Our Own Dr. House

Clinical two is over! Crazy I must admit. This day went much smoother and there was more hands on things to do. When I went to the hospital on Saturday to get my information I was a bit shocked to see that I was assigned Miss A**** yet again. (I must have checked the list ten times to make sure I was reading it correctly.)

I was a bit frustrated but at least my profile wouldn't take me as long! So I got the new information I needed and got out in less than an hour...

Fast forward to Monday afternoon, I showed up to the hospital and my instructor, Mrs. Page, was waiting for us in the lobby. She asked if I would like to do meds with Tyler this week and I kindly agreed (I figured less time with Miss A****, I know my attitude needed a check.)

We reported to the floor at 1445 and I got report from my nurse around 1500. I felt more "at home" this time although I was anticipating giving my first medications. Mrs. Page worked with Tyler and me on the accudose system, which is the computerized medicine dispensing machine. At about 1630 I got the meds out of the machine and carted the C.O.W. (computer on wheels) down the hall towards Miss A****'s room. As I pulled up the medicine screen to scan the patient and the med to make sure they matched my heart about stopped as I realized I would have to give her an insulin shot. Trembling I watched as Miss A**** took the meds and then I talked myself through the injection in my head. As I prepared the insulin Mrs. Page was right beside me reaffirming the steps and telling me I would do fine. All I can remember is pinching Miss A****'s abdomen and hesitating for a moment. In and out it was done! She even said I was a good shot giver, she didn't feel a thing. I was just so relieved! My first shot - the first one in my clinical group!

Before I went into a hyperglycemic state we all made our way to the cafeteria...and thats where the fun began. As we went around the table and invested in each other's lives it felt like a little family! I'm very blessed with a great clinical group - I even have one among me who wants to be a mom first and nurse second (they are rare to come by!), and an instructor who is so helpful at the bedside. She's the perfect mix of crazy, walk you through but with just enough push, loveable nurse instructor. We nicknamed her House because around nine o'clock something goes off in her and she gets a little wild. She sings, laughs at everything, and well looses her mind, ha! She was helping (by sitting in a chair with her leg over the other one talking them through it and asking questions - totally House style) three girls give a patient who was at risk for aspirating medication. She asked one of them to run and get the patient a cup of water. By the time Kati came back the patient had gotten the meds down. So Mrs. Page grabbed the cup, said "Thank You," swigged it and walked out! Later as we were walking across the street to get to our cars she almost ran us over (jokingly of course) but laughed and said "watch out kiddos Dr. House is loose" haha. I will say the relaxed atmosphere she provides gives us the baby steps we need to get our foot in the door and feel comfortable and at ease when in the hospital, where we will spend out life next year!

Highlights:

1. Miss A****'s assessment. She was in a much better mood, I was more thorough, and I even got to understand why she was the way she was. That's what nursing is about - investing in not only the physical condition of the patient but by investing in their life, that is how to make a difference. I LEARNED A BIG LESSON, keep my attitude in check, you never know how God will use you. Even difficult people need to be loved on.

2. Glucose monitoring. I got to do two pricks. I just love doing these. Tyler announced later in the evening that it was "Glucs gone wild" on the floor. Haha, he followed it up by saying "I milked that sucker for minutes straight." I about fell on the floor laughing, he was talking about the patients finger but we all missed that part! Context is key...

3. My first shot! Though I may not remember it all, I feel accomplished and am ready for my next one, any takers????

4.Helping Tyler assess his patient Mrs. B***. Ok this woman was so frail, she was in with a pelvic fracture, but very sweet. She was in her chair when we went in and she wanted to be positioned with the feet up, you know like a recliner. So we pushed the chair back but it would start to go back towards the normal position. Well when the chair would move she would grasp the sides real tight and make this face like she was riding a roller coaster. It was quite comedic, although I felt bad that she was so scared she would fall. 

5. Spending time laughing with my group

I look forward to clinical in two weeks!

Nursling

(Here I am in my oh so lovely uniform - eagerly anticipating the shift before me)

(Oh my way to the hospital!)

When I arrived at the hospital I was surprised at how calm I was. I have learned that I am not so good with anticipating new things but I undoubtedly know that the months of prayer provided me with the calm spirit. Once my clinical group assembled we discussed the logistics of the day, such as partners, contact precautions, how to contact our instructor, what to assess for, charting...you know all the good stuff. We prayed (how cool is it to be able to pray as a group over the day ahead of us with our teacher?!) and hit the elevator. A nurse ending her shift giggled as ten of us filled onto the elevator after our instructor. "It's always exciting to see nurslings," was her comment to us. With a "good luck" we were on our way to floor two.

We stepped out of the elevator and reported to our nurses. This is the first thing she said to me, "I am so sorry you have to have Miss A as your first patient. She is very confused, cries at everything, and is very needy." *Ok it is never a good sign when you hear I am sorry. Ha. After report I suited up (my patient was on contact precautions for MRSA so every time I went into the room I had to wear a bright yellow gown and gloves) and walked confidently into the room. The first few minutes were fine. Miss A was very compliant and pleasant. Then something snapped. She started crying that her hair hurt. She needed pain meds (which I was not allowed to give her) and as I continued to preform the assessment she looked up at me and said "If you were a real nurse I would take my gun and shoot you." Shocked and caught of guard I tried not to let any emotion show and I said "good thing I'm not a real nurse eh?" I calmly explained that I had to keep assessing her and laughed to myself of course I would be the one to get the difficult patient the first day. Guess its just a glimpse of my future eh?

Granted I had to keep in mind Miss A was in a lot of  pain (she had had the screws in her femur removed because they had gotten infected) and confused, and just wanted to "go back to her people" at her nursing home. My mission was to stay calm, make her as comfortable as I could, and not take the insults or anger personally.

Highlights of my experience:

Helping the wound nurse change Miss A's dressing ( I thought I would be freaked out seeing a deep wound but actually it was neat to see the bone through the missing tissue)

Take Miss A's glucose reading with the glucometer (I thought I would have a hard time pricking someone but it was easy and I really enjoyed it as strange as that sounds)

Helping the nurse put the bed pan under Miss A (Miss A was in a diaper but she was able to tell the nurse sometimes if she had to go so to help her keep her dignity the bed pan was offered. I never realized what a daunting task getting someone on a bed pan can be. We must have rolled Miss A back and forth 10 times while roughly pushing the bedpan under to get the right position. Finally it was in place after urine had already gotten on the wet sheet! At least she got some in the bedpan and felt better!) 

Listening to Tyler's patient's bruit. (Tyler got a really nice patient. He was on dialysis and had a shunt thing in his arm and he patiently allowed each of us to listen to the bruit!)

Listening to Moriah's patient's heart murmur. (This man was 90 something and hilarious. When six girls walked in he lit up. He was loving the attention. He asked Tyler why he hadn't asked any of us out. haha. When I told him that I would be listening to his heart he was like "sure thing hunny" and began to lower his gown! Then as we were leaving he was like "hey hunny" and waved his finger in a circle at me. Too much!)

Although at the end of the shift my legs ached and trying to figure out charting on the computer left me frustrated and exhausted I realized that nursing is definitely going to be an adventure. I have to say that I am excited for next week!