The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

Archive for December, 2010

The Graveyard

Posted by isntshelovlei on December 22, 2010

Armed with Starbucks and diet Mountain Dew (please no caffeine-after-dark lectures—I was a caffeine junkie when I worked days and this is now my day so I’m just adjusting my addiction accordingly), I’ve now joined the ranks of those that work night shift. The first day I was cool—I was wide awake all night just sipping away on my Mountain Dew (while other people  managed to sleep sitting straight up). I drove home the next morning still on a MD high, and couldn’t get myself to sleep. I called my husband to let him know that I survived the night and by his amused tone I knew I must have been rambling like a raving manic.  I have since tweaked my nightly regimen to cut off caffeine at around 4-5am so that I am able to simmer down when I get home.

The second night (which happened to be a week or so later) didn’t go as well. First, I didn’t get a (good) pre-nap in. The kids just wouldn’t let me be—they were running around like park apes, excited about finding our escape artist cat who came home looking all mangled (and probably pregnant my husband insists). Second, I had a headache that was on the verge of escalating to migraine status. And third, I was bored to tears (knock on wood). Some things take other people hours to do, but I like to knock them out and get them over with. Then I end up sitting there twiddling my thumbs and clock-watching (which really makes the time go even slower). And with the semester being over I had no homework or care plans to do, and no tests to study for.

Cheese. On. Bread.

When I finally went on break at about 4am, to my dismay McDonald’s had already started serving breakfast and I was craving salt (in the form of fries not some processed sausage patty). They’d also run out of fruit and yogurt parfaits which are about the only two things I’ll eat out of that place (sorry Ronald). And of course I had forgotten my “lunch”—if you can even call it that when it’s consumed at 4am. So I bought an orange juice which I figured was safe and settled down to play a few rounds of Angry Birds and Cut The Rope before going back to the unit.

And is it just me or is it extra cold in the hospital at night? Snuggie anyone?…

But things have gotten better; I’m adjusting. Even though I sleep when I get home in the morning it’s important for me to get that pre-work nap in—it really does make a world of difference. Any other night-shifters with suggestions feel free to drop me a line.

Meanwhile, I am loving winter break. I’ll be back to the wonderful world of nursing school on January 19th.

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Pet Peeve: Cafeteria Cooties

Posted by isntshelovlei on December 19, 2010

Now that the semester’s over, it gives me a little more time to catch up on my blogging. 🙂

So, without further ado…something that I have noticed in the past month or so that really bugs me is surgical gowns/dress in the hospital cafeteria. I mean full garb—right down to the caps and shoe covers. What is up with that? Take that nonsense off before you go to your breakfast/lunch/dinner break. I can’t think of one reason why you would need or want to have that stuff on when you’re about to eat. If you just came from a procedure I’m sure that you don’t want any inconspicuous gunk migrating from your immaculate (I’m sure) gown onto your nicoise salad, and if you’re on your way to surgery I’m sure that your patient doesn’t want shredded lettuce falling from your sleeve into their open wound.

The whole point of surgical gowns is to reduce/eliminate the transfer of bacteria. Do you know how much bacteria one comes into contact with in a cafeteria? The reusable trays, the handles on the refrigerator cases, the exchange of money, the tables, hell even the food itself if it’s not cooked to the proper temperature…Not to mention all of the other sick people in there. Sheesh.

I know that in the health care we are forced to find creative ways to do more with less time (and I also understand that people gotta eat), but I don’t think salmon with a side of soiled linen is a viable solution.

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Insights in Nursing Podcast, Episode 23

Posted by isntshelovlei on December 17, 2010

This week on Insights in Nursing the panelists delve into the Institute of Medicine’s report, The Future of Nursing: Leading Change, Advancing Health. Topics on the docket include the IOM’s recommendation to have eighty percent of the nursing workforce be BSN-prepared by 2020 as well as extending full provider status to advanced practice nurses—something that has seen much resistance by our physician-friends in the media recently. In addition to the nursing shortage there’s also a shortage of primary health care providers—APN’s are ready and able to fill that void. I’m not sure if the problem that (some) physicians have with this idea is because some still live in the ice age and believe that nurses are some type of subordinate health care professional that needs to work for not with doctors, or if they just don’t want us dipping in their honey pots… You be the judge.

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And Then There Were Three…

Posted by isntshelovlei on December 16, 2010

Finally!! Winter break is here. Thirty-four glorious days of care plan-free bliss. Final grades are up on Blackboard—I got an A in mental health/psychiatric nursing (thanks to getting a 102 on the final exam—gotta love those extra HESI points!), and to my chagrin I think I’m getting an A- in pediatrics. My final grade is a 92.83 so I’ll miss a solid A by 0.17 and I’m pretty sure she won’t round that up to a 93. Rounding?!? There’s no rounding in nursing school!! (in my Tom Hanks/Jimmy Dugan voice)…

But whatever, that’s four semesters down, three more to go—it’s all downhill from here—December 2011 here I come!!

Next up, Nursing Research (boo to 30-page papers!) and Med-Surg II…

Dec 21st update: 4.0 for the semester baby!

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Peds Wrap-Up

Posted by isntshelovlei on December 5, 2010

Although there were no sudden flashes of perception or insight, I was not visited by any wise men (or wise women—maybe in the form of Florence Nightingale?), nor did I experience any other surreal epiphanies causing me to exclaim “Eureka!” in the middle of doing a straight cath, pediatrics was definitely one of my better clinical experiences thus far.

So just a few things I’ve come away from this rotation with…

I now (to my children’s dismay) calculate safe dose ranges before I give my kids any medicine, even Tylenol. I’ve also gotten into the habit of calling drugs by their generic names and forget that I do so until I get a dumbfounded look from my husband after asking him to pass me the acetaminophen.

The fact that I have three children ranging in ages up to eleven has also helped me appreciate some of the more theoristic (is that a word?) stuff that you learn in pediatrics—which to be honest, up to this point has for the most part gone in one ear and out of the other. Take Erikson for instance. My four-year-old is definitely in the midst of the whole initiative vs. guilt stage. She doesn’t need you to tie her shoes, she can and wants to do it herself…and I have to force myself to let her—even if it takes five, or ten, whole minutes—for-one-shoe (oy vey). Same thing with the zippers and the buttons on the sweaters and jackets. Though if she could tear her attention away from NickJr. for a couple of minutes that might speed the process up a bit…

Even Freud wasn’t as out there as I’d originally thought he was. That Oedipus-Electra complex stuff may actually have a ring of truth to it. I don’t know about the penis envy and all that but my daughter is definitely a daddy’s girl and I am her number one competition. She makes sure to let me know that my husband is her daddy; don’t touch her daddy, etc. And she’s always talking all this “Mommy’s in the red, Daddy’s in the green” nonsense—what’s that all about? LOL.

This rotation I also felt more like a nurse and less like a PCA (no offense to my PCAs, but that’s not what I’m paying $500/credit to learn to be). This semester I got to do a lot more “real” nursing stuff and not just vital signs, AM care, and changing sheets (though I can miter like nobody’s business). Since the patient population we were working with consisted of mostly spinal cord injuries and scoliosis (i.e. post-op spinal fusion, veptr, halo, etc.), there were plenty of straight caths to go around (and to think I used to be scared to do those…), plus lots of IV meds, and pin care. Dealing with children and adolescents I got to practice my art of persuasion (or I guess in nursing it’s called “therapeutic communication”) to encourage them to meet their goals, where it was to increase their fluids or work on becoming more independent with their ADLs.

So all in all I think my pediatric rotation went pretty well. I also not only made benchmark on the peds HESI, but it was my highest scoring HESI exam to-date. 🙂

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