Tuesday, June 22, 2010

Keep on Truckin...

Sorry for the lack of recent posts... Life has been crazy, and so has class.

Recently, I finished my pediatric rotation. I really liked this; kids are great! Something negative things I've noticed is that it's really difficult to keep your mouth shut when you see things going on with the parents.

For example, I had a 7-month old little girl with a mild case of pneumonia. Not RSV, croup, pertussis, or one of the other respiratory supervillians, but just a case of regular, mild (at best) pneumonia. There was no emergency; however, the mom, a young girl, probably still in her teens, demanded the baby stay longer. She remained on her Boost prepaid cellphone nearly the entire time (she must have had the unlimited plan). She apparently had one or two more kids and was loving the fact that her "baby daddy" had to take care of them while she was in the hospital. She also loved the fact that nurse's were taking care of her baby and bringing her refreshments whenever she wanted. She did not appear to be worried at all. She even went so far at one point as to suggest that the nurses needed to change her babies diapers more often as she sat on the couch in the room talking to god-knows-who.

The class itself is pretty straight forward. I've compared it to med-surg on little people. Learn the stages of development (pretty easy and mostly common sense) and the childhood diseases (a little harder, but not that difficult). There's a little more content to the mother-baby and L&D portions, but even that's not really all that difficult. It's definitely not nearly as hard as my med-surg class.

The biggest revelation for me at least this semester has been that any of the mother/baby departments: Labor and Deliver, Mother Baby, or Peds, is that this isn't a happy time for everyone. For every labor and birth that the whole family shows up with balloons, cards, and gifts, four more children are born without fathers, without extended family, born addicted to drugs, and/or born into weird situations (such as incest, rape, adoption, etc.) I really thought this would be a totally positive experience; however, you have to realize that situations like this are far more common than you'd believe.

Labor and Delivery rotation so far is pretty much a joke for me. I don't even think my clinical instructor is attempting to even get me a patient. I can't complain though, because truth be told, I have little interest in having a patient in labor. I think birth is pretty cool, it doesn't make me queasy or anything, but with only one more week of class left, my feelings won't be hurt if I don't get a patient. I already wrote a careplan on a fictitious patient anyhow!

As far as my grades go, I've pretty much been slam dunking this class; it's not very hard. Three papers, all 95% or greater and one test I got an 84% on. I took another exam yesterday and I'm pretty sure I did good on that too. Technically speaking, I only have my final exam left for this class and then I'm done.

I also got my acceptance to the RN program. It is essentially two six credit classes that run from Septmeber through April. After that, it's NCLEX-RN time baby! My good grades even nabbed me a space in the limited-availablity evening program; only sixteen slots were available.

Another seven weeks and I'm done with the first portion... the beginning/middleish of August, I'll be ready to take my NCLEX-PN!

Tuesday, June 1, 2010

Last Week's Clinical: The Nursery

Last week my clinical experience was in the nursery.

At first, I definitely felt out of place again, though not quite as bad as the previous week's perineum-and-episiotomy inspecting madness. The nursery was where all babies just born are taken care of, inspected, and assessed.

I love babies, so that part was cool. It's a totally different type of nursing though. It's scary to me to think that with all the education I'm cramming into my brain, when I graduate, I will basically be a blank slate that needs to be trained all over again in whatever special area I work in. I thought I'd be an all-knowledgeable RN, but as it appears, I'll only know the bare basics of nursing in general: my real training begins in the workforce.

In addition to the basic newborn care, I got to do a newborn assessment, which was really cool. Different reflexes, such as the Babinski reflex, startle reflex, etc. You also document size, shape, and location of the fontanelles (soft spots) on the head, take vital signs, monitor I&O, and other various things.

It was a mostly positive experience, however, I had a spiteful staff nurse working for me. I will say that I have never had a negative experience with any staff member until this point, but this girl's pissy attitude really got me fired up. She did three major things to piss me off:
  1. I went into the parent's room, introduced myself, and took the baby's vital signs. I returned to report them to my instructor. She asked me if the baby had voided or stooled. I did not know .so I stuck my head in the parent's room and asked. I noticed that the staff nurse was in there. I reported back to my instructor and resumed my normal clinical duties. The staff nurse waits, purposely, until I am next to my instructor and nearly my whole clinical group before coming over and saying, "Next time you go into a patient's room, you need to introduce yourself. They wanted to know who you where and what you were doing with their baby. You make them very uncomfortable." Thank god I had a student vouch for me that she heard me introduce myself. When I asked the parents they said they never said that. My instructor told me not to worry about it.

  2. I had to do a newborn assessment. I got the baby and performed my assessment. The baby's temperature dropped a little bit, so I stuck the baby under the warmer. When I told the staff nurse, she said, "You had the baby uncovered too long! Now it's on the warmer and you need to go tell his/her mother! She's going to totally freak out!" I told the mother, and, as expected, she did not freak out.

  3. Realizing that I was dealing with a possible pre-menstrual superbitch, I assumed that after I did my assessment she would be doing the exact same assessment on the neonate, hoping to find something I missed. Since the baby had thermoregulation issues and was on the warmer, I told her, "If you want to do your assessment, the baby is undressed and on the warmer." I resumed my normal clinical duties and checked the baby's temperature a half hour later to find that it had returned to well within normal limits.Then, I got the baby dressed in a new onesie, changed his diaper, bathed him, put his hat on, swaddled him, and covered/tucked him in his bassinet. On my way out of the nursery to return him to his mother, I am stopped by the staff nurse. "I need to do my assessment before you return the baby to his mother." Are you effin' kidding me? I just got this kid dressed, ready, and warm, and you are going to undress him again, knowing that he has temperature control issues? Pissing me off is one thing, but caused a baby more discomfort to achieve this is absolutely ridiculous!

We have to evaluate the friendliness of staff and the educational experience of the site itself. I expect that I will be writing quite a lengthy review. I enjoyed the clinical, however, this girl made me really uncomfortable and tried to get me in trouble for nothing. Maybe I wronged her in another life... maybe I got a little too lit at the local bar a few years ago and don't remember her. Either way, her actions were inexcusable. I can't wait for the clinical site review...

Is the word 'asshole' inappropriate for official documentation?

Tough Times

The closer I get to the end of nursing school (the LPN part anyhow), the more my personal life seems to fall apart.

Continued troubles with my wife always weigh heavily on my mind, but my mother, who lives alone and has a seizure disorder, has been acting very strangely. Personally, I suspect Dilantin toxicity or a grand mal seizure occurred in the last week. She has been calling, crying, saying she wants to be with dad (who died about eight months ago) and she has been refusing my repeated attempts to take her to the hospital. If someone can state their wishes, and does not want to go to the hospital, you cannot make them go. This has been an endless source of frustration for me. I suppose I could attempt to petition the court for an EP, however, I'm sure doing such would completely ruin my relationship with my mother because the last time I did it she didn't speak to me for a over a year.

Couple this with the fact I'm quickly running out of money is making me concerned to say the least. Bills are getting out of control, partly due to the fact I'm in school and making less money at my main job and spending more money to fund my school adventure.

I've been unable to afford my textbook, which is pretty pivotal to me passing the test that I need to take at about 6pm this afternoon. I'm going to study my class notes and hope that there is no questions pulled from the text we didn't cover in class.

This weekend, I worked overnights at one job and days at the other, making me get a total of six hours of sleep between Saturday morning and Monday evening.

I'm really at wits end attempting this school thing. I definitely am not quitting, but I feel like all this stress is going to give me a nervous breakdown: lack of sleep, a crazy mother, an evil (at times) wife, and a severe lack of money which is quickly catching up with me.

T minus 9 weeks until NCLEX-PN eligibility... Hope I make it that far!

P.S. I love the cartoon I posted because the 'due date', cigarettes, coffee, and laptop issues are definitely me at this point in time!