YKYW - Nursing Student Blog

Clinicals have been interesting lately. I spent a few days in the ER. Things get really busy in the evenings! I was able to do an in and out urinary catheter on a woman, and I started 7 IVs. Well, I attempted 9, but only successfully started 7 of them. Considering these were my first attempts on a real person, I’ll take it!

I also got to see an active MI (myocardial infarction)! Seeing someone come while in the middle of a heart attack was very exciting. To see how it was handled, how people responded … I even got to follow it up to the cardiac cath lab and see them place several stents (not shunts) and a pacemaker. I’m still amazed at how fast everything was done.

Our major care plans were due last week. Mine came in at almost 40 pages long. I wrote mine on a patient who had a recent kidney transplant, and developed an infection.

For the most part, my teacher has turned me loose. I’m giving oral medications, injections and hanging IV piggybacks totally on my own. It’s almost like I’m a real nurse!

As for lecture, I’m doing okay. Not great, but not too horrible, either. Things are still a bit touch-and-go, but I’m trying to turn it around.

Several people have written to ask me how things are going. This has been a heck of a year, lemme tell you!

One of the reasons I’ve been stressed out is because I’ve been experiencing significant abdominal pain pretty much every time I try to eat anything. Over the Christmas holiday, I went to the doctor to have some testing done and when I got the results, it threw me for a bit of a loop. I’m allergic to a ton of stuff, including gluten, egg yolks and whites, dairy, soy, corn, tomatoes, and safflower. And those are just a few of my food allergies! The entire list is rather long.

Needless to say, since I was trying to live on bananas and orange juice, I tortured my immune system. I’ve been sick since early January and finally went to the doctor earlier this week (being a student with no health insurance really bites!). It’s just bronchitis, so they gave me some steroids, antibiotics and stuff like that. I’m trying to bulk up on my vitamin C and take better care of myself.

As for school … I really didn’t do well on the first test, but I did fairly well on the second one. I didn’t quite pull myself out of the hole I dug, but hope is not lost. I’ll have my third lecture test next week (out of five total), so I’ll have a good idea then of where I’m sitting overall.

Clinicals are going fairly well. I’ve had some really interesting patients, and I’m getting to do a ton of nursing skills. I’ve been giving oral meds on my own for a while now (no more waiting on the instructor!), and I just got the OK to start hanging IVs on my own, too! The first time I went around handing out oral medications to my patients on my own, I really started to feel like a nurse. I can only imagine the feeling when I get to hang that first IV without my instructor!

I haven’t been able to start on IV yet on a real person, but our instructor is really trying to find us good situations. Since I’m still trying to develop my sea legs, so to speak, and not get queasy, I’m not in any hurry.

So, yes, I’m still here, plugging away. Thanks to everyone who’s written to ask about me and wish me well!

In this nursing program, passing requires a 78 minimum average. If you fail one class, you have to repeat every class in the entire semester. Going into my final this morning, I knew I was barely passing my lecture class.

As I sat down in front of the computer, I tried to give myself a pep talk: You just need to pass this test. You can do it. I closed my eyes, took a deep breath, and started the test.

And had no clue what the first 10 questions were even talking about.

After going through all the questions at least twice, I was ready to finish the test. Hovering over the ’submit’ button, afraid to know my results, I tried to prepare myself for whatever might happen. Steeling my resolve, I hit the button.

70

I don’t think I can even tell you a portion of the things that went through my mind as I saw that failing grade come up on the screen. I disappointed everyone who believed in me and I was ashamed to have let them down. What’s wrong with me and why am I such a failure? Could I really do this entire semester all over again?

Still in shock, I spoke to my teacher about the readmission process. My friend was waiting for me in the hall. ‘How’d you do?’

‘Not good,’ as I slowly shook my head and headed down the hallway.
‘Are you still in the program?’ she asked, worry clouding her voice.
‘Nope. I failed. Bad.’

She was silent, then, not knowing what to say to comfort me.

After a moment, ‘Are you sure?’
‘Pretty sure,’ but I dug out my phone to use the calculator. ‘I can’t even remember my grades; I just remember my average!’ as the frustration starts to creep over me.
‘Just multiply it by 4.’
‘Oh, right.’ *4)+70))/5

I lean heavily against the wall, trying to find the courage to look at the answer.

77.8

Turning to my friend, I whisper, ‘77.8?’ Then there’s a slight pause because I can’t find my voice and I literally collapse onto the floor. ‘That’s passing, right?’
‘Yes! Are you sure?’ She pulls out an adding machine (yes, she carries and adding machine with her; I have no idea why) and we’re both doing the math.

It’s right! I made it!

In the end, it wasn’t that close after all. There were a few test questions tossed out of this test and the last test, so I wound up with plenty of cushion. Even knowing that, while trying to write this, attempting to recapture the horrible feelings from this morning, I feel nauseous. That walk down the hallway, with dismay weighing so heavy on my soul, was the longest 10 steps of my life.

I almost didn’t write about my morning; I could just say I passed, and nobody would know that I came so close to failing. But, I’m not perfect, and this is a difficult journey.

I’m just glad I’m still on it.

My time in labor and delivery and in the newborn nursery went well. Actually, it went a lot better than I thought it could. The brief version? Not only did I see babies born — I actually CAUGHT one as he came out. It was gross, and pretty awesome. While in the nursery, I was appointed the offical ‘Fussy Baby Holder.’ People with several kids couldn’t get some of the babies to settle down, but they’d snuggle up, content, within moments of being passed to me. I really have no idea why, but they stopped crying, so I’m trying not to question it. But, the biggest news?

I DIDN’T FAINT.

Woo! Thank you all for the support and encouragement!

Things have been hectic here in nursing student world. Last week, I spent a day at a local immunization clinic. It was a pretty awful day, really. A whole shift of just giving shots to kids? I don’t envy the nurses who do that job on a regular basis.

I also spent a day on a post-partum floor, shadowing a nurse. Before the day started, I wasn’t excited about it. But, I had an amazing nurse and learned SO much. She had me doing full assessments — the first time I checked for colostrum and lochia, I was a bit hesitant, but by lunch time, I felt like an old pro.

This week, I have to take care of two patients in post-partum on my own, then I’ll move on to labor and delivery and finally the NICU.

I have a confession to make. I’m nervous about my time in labor and delivery because I don’t deal well with blood and people in pain. I know, what am I doing in nursing school if I don’t want to see blood? I think I can learn to deal with it; I’m just not sure HOW to learn to deal with it. Is there anyone else who was squeamish when they started nursing school? If so, how did you deal with it?

Holy cow!

‘The male sperm is capable of fertilization for up to three days after ejaculation.’

I had no idea.

(I’m studying for my first lecture test in my nursing class — it’s tomorrow.)

Last week was my first experience in a pediatric unit. Compared to the hospital where I spent my first clinical rotations, this one is amazing. I wouldn’t mind working here. This is the first time I’ve seen nurses on the floor who were excited about what they were doing. My experience with my patient was pretty emotional, but it turned out to be a very good thing.

This hospital is only about 20 minutes from my new place, and my next rotation is less than 3 miles from my condo. The short commute is one of the reasons I wanted to move to this area. Last semester, rotations started at 6:45a and it took me an hour to get there. This semester, our rotations start at 5:45a. That’s way too early.

The first skills check-off of the semester was this morning. We had to do SQ injections. My orders required mixing insulin, so it wasn’t too bad. I did practice with a chicken, but it was pretty messy. In the end, one of those stress ball things worked really well for me.

For awhile, I was really struggling when it came to actually inserting the needle. I couldn’t seem to get it to go all the way in no matter how hard I tried. In the end, I realized my problem was that I wasn’t following through with my wrist motion. Once I started working on my follow-through, it was a piece of cake!

Now it’s time to start preparing for the first lecture test of my second semester of nursing school. The test is next week. IM injections to are next in skills lab.

As I put on my lab coat this morning, I realized how much I had missed wearing it. Nursing school started up again on Monday, and today was our orientation to our pediatrics hospital. After my pediatric rotation, I’ll go through obstetrics and finish up with a bit of medical/surgical.

Rotations will take me to two different hospitals this semester. While it will be nice to see how different hospitals handle things, it will be a little nerve-wracking to move to a new hospital about the time I figure out where everything is at the first one! One thing’s for sure — being a nursing student teaches you to go with the flow

During skills lab this week, we started on injections. My goal is to learn to do my intradermal injections better than the guy who gave me my PPD test — I have a nasty bruise on my forearm. I think I’m going to buy a couple of chicken breasts and practice over the holiday weekend. Someone also said that hotdogs are good for practicing injections. How do you practice your injections?

Second semester starts next week, and they are still changing the times and days of our classes. Luckily, my work schedule is pretty flexible, but it’s really messing with other people who are trying to figure out when they’ll be able to work.

I bought my books last week, and I recertified my CPR today. Our school makes us do it every year even though our cards are good for two years. Is it just us, or do other schools do that, too?

I’m really dreading this semester … for a lot of reasons, really. I guess I will finally find out if I can motivate myself!

Microbiology is coming along fairly well. I just finished my third lecture test, and I’m waiting to go into lab. Our unknown projects are due tomorrow. I was a little apprehensive going into this project, but I’ve had a lot of fun. I don’t know if other schools set up the microbiology unknown projects the same way, but this is how ours works:

We are each given two different specimens in a broth culture. All we know is that we have one Gram positive and one Gram negative. We have to get pure, isolated cultures of each, and properly identify each organism.

My first TSA streak plates didn’t go well, but I did have some growth on both my EMB and blood/PEA plates. These were a big help to narrow down which specimen was Gram positive and which was Gram negative. Gram staining is so tricky!

After isolating my Gram negative specimen, I started running tests on it. The glucose test came back positive: bright yellow, with gas in the vial. The lactose test was also positive with the top of the tube red and the bottom yellow. With these results, I decided to use the citrate and indole tests. In the citrate test, the slant was a bright, Prussian blue — positive! The negative indole test confirmed my results. A positive result on my Voges Proskauer test eliminated a couple possibilities, and I decided my Gram negative bacillus is Enterobacter aerogenes. I ran a few other tests (ornithine, phenylalanine, nitrate, TSI and urea) to confirm my results. So far, all the test results are in line with what is expected of Enterobacter aerogenes.

I made a mistake with my Gram positive specimen, so I had to rerun a test overnight. As of now, I know I have Gram positive cocci. It bubbled like crazy during the catalase test, and it is glucose negative (red) with no gas. I tried to run the nitrate test, but I got a little impatient. I only waited about a minute after putting in the Nitrate I and II drops before I added the zinc. I got a reaction! But, since my Gram positive specimen is such a slow grower, I should have waited a full three minutes. I suspect I have Sarcina lutea (which means it reacted to the zinc, and has NO3-, but I’m not sure. If the reaction was due to the Nitrate I and II drops, then I have Micrococcus luteus. I’m fairly sure I have Sarcina lutea, and will confirm soon.

What a way to spend a summer, hmm?