An Update:

Well. It’s the fourth week of the semester, and depending upon my enthusiasm in May, I have about eleven or twelve left.

How’s school going? you may ask. It’s going. I’d forgotten what it was like not to feel pressured so heavily – to primarily have that study left at work. In some ways, I like it. I have more time to focus on other things. I need to take this time I have and use it well – for, Lord willing, I’ll be dealing with that pressure again soon enough. Until then, I’m enjoying reading snippets of good composition and nutrition, and thinking how different this algebra is from a heparin protocol dosage problem.

Some random observations:

  • What is it with the crazy commercials these days? Really? Yes, I’ll come and buy loads at JCP because of your screaming commercial. You had me at the man stomping off shouting from a line.
  • Tape players. It’s weird to think how outdated they are. I remember listening to tapes all of the time when I was really little. We use them at work for nurses’ reports to the next shift. Managed to drop one smack on top of my right  big toe last week. Thank goodness we can’t find batteries for the things, or it would’ve hurt a lot worse.
  • A movie review for composition 2. Really? That’s unfortunate.
  • Angry birds is highly addictive – but it’s also easy to get tired of too. Thank goodness.
  • I’ve started the Weight Watchers program. It’s working well, and I’m glad of it. I tried Alli with great results a few years ago, but once I stopped taking that pill, I gained it all back. This program helps in developing a lifestyle.
  • To the Brother: These boots in sandy tan do not look like Princess Lea boots.

Happy February.

 

Remember Me When I am Gone Away

As most of you already know, a dear coworker of mine was murdered last week. I didn’t know her much outside of work, but we become a sort of family in the medical field.

Remember me when I am gone away.
Gone far away into the silent land;
When you can no more hold me by the hand.
Nor I half turn to go yet turning stay.
Remember me when no more day by day
You tell me of our future that you planned:
Only remember me:  you understand
It will be late to counsel then or pray.
Yet if you should forget me for a while
And afterwards remember, do not grieve:
For if the darkness and corruption leave
A vestige of the thoughts that once I had.
Better by far you should forget and smile
Than you should remember and be sad. 

~  Christina Rossetti

I wish I knew, or at least had more opportunity to talk with her about faith.

How hard it is to be reminded that life is a vapor.

Postfinals

As most of the readers here have gathered (I assume), I didn’t make it to second semester of my ADN year. I passed everything but Lifespan, and even there (I think), my grade was higher than my Family Nursing grade last spring. Thank you, RN year grading rubric.

What am I doing now? I’m working as an LPN and getting that vital experience of critical thinking. I sincerely hope that the responsibility I take at work and the more responsibility I take in my life will help with that. Also, as there has never been a “year off” in school in my short life, I couldn’t imagine just sitting this semester out. I’m taking 7 credits: Higher Algebra 2, Composition 2, and Nutrition. Thing is, I’m so used to the pressure of nursing classes that I’m currently acing everything – even though the grading rubric is way easier.

Am I disappointed? Understatement. I didn’t fail that class, I just didn’t get that 80%. I was very close. If I had really failed, I would hope that somebody would come up and give me a whack across the back of my head and tell me to “Grow up.” But this isn’t the case. I’m trying not to mope about it much now, and it has become easier to bump into classmates and tell them why they haven’t seen or heard from me for a while.

The college I attend requires that I submit a petition to retake the class not passed. My Lifespan teacher (and Nursing Program Director) graciously approved it without batting an eye, and I’ll, Lord willing, retake the one class next fall. No, I don’t have to retake skills and clinicals. I passed both of those just fine. Further encouragement that I can do this.

Now all of you fellow students know. Be encouraged and don’t take any passing grade for granted. :)

Prefinals

There’s something about ear-buds when only one of them work. I feel completely lopsided, and this is coming from a person who usually prefers to only have one in anyways.

But that’s besides the point. I’ll buy some new buds tonight, and no one will be happier.

Finals are next week. Next Wednesday to be precise. To say that I’ve been busy is a slight understatement, but things are working out well in various areas. Midterms were not fun, and my grade said as much.  My nice and round B dropped after that, and 80% is our passing grade. Yes, this means that 79.99% is failing. I’m very close to hitting that 80%, but I never thought that I’d have a class that I’d be fighting to pass. As long as I get a good grade on the final, I’ll be good. I’ve heard that the final is better than the midterm, but we’ll just have to see.

Clinicals went fabulously. I just realized that I hadn’t posted since before I started them. I had a day in infusion and surgery, and a few on the med-surg unit floor. It is a lot easier this go around, and the butterflies I had last year before walking into a patient’s room have all but disappeared. I contribute that to the experience work has given me. And, while I miss the hospital setting, I don’t miss the early mornings. Working the evening shift has done nothing to help my night-owlish tendencies.

Being in an RN role has taught me a lot about humility. Would that I’d remember that humility all of the time. :)

But there you have it: an update. And, I’m afraid, that’s all I can do now.

Best of test-taking and studying to all of you students out there!

Making Sense

Now I see why I didn’t work last year.

Balancing School and work and family and friends is starting to get to me. It’s starting to get to nearly all of us, and we’ve already had one dropout due to it. The wind sings outside with the huge temptation to just sit and look at all of the beauty, and we put in earplugs or ear-buds to tune it out.  Oh well. It’s only till May, right?

On a slightly different note, I have a question for both patient and nurse(ing student).  In my last post, I mentioned a cardiac case study that I needed to have completed, and now’s the time people are required to post “peer responses” to them on the class discussion board.

Here’s the case with the specific question I’d like your input on:

You are the charge nurse working in a long term care center. Mabel is an 85 year old resident with a long history of congestive heart failure, a myocardial infarction 3 years ago, COPD, hypertension, and degenerative joint disease. Her medications include: furosemide 20 mg QD, enalapril maleate (Vasotec) 5 mg QD, digoxin 0.125 mg QD, KCL (potassium chloride) 40 mEq QD, and ibuprofen (Motrin) 200 mg QID. 

Today, Mabel (who is consistently alert and oriented x3) complains that she “just doesn’t feel right.” The nursing assistant reports that Mabel’s pulse is weak and irregular at 116 bpm and her skin feels cooler than usual. You go to her room for further assessment.

After reviewing the ECG, the physician decides that Mable is in atrial fibrillation. Mabel is again alert and oriented and her daughter is with her. 

6)    How would you explain atrial fibrillation to Mabel and her daughter?
Because the condition is being explained to those outside the medical field that are most likely frightened at this diagnosis, it is important to bring the explanation to their level of their understanding. An important thing to make sure of before explaining what afib is is to provide any education (if needed) on how the heart works – its parts, what they do, etc..

Atrial fibrillation is the fibrillation of the atria of the heart. Fibrillation resembles a sort of quivering. The heart rate is quick and irregular. This means that instead of moving all of the blood from the atria, the atria will have some significant pooling. The ventricals of the heart can beat more rapidly, causing the ventricals to have decreased filling. Because of this, there is a decreased cardiac output. (Iggy, 745)

Atrial fibrillation can be caused by many different things:

  •  High blood pressure (hypertension)
  •  Diabetes
  •  Congestive heart failure
  •  Valvular disease
  •  Male gender

We can assume that Mabel’s atrial fibrillation is due to her congestive heart failure.

Another important thing would be to discuss the treatment for atrial fibrillation.  But this education would probably be best provided when the doctor orders the treatment(s).

There is no offense implied in “bringing the explanation to their level.” I know that it would be difficult to have an explanation of something I didn’t understand in the most complicated unfamiliar jargon presented to me. I’m hoping that this part isn’t insulting anyone’s intelligence.

Now, some of the peer responses I’ve gotten back are saying that I should include things like how atrial fibrillation can increase Mabel’s chance of death, and stroke (she already has CHF). I didn’t add this at this time, quite frankly, because this was what I believed was the initial explanation.

But what do you think? Is this an explanation that is easy to understand or no? And, what should I add or take away from it to make it more beneficial for Mabel and her daughter?

Thanks!

(P.S. Don’t read into any incorrect form of grammar here . . . I didn’t exactly take the time to iron out all of the wrinkles.)

 

Update Time:

I’m sitting comfortably in my room right now. There are books on the floor by my feet, pencils and post its on the shelf and table next to me, a Denver II test set to the side that can’t seem to shut up . . . and in front of me is my whiteboard with my “To Do” list on it.

  • Cardiac Case Study #3 (nearly done)
  • Denver II test (just did today, but haven’t written anything down)
  • Community Paper
  • Adult Nutritional Assessment (1/4 of the way through it)
  • Lab reading Assignment
  • Finish studying Resp./Cardiac Reading Assignment
  • Cardiac Reading Assignment

And, to prove that I have a life:

  • Crochet 3 rows on blanket

Ha. Aren’t you convinced.

Anyways, school stops for nobody, and faint heart never won nursing degree. Grades are becoming more consistently pass-worthy (yes, there were a couple of complete bombs), and while I wanted Dean’s list, I’ve since been convinced by past RN students and current experience that 80% C’s are beautiful.

Hope all of the other students reading this are having a good year so far!

 

If It Was Easy, Everyone Would Do It

I guess I’m not so good at posting on here. And, from what this school year has already entailed, I’ll not be posting as often as I’d like.

Registered nursing coursework is in full swing. I’m only taking nine credits this semester, and one of those credits is a med ethics class that doesn’t start until October 17. It’s hard to believe that we’re already into week three. I’d have a countdown till Christmas break, but that would just make things more stressful. Focusing on the current coursework is enough work.

This year, the teachers made it extremely clear that we wouldn’t be focusing so much on the data and information that needs memorized as we did last year. Instead, we’ve to learn to think in a whole new way. Yes, we have to remember the information from last year, but we have to use that knowledge and apply it to critical thinking.

And here I thought we were doing a good deal of that last year. Guess not.

The tests are amazingly difficult. The questions are all testing our ability to think critically for different scenarios. I have yet to see a question that simply had to do with knowledge of the material we covered. Last year, we had questions like “Below are listed various lab values. Match them to the appropriate lab tests.” This year, we have questions like:

“Day 1, noon. Jake is a 55-year-old Caucasian male admitted to acute care with a respiratory infection. Jake has a 50 pack year history and a diagnosis of COPD. He awakened this morning with increased shortness of breath and coughing up greenish- brown sputum. Vital signs are BP 146/84; P. 92; R 30; T 100.2 orally. Physician orders include:
– ABGs stat
– Sputum for C&S
– Ampicillin 500 mg IV q 6 hours
– IV D5W at 100mL/h
– Albuterol 3mg per nebulizer qid and prn for acute dyspnea
– 02 at 1.5 – 2 L/min per nasal cannula

 Relate this clinical data to the diagnosis of COPD. What other sings or symptoms would you expect this client to exhibit? In what order would you implement the physician’s orders?”

And that still doesn’t quite seem like the best example. But you get the idea.

The first two weeks we covered mental health. I thought that it would be pretty easy, but – again – I was proved wrong. The question you see quoted above is from a case study for our week 3 respiratory unit. I’m looking forward to these units. Even that question has an answer that makes more sense to this overloaded head of mine. :)

We’ve had labs on starting IVs, changing central line dressings, NGs, assessing the adult from head-to-toe, communication, and miscellaneous other information. Tomorrow, we’ll cover the pediatric assessment.

Speaking of, I’d better get back to reading for it.

Happy September!