Ambulance Drivers

Yes, i know this term is now frowned upon, but in the four years I spent working as an EMT, and now almost a year trying to get my cert BACK after letting it lapse while doing nursing prereqs I have NEVER been allowed to drive the ambulance farther than the edge of the parking lot. The insurance won't let anyone under 25 drive it, unless they have special licensing or what have you.

THAT ENDS TODAY! Today I finished my two-day EVOC class, and can now drive the ambulance. I made it through the ENTIRE slalom course, and the parallel parking, and EVERYTHING without hitting a single cone. I win!!! I can drive the ambulance!!!

Report

Today's exercise in clinical was in Giving Report. I had a bit of an ace up my sleeve here, in that I, unlike my clinical classmates, have actually DONE this before as an EMT. Not in the same depth, but I'm used to saying things like "Mrs. Diabetique is an 82 y/o caucasian female, who presented at home with an altered LOC, whereupon EMS was called. She was placed on 4lpm O2 by nasal cannula, and restrained after trying to kill us all. Her blood glucose was 23, so we gave her an amp of D-50, which quickly restored her to complete sanity. She's A+O x 3, resting comfortably, and has a past medical history of every diagnosis in the book. Here ya go, please sign right here."

I enjoyed getting my patient, doing his workup and then reporting. Didn't hurt that he was conscious, and going home later today.

On the other hand, his family are all christian scientists, which made getting a "family history" next to impossible. "I dont KNOW what they have!" he said. "They dont go to doctors!'

Oh...hmm...

Spring?

Arrived back in The Mid Atlantic yesterday evening after a HELLISH 8.5 hour drive. It SHOULD take more like 6.75, or 7 hrs. WITH stops. I hate the Jersey Turnpike...well...ALL of I-95 was clearly designed and built by Lucifer himself.
Aaaand I'm not feeling well. Vague GI complaints, and THIS time I KNOW it's not giardia. Nowhere I could have been exposed, so it must just be one of those things. Lots of Pepto Bismol and hot tea should fix it. AND not dressing for class- sweats head to toe today. It feels almost naughty, and i KNOW it's "not attractive", but it's raining, and I feel gross, so sweats it is.

Tomorrow we're doing a "special project" in clinical. Stay tuned...

Easter

Tomorrow is the dreaded Lab Day with blood transfusions and PACU patients. Wheee...
Immediately following that, I'll be heading home to the Frozen Northlands again until Tuesday. Hopefully the traffic on the GW bridge wont make me cry THIS time.

Back to OB

Good news! I just found out that I get to go back to do a second OB floor observation! This time I'm going in for a Friday dayshift, so that hopefully I can see an induction and/or C-section...or just a plain old BIRTH! I'm a little unusual for my classmates...I'm a natural birthing advocate ALREADY, thanks to my Mama. She was adamant about her own natural childbirths (me and Younger Brother), and it really rubbed off on me. I even went up until surgery with my appendicitis because i knew that childbirth HAD to be worse, and if Mama could do it, so could I (turned out to be a great choice, as I was lucid enough to refuse full anesthesia, and got a spinal instead, which worked MARVELOUSLLY well).

Still...a C-section would be really good to see, since I'm sure we'll see them on our OB rotation, and I'd like to see one before i have to be knowledgable and competent as an assistant.

For Patients and Others: Why you WANT a student nurse

Sometimes we find, on our clinical days, that a patient may want nothing whatsoever to do with us. This is rare. MUCH more frequently, it is their RELATIVES who want us out of the room, and out of their lives. This is, for the most part, A MISTAKE. Yes, I know that we aren't "Real Nurses" yet. Yes, I also know that our questions may worry you, as we are probably young enough to be your grandchildren. You still want us to care for you.
Why? For many VERY good reasons.
1. Your call bell will be answered INSTANTLY. We have (usually) no more than 2-3 fairly stable patients. Odds are, if we see your call bell, we're in there RIGHT AWAY. You see, unlike the staff nurses, we are being GRADED every day. If you are unhappy with us, and tell our instructor that we ignored you, and it was TRUE, we're in Very Big Trouble. So chances are, you WONT be waiting half an hour to go to the bathroom, or get some reglan, or a juice box.

2. We're REALLY (most of us) still idealistic. We tend to really want to help you, and all of our therapeutic techniques are still shiny and new. We still think giving backrubs is entertaining AND we've got the time to TRY all those "non-pharmacologic analgesic techniques".

3. We're terrified of screwing up. We're going to double and TRIPLE check everything we do, and we're paying COMPLETE ATTENTION to the whole procedure.

4. Many of us (especially from MY school) are cute. While I know this has no direct bearing on your patient care, it never hurts.

So please, be kind to your student nurses. We ARE trying our best here, and if you just give us a chance, we'll get you your hot tea in just a minute. After we finish tucking you in with warm blankets.

Floor Code

Yesterday I spent the day watching 3 colonoscopies, and hanging out with a VERY cool nurse anesthetist. I never realised how FAST they are- average scope time was about 10 minutes.
On the ortho floor, where the other half of the group is stationed, there was FAR more excitement. A woman, a few days post-op for a spinal surgery, went into trigeminy. No big deal according to the telemetry guys. Then bigeminy. Slightly more worried, especially when it continued for a few minutes. After about 5 minutes, the telemetry guys called up to the floor, and informed the nurse to maybe go check her patient. Upon entering the room, she immediately yelled "IM GOING TO NEED SOME HELP IN HERE!!!" within 30 seconds, the patient stopped breathing. They coded her for 45 minutes, and technically got her back, rushing her off to the ICU.
The problem is what CAUSED the code- probably either a PE or a stroke, according to my instructor. Probably lots of brain already dead. Who knows if she'll ever wake up.
Two of my classmates were traumatised. They had never seen a code, and NEVER a young person dying.
Slowly but surely, we're beginning to think less as laypeople, and more as nurses.