Summer externship is over

:-(

I worked my final shift last week.  Clocked out, said good-bye to my preceptor and a couple other nurses I'd worked with, and then walked out of Externship Hospital for the last time.  Well, as a student nurse extern, that is.  Who knows...I might be back there as a PRN RN at some point (holding on to that as an option!)

What can I say about my experience as a student nurse extern?  For one thing, I really did enjoy it.  I gained so much more confidence working with and talking to patients.  I feel less awkward doing various assessments, taking vitals, and other tasks.  I've picked up little tips and tricks that I didn't learn in clinicals.  I got used to the flow of a full shift, giving and getting report, and of working with more than one patient at a time.  And I learned the importance of getting charting done ASAP, because you never know when you'll get an admission or one of your patients will require extra time.  I most definitely recommend this kind of experience to any nursing student.  It will prepare you for your senior practicum and for your eventual RN job.  Plus as a nursing student on a unit, you find out you'll get to do a lot of tasks/skills for your skills log because the nurses/techs will gladly pass it on by saying "hey, let the student do it!"  :-)

As for orthopedics, I enjoyed it too.  In Externship Hospital, the ortho unit handles true ortho patients - joint replacement program (JRP) patients and any ortho eval admits from the ER or direct admission - as well as med/surg overflow patients.  I literally did a little bit of everything.  Am I specialized in any one thing after this summer?  No.  But do I feel a lot more knowledgeable about general nursing?  Absolutely!

Up next...semester 4 (!!!  SEMESTER 4!!!) starts in about 2 weeks.  Not sure what to expect since we're not really in class as much this semester.  We did get info on our practicum and got a chance to make our unit and shift preferences known.  I asked for night shift (please, oh please, let me get nights...) and said I was interested in med/surg, cardiac, neuro, and ER.  We'll see what happens.

So I have a couple weeks to enjoy the last little bit of stress-free freedom before classes start.  I have a feeling I'm going to hit the ground running and it's going to be busy right up until the end.  Juggling practicum hours with classwork with kiddo activities with studying with projects..fun fun!  But this is my FINAL semester...I made it through 3 others (4 if you count my Patho/Pharm "pre-nursing" semester), I sure as hell can do this one more time!  Graduation is in sight...NCLEX is coming up (eek!)...the light at the end of the tunnel is getting brighter!

On that note, I am off to watch the late night showing of tonight's prime time Olympics - still on night shift sleep schedule, love having something to watch all night! - and just relax.

Laters  <---shamelessly swiped from "Fifty Shades of Grey", which I will admit to reading over the summer.  Yep, I succumbed.  So sue me.  I needed something to keep me awake when we had cooperative patients who actually slept at night  :-)

Haven't been around much...

...but I'm still alive and kicking.  Keeping busy with my externship, the kiddos, and just life in general.

The externship: I'm a little over halfway done with the 10 weeks (already?) and I'm still enjoying it. I've changed colostomies, put in straight caths, emptied hemovac drains and foleys, changed surgical dressings, and other very much un-glamorous things...but the one thing I hate the most?  CHARTING. I understand the necessity of it, but OMG, I just hate it. I'm a lot faster at it than I was before, but still...it's monotonous and boring and the one thing I do not look forward to at all each shift.

Regardless of how much I dislike it, learning Epic and having to do the charting each shift will definitely help me out with precepting in the fall, plus with my job after I graduate. And I think about my classmates who aren't externing this summer...they are going to be so behind this fall! For the past 3 semesters in clinical, we've cared for only one patient, have had limited IV/PICC experience, haven't gotten to do many procedures, and haven't really had a chance to set a good routine. Thanks to being tossed right into the fray by my preceptor this summer, I now know how to manage up to 5 patients a shift, I've gotten a vitals/assessment routine down, I've learned a lot of pharm, know which drugs require additional assessments, have become a pro at almost anything related to IV meds (well, as far as getting them set up and going), know how to draw labs from a PICC and change the caps, plus have learned a few new skills. And I know how to handle 12-hour shifts, deal with night shift, and can do back-to-back shifts. Yes, I've had some rough shifts, some patients (and family members) who aren't my favorites to deal with...but I still feel like I'm right where I belong, doing what I really am meant to do :-)

As far as academic school stuff....erm...yeah. Haven't opened a book this summer at all. Guilty as charged. Maybe I can read a little in the couple of weeks between the end of my externship and the start of classes...

BUT...I found out I didn't make the Dean's List last semester...instead I made the Dean's Scholar List! WOOT! And I can apply to graduate starting July 15th. And you better believe I will be on the school's website on July 15th filling out that information! I GRADUATE in just a smidge over 6 months! And that means I take NCLEX in probably a little over 7 months!

On that note, I'm off to enjoy not working tonight :-)

Survived my first 12-hour night shift

I did it, I managed a 12-hour shift from 6:30p to 7:00a. I got tired, I was yawning and dragging at times, and by about 6:30a, I felt my brain shutting down (which is amusing when giving report to day shift and you can't remember basic words). But I managed!

It ended up being an insane night. My preceptor said that most nights are not that nuts, but we got through it. I felt bad a few times that she was bogged down having a student, but I think I ended up helping overall, especially with rounds and charting. We started out with 5 patients, 2 were "high maintenance" (not bad, just needing more attention because of their situations/interventions), the other 3 were pretty easy keepers - just round on them, give meds, etc. Over the course of the night, the unit got 8-9 new admits, 2 of them going to my preceptor and me. So on top of the 5 patients, we had 2 sets of admission paperwork and assessments to do. Fortunately both new admits were relatively easy keepers, probably because it was overnight and their PCP's weren't around to write up orders and start their home meds.

I clocked in at 6:30p and didn't sit down in a chair until right around midnight. And then didn't get my dinner break until 1:45a. We were both starving by then and spent our 30 minutes in almost silence as we were stuffing food in our mouths. I gave most of the PO meds, hung IV meds, programmed the pumps, flushed IV lines, did assessments, changed a PICC line cap (first time I've done that...pretty cool!), fetched supplies...I did a lot of stuff! Even though I was exhausted by the end of my shift, I have no complaints. I'll gladly return for the rest of my shifts this summer! Because last night...even though I was busy and tired and feeling incompetent...the experience just reinforces my decision to go into nursing.

So after sleeping a few hours and returning to something that better resembles a human, I'm now heading out to walk a few miles and enjoy some fresh air.

Happy Wednesday  :-)

Orientation is complete!

2 days of new employee on-boarding, plus 2 1/2 days of student nurse extern orientation...and I am deemed good to go now!

Got checked off on IV and Foley competencies, plus lift equipment, blood glucose checks, pneumatic tube delivery systems, restraints, and other topics that are currently eluding my tired brain.  But I passed, I can do what they expect of me.  And according to Externship Hospital, the only things I cannot do as a student nurse extern are give blood products, chemo drugs, and take verbal physician orders.  Anything else - Foleys, NG tubes, dressing changes, IV starts, med admin - I'm on it.

But now, I must recover from a week on day shift hours.  Getting up at 5 AM for 5 days in a row, driving, sitting in orientation sessions all day, driving again, and getting home between 5 and 6 PM...yeah, this girl is tired.  I can handle 5 AM if I'm still awake from the night before, but not so much when I have to wake up.  I'm weird.

Happy Friday!