Apologies for the delayed update but this term has been slightly on the crazy side.
This term of clinical brings us the wonderful world of adult medical-surgical nursing. The units I am on are primarily surgical units with emphasis on orthopedic surgeries and otolaryngology.
What has been really neat about this clinical rotation so far is watching my development as a nursing student on the verge of a practicum term and graduation into a real nursing position. I've definitely forced myself to overcome some fears in regards to providing care by myself and through this have strengthened my skills in providing top-notch care.
My primary patient this week is recovering from a total hip replacement and is pretty low maintenance care wise. Because of this I provided care for the other patients that my nurse was taking care of, so I got to do a lot of medication administrations, discontinuation of patient controlled analgesics, and IV locks and/or removals. These are fairly simple tasks, but it's awesome to finally be at a level of comfort where I can just go in and get the job done and not need to have someone watch or come with me.
A moment of excitement today occurred when I went in to give a patient a Heparin shot only to find him sleeping on the floor while his mother slept in the hospital bed. As this had never happened to me, I tracked down my nurse and let him know what was going on. Lesson learned: call a code. So, that was a bit of excitement for the day as I stood in the corner watching my first code response. In the end, the patient was fine and we aren't really sure how he ended up on the floor in the first place.
There are still plenty of weeks left of clinical, and who knows what adventures await me! I have to say, the highlight of the experience so far has still been the day my patient who had undergone massive otolaryngology surgery wrote me a note that said that I would make an amazing nurse because of my personality and gentle touch (drat those bedside urinals for dripping onto the notepad, otherwise I would have saved the note).
My biggest goal this term is to do my first blood draw and IV start. Fingers crossed big time on those ones!
Less than four months until graduation! Time to really hone that nursing knowledge before I enter the big, wide world of job hunting!
Tuesday, April 26, 2011
Wednesday, January 5, 2011
And Now For Something Completely Different.
I have a feeling that my community health experience is going to be more interesting than I initially perceived and I feel that it really will give me an opportunity to work with a population's culture completely different from my own. While extremely different from an acute care setting, it really will provide an opportunity to develop communication skills and look beyond the immediate in attending to a holistic health care approach.
From the information on the developer's website it's like our own taste of Pleasantville. Lots of pictures of people enjoying a sunny Seattle day in their ideal community. After one day of doing a fairly superficial assessment of the community, I feel that it has the potential to be a closeknit community made up of diverse cultures, socioeconomic standings, and personality types but it appears as though it has quite a ways to go until then.
Background on Highpoint: Historically this was a low-income neighborhood occupied largely by immigrants to the United States. All of that was bulldozed and in its place was built a neighborhood composed of apartments, town homes, duplexes, and single family homes. The mixed and varied cost of the living environments provide a community made up of extremely diverse persons and the green standards upon which the community are built are extremely progressive in their consciousness of the environment. The community is chock full of green spaces, playgrounds, well lit sidewalks, and community centers and services. But it seems like this project was treated like most really good ideas are when they become a reality: people are there to build the program but a lot of people abandon ship when it comes time to develop and implement the program. I also feel like there are a lot of questions left unanswered in the developing stages such as:
-Where are people supposed to buy groceries if they are on a fixed income and there isn't an affordable option within walking or convenient bussing distance?
-Where are people supposed to go to hang out, grab a cup of coffee, or a bite to eat when the only non-residential space within walking distance is a community center that caters only to providing activity space for larger groups but not more intimate settings?
-How do we accommodate for the spiritual needs of the community when there isn't a nearby religious center for them to practice their faith?
-Who builds a playground without swings? Blasphemous in my own opinion.
From the assessment today, it appears as though there really is a solid mix of cultural and socioeconomic backgrounds. However, we were informed by our clinical instructor that there exists a certain amount of tension between the various groups and as recently as yesterday a community member was attacked in an act of violence by another community member.
A lot of work needs to be done in beginning the slow process of bringing together such a diverse group of views and lifestyles. And that is part of our job as community health nursing students!
The term group that was in the community before my group created an incredibly solid foundation of developing relationships with community leaders that has given my group a starting point to not only continue developing relationships with but also the ability to continue developing programs aimed at community needs and wants.
In a way, I feel as though I am an RA again only instead of helping college freshman, I'm helping families and blending extremely diverse cultures together. Luckily, my team is awesome and seem just as motivated to continue helping the community learn to work and communicate more efficiently together.
I really feel that this planned neighborhood has a lot of potential, but it's also extremely important that programs and services are developed and relationships within the community are strengthened or it could easily become a forgotten project that fell apart over time because nobody had a plan for the community once it was built.
From the information on the developer's website it's like our own taste of Pleasantville. Lots of pictures of people enjoying a sunny Seattle day in their ideal community. After one day of doing a fairly superficial assessment of the community, I feel that it has the potential to be a closeknit community made up of diverse cultures, socioeconomic standings, and personality types but it appears as though it has quite a ways to go until then.
Background on Highpoint: Historically this was a low-income neighborhood occupied largely by immigrants to the United States. All of that was bulldozed and in its place was built a neighborhood composed of apartments, town homes, duplexes, and single family homes. The mixed and varied cost of the living environments provide a community made up of extremely diverse persons and the green standards upon which the community are built are extremely progressive in their consciousness of the environment. The community is chock full of green spaces, playgrounds, well lit sidewalks, and community centers and services. But it seems like this project was treated like most really good ideas are when they become a reality: people are there to build the program but a lot of people abandon ship when it comes time to develop and implement the program. I also feel like there are a lot of questions left unanswered in the developing stages such as:
-Where are people supposed to buy groceries if they are on a fixed income and there isn't an affordable option within walking or convenient bussing distance?
-Where are people supposed to go to hang out, grab a cup of coffee, or a bite to eat when the only non-residential space within walking distance is a community center that caters only to providing activity space for larger groups but not more intimate settings?
-How do we accommodate for the spiritual needs of the community when there isn't a nearby religious center for them to practice their faith?
-Who builds a playground without swings? Blasphemous in my own opinion.
From the assessment today, it appears as though there really is a solid mix of cultural and socioeconomic backgrounds. However, we were informed by our clinical instructor that there exists a certain amount of tension between the various groups and as recently as yesterday a community member was attacked in an act of violence by another community member.
A lot of work needs to be done in beginning the slow process of bringing together such a diverse group of views and lifestyles. And that is part of our job as community health nursing students!
The term group that was in the community before my group created an incredibly solid foundation of developing relationships with community leaders that has given my group a starting point to not only continue developing relationships with but also the ability to continue developing programs aimed at community needs and wants.
In a way, I feel as though I am an RA again only instead of helping college freshman, I'm helping families and blending extremely diverse cultures together. Luckily, my team is awesome and seem just as motivated to continue helping the community learn to work and communicate more efficiently together.
I really feel that this planned neighborhood has a lot of potential, but it's also extremely important that programs and services are developed and relationships within the community are strengthened or it could easily become a forgotten project that fell apart over time because nobody had a plan for the community once it was built.
Thursday, November 11, 2010
It's the End of the Term As We Know It
One more round of clinicals done! Although this time it's pretty bittersweet.
For the first time in all of my clinical experiences, I don't feel ready to be done but rather feel like things are just getting started and that I have so much left to learn! So that's a good sign for future career prospects at least.
The last two weeks of clinical were pretty uneventful, no super interesting cases to report. However I did administer my first intramuscular injections! Terrifying at first, but now I'm pretty pro. Although using a pediatric needle is much less intimidating than using an adult sized IM injection needle (the big fat ones that hurt). But, now at least one whole family that visited the hospital is vaccinated against the flu this year!
All in all it was probably the most inspiring and best term of clinicals. I could not have asked for a better clinical instructor, hospital staff, or peer group to work with! And, ending with a giant feast (pizza, hummus plate, two salads, two cheesecakes from the cheesecake factory, and oodles and oodles of really good candy snacks) prepared for us by our instructor didn't hurt either!
I'm just really amazed at how much doing a term of med/surg nursing really advances your skills, knowledge and confidence. I think it's mostly because it's the first time you are actually doing something as opposed to standing around and shadowing.
Next on the docket is community health, but I can't really promise anything exciting from that session of clinicals as no one has yet even explained what we are doing. So, we shall see.
In a final note, if this hasn't been made clear already: I LOVE PEDS!
For the first time in all of my clinical experiences, I don't feel ready to be done but rather feel like things are just getting started and that I have so much left to learn! So that's a good sign for future career prospects at least.
The last two weeks of clinical were pretty uneventful, no super interesting cases to report. However I did administer my first intramuscular injections! Terrifying at first, but now I'm pretty pro. Although using a pediatric needle is much less intimidating than using an adult sized IM injection needle (the big fat ones that hurt). But, now at least one whole family that visited the hospital is vaccinated against the flu this year!
All in all it was probably the most inspiring and best term of clinicals. I could not have asked for a better clinical instructor, hospital staff, or peer group to work with! And, ending with a giant feast (pizza, hummus plate, two salads, two cheesecakes from the cheesecake factory, and oodles and oodles of really good candy snacks) prepared for us by our instructor didn't hurt either!
I'm just really amazed at how much doing a term of med/surg nursing really advances your skills, knowledge and confidence. I think it's mostly because it's the first time you are actually doing something as opposed to standing around and shadowing.
Next on the docket is community health, but I can't really promise anything exciting from that session of clinicals as no one has yet even explained what we are doing. So, we shall see.
In a final note, if this hasn't been made clear already: I LOVE PEDS!
Wednesday, October 27, 2010
And That's How I Almost Cried During Clinical
This week I was supposed to be in the PICU (pediatric intensive care unit) for both days. The PICU has had census problems all term and usually ends up being closed because of a lack of patients. So I was incredibally stoked when they had one Monday evening who would be there both days and who had a lot of interventions that I had never seen or worked with before (wound drains, a colostomy, a PICC [Peripherally Inserted Central Catheter] line). So, Monday night I spent about 5 hours looking up all of my patients labs and medications and brushing up on my skills to make sure I would be able to provide awesome care. And I was very excited to do all these interventions too.
But then I arrived at clinicals. And was told that I could no longer be with that patient because the newly hired nurse would be working with him. Which is understandable, and I was fine with that aspect of it but what I was not fine with was the fact that I had all this pre-clinical work completed and was being switched to a patient that needed no care and was being discharged that day. ARGH!
So, we made the decision at the end of the day to have my second day take place on the regular pediatric floor. And that was an amazing decision!
My primary patient today was a 12 year old who has a BMI of 48 (over 30 is considered obese). In addition he has ashtma, COPD, gout, multiple admissions for respiratory infections including pneumonia, and arthritis. He was admitted this time due to cellulitis on his arm (a bacterial skin infection) and possible kidney failure. Unfortunately they inserted the PICC line before I got there, which was kind of a bummer, but I did get to do a heparin flush (to keep it open and free of clots) which was kind of neat and I got to play many round of connect four (a favorite board game) with him. It was really just fun being around him but also extremely heartbreaking. Many cultural and lifestyle factors are keeping him from losing weight, but unfortunately if he keeps going the way he's going his life expectancy isn't very long.
Other big news: I got to place my first NG tube today! Probably the most traumatizing thing I've ever done to an infant. Getting the tube down the nose and into the stomach was not big deal (first try I got it in the right spot, holler!) but taping down the tube to an extremely angry infant's face and needing to use scissors to trim the tape all during crying and moving on the infants part? Traumatizing. It's good that it happened at the end of my day or I would have been on edge for the rest of the day.
So that was my week! It ended on a pretty cool note I must say. And the further into this I get the more I'm pretty sure that I was created to work in pediatrics. Hooray!
But then I arrived at clinicals. And was told that I could no longer be with that patient because the newly hired nurse would be working with him. Which is understandable, and I was fine with that aspect of it but what I was not fine with was the fact that I had all this pre-clinical work completed and was being switched to a patient that needed no care and was being discharged that day. ARGH!
So, we made the decision at the end of the day to have my second day take place on the regular pediatric floor. And that was an amazing decision!
My primary patient today was a 12 year old who has a BMI of 48 (over 30 is considered obese). In addition he has ashtma, COPD, gout, multiple admissions for respiratory infections including pneumonia, and arthritis. He was admitted this time due to cellulitis on his arm (a bacterial skin infection) and possible kidney failure. Unfortunately they inserted the PICC line before I got there, which was kind of a bummer, but I did get to do a heparin flush (to keep it open and free of clots) which was kind of neat and I got to play many round of connect four (a favorite board game) with him. It was really just fun being around him but also extremely heartbreaking. Many cultural and lifestyle factors are keeping him from losing weight, but unfortunately if he keeps going the way he's going his life expectancy isn't very long.
Other big news: I got to place my first NG tube today! Probably the most traumatizing thing I've ever done to an infant. Getting the tube down the nose and into the stomach was not big deal (first try I got it in the right spot, holler!) but taping down the tube to an extremely angry infant's face and needing to use scissors to trim the tape all during crying and moving on the infants part? Traumatizing. It's good that it happened at the end of my day or I would have been on edge for the rest of the day.
So that was my week! It ended on a pretty cool note I must say. And the further into this I get the more I'm pretty sure that I was created to work in pediatrics. Hooray!
Wednesday, October 13, 2010
Peds Clinical >>>>>> Spring Quarter Clinicals
Today was my fourth and final day in the ISCU during my Peds rotation and while it was a tad chaotic, it was also epic too. This clinical term is so much better than the spring, mainly because I'm actually doing things now instead of awkwardly standing around.
Today I took full care of two (instead of one) patients by myself. This in itself was epic and it felt like such an accomplishment on the road to working as a real live nurse. Everything went well, I've long been accomplished at time management and multi-tasking, aside from the couple of minor incidents that were baby related.
Patient #1:
Baby Girl 1 was born at 36 weeks gestation with gastroschesis (intestines outside of the umbilicus). This was quite a fascinating pathophysiology as the surgical correction is quite simple (putting it all back in through the umbilicus) and visually the only physical difference between this baby and one not born with gastroschesis is that my patient has a very tight, very distended abdomen (it should be soft and non-distended). Baby Girl 1 is a couple days out from discharge but is having troubles holding down feedings. I kind of learned this the hard way as yesterday all her feedings went well. I thought everything was copacetic post feeding as I rocked her to sooth her fussiness. Then, out of nowhere: a contorted face and about 30cc's of formula all over herself. Luckily, none got on me and I quickly responded by laying Baby Girl 1 on her side to prevent choking or aspiration. This happened with every feeding, making it frustrating more than anything else as this usually required a new wardrobe and set of sheets. However, she's doing as well as expected and once the regurgitations are gone for sure she will get to leave and enjoy home.
Patient #2:
Baby Girl 2 was a baby born at 31 weeks gestation and really in only in the ISCU so that she can grow and develop her suck and swallow coordination so the feeding tube (NG tube) can be removed and she can either nurse on her mama or a bottle. This means I got to give her medications through her NG tube and gavage feed her. Unfortunately, as I had never set up a gavage feed on my own, it took a couple of tries to smoothly set it up on my own.
Feed #1: Everything was set up the right way (the nurse showed me how) but I didn't depress the plunger on the syringe that the food was in enough so it was awkwardly stagnant for most of the feed. Kind of embarrasing at the time, no big deal now.
Feed #2: Equipped with the knowledge of needing to give the plunger a good push, I thought I would ace this feeding effort. However, I made the mistake of not connecting the syringe to the feeding tube before putting formula in. When I took the cap off the syringe, forumla went EVERYWHERE. Awkward.
Feed #3: Success! I was pro by this point. Hooray!
All in all, it was a wonderful day and I've felt really proud of myself working in a more autonomous nursing role. Win!
Next week: Surgical Observation Day
Today I took full care of two (instead of one) patients by myself. This in itself was epic and it felt like such an accomplishment on the road to working as a real live nurse. Everything went well, I've long been accomplished at time management and multi-tasking, aside from the couple of minor incidents that were baby related.
Patient #1:
Baby Girl 1 was born at 36 weeks gestation with gastroschesis (intestines outside of the umbilicus). This was quite a fascinating pathophysiology as the surgical correction is quite simple (putting it all back in through the umbilicus) and visually the only physical difference between this baby and one not born with gastroschesis is that my patient has a very tight, very distended abdomen (it should be soft and non-distended). Baby Girl 1 is a couple days out from discharge but is having troubles holding down feedings. I kind of learned this the hard way as yesterday all her feedings went well. I thought everything was copacetic post feeding as I rocked her to sooth her fussiness. Then, out of nowhere: a contorted face and about 30cc's of formula all over herself. Luckily, none got on me and I quickly responded by laying Baby Girl 1 on her side to prevent choking or aspiration. This happened with every feeding, making it frustrating more than anything else as this usually required a new wardrobe and set of sheets. However, she's doing as well as expected and once the regurgitations are gone for sure she will get to leave and enjoy home.
Patient #2:
Baby Girl 2 was a baby born at 31 weeks gestation and really in only in the ISCU so that she can grow and develop her suck and swallow coordination so the feeding tube (NG tube) can be removed and she can either nurse on her mama or a bottle. This means I got to give her medications through her NG tube and gavage feed her. Unfortunately, as I had never set up a gavage feed on my own, it took a couple of tries to smoothly set it up on my own.
Feed #1: Everything was set up the right way (the nurse showed me how) but I didn't depress the plunger on the syringe that the food was in enough so it was awkwardly stagnant for most of the feed. Kind of embarrasing at the time, no big deal now.
Feed #2: Equipped with the knowledge of needing to give the plunger a good push, I thought I would ace this feeding effort. However, I made the mistake of not connecting the syringe to the feeding tube before putting formula in. When I took the cap off the syringe, forumla went EVERYWHERE. Awkward.
Feed #3: Success! I was pro by this point. Hooray!
All in all, it was a wonderful day and I've felt really proud of myself working in a more autonomous nursing role. Win!
Next week: Surgical Observation Day
Tuesday, October 5, 2010
Babies Smell Like Warm Cheese.
I blame it on the breast milk (which is all over my scrubs due to a gavage feeding mishap described alter). I never had the chance to notice this scent during my stint in L&D because most of the babies were still guzzling down colostrum (the pre-milk if you will). After my first day in the ISCU (Infant Specialty Care Unit) I had more than enough time to peg down that odor.
Here is what I find really cool so far this term during my peds rotation: I'm actually doing something for the first time. While the interventions may be simple (gavage, diaper changes, and med administration) it's the first time in my clinical experience where someones care is almost soley in my hands. And knowing what to do when and why is a pretty cool feeling.
Today my patient was a 2 week old infant born at 36 weeks. After an emergency section, the baby was hypoxic and wasn't breathing very much/well for about the first five minutes of life and about 10 hours later began having seizures. The last 2 weeks have been a time of stabilization, understanding what damage may have occured during the hypoxic period, and controlling the seizure episodes.
It's not uncommon for preterm infants to have difficulty nipple feeding as their sucking and swallowing reflexes are not properly coordinated. In addition to this, my patient isn't always the most alert baby (as in no crying or fussing what she's hungry and pretty drowsy during feeding) so the majority of her feeds are done via gavage (a fancy way of saying feeding tube + gravity). So, today I learned how to set it up, how to fortify her mom's breast milk, and how not to take it all apart in the end. Basically, the lesson of this story is don't try and unhook a feeding syringe from a feeding tube with a baby in one arm or the tube residual will likely end up all over your clothes and the floor (luckily not a great quantity but enough to be frustrating).
I also got to administer my patient's anti-seizure medications through the same NG tube that her meals come through. Pretty simple, its just depressing a plunger slowly, but it's still a novel feeling to dispense medications almost by myself (someone still has to watch as I am still a student).
The rest of my day was spent snuggling a different patient who is a withdrawal baby and just needed some TLC and an occasional pacifier to nibble on. The only danger with this is when you are sitting in a dark room, rocking in a chair, holding a warm baby after getting up at 5:30 to get ready you find yourself nodding off occasionally. So cozy!
Tomorrow I will be with the same patient but things will go much smoother as I made the awkward mistakes today! Until next week!
Here is what I find really cool so far this term during my peds rotation: I'm actually doing something for the first time. While the interventions may be simple (gavage, diaper changes, and med administration) it's the first time in my clinical experience where someones care is almost soley in my hands. And knowing what to do when and why is a pretty cool feeling.
Today my patient was a 2 week old infant born at 36 weeks. After an emergency section, the baby was hypoxic and wasn't breathing very much/well for about the first five minutes of life and about 10 hours later began having seizures. The last 2 weeks have been a time of stabilization, understanding what damage may have occured during the hypoxic period, and controlling the seizure episodes.
It's not uncommon for preterm infants to have difficulty nipple feeding as their sucking and swallowing reflexes are not properly coordinated. In addition to this, my patient isn't always the most alert baby (as in no crying or fussing what she's hungry and pretty drowsy during feeding) so the majority of her feeds are done via gavage (a fancy way of saying feeding tube + gravity). So, today I learned how to set it up, how to fortify her mom's breast milk, and how not to take it all apart in the end. Basically, the lesson of this story is don't try and unhook a feeding syringe from a feeding tube with a baby in one arm or the tube residual will likely end up all over your clothes and the floor (luckily not a great quantity but enough to be frustrating).
I also got to administer my patient's anti-seizure medications through the same NG tube that her meals come through. Pretty simple, its just depressing a plunger slowly, but it's still a novel feeling to dispense medications almost by myself (someone still has to watch as I am still a student).
The rest of my day was spent snuggling a different patient who is a withdrawal baby and just needed some TLC and an occasional pacifier to nibble on. The only danger with this is when you are sitting in a dark room, rocking in a chair, holding a warm baby after getting up at 5:30 to get ready you find yourself nodding off occasionally. So cozy!
Tomorrow I will be with the same patient but things will go much smoother as I made the awkward mistakes today! Until next week!
Saturday, June 5, 2010
In the Words of Mister Bon Jovi....Whoa, We're Halfway There
And so concludes a second term of clinicals and the first of two years of nursing school. Crazy, right? Especially since just a year and a couple of days ago I didn't even know I'd gotten into nursing school yet. My time this term in psychiatric and gerontological nursing wasn't event worthy enough to write a new post every week, so instead I will treat you with a comprehensive summary of each experience. I also don't feel like studying for finals quite this minute so this also is a good something else to do.
Psychiatric Nursing
Whether it's bad or good to say it, I was pretty disappointed when I found out the majority of my psych nursing time would be spent in a substance abuse rehabilitation center with the rest of it spent in a geriatric psych. unit. However, looking back I'm really glad I got the experience I did for a couple of reasons.
I have a much deeper understanding of addiction and the road to recovery than I would ever be able to receive in my education. This is significant because the rates of addiction in the general population are relatively high, and having a better understanding of the disease and the treatment will be applicable in any unit I decide to work in and will also make me a better advocate for my patients. That's a pretty empowering feeling too, so kudos rehab.
My time in the geriatric psych. unit was pretty interesting as well. It's a mental health unit for those over the age of 65, however my patient that I spent the most time with was 52. Honestly, I think it would take a very unique personality to work in that particular setting. People are agitated very easily and when they aren't agitated they spend most of their time wandering the hallways. The nursing staff were really good in this particular unit and knew how to keep patients calm and happy with simple tasks like folding napkins or helping push carts around. One of the days I was in gero psych, I was sitting having a perfectly normal conversation with a woman about the weather and breakfast when all of a sudden she turned to me and said "I don't think the bus driver knows where he's going, this doesn't look like Pennsylvania." It caught me off guard, but also underscored the way that patients with dementia can slip in and out of reality easily.
Overall, I know that psychiatric nursing is not in the cards for me, but I did get a lot of good experience this term with therapeutic communication and exposure to different mental health problems.
Gerontological Nursing
This was the term I had been dreading the most out of my two year program because I've always known that this is not my forte. I'm don't have a fear of aging in the sense that "oh no I'll have lost my youth" but I definitely have a fear of the inability to take care of myself and the physical changes that occur as a result of age. I thought that this term would help assuage these somewhat, but it really didn't until my professor pointed out that the majority of the elderly population don't live in assisted living facilities. It really did underscore the importance of taking care of yourself now instead of waiting until later.
One of the two patients I was the closest with was a man who had a stall in the Market until October when he fell and fractured his hip. He moved into the facility to heal up and begin walking therapy. He was a very quiet man who kept to himself but as the weeks progressed, he opened up and I even got him to laugh a couple times. Once, after I shaved his face I almost forgot the aftershave. He pointed this out to me, and I replied "Of course, you've got to smell fresh for the ladies!" He was greatly amused by this and it's these little moments that I will remember with him. Once he began his walking therapy I created a poster for him to keep track of his progress once I was gone. When I told one of my peers this she replied "A poster? You are such an RA!" Yup, I still am deep down inside an RA and I'm okay with that. On the last day I was going to hang up the poster in his room but was going to check his chart before I greeted him for the day to see how his walking had progressed in the past week. I learned that the night before he had a stroke and was sent to the ICU of a nearby trauma 1 hospital. The sense of loss I felt was very great and it was hard to not start tearing up right there. It was such an abrupt end to our relationship and just was so shocking given that he had been completely fine the week before. I hung up the poster in his room with a note anyways in hopes that he 1) returns to the facility and 2) is able to start walking therapy again.
The other patient was a 93 yo woman from New Orleans. Nothing major other than she was just your classic sassy and strong southern woman who liked a good game of poker. And for 93 she's in really good shape too. Her major health problem is vascular dementia that results in delusions of maggots in her food and a man who comes in her 3rd story window every night to knock over her plants and scuff up her carpet.
All in all, it was a fairly decent term and at the very least I know two areas of nursing that I'm not particularly interested in! Next term is a different story as I am very excited to be doing pediatrics, a specialty I was set on back in the days when I wanted to go to med. school.
Enjoy the summer, I'll be back in the fall!
Psychiatric Nursing
Whether it's bad or good to say it, I was pretty disappointed when I found out the majority of my psych nursing time would be spent in a substance abuse rehabilitation center with the rest of it spent in a geriatric psych. unit. However, looking back I'm really glad I got the experience I did for a couple of reasons.
I have a much deeper understanding of addiction and the road to recovery than I would ever be able to receive in my education. This is significant because the rates of addiction in the general population are relatively high, and having a better understanding of the disease and the treatment will be applicable in any unit I decide to work in and will also make me a better advocate for my patients. That's a pretty empowering feeling too, so kudos rehab.
My time in the geriatric psych. unit was pretty interesting as well. It's a mental health unit for those over the age of 65, however my patient that I spent the most time with was 52. Honestly, I think it would take a very unique personality to work in that particular setting. People are agitated very easily and when they aren't agitated they spend most of their time wandering the hallways. The nursing staff were really good in this particular unit and knew how to keep patients calm and happy with simple tasks like folding napkins or helping push carts around. One of the days I was in gero psych, I was sitting having a perfectly normal conversation with a woman about the weather and breakfast when all of a sudden she turned to me and said "I don't think the bus driver knows where he's going, this doesn't look like Pennsylvania." It caught me off guard, but also underscored the way that patients with dementia can slip in and out of reality easily.
Overall, I know that psychiatric nursing is not in the cards for me, but I did get a lot of good experience this term with therapeutic communication and exposure to different mental health problems.
Gerontological Nursing
This was the term I had been dreading the most out of my two year program because I've always known that this is not my forte. I'm don't have a fear of aging in the sense that "oh no I'll have lost my youth" but I definitely have a fear of the inability to take care of myself and the physical changes that occur as a result of age. I thought that this term would help assuage these somewhat, but it really didn't until my professor pointed out that the majority of the elderly population don't live in assisted living facilities. It really did underscore the importance of taking care of yourself now instead of waiting until later.
One of the two patients I was the closest with was a man who had a stall in the Market until October when he fell and fractured his hip. He moved into the facility to heal up and begin walking therapy. He was a very quiet man who kept to himself but as the weeks progressed, he opened up and I even got him to laugh a couple times. Once, after I shaved his face I almost forgot the aftershave. He pointed this out to me, and I replied "Of course, you've got to smell fresh for the ladies!" He was greatly amused by this and it's these little moments that I will remember with him. Once he began his walking therapy I created a poster for him to keep track of his progress once I was gone. When I told one of my peers this she replied "A poster? You are such an RA!" Yup, I still am deep down inside an RA and I'm okay with that. On the last day I was going to hang up the poster in his room but was going to check his chart before I greeted him for the day to see how his walking had progressed in the past week. I learned that the night before he had a stroke and was sent to the ICU of a nearby trauma 1 hospital. The sense of loss I felt was very great and it was hard to not start tearing up right there. It was such an abrupt end to our relationship and just was so shocking given that he had been completely fine the week before. I hung up the poster in his room with a note anyways in hopes that he 1) returns to the facility and 2) is able to start walking therapy again.
The other patient was a 93 yo woman from New Orleans. Nothing major other than she was just your classic sassy and strong southern woman who liked a good game of poker. And for 93 she's in really good shape too. Her major health problem is vascular dementia that results in delusions of maggots in her food and a man who comes in her 3rd story window every night to knock over her plants and scuff up her carpet.
All in all, it was a fairly decent term and at the very least I know two areas of nursing that I'm not particularly interested in! Next term is a different story as I am very excited to be doing pediatrics, a specialty I was set on back in the days when I wanted to go to med. school.
Enjoy the summer, I'll be back in the fall!
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