'm not scared or freaked out or intimidated by it.  I have no plausible explanation for my reaction to being in the hospital...but my instructor and a couple classmates wondered if I was picking up the supernatural vibe of the place.  I know...science wouldn't back that up, science would have an explanation to what was going on...that I was subconsciously anxious, that I had low blood sugar, that I was tired...  But I went from completely normal in the entry area to feeling all weird after walking through a doorway, then would go back to normal after leaving the main building.  Hmm.  No matter what was going on, I know that I have *no* desire to go back inside that building.

So that's my adventure.  Other than struggling to make it through the tour, it was actually a good day.  :-)  Got to have some good chats with classmates on the way down and back, had lunch, got away from home and our regular clinical sites...

And now I must finish clinical worksheets and work on my psych careplan.  Buh.

5 weeks in...and I seem to have disappeared

I haven't, really...just been consumed by this somewhat demanding entity in my life that is nursing school.  The concept of insane busy has ramped up a whole lot more this semester...to the tune of spending at least 10 hours each week for my Med-Surg clinical pre- and post-work, not counting the 7-8 hours of actual clinical time on the floor.  And that's just clinical for one class...I have plenty of work for the other classes.  I've decided that if I didn't need to sleep or eat, I would have a lot more time to get things done.  Unfortunately, my overall health and wellness don't really go for that, at least not on a long-term basis.  And I now have better knowledge that "long-term basis" refers to more than 1 night of not sleeping at all, and probably 3-4 nights in a row of minimal sleep (like, 2-3 hours).  Nursing school educates you in so many ways!  *sigh*

Things are going pretty good.  I've gotten a few clinicals under my belt, getting more confident around my patients and providing their care.  Still not a fan of the content area, but Mental Health clinicals have been interesting, both at the childrens' psychiatric hospital and at the various sites out in the community.  I really can't elaborate much, but I will say that humans can really, really suck sometimes..especially the parents of these kids we see at the psych hospital.  Especially when some of the kids get to doing better at the hospital and are released back into the hellhole that is their normal lives, and end right back up at the hospital.  Hello, people, YOU are what's wrong with your kiddos.  :-(

Med-Surg is probably my favorite, despite the crazy workload and the...umm, tribulations...with the new instructor.  We're all still in the learning curve, trying to find the best balance...and that's probably all I should mention about that.  Loving clinicals despite the crazy amount of weekly busywork to do.  Our time on the floor has doubled from last semester, we're more involved in the direct patient care process (as skills allow) and we're actually getting to do some procedures other than passing PO meds.  IV meds -- usually PRN morphine into peripheral IV's, but one classmate gave some scheduled meds into a central line (and the meds this patient was getting q2hr would have killed a horse...and not only was she not knocked out, she was talking coherently and walking around the unit.  Umm, yeah, OK...), lots of blood glucose testing and insulin admin, plus someone pulled a PICC line, someone pulled a Foley cath...and I'm saving this one for last...*someone* (ahem...ME!!) got to put in an NG tube.  And I have to say it was pretty darn cool to do it.  It was a textbook insertion on a non-textbook patient...in that he couldn't follow directions to swallow on cue.  Regardless, I hit the esophagus and stomach on the first attempt and my instructor said I did an excellent job.  I didn't give PO meds that day, but I think the NG tube insertion more than made up for it.  That was a week and a half ago and I'm still all jumping-up-and-down-excited from it.  Imadork.

First Med-Surg exam is under my belt -- got a good solid B on it, I'm happy with it -- and first Mental Health and EBP exams are coming up.  I'm trying to keep up with my text and ATI reading, hoping it helps with semester exams as well as the ATI testing at the end of the semester.  And other than that...just trying to keep my head above water.  Two more weeks of classes until fall break, then we're on the downhill slope of the semester.  Awesome possum.

Oh...and after almost a full year battling it...I finally "passed" my HepB titer and I'm now clinically compliant.  It took 6 vaxes and 3 titer checks, but I'm in the clear.  After all I've been dealing with this thing, that's almost worthy of a celebration...lol

'Tis Friday, which is my day "off" (ha...as if I really have a day off...), so after I get kiddos on the bus and delivered to school, I'm heading out for a much needed solo walk/run.  I do believe I'm going to have Frank accompany me (Frank as in Sinatra; accompanying as in his lovely voice from my Zune to my ears)...because I'm in an Ol' Blue Eyes kind of mood.  Then I have some cardiac reading, some psychiatric pharmacology reading, and some topic research to get to work on.  Yay, stuff to do.

Happy Friday, y'all...enjoy your weekend!

No more clinical until fall!

Last week we did our final clinical on the hospital floor...today was the final Community Health clinical.  I went to one of the Head Start preschools...and hoo boy, was that an experience.  I admire school nurses for their work, because someone's got to do it...but I am pretty confident in saying that it will not be me.  But, I had an interesting morning, plus I got to leave a bit early due to their schedule...so I went home and soaked up some natural vitamin D.  :-)

Still marking things off my to-do list...but it's showing more items marked off than not!  Care plan is due Friday, finished it last night, need to send it off and be done with it.  Assessment final quiz has to be done before tomorrow afternoon, will most likely get it done tonight after kiddos go to bed.  Next Wednesday is skills check off for 4 skills -- Foley insertion/removal (which I rocked in practice yesterday, even though it had been a few weeks since we first learned the skill), trach care and suctioning (not a fan), NG insertion (not too bad), and sterile wound dressing (not loving wound care).  I hope I draw Foley and NG...I know those 2 the best.  Plus a group presentation, skills DVD quiz, 1 more in-class exam, 2 ATI exams, and the Assessment video...and I am FINISHED until August!

Found out some most excellent news this week -- I happened to finally check my transcript, only to discover I got an A in my Patho class last fall...when I thought all along I'd gotten a B!  I checked on Blackboard...my grade was still listed as a 92.08%...93% is the cut-off for an A.  Not sure what happened in between Blackboard and the grades being turned in, but I'm not going to turn it down!

2 weeks from now, I will be on summer vacation.  Hoping my cortisol levels drop back down, I can actually enjoy things I haven't gotten to do the past few months -- reading something other than textbooks, hobbies, shopping, seeing friends and family -- and can get back on a normal eating and exercise pattern.  I so need the summer off  :-)

And with that, it's time to haul kiddos to soccer practice.  Happy (Almost) Weekend!

Catching up

I'm still alive...just still in very insane-busy mode.  I had to make a list of all the things that need to be completed between now and the end of the semester and am just marking them off as I get them done.  I focus on things a week at a time...whatever has the nearest deadline is what gets the attention, then I move on.  No sense in freaking about my last TNI exam on April 25th when I have my portfolio that's due in a few days.

Recent stuff...past 2 weeks of TNI clinical were awesome.  In addition to getting more confident doing assessments and prepping/passing meds, I had 2 pretty good (as in interesting cases) patients -- last week was my first C. diff. patient (I've heard "once you have a C. diff. patient, you won't ever forget it"...yeah, that's a statement of truth!) with a bunch of other chronic medical issues, requiring a lot of meds, a glucose test, and an insulin injection, all of which I got to administer.  And this week was my first A. fib. patient...and wow, was she ever in A. fib.!  I had to really focus when counting her pulse and getting her BP because the sounds were all over the place.  She also had lots of meds that I got to administer...plus her nurse took me in there when it was time to pull her Foley...and I got to do it!  I had the same nurse the past 3 weeks of clinical, and I really loved working with her.  She was a great mentoring nurse, let me follow her and ask questions, was super patient when I didn't know something, and let me get in there and do things as much as my skills check off would allow.  In talking to some of my other classmates and finding out that the nurses they worked with weren't like that at all, I consider myself very fortunate.

Another high point...we put on a mini health fair for a group of retired nuns at their...nuns' home.  Our Community class was split into 4 groups, each with a specific topic -- Hypertension, Nutrition, Diabetes, and Breast Cancer.  We had to set up a presentation and educate the nuns about our assigned topic.  It ended up being a great day!  The nuns were really sweet, they asked some great questions and shared their personal experiences, and seemed to really enjoy having a group of young people to talk with.  We even got a mention on their website!  (edited to add:  Yes, my real self made it into a picture.  Actually I'm in 3 of the 4...but one is a closer view than the others)  Our Community instructor said that we were the best group she's taken out there, that we were very professional and well-prepared.  It was a lot of fun and I think we all really enjoyed the opportunity to get away from the hospital and work with a great group of people.

I can't believe I'm a little over 2 weeks away from being finished with my first semester of nursing school!  The time has passed slowly, but at the same time, has flown by.  I've learned a lot since January...and according to local hospital policies, I'm now eligible for any of their Nursing Assistant jobs.  I am seriously considering trying to get a couple overnight shifts a week this summer...just to get my foot in the door, get my name known in the hospital system, and make at least a little bit of money.  Currently there are some openings in general medical...might have to look into that.  My clinicals were on one of the med floors and I wouldn't mind working there.

Alrighty...time for me to quit yappin' and get back to work.  There are things beckoning -- portfolio, care plan, involved community paper/presentation...  No rest for the wicked!

Later(s) gators  :-)

Back to reality

So spring break is over, back to the grind.  I actually had a decent week -- thought it was a bit rough getting back into the swing of things after a week of doing nothing and sleeping a lot.  But I did OK, despite the intentional lack of caffeine!

A big highlight -- 1 group project down, 3 more to go.  My group had our ethics presentation for our Foundations class on Tuesday...and I think we rocked it.  I'm not sure when we'll get our grade, but unless she went uber psycho, I can't imagine not getting a good, solid A on it.  But...this is our director who teaches this class, and you never know what you're going to get with her...so it's actually up in the air.  I know we didn't fail it...we hit the main points she wanted us to, we had a ton of properly cited research...but we'll just have to wait and see!

3 clinicals this week -- 2 were awesome, 1 was OK.  Actually, I really should say all 3 were good, just 2 of them were even better.  Optimism...trying to use it a bit more!

Anyhoo...Wednesday's TNI clinical was great -- actually felt more like a real nurse than I have so far!  The main tasks were passing the 0900 meds and doing some basic assessment.  My patient's nurse handed me the MAR and I got to work.  While waiting to get access to the wallaroo, I got my patient's chart and started poring over it, because I needed to get info for my care plan assignment.  This patient will make a great care plan subject -- lots of acute and chronic disease issues, so lots of nursing diagnoses and interventions at my fingertips.  Well, sort of...you know what I mean.  Anyway, I must have looked like I belonged behind the desk at the nurse's station, because another patient came up and started asking me questions about being discharged.  Sweet little old man...reminded me a lot of my own Granpa.

So that gets me to Thursday, which was my turn at the family planning clinic at the local Health Department.  I had observed a couple procedures there earlier this semester and was fascinated...couldn't wait for my turn there all day.  Most of my classmates who have been there were not impressed with that experience.  Me...I *loved* it.  Saw an IUD insertion, several Pap's, several general pelvic exams, STD checks -- including a live sample of Trichomonas vaginalis -- and a colposcopy.  I've always been interested in the OB/GYN side of things, but this clinical visit just reinforced that.  To the point of where, if I do go on and get an advanced nursing degree at some point, I'm leaning toward a CNM degree.  But that right there is a big if.  Let me get out of school and earn a paycheck for awhile, then we'll see what the future holds as far as a graduate degree.

And that leads to Friday's clinical, which was in another small clinic setting.  Little clinic run by a FNP that offers discounted healthcare to those with little or no insurance coverage.  Saw what I've seen before -- patients triaged in, discuss issues with FNP's, they make their recommendations, referrals for labs, etc., then out the door.  Nothing new, nothing earth-shattering, other than the building being new and it was a REALLY nice facility.  But the staff there were really nice and put up with us following them around like shadows most of the day ("us", in that one of my classmates was also there)

The other big deal this week was learning catheter skills.  Our instructor demo'd a straight cath, but our kits were for Foleys...so we learned both.  As I was practicing on the dummy, my lab instructor asked if I'd ever done these before...I said no.  Then he asked if I'd ever worked in a healthcare setting before...I said no.  He commented that he was surprised that I hadn't because I'm doing skills like someone who's had some experience.  *beaming smile*  That boosted my confidence a bit.

That is about it, at least items worth mentioning.  So I shall enjoy my weekend, as much as I can around working on my care plan, knocking off some group project work, and doing other non-school things.  Soccer...pug-sitting for a friend of mine...sleep...

Have thyself a happy and a healthy!

Passed my Med Admin Skills test!!

No having to go back to lab next week and demonstrate any skills again!

Went into lab and chose a folder that had the doctor's orders and the patient's MAR, then chose one of the dummies that I would be working with.  I checked the MAR against the orders, got my meds and supplies, loaded up my med drawer, and went to the bedside table.  Drew up the injections, got the right pills, and started interacting..."Hi Mrs. Smith, I'm Kendra and will be giving you your medication right now, can I get you to tell me your name and birthday?"  Had to give subQ "insulin", IM "Demerol" in the ventrogluteal, and a PO dose of...something...forgot what it was (or actually what it was supposed to be...who knows what our practice drugs really are...LOL).  Demonstrated how I would give the injections (didn't actually give them this time), talked how I would give the oral meds and make sure they were taken, then that was that.  My lab instructor said I did an excellent job.  :-)

Now I'm cleared to give PO, subQ, and IM meds.  I can handle giving PO meds, and probably even subQ, since they're small doses.  But when I have to give my first IM on a real person...hoo boy, I will be nervous.  But, we all gotta start somewhere!

Thankful it's the weekend, thankful I had my day off today (so needed it)...and thankful for only 1 more week of classes before my spring break.  Just gotta get through a Community exam on Monday and some major work on one of my group projects...and my regular weekly busywork.

But for now...I will enjoy my weekend!

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!

Slowly getting there...

Officially finished with the 2nd week...not going to mention how many more to go  ;-)

I feel like we haven't really done much, but I'm guessing that will change in the next couple of weeks.  I don't anticipate much change with the lecture classes -- sit and take notes, discuss, ask questions, etc. -- although we do have some group presentations at some point for a couple of the classes.  Regarding labs and clinicals, we're working our way to our regular schedule.  Week 4 is the first week we'll be in both labs and both clinicals.  One more week of prep and then we're doing the real thing!

This past week we had our first labs for Health Assessment and TNI:

• Health Assessment -- we just worked through our complete health history packet with our classmates.  The goal was to get us acquainted with the 26 pages (I am not kidding...26 pages!!) of questions so we'll have a better idea of what to expect when the time comes for us to do our real assignment.  Now, after having looked at some of the questions in this sucker, and knowing how detailed and specific some questions get, I have no idea who I plan to interview for my assignment.  I love my friends and family, but I really don't need to know them quite this well!

• TNI -- over last weekend, we were supposed to watch certain skills videos to prep us for lab.  I'm proud to say I got all my videos watched and did well on the review quizzes  :-)  Anyway, in lab itself, we worked with our supervisors on giving bed baths, making beds, providing peri care*, putting on TED hose, and using a gait belt.  She demonstrated, then we had to run through the skills ourselves.  I will say it's more than a bit awkward to talk to a mannequin (Mr./Mrs. Smith, whichever the interchangeable parts may indicate) as if it's a real person, especially with your fellow classmates watching.  But, I did it, and I think I'll be good to go for our skills evaluation this week.

*provided much fodder for laughable moments...especially when the female supervisor, when changing Mrs. Smith to Mr. Smith, said to the male supervisor "I need your penis"  :D

I was supposed to have my first Community Health clinical this past Thursday, but bad weather put a kink in those plans.  Not sure what we'll do, but our instructor says we'll have some kind of make-up or alternate clinical.  I was bummed because I was looking forward to having clinical...but then again, I know I have plenty of future opportunities.

So that's a good wrap-up of week 2 of Kendra's adventures in nursing school...not too many adventures on which to report yet, but stick around, I'm sure this space will contain more "adventures" soon enough.

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Now, an off topic and somewhat girly-girl mention before I head over to Blackboard to take a skills quiz:  Cartoon Characters asked me what color I use on my hair.  I always use Garnier Nutrisse and the color varies each time.  I just colored my hair in December and used shade #56, Medium Reddish Brown (Sangria)...although it's faded quite a bit already.  I'm going to let it slide until about March and then re-color it.  Not sure what color I'll go with then, but it'll no doubt be some form of red again.  I'm still digging my red hair, even if it comes from a box.

OK, girly-girlness is over for now.  :-)

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Thanks for stopping by and thanks for comments...all are appreciated!

Have yourself a good weekend and best of luck to those who are starting classes this coming week!