Monday, February 7, 2011

Week 5 of Semester Two of Nursing School

Falling Behind

At almost halfway through the semester, the assignments and exams were rolling in. I was barely keeping up, and I was running at 4-6 hours of sleep per day in order to get my homework and studying done on time.

Monday: Human Anatomy and Physiology quiz
Tuesday: Nursing Communication quiz
Wednesday: group presentation on Delirium, Dementia, and Alzheimer's Disease
Thursday and Friday: clinical days

For clinical, I had to look up 9 medications and read up on illnesses such as brain tumors and hypothyroidism. I also had to finish a Journal Reflection on a significant experience, and I had to fill in something called a Decision Making Worksheet, which lists all the patient information needed to make decisions and plan care for a patient. It was busy and go-go-go all week, but I felt pretty good by the end of it.

Screwing Up in Clinical

In clinical this week, we were partnered up with another student and given one patient to care for. It was exciting for me because I could focus on one client instead of a large group at once. Well, at least that was what I was expecting. In actual fact, there are 4 clients in one room so you're really taking care of all 4 of them at once. You only have a single patient if everyone else in the room is okay.

I greeted my patient with my partner and he turned out to be a really nice guy. He joked with us and he promised he'd try to help us pass our course, lol! Of course, the easy part of my clinical experience ended there.

I attempted to take his blood pressure and found that I could barely hear his heart beat when I put my stethoscope on his arm. I listened very carefully twice. The first time I couldn't hear it at all. The second time, I could barely hear it. I didn't trust such a sketchy report so I got my partner to check his blood pressure and I used the machine to get his blood pressure once too.

I reported the machine blood pressure to the nurse and my teacher got mad at me. She said, "We nurse patients, not machines!" She wanted us to be able to give a manual blood pressure reading and to be confident in our reports. Machines are often not as reliable as a manual blood pressure reading, so it is important for a nurse to be able to give accurate manual "bp" readings.

I attempted to check the patients blood pressure again the next day, but I really couldn't hear a thing. I went to the teacher and told her that I was having trouble with taking bp's and that I would like to have some more practice. "I can't hear a thing!" I said. So she gave me another patient to try it on.

Lo and behold, I couldn't hear a thing on him either. By this time, I was getting suspicious. I thought that I couldn't hear anything on the other patient because his blood pressure was low, but this patient should have had a regular blood pressure. I returned to the teacher and told her that I suspected that something was wrong with my stethoscope.

She was about to lend me hers when she stopped and suddenly had a realization. "Do you have it turned on to the right setting?" Oh, I almost died there. She tapped on my stethoscope. "Do you hear this?"
"I hear tapping..." She turned the stethoscope head and tapped it again.
"What do you hear now?" It was super loud!

Oh my goodness, I had done the ultimate newbie nurse mistake. I had been trying to listen to a patient's heart with my stethoscope turned off. Ugghhhh! I was so embarrassed. I could comfort myself that it's pretty good that I almost had the the blood pressure right even though my stethoscope was off, but that's really stretching it.

Anyhow, we had a couple more eventful moments in clinical where we were scolded for other newbie mistakes, but our client was so sweet. "It's okay, " he kept saying. "I don't mind! You girls are getting so stressed out! It's really fine with me!" He gets top marks for being supportive and thoughtful!

Since none of my clinical group proved to be stellar this week, we'll remain paired up for next week. We get new partners though and new patients. I'm spending a lot of time this weekend brushing up on my skills so that I'll be better prepared for next week. Newbie mistakes are forgivable, but I don't feel confident enough with some tasks like head-to-toe assessments and charting. I want to brush up on those kinds of skills.

Still Loving Clinical

Mistakes aside, I really enjoyed my clinical experience. I enjoyed talking with the patients and I flitted from room to room keeping an eye on little things like whether their water pitchers were empty. It was nice to say hello and to bring a smile to their faces. I also kept an eye on whether patients looked like they were not doing as well as before.

One fellow looked pale and dazed and I asked him if he was okay. He described feeling "not so good" and that he was dizzy. I got him to lay down and called the nurse over. I checked his vital signs and every thing was normal according to the machine, but when we manually checked his pulse it was irregular. (See why the machine can be a problem?)

There's just so much going on in a hospital ward all of the time. It's no wonder everyone is asking for more nurses. I'm glad that there are student nurses running around helping out, even if we do make some mistakes. We're at least another pair of eyes that can alert the nurses when something goes wrong, and it helps the nurses a lot to have us helping with the bathing and other menial tasks. The patients definitely appreciate the extra attention.

Anyhow, I better get back to the studying. I hope you all have a great week. Take good care of yourselves!!!
My Nursing School Diary

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