Back into the game

We had a break. A LOOONG break. Almost 6 weeks. I visited family and was gone for most of it which was lovely. I enjoyed my last non-working holiday. We are now back in session. I have been for three weeks now. We are having precepted clinicals. Which means... no professors breathing down your back. I am paired up with an RN. I LOVE her!

I am on a med/surg floor at the hospital that I want to work at once I graduate. I'm so excited. I had my first of clinical this past week. It felt so nice to be on my own in a way. My RN followed me for part of the day to make sure I did everything correct, she watched me do my assessment, questioned me on things to watch for when administering a certain medication, observed me while I administered them, checked over my charting, and checked in at times. I chose to only have one patient on the first day so I could learn the computer system, and the floor and not feel overwhelmed. My patient was a sweetheart. She had cellulitis of her leg and was very low maintenance. She was also very understanding of me being a student and patient.

I was pleased with my work. My patient told me several times she thought I'd be a good nurse. To me that is the best compliment I can receive.

I was also given the opportunity to start a catheter on another patient! A male one this time. It was my second catheter ever. It was an 80 year old man and I couldn't get the first catheter past his prostate. My nurse also tried and couldn't do it. I felt a little better that she couldn't do it either. She decided to get a coude tip catheter and try later. The patient was very nice and understanding, he had actually asked for the catheter. lol

After some calls and waiting a while we got the coude catheter and went to town. I prepped him again and got it in without any problems at all. It was beautiful. He was so happy to have it in too. And such a nice man, completely in love with his wife and very sweet to the staff. I helped him later on with his dinner and talked to him for a long time.

It was a great day. I gave report to the night nurse and went over my evaluation sheet with my nurse. She was happy with me and we decided I'd take two patients the following clinical. I'm thinking I'll get to three and four the third and fourth time. It'll be good to work on my time management skills and prioritizing between patients and charting on all of them!!

Graduation will come soon enough.

Labor and Delivery

I was able to watch three cesarean and one vaginal delivery during L&D rotation. I think, no.. I know I don't want to be an L&D nurse. I never thought I did. But rotation confirmed it. It was great to see these babies be born, but I don't enjoy being in the OR or dealing with the mothers. It's all the coaching that doesn't appeal to me. I love when the baby is out and doing the assessment on them, and seeing them for the first time, but really it was all I cared about... the baby. Dealing with mom's anxiety, pain, breathing techniques, position changes, monitoring contractions, checking cervixes, monitoring baby's heart rate, family hovering around was in no way appealing to me.

However let me share my experience. I was assigned to an RN that had a scheduled C-section. The patient was late 45 minutes so we just sat around and waited until she got there. We got her prepared and were waiting on the doctor for another hour. I was bored. We go in and I'm standing at her feet. I can see everything, and more than I wanted to. I'm hoping and praying that the smell of the cauterizer isn't going to make me pas out. I was good. She gets her anesthesia and my nurse is holding her hand and being all supportive "now just breathe, you're ok". They lay her down and strap her in for the ride. They start cutting her open. It took a long time to cut her open, they had to tape her belly on a bar because she was large so they could get low enough. They finish cutting, pull baby out, hand baby to nurse, and pull her uterus out of her body and plop it on top of her!!! I was in shock that they would pull it out of her just so they could stitch her uterus back together. The doctor calls me closer and starts pointing to the different areas "and here's her fallopian tube, and her ovaries, and this is her uterus, and we're going to do a ligation on here". Seriously. The patient is awake listening to the doctor talk about her insides. It was great. They stitch her uterus, shove it back inside of her, and start stitching her back together layer by layer. Oh that takes forever! I left the OR before they were done. It was pretty cool to watch the surgery and see all the water and blood. I'm glad I didn't pass out or puke in my mask.

The vaginal delivery was horrid! It scared the desire to have children right out of me! I mean the mess, the head coming through the birth canal... it was a little too much for me. I had a premium seat for this one too. She was pushing and pushing and I saw the head crowning and pushing and out baby comes. It was a mess, and mom had a tear and delivering a placenta. Oh it was just bad. I think if every teenager watched a delivery then we would eliminate the whole teen pregnancy thing. But again as soon as I saw the baby I was happy. I wasn't able to be involved with this baby because he was a preemie and there were tonz of people in the room. I mean like 15 health care people in there. It was nuts.

L&D was fun for the day. But definitely not something I ever want to do. I hope that when I'm pregnant I have sweet L&D nurses that love it, like all the nurses I came into contact with at this hospital. So because of that it would be bad if I went into it, because I really don't like it!

G: 11 P: 9

There are many people I know that have fertility problems. Good couples that want nothing more than to be able to have a baby of their own, some are waiting for a long time on somebody else to give up their baby for adoption so that they can raise that baby in a happy, stable home.

When I was in the mother/baby unit one of my patients was a 34 yrs old female that was gravida 11 and para 9. She was addicted to cocaine, bipolar and schizophrenic. I was told that CPS was involved and the patient didn't have custody of any of her previous children. And she wasn't going to have custody of this sweet baby either. Her little boy was a sweetheart. He was being treated with antibiotics because mom also had herpes.

After feeding him my nurse told me to take him to mom for a supervised 15 minutes visit. I was in there for barely 5 minutes and while she was holding her baby she was falling asleep and baby was almost falling on the floor. She asked to put him in the crib and take him away.

My heart broke for this little innocent baby boy. I wanted to take him home with me. I wanted to give him a life full of love and happiness. I wanted him to know that someone cared enough for him to hold him and cuddle him. I wanted him to feel wanted. I was so angry at this mom. I understand she has a long psych history, but I was still angry. While so many people I know want to be blessed with just one baby. She had been blessed with nine! Nine living children. And she had taken them all for granted that she didn't even have custody of them. They're in state's custody. Many women don't understand the blessing that fertility is. Many of them take it for granted, those are the ones that can have them by the numbers. Why is it that those that want nothing more than to be a mother can't and those that are shouldn't be?

I hope this baby boy goes to a family that wants him and that he is raised in a loving home. All I could do was love him while I was there. I fed him, and changed him, and held him as much as I could. I hope he felt wanted and cared for while I took care of him. Babies are a blessing and we should treat them as such.

Changing beds

Nothing beats the amount of times you need to change a bed in one shift for the same patients like diarrhea does. My sweet patient was an elderly lady that came in for renal failure and while in the hospital started having some diarrhea. I started the day doing her assessment and she had just started the diarrhea early that morning. The nurses kept saying it smelled like C-dif... I didn't know the difference. She has a catheter in place and felt weak so getting to the bed side commode was difficult for her. Shortly after the morning assessment she went potty the first time on her bed, so I got her out of bed, cleaned her up and changed her bed. She felt so bad, but I didnt mind. I tried to get a sample for it to be tested, but my nurse had given me tongue depressors to collect it with. I needed something more similar to a ladle to be able to get anything. But I tried,I got very little and sent it off to lab. During the morning she went four more times in bed. No matter how hard she tried she could never make it to the potty in time. I became her stalker after that. I was outside her door anytime I wasn't in another patient's room. AS soon as her call light would go off I would run in there trying to avoid changing her bed for the 5oth time. I was successful three times but by the end of the day I had changed her bed eight times in a ten hour period. The thing was that even though it was hard and really... a pain to change her bed so many times, in the end it became rather funny. She was very sweet, and enjoyed having me as her student nurse. I felt bad for her and didn't mind cleaning her, just for the simple fact that she didn't treat me like it was my job to do it. She was grateful. It was fine, just that simple fact. I would have changed her bed and cleaned her up 8 more times if I had to. It's patients like her that make me so happy I entered this field. No matter how much poop I encounter!

I love the NICU

I finally had my NICU rotation and I've fallen in love with those babies. I spent all day taking care of four sweet babies. Two boys and two girls. Two with tube feedings, one in an incubator. I just loved how mellow things were. Yes... things got busy if any alarms would go off, but it was so nice to not be running around from room to room trying to get my meds in on time. I was on the side with the growers and feeders. My nurse was kind enough to take me to the other hall where the sicker babies were. I saw all the tubes and ventilators and the super tiny babies. While I thought it would break my heart too much and I wouldn't be able to do it, I was wrong. It didn't break my heart, instead my heart was filled with so much love for these precious little babies that were so sick.

I still wonder if NICU will be too much for me to handle emotionally. I told my professor that I got the honeymoon side of the NICU since all my babies were pretty stable. I didn't take care of any dying babies. I still worry that a dying innocent baby may break my heart too much. I'm hoping to know for sure soon. I start applying for internships in January. The NICU of the hospital I did clinicals at really want me to apply to their internship. It's an amazing level 3 NICU, the nurses and managers were wonderful. Their internship is 6 months long after graduation. So I'm confident that they'll prepare me enough to take care of these preemies. However... part of me wants to do that year of med-surg. NICU was only for a day and while I loved it, I don't feel like I spent enough time there to really know I can do it. I have spent 2 semesters in med-surg and I know I can do it. Unlike my peers I enjoy med-surg. Oh the decisions!

I did it!

I finally put a foley catheter in a real person! My first one was even on a woman! This little 84 yr old lady was on her way to ICU shortly after I did the catheter. Now before you go thinking that it was my fault she was sent to ICU let me reassure you by telling you that the whole reason we were given the order to do it was because she was going to ICU and they were going to put one in there anyway. I was super excited and terrified at the same time. I had my instructor there and another student nurse, a smart buddy. :) The hardest thing for me was holding things open. My hands hurt afterwards and I could feel my shoulder shaking a bit. The "hole" was much further down than I expected and I really had to hold it open far apart to see it. I spotted it, cleaned her, and went. I got in first try. No problems. I couldn't believe it was actually going in. My instructors is "cheering me on" and telling me to keep going and I'm thinking how far am I going!!! And then I saw the most beautiful thing... urine coming down the tubing and into the bag. The tubing that I inserted! My buddy inflated the balloon and it was in for good.
My professor was very proud and she said I did great, and my buddy said she's never seen a better first try foley. I was obviously gleaming with pride. However the best thing came after everyone left and it was me and my patient. She was all clean and covered up again. I held her hand and she looked at me and asked if she could go pee, I told her she didn't have too because she had the catheter. She asked me again if she could go pee and I understood what she meant and said yes you can sweetie. She looked into my eyes with the most honest and grateful eyes I have ever seen and said thank you so much. I was touched by this, I felt like she had done me a big favor but she felt like I had done the same to her. It's just such a "degrading" procedure and you're so exposed that I really felt like she meant it and was honestly grateful for the catheter. It really was a great experience. It wasn't easy, but it was great.

A little strength needed