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Friday, June 29, 2012

I got a flashback!

Where did June go? That's what I would like to know. Somehow the days, weeks, and months just keep flying by...and I don't have time to catch my breath! 


Well I've had a change in attitude since my last post. Today at clinicals I was working with my primary nurse and when things had slowed down for me I reminded her that if she had any skills or tasks that she should feel free to delegate to me as needed..especially if she had any IV's that needed started!!! I told her that no one in my clinical group had started an IV yet and as soon as she heard that she said, "WHAT? Are you kidding me? Well, your first one isn't going to be on a patient! Come on..." So we went into an empty patient room (along with a couple other fellow classmates) and we all had the chance to start an IV! :)


Let me just say starting an IV on an actual human being is nothing like my awful experience with that stupid mannequin!! I got everything set up and she helped me look at all my different options for starting an IV and after she told me that she hates starting IVs on the back of the hand I proceeded to start one on the back of her hand! FIRST STICK! I was so excited as I just barely got the needle in there and I GOT A FLASHBACK!!! WOOT! I advanced the catheter all the way in, put pressure on her vein, pulled the needle out...and she proceeded to bleed...thankfully it wasn't a large amount of blood and I didn't panic (I didn't even sweat!!! HOLLAR!!!) and I got everything hooked up and flushed her vein...yes, I had a good line! I didn't blow the vein or anything! All of my fellow students got the IV in on the first stick too, only they didn't make a bloody mess like I did!! :) 


So then a few minutes later my instructor was walking by saying that a patient needed some blood drawn and would any of us like to do it, so I jumped on that like my life depended on it! Went in there with confidence and got the stick on the first try again! I also think it might have helped that it's tiny needles that you use to draw blood!! :) Good 'ole butterfly needles! I filled up my tubes and that was that...again no pouring of sweat episodes so that was a huge relief! 3/4 of us today got to start IV's and do a blood draw!


I think my greatest advice is to just have confidence. If you don't show the patient that you're nervous then they don't freak out and it makes the experience a lot easier. So...for those of you who need an IV started or some blood drawn..I'm your girl! Now if you're dehydrated or don't have veins that pop out and yell my name, then that might be a different story, but practice makes perfect right?!?! 


So I can sleep now knowing that I'm not a complete oaf when it comes to IVs!!! :) That's a huge sigh of relief!!!



Thursday, June 21, 2012

Experiencing difficulty...

Well, Exam one is done. That's all I have to say! You know, it's level four and we should have a handle on the dang exams right? Somehow I studied for a harder test though and managed to study the impertinent material. Ugh. However, I'm not the only one that got bit by the testing bug, so I'm not too discouraged!!

Well, I wasn't too discouraged until I got into the classroom today where we have our simulation week clinicals. One of the first things our teacher says is, "So you guys are going to take an exam, don't worry...it's just an exam!" (as if her smile and statement "don't worry" would really calm us down and make it that much easier) Nursing students + post-exam + no coffee + unannounced exam = lots of fun...NOT! We all sighed, moaned, (some cried), or stormed out of the room, and others (like me) just laughed. Just when you think you've got a handle on it...things like that happen and if you don't laugh it seriously eats you alive!

So we made it through our exam (which wasn't even for a grade) and actually learned a few things from it...and then it was time for starting IV's. Fortunately but also unfortunately we're not able to practice on one another and only get crappy mannequin arms that seem to have shark skin to penetrate! I was really looking forward to this lab though, I was excited and confident in my ability...well...so I thought! Allow me to set the scene:

We're in a small classroom (with 6 patient beds) and there are about 16 of us in the room..  2 of the mannequins aren't IV accessible so there were about 3-4 people per bed. Now, this building has been under construction the entire time that my class has been in nursing school...unfortunately for us we also seem to get the crap side-effects of the construction (hammer-jacking, fires, no available restrooms, no air conditioning). Today we didn't have any air conditioning. So we're in a little room (with no ventilation or air conditioning) and students all over the place are nervous so the room just continues to get more and more humid and muggy. Okay...so there's the scene.

We were paired up with students that had already put in IV's and they were to "teach us" about techniques for starting IVs, accessing veins, what-have-you! I somehow managed to miss that part of the conversation. I was gathering my equipment and when I went over my fellow classmate was already starting to insert the IV. He did a pretty good job, you know, it took a little maneuvering of the needle, but he got the flashback, advanced the needle, and had a patent line! So, then another guy (who has had practice with IVs) inserted the IV without a problem!

Now it was my turn! Honestly I wasn't nervous going into it...I mean it's a mannequin and they're quite acquainted with us nursing students and tolerate being poked quite well! ;) So I gather my equipment and the moment I take the cap off of my needle bullet drops of sweat start dropping off of my face! But I go for my stick..nothing. I maneuver the needle around trying to get into the vein and I can't make it happen. I pull back and go at a deeper angle, nothing...(I'm right over the vein mind you so I can't imagine what the problem is) I try and go in at a more superficial angle and still nothing. So I decide to pull out and try a different vein! Dang it. I was so frustrated...and my shirt collar was soaked in sweat by now. So as I'm getting ready to go in for my second poke I have an audience and my instructor by my side.  I'm now nervous and slightly irritable but determined to get a successful poke! So I prepare myself again and find a different vein and go for the kill. I'm right over the vein, it felt like I went in and...nothing. No flashback. So again I try to manipulate the needle to get it into the vein...nothing! So my instructor steps in and decides to try and help me out..she tries and tries and doesn't have any success. I pull out again.



I decide to take a break at let someone else give it a go. So another guy gives a a whirl and...success. Immediately, first stick, he gets it in and has an immediate flashback, advances the catheter, and has a patent line! Now I'm just furious! Thankfully by the time I get to try again my crowd has dispersed among other happening around the room so it's just me and my instructor! By now I'm determined to have a successful stick! I will not be told no! I can just imagine these veins getting a kick out of all of my attempts that have just been in vein...hahaha...get it? Vein!?! They're sticking out at you, yelling at you to poke them, daring you to stick a needle in them, and then what do they do??? They make a fool out of me! But I was not to be made a fool of any longer. My nursing instructor was by my side and I grabbed that 18 gauge and went straight for the AC ( antecubital )...What do you know? I got a handy little flashback! Ugh. I guess the third time is a charm! I'm hoping that my simulation experience is not any indication of how it will go in actual clinicals. Now I'm realistic about the fact that I will blow a vein on an actual patient, I'm going to make them bleed all over the place..but gosh darn it I'm going to get that catheter into the vein! So, I have one more day in our simulation lab and then it's back to the real world..and I'm ready to tackle some veins! So until then...

Monday, June 18, 2012

Yikes!


I keep meaning to write a post but there just never seems to be enough time in the day! I keep reminding myself (as do all of my other nursing school friends) that it was just one short year ago that I was sitting in our lecture hall...hands trembling, forehead sweating, and doubting my ability to crack those ridiculous test questions. And now, here I am, with eight weeks left until I graduate! My hands don't really tremble, I think I will always drip sweat from my forehead, and those test questions still give me a run for my money! But the difference between now and one year ago is that I've acquired a whole lot of knowledge, a descent amount of skills, and a little more confidence in my ability to care for an individual as a whole! 


I can tell in class and in clinicals that our instructors are pushing us to "spread our wings and fly". It reminds me of what my mental health clinical instructor always reminded us of..."you guys have all the tools you need...you just need to use them the right way!" .... What she was really telling us was use the think system...stop relying on us (instructors) to give you the answer. You know the right answer, you've been taught everything you need to know..now just put two and two together!


I can tell that this semester is centered around fine-tuning our skills and habits and making us trust our instincts, use our critical thinker (aka our brain), and go and do what we're supposed to do! 


This semester for clinicals I'm back at the VA on their cardiac telemetry floor (aka...everyone is on a heart monitor). The first week we had our first and last careplan of our nursing school career!! WOOT!!! Can't tell you how exciting it was to be able to turn that puppy in; and no, I didn't look back! It has been a lot of fun being able to do everything for our patient. There's no more wondering, "am I allowed to do that?" This semester my hurdle to jump over is going to be starting IV's! I wish I could bring equipment home to practice on my family, but I don't think the hospitals, CNM, or my instructors would be too happy with me for doing that. But thankfully my clinical instructor will be sending all of us to the ER where everyone needs an IV and by-golly I am going to start a dang IV! I've had several different opportunities arise and they fell through for various reasons...but no more! If nursing school has taught me anything it's that I have to advocate not only for my patient but for myself. If I can't look out for myself then how will I be able to look out for anyone else? 


Well, I have my first exam Wednesday...YIKES! I was studying hard the past few days going over all of the cardiac information that was supposed to be on the exam and tonight my instructor posted an announcement saying that all the cardiac material was going to be moved to the second exam!!! Needless to say I was extremely disappointed and frustrated that all the studying I'd been doing for the past few days was in vain and could have spent reviewing all the other information that's going to be on the exam. However, thanks again to nursing school, I've learned that you just gotta roll with the punches and move on. So no use complaining right?! :D I think the best thing I can do is go to bed and get some much needed shuteye!


So there's my update! Oh, and for those of you who are curious, baring any setbacks or unfortunate events; my pinning ceremony (aka graduation since the summer semester doesn't get a commencement ceremony *tear drop*) is in 54 days!!! ..not like I'm counting!! :D