The Dog Ate My Care Plan…

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

Posts Tagged ‘clinical’

Welcome to Whoville

Posted by isntshelovlei on October 3, 2010

I’ve nicknamed my mental health clinical Whoville (land of the “small” people). One of the nurses on the unit, I’ll call her Cindy Lou Who, hasn’t been outright mean (like some of the Nurse Nastys of yonder clinicals), but she just makes these random, jabbing comments. First it was that we were only allowed to look at certain charts. “Well, you can’t look at all of the charts…just the one for the specific patient that you’re going to talk to…” Well um, since we’re not assigned specific patients, I kinda need to look at a few to decide which one I want to attempt to talk to since none of them really want to talk to us anyway. But fine, whatever, I brushed that one off. Then it was, “You do know what HIPAA is right? That you can’t talk about the patients when you leave here and all?…” Thanks for the heads up but um yeah, I didn’t start nursing school yesterday… Brushed that one off too.

Then today was the kicker. The patients have morning community meeting directly followed by another group. To make a long story short, for various reasons we decided (along with our clinical instructor) that we were not going to attend the second group meeting. Cindy Lou Who pops her head in the report room where we were working on our process recordings and says they were about to start group and that “if” we wanted to go we should go now as to not disturb the group being late. We nodded/acknowledged/said okay and continued to work on our assignment. When we emerged a little later Cindy Lou Who assumed that we had left in the middle of group and starts going off about how we can’t just walk out of group. In order to calm her frazzled mind, I jumped in “Oh no Cindy Lou Who, we didn’t walk out—we decided not to attend the group today. Our instructor thought it might be better if we gave the patients a little space and not attend both groups since they’re back-to-back.” Well the sky just opened up and the lightning struck. She goes off saying that she went out of her way (ten feet down the hall?) to ask the guy if he minded if we attended his group (he honestly did not care one way or another) and that we should have told HER we weren’t going to attend and that the fact that we didn’t was “disrespectful.” Now I admit that maybe there could have been an ounce more of communication, but disrespectful? I think that’s a bit much.

So for the remainder of the day, Cindy Lou Who’s whole demeanor towards me changed (you get very good at reading nonverbal/body language when you take psych) and at the end of the day when we made sure to tell her (because I for one sure didn’t want to be accused of being disrespectful again) that we were going to post-conference she gave me the grizzly!! WTF?!? How old are we again?

Then we have Betty Lou Who, the other nurse on the unit, who usually just flat-out ignores us. She even told our clinical instructor on our first day in not so many words that they “don’t really deal with the students.” Some teaching facility huh? Most days I am just splen-dant with just tuning her out. But today, she asked if we minded doing some vitals for her. Surprised that she even acknowledged our presence we said sure no problem, it’d provide an opportunity for some small talk with the patients…especially since they were still a little hesitant to open up to us. Then one of the other staff said to her that we weren’t “here for that,” but were “here to learn about mental health.” To which Betty Lou loudly replies (as if we weren’t standing right there) “SO!! It’s not like they have anything better to do!!” WOW. Just. Wow.

After lunch, we normally have a mini post conference with our instructor to discuss any morning issues before we head back to our units. Perhaps she thought we had snuck off to Starbucks or something so I guess she thought she was putting us on blast or getting us in trouble when she exclaimed quite grandiosely (in front of our instructor) “OMG!!! You missed it!! You missed the patient escalating! Where have you been all this time?!?” I was pretty much dumbfounded with her behavior at this point as for the past month or so she hasn’t given us a second glance so I am pretty sure my mouth just hung as I looked at her like she was crazy. She had this sort of self-serving smirk on her face as if she had really stuck it to us. Imagine the amount of salt she had to remove from her shoulder when she was informed that where we had been, was with our clinical instructor (imagine that…).

I really don’t get the whole nurses eating their young thing, but to me it just goes against the very grain of what I thought nursing is supposed to be…

“You’re a vile one, Mr. Grinch…You have termites in your smile…You have all the tender sweetness of a seasick crocodile…Mr. Gri-inch…Given the choice between the two of you, I’d take the uh… seasick crocodile…”

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Posted by isntshelovlei on March 22, 2010

Our first day in Maternity/OB clinical was pretty uneventful–almost downright boring. Part of the problem is that we have clinicals on the weekend. C-sections and inductions are not typically scheduled for weekends. So we are basically just sitting around waiting for someone to spontaneously go into labor (and with all the planned C-sections these days I’m not sure if people still do that…). There was a single postpartum mom on the entire unit. The clinical instructors had to go “find” a baby so that they could show us how to do a newborn assessment. I will admit technically it was just our hospital orientation day (which translates into boring computer training on yet another EHR system), but I was all ready to palpate some funduses (fundi?) or something. I also heard that we’re not even going to be giving meds which leaves not much else to do than a lot of patient teaching–if there’s anyone there to teach…

So although many of my fellow students are still excited about this rotation since some would like to work in maternity, I can already see it’s not my cup of tea. I need more “action”–like in an intensive care or ED environment (but real emergencies–not “my baby has hiccups”). Not that I thrive off of dire emergencies or people being critically ill/injured but when you’ll be working 12-hour shifts I’d like to be doing a little more than reading the tabloids at the nurse’s station (don’t act like you haven’t seen it). Who really cares how Kendra Wilkinson lost 10 lbs in 10 days?–she probably ran 5 miles a day on a strict diet of romaine lettuce…

Of course now I’ve totally jinxed myself and this weekend it will be on and popping (hopefully)…

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Slow and Steady Wins The Race!

Posted by isntshelovlei on December 18, 2009

So it’s a wrap! At times I wasn’t sure that I would be able to do it (or that I even wanted to anymore), but I made it through my first semester of nursing school! I also got my first B in about eight years—damn philosophy/ethics! It was a high B at that—like an 88.5—so close and yet not close enough. But I’m actually okay with it. My primary focus was on nursing and I did extremely well. Finals were not as bad as I expected them to be; neither was the dreaded HESI. For anyone planning/needing to take it, what I found to be really helpful were the case studies and practice quizzes/tests on Evolve. I also liked that they gave you the rationales for the correct and incorrect answers—it really helps you learn to critically think through the scenarios. I’m not saying the HESI was a breeze because it wasn’t, but it was manageable. Some of my classmates may not agree with me seeing as though the class average on the exam was a 613. But I got a 1033—not too shabby. So I’m feeling pretty good—and it was comforting to know that all of the stress, the meltdowns, and the hair loss were actually turning out to be worth it.

But now when I get home from work I find myself totally stupefied. No chapters to read, no care plans or concept maps to develop, no exams to study for—what in the world am I supposed to do with myself for an entire month? And has cable always been this crappy?—there isn’t anything good to watch that I haven’t seen enough times to be able to recite the script on my own. I will get to spend more quality time with my family though. It gets so hectic during the semester that sometimes I feel like I’m just a family member visiting from out of town. Even my son has said a couple times—“it seems like I haven’t seen you for three days!” Between getting up at the butt crack of dawn to go to work, not getting home from class until after they’re asleep, and then tiptoeing out to clinical like a thief in the night on the weekends—sadly, sometimes that’s almost true. In order to pull this off everyone is making a few sacrifices—not just me.

During the break I’ll also have a little time to work on a few scholarship applications (times is hard, lol)—I know for one the deadline for the FNSNA scholarship is coming up in mid-January. Join me for a little friendly competition?  

But before I know it I’ll be bored out of my mind and ready to go back to school (and back to bedlam). Spring semester I’ll be taking Health Assessment and Maternity—maybe I’ll get to catch a baby or something 🙂

Happy Holidays and New Year to all—I’ll see you in 2010!

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Finally—Patients With A Pulse!

Posted by isntshelovlei on October 16, 2009

thumbnailSo we are finally out of the lab and in the hospital—woohoo for making it through all the exams, math tests, and lab practicum that made it possible. For a minute there I was becoming a little unraveled and thought I wasn’t going to make it. Our first day we had hospital orientation—which of course was boring as all hell. Videos upon videos we watched—fire safety, restraints, Accu-Cheks—ancient VHS tapes (do they still make those?) that they’ve probably been using for decades. And since watching TV has become such a rarity in my life these days, having to sit there and actually watch those videos for hours was just pure torture. Afterward we took a tour of our unit and the staff rolled their eyes at us with this “OH GAWD–we’re being invaded by nursing students” look on their faces. But whatever—never mind them. On my way home I stopped at Barnes and Noble to pick up a care plan book—Ackley’s Nursing Diagnosis Handbook—I LOVE that thing and highly recommend it. That along with my Medical-Surgical Nursing textbook (which at 2016 pages is more like a nursing bible) helps me crank out care plans with no problem.

Day 2 of clinical we were actually assigned a patient. The nurses were still less than enthusiastic at our presence, but none of them were downright nasty—though there were a couple that were a little more snappish than I would usually tolerate. But since this wasn’t my turf I had to fall back. I was assigned a sweet, older woman who basically had surgery but was discharged from the hospital too soon (imagine that—damn insurance pressure). So she had a fall, which landed her right back where she didn’t want to be. Acute pain, impaired mobility, and risk for peripheral neurovascular dysfunction were my nursing diagnoses for her. Probably should throw risk for impaired skin integrity in there as well. But basically all I did all day was vitals, hygiene/toileting, and meals. I didn’t get to give meds even though my patient was on plenty of them. I must admit I was bored out of my mind. The downtime at least gave me a chance to get a head start on my care plan. But even that was difficult given how cumbersome the nursing station had become with all the extra bodies—the only place left to sit was probably the bathroom!

And last but not least, we took our Fundamentals midterm last night (NCLEX-style questions of course)—I didn’t think it was so bad. You can usually narrow each question down to just two possible answers anyway. Both might even be right answers, but you have to determine which one is more right. Ah, the joys of nursing school…

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