Saturday, March 26, 2011

First Week Down!

Soooo stoked that my first week on the floor is O-V-E-R!!!! Its all down hill from here (hopefully)! Now that its all said and done....I can honestly say....I have learned SOOOOO much over the past three days! I have accomplished things I would have never in a million years thought I could have ever done....and I have over come challenges beyond anything I could have ever imagined. I know I have a long road ahead of me.....but this first week (and the next few weeks that are to follow I'm sure) have been the most exhausting, most insane, and sometimes traumatizing times that I could have ever imagined having!

So this is how my week went:

Tuesday: Day 1: Marathon day! After going to both of my morning classes, taking a bio test, and then reporting to work was definite madness! I basically just followed around the NA who was training me....she walked me through everything I would be doing on a daily basis and sort of oriented me to the floor. With that said let me just say....I felt completely lost....every time I walked out  of a room I had no clue which closet was where,  which way was up, or where to find ANYTHING. I would have gotten frustrated, but I had to keep reminding myself that everyone probably feels this way and with time it would all be ok. Everything was pretty low key and seemed pretty routine....nothing to insane...which was DEFINITELY a good thing.
The highlight: getting to prep a patient for a procedure....and I'm sure you've ALL heard this story by now :-P

Wednesday: Day 2: Thank goodness for adrenaline! I had to wake up and go to my lab....which wasn't too bad, and even had time to relax a little at home before day 2 on the job. For the most part I was still just a little duckling following around my momma duck NA....I did take my first blood sugar which was pretty exciting!!! :) and got lots of experience transferring different patients to different labs and procedure areas around the hospital. By the end of the shift I felt a little more confident on where things were on our floor and learned a few new shortcuts around the hospital.
The highlight: One word. Enema. --- For awhile now I have heard that every nurse has a "thing"...and its the one "thing" that he/she just can't get over and has trouble dealing with. I thought vomit would be mine...I was wrong. Poop is my thing. After having to assist the nurse with a doctor ordered enema I learned this. (a milk and molasses enema no less---which looks as DISGUSTING as it sounds). I started feeling light headed, I got INSANELY hot, and dizzy. I had to sit down...and eventually had to leave the room. (I have spared the details on the events that led up to this feeling...because I KNOW I will never forget them...and I KNOW nobody reading this blog wants to hear them).

Thursday: Day off: Thank goodness! 8am class---was TORTURE!!! I have a new found respect for the phrase "slow as molasses" ... and I don't think I have ever felt this exhausted in my LIFE!!! After class I napped...and it felt so good!

Friday: Day 3: After the events on Tuesday---I was VERY anxious on my way in to work. As I was sitting in my car (b/c I get EVERYWHERE early and everyone here gets EVERYWHERE late) I couldn't help thinking ---What in the hell am I doing?!?! I felt nervous and probably had a small panic attack. I couldn't stop thinking about alot of things---the biggest being how sick I am of feeling nervous/anxious ALL THE TIME. Everything is a first here...everything is new...and I'm just ready to feel normal!! I'm ready to feel comfortable (which is the #1 reason why I'm super stoked that bff Jillian is coming this weekend!)
After I sucked it up and walked in ---everything turned out even better than I could have imagined. I was with a different NA (who was super super nice and also in nursing school---the other NA was older and really hard for me to relate to/connect with...which probably contributed to my not so great experiences the first 2 nites). So this NA explained everything she did, her routine, how she handled handoffs and lots of little details that I don't think I would have learned until I was overwhelmed on my first day on my own (which is in a few weeks). She basically let me do everything while SHE followed ME around...helping when I needed her to...which was soooo incredibly helpful! I took all the blood sugars, dealt with all the admits (hooking them up, taking their vitals, etc.), and everything in between...finally handing off to the night shift NA! (one of the things I was super confused on)
The highlight: combative patients who wanted to pull out NG tubes, catheters, flexi seals (i.e. poopie bags) etc etc----ending in restraints. I can already tell there will never be a dull moment in this place!
After the night was over....I felt so much better about EVERYTHING. I felt like I had made a friend, I felt like I could actually do the job...and it felt great! :) Hopefully this feeling will stay with me on Tuesday when I'm sitting in the car waiting to go in again!

Until then...I'll be enjoying my weekend off....preparing for Jillian's visit....and studying up for my chem test!

Monday, March 21, 2011

First Day #6789347584932865749375829


Tomorrow is another "first day"......OF WORK!!! I feel as though "first days" have come and gone....and come back again....ready to have "first days" behind me!!!

So my day tomorrow is as follows:

5:30am---wakey wakey eggs and backey
leave for class at 6:45am.....class from 8-11am
Bio test #2 from noon-2pm
First day of work at 3pm-11:30pm....and hopefully home by midnight....
Up on Wednesday to rinse and repeat (minus the test)

Say your prayers for me....its going to be a long couple of days!!!!  Working 3-11:30pm Tuesday, Wednesday, and Friday....for the next few weeks.....eeeeekkk!!! excited, nervous, scared....you name it...thats me!

Friday, March 18, 2011

Orientation Week

So I've been a horrible blogger....but this week has been B.U.S.Y. ---Let me catch you up (don't worry...there were no blood, guts, or dead animals).....

It was orientation week...and while it was pretty boring content....we had a super fun class and I got the chance to meet some pretty fun people. There were 9 of us (going to different units of course)...all learning lots of fun stuff about what we'd be doing on a daily basis in our unit...the equipment we'd be using/operating and some basic skills. First we watched lots of boring videos about what to do in a fire and whether related emergencies (b/c we do have tornadoes here), how to call codes and rapid responses, what to do in the event of a chemical spill and procedures on other hazardous materials, bloodborne pathogens, mandatory reporting, standard precautions...etc. SUPER BORING!!!

Then we got to do a BUNCH of hands on stuff....with lots of fun equipment...and that was super fun!!!
We got to play with oxygen, suction, and monitors for feeding tubes, ted hose (that are used to promote circulation) and other circulation devices for bed bound patients who don't get to get up and move around to prevent blood clots etc. We also got to play with ergonomic equipment---stuff to make our jobs easier---like the stedy (this super cool walker looking thing that has this area that the patient can step into and sit down in to be pushed if they need to get where they're going asap--like to use the potty), maxislides (that reduce friction on the skin--which causes skin breakdown--and helps in transferring patients up on the bed), maxisky (that looks like a hanger on the ceiling and is motorized that you can attach a patient in a sling to transfer them to different beds etc). Then we got to learn how to give bed baths (which I'm NOT looking forward to), make beds while you're giving bed baths (and make beds in general), how to place patients on bed pans (again, not looking forward to)...and measure....EVERYTHING....I&O (intake and output--and yes that means pee, poop, emisis--vomit, sputum and what the patient eats and drinks), vital signs (temperature--oral, tempanic, axillary, and rectal, pulse--and all the pulse sites, radial, brachial, femoral, pedial, coratid, respiration's, blood pressure--with a sphygmomanometer and stethoscope...thats right...the old fashion way, and pulse oximeter). We got to play with Foley Catheters, Jackson Prats, feeding tubes, NG tubes---how to clean them, empty them,  and how to measure the fluids that come from them. And we learned about blood transfusions and aaaaaalllll the rules that go along with it (your blood is serious business people).
We learned about Code Green and what is considered a restraint and a restraint alternative. And we learned AAAAALLLLLLL about docflowsheets and charting which was also pretty fun.  We also had lots of computer training which showed lots of resources for patients/their families, and us on policies and procedures (which will be uber resourceful when a nurse tells me to do something that I'm supposed to know how to do but don't). We learned protocol on admitting, transferring, and discharging patients and our role in these processes. How to collect specimens (i.e. pee and poop, emisis--or vomit, and sputum--or that gunk thats in your lungs that you cough up).
Today we learned about care of the deceased and we took a trip to decedent care (aka the morgue)...let me just say...its on the lower level of the hospital and it is S.K.E.T.C.H.Y! you have go thru these dark halls that have exposed pipes and ride this super scary freight elevator that is TERRIFYING....needless to say I don't think I'll ever be taking any trips there without a few people I trust with my life!

The highlight of the week for me was AccuChecks---these are for measuring blood glucose levels....we got to prick our own fingers which made this uber exciting. I now know that I can do it and not kill somebody--and that was reassuring. I also learned that "normal" blood sugar is whatever is normal for you....I apparently have high blood sugar....very close to being hyperglycemic. Along these same lines we learned about neuro checks, and circulation checks.
Another highlight was getting fit for scrubs (b/c we get to wear hospital scrubs and have them do our laundry---sweet!) and I was THRILLED to find out I am a petite extra small!!!! Unfortuantley I had to go buy a few pairs of scrub pants (we get to save a few extra dollars and not buy scrub tops b/c we get to wear t-shirts as our tops----double sweet!) because they had to special order my hospital scrubs....which also made me feel uber skinny and special! :)

I also had the chance to go up to my unit to get my schedule----and lets just say....I very seriously doubt I'll be having any sort of life any time soon.....I'm mostly working 2nd shift....3-11:30 and my first day is Tuesday!!!!! I have about 3 weeks with an RN to have time to orient to my specific unit and the things they do....and then I'm own my own!!!! eeeekkk!!! So I'll be in class all morning from 8am-11am/12ish and then working till 11:30/12 at night...and back up the next day to do it all over again(3-4 days a week).... I'm a little nervous to say the least....but I'm super stoked to get in and get some experience.
After this week and a couple of "tours" the hospital is finally starting to not be a complete maze to me (which is also exciting) and hopefully once clinicals start I'll be a step ahead of the rest!

Wednesday, March 2, 2011

Dissection Day 2: Wilbur the Fetal Pig

Next time you bite into your pork chop, bacon, and/or ham sandwich....I hope this image stays in your head and ruins your meal....
Meet Wilbur



That's right folks....today was dissection day 2....sorry for two super sad blogs in a row...but sometimes that's how the cookie crumbles. Today was purely a cut and poke around kinda day...no playing with fetal pigs in jars or anything...so it was a little easier. And when I say easier I mean I never got to see them alive .... they were in these air tight bags in some sort of gross preservative/formaldehyde liquid so they wouldn't smell....which I was UBER excited about (b/c I was slightly terrified I wouldn't be able to get past the smell). So after giving little Wilbur his last bath to get those juices off we layed him out belly up on our little dissection tray, identified all his external organs, and started cutting....one long lateral cut down the middle, 2 parallel cuts around the umbilical cord (b/c he is a fetus people), and 2 horizontal cuts across....one on each end of the sternum (which is a sort of hard surface that I was completely not expecting as I was cutting for some dumb reason...the sternum connects the rib cage that protects the heart, lungs and major blood vessles from being damaged)....the cuts opened up the body cavity (that was covered with a shiny membrane that holds all the organs together that we obviously cut through) so we could see all his little piggy organs and after pinning back the flaps from the cuts we flushed out his insides (that were also filled with the perservative/formaldehyde liquid) and we were ready to dig in!
First, let me just say from a stand point of being completely stupid/blind/ignorant when it comes to anatomy and the insides of ANYTHING.....its a little weird to see mini versions of the same things that are inside us... in real life... laying right there in front of me....so once I got over the fact that this poor little aborted fetus was pinned down to this tray that looks like its filled with burnt brownies....I got a little excited to see some real life organs right there in front of me.. ready to be poked and prodded and dug through! So let's dive in...and I'll give you a tour of little Wilbur the Fetal Pig's organs....bless his soul for having to die for me to be able to do this...and may he rest in peace with his bff Peter in lab animal heaven....amen.



Starting at the anterior end (at his head)...and although you can't see them clearly in this photo.. I'm talking about the area that is just under where the cut starts (just above that round circlular thing that is his heart!!!) all that in that glob of open mess is his salivary gland, larynx, thyroid, thymus gland, esophagus (that connects to the stomach where chewed up food travels through), and his trachea (that goes from the mouth and attaches to the lungs)
So then you get to that circle thing.. the HEART...which I always thought was shaped like <3 that...but apparently society has mislead me for the past 25 years! The <3 is the heart of the circulatory system...it is the pumper of blood...blood flows all around this little thing in all these little pathways and tubes before going out into the rest of your body...on top of the heart is this tube like structure called the aortic arch,  next to that is the pulmonary artery, just below those are two sections on each side called the right auricle and left auricle...below those is yet another section called the right ventricle ... seperated from the left ventricle on the other side via the coronary artery. Once you cut open the heart theres all these little tubes and pathways and crazy things that look super cool and connect all these sections so blood can flow through. (I haven't learned yet which way the blood flows and where it goes, etc ...but I'm sure if you stay tuned there will be a blog on that as well) There are also tubes off of the left and right (these are called pulmonary arteries) that connect to the lungs...a tube off the top (called the aorta) that travels to the body, and the one on the bottom (called the descending aorta) that travels to the trunk and legs.
To the left and right of the heart are these flat-ish things that are abstract in shape (but I guess could be close to triangle-ish..which again I could have never guess without my handy dandy diagram telling me what they were) are the LUNGS....they get oxygen that you breathe in from your mouth/nose and take it via your trachea to your lungs...where your body then uses it to oxygenate your blood that flows through your heart and takes it everywhere you need it via your blood vessles, veins, etc. Your lungs are apart of your Respiratory System and I guess are kind of a big deal.
Just below the lungs are the diaphragm (which you can't see from the photo above)...but just below that you CAN see the big dark brownish shape....is the LIVER. The liver is composed of 5 lobes and is a part of the digestive system. It produces enzymes that metabolize nutrients, and filters components of the blood...just under the liver is the GALLBLADDER..it was sort of green-ish because it is the major producer/storer of bile salts that are acids that help us digest our foods. There is this small tube that joins the hepatic ducts that come from the liver to form a common bile duct that empties into the duodenum (a small place where your stomach empties food little bits at a time so your body can digest it and feed it into the small intestine where it can be absorbed for nutrients, sent to the large intestine--or your colon-- where it is compacted and expelled as poop).
Just under/to the right of the liver is the STOMACH. It looked like this empty little sack w/ all these vessles/veins running through it with a tube connecting it to the esophagus at the top, and at the bottom to the SMALL INTESTINE---which you can see are those short stringy looking glob. This is where your food, after it is digested, passes through and the nutrients get absorbed for your body to use.
Just under the small intestine is the PANCREAS. The pancrease produces digestive enzymes and secrets insulun to regulate your blood sugar.
The larger tubes connected to the small intestine (via the caecum--i.e. your appendix) are the LARGE INTESTINE--this is where your waste is "perculating" before you poop it out....it is also called your colon.

*these masses are seen in those coils just below the darker browish thing thats the liver*


Then theres a big wad of mess down near the posterior end (near the tail) that consists of the Urinary System and the Genital System. If you lift the visceral organs (all the small intestine, pancreas, stomach, and large intestine...etc) you'll find the paired KIDNEYS located on the dorsal (back) body wall. And yes they are bean shaped...just like the dried ones we played bingo with as children. The kidney is connected to the bladder (that you can see in that long shape thing that is coming out from between the legs--thats right...its not a penis...its a bladder-- in this fetus is connected to the umbilical cord b/c thats how fetus' use the bathroom) and in our girl pig (yes wilbur is a girl) joins the vagina. There is also this structure beside the kidney.. that is the adrenal gland (which is a part of the endocrine system).
If we had cut another incision between the hind legs (which we obviously didn't do) ... we would have opened up the pelvus area exposing the ovaries, uterus, vagina, and finally ending with the rectum and anus. Apparently the lab partner and I got slack and quit before it was over.....shhh don't tell my TA.

So here is another diagram of everything I just described up close and personal...just in case you want to study for the quiz next week ;)




Hope you guys will remember this anatomy lesson when you eat your next slice of Wilbur --- Good news is: this was our last dissection for a few weeks...*high fives*