This week we got to do more simulation training. We learned how to clean a PICC line (peripherally inserted central catheter). A PICC line is a catheter that is inserted through a vein and ends at the superior vena cava. This skill is a skill that needs to be completed while maintaining sterility.

Last semester we learned how to complete a full body assessment that lasted about 30-40 minutes to complete, but during the simulation, we learned to perform a 10 minute shortened and more focused health assessment.

Since my clinical rotation is at Memorial Medical Center, I had to take a class on their computer system. Their system is named EPIC and it as a very efficient form of charting. Thankfully, it doesn’t seem too difficult to use, even though it was very tough for some of the older, more experienced nurses at the hospital to learn it.

So far, second semester does not seem overwhelming yet, but then again this is just the beginning of second semester.

Today was such an overwhelming day. It started at 8:00 AM with a math test, went over the concept of making a care plan, inserted our first IV’s and ended at about 4:00 PM after getting to meet with our clinical instructor.

We first had a math test, which we have to complete with a score of 100%. We had 45 minutes to complete what seemed like a butt-load of questions. There was a moment when the instructor said “you have ten minutes remaining;” I thought I was going to die because I had about five pages left to complete. Thankfully, I completed the test in time, but have yet to find out my results. I hope I passed.

Second thing on the schedule was understanding how to make a care plan for which ever patient we end up choosing each week. A care plan is somewhat of a “map” to achieve care for a particular patient and includes information like diagnosis, assessments, interventions, and patient teachings.

 

 

We also performed our first IV today. I was so terrified. I thankfully had a great partner. My first try failed, so I was disappointed. Thankfully, I got it on the second try. I think I was more worried about the mess I made then actually getting my first successful IV stick, but now that I look back, I am very happy I was able to do it.

 

Thursday is our first day of our second semester and I could not be dreading it more. We have to write several (like 40) medication cards, review our nursing skills, read about how to insert IVs, and study for a math test. We have to get 100% in this math test as well, which puts on the pressure. I’m glad that we finally get to learn how to insert IVs; that’s the one thing I am very excited about.

Since I work in an ER as a scribe, I get to be exposed regularly to patient care. I learn even when I’m not in class. I feel like all of this information I learned first semester and the stuff I’m exposed to in the ER is finally clicking. I am starting to “connect the dots” when thinking about a patient’s condition.

The assignments we are going to do more than enough of this semester are going to be care plans and I think I’m ready for it. Care plans involve all nursing interventions, outcomes, teachings, etc. that will be used for our assigned patient. Each care plan is specific to each patient, of course. 

Although, I hate that I’m gonna get super stressed out again, I think I am ready to take this semester on head first.

Alright, it is a new year and like other Americans, we nursing students also have new year resolutions. Last semester I tried the 17 Day Diet, which by the end of the 12th day was making me lose plenty of weight, but was making me a very miserable human being. I was not able to concentrate and it was finals week, VERY BAD MOVE. I still passed my finals, but left me slightly demoralized. That diet gave me head aches, a bad mood, and clogged me up to the point in which it looked like I had a beer belly…not pleasant, but now that i think about it, hilarious. I self-medicated with Milk of Magnesia and it was brutal, ha ha ha. So, I definitely stopped doing that diet.

My last year’s resolution was to lose weight in general. I went from 189 lbs to 155 lbs. So, I’m happy with that. My 2012 new year’s resolution is to get down to 120-130 lbs, which I think is very doable. I have had a good start by finally starting to work out again. I just have to continue this routine when second semester starts. I am sticking to a Mediterranean style diet, in which I can eat lots of seafood, but I have to remember to keep it under 1200 calories a day. So, I will be going back to using myfitnesspal.com again. If it works, why not use it again.

When I went to the hospital the second day, I was not as excited than the first for some reason. It probably was because that the adrenaline rush from the first day was completely gone. I was assigned to be with the charge nurse. She had a patient that had a traumatic injury with several broken bones and another with psychiatric issues. At this point I was able to see how much a nurse’s job is medication administration and how much is actual “nursing.” A majority like 80% of a nurse’s job is to give medications.

Much of what I did this day involved taking more vital signs, observing the nurse administer medications and keeping our patients comfortable.

Honestly, I wasn’t really impressed by the charge nurse. She seemed more willing to give up on one of the patients than the doctor, which left me disappointed and conflicted. I clearly remember one of the patient’s doctors tell her “we have to give him a chance.” That nurse wanted to put a patient on palliative care, which is care that is used only to prevent further pain and suffering, but not to necessarily treat a patient’s medical illnesses.

After this day, I left the hospital a little frustrated about the care that should be given. This day reminds me that I have to make sure that when I get to start second semester or my nursing career in general, I am able to provide the best care possible and not give up on my patients…….ever.

This concluded our Mentor Days and intro to being in a hospital care setting.

Mentor Days was a two day introduction to the clinical setting we are going to be performing a majority of our work at next semester. We follow a nurse and get to practice our nursing skills.

My first day started at an early 4:30. I unfortunately, live about an hour away from Memorial Medical Center, the hospital I’m assigned at. I was really excited to finally get to interact with real patients. I had the opportunity to learn how to use a new thermometer that measures the temperature of the temporal artery. I took plenty of vitals and got to assist patients with activities of daily living.

The nurse was showing me a little about the computer charting system. Memorial Med Center is a hospital that has gone fully computerized. When a medication is being administered, the nurse must scan the patient’s wrist band and medication.

The most exciting part of my day was when I had the opportunity of pulling out an IV. We are not allowed to insert IVs until second semester.

When observing my nurse, I assisted in providing a health assessment to the patients. I observed how she implemented patient teachings during discharge. I got to practice my teaching skills after that by teaching a patient how to use an incentive spirometer. An incentive spirometer is a device in which a patient inhales to promote full deep breaths, this prevents lung collapse and is for post surgery patients.

That concluded day one.

Tomorrow is our first day at the hospital. This day is called “Loading Day” at Stan State. It is an all day event in which we get our orientation to our assigned hospitals. I purchased my uniform, I have my white shoes, and now I’m ready to go.

The hospital I am assigned to, Memorial Medical Center, has the longest orientation, but I think it is one of the better hospitals. It is well worth it. The day will begin at 8:00 AM (or 0800 military time) and go on until maybe 4:30pm (1630). That is a rough estimate. They will go over their policies, technology/system used, and HIPAA. HIPAA is the law protecting patient information and helps remain patient information confidential; we will get a very long lecture on this, I’m sure.

The nursing program is incredibly stressful. There are projects to complete, skills to practice, and more than enough tests and quizzes to take. I am four weeks away from surviving the first semester and the stress is still exhausting. I have two online quizzes this weekend, the medication administration skill check off Tuesday, a presentation in my nursing research class and a test to submit next Wednesday.

There was a point in which I reached a new low, it was during midterms, and I just broke down. There was too much to do, too much work, and too little time. I would go to school and work, get home and start studying. I had no time for myself. I had to quit one of the part time jobs I had; my nursing skills instructor ordered me that I had to quit. Best advice I have ever had.

I am going to have to cope with this stress until 2014, when I finally graduate and take the NCLEX.

Right now some of my coping mechanisms are:

1. Humor- Nursing is a serious profession, but having a giggle every so often keeps your moral up. I have a tendency of blurting out funny comments; this helps me laugh and destresses me out.
2. Utilize Medical Terminology Out of Class- using medical terminology out of class by having a job or volunteering at a medical institution reinforces and adds to what you learn in class.
3. Texting Abbreviations- I use this for humor. I sometimes will text my boyfriend a general request or comment and incorporate a medical abbreviation like PRN (as needed).
4. Working Out- When there actually is time available, working out gets my mind out of my current situation.
5. Day Off- Take a day during the week like Sunday (if possible) to get out of the house and not do anything regarding studying or homework.
6. TV- Good ol’ TV is super relaxing except for when the only things on are Spanish programming, news and the Big Bang Theory…then it becomes a stressor. I always find the Maury show a destressor; when you are feeling down, it’s always better to make fun of people on that show.

If you are/want to enter the field of nursing, be ready to take on the stress that will accompany it.

Before I started the nursing program, I had been a serial procrastinator. Getting good grades had been a very important priority for me, but I always waited until the last minute to do anything. I ended getting plenty of A’s and about three B’s. I was able to do this while procrastinating.

I was sure that it would stop the moment I went through the program…I was completely wrong.

My thought was “if it ain’t broke, don’ fix it.”

I always considered myself a good procrastinator, but now a realization set in that being good at procrastinating is not going to get me anywhere. Much of the information that is heard or read during the program should be kept for the long haul and procrastinating doesn’t really help retain information.

Those habits are very difficult to surpass. It’s as if I was going through the whole diet rollercoaster ordeal: I say, “I am starting my diet on Monday,” but then Monday comes around and I continue eating the same crap as the day before, someone sees me and responds, “I thought you were starting your diet today?” I reply, “I was thinking of starting it Wednesday instead,” and so on.

It’s going to be time to make a change. I am promising to myself that I will stop procrastinating on all assignments second semester.

I am not going to lie; trying to lose weight during the nursing program has been the toughest challenge ever. During the beginning of the year I was a whopping 189 lbs; for a woman my height, 5 feet 3 inches, that is way too much. I had managed to get down to 159 lbs by the time the semester started and that is where it stayed until now. My strategy to losing that weight was to exercise 3-5 times a week and to maintain a 1200 calorie diet by using a free calorie counter; I used myfitnesspal.

I completely recommend using the myfitnesspal website and app for weight loss; it is great and totally free.

Unfortunately, the program is so challenging that I ended up using my time solely for working and studying, which slowed my weight loss significantly. It is difficult to track calories and exercise when you have no time to actually do it.

I had been 159 lbs until two days ago because I am trying a new diet that I heard about on Dr. Oz called The 17 Day Diet. This diet goes in 17 day cycles. It is a high lean protein, low fat and low carbohydrate diet. I ended up binge eating chocolate chip cookies the night before to signify my last high sugar, carbo-loaded to no avail meal. I went all-out with the cookies, ate pasta with meatballs and munched on my favorite candy, pretzel M&M’s.

I am barely on day 2 and it is difficult, but I keep a calendar to keep me motivated, I weigh myself daily, and I have a boyfriend that reinforces my commitment to weight loss. Today I weighed in at 156.6 lbs.

The diet is definitely working.

Before                                                        After, but not done.