Disappointment
Every once in a blue moon I fall off my horse (pony... whatever). I have a BIG bruise from falling on my pride... and the 72 (need a 75 to pass) I made on the recent Med-Surg cardiac exam. Believe me. No one is more disappointed. I dropped from an A average to a middle B. I studied for that exam all break (a week) and reviewed the information again starting Sunday for the test on Tuesday.
It is too easy to blame the instructor (as others have done) but I know the responsibility to learn the information lies with me. My goal was to knock the two cardiac tests (Pharm and Med-Surg 'out of the park'... oh well). I really wanted to demonstrate to my instructors that I am worthy of an advanced placement next semester. I sooooo want to work in a trauma unit, emergency room, critical care, intensive care... etc! I may have blown my chance.
I know what I did. For the first time in a loooong time... I panicked. I broke at least two rules I have for myself when preparing for a test. I studied a second set of notes (the instructor's... which I NEVER do) and I got only one hour of sleep the night before the test (due to losing confidence). Just stupid. I freaked out and suffered the consequence.
Moving on.
OB clinical... The Patient from H-E-double hockey sticks!
I know things sound negative this week but this is actually funny (now that I can look back on it).
Wednesday I worked post partum. I was assigned two patients. My first mommy was a day one post partum that delivered vaginally (this was her third) and... as it turned out... was an RN! (OMG!!!) But everything turned out well. She was easy and very pleasant. She was more interested in my program of study than being a difficult patient (which she was NOT by any stretch of the imagination). Very nice lady.
My second 'assignment' was a day two post partum that delivered C-section. Oh... if only my second mommy was as pleasant as my first. Its always a bad sign when your patient whines [Disclaimer: I was not the only one on the floor that commented about the whining... every nurse and even the physician commented on it]. Every hour... minute... second... spent whining. For those of you old enough... she was the real life version of the SNL character portrayed by Gilda Radnor, 'Wendy Whiner'. [Correction: Robin Duke portrayed 'Wendy Whiner'... not Gilda]
Anywho... my shift started at 0630. By 0631 I received notice from the nursing desk that mommy #2 (the C-section) was requesting my presence in her room. Fortunately my instructor went with me.
Upon entering, mommy #2 was standing in the middle of the room angrily shaking her IV pole and demanding, "I want this thing D/C'd (discontinued) now!" She wanted to go to the cafeteria with her boyfriend but didn't want to drag the IV with her (okay... I see). Before I could even open my mouth my instructor was handling it. After some back and forth it turns out that mommy #2 who had been on a liquid diet decided to eat an Italian 12" sub sandwich the night before without telling anyone [chuckle].
We discontinued her IV.
Here is an abbreviated version of the rest of the day with mommy #2:
- 0800 pt reported pain of 9 out of 10 in neck saying, "its like pleurisy," with student nurse replying, "pleurisy... in your neck?"
- 0805 student nurse notifies instructor that a telephone call to pt's physician is in order seeing that the only opiate PRN pain med on MAR is morphine IV [chuckle]
- 0830 student nurse reports to pt the situation with the pain med and a call has been placed to her physician; pt replies, "if y'all can't get my pain under control I'm going to the ER!"
- 0845 instructor marches to pt room and informs pt that she is not going to the ER and reminds her that if she hadn't insisted on her IV being taken out she would have gotten her pain med by now.
- 0900 telephone order from physician received by instructor; pt receives oral and IM pain meds... enough to knock out a horse!
- 0945 upon entering room pt found walking around room holding BIG camcorder filming baby in bassinet; pt surprised to see student nurse; pt reports pain is now a 10 out of 10!
- 1000 instructor rolls eyes as student nurse reports latest with mommy #2; instructor tells student nurse, "check on pt again in one hour."
- 1100 pt in high Fowler position nursing baby on right breast and watching television
- 1130 instructor returns with student nurse to room to conduct education session; instructor begins with topic, 'Proper Nipple Care for Nursing Mothers' with a swift reply from pt, "I don't breastfeed. I use formula"
- 1131 instructor undetered proceeds with new topic, 'How to Prevent Milk from Coming In'. [chuckle]
- 1200 instructor asks student nurse in hallway, "Wasn't she JUST nursing that baby an hour ago?"
- 1200:03 student nurse replied, "Yes. And her chart reads that way too."
Med-Surg Clinical Week 4 - Contact Isolation
The patient I picked up on Thursday with a diagnosis of abdominal pain evolved into a diagnosis of E. coli 0157 by the time I arrived on Friday. When I asked my reporting nurse about a blood pressure/pulse oximeter for his room I was told:
"Just grab any of the ones from the hallway... that's what I've been doing all shift."
"Is there at least a cuff and a thermometer in his room?"
"No. I've just been using the ones in the hallway."
"Uhhhh. Okay."
It was amusing that the nurse manager felt the need to take ME aside to sternly grill me about proper use of gown and gloves. But, I think I won her over quickly. I told her I understood and brought to her attention that my patient, who is on contact isolation, has no equipment dedicated in his room for checking vitals. She thanked me and then proceeded to quiz my reporting nurse by asking, "What equipment have you been using to take this patient's vitals?"
Ouch! I stayed out of that one.
My poor pt turned out to be an easy case. He was a walkie-talkie that stayed in his room, watched tv and drank tons of soda!
Again... nice guy. I hated that he was going through all that.
Posts
Oh, my. Good job getting through the day! :)
ReplyDeleteWhat a day! I think you and your instructor handled that OB patient very well. :) What doesn't kill you makes you stronger, right?
ReplyDeleteAbout the equipment for taking VS on contact isolation pts... where I work as an aide, it's common for roughly 40-50% of my patients to be on contact isolation. Wanting to maintain that isolation, I would try to use the on-the-wall BP cuff and in-room disposable stethoscope to take VS. Except that the BP cuffs were always disconnected, with holes, etc., and there was never a stethoscope in the room! I used to wonder why it took me so much longer to take all my vitals than the other aides.
Until I realized that everyone else was sharing the BP machines between ALL the patients.
Later that week a memo was sent out to the floor staff reminding them about rules of contact isolation, and the need to have dedicated equipment for isolation patients.
Sounds like your clinicals have been exciting!! You have a great story telling ability!!
ReplyDeleteI.love.your.blog.
ReplyDeleteThanks for making me laugh. I read your blog while attempting to get my 2 1/2 year old to bed (not AS I'm doing it mind you, when I walk away from her as she's screaming at me).
Don't worry about the bad test grade. You'll be able to pull up your overall grade, there's plenty of time left right?
Sounds like we have more in common than you think. As a pastor, I too must deal with "whining patience." Yet I wouldn't change a thing!:)
ReplyDeleteMy labor/delivery clinical rotation starts in Aug (stop me if Ive told you this already...lol) I have four kids, but Im freaked about it. Have you witnessed a birth yet? We are required to witnessa a cesarian birth and at leat 4 vaginal births as part of our clinical requirements. Im geeked!
ReplyDeleteI am enjoying your blog and Ive added you to my blogroll. Good luck in your studies. As a side note, on our first day of class we were told to give up the drive to 4.0 everything, what they forget is that we are conditioned to perform this way when we are 1 of 2500 applicants for 128 nursing student seats per year!!
Great blog. The hook that made me read was not only that you are also a nursing student, but one of your favorite movies is Orgazmo. Even thinking about it makes me laugh, and since only 30 people on Earth have seen it, I can't say DVDA to anyone who gets it but my husband!
ReplyDeleteYour day sounds as exhausting! But you made me laugh out loud. Thanks. Nursing school tests suck by the way; I'm one of the babies that blames the professor completely. Good for you for rising above it!
ReplyDeleteEnjoying your blog! -dfs