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I survived my second Hospital Clinical, and my first as student nurse largely in charge of my own patient! Here’s how it works: the actual hours at the hospital are from 6:30 AM to 12:00 PM. If it’s your day, you show up at the hospital the day before between 3 and 5 pm to ‘get your patient.’ It puzzled me when I first heard the term: do we take the patient home for a trial run? Do we play practical jokes on the patient and yell “Gotcha!”?
Or maybe just start building that important nurse-patient relationship….
Actually none of the above. “Getting your patient” means you look at the yellow paper in the nurse’s break room and see what patient you will be assigned to. Then you look through several different charts and write down….. well, if you’re me you write down everything you can decipher (which includes pretty much nothing from the physician’s notes.) In particular, you write down why this poor guy is in the hospital, what meds he’s taking, what therapies have been ordered, results of labs. There is NO patient contact at this time. Then you go home, research all the medications and why he’s taking them, research his disease process and what things nurses can do to make it better, and try to come up with some dang nursing diagnoses.
Our group was the pilot group, and 2 hours before our very first get-your-patient time, we got some startling news. There might not be enough patients to go around; the hospital census was low right now. If necessary, some of MAY have to be ‘team leaders’ or just go around and help other people with THEIR patients. Sure enough, half-way through Pharmacology Class, we got an announcement: Kathy and Adriana go see Heidi (one of our instructors) after class. We were going to be team leaders, while the other 7 students were assigned to a patient.
Even though we didn’t have to, I went to the hospital and ‘helped’ Kim gather info on her patient. I was rather disappointed and wanted to learn all I could and have as much of the clinical experience as I could muster. Also, Kim was my ride; I wasn’t goin’ nowhere til she was ready! While we were there and all had charts pulled out, we heard a ‘code blue’ for room 223 go out on the loudspeaker. Suddenly, Monica didn’t have a patient either!
At the hospital the next day, I really wasn’t sure what I was supposed to be doing. I ended up checking meds for Monica (who got a newly admitted patient the next AM), fetching iced water and making beds. The highlight of the day was getting to give flu and pneumonia shots to a woman in the hospital, under strict observation of the nurse, of course. It wasn’t nearly as scary as I though it would be.
So, for Clinical #2, Adriana and I were pretty much guaranteed to have a patient. And again we ended up with 2 team leaders; Melissa and Charity. I had the perfect patient for my first day. He had had surgery for prostate cancer and was recovering nicely. I got to take his IV out, do a physical assessment on him and give him his oral meds. I had a slight mishap there, as one of his pills leaped over the table and skittered under his bed when I attempted to remove it from its foil backed enclosure. Charity had to call the Pharmacy and get me another one! I was able to be there when his doctor came in, and help out with his discharge instructions. Yep, he got to go home, which made him very happy.
So though I have a lot to learn, I am happy that my first day went as well as it did. Hopefully next time even better, and hopefully next time I will do better on my assessment and documentation. Really, Heidi, I promise.
I’ve been meaning to post, really I have, but every time I think about starting I feel guilty and end up reading about respiratory function or thyroid hormones or watching videos on wound care. Tonight I am stifling and/or ignoring those nudges; besides, tomorrow is a holiday!
I had a revelation yesterday while Melissa and I were shadowing Chip, the Cardio-Pulmonary expert at the hospital ; people look at you differently when you are wearing scrubs, especially in the hospital. They look at you as if you had a right to be there and as if you actually know what you are doing (which is not at all the case, at least not yet!) It was very interesting, and Chip was funny and very informative. I was having a little problem that day; my ears, particularly my right year had been completely plugged for 2 days. I had tried Q-tips, vinegar, peroxide and isopropyl alcohol in the ear to no avail. If I inserted my finger and pulled down on the ear canal just right I could gain a few seconds of clear sound. I explained my problem to Chip “I can’t hear unless I do this with my ear.” “What?” he asked. I explained 3 times before I realized he was messing with me. We watched Chip do a nebulizer treatment for a 4 year old boy. The little tyke was cheerful and friendly, despite having a nasal canula up his nose and an IV in the back of his hand. It was hard to get him to stop talking long enough to listen to his wheezing and rhonchi lung sounds as he showed off his very own yellow plastic stethoscope and offered us some of his cookies.
We saw Chip perform an EKG on an elderly man who knew exactly what was going on. After the patient updated Chip on his symptoms he asked, “How is my heart? Am I in fibrillation right now?” After we left the room, Chip informed us that the man was a retired dentist. A middle-aged woman in ICU needed an EKG as well. As he hooked up the leads, Chip was teaching us: the black one goes above the red one- smoke before fire. The blue one went above the green one-sky above grass. This one was the ground. As he attached the ‘ground’ the patient suddenly yelled, “Aaaaah!” Melissa and I jumped three feet and nearly went into cardiac arrest on the spot. “Gotcha!” The patient was grinning at us. Sheesh!
It wasn’t terribly busy so Chip took a lot of time to show us the machines and tools of the trade. I was very surprised when this brilliant respiratory specialist had to take a smoking break. As Chip talked about secretions and mucus he told us a joke,”Here is how you can tell a nurse from a respiratory therapist,” he said. “You put everyone in a room with ‘excrement’ (word replaced to avoid pesky censors) up to the neck, then you hock a loogie into the room. The ones that duck are the nurses.”
At 11:00 AM our 4 hours were up and I left the hospital, determined to see a doctor about my ear that same day. After a little calling around, I got an appt with a nurse practitioner for a few hours later. UltraDad had some appointments of his own, and we met for lunch before heading our separate ways once again. After an assessment from the ‘doc’ the medical assistant put in some ear drops and irrigated my ears, removing a bunch of wax. Suddenly I could hear again! It was a miracle!
Today for nursing class, a couple of other people from the respiratory dept at the hospital came to our classroom and demonstrated a lot of the devices they use to help people breathe or breathe better. We also got a lecture on alveolar gas exchange and partial and negative pressures. Long ago when I had a bout of pneumonia I decided that breathing was a vitally important part of life that I usually quite took for granted.
Okay, time to wrap it up. You should really feel important. You beat out Senior Home Visit Assignment, Respiratory assignment and reading of 3 chapters in myNursing Fundamentals book to write you this post! More adventures later so stay tuned…..well, or at least check every couple weeks or so!
UltraMom
I thought Chip was going to miraculously cure your blocked ear.
That would indeed have been a satisfying ending, but he really didn’t seem at all concerned about my ear. Maybe if I had stopped breathing....
Ah yes, Wheezes and Rhonchi, less successful contemporaries of Captain and Tenille. Sounds like you are working very gard to great success. We are very proud of you!
Bob, it is making me type the work again...oh well...you are worth it. Kathy, I love all the stuff you are learning. Sounds like he did a really nice job. The smoking part IS pretty wierd, but I work with a RT who smokes as well...glad your ear got cleared up.
Aunt Debi, Bob says when it makes you type it all in you need to click log in and log in again. He says that will be true every time it happens. Great post Mom, I’m glad you could take a little bit of time to ‘relax’ and post on the blog.
I am so proud of YOU!!! It will be so fun to talk about nursing with my nurse sister!!! Way to go.
That sounds very exciting to get your own patients. And I bet taking out an IV made everything seem very real. Hopefully Elko will stop being so healthy and there will be enough patients to go around soon.
Hmmm. I commented a couple days ago and nothing is showing. I think I said something about how impressive it is that you are already being assigned your own patients. It’s probably a little intimidating and I know you will excel at it.
Site editor’s note, the wishing of ill health on the entire city of Elko is entirely an activity of Chenoa and in no way reflects the wishes of the Dynamic Duo. The entire Dynamic Duo community would also like to take this opportunity to proclaimhow extremely proud we are of UltraMom’s ongoing efforts/successes.
Okay, I am mollified. I thought I had lost my one consistent reader. Thanks for not letting me down, Chenoa!
Nice post.I appreciated your efforts.