Sunday, April 18, 2010

Week 14 as a level 3 nursing student!

The weeks are diminishing and I can't believe this semester is almost over - yet it also feels like this has been one LONGGGGGGGG semester.

Mon was our last PBL class for this semester! This PBL has been one of great learning for me, not in terms of the content (even though I did learn), but in terms of dealing with other ppl. I've found that I am still trying to find the line between being assertive and aggressive. One valuable lesson from this past semester is the urgency of approaching problems as they come up, instead of 'letting it lie' and in a sense, percolating.

I had no patient assignment on Tue so I had a bit of a harder time researching the diagnosis on site while still answering the questions the parents had. My patient was on contact and droplet precautions, so I had to wear a gown, mask, and gloves. Imagine trying to become friends with a 5 year old with half your face covered and coming into the room with this oversized yellow gown on! Daunting, to say the least! Tuesday was pretty rough, trying to look up information, I was getting used to the Fraser health charting, and trying to make sure that I found the right answers to the questions the parents were asking. In a nutshell, I felt incredibly disorganized.
Organization aside, I managed to get along sooooo well with my patient. She had scarlet fever and was still sooooo cooperative and adorable. I couldn't help but grow attached to her just because she was such a sweetheart. I was checking her pupils and I asked her to close her left eye and she closed her right one instead (I didn't bother correcting her, but her mom did!)!! And while I was finishing her head to toe assessment, she paused to show me how she could fold her socks together!! I also gave her stickers for each assessment I did and she was so excited every time!

Because of how Tue unfolded, I was on a mission on Wed! I felt so much better and so much more on top of things! On Tue, I was still charting at 1300, but on Wed, I was done everything including her meds by 0900! And on top of that, when I entered the room to wake her up, her mom said to her, "Honey, guess who it is, your friend's back...." Me!! I was her friend!! Never have I been so excited to be friends with someone. Hehehe! This day was so much better because she had already been on her antibiotics for over 24 hours, she was no longer on droplet/contact precautions, so I was able to go in without the gown and mask and gloves! When I went in later on to see how she was doing, she was drinking her juice. You know how some juice cups have foil on the top and you use your straw to poke a hole? Well she was sipping already and wanted to show me how she was able to poke the hole herself, so when she made another stab, I said, "That looks like a heart!" and she said, "Because I love you!" Sigh.... :)

She got discharged around 1015, so I didn't have a patient assignment, but because of this, I was able to give an intramuscular injection! And also, I was able to shadow a Dr who was giving botox injections to patients with cerebral palsy. The botox allows their muscles to relax and not tense up. It was pretty tough, though, because I had to hold someone's leg while they were screaming and crying to not get it done. That did not make me feel good at all....and I almost cried because it was so hard for me to do.

I also learned about Rett's Syndrome which is a degenerative neurocognitive genetic disorder. I don't think I'll ever be able to forget the matter-of-fact way the mum had to present information to the Dr. It's not that she's heartless, it's that this has been something she has had to deal with for many many many years. Death for everyone is imminent, but to have to be with it everyday is heartwrenching for me. I very much admired the amount of strength and perseverance that patient's mother displays on a daily basis.

But en keeping with the sandwich effect, (good, bad, good) I am very much looking forward to another week in paediatrics to see how I deal with another age group!!! And I know NOTHING about Hannah Montana, Wii, Dora, pretty much everything child related.........but I'm willing to learn! :)

Week 13 as a level 3 nursing student

Sorry for the late post! This week was my first week in paediatrics! After orientation on Tuesday, Wednesday was our on-site orientation. As usual, it was pretty much just us getting acquainted with the way things were going to be done in this particular rotation and the ward tour. Nothing incredibly eventful happened this week because there wasn't any patient interaction.

Saturday, April 3, 2010

Week 12 as a level 3 nursing student

This week marked the last week in my obstetrics rotation. After this week, I feel as though I have truly found my niche. On Tuesday, I was able to connect so well with the family and was able to do my very first baby bath!!!!!!! I was so nervous but it was so exhilarating at the same time! I think it's such a special opportunity to be able to take place in such an exciting time for a family. The husband was so excited to see the baby bath that he ran back to the room to see it. When I first walked in, I was so taken aback because the mum was asking if I was her nurse or if the RN was her nurse because she couldn't be interrupted from sleep all the time. I was so shocked but I totally understood what she meant. After hours and hours of painful labour, I don't think I would be very receptive to ppl interrupting my sleep either. I don't even like being woken up normally!! But the more I got to talking, the better we got along and it's always so incredibly rewarding for me to be able to come back from a situation like that. The greatest therapeutic relationships to me are the ones where I'm not 'welcome', so to speak, in the initial encounter. It's like a bit of a challenge for me. I like to see how long it takes/ how hard I have to work in order to make someone like me. It's kind of geeky. Haha!

I always ask for a new patient because I like the extra teaching I get to do to new patients and I like building relationships with new ppl so that I can learn more and see what works in building rapport and what only works well in certain situations. This Wednesday, I had a new family I was working with and yet again, the assumptions assignment came SCREAMING back at me. In report, I heard that the mum had bipolar disorder and I didn't necessarily think - uh oh, she's got issues, but I was thinking about how to approach it. When I opened the door, the husband seemed quite stern and not too welcoming, but nice. Nice, but not friendly. As soon as I got started on my assessments, though, I did a tonne of teaching about breast feeding, checking the mum's uterus, and a tonne of other things! The mum was SUPER nice and friendly and as soon as I started teaching them what I've learned in the past 4 weeks, the husband opened up SO much! I also think that being very respectful of their own wishes helped tremendously. The whole notion of critical social theory and not overpowering a family with your own knowledge has really taken a big role in my nursing practice. When I'm offering some information to a patient now, I don't tell them, I advise, but I tell them that ultimately it is THEIR choice, but that this is what I've learned in school and it's what the literature shows. But it is their life and it is their health and these choices are theirs to make. In general, people react SO well to that! When I was doing my newborn assessment, they were so adorable! The husband was taking notes of the things I was telling them and when I made a point about it, he said, "Yea, I know, I'm a geek." And obviously, seeing my weekly blog, I have that in common with him. We had quite the chuckle and it was just so nice. I guess there really isn't a better way to put it other than 'nice'. Heartwarming, maybe? Something along those lines!

I really felt like I took initiative this week. I was asking what I could do and was actually able to do things this week. I was really proud of myself because I felt like I took my learning into my own hands. I felt as though I put myself out there and got all the opportunities available to get as much hands on experience as I could. I was able to do 3 baby baths on Wednesday and I also offered some for other students to do, but it was huge for me because I took initiative to find those baby baths because I asked. I asked because I am hugely interested in this area of nursing and I wanted as much hands on experience as I could, since it was my last week, anyway.

This was a great week and I am so thankful for this long weekend 4 more weeks to goooooooo!!! AND THEN I WILL BE HALF DONE MY NURSING EDUCATION!!!!!!

Week 11 as a level 3 nursing student

Yet again, a late entry. Sorry folks, it's been a bit crazy as of late. Week 11 was a bit frustrating for me but I was very enlightened with all the assessments I was able to perform (all.....two of them haha!). I was able to get along very well with my patient and learned so much about her. She was a fellow nursing student! I was so excited. I honestly feel that the ability to remember the names of patients and their family members really builds a fast an effective rapport. I always think about how special I feel when someone remembers my name and I try to do the same thing.

That week, I was able to do my first newborn assessment. I have had quite a bit of interaction with children and babies, in my life, I'd say. Through St John, I have been able to practice flipping babies from back onto front for the CPR protocols but flipping a REAL baby is so different. I was kind of nervous, I'm not going to lie. I know the technique, but actually executing the process is different! A bit daunting, but also very exciting. Babies are very resilient. Hehe.

Something I find very frustrating as a student is going onto a new ward and getting acquainted with all the new knowledge. I feel as though it's a constant world of not-knowing and trying not to look stupid. In week 11, we were only able to do the basic maternal assessments and we had JUST learned the baby assessments, we weren't able to do baby baths or much else. I just find it a bit frustrating when I'm trying to find something to do and I keep on asking the other nurses if there's something I can do but the things I'm able to do are so limited. Oh well, see the next entry for a more optimistic view!

In PBL, we were able to get a fair bit ahead! We were able to start class in week 12 an hour later! I was very excited to be able to sleep an additional hour for week 12.