22/5/14
Today was interesting, being the first day I had a different nurse as my preceptor. Funnily enough the nurses were both relieving for the sick nurses who were rostered, so I was more familiar with the ward and the patients then they were. They were fabulous and lovely, and I had a great shift.
Started out watching the bundles of procedure surrounding blood transfusions, and ended up doing regular blood transfusion obs, watching for any reaction or issue. I also assisted with the mountains of paperwork that accompanies discharges and admissions. And believe me there is buckets.
Removed a cannula without any fuss *self hi-five*, thankfully no haemorrhaging occurred but by God I was prepared if it did. Also must admit I'm feeling pretty confident with subcutaneous injections, with patients saying they can't even feel when I administer it. I wrote a couple of sets of patient notes, then it was home time. Not all that much to report really, although during the shift you feel you are working flat out. Enjoying clinical to the extreme, but it feels like it's going pretty fast already. Must keep on top of sleep.
Wednesday, 28 May 2014
Monday, 26 May 2014
Day Three
21/5/14
Today was much of a muchness really. Which is not to say it wasn't enjoyable, rather a consolidation of my basic practise skills.However the more I see, the more I realise I don't know. Two of the biggest gaps in my knowledge are conditions and medications. That's 90% of nursing I hear you shout! Well I roll my eyes at you. Of course that's a huge part but just in these last few days my focus has been more skill based, practising injections and such, and identifying and utilising the 'therapeutic relationship' stuff that seems like such garbage in class. The problem is not that I know nothing, in fact I am quite familiar with a good range of the medications I've come across, but that the more obscure ones all sound so bloody similar. Latin names for surgeries, abbreviations for conditions, and medications that could be in welsh for all I know. I have made it my own homework to become more familiar with such terms, but I do not fear. It will all come with time.
With that rant over all that's left is what was new today. I removed a cannula (IV line) after I was shown how to yesterday. Well yesterdays one was all very nice and simple. But this one, gosh it bled. Through no fault of mine I might add. Apparently it just happens sometimes. Or so they told me. After this woman had near haemorrhaged into my hands.. I jest of course, but honestly I had removed the cannula and stuck down the plaster, pressing down incase it bled. Lifted y hand off to check all was well and it bled making a smug wee bastard flower as it blossomed to the edges of the round plaster. Crisis averted with a firm grip and a flannel!
I also did another subcut injection which is pretty damn exciting. Especially as I asked the patient after if it was alright. She said she didn't feel a thing, unlike when the RN had done it yesterday!! Beam!
Today was much of a muchness really. Which is not to say it wasn't enjoyable, rather a consolidation of my basic practise skills.However the more I see, the more I realise I don't know. Two of the biggest gaps in my knowledge are conditions and medications. That's 90% of nursing I hear you shout! Well I roll my eyes at you. Of course that's a huge part but just in these last few days my focus has been more skill based, practising injections and such, and identifying and utilising the 'therapeutic relationship' stuff that seems like such garbage in class. The problem is not that I know nothing, in fact I am quite familiar with a good range of the medications I've come across, but that the more obscure ones all sound so bloody similar. Latin names for surgeries, abbreviations for conditions, and medications that could be in welsh for all I know. I have made it my own homework to become more familiar with such terms, but I do not fear. It will all come with time.
With that rant over all that's left is what was new today. I removed a cannula (IV line) after I was shown how to yesterday. Well yesterdays one was all very nice and simple. But this one, gosh it bled. Through no fault of mine I might add. Apparently it just happens sometimes. Or so they told me. After this woman had near haemorrhaged into my hands.. I jest of course, but honestly I had removed the cannula and stuck down the plaster, pressing down incase it bled. Lifted y hand off to check all was well and it bled making a smug wee bastard flower as it blossomed to the edges of the round plaster. Crisis averted with a firm grip and a flannel!
I also did another subcut injection which is pretty damn exciting. Especially as I asked the patient after if it was alright. She said she didn't feel a thing, unlike when the RN had done it yesterday!! Beam!
Friday, 23 May 2014
Day Two
20/5/14
Firstly today I can proudly say that I figured out how to get to the ward without getting lost or taking long sidetracks. Also I have a swipe card which allows me access to most door I've come across, so I feel like the real deal.
Shift began as usual and working with same two nurses from last night. I am now at the level of writing my own shift plan for timing of meds, obs, and other things that need to be addressed. On hearing that we were receiving a patient from another hospital we hopped to and switched rooms around so the new patient would be in a side room. Patients from hospitals outside the DHB have to be put under contact isolation precautions until their swabs are clear of MRSA. Contact isolation is wearing gowns and gloves, but not face masks etc as per full isolation. But as we all know there are a few problems with contact isolation. 1) many nurses ignore the precautions, as seen on my previous placement, and 2) the gowns the have are reused, put on inside out, and left hanging by the door, so no real infection control in in place. And they wonder why they have hospital bugs. We washed down the room as this particular ward doesn't usually have a care assistant, so nurses do most of the cleaning and washing. Honestly it is quite nice to make sure the place is clean and pleasant enough for a new patient. There's nothing worse than arriving in a new room with the last patient's rubbish still in the drawer.
I observed a cannula removal and abdominal dressing change, taking as many mental notes as possible while staring at a woman's crotch and still trying to look decent. Our new arrival was still to arrive a few hours later which luckily gave time for me to watch a naso-gastric tube being removed. Any part of having a NSG is uncomfortable, but this removal was made worse by the tube being rather long. The technique I was taught is to measure from the ear to the tip of the nose to the bottom of the sternum. Our patient was short and sensitive, and if not for her discomfort it would have been bizarrely comical as the RN kept pulling hand over hand at the seemingly endless tube. But I was able to hold the patients hand to comfort and to her credit she recovered quickly.
A first for me! I prepared and administered medications charted for a couple of patients. The medication room is complex but after I found my way round the hundreds of bottles and boxes, and recited the 5 Rights of Medication to my preceptor (right medication, right route, right dose, right time, right patient *Phew!*) I was allowed to start. A bit nervous after being so hands-off last year, I read and re-read charts, double checked expiries, and did my calculations several times over before taking them bedside and running the old identification spiel. So no big deal after all, though still exciting to have this new level of responsibility.
Finally our new admission arrived and oh, the paperwork. Such fun! Luckily I was able to toodle off and check her obs and blood sugar.
Later, after emptying catheters I put the contents, and the cardboard containers it gets collected in, into the macerator which is supposed to breakdown the cardboard and send the whole lot away, no mess, no fuss. However, this machine was apparently malfunctioning and halfway through the cycle water began bubbling out the seal. Imagine, if you will, a top-loading washing machine for urine, bowel motions, and cardboard. Then imagine the horror of it leaking mid-spin. Oh God! I've broken their machine. I'm literally in the shit. It was one of those times (and I've had many) where instead of doing the sensible thing and telling others so they can help with the aftermath, I panicked and desperately cleaned it up before anyone could walk in the room. I cleaned, bleached, and sanitised the floor, four wall and ceiling faster than you could believe. That room was the cleanest it had been in years. Thinking I had used the machine incorrectly and not sealed the lid right I left it at that. I have subsequently been told that its broken and it was broken before I even used, and I am happy to tell you there is now a sign on it if any other unfortunate like me comes along.
Another first! The night ended on a high with my first ever injection performed on a real human person! I performed a subcutaneous injection on a lovely lady who knew it was my first time and said she was happy to be a guinea pig. (subcuts use a 20mm long very thin needle into a fatty area like the stomach or thigh). All went well, steady hands, correct technique and the patient said she didn't feel a thing. Success!!
Firstly today I can proudly say that I figured out how to get to the ward without getting lost or taking long sidetracks. Also I have a swipe card which allows me access to most door I've come across, so I feel like the real deal.
Shift began as usual and working with same two nurses from last night. I am now at the level of writing my own shift plan for timing of meds, obs, and other things that need to be addressed. On hearing that we were receiving a patient from another hospital we hopped to and switched rooms around so the new patient would be in a side room. Patients from hospitals outside the DHB have to be put under contact isolation precautions until their swabs are clear of MRSA. Contact isolation is wearing gowns and gloves, but not face masks etc as per full isolation. But as we all know there are a few problems with contact isolation. 1) many nurses ignore the precautions, as seen on my previous placement, and 2) the gowns the have are reused, put on inside out, and left hanging by the door, so no real infection control in in place. And they wonder why they have hospital bugs. We washed down the room as this particular ward doesn't usually have a care assistant, so nurses do most of the cleaning and washing. Honestly it is quite nice to make sure the place is clean and pleasant enough for a new patient. There's nothing worse than arriving in a new room with the last patient's rubbish still in the drawer.
I observed a cannula removal and abdominal dressing change, taking as many mental notes as possible while staring at a woman's crotch and still trying to look decent. Our new arrival was still to arrive a few hours later which luckily gave time for me to watch a naso-gastric tube being removed. Any part of having a NSG is uncomfortable, but this removal was made worse by the tube being rather long. The technique I was taught is to measure from the ear to the tip of the nose to the bottom of the sternum. Our patient was short and sensitive, and if not for her discomfort it would have been bizarrely comical as the RN kept pulling hand over hand at the seemingly endless tube. But I was able to hold the patients hand to comfort and to her credit she recovered quickly.
A first for me! I prepared and administered medications charted for a couple of patients. The medication room is complex but after I found my way round the hundreds of bottles and boxes, and recited the 5 Rights of Medication to my preceptor (right medication, right route, right dose, right time, right patient *Phew!*) I was allowed to start. A bit nervous after being so hands-off last year, I read and re-read charts, double checked expiries, and did my calculations several times over before taking them bedside and running the old identification spiel. So no big deal after all, though still exciting to have this new level of responsibility.
Finally our new admission arrived and oh, the paperwork. Such fun! Luckily I was able to toodle off and check her obs and blood sugar.
Later, after emptying catheters I put the contents, and the cardboard containers it gets collected in, into the macerator which is supposed to breakdown the cardboard and send the whole lot away, no mess, no fuss. However, this machine was apparently malfunctioning and halfway through the cycle water began bubbling out the seal. Imagine, if you will, a top-loading washing machine for urine, bowel motions, and cardboard. Then imagine the horror of it leaking mid-spin. Oh God! I've broken their machine. I'm literally in the shit. It was one of those times (and I've had many) where instead of doing the sensible thing and telling others so they can help with the aftermath, I panicked and desperately cleaned it up before anyone could walk in the room. I cleaned, bleached, and sanitised the floor, four wall and ceiling faster than you could believe. That room was the cleanest it had been in years. Thinking I had used the machine incorrectly and not sealed the lid right I left it at that. I have subsequently been told that its broken and it was broken before I even used, and I am happy to tell you there is now a sign on it if any other unfortunate like me comes along.
Another first! The night ended on a high with my first ever injection performed on a real human person! I performed a subcutaneous injection on a lovely lady who knew it was my first time and said she was happy to be a guinea pig. (subcuts use a 20mm long very thin needle into a fatty area like the stomach or thigh). All went well, steady hands, correct technique and the patient said she didn't feel a thing. Success!!
Thursday, 22 May 2014
Year 2 Med/Surg
19/5/14
Day One of my first placement in second year nursing! What excitement to start my first ever med-surg experience!
I am to be working on a surgical unit which specialises in female post-op patients with gender related surgeries, eg. hysterectomy, mastectomy, or abdominal surgery.
The first shift passed without a hitch. I found the ward after a brief but worried jog through the endless identical hospital corridors and still arrived on time. The nurses on were lovely, all very kind and funny, and one I had met on my previous placement in first year. She remembered me too so I must have made some sort of impression, good or bad. It was only a short time before I had my bearings, the ward being a quarter of the size off my last placement. I got the official tour and felt relaxed,comfortable in the familiar setting. My nursing preceptor, a lovely no-nonsense woman with a wicked sense of humour, showed me round the medication room. I am now allowed to touch drugs! No, don't report me, I won't go crazy. But after placement last year where we were told we would be pulled from the course if we handled or gave out medications, to suddenly being given the responsibility of measuring up and administering charted meds is a big step and a big deal. But I am cool calm and collected on the outside *deep breaths*. Thankfully I didn't have to do much at all today, just followed the RN around and tried to get back into the swing of things in the ward setting. Performed the obs and other necessaries which I thought would be a bit rusty but came back to me like riding a bicycle. Because the ward is smallish I had time to stop and chat with the patients which was really nice. In class we talk a lot about communication and building therapeutic relationships with patients to aid in their recovery, which is all a load of crud really when you have to write essays on it, but is completely relevant in this setting. Although I'm not sure if its something you can really teach from a book, or in fact at all. I was anxious at first to see how it would be relating to patients of different ages. Last year in elderhealth placement the older patients were lovely and very easy to get along with. All was well however and I was happy to feel (and get feedback) that I was developing good rapport with patients and families of all ages and backgrounds. One patient that did come as a bit of a wakeup call, a woman the same age as me who had just had a double mastectomy and whose recovery prospects were not bright. She was very funny and nice, and the injustice was difficult to swallow. I appeased myself with trying to make her time on the ward as pleasant as possible. Another stand out patient for rather different reasons) was a woman who was sabotaging her own recovery in order to stay in the hospital. As a healthcare worker you can imagine how frustrating it is to not be able to give a bed to someone who needs it because another patient who is medically sound wants a longer break from work and responsibilities.
Tomorrow is the beginning of my real involvement in the ward, and I am very excited. Happily I already feel comfortable and relaxed so I am ready for the challenge. Lots to learn.
Day One of my first placement in second year nursing! What excitement to start my first ever med-surg experience!
I am to be working on a surgical unit which specialises in female post-op patients with gender related surgeries, eg. hysterectomy, mastectomy, or abdominal surgery.
The first shift passed without a hitch. I found the ward after a brief but worried jog through the endless identical hospital corridors and still arrived on time. The nurses on were lovely, all very kind and funny, and one I had met on my previous placement in first year. She remembered me too so I must have made some sort of impression, good or bad. It was only a short time before I had my bearings, the ward being a quarter of the size off my last placement. I got the official tour and felt relaxed,comfortable in the familiar setting. My nursing preceptor, a lovely no-nonsense woman with a wicked sense of humour, showed me round the medication room. I am now allowed to touch drugs! No, don't report me, I won't go crazy. But after placement last year where we were told we would be pulled from the course if we handled or gave out medications, to suddenly being given the responsibility of measuring up and administering charted meds is a big step and a big deal. But I am cool calm and collected on the outside *deep breaths*. Thankfully I didn't have to do much at all today, just followed the RN around and tried to get back into the swing of things in the ward setting. Performed the obs and other necessaries which I thought would be a bit rusty but came back to me like riding a bicycle. Because the ward is smallish I had time to stop and chat with the patients which was really nice. In class we talk a lot about communication and building therapeutic relationships with patients to aid in their recovery, which is all a load of crud really when you have to write essays on it, but is completely relevant in this setting. Although I'm not sure if its something you can really teach from a book, or in fact at all. I was anxious at first to see how it would be relating to patients of different ages. Last year in elderhealth placement the older patients were lovely and very easy to get along with. All was well however and I was happy to feel (and get feedback) that I was developing good rapport with patients and families of all ages and backgrounds. One patient that did come as a bit of a wakeup call, a woman the same age as me who had just had a double mastectomy and whose recovery prospects were not bright. She was very funny and nice, and the injustice was difficult to swallow. I appeased myself with trying to make her time on the ward as pleasant as possible. Another stand out patient for rather different reasons) was a woman who was sabotaging her own recovery in order to stay in the hospital. As a healthcare worker you can imagine how frustrating it is to not be able to give a bed to someone who needs it because another patient who is medically sound wants a longer break from work and responsibilities.
Tomorrow is the beginning of my real involvement in the ward, and I am very excited. Happily I already feel comfortable and relaxed so I am ready for the challenge. Lots to learn.
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