Done with Fall I!!!

OB in an Accelerated Program is HELL.  Especially when your teacher is also known as the Warden.  *sigh

Thank GOD that’s over.  On the plus side, there was absolutely NOTHING that they threw at me on the floor at Hospital-of-Changing-Church-Affiliations during OB/Newborn exams or Fetal Monitoring Strips that I didn't know about. (of course not experienced in it, but nothing I didn't already know about!)
Fall I semester-- I completed Health Assessment, Health Assessment Practicum, Med Surg I, Childbearing Family (OB with a couple of kid development quizzes thrown in), and my OB Clinical Rotation/PACU/One-Day Surgery.

And this semester, Mike the astronaut’s got nothing on you babe…na-na-nathing on you babe…ok, so nothing on ME this semester.

I finished this semester with a pocket full of ‘A’s.    I have never worked harder.  Or had to work so hard in…my…life.

The class before us told us at our orientation that if we could just make it through Fall I, we would have smooth sailing.  I now know, that was her way of telling us that if OB doesn’t kill you and once you adapt to the study schedule, you can do this.  Well, one of us couldn't do it.  She didn't have a 75 for OB and she's out.  That's two gone from our original 24.  Sad shit.  The plus side is that she was admitted into the traditional program, but she can't jump in until January, because we're ahead of the trads!  Or the 'generics,' as some of our teachers call 'em, LOL

Health assessment, we made videos.  It was GREAT.  It made me much more confident, because for my Assessment, I felt like I was teaching on a video instead of being inspected in a Practicum return by a bunch of teachers. (which I still was…by video.)  In exchange for getting to make videos, we agreed to the use of our videos for future teaching! 

So, here’s the final:  Do a basic head-to-toe exam on your partner, and draw out of a hat a scenario for an Advanced Health Assessment.  So we had to know ALL the advanced health assessment things, like deep tendon reflexes (where and how to assess), testing and naming all the cranial nerves (which I could already name; I loved Anatomy.), proper use of ophthalmoscopes and otoscopes…let’s see, what else?  Hearing tests with tuning forks like Weber and Rinne.  Sight exams like Snellen and Rosenbaum.  Lymph node palpation and their names.  Inspection, Palpation, Auscultation, and Percussion of chest, lungs, and abdomen.  It is really cool all of the assessment techniques I’ve learned.

So I had to know it all so I would be able to draw a scenario out of a hat and be able to assess for the scenario.  Loved it!  I absolutely adore Health Assessment.

I like Med-Surg a lot.  We got to do a lot about Diabetes, Electrolytes, and Fluid Imbalances.  That was the majority of Med-Surg I, which is pretty important shit. 

OB.  That rotation was pretty cool.  Got me feeling like a nurse.  Really pissed me off seeing my first episiotomy/first live birth which was on my last day of the OB part.  I couldn’t even enjoy the childbirth because I was so pissed at the cutting.  The baby was not having trouble; why are all these doctors so cut-happy?  I know there are two sides to this divide:  Those Who Like Episiotomy and Those Who Don’t.  I am of the “Those Who Don’t” persuasion.  I think a tear is injuring what was necessary, where an episiotomy is quite possibly more injury than was necessary, but we won’t ever know BECAUSE YOU’VE INFLICTED IT ALREADY.

OK, so there are times and places for being cut.  But the docs at this particular hospital LOVE to cut.  Boo. 

Also, I hate the nursery.  HATE.  It felt more like babysitting than working with a patient.  This medical center is not set up for sick kids; they all get packaged and shipped to a higher level 2.5 hrs away at a BIG children’s hospital.

My most memorable experience in OB was the day I got to stay with one patient from pre-op, to wheeling her down to surgery holding area, to surgery, WATCH the surgery/baby born/Daddy cry, and wheel her back to her room afterwards.  Really cool to be there for her throughout the whole experience.  As we were going back to her room, one of the ‘real’ nurses was talking about the rest of the day’s events, when the patient interrupted her.  “Where’s my nurse?”  The nurse talking to her stated, “Hon, I’m right here.”  And the patient said, “No, my NURSE.”  She meant ME!  That made me feel unbelievable. J  The ‘real’ nurse kinda scoffed, “Oh, you mean your STUDENT nurse?” but it didn’t matter to me at that point.  The point had been made; I was a good at taking care of  my patient, she trusted ME, and ‘student’ status be damned, I am good at this.

*happy sigh

One Day Surgery.  It was a great experience…except for at the very end.  Which soured the whole day.  So let me explain.

I got to get SEVERAL patients ready for their various surgeries that morning.  Had to be there at 0530…woo, that’s early.  So I got my first IV (woot!) but the nurse I was following was kinda in the middle of it too.  She thought she had enough pressure on the site (which she DIDN’T) and I was trying to work AROUND her, and my patient bled everywhere.  I’d been fine if the nurse would’ve just let me do it.  So then, we finally get her hooked up to her LR and now I’ve got to clean up blood that is all over everything.  *sigh.  That lady was really nice.

So I set up lots of tubing and fluid kits and antibiotics.  I started 3 or 4 more IVs and had to have help ‘getting’ about half of them.  So I’d miss and my nurse in charge of me would salvage it.  So I’m not really happy with my performance there just yet.

Then there was the patient that just whined and cried and belly-ached when I stuck her.  It was all I could do to keep from rolling my eyes.  What I WANTED to tell her was that I was using a 20 gauge and that the folks in the OR wouldn’t even like THAT because they want an 18! (bigger, for you non-medicals, in case they need blood).  God, what a fucking baby.

I started an IV on a 17 year old an hour later, and even though said over and over before I stuck her that she hated needles, once I actually did it, she was really pretty good with the whole thing.  Faced her fear and all that.  I just kept her talking about playing clarinet in band.  So how’s that for therapeutic communication, eh?

So the sour part.  The really GREAT nurse that let me come assist (ahem, observe) with a bronchoscopy, and who had let me do all kinds of great stuff all morning used tape on the end of an IV.  And was written up for it.

The back story:  she and I both went to another floor to pick up the fairly demented patient for her procedure.  We were going to take her down, and the cap was somehow no longer on the end of the IV tubing.  I even had another CAP in my pocket that we tried to use, but it was for a different set.  So, instead of scrapping the tubing, she taped it.  With my tape.  Yeah, I felt sick, because it didn’t seem correct.  Like Jo says, if you have to fuck with it, it’s wrong.  Well…tape is NOT STERILE.  Had we plugged the lady into that, it would have been a possible portal of infection. 

So my assigned nurse got an ass chewing and a write up by her other associates in that area.  Well, there’s a lesson I’ll never EVER have to learn firsthand.

Know what? When you act like a nurse, everyone treats you as a nurse, and I’ve found it quite easy to take on the role.  Most people found out at the END of their time with me that I was a student, and that is good. 

The upside to my 8 hrs on One-Day was that I got to do discharge on the Bronch patient, and it was gratifying to get her dressed and wheel her downstairs to her awaiting brother-in-law’s truck.  She told me she hoped to see me at Walmart or somewhere out shopping, and never here again.  And I told her I’d love to see her out shopping and never here again either!  …Bless her heart.  We were looking for mets to her lungs on a cancer that had almost taken her once already, and it was looking promising for good news.

So that leads me to now.  I’ve just come off a very lovely Fall break in the amount of 4 consecutive days off with no homework, assignments, or tests to study for.  I am now in Fall II and I am taking Mental Health, Community Health, Mental Health rotation, Comm Health rotation, and Pathopharmacology.  Hmm.  I think that is it.

I like it all so far.  I missed the first day back to my first cold of the year.  To be continued.