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Sorry for not updating last weekend, I was feeling under the weather and missed a day of clinical!! Gasp, I know! In week 8, I was reminded of the assumptions assignment we did in level 1. I can't even begin to stress the importance of not making assumptions about patients. I know it and can say it, but I don't know why it still happened. I still take the time to get to know the patient and their life and it doesn't affect my care, but the outcome is that you (I) end up feeling like a big fat jerk. So all you reading this right now are going to help hold me accountable, ok? 
Nothing really outstanding happened in week 8, but we got to learn about IVs in lab.
Week 9, on the other hand!!!!! I gave my first injections in the hospital this week and boy oh boy was I ever nervous!!! My instructor said I was fine, but I was nervous, and I think he was just being nice. Haha! We had our 12 hour shift this week and boy was I ever beat and I only had one patient! Granted, he was total care, but still, it was like level 1! I got to do a dressing change, as well! I was feeling very nervous about not having done many new skills this semester, but in that one day, I got to give two injections AND change a dressing! Woohoo! Definitely room for improvement, but that only comes with practice!
This week I learned the importance of body language and actions. My patient and his wife didn't speak a word of English and I don't speak a word of Punjabi! It was an interesting experience and I still need to reflect and think about what I can do differently for next time. But I gotta say, despite the language barrier, a smile is universal. My patient was in and out of consciousness, and when he came to a few times, I smiled at him and said "Hello Mr X" with a subtle smile and I'm just always going to remember that. No matter how unwell he felt, he was still able to respond to my smile. Sigh. I love nursing! 
This week I learned the importance of patient advocacy. That is, speaking out for what your patient needs and wants. I had a patient who was in pain and the nurse advised that we did not give them their prescribed narcotics because it would make their constipation worse. The patient had two bowel movements that afternoon so I was wondering why we couldn't administer them. There was a very intense conversation between myself and my buddy nurse that ensued. My nurse said to administer acetaminophen (Tylenol) but my patient claimed that it would upset their stomach and declined my multiple offers. I had another conversation with my nurse and she said that a lot of the time, pain was psychological, but I knew that it was the biggest concern for my patient because I spoke to them about it quite extensively. A few hours later, I spoke to my instructor about this concern of mine and explained my rationale behind my way of thinking and he was incredibly supportive, went to ask the RN for the keys to the narcotic cupboard, and we gave my patient their narcotic.
This week was my first time having such a tough nurse since I started school. Assertiveness has always been something that I've struggled with, because I feel as though if not done appropriately, it's just being plain rude. We're always taught to 'play the student card' if we're questioning the rationale behind our buddy nurse's decisions, but this week, it just didn't work and I was having a really hard time communicating. I'm still thinking about how I can improve this weakness in myself, but I'm also really glad how far I've come in the clinical setting in terms of assertiveness. There's still a HUGE way to go, but this is the most improvement I've seen since starting in January.
The second invaluable lesson I learned this week was on patient education. I had the honour of helping my patient learn about an abundance of things related to their condition. I was able to teach them about lab values, community resources like peer support groups, the blood transfusion they were about to undergo, etc. I have been trying to work on my patient teaching and this week I just really felt like I was able to do it. Another thing I noticed is that I really connected with this patient this week and leaving wasn't hard for me. The last time I really connected with a patient, I had a really hard time leaving and even cried (I know, emotional!), but this time wasn't bad...I must be understanding this whole 'therapeutic relationship' thing.
I didn't have an exceptional week, or even a good week for that matter, but I really learned alot; and that's what's important, learning.
This week was packed! I had my first shift on Monday night until 2315 at the school gym and then had an early morning class on Tuesday at 0830. Luckily, I was able to do a tonne of studying for patho between my patho lecture and work on Monday. You sure can accomplish alot in a 6.5 hour break!
Lab was great this week! We got to practice landmarking for injections! Woohoo! Note to any potential nursing students, for this lab, wear pants and if possible, tights! They're great for feeling the muscles you need to landmark.
Wednesday was the dreaded patho/microbi midterm day! I joked with David (our instructor) saying that they purposely schedule two midterms on one day just to see if student nurses could handle stress. Haha, if you can't handle two midterms on the same day, get out of the program. Haha! It's like their screening or filtering process or something. 
I was fortunate enough to go to the OR again on Thursday, so I didn't have any patient research to do on Wednesday night, woohoo!! It was such a nice break, I went home, napped, and pretty much did nothing except for my pharmacology posting. And of course, the much anticipated CRIMINAL MINDS season premiere was on Wednesday, so I obviously watched that. You have to find time for yourself. Mental health = often overlooked but very important.
The OR experience was neat, don't get me wrong, I was able to watch a bilateral ureteroscopy with lithotripsy. In short, it was a kidney stone removal from both sides using a scope. Haha! Medicine and its fancy terminology. I really got to know my patient this week, but I pretty much just observed the entire time, so I would have preferred doing something hands on, myself. I'm sure I could've asked to do more, but I wasn't sure if I should or not? So I was in pre-op with the patient, went to the OR and observed the procedure, then went to the post-anesthetic recovery unit with them as well and back to surgical daycare before the patient was discharged. I actually had a better time in the eye surgery clinic because I was able to do more and see more operations and admitting/discharge procedures. Anyway, it's exciting because we're starting to do injections in the hospital on real patients now, so it feels more nurse-y. Oh! And we missed clinical on Friday, so I haven't had two patients yet, but everyone else started with 2 patients this week! Yay!!!
This week is pretty relaxed, I think. No assignments due other than the regular lab readings and questions. I do have to do some assignments for PBL, though, but that shouldn't take too long and I can do that on my 6.5 hour break tomorrow. Woohoo!!!
This week we had a quiz for patho which went quite well, in my opinion! I really like that we're getting quizzes periodically - it keeps me on the ball. I'm trying a lot harder this semester in patho and things are making a lot more sense, so I'm happy.
In PBL, we had presentations but I've done 2, so I pretty much sat back and absorbed information this week, which is always nice. In lab, we got to practice drawing up injections and fake insulin. I'm so grateful for my time at the clinic (where I used to work) because it's given me so many opportunities to learn things like drawing up vaccinations!
Clinical this week was exciting, as usual. I was able to use my Cantonese to help my patient! It was so exciting, I'm always looking for those opportunities. It's amazing to see first hand how quickly ppl are put to ease when they're able to build a connection like that. Building rapport with a patient is so much easier, in a sense. On Thur, we got an in-service with the OR educator, and turns out I get to another alternate experience in the OR! A different one from the eye surgery clinic! How exciting! I'll get to go to watch a different surgery, so possibly a TRAM flap surgery (for ppl diagnosed with breast cancer, their breast is removed and in this particular surgery, there is also an implant from their abdominal tissues or other forms) or a TUPR (for men with enlarged prostates).
In this upcoming week, things worth noting include:
2 midterms on Wed
OR experience on Thur
On a semi-related note, from www.givesmehope.com (a site I strongly encourage you to read!) I found this experience which is fitting for me, as I will be learning injections this week in lab and exercising that skill in clinical on Friday!
A bit of history on this site, it's for ppl who are optimistic and post up their positive experiences which give them hope. It's just an information freeway for everyone to enjoy and believe, I guess? I don't know - I'm kind of a sap like that, so needless to say, I read this on a regular basis. Haha! Enjoy!
"In my first year of my nursing degree, I was so nervous about giving my first ever injection to a patient. The patient told me to relax, take a breathe, and that the faster you inject it the sooner it would be over. My patient was 8 years old, and I still pray that she survived. Princess, you GMH."
This week flew by because of the long weekend, so essentially, I was at school for 2 days and then in the hospital for 2 days. Sweet! On Tue, we learned how to do blood glucometers, 4.9! Normal range 4 -7, no diabetes! Knock on wood...that was new and exciting. Something I learned from that is to stick the strip on the drop of blood straight on and not on an angle, otherwise you'll just get a smear. I hope none of you will ever have to practice on yourselves or loved ones. If you're coming into nursing, then this'll help A trick passed on to me by my colleague who is a paramedic!
In PBL this week, I had a presentation on labs which didn't go as well as I'd hoped. My instructor wanted me to be the first person to try and walk around while speaking, which I hadn't intended on doing at all. So there were some difficulties there, especially with a smaller room setting. I definitely laugh when I'm uncomfortable, something I'll need to work on. Actually, it's something I've been working on for a while, but a smile just so easy to hide behind sometimes. I was also not fully prepared for this one (completely my fault) so I didn't do as well. But it's ok, because it's a learning process.
Thurs was a very low-key day because my pt was discharged very early on in the day. I did, however, get to remove his saline lock! A new procedure for me! I felt pretty disorganized and worried, though, so definitely room for improvement. I got to follow through discharge procedures with my pt, so that was neat! I got to talk to him about his diet plan, home situation, etc, etc and taught him about his new prescriptions! Ah! Me! Imparting knowledge, who'dathought?! Granted, some of those drugs I had just looked up myself, but still!
So because my pt had been discharged and there weren't many new admissions, my classmate and I were able to go down to the eye surgery clinic!!! It was AMAZING! I never thought I'd be so excited to do OR nursing, but I'm thinking it's pretty cool. I got to watch 3 eye surgeries! I got to see a trabulectomy (for glaucoma, increased pressure within the eyeball caused by hypertension, diabetes, heart disease) and a phacoemulsification (for cataracts, which is when part of the eye becomes opaque, distorting vision). I am amazed by the precision of surgery, the flow of an OR, and the teamwork that goes into it. I was also lucky enough to shadow a number of very knowledgeable nurses who were willing to explain the procedure and what their jobs were.
This week will be less busy, but it's the calm before the storm. Two midterms on the same day next week! Woohoo for pathophysiology and microbiology! Yayyyy I'll make it through. With a smile, too!
One word to sum this week up is 'awesome'! The weeks just seem to be flying by with clinical at the end of the week!
Lab was exciting because we to practiced removing catheters on Terry, the lab doll. Then I had PBL. Something that I'm continuing to work on is being assertive.
PBL is so great because it allows me to practice this in a 'safe environment'. Ideally, though not always, everyone understands that we are all there to help each other improve and hone our own skills. As the chairperson, we get to work on time management, practicing our assertiveness by 'reigning everyone in to focus on the task at hand', organization, and smooth transitions. This week, it was a bit difficult for me because the presentations are all quite well done yet we still need to maintain timeliness for our agenda in order to get everything done. I had to ask ppl to be quiet many times, once or twice to the instructor, even, which is something that is SO uncomfortable to do! It's something I'm working on, definitely, but I honestly love PBL! Personally, I really see the value in it, as cheesey as that sounds. I think it's helped me with my teaching significantly and I really enjoy presentations, so it's great! But this week I was definitely feeling "the physiological signs of stress" after that class. Haha.
I had a meeting with my instructor on campus this week which was great because we didn't have many of those last semester and I felt like it was really helpful because there are fewer distractions. It's more efficient and the time is more devoted to the student and where our strengths and weaknesses lie. I went over my journal with my instructor and then we discussed my learning plan. I also got some good feedback, which was exciting, but it's still very early on in the semester.
Clinical this week was so good! We were on mornings with our own assigned patients. This semester, the patients are so much more independent, so for the most part, only set-up is required for tasks like morning care and washes. I felt really nervous because it was 0900 and I still hadn't done my head to toe assessment yet because my patient had gone to the bathroom and was on the phone after I gave him his 0800 meds. But as soon as I got the head to toe done, it was pretty smooth. I am struggling to find things to do during the down time, so I've been doing things like emptying linen bags and asking the nurses if they need any help with anything. I also made friends with one of the nurses on the unit and he showed me how to do an admission for a pt and explained continuous bladder irrigation to me! Some of my classmates got to do catheter removals and remove saline locks! It was really exciting to hear that they were starting to do those already and I can't wait to do those, too!
This long weekend will be dedicated to working on my PBL presentation, the PBL paper, lab homework, and brushing up on my patho/microbi!! Woohoo, long weekend, here I come!!!
This week was busy as anticipated with meetings, a nursing clothing sale, presentations, clinical!!!!, and doing my homework ahead of time in anticipation for our leadership retreat with St. John. However, I pulled through like a champ!
So Monday was long because I had a 3.5 hour break between my 1 hour patho seminar and the CRNBC SR meeting, but it was spent selling clothing to the other levels.
On Tuesday I had my presentation for PBL and it was good but draining, too, because I shared some really personal experiences on loss and grief. Skills and techniques class was good this week, it really gave us a good idea of some potential problems we could see in our patients post-op. I think that was the best sim lab class I've had so far in my time at BCIT!
Wednesday was the science-y day filled with Patho and Microbi. I'm still trying to get used to the varying teaching styles between the two instructors and I'm not sure what to expect for microbi, but I'm kind of worried because sciences have never really been my strong suit. Haha.
Clinical this week was awesome! I'm still trying to figure out what my role is in this new semester. There will be a lot more skills learned, but we can't do them yet because we haven't learnt them in class. So we were all kind of floundering around, trying to figure out what to do, kind of twiddling our thumbs, trying to look busy. I did all this research for my patient only to find that he'd been discharged that morning!!!! So it was a bit disappointing, especially because he seemed really funny and nice when I met him the day before.
This week is going to be dedicated to reviewing microbi and patho! Oh, and my first PBL paper is due next week, so that will also be done!
