Tuesday, December 29, 2009

H5N1: H1N1's Big Bad Brother

Dr. Chan of WHO, the World Health Organization, warns that the H1N1 flu could still mutate warns.

More than 11,500 people have died, although it looks like we are through the worst. It could still mutate into a more deadly strain, however, the real danger is still from H5N1, the bird flu, which is even more deadly than the H1N1.

Imagine the uncontrolled rate of infection we experienced with H1N1 with the deadly power of the H5N1...

We really need to prepare better for these outbreaks.

What Does an OR Nurse do?

I'm really up in the air about what I eventually want to do with my nursing career. As such, I like to look up various advanced practice nursing careers and see if any particular one strikes my interest.

I've always thought surgery was cool; I enjoy watching every surgery I can on TV. But nurses aren't surgeons... so what is it exactly that they do? What I did know: nurses setup and observe the sterile field for potential contamination. What I didn't know: there's quite a bit more they do!

An article at allnurses.com written by member BethCNOR, describes an OR nurse's role perfectly. In my nursing studies, I know all about ADPIE (that's assess, diagnose, plan, implement, and evaluate in case I have any students here not in their first nursing semester), however, how do these actually apply to the OR nurse? Here's what I found out by reading this great article:

  1. Assess - Assess the patient before surgery for NPO status, medications and when they were taken, skin color, respirations, verification of vital statistics, placement of any devices such as a pacemaker, defibrillator, etc.

  2. Diagnose - Several great nursing diagnoses here: impaired gas exchange, activity intolerance, anxiety, alternation in nutrition: less than body requirements, r/f infection all of which can be r/t anesthesia, pain, or surgical procedure. No shortage of nursing diagnoses for the OR nurse!

  3. Plan - Nurses may set up the surgical instruments without contaminating a sterile field, plan where equipment will be placed to avoid contamination and provide the surgeon with a clear workplace, ensuring that the patient is properly marked and that none of the requested anesthesia poses a threat for an allergic reaction. Nurse may also plan care for the recovery suite; deep breathing, activity, mental status, etc.

  4. Intervene - Placement of foley cathether, correction of any breaks in the sterile field, surgical skin preparation, etc. Long list for interventions!

  5. Evaluate - Probably the easiest one to guess; evaluate the effectiveness of your interventions, the condition of the patient, etc.

This seems like a really cool job and one that I'd be interested in to say the least. Great article; stop by and see the original for yourself!

Monday, December 28, 2009

EMTs in New York Refuse Care; Patient Dies in Bathroom

Two New York City
EMT's accused of walking away from a pregnant woman who collapsed and later died
have been suspended, city officials said today.
The two fire department
employees, Jason Green, 32,
of Long Island City and Melissa
, 32, of Queens Village, were suspended without pay as the
investigation continues into allegations they refused to help the woman because
they were on break and wanted to eat breakfast.

This is absolutely horrible. I hope that they are found guilty of criminal negligence.

When you are an EMT, nurse, doctor, or whatever, you have a moral obligation to help people in need, especially one who is collapsed in a gas station bathroom, pregnant, and having difficulty breathing.

What's the first thing we learn when prioritizing patients? It's simple as ABC. Airway, Breathing, Circulation. This poor lady obviously did not an unobstructed airway. Prioritizing means figuring out what'll kill you first; not the most painful, not the most difficult... the quickest. This is utterly ridiculous.

I absolutely love the mayor's quote when asked if burnout could have been a factor: "Burnout? They were sitting there having coffee. How could they be burnt out? They're human beings. Somebody is dying down the street and [people] say help them and they just sat there."

Bravo Mr. Mayor. Bravo.

(Source: http://www.nbcnewyork.com/news/local-beat/EMTS-Suspended-After-Leaving-Pregnant-Woman-to-Die-79860937.html)

Saturday, December 26, 2009

A Nightmare on Christmas

Locally, its been a rough few weeks in my small community.

On Christmas day, nearly 3,000 volunteers conducted a search for a missing child that was kidnapped from her bedroom on Tuesday. While all were hoping for a Christmas miracle, it wasn't to be had and her body was recovered several hours after the search. Thankfully, the suspect has been apprehended and is being held without bond.

I've never seen our community turn out in numbers like this for anything. I was truly impressed and proud to live in this community. This particular child was a classmate of one of my kids and the loss was truly devastating. Personally, I was refreshing the local news every five minutes on my phone as I took my family to the movies to see Avatar in 3D. I expected a Christmas miracle and tried not to lose hope, but alas, Christmas was not a joyous one this year.

I can't imagine... Truly a horrible story.

There needs to be safeguards in place to stop this kind of thing from happening. I realize you can't stop them all, however, this particular case had many clear warning signs. Pedophilia is a disease, condition, sickness, or whatever the hell you want to call it, that needs to warrant the complete, immediate removal of individuals from society.

Monday, December 21, 2009

Things Nursing School Made Me Do

As I'm enjoying a month off, for any who are considering nursing school, especially if they have a job and/or family, here's a few things that jacking nursing school into my schedule made me do last semester:
  1. Stayed awake once for 34 hours; stayed up more than 24 hours multiple times.
  2. I've had to change for work in my school or clinical site's bathroom; I've changed into my student nursing scrubs at my job and go to clinicals.
  3. I've worked and/or school for more than 24 hours straight.
  4. Certain nights of the week I would only get two hours of sleep.
  5. I installed a clothing rod in my minivan; it always contains a set of casual clothes, a set of work clothes, a set of work scrubs, a set of professional clothes, a lab coat, and a set of clean nursing student white scrubs.
  6. I have a milk crate filled with soda and juice boxes in my van.
  7. I've slept for 3 hours in my van between classes and/or school and work.

If you're considering getting into nursing for the money, I've got this advice for you: find a new reason. I'd pay $60,000 a year not to have to go through this! Don't consider this whining or bitching though. I'm reminded of a quote from Lucy McLane from Live Free or Die Hard:

"...Just take a minute and dig deep for a bigger set of balls, 'cause you're gonna need 'em before we're through."

Friday, December 18, 2009

Passed First Semester!

After being as nervous as a nun in a dick convention for about 24 hours, I got the final grade: B in the class. I scored an 80% on my final skills quiz and an 81% on my final exam.

The final exam felt like it was written by Satan himself... but I'm pleasantly surprised by my performance.

I won't bother creating my super tedious grade calculation; all that matters is that I passed and that above and beyond passing, I actually got a 'B'!!

I'm so excited and I have nearly a month off before classes begin again!

Friday, December 11, 2009

Skills Check Final Passed (and more grades!)

I passed my skills check! These checks make me extremely nervous. You are watched intently on everything you do and if you're lucky, you might get a subtle nudge in the right direction if you mess something minor up, but it's truly a horrible experience.

I ahd the pleasure of having my instructor watched me as I set up a sterile field. Now this is probably the most complicated thing to do because it's very easy, especially for inexperienced nursing students, to comprimise a sterile field. I performed a sterile wound dressing and I inadvertently comprimised my sterile field by simply pouring the sterile water (the outside of the bottle is not sterile) and having the base of the bottle extend about 3" over my sterile work area. I've often said that a sterile field is the hardest simple thing to learn!

So my class is nearly over! I can't believe it really, it's definitely been a journey. This is a very difficult class and I'd go so far as to say four three credit academic classes are actually easier than one six credit nursing class. Next class, is NUR151 - Adult Nursing. This is where we get down to the nitty-gritty on common diseases (I'm looking at you diabetes mellitus) and the more technical skills like NG tube insertion, foley catheter insertion, starting IVs, administering IVPB medications, nasal suctioning, and even more! I'm excited and scared all at the same time; I have no idea what to expect.

Only one more exam... class is officially over and I return Thursday to take my final exam. Barring any catastrophic failures on my final exam, I'll be moving on pretty easily!

I got my final theory grade! My grade looks as follows:

Theory Grade (50% of grade):
Exam #1: 78%
Exam #2: 87%
Exam #3: 95%
Exam #4: 80%
Writing Assignment: P
Current Grade: 85%

Lab/Clinical Grade (50% of grade):
Skills Quiz #1: 97%
Skills Quiz #2: 76%
Skills Quiz #3: 94%
Skills Quiz #4: Still pending...
Skills Check Mid-Term: Pass
Skills Check Final: Pass
Drug Calculation Test #1: Fail first attempt, passed second attempt. (-2 to total lab grade)
Drug Calculation Test #2: Pass
Graded Nursing Care Plan #1: 95%
Graded Nursing Care Plan #2: 82%
Current Grade: 88.8%>89% - 3 penalty = 86%
Current Total Grade in Class: 85.5%> 86%

Things get bumped up a notch next semester. I hope I'm ready!