One More Final Till Christmas!

I've got one more final (Pharmacology...shockingly, my favorite class) tomorrow at 1 pm! So today is Clean The Apartment (which looks like it was hit by a tiny VERY well aimed tactical nuke), pack all my stuffs, study for pharm, all that good stuff. That way I can shove all my sheets and towels and such into bags in the morning, put everything ELSE in the car (if I don't do it tonight), and go straight from the final to the ROAD!
I looked the car over, gassed it up, checked/equalized the tire pressures, I am all KINDS of set. I also located ALL THREE of my window-scrapers (you never know which one you will need, or if somebody will take one and not give it back).
Mildly inconvenient that I'll be going home at about 3 pm and not getting home till 10 or 11, but hey, it's better than driving through rain / ice / snow as I go farther north. There's BOUND to be that awful band of nasty ice around Massachusetts. And Mass drivers are batshit-crazy WITHOUT ice. (No offense Massachusetts drivers, you're nicer than CT drivers, just crazier).

Pre-Christmas Madness

Today I went to Target, got a few final things for Mama's stocking, came back, wrapped EVERYBODY'S presents, including stocking stuffers. This is VITAL, because otherwise when I go home Thursday afternoon or Friday morning people will PEEK! O Noes! In fact, I'm so sneaky that I'm not even going to say what I got ANYBODY, as I know that at least my dad knows how to find this blog. HAH!
Made another Eggnog Coffee Cake, this one for some family friends. I'm going to the German Christmas Market with them tomorrow, and the Reading Terminal Market. Squee! Christmas lights! I LOVE CHRISTMAS LIGHTS!!!
Then more pharmacology studying.

Final Grades: Part 2

Second final exam for the week, finished, 5/7ths of the way done for the semester! Yay! I can't wait to be doing REAL nursing next term with REAL procedures instead of just AM care stuff.

Final Grades: Part 1

Took my first final (of THIS half of the semester) today, grades already posted. That makes 4 As so far...but sometimes I feel as if some people in my school are rather anti-intellectual. The sort of people who have a mantra of "Bs and Cs get degrees!"
It's people like that who make me HIDE MY TEST SCORES.

Another final tomorrow, and then six whole days of Nothing, before the last two finals. During that time I will wrap presents, go to the Christmas fair, maybe ANOTHER Christmas fair, and then hopefully be able to also go back to the hospital for another OB shift when there might be active laboring, and/or a scheduled C-section.

OB-servation

Today's OB shift was COOL...even though we didn't get ANY active labors. Drat. On the bright side, (bright for me, bad day for the baby) I got to see a circumcision. Kid came through it like a champ, didn't cry once, even during the lidocaine shot. Also got to see a NICU admission. Poor little peanut. Lungs went all cloudy on it, hopefully it'll clear up soon.
VERY COOL, wonderful nursing staff. I brought Eggnog coffee cake, it was fun. I'd love to go back another day (yes, i was invited back) hopefully to see some actual labors.

My Weekend Plans

So I turned in the final paper of the semester! (That's the good news). The BAD news is that the apartment looks like a very clean tactical nuke went off in the vicinity of my closet. Which means that MY Saturday plans involve a THOROUGH cleaning and tidying and dusting, vaccuming, scrubbing, and cleaning of the whole place. Also laundry. Gotta do the laundry, or my uniforms (which are Godawful) might still have Nursing Home Cooties. Once I'm done with that, I'm thinking of a nice brisk 2 mile walk down to the J. Crew to pick up some gloves for my mother that she requested (no J. Crews that I know of in The Frozen North). Four miles is a nice workout. THEN I have to make an Eggnog coffee cake to take with me on Sunday, when ~glee~ I get to do my Obstetrics observation day at a place called Riddle Memorial. Hope i can find it at 0630. That's bloody early.

Last Day of Clinical (for the semester)

Woah. That went fast. In only four clinical days, I went from complete disorganization and panic to performing (admittedly VERY basic) care so fast I had NOTHING TO DO. I wound up running errands for the nurses and stocking bedlinens, because my patient didnt need or want anything. That's what you get with stable patients!!!
Sadly-ish, one of my fellow students lost her patient this morning, just before we got there. It is sad, because nobody was there, and my classmate was very upset, this being the first dead person she had ever seen. NOT sad, because this woman had a NASTY stage IV sacral pressure ulcer, no healing ability, in pain, terribly terribly fragile, not especially consious, you get the picture. She went very peacefully, in her sleep. I helped the funeral home move her body to their stretcher, because they needed help, and the two techs were REFUSING to assist, as they didnt want to "touch a dead lady". Geez. It's just a dead person. If it were a zombie, or somebody trying to bite you, I could understand freaking out. But these are people who work as nursing home techs! How do they manage NOT to touch dead people?

The Granite of The Northlands in their Muscles and their Brains

I really am a northern girl at heart. It's December! Where's my snow? Last winter up in The Frozen Northlands, we started getting lovely snow round about mid-December, and it didn't leave until mid-April. BEAUTIFUL. I like it best when there is about 2.5 or more feet of snow, and the trees are COVERED. I was the little kid who read The Lion, the Witch and the Warderobe and got sad when they got rid of winter. Especially in the old Wonderworks movie version filmed in Norway. Winter looked DAMN good to me!
Other things that are nice about northern winters: No black flies, mosquitoes, or slugs; wood stoves smell nice; you can add as many blankets to the bed as you want; nordic skiing; all the lights in all the towns look all sparkly and pretty; the snow evens out the potholes so the roads are smoother than they are any other time; you can use the mudroom as a secondary refrigerator!
Yes, I totally have to live in the north.

Thanksgiving- I am thankful for not screwing up

Well, I'm back in the Mid Atlantic, after going home to the Great North Woods for Thanksgiving with the family. Technically there IS internet there, it just isn't fast, or reliable. Hence, no post for a bit.
I have clinical Monday and Wednesday, and then I'm done for the semester. I can't wait to start learning more skills, like EKG interpretation, actual med administration, pathophysiology and such. I know we work our way up, but I'm really looking forward to being put into a real HOSPITAL, and hopefully a situation where things move faster...on the other hand, if they'd moved much faster this semester, even at the Nursing Home, I'd have died, cried, or panicked. And that was just doing AM care and a basic physical assessment. I get nervous around stable patients.

Very First Clinical

I survived my first day of clinical, and so did my patient! I would have been quite surprised if he HAD died, as I have seldom seen a patient so stable in my earthly existence, but hey! I'm not used to people who STAY OK for the ENTIRE time I'm there. Usually they are either getting better or worse...this patient just sorta chilled.
The worst part about being assigned to a ~shudder~ nursing home ~shudder again~ is that I still have trouble thinking "like a nurse" as my instructor says. When I get nervous I automatically fall back on the ABCs. Airway, Breathing, Circulation. That doesn't WORK when your patient is stable as a rock, and their only problem is chronic orthostatic hypotension that causes them to fall over if they stand up quickly.
So the good part was my patient was delightful.
The BAD part is that I have to go back to that awful place THREE MORE TIMES. Why couldn't they have sent me to a hospital? Maybe a nice ER with patients coming in bleeding, or even drug seeking! I KNOW how to evaluate that!

11 Hours

Until I meet my very first patient. Well, my very first patient as a nursing student. My very first patient EVER was as an EMT, four an a half years ago. They say you never forget your first patient, and I'm sure I never will. After all, he died. My very first EMT call was a nasty car crash, which resulted in the rapid demise of my patient, about 30 seconds after we finally got him extricated.
In some ways, this makes me less nervous about tomorrow- after all, the odds are that THIS patient won't die on me. On the other hand, the odds of my getting a fatal car crash on my first day were pretty low too.
The professors told us that they expect us not to sleep tonight, to be worried about killing someone, and to obsessively study our texts. I'm not sure that's a healthy attitude, and I'm going to do my best now to get to bed.

36 hours

It's about 36 hours until my very first clinical day. To say that I'm nervous would be an understatement. I'm TERRIFIED of stable patients. I mean, give me a person whose oxygen sats are falling, who is gasping for air, and has some sort of critical problem, and I'll work my way through the ABCs, and work to get them back to stable. Once they're THERE, I run into problems. For one thing, I get bored. I mean, they're HEALING. They're doing FINE! There's nothing to fix! I'm certain I'll find some way to screw it all up, and leave them worse off than I found them.
I AM however looking forward to removing surgical staples. That sounds like fun, as does doing actual catheterizations. The facility we're being sent to "Doesn't Do Venous Access Onsite", so no IV training for me. ~sigh~ not fair. Why couldn't they have sent us to an ER?

Med Dose Calculations

I'm procrastinating...or rather, I'm in the middle of my 4th of 8 "Meds Pub" modules to do today, all to do with medication administration. And the 4th of 8 tests. Blech.
I have been told that SOME people leading our clinical groups will test us on this WITHOUT ALLOWING CALCULATORS. I will hyperventilate and die if this includes me. I can't do division, and never HAVE been able to. I promise NEVER to calculate a patient's meds without a calculator, if they will only let me have one for the test. I'm not stupid, I KNOW not to let myself do it without a calculator.

Non-Medical post

What a treat! (for me, not for him) My dad got stuck in Philadelphia overnight, so I picked him up at the airport and he stayed overnight with me! And we had dinner, and it was lovely!

For the rest of the weekend, I'll be writing papers, working on a Care Plan, and studying up on GI and Mood-Altering Pharmacology.

OB Observation

In other news, I'm still waiting to hear if my professor has gotten somebody to let me follow them around for a shift on the L&D floor of one of our (MANY) nearby hospitals. Being in the greater Philly area does have its blessings. OB/GYN is a complete mystery to me, so I'm terribly curious and would like to give it a shot. You never know till you try!

I'm Alive!

The Deathbug has migrated into the sinuses, where it is under tolerable control with Real Sudafed and cough syrup. Today in pharmacology we covered Antipsychotics. Three of us in the front row gave a "Shout Out To Haldol" and amused the professor. WONDERFUL drug, especially in the ED. One of our major focuses today was on "how benzos can mimic barbituates in CNS depression if you accidentally/on purpose mix them with antihistamines and alcohol. How this could happen accidentally eluded me, until I realized that if you were panicky AND had a cold, and happened to take Nyquil, you'd have all your ducks in a row right there. Oop.

We practiced catheters in the lab yesterday. I don't think the dummies were a very good approximation of human labia though. They were STIFF! I could barely get them to stay open, even wedging a knuckle between them (which would NOT be tolerated by a human, I have no doubt). Then the catheter balloon-syringe popped out of place and sprayed everyone with water. I'm praying it won't happen in clinical, making me look like a COMPLETE incompetent. At least with emergencies you just work your way down A-B-C. Stable people scare me.

Blood from a Stone

So I checked into the student health center for a few hours yesterday, because of a fever/sorethroat/painful cough. The WONDERFUL nurses, after tucking me into an in-patient bed with three blankets, in semi-Fowlers, call light within reach (as per protocol- no, I DID NOT use it) decided they needed a CBC and Mono blood test. Well fine! I always like watching nurses work, it gives me valuable tips for the eventual time when that will be ME. So on went the tourniquet, in went the needle and...nothing. Try again? Sure! Nothing. So she called in a colleague, who tried a back-of-the-hand. Nothing, apparently the veins are not only tiny, they roll. So a THIRD colleague, an NP tried the vein in my thumb, hit a nerve and STILL didn't get any blood. At this point, noting that I had been drinking NON STOP in an effort to give them something to work with, and all the previous sites hadn't actually bled at all, these poor souls decided that my body didn't want blood work done. Apparently I'm either the walking dead, or just the WORST set of veins in somebody my age ever seen. The irony is my skin is pale enough to look like a ROADMAP with the veins perfectly visible underneath.

Sore Throat

Spent today "admitted" to the Health Services clinic, getting high-test painkillers for the worlds WORST sore throat. Am now at home, still on high-test painkillers, awaiting the results of the mono test and throat cultures...bacterial or viral? ONLY TIME WILL TELL!
Other than the throat, fever is holding at 101.7, grossly swollen cervical lymph nodes. blech.

Oof.

Well in the past 24 hours I took three midterm exams and voted in the general election. I am all KINDS of exhausted.
I found out where I'll be going for my first clinical rotation which (thankfully) only will consist of the four sessions before Christmas break. Next semester we get a new assignment (and I hope and pray for a BETTER one). I'll be going to the local "skilled care facility". Now I know that these places are necessary, can be fulfilling places to work, and that many of their patients are perfectly wonderful individuals. But, honestly, I can't think of a posting that feels more like a circle of hell for me. I like trauma, blood, fast moving departments, and babies. But still, it's something you've got to do to get through this program.

Bathing Your Patient

Today was "Hygiene and Mobility" day, also known as giving bed-baths, changing occupied AND unoccupied beds (with mitered corners, no less) and learning how to use all sorts of spiffy lift-assists that we are assured will NEVER be there when we need them. It was hilarious. Bathing a fully conscious, morally outraged classmate is a unique experience I hope never to have to repeat, and the water really DOES go cold faster than you'd think. Highlights included the lecture by one VERY straightlaced catholic professor on the importance of "putting the foreskin of the penis BACK after washing". It never occurred to me that this would actually be a HAZARD of receiving a sponge bath. I wonder if it will be declared a "never event".

Tomorrow is the dreaded Pharmacology exam. I WOULD simply quake in fear, but NOW thanks to my rapidly progressing education, I know that I am instead experiencing an activation of my sympathetic nervous system, and that an appropriate antidote to my rise in blood pressure would be propanolol, except that its successor metaprolol has fewer side effects.

I WOULD fear for my sanity, but that would only get me started on drugs that can cross the blood-brain barrier and interact with my dopaminergic pathways. I'm screwed.

Wear A Helmet

Now, I'm from the frozen northlands, and I volunteered as an EMT up there for four years, prior to this little relocation-for-school thing. My home state has no helmet laws, preferring to rely on Darwinism-In-Action. While this may work really really well from a "Live Free or Die" standpoint (literally), it works LESS well from the point of those who are scraping you off the pavement. A few years ago we had a DOZEN fatalities in ONE TEN DAY PERIOD during Bike Week. That averages to over a death EVERY DAY. And that's just DEATHS, not taking into account permanent coma, serious brain damage, and all that sort of thing. If the first time we meet is while I'm in full trauma gear, and I'm struggling to even VISUALIZE YOUR THROAT, we are not going to be good friends. If you are breathing three times a minute, and decerebrate, this is not a good day for you. So put on a helmet, please.
While I'm at it, please also refrain from mixing marijuana, alcohol, and your desire to ride your awesome motorcycle at night. Because your reflexes just aren't up to it. We have lots of beautiful roads, but they get awfully dark at night, there aren't many people to find you, and it's going to be a LONG TIME until we can get you to a hospital. If there isn't DHART (air ambulance. love them.) available, it's going to be AT LEAST a half-hour transport. Your depressed skull fracture is not going to be pleased. So just...don't do it. Or if you MUST do it, please have the decency to ride in a populated area where somebody MIGHT come across your mangled body in UNDER an hour? We don't start CPR if you're in rigor.

So please, be sensible. Wear a helmet, don't play chicken with our forests (they're going to win), avoid the moose, don't pet the bears, and for the love of God buckle your seatbelt!

Pharmacology

I love my pharmacology class. It's amazing, really. It has, however, lead to a certain amount of understandable paranoia among my class- we're all convinced that somehow, probably on our very first day of med administration, we will all kill somebody. This is understandable, once you realise that our only actual practice in administering parenteral medications was ONE SHOT for practice in both IM and SubQ injections. ONCE. I was really picturing a bit more practice than that before being set free on an unsuspecting sick population. I mean, I can barely flick the inevitable air bubbles from my syringe, much less competently hold the thing "like a dart" and wince when it goes in!
Aside from the fear that we might kill somebody through sheer incompetence in med delivery, there are so many drug interactions that we're being taught that it seems a miracle that ANYBODY makes it out alive! I feel I've started to reach that critical nursing student point where I know JUST enough to be REALLY dangerous.

Omphaloskeptics

I've been reading other people's medical blogs for a while now, and have seen a trend that REALLY irritates me. Not with the bloggers themselves, but with their commenters. In a typical scenario, a poor overworked blogger will use his/her OWN BLOG to vent about a problem at work that has irritated them past all patience, related to people faking symptoms, people who are VERY difficult to treat due to psychosocial reasons, and drug seekers. Then, like lightning, a bunch of people with chronic pain, with those same psychosocial concerns, or who take narcotics will descend on this blogger, taking PERSONAL OFFENSE at the blogger, and, on at least one occasion telling them that they should KILL THEMSELVES because they are a bad person.
Just how self-absorbed do you have to BE to see YOUR situation in ALL blogs about drug seeking behavior? These medical people KNOW that there are good reasons to take narcotics! They KNOW that migranes are an actual phenomenon! And yet these rabid commenters treat medical bloggers as if they are saints! To be a "good doctor" or "good nurse" according to these people means having no actual clinical judgment.
If this means I am going to get flamed next month when I start getting my own patients, so be it, but honestly, some people need to take their heads out of their navels, and stop seeing their own pain in EVERY blog.

Disinfranchised!

This state just sent me a letter saying that my voter registration was incomplete, and I may not therefore vote in the election. This is bullshit. I registered IN AUGUST, when I moved here. They sent the letter AFTER THE DEADLINE. And my registration WAS complete. I got my driver's license for this state AFTER registering. Therefore, the ABSENCE of the aforementioned license number on the application was BECAUSE IT DID NOT EXIST!!!!!
I won't stand for it. My grandmother was born before women were even ALLOWED to vote, and i'm certainly not going to let it happen to me!!!!

DAMN THE TORPEDOES! I WANT TO VOTE!

A Sad Realization

I am no longer as young as I once was. I don't think I can keep doing this EMT class, because I'm taking 17 credits already, and will be taking 21 for spring, and to take another 6-8 hours of classes UNcredited, in addition to some weekends, I dont think my precious sleep schedule can take that. I NEEED sleep. The first time through college I could schedule more and worry less about my naptime. :-D
Of course, my chronic need for sleep is partially responsible for my decision NOT to go to medical school. On fewer than 7 hours of sleep a night, I cry like a six year old girl, I kick people in the shins with no provocation, and I get violently sick to my stomach. Somehow I don't think that would lend much credence to my claims to be a professional.

Tomorrow I'll have to tell the EMT squad on campus that I cannot continue to hang with them. Is ok though.

EMT class

First EMT class this evening. I have to take the whole bloody class over again because my bloody cert lapsed. Bah.

Adding to the pile of medical blogs

Yes, I know that it's halfway through the semester, but better late than never! Here's the background- I have have returned to school after recieving ONE useless liberal arts degree, heading south into the Mid Atlantic to do a two-year second bachelors program in nursing, since I've loved the past four years as a volunteer EMT in the frozen north woods.

So far I don't really feel much like a nurse- I keep thinking like an EMT. A professor will tell us a hypothetical patient has vital signs of P. 74, R. 15, T. 98.2, BP 155/85, and I'll say "oh, he's fine!" Yes, I am aware that 155/85 means hypertension, but it's probably NOT a hypertensive CRISIS, and since they DIDNT say that the patient was clutching their chest, having runs of V-tach, had a low pulse-ox or anything else like that, I'm used to thinking "oh meh, they've got high blood pressure...just like 2/3 of the people I see. It's PROBABLY not their chief complaint".
Except now it MIGHT be their chief complaint! OH NO! We ARE the people who take care of that sort of thing!

I have decided I DEFINITELY need my NP, or even to go on for a DNP. Because my classes are so FUN!!! I LOVE pharmacology, I LOVED A&P and can't WAIT for Patho. I'm sure the classes at the grad level are even better!