Classes & Clinicals & Exams- Oh My!

Tomorrow, we find out where we will be assigned next semester.  The possible hospitals are Littleton Adventist, St. Anthony North, Sky Ridge, Azura (a rehabilitation center) or Exempla St. Joseph's.  I really want to go to St. Joe's - that's where I had my 'go to nursing school' call.  They're fantastic at what they do.  But any of the hospitals would be fine, I just don't want the rehab center.  I signed up for dual-enrollment in a BSN program just to avoid being sent to a rehab center.  

The news is supposed to be delivered tomorrow morning at the mandatory evaluations/potluck.  If it's bad news, at least I'll be able to self-medicate with food ;)  

APA is so stifling.  There's no room for humor, or creativity, or dragons....

One of the first things we were told in orientation was that if we had any OCD issues about cleaning and cooking, we’d best drop them at once. Easy to say. I don’t claim to be Susy Homemaker, but I can let things slide for just so long before reaching critical mass and having what could be termed as a freakout.

I found myself looking at a giant pile of homework and shrieking “BUT I NEED TO DUST!” This might be a sign of the Apocalypse. Or it might be a sign of the end of the semester. Either way, it just isn’t something I would say while in my right mind.

Actually, nursing school reminds me of working the holiday season at Wen Chocolates. So much to do, so much to keep track of, great coworkers, and that temperamental, self-centered mistress Chocolate, who says “Do not trouble me with your schedule, puny mortal. I’ll go into temper when I’m ready, not before.”

Last night I was dreaming about taking an exam - it might have been pharmacology because my pharmacology professor was there.  Instead of the usual multiple-choice scantron, it was short answer and fill-in-the- blank.  It seemed to be going well until I reached the question "In which movie does Audrey Hepburn's character kiss someone on a bridge in the rain?"

First of all, gratitude and respect to the nurses and patients at my clinical site for their patience, generosity, courage, and humor.  I gave my first insulin injection today - "Oh, no! A student!" said the patient. "She probably got the biggest, dullest needle in the place - oh, go on.  Just stab me, I know you want to."  So I did.  "I'm still alive! Good job, sweetie!"  

A bit later a nurse came and asked if two of us like to observe a wound vac dressing change.  Sure. Sounds cool.  When we got there, we found out that by 'observe', the RN meant 'do'.  So on our fourth day of clinicals, without having done anything more complicated that a sterile wet-to-moist dressing on a mannequin, my classmate and I did a complicated dressing change from start to finish on a ninety-year old man.  A man whose response to "Mr. S., these students are going to do your dressing change," was 'okey dokey'.   So we gather all the supplies, and the RN takes off the patient's cowboy hat, and underneath is a dressing that is slightly bigger than a yarmulke.   So we turn off the suction, gently pry up the thin tagaderm that holds the sponge dressing in place, and reveal something that looks quite a lot like this, just not as big.

Holy F*&k, I want to say.  RN says "Mr. S. had a tumor removed here.  As you can see, the site goes almost down to the scalp." Yes.  Yes, I can see that.  Wow.  

Today my preceptor delegated the removal of sutures to me. The patient is a retired nurse, who said encouraging things like "Don't worry, honey.  Any fool off the street can take out stitches." 

She was right.  No problems, no bleeding.  I felt so nurse-like.  Then my patient's roommate said "Come look at this if you thought her measly little stitches were fun!"  She pulled up the leg of her sweatpants and displayed a row of about thirty staples.  "Bet you wish these were ready to come out, don't you doll?", she said smiling.

I have to admit, she was right.  We just learned staple removal and steri-stripping yesterday; she'd be great practice.

I also got to do wound care around the posts of an external fixator - a torturous looking device that holds broken bones in place from the outside.     

On a completely different note, I noticed last time that one off the night nurses looked  familiar.  This morning I heard her giving report and recognized her voice.  "Is your name Chris? Did you work at HSJ in the early 90's?"

Yes, it was my old charge nurse.  Not only does she work at my clinical site, she's also an instructor for my school.  So, yeah. 

So we all got a catheter kit and some extra sterile gloves so that we could practice our technique outside of class.  No, we were not in any way encouraged to practice on family or friends. Eeew!  The lab instructor told us to use an empty bottle and something to keep it from rolling around while we practiced our sterile technique. It went something like this:

Set up 'patient'.  Remove cat.

Set up sterile field.  Remove a different cat. Start over.

Start inserting catheter into the 'patient'.  

See the 'string!' light go on in cat's eyes. 

Fight cat for catheter.  

Thank cat for injecting bacteria into the catheter.  Be glad that 'patient' is incapable of getting a UTI. 

Remove 'patient' to a different room.  Shut door.  Ignore whining of cat.