New Clinicals… I am now Junior II.

Sup, yo. Sorry I havent been writing. But its a whole start of a new semester. My two clinicals are for my Maternal-Newborn Nursing Class and Adult Health I Competencies class. My days are on Fridays and Saturdays 645a-645p. They are in Clearlake Hospital and Memorial Hermann.

I dont start clinicals soon but its going to be a roller coaster ride this semester.!

UPDATE UPDATE.

Sorry I havent posted the last two clinical events. These two weeks have been crazy. I will real short with what happened:

Week of October 20: – Did a Thorax assessment— again, mixed vicodin and NaCl. Saw how to remove Foleys.

Week of October 27 (I turned 21!) - Observed A Da Vinci robotic assisted mitral valve repair surgery. Very fascinating and wonderful. Saw the actual valve!

Thats all for now— ive got clinicals tomorrow… doing cardio assessment!

Clinical: Week of October 13

Background: Monday night compared to the week before went a lot faster. I was able to print out all the assessment data and the complete physical form of my patient. I was able to get out of  Medical Center by 7pm. My patient was one very interesting tough old man— he had multiple cancers (colon-rectal, prostate, bladder), HPT, two open heart surgeries (CABG). He was in for atrial fibrillation but they found that he has rectal carcinoma. I was  pleased that the nurse gave suggested him (i told her i needed a patient I can do a good skin assessment on). He had a stage 2 pressure ulcer on his sacral region (which TMH didnt cover, i dont know why…skin intact though) and he had many variations in his skin, seeing that he was 87. I was excited to talk with him the following day.

Day Of: The day nurse was nice to me for the entire day. My patient was on fall precaution (as well as on a telometry)  so he had a sitter the whole time, who turned out to be the same PCA i had last week.  He was a sweet old man, he talked about his career as an engineer and his wife (he is a widower). Anyway, here is a breakdown of what I did that day (if i could remember…) this is all lesson related…:

- did vitals on my patient (which i totally forgot to do respirations thought machine would do it!!) shame. The nurse told me to get it afterwards, so it was cool. still. shame!
- did a bed bath and assessed skin at the same time
-assessed skin around his ileostomy and perineal region (had a Foley). Also assessed his pressure ulcer.
-learned how to use TMH’s “Accucheck”, or glucose check machine.
-auscultated patient’s abdomen as well as palpated for his dorsalis pedis pulse (hard to find!)
- i was able to let the nurse know about redness on the heels of my patient
- able to mix vicodin and sodium chloride (not for my patient though)
- learned what a whipple surgery is. (whipple surgery is when they take a head of the pancreas and a part of the small intestine out). Thats why some patients are on insulin even if they dont have diabetes.
-help nurse chart my patients assessment data on MetHOD

Hmm. Thats all I could think of. That morning, Spring was so nice, she bought us Kolaches! Yup. So, I have to write a BETTER care plan next time. and type up meds.
This week of clinicals rate a 8/10!

Clinical: Week of October 7

Background: On Monday night, the group on 8 East and I rode the TMH bus to Scurlock. We headed to the unit office and looked for our instructor. When she came, we met with the nursing director of the floor and she told us how the floor ran by nurse teams; we had to choose teams on each floor and meet the team nurse leader. After a short talk on what to do, I went over to the nurse station next to the rooms 861-867. I met the day nurse Paula and introduced myself. She handed me a paper on her reportson the several patients she was taking care of. I ended up with a lady I will name “Juno”. I wont say much about her, but I will tell you this… she was an interesting case…
I asked her if I could be her nurse tomorrow and she happily and cooperatively agreed.

The day of: Monday night proved to be very exhaustive. I came home that night doing my care plan and making Juno’s care plan. The next morning, I drove to Kara’s to ride down to school. We reached our hospital unit promptly at 645am and we all looked for the night nurse. My night nurse, Christel, was busy and I followed her and introduced her. She then gave her change of shift report to the day nurse, Stephanie (a really sweet lady). I realized the many details they tell each other in each change of shift report. Especially all the lab values.

Stephanie and Christel also found out that my patient was Juno. They were asking me to change patient and I was hesistant and asked my instructor first. I realizexd many odd things about Juno throughout the day…I will just say that her mood that morning was unlike the mood she had during routine vital signs…

I ended up switching my patient to an older man that proved to be really cooperative. I mean, I know im going to be dealing with many different patients who are uncooperative and cooperative…but granted that my time was almost up to attain a complete health history, I had to get a move on and find a more cooperative and nice patient.

I also met the PCA “Beth” and followed her around. I saw how they drew blood, use their vital machines, communicated with patients, ordered food, bedmaking, and even saw a patient die. It was quite sad, I teared as the son of the old woman was telling her that she was strong… (she was on DNR).

I hope next week will turn into something awesome (though I am anxious).