Update 2 of 2

So I got to do 2 12 h shifts in the ER.  LOVED IT.

There is such a swagger, a don't-stress-out-about-this-sh*t attitude there, and I was instantly in love.
When the floor realized they had a willing student, I got 8 IV starts and I hit 7.  What a confidence boost!!!!!  I've not started IVs in like MONTHS, seriously.
I learned how to do blood draws with the vacuum tubes, butterfly blood draws, and set up chest leads for EKGs.  I gave injections, pushed a helluva lot of Dilaudid (super great/strong pain med), I coordinated with CT on people who were finished with their Contrast-Lemondade, and I discharged patients.
A total blast.  I didn't have any patients who had extreme trauma, so I don't know how I would've been in that situation, but I did get to help set people up with severe chest/abdominal pain in the triage, slamming bp cuffs, leads, oxygen, you name it, on folks to determine where we're at.  LOVED IT.
(side note: I also applied to the ER, but they are done hiring new grads there for the minute, and so they told me in my interview that they would be declining me on that. Fine.  I've got a lot to learn; may be best to learn it in a less extreme environment.)
So for ER, they had us do 11a to 11p so we'd get to see lots.  Because a lot of the best stuff creeps up in the night. ;-)
And it did.  We had a tweaker who had rubbed all the skin off of his nose (crank-bugs, anybody?) but was there for a real reason; he'd had abd surgery a week ago, didn't rest after the surgery (tweaking!) and now has probable infection.  That crap gets serious in a second.  This was my miss in the IV department.  Hard to hit a vein when they are all burnt up and gone.
We had another suspected psych/tweaker who claimed to have suicidal ideation...who was bored and decided to put an insulin syringe in her vajayjay.  *sigh.  Really?  The on-call doc spent 15 minutes trying to convince a nurse to do the pelvic exam, lol.
The verdict?  NOTHING.  I know, right?
Anyway, I love the craziness, the crazy people, and the fast pace of the ER.  Maybe I'll work there some day.

Which almost brings me up-to-date.  In between all the good stuff I've posted about, I've been doing Med/Surg on a Bone and Joint floor.  I actually like it quite a bit, but I do not want to do Med/Surg, really.  Heh heh, looks like I don't have to, huh? (though I know that Sainted Big Dog Hospital is really bad about floating nurses from floor to floor, so I may do more than a little Med/Surg afterall...)

I had a day in Simulation Lab to learn how to hang blood and watch for transfusion reactions.  I also got to learn Central Line care and how to do blood draws from Central Lines.  Cool.

Now I'm in ICU.  They save the most critical patients for last, and as you can imagine, that is the smartest way to do it for students.  The crap I thought was hard 7 months ago doesn't hold a candle to 1:1 care of an acutely ill person in  ICU.
My first week of ICU was this past week and my little old lady was pretty much palliative care only. (YES. = comfort care only)  So I got off easy the first week.  No, I'm not happy she was almost dead, I'm just saying I was able to get all of my nursing tasks and my mountain of paperwork that Ms. Acute Care teacher requires each shift.
Poor patient.  You name it, she had it, and she finally just couldn't fight anymore.  She had cancer and the treatments pretty much left her susceptible to the really CRAZY sh*t that only people with full-blown AIDS get.  In a week's time, she'd gone from just ill and confused, to completely unresponsive to anything but pain, and only then would  moan.  She was in Septic Shock, which at that point, you have multi-organ failure...and you usually don't come back from that.  So I kept her weeping extremities dry and bandaged, and kept her morphine coming, and that was pretty much my day with her.  I had lots of time to do the stupid paperwork for my instructor.

PRECEPTORSHIP
So that is the final block in the wall, the final jewel in the crown, ha.  Pick someone in nursing to follow around.  I have a friend who is a Nurse Practitioner, and she was an easy choice.  She works in Internal Medicine and huge practice and it was REALLY neat to follow her Friday.
We saw a crap-ton of upper respiratory/sinus/ears problems (for which I have a crap-ton of steroid shots), a case of Bacterial Vaginosis, a huge mass on a shoulder, and a 40 something woman who is rapidly losing her ability to breathe. She got a CT - hope I get to see the follow up on that.
Monday, I'll follow a doctor's RN from the same practice (thanks to my NP buddy for setting  that one up) as she makes hospital rounds.  I have really wondered about how that works, an RN making rounds...as opposed to a Nurse Pract.

So I've got RN hospital rounds and a pee test to look forward to tomorrow on my 'day off,' and then 3 12 hour days in the 60-degree ICU, followed by another day shadowing my NP friend on Friday.  Busy week.