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.

July 2011, already? Update 1 of 2

Gotta do another 'catch-up' entry.
I helped welcome the new Accelerated BSN class at my university.  Can't believe that almost a year has gone by and now I'm giving info to the next hopeful and excited class. ;)
I gave them good info like BUY A PARKING SPOT (super limited at my university), actually study, etc.  It was fun.
I applied to 6 jobs.  I applied to 2 jobs that are an hour away, one in Respiratory nursing, another in Transplant.  Hey, shoot for the moon and be happy with a star.  3-4 weeks later, got  the ol' rejection email.
I also applied for a job at St. Jude Children's Research hospital.  Super glad that I was "not selected."  I got to spend 2 days at my state's own research hospital, and while is is an AMAZING hospital, and a ridiculously AMAZING with kids, I hate it.  I'll go into the whys sometime. :)
I applied at a local hospital's One Day Surgery/PACU.  It was only a part time position, but I REALLY loved PACU (see above posts) so I thought, "hey, good foot in the door."  Yeah...still haven't gotten a call from them.
Which leads me to Sainted Big Dog Hospital.  They told us in a recruitment luncheon, that they would be actively pursing our class of Accelerated students, and she wasn't kidding.  I applied on a Friday night and received a call Monday morning at 9 am!!!

The Interview
I interviewed the following Friday.  Talked to the HR/Nurse Recruiter lady for an hour about my past work experience, best parts and worst parts of me, times when I was able to work through conflict, yadda yadda.
Guess she liked me.  She had me watch the Big Dog customer service expectation video, and when it was over, retrieved me from that room, handed me a packet of drugs and calcs to know for an exam, and asked if I had time to  meet the manager of the Unit I'd applied to.  ErrrrmYES.

So she walked me up the hill to the hospital and to that Unit and I had another interview on the spot.  This manager seemed REALLY cool.  A really great conversation, even if I *did* get a little excited in talking with her.  She seemed not to mind, and even commented that she thought that I was very much a people-person (indeed!).
The verdict?  She offered me a 7p-7a position right on the spot.  YAY!
I'm going to be working the Clinical Decision Unit.  It is a unit for people who aren't sick enough to still be taking up real estate in the ER, but the docs/nurses aren't comfortable with sending them home just yet, either.  A lot of it will probably be late night chest pain, and holding them until AM for stress testing.  That's ok by me.  Manager says that they TRIED to have this unit in the past, but it really just ended up being an overflow.  They shut it down, did the research, and are trying to do it right this go-around.  I think that is why they brought her on board; to start it.
So yay, I think I'll be able to see a lot and see it fast in this unit, and I'm SUPER excited to already have employment.
Tomorrow, I go in for the obligatory pee test, physical, hand in my mountain of paperwork and copies of cards (cpr, social security, etc) and take my darned meds/calc test.  I am fine at dose calcs but it does make me nervous.
They are giving a huge leeway.  You can make an 80%.  Which I can't believe, because you're technically killing or harming 20% of people, but it definitely is in my favor.
I told my classmates on our private group page on Facebook that I had a position, but I'm not announcing to the world until tomorrow is all done.

Wow, I saw a lot of shit this week.

Week in review

Tues at PACU

*TEE (transesophageal echocardiogram)
*Cardioversion (shocking someone to make heart beat in proper rhythm...in a person who didn't gave fatal arrhythmia.
Should be done in those who could have better quality of life from it. This lady had terrible skin wounds, morbid obesity, & renal failure.  I'm like, really? Funny beats were this lady's lowest priority. We got her out of arrhythmia, alright, but she was so bradyed down (slowed) she wasn't hardly getting blood around. (perfusing).
*Art line (arterial) in wrist
*TURP (trans urethral resection of prostate)
Murphy drip (major irrigation after *TURP)
*Dopplered a lady's pedal pulses after total knee

Wednesday

*Personally tried/failed 2 IVs for lady in renal failure
 (made me feel better when 2 other RNs failed. She's in renal failure for crissakes, & has no veins).
*Miscommunication with primary on meds, gave meds late. Boo.
*Gave 40 meds. FORTY. IN. ONE. DAY.
*Learned more about sickle cell crisis as I cared for a guy w/ it.
Sickle cell guy was *arrested* in the hospital! lmao. What a day.

Thursday

*Discharge on terminally ill guy ( who got the majority of yesterday's 40 meds), who hugged me and said he'd remember me. (aw!)
Pedi experience:
*Post surgery care on girl who just turned 16 & had a near fatal car wreck.
(She had a 'headband' of staples from ear across head to other ear. Way better through the hair than on forehead, scar-wise. VERY important for 16 year old, too.)
* Discharged her home, yay! I think she'll be ok.
*Assisted w/ 2 failed IV starts on a toddler
*Assisted w/ 3 failed in-and-out caths on infant. (on a failure-to-thrive baby)
*Assisted w/ 4 failed IV starts on same infant.
*Saw first hand how well sucrose drops work for pain relief in babies! Short term, but oh-so-helpful in procedures.

(He was bone dry. We fed him 3-4 oz of formula, a LOT for such an itty bitty...& then he projectile threw all of it up. Poor little guy.
Baby's 2nd admission in the last couple weeks. His mom was feeding him sugar water. Only. Not formula.  Grrrr!)

So it was interesting working on & with  children this week. Still sorting out how I feel about it.

Really great week, experience-wise.

Best friends at the Best party

Week in review

Choir concert two nights this week in a town about 1 hr away. Went pretty well.

I'm too busy for that stuff right now. Glad I did it but glad it's over, too.

Reconsidering CNS for grad school. Looking at Family NP. With my background in Training, and masters in Health Ed/Promo (public health), & plans for getting a DNP, I think I'll get at least some of the aspects of a CNS. And as an (a?) NP, I'll have lots of great clinical hands on experience.

So I'm wallowing in that indecision for now.

Research. Love it in the real world; despise the class. About to take an exam.

Later.

Bored.

So as predicted, after a few days of luxurious NOTHING TO DO, I'm bored/depressed. Boo. Class, albeit ONLINE, begins again tomorrow.

So posted next will be a photo of my rescue doggie, LoLLie the Bichon, wishing me a Happy Mother's Day and trying to cheer me up.

Recent Honors

I was invited to Phi Kappa Phi, the oldest academic honor society (non-departmental).  Pretty cool.

But *GIRL SQUEEEE!*   I was invited to Sigma Theta Tau, the “International Honor Society of Nursing!”  (STTI) YAY-YAY-YAY!  I have worked SO hard this year towards that goal.  And I thought having that one ‘B’ in nursing would exclude me, so when I was notified…wow.

The way that all happened, though, was a bit sad. Several of us were sitting at a Filipino restaurant in another town after the first part of a Nursing Research Day at Private-Beautiful-though-Church-affiliated University.   Each one of us around the table got an email…except one. *sigh.  We graciously put off the celebration until we were not with that person, but, STILL.  How on earth the stars line up for us to all get in but her?

Anyway, it is the top third of the class, and in a class of only 22, the spots are pretty limited…and coveted.

Induction into the societies are the next two Monday nights…yay!  I could not be more excited and humbled to be a part of them.

Musical Honor:

 I have been a guest singer with a band as of late.  As kind of a long story, one of my dear friends who is a Psych Nurse Professor at my Podunk U is married to the lead singer/bassist.  (She isn’t one of my teachers, so we get to be friends.  Can’t wait for a few more of my teachers to get to be friends, too, but I digress).  Anyway, the band was doing a wedding, the bride wanted Carrie Underwood’s “Mama’s Song,” and the band wanted a chick singer.  We had all hung out one night, they heard me sing a couple of bars to the Enzyte commercial (lol, another story) and I was asked!  I was really nervous, but now I LOVE it.  It went really well, and I was even tipped $100 to sing it again at the end of the reception night.  I sang it with them at a bar again the other night.

They guys gave me an open invitation to learn some more of their stuff.  FUN.

And I’ve joined a community choir that is working on the Brahms Requiem in English.  Quite a contrast from country music, huh? (that is the ONLY country music that both I sing or the guys in the band perform, btw.)  It is weird to be back in the professionally trained singer world, too.  But it is challenging, and it is good for me to work on something besides nursing all the time.

What an Accelerated Program is.

Just what exactly is an Accelerated Program, you ask?

A program in which:

• People who were brilliant enough to get in, can't hack it and get kicked out.
• People who don't make anything but 'A's now make 'B's.
• People who have never quit anything in their lives have to discontinue.
• People who have never had mental illness find themselves dealing with depression and anxiety.
• People go on Paxil and Xanax to make it through.
• People get divorced. Or hopefully just have to start marriage counseling.
• People struggle with tiptoeing around 'too much' alcohol.
• Sleep deprivation is the rule.

Because it is a whole year of crisis. And mental health is Never challenged more fully than in a crisis-state.
I had the ego to think when I joined, "*I* won't feel that way. Maybe THEY just didn't know what they were getting into."
Nope, they were right, and I hadn't a clue as to what *I* was getting myself into. ;-)

Dear reader, I'm still hacking it. Proudly. I haven't made all A's. My marriage has come out of a dark November-December. Some of my dearest friends in the world (dearest as a result of this program) are having some of the other points stated here.
I think it is the bootcamp of nurses, an Accelerated program. And this one is just a year, so it's just that much more tight.
Any other program, especially a 4 year program, though, would be exceedingly boring.

The Catch Up!

Gosh, I don’t even know where to start.  I never intended to not write at least weekly, but an accelerated program is, well, accelerated!  Who the heck has time?  I want to make time. :)

Well, let’s see…I had a 2^nd not mandatory orientation on Monday and Tuesday before class started, so I really didn’t work those last two days.  Just a couple of hours.  It was a really great way to transition my work life to school life.  My office threw me a great going away party.  I’ve been told by everyone that the office is not the same without my loud-ass laugh.  I’m glad I was someone to miss; that’s what I always want to strive to be.  Miss me instead of ‘good-riddance,’ ya know?

So... school!  It is GREAT.  I’ve already had plenty of “the thrill of victory; the agony of defeat.”  Aug Interim was 3.5 weeks of 8-5, Monday through Friday.  I worked really hard, did several Returns aka Check-Offs.  On female/male cath or sterile wound dressing, I drew sterile wound dressing.  And I left that return barely holding it together.  I broke technique twice without reporting it (without NOTICING it) and though my teacher was very nice and I took it gratefully, by the time I got down to my locker and a sympathetic friend saw the look on my face, I started bawling.  I don’t want to potentially hurt someone by breaking sterile technique!  I don’t want an 85 either! And I don’t know why I didn’t get a worse grade than that.  Sigh.  That was a very hard afternoon.  I actually asked the teacher before she gave me my grade when I could retest because I am very hard on myself.  Glad it wasn’t necessary; she said I had the principles, I just needed more practice.  So.  I hate even reliving that day here in words.

The weekend before our finals/final grades, we all went to happy hour at a great local bar.  Well, not all of us, but like, 12 of us.  What a blast.   We all got quite drunk. J Good times.  Steph reported to us Monday that she was parading around her house naked afterwards, looking to see if her grade had posted from the test we took earlier that day.  LOL 

My dear Indian friend who comforted me that day didn’t make the cut at the end of Aug Interim.  It was too sad.  She didn’t make the grades.  All of our tests are in NCLEX format to teach us to test that way AND she has the language barrier.  She’s incredibly brilliant – she was going Pharm until she tried out for this program.  But her grades weren’t good enough and she was eliminated.  We were all so dismayed.

I ended up with a 93 in the Fundamentals class that I screwed up the sterile wound dressing.  And I didn’t do good enough on my final for Essentials.   I couldn’t believe it when the final grade posted; an 89.3.  Are you kidding?  89.3!!???  The College of Health Professions has a college wide agreement that there is no rounding.  So I got a big fat B in my Essentials course.  I didn’t study nearly enough on the different theorists and stages of development:  Freud, Erkison, Piaget. (This whole going back to college thing is TOTAL Identity vs. Role Confusion, LOL) And it totally burned me.  My fault—I have to work harder next time. 

Here’s the kicker.  We have a guy in class, Mike, that is a big work-avoider, laid back, dry humor—really a lot of what I was used to in my IT Office that I used to work in.  So his humor is great, but his laziness isn’t.  First day of class, he was dubbed “Astronaut” and the freaking Astronaut got all A’s.  And I got an 89.3.  That pissed me the FARTHEST off.  I did worse than the freaking Astronaut.  *Sigh  J

Other things…

God, I LOVE the GEICO commercial “did the little piggy cry wee-wee-wee all the way home!”  I am so Maxwell, the piggy. :D Weeeeee!  Weee-weee-weeee!!!!!

What else.  OK, so Fall I started.  I have Med-Surg, Health Assessment online, Health Assessment Lab, Childbearing Family (ob), and my FIRST CLINICAL ROTATION! Weeeeee!

OH, our Childbearing teacher.  Man.  She is…something.  She can be so funny, and then so damned strict and sharp tongued, you just never know where you are with her.  So we all had to RE-check off on doing IVs with her before we went to clinicals.  And we’re all like, “we just checked off on this with our other two teachers in Fundys.”  But in Fundys, they allowed us to use the fake IV arms.  They bleed and everything, but according to Ms. Childbearing, it ISN’T the same.

So what was told to us to be a voluntary stick-clinic, was quickly changed to an INVOLUNTARY stick clinic once we got in Ms. Childbearing’s class.  It created a bit of an uproar, honestly.  And after belly-aching on the part of many in our class, we did get the option to do our (re)check-off on either the fake arm again or the living.  Our classmates.  A choice…sort of.  No one wanted to admit that they were one of the ones who bitched to the program coordinator, so everyone chose to stick a classmate. J  Ms. Childbearing said, “There is nothing like doing the real thing.”  And as much as I on-again-off-again don’t like her, she was absolutely right.  I planned from the beginning to stick a real person, because I need the experience, but I was really, really glad that I did. 

My bestie in Nsg school is a LPN.  For some, this might add some performance anxiety, but she is a great teacher and encourager, so she really is great for a partner.  As it turns out, she is also an exceptional bleeder.  I had her blood all over everything and the floor when I stuck her.  I got the cathalon kinked, so I didn’t get to do the whole thing.  It was fine for the check off, but not enough for ME.   So I hung around and there was another girl who wanted to do a 2^nd stick at the end.  I was so glad, because I felt like I had to redeem myself.  So we restuck each other.  Two bruised hands later, we felt great.

My first exams, ‘A’s in everything except Childbearing.  89 in that one.  Goatee Man had a hypoglycemic episode the night before (diabetic) and I lost 2 hours of study time the night before.  Thank goodness that was the first test; still have time to make that B an A, hopefully.  

My first rotation is OR/One Day Surgery/OB at Hospital-of-Changing-Church-Affiliations.  We do one day in OR, 4 in OB, and one in One Day Surgery.  So I observed my first week, in the OR.  Pretty cool.  I saw a C Section and a total hysterectomy on a girl younger than myself.  Enjoyed it, but OR is not for me.  I don’t want to look at the same 5 people all day long.

OB was this past week. FAB.  I, after panicking internally the first hour, fell right into my role.  The more you act like who you are, the more you are treated like who you are.  Same applies in nursing.   See my next post for a glimpse into what happened.

I’ve spent around 18 hours this weekend studying for various tests coming up this next week.  I really want those ‘A’s.  And I really want an invite to Sigma Theta Tau.

Guess that’s it for now.  I’ll catch you up as I remember stuff.  I am so honored to be among the chosen, everyday.  Of course this is hard work, but I love it.  I'm going to be a RN!