- Assessing heart sounds
- Assessing lung sounds
- Assessing bowel sounds
- Assessing vascular abdominal sounds
- Administering a bolus or continuous feeding (open and closed systems)
- Administering any medication (other than IV or obviously IV push)
It was nerve racking. I've never had such horrible test anxiety in my life. Not to mention my instructor threw some curve balls at me. Assessing the lungs, heart, abdominal vascular sounds, and bowel sounds were fairly simple but she threw some landmark questions at me that were pretty specific. We are required to know exact landmarks, so if she asked me where I might expect to hear the S2 heart sound loudest, unfortunately, "Right there!" is not an appropriate answer: it would of course be at the fifth intercostal space, midclavicular line.
The tube feeding was fairly easy;I just remember that on skills check I have to check the pH of stomach acid each time before administration, but in all honesty, I don't think I've ever actually seen this done on the job.The tough ones were the meds; they threw some tricky ones at me to catch. Doctor orders for enteric-coated pills to be crushed and given through patient's NG tube, antihypertensives that required me to take an apical pulse for 1 minute and ended up being contraindicated, drugs given in larger-than-therapeutic doses, and sublingual nitroglycerin pills for an NPO patient (which I remembered that the benefit of nitro, as long as it's sublingual, outweighs the risk in an NPO patient).
I made it through though and am happy to be continuing my clinicals in a larger, more-renowned hospital with much sicker patients than the last hospital I did my clinicals at.
Oh, even more good news! If you read my last blog post, you know I was waiting for a grade for an exam. I got an 87%... that's freakin' awesome! That brings my theory grade to 83%. I'm sitting pretty on that for right now. I expect I'll be completing this class successfully, unlike last year.
Yesterday, I also got a free H1N1 vaccine because of being a nursing student. This is wonderful news because if I brought this home to my kids, I would be devastated. Secondly, if I caught H1N1, the resulting isolation and week of recovery time would likely destroy any chance of completing nursing school.
I also have attended an interdisciplinary workshop on elderly assessment. I got some great tips from physical therapy on determining fall risk, a great screening tool for geriatric depression, a "brown bag review" program, and some other really helpful stuff.
All-in-all, it's been a pretty positive nursing experience for the last two weeks. Things are looking up and I really think I'm going to be successful this year!