Today will be my first preassignment (this is when I meet, assess, and develop a plan of care for a client before attending clinical the following day.) I'm going to a LTC (Long Term Care) facility here locally. This was the same clinical location I was at a year ago when I failed the first nursing course... and with the same instructor. The good news is that I think I have the expectations down fairly well, and think I will do well.
I do not think LTC is for me. With many mentally challenged and elderly patient, my plan of care will likely focus on mostly psychosocial things. I like IVs, medications, ongoing assessments, etc. I think I will do well, but only time will tell.
As far as skills, I've learned everything there is to know about IVs other than starting them. I can hang an IVPB (IV PiggyBack) bag and get the whole system running at the correct drip rate by gravity with a plastic roller clamp. It's very cool because during clinicals last semester I was not allowed to touch patient IVs, and most of my patients (who were hospitalized, i.e. acutely ill) had them. I'm looking forward to learning how to start them soon as well.
As far as skills, these are the official skills I've learned in the first two weeks of my second LPN semester:
- Full assessment (of course!)
- Applyinmg a dressing (dry and mosit-to-dry)
- Applying a pressure bandage
- Applying a transparent dressing
- Applying hydrocolloid, hydrogel, foam, and absorption dressings
- Negative pressure wound therapy
- Applying gauze and elastic bandages
- Applying an abdominal and breast binder
- Perform wound assessment
- Perform wound irrigation
- Performing suture and staple removal
- Managing wound drainage evacuation
- Surgical hand antisepsis
- Donning a sterile gown and closed gloving
- Preparing a patient for surgery
- Demonstarting postoperative exercises
- Performing postoperative care of a surgical patient
- Pouching a colostomy or an ileostomy
- Pouching a urostomy
- Catheterizing a urinary diversion
- Changing IV solutions
- Changing infusion tubing
- Changing a peripheral intravenous dressing
- Discontinuing peripheral IV access
Quite a few skills for the last two weeks. Throw in the fact I have about 11 one hundred question NCLEX-style tests and another class, and I'm pretty much swamped. The tests are body system specific Med-Surg tests, for example, Gastrointestinal - Med Surg.
I have another class called Nursing in Society; it's a little one credit, one hour once-a-week class to teach you about the LPN/LVN role and their legal and ethical responsibilities as a member of the healthcare team. It's basically like reading Chapter 1 of my Fundamentals book for an entire semester; not my idea of fun, but a definite gimme credit.