RN 2 Be

A Student Nurse's Experience

RN 2 Be - A Student Nurse's Experience

5th Semester Done! One More to Go!

One thing that keeps happening while I go through this journey of nursing school is endless learning. Nursing involves learning every single day due to the changes in health care. As always, I have learned even more about what being a nurse is all about. I had a great opportunity to care for critically ill patients in the ICU to moderately ill in the ER. It has been such a great experience. From placing foleys, inserting nasogastric tubes, to giving very potent IV medications, it has been an experience that is going to help me further my confidence to get ready for practicum and start my nursing career.

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Thankfully, I was able to get through fifth semester and get through its challenges. Although it feels like nursing school is starting to wind down, I still feel the pressure. I still get plenty of stress, which is probably gonna be present until I retire from nursing, many, many years from now. I feel happy that I am one step closer to accomplishing my dream of being a nurse, no matter how stressful it may be.

Emergency!

I had the unique opportunity to be in the emergency room several times during clinical. It was a great experience. The ER is different compared to other floors in the hospital in the fact that, you do more focused assessments revolving on patients’ complaints. The types of patients a nurse may be caring for in the ER include patients with infections, bleeding, trauma, etc. You never know what problem the next coming patient will surprise you with. I got to practice many of my skills including placing my first nasogastric tube and inserting foley catheters, with proper sterile technique.

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There is some excitement, yet nervousness when getting to work with patients involved in traumas or that are severely ill. Overall, I really enjoyed the ER, even though the reality of time hit me. Five minutes have passed by, or so you think, but it has been over half-an-hour! Time flies when there are lots of things to do. I really learned the importance of understanding what happens to the human body in the ER. If a patient arrives to the ER with a certain complaint, it is important to anticipate what can go wrong, what the problem is, and what are the actions needed to relieve or attempt to relieve the problem.  I definitely learned the most here. The emergency room would be a floor I would want to work in.

In the ICU

The ICU or Intensive Care Unit was a good experience. Normally, the nurses in the ICU have two patients, but it can range depending on how sick the patients are. When I was doing my rotation, I got to care for one patient at a time. The great thing about the ICU rotation was really getting to practice my assessment skills. It was about trying to evaluate for subtle head to toe changes of the patient’s condition while also infusing plenty of intravenous drips. The patients normally have tubes coming out of many orifices such as a Foley catheter for voiding. When on a medical/surgical floor, it is more difficult to keep a watchful eye on all of your patients because normally you would have about five patients to care for. It was a great learning experience.

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I really enjoyed the ICU. I felt more and more like a nurse. Of course, I had a bit of fear due to how sick the patients were. I definitely learned so much on this floor and I could see myself doing ICU nursing.

Nursing Skills Faire

One word to describe our Nursing Skills Faire: EXCEPTIONAL!

The Nursing Skills Faire is an event in which all nursing students have a chance to practice their skills. Students from all semester get to interact with each other and share their ideas. It is an event that had just recently been started and it has a great future in our nursing program. I had a great time practicing my skills including attempting to place in an IV line, tracheostomy care, etc. I also had a chance to teach fellow nursing students information about interpreting laboratory tests.

Overall it was a great experience for me and hopefully for all the other nursing students and faculty involved. I hope to attend the next Nursing Skills Faire.

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IV Station getting ready.

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Practicing IV insertions on a “dummy” arm.

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Getting quick lecture on chest tube management by a clinical instructor.

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Chest xray interpretation by a clinical instructor.

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Clinical instructor assisting a nursing student.

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Successful IV insertion close up.

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Practicing blood IV infusion.

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Practicing at the foley catheter station.

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Clinical instructor assisting nursing student with utilizing the bag-valve-mask.

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Crowd of nursing students practicing at the PICC line station.

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Practicing tracheostomy care.

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Practicing more PICC line dressing change close up.

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Looking for a vein to insert an IV.

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IV after being successfully inserted.

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Practicing CPR.

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More foley catheter practice.

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ME doing some tracheostomy care.

5th Semester Starting

So my 5th semester in nursing school is gonna start soon. I am excited  to get back into the hospital and get to experience other floors. Floors that we get to learn this semester include the ICU (Intensive Care Unit), Emergency Department, OR (Operating Room), PACU (Post Anesthesia Care Unit), etc. These floors are specialized more compared to a regular medical-surgical floor and involve a higher level of expertise.

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In the mean time, our CSU Stanislaus Nursing Skills Faire is tomorrow. The skills faire is an event in which nursing students from the university can practice their nursing skills before school officially begins. I think I am ready to warm up on my skills including catheterizations, IV’s, and other sterile technique procedures. I will be working on the lab station and will be the acting photographer of the day. I am happy to be a part of this unique event that welcomes all nursing students from CSU Stanislaus to participate.

 

Community/Public Health Nursing

I finally felt that I was a nurse during my community/public health clinical. During our clinical for community health we had the opportunity to care for our own patients in their own homes. We had one instructor for the 10 of us, which meant that we would mostly be on our own. I learned so much about how to talk to my patients and how to prioritize their care. Since, we were mostly on our own, I was able, using “critical thinking,” to negotiate issues in regards to my patients. This clinical provided us a great opportunity to provide extensive patient teaching because we were able to see the same patients for several weeks.

 

One of my patients had uncontrolled diabetes and usually had blood sugars ranging from 200-300. After several visits, the patient was able control the diabetes. The patient’s blood sugars improved to a range of 160-180. I felt as if I actually made a difference in my patients’ lives.

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During this course we also learned how to evaluate the community we were serving. We developed a care plan that included interventions that may be attempted in order to improve the overall well being of the community and its members.

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We had plenty of speakers that gave perspectives on what other nursing careers are available including a correctional nurse and a nurse that works for emergency management. The emergency management public health nurse works for disaster preparedness and was the one that intrigued me the most. She plays an important part in allocating resources, staff, and other during a disaster. She has a job of developing a plan for any potential disasters that can occur depending on the vulnerability of the community.

 

Overall this is one of my favorite courses and makes me want to consider a career in public health when I am a more experienced RN.

 

School Nurse, How Cute!

I had a great opportunity to follow a district school nurse in the small town of Winton, CA. All I can say is that it was the cutest thing I have ever seen. The nurse, health aide, and I were assessing the children that were going to attend kindergarten. The assessments that were included were height, weight, and vision.

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It was very interesting to see the different personalities. Some of the children were happy to do it, the other were not. Those that did not want to participate were scheduled for a later date. After we were done screening some of the children, the school nurse and I went to another school in the district to assist a child with type I diabetes. The child understood how to administer her own insulin shot and was able to calculate all the sugars and carbs she had eaten in order to give herself the proper dose. As we were doing that, there were two other children that collided with each other while playing. Both were fine just a few bumps; the health aide helped the two kiddos involved in the collision with an ice pack and called their parents. It was as if it was a mini ER. Children can go to the health aide or the registered nurse if they have a complaint including stomach ache, head ache, or fractures. The aid or nurse will make the decision to call the parents to pick them up, 911, send the child back to class, etc.

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It was such a great experience. The staff from the school district was great. The nurse was a former CSU Stanislaus nursing program graduate and she was phenomenal. I can definitely see myself doing school nursing sometime in the future. Not necessarily as a new grad though.

Mental Health Nursing

Although this was not my favorite clinical, I learned plenty during mental health. Many, including myself, are scared of patients with mental illness. After this clinical, I realized that society has influenced us to have that fear. Patients with mental illness did not ask for it and it should be viewed as other illnesses are viewed.

 

I performed my mental health clinical in a locked facility called Doctor’s Behavioral Health Center, in Modesto. The center is split off into three areas: C1 (most functional), C2 (somewhat functional, mixed), and D (patients that are unstable and less functional). We did several days in each area. During other days we did get to go to outpatient locations to observe what forms of psychiatric care is available in the community.

I was given the opportunity to get to interact and practice our “therapeutic communication” with patients. I realized that there is no need to be afraid of these patients. There are treatments available that can improve the condition of a patient’s mental illness.

 

I am not going lie, it was sometimes VERY entertaining. It is our job to re-orient the patient, but when they state that they are someone famous or other “out-of-the-box” remarks, you can’t help but smile at the end of the day. One of the issues that I had was that we did not practice any nursing skills besides assessing the patients, giving out medications, and therapeutic communication. I don’t feel that psychiatric nursing may be for me.

Finishing 3rd Semester and On to the 4th

One of the last, very memorable clinicals we completed was in Madera, CA. We had the great opportunity to care for uniquely ill children at Children’s Hospital of Central California. I got to complete that rotation in the respiratory floor. In the respiratory floor, patients vary from those that have cystic fibrosis, need tracheotomy care, respiratory infections, etc. I feel that this experience really opened my eyes on how difficult it is for children along with their families to deal with difficult medical conditions. It made me happy that these children were in good hands with the staff and also the advanced medical technologies available for their treatment, specially in the Central Valley. We completed two days at Children’s Hospital and although it was a bit of a commute for me, I find it a very positive experience.

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Now that our baby-mama semester is over, it is time for 4th semester. Our 4th semester consists of Mental Health and Community Health. In mental health we care for patients with mental illness. Those illnesses may include bipolar disorder, depression, and schizophrenia. I was very intimidated and still are. It is important for us to learn therapeutic communication and to utilize it appropriately towards these patients.

Community health nursing, also called public health nursing, is one of the unique experiences that differentiates an Associates Degree nurse vs a Bachelor’s Degree nurse. A public health nurse (PHN) is involved with the health of the entire community rather than just solely focusing on the health of an individual. A PHN also performs home visits to different clients’ homes providing nursing interventions and teachings. We have yet to perform home visits on our own, but I am very curious about it.

Labor & Delivery…..OMG!!!

What can I say about labor and delivery?

 

I had the opportunity to observe several vaginal and cesarean deliveries. The experience of being next to the mom, helping the father get involved in the delivery was indescribable. It is that special moment of being able to see a human being in brand new condition, hahaha! My opinion of the birth process is that it is very traumatic. There is nothing more terrifying then seeing a woman in such a vulnerable position.

 

We monitor the baby’s heart rate and the mother’s contraction. Decisions are based on how everything is advancing. I feel like L&D is somewhat calm followed by a panic the WILL happen.

 

One of the things that we had to do after the delivery was to take the newborn’s vital signs including length and weight, APGAR score (general health of infant), and provide the infant’s first vaccination of Vitamin K to prevent bleeding. We also provided Erythromycin in the infant’s eye to prevent eye infections.

 

We monitored the moms regularly before and after the delivery, inserted IV’s, gave fluids, gave medications to prevent bleeding like Pitocin, then we sent them to postpartum.

 

It was a unique experience to be able to witness deliveries and get to see babies!