Happy first day of October!! I actually just forewent all my catching up so that I could accurately capture the mood of today. Not that when I miss a day or two (or a week or two) of writing I forget how I felt on a particular day. It just takes some thinking, and right now, in this moment that I'm writing, today is still pretty fresh.
So, clinical day today. Wow. It started with a bang... Actually it started with nothing at all. Yeah, no alarm that is. I looked up at my clock, wondering what time it was, and it was 6:35. After a few seconds of stunned silence, I shot out of bed like a rocket, thinking, "I needed to leave five minutes ago!!!" There were also a few expletives in there, but I will let you use your imagination on where those appropriately go. I will say that I briefly investigated the reason for the faulty alarm, and I found nothing wrong with the volume (which I checked the night before), and I did not push the snooze button while half-asleep. Radio broadcasting issue is all I can think of.
In any case, I was grateful that I had set out my stuff the night before, because all I had time to do was throw on my scrubs, grab my bag (which has my wallet, textbook, stethoscope, ID badge, clipboard, etc.) and my lunch. I left my house at around 6:44, and arrived at the hospital at around 6:56. I had just enough time to RUN to the elevator to get up to the floor in time for 7:00 morning report. Yes, I probably could and should have booked up the four flights of stairs (yes, four; the bottom floor is considered Ground, the next floor up is Floor 1), but I figured I wanted to be able to breathe when I got upstairs.
Lucky for me, morning report was a bit late, so I had a few moments to compose myself and tell my bladder to quit harassing me for just a few moments. So, morning report was successful, and then I learned how to do a measurement for a patient with a PICC. Then, off we went to go gather vitals.
My patient today was a rather large fellow, although was pleasant enough for most of the shift. I was happy that he was as cooperative as he was, because everything else was very, very tough with him. Because he had a fistula (for dialysis) in one arm and a PICC in the other, blood pressures had to be taken in a leg, which was a new experience for me. I barely was able to take his vitals and chart them before I needed to get back into the room for bed bath and changing dressings. Oh, and the room was contact precautions--so gown and glove up!!
I required some help with bathing the patient, as he had lots of tissue to move to get to fungal infections and because he had a hard time rolling to one side for us to scrub his back. Thankfully, I had a classmate who was willing to help, and I truly don't think I could have managed alone. It was a great day for the "TEAM" in "health care team". After spending most of the morning changing a dressing, doing his bath, helping him move up in bed a few times, and doing a brief assessment on him, I finally got a moment to sit down at around 10:45. At this point, my bladder had given up hope that I would respond, so I took an opportunity to take care of that little hiccup. Then, I had some water--I was parched from a lack of breakfast! No sooner did I enjoy some water and sit down for a few moments to begin writing down my assessment findings then my instructor walked in to tell me I needed to do a blood glucose on my patient. He was about ready to have lunch and needed the glucose taken beforehand, so we would have enough time to feed him before taking him down to dialysis.
As I was preparing to enter the room to do the glucose test, he called for a bedpan. I snagged a classmate to help me, and once again, I was incredibly grateful that she was willing to help. When he was finished, I went back in to do the glucose test, get him off the pan and clean him up, do a hemoccult test on the stool, clean the bedpan, and then assist 3 other nurses to put the patient in his dialysis chair. After we got him comfy there, he had his lunch, and then I took another set of vitals and wheeled him down to dialysis. Once there, it took 4 of us to move him up in his chair so he was comfortable (he tended to slide down a lot). At this point, it was around 12:00 or so, and I got to put in the second set of vitals and start eating my lunch.
Lunch was interrupted twice for me so I could respond to the care my patient needed (move up in the chair, scratch his back). Today was the day that I truly began to understand what our professors have been talking about when they say that nurses don't really eat meals, they sort of graze throughout the day.
So, that pretty much concluded the care of my patient for the day, because dialysis was a 3-hour process and that about finished my day! He actually just got rolled back into his room when I was leaving for the day.
I spent some time doing my charting and finishing my lunch, and then we had some post conference meetings and a quiz. We reviewed our concept maps and care plans individually with the instructors. My instructors said that I did very well on my homework, taking first place in the "least red ink" contest. They also made a point to tell me that I am doing very, very well on the floor and that I'm a huge help. This made me feel pretty good, because I haven't really felt like I've been doing much. It seems like we are so limited on what we can do because we haven't learned it all yet, so I tend to feel useless or like I'm just sitting around doing nothing.
The one instructor also said that the patient they gave me today is a patient they never give to students unless they are very short on patients. So, apparently they think I am capable enough to handle a rough patient. This also made me feel good, and I told them to keep the tough ones coming, because I am loving the opportunities to learn.
After clinicals today, I had to rush home, shower, and change, because I had a Denver II test to administer to a 3-year-old. It was fairly simple to do, especially considering that I hadn't really looked too intensely into what I was going to be doing with her. But, she did really well and was exactly where she needed to be developmentally. She got a little shy when I was asking her questions, so there were things that I couldn't pass her on; I just simply stated that she didn't do them, which isn't to say that she can't.
Afterwards, my friend who set this up and I sat around talking for a good hour or so, and then she invited me to stick around to study with her. I didn't have anything to study with, so I offered to go home and gather what I needed, as well as pick up some dinner for us, and then we could have dinner and study together. She appreciated the company, as her husband and children were out of town, and I was happy to have someone to hang out with and study with (otherwise there may not have been any studying happening).
So, we completed the Denver II write-up and got a good way into the IPR write-up. I didn't get done everything I wanted to get done, but I feel like today was a good, productive day.
And, my thought for the day, after a wild crazy day, is: It is better to conquer yourself than to win a thousand battles. Then the victory is yours. It cannot be taken from you, not by angels or by demons, heaven or hell. ~Buddha
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