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  :-)

Externship...4th semester...graduation...

...lots on my mind right now!

Externship: 2 more weeks and my summer externship is over.  It's a little bittersweet...the end of my externship means one step closer to being done with school, but at the same time, I've really enjoyed having a job this summer, earning a little money, learning all kinds of things, and being an important part of the patient care team (as opposed to being just an observing student).  I'm pondering a gift for my preceptor, planning to take some sort of food/goodies on my last night (especially since night shift often misses out on any goodies that are brought in on day shift...grrr).  And I'm planning on getting contact info for a couple of the nurses I've worked with, in the event I need a reference when I start applying for jobs.

4th semester: 2 of my 3 needed books have arrived, the other will be rented closer to the start of the semester.  The 2 I have - cardiac.  Cardiac is really not my strong point, so I'm going to have to do a lot of cardiac review before the semester starts.  I've started reviewing cardiac meds...beta blockers, ACE inhibitors, antiarrhythmics, CCB's...remembering side effects, dosage parameters, contraindications.  Also need to review disorders, although I'm pretty good on CHF, HTN, and CAD.  Probably should review the congenital disorders as well.  We had an excellent cardiac section in Patho and I'll probably dig those notes out for review.  I'm a bit nervous about this class, hoping that I get through it OK.

So this semester I get to apply to graduate in August...and then we have our pictures taken...and our pinning ceremony...  I have a lot to look forward to  :-)

Graduation: December 13th, 7:00 PM eastern time, Freedom Hall, Louisville, Kentucky.  142 days left.  Not that I'm counting down or anything!  ;-)

And on that note, I'm off to be lazy and watch TV.  Nothing like enjoying a night of not working.

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  :-)

Completed hospital orientation!

Spent the past 2 days at Externship Hospital going through new employee orientation stuff.  History of the hospital, employee services, patient safety, HIPAA, security, benefits... Just lots and lots of stuff.  But now I'm considered knowledgeable enough on the general hospital employee info...and if not, I have a lot of phone numbers of people to call...so now I can move on to Nurse Extern orientation for the next 2-3 days!

And I got my official hospital ID badge, so I'm good to go!  I actually managed to take a good picture on this one, so at least I don't look all funky like I do on my nursing student ID.  Small victory  ;-)

2 days closer to working with patients again...

Necessary Pre-Externship Appointment #1

Went in to Externship Hospital for the first time today to get my paperwork filled out (signed my name about eleventy-billion times), photo taken for my ID badge, drug test, TB test, and pick up a packet to fill out by the time I return for Necessary Pre-Externship Appointment #2 on Thursday (to get my TB test read and have my formal physical).  So now they have my signature on file eleventy-billion times, plus all kinds of information on me...so I guess it's getting more and more official!

Then to make it even more real, I got a phone call from one of the nurse team leaders on my unit to talk to me about my schedule!  I told her of my preference for night shifts and she said that she would make that happen.  Got assigned to a preceptor (who is very excited to have a student nurse to teach...I hope that's as good a thing as I think it might be) and got my first shift on the floor scheduled.  Because of the timing of our orientation and training next week, I can work only 4 more hours for the pay period as a nurse extern, so I got a short 4-hour shift.  BUT...it's overnight!  I go in at 10:30 PM and get off at 3:00 AM.  Now I'm sure I'm absolutely nuts, but I'm loving those times!  I'm ready to join the night shift world!

And I stopped by a scrub shop in the town where Externship Hospital is to look for my needed scrub tops.  Found the one style I had REALLY wanted, plus at a cheaper price than I have seen anywhere else (even online!), bought one, ordered another.  So I'm finally set as far as my scrubs.

*squeee* I'm in the files as a new employee, have my orientation/training next week, my first shift scheduled...THIS IS REAL!

*jumping up and down like a dork*

Last day of 3rd semester

And I am now on my summer break!  It's a very welcome feeling to not have studying or schoolwork hanging over me and to not have to deal with it until August.

It's been a long semester and I'm just glad it's over.  What was, in my mind, supposed to be a great semester, turned out to be not so great.  Ironically, I've done the best, grade-wise, that I ever have since starting at my nursing school, but getting there was tough, almost impossible.  And while that sounds like I might be exaggerating, I'm really not.  I can't go into great details in the event people affiliated with my school read this, but I will say that nursing school is hard enough on its own, much less when an instructor does her best to keep you from getting an A.  I ended up with the A (barely), but an A is an A.  And this one was a hard-fought A.  Plus it got me a 4.0 this semester, which I'm thrilled about. This is my first 4.0 since I was taking my pre-reqs a couple years ago, and anyone who's been in nursing school knows that a 4.0 semester is a pretty big deal.

So I'm now off for a couple weeks before I go in for 2 days of hospital orientation and then 2 days of extern orientation, 7:45-4:00 every day.  At least I get paid  :-)  Ahh, that's going to be fantastic...getting a paycheck of my own after 10 years being a stay-at-home mama.  Granted my salary this summer will be going toward paying my tuition next semester, with anything left over going for books and such, but still.  My work, my paycheck.

I also have to finish getting my scrubs for this summer.  We were told student nurse externs wear navy and white, either solid navy, solid white, or a mix.  Umm, yeah, I'm going with solid navy.  I have one pair of scrub pants, because the scrub shop here happened to have only 1 pair in my size when I was in there recently, but I need another one yet.  Plus a couple scrub tops, and I'm quite the girl when I'm excited that I get to choose girlish scrub tops -- ones with a feminine shape rather than the unisex feedsack-looking shape (like our school scrub tops).

So...no more pencils, no more books...  And a couple weeks to chill before my externship starts.  That works for me  :-)

For those still slogging through final exams...good luck!  And those lucky enough to be graduating soon...congrats!

Later

5 weeks in...I think??

I'm too lazy to get my planner out and count, but I'm pretty sure it's the 5th week of classes.  And things are going fairly well.

The high point of the semester so far was my day in the NICU yesterday.  THE Hospital has a Level 2 NICU, so while there is nothing majorly super serious there (those little ones get sent off to Kosair's, which is a couple hours from here), it's still nice to have the experience in the NICU.  I didn't really do a whole lot but observe, taking part in some very basic interventions.  But what I really loved...I got to see a c-section.  And it was, hands down, one of the coolest things I've ever been allowed to see.  I was in there as a "guest" of the Nursery RN and NP, but the L&D RN's and even the OB were so nice and explaining what was going on.  It was awesome!  After yesterday, I am more sure that my future is in OB nursing...maybe not so much in L&D, but I'm thinking NICU/Nursery (they work in both and float back and forth as needed) or Mother-Baby.  Each time I think about another area I might want to work in, I always come back to OB.  Must be a sign  :-)

Other big news...I'm applying for student nurse extern positions for the summer, at THE Hospital and a bigger hospital that's about 45 minutes away.  Both are 10 week programs, 24 hours a week.  And both offer the chance to stay on as a NA after the program is over...and I'm *REALLY* hoping they might offer a foot in the door to employment after graduation!

Anyhoo...school stuff beckons, as usual.  Working on my clinical assignment after being in the NICU yesterday, as well as reading and working on study guides for upcoming exams.

Later  :-)