sandanrn

Jesus meets Martial Arts meets Nursing School

Archive for the category “First Attempt At Nursing School”

CATCHING YOU UP TO DATE!

It’s been a long while Since I posted on this blog. Here is the short version of what has happened since I last wrote.

 

December 2011 – Missed the minimum grade I had to have by 2 questions on the final exam so I was “kicking out” of nursing school.

January 2011 – Retook the CNA state certification test (the skills part) and passed!

January 2011 – Started a CNA 2 course at NCC.

April 2011 – Completed CNA 2 course and am now registered with the NC BON as a CNA 2! WOO HOO!

April 2011 – Received my acceptance letter to both Nash and Edgecombe for LPN and RN programs, chose ECC!

 

And those are all the major happenings. I hope to be more consistent with my posts from here forward, trying for one post per week – though I may post extra before nursing school starts to get the jitters out for what is about to take place as I begin my 2nd effort at getting my RN

 

Sandanrn

 

Clinical Orientation

Wednesday of this week we wore professional clothes with our lab coats and name tags and met with our clinical instructors at our clinical site to go on a tour and hear some lecturing from our individual clinical instructors about requirements, paperwork, and details on dress code.

The place has four halls with a central nursing station. My Clinical Instructor is Ms. Lewis. There are 10 of us students that work under her, and the first week we are going to be paired up! YES!

The biggest leg up I have is having already done CNA clinicals… aside from physical assessment much is still the same. AM CARE, showers, bed baths, hair care, mouth care, denture care, toileting, etc. That kind of thing.

Most rooms at the facility are private, and we will start out with only one patient (per pair). By week two who knows if we will be alone. Ms. Lewis said she would add additional patients on as our confidence increases.

Hope this gets you as excited as it does me!

 

Off to study,

sandanrn

A week of tests

Welcome to nursing!

I feel like that should be said every week because nothing seems routine yet. We are still juggling teachers, seeing at least one a week for the first time – there are 3 teachers left we haven’t had yet.

Anyways, two weeks ago I had a lot of exams and here are the results to them. While I was not happy with any of them really, I plan to do better by the next exam date.

1. CNA boards – Passed written, Failed skills (forgot to do ROM on foot)

2. Exam 2 – I made a 72 and haven’t finished the assigned remediation work, which is due by Oct 20th I think it is.

3. ATI Test on Critical Thinking – made a 78%

4. Assessment check offs – PASSED! 😀

5. Drug Calculations math test – made 85, needed a 90 so the second chance (of 3) is Friday, Sept. 30th at 10 am (after lecture)

Like em or love em, there they are.

 

sandanrn

Back to oiling and sharpening the sword

My dad brought up a great example of what I’m doing today. While I hadn’t personally seen this particular connection, I thought it warranted its own post!

I took my exam (went to battle) and passed (survived with minor wounds). Now I am back home (home) and am reorganizing my note book (removing and cleaning my armor) for the next section/exam (battle). I am reviewing what I missed (bandaging my wounds) and celebrating (drinking sake’)

Okay, so he didn’t say the sake’ part, but I just couldn’t resist the reality of what battle was. Much like today’s soldiers, when they come home they celebrate the living of life usually with alcohol and family gatherings. I won’t be partaking of any, but I reminisce over visual images like that in the movie, the Last Samurai.

Anyhoo, food for that!

sandanrn

 

 

Test 1 – 84… so far

In martial arts you spend years progressing in the ranks of black belt. (Lower belts are like primary school, and the black belt ranks like going to college) Considering I’m in college at nursing school, I saw this exam very much like a yudansha (black belt holder) exam. They both required lots of study time, great internal motivation, and the determination to see it through and stay focused.

So, needless to say, Test 1 came and went this morning. The application style was just as hard as I expected, so at least I wasn’t blind-sided by that. Here is how I found out where I stacked up against the class!

We had tests (w/ the questions typed out) and scantrons (where you bubble the answers so they can be graded electronically). When the test was finished, you just sat there with your exam face down until the grueling hour was complete! (I went SLOW and reread questions several times, taking my time… and STILL managed to have 25 minutes left over to go crazy with my Attention Deficit Disorder (ADD) self! )

Anyways, we took a break after the hour was complete and put the scantrons in a stack on the front desk. I glimpsed at the pattern of a classmates and saw that about half were similar, miniscule relief that was.

When we got back from break, we went over the exam and had Remediation Worksheets that we would write the question number we got wrong followed by why we got it wrong. Example: “#1    I narrowed down to two answer choices and picked the wrong one”. There were 25 slots on the paper, so I assume they think we’ll get at least half of them right! (LOL) So I wrote down 8 items missed for my worksheet though I honestly couldn’t remember what I picked as an answer for one of those, so I may have only missed 7.

The reason I write “for now” in the subject line is that the exam is up for review until the end of the week. Every professor in the department has to read it and compare their thoughts with the results from our class (ie. how many missed each question) to see if any questions will be thrown out. If they are thrown out, you hope it’s one that you got wrong, because the number of questions subsequently drops making the value of points per question greater. So if you did miss one they throw out, your score goes up; conversely, if you didn’t miss the one they threw out, your score drops b/c the point value for the ones you DID get wrong increased. (I know that’s sticky math, but hopefully you get the gist of what I’m trying to say.)

I shared my grade with one other person in the class, who asked me point blank how I did, and she threw her arm around my shoulder and said, “Great job!” That made me smile, and still does. My parents all (3) thought I did well, but I was really hoping for a 90%. I will try again for the 90% on the next test, but for now it will have to do. Hey… as long as my average is above a 77%, then I’m passing! WOO HOO!

Take care and celebrate with me. Do a little dance, make a little — wait, nevermind. That’s gross! But take a moment to smile at life and appreciate the little successes you have had today/recently!

sandanrn

Dad taught us archery when we were little. This pictured reminded me of those good days and also shows the arrow at about where I scored on the test. Not an A, but I can taste the bullseye!

Hurricane Irene kills electricity – Allows for extra day of studying

Hurrican Irene took down trees and also power lines. Our power was off 10 hours on Saturday, and then about 20 minutes on Sunday. My college cancelled all classes for today (Monday) and therefore our test was postponed until tomorrow!

I looked at the schedule for the next couple of weeks and I’m up the creek without a paddle for this week because we lost four hours of lecture that are now going to be crammed into the remaining hours of lecture this week. (Entire week is on one topic) We had scheduled for Tuesday and Wednesday of this week to be clinical check offs. That is when you go into the lab (on college campus) and do hands on nursing skills while an instructor grades you as a pass/fail for that skill. You have 3 chances (not the same day) to get a grade of “Pass” or you are kicked out of the program. That has me really nervous! Anyways, there are about 15 skills we have to know for the upcoming check-off. While most of them I learned in CNA classes, some include differences from what I learned, and a few of the skills are entirely new (med administration for one).

We find out tomorrow how the material and class time is affected. We cover caring interventions and medication administration (including dosage calculations) all this week, and then we have a break. Monday of next week we are off for Labor Day. Tuesday and Wednesday we have lecture (I think) – or possibly check-offs for assessment and vital signs. Thursday will be an open lab time for us to practice on the mannequins in order to hone our skills. and Friday we will start Unit 10 (the second half – already did first half) on Sleep and Rest for an exam on the following monday.

Exams every two weeks makes for a fast-paced study regimen. Every night I am putting in 4-6 hours reading material for lecture, printing out and looking over lecture powerpoints, and reading over my class notes. Occasionally I’m making flash cards, but they take up a lot of time to make and little time is left after all of the above to reap the benefits of them.

I’ll leave you with two drugs that I’m having trouble remembering: 1) propoxyphene (Darvon… with tylenol it’s darvocet) which was taken off the market because of the adverse effects to the heart electrical conduction. 2) merperidene (Demoral) which is an opioid narcotic. Hopefully I’ll have them memorized before 8 am tomorrow!

Take care and thanks for reading!

sandanrn

 

me flying thru the hurricane, but hanging onto my study skills (the sign)

I’m a Director!

Hello all,

I’m writing to let you know that I went to the first Student Nurses Association meeting on Thursday and was nominated for the position to be the Breakthrough to Nursing Director. I was voted on and received the position title along with the responsibilities associated with it. I will be in charge of recruitment to Nursing in general as well as our college’s specific nursing school. They said (before I was nominated) you have to be excited about nursing, so I thought it was pretty cool people around me noticed my enthusiasm.

However, the looming anxiety still exists for this first test. The question style is very different from most college exams. You have to know background information that is in the question (only written as a diagnosis ie. diabetes mellitus) and then the question asks which is the appropriate intervention that a nurse should do first? The choices are then worded in technical terms as well, so you have to know what all of them mean. And there are always two “good” answers, but only one “correct” answer. Some of the second year students say you can study to eliminate the two wrong answers, but its almost “enie-meanie-miney-mo” to narrow down the two good answers to pick an ANSWER.  I feel like I won’t be able to do it as well as I know I’m capable of. I don’t want to let any of you down!

Please comment with any questions and/or support you can offer. Thanks!

sandanrn

 

Need sleep! Studying to the max, almost

This post is short, but I want to let you all know the week has gone well. We have covered learning skills for assessment, blood pressure, pulse, respiration, temperature (tympanic, oral, temporal, and rectal). It has been a busy week though.

Tomorrow I only have class from 8-10am but its on an entirely new section that won’t be covered on our FIRST TEST on Monday. It’s on bed-making, hair care, bed bath, fingernail care, mouth care, and medication calculation/administration.

Last week we covered how to adjust walkers and crutches to normal height and how to turn patient over in bed as well as how to transfer from bed to wheelchair.

Off to bed.

sandanrn

LONG POST – what I did for homework

Here is what I typed up to study by. It is the BASICS of doing an assessment. These are required when a patient first arrives at the facility. This is known as an Initial Assessment. Should be completed in 15 minutes or less! OMG! Happy reading, and I understand if you choose to skip this post! lol — sandanrn

 

Assessment

Equipment: BP cuff, stethoscope, thermometer, pen light, tongue depressor, tape measure, reflex hammer, clean gloves, scale, alcohol swab, cotton ball, wrist watch, draping

 

Remember:

  1. Inspect
  2. Palpate
  3. Percussion
  4. Auscultation

 

Except abdomen which is look, listen, feel.

v  Introduction

  • Knock
  • Enter Room
  • Introduce self
  • Explain procedure.
  • Wash hands (ask how they are doing and if feeling any pain. Address this first.)
  • Ask if they need to void before beginning assessment.

 

v  Health History

  • Medications
  •  Allergies to medication or food
  •  Past surgeries
  • Medical Problems
  • Family History
  • Alcohol, Cig, Drug Use
  • Recent Falls (Fall Risk)
  • Belongings (DOCUMENT the path every belonging takes ie. To safe, home with relative, etc.)

 

v  General Survey

  • Vital Signs
  • temp (thermometer)
  • pulse (wrist watch)
  • respirations
  • bp (sphygmomanometer)
  • pain (follow-up)
    •  Height and Weight (tape measure, scale)
    •  Racial or ethnic variations

 

v  Psychosocial Status (affects physical recovery)

  • How do you feel?
  • Any recent changes?

 

v  Neurological System

  • Level of consciousness – are you alert?
  • Orientation (oriented x3)
    • name?
    • year, who is president?
    • where are you?
    • Language
      • voice clear?
    • Memory

¨       STM (paper, pencil, pen… explain for them to remember the words because you will ask them to repeat later)

¨       LTM (birthdate)

  • Affect

¨       looking for congruency between mood and affect

  • Motor Function

¨       -flacid (can be moved, but you have to move it for them)

¨       contracture (rigid, fixed in place)

  • Sensation  (cotton ball, alcohol swab)

¨       upper and lower extremities on both sides for dull (cotton ball) and sharp (corner of alcohol swab packaging) sensation

 

*** ASK WHAT STM WORDS WERE ***

Strength (use only 2 fingers for safety!)

¨       -squeeze with each hand

¨       press against hands with hands and feet (gas pedal)

 

 

MAKE SURE BED IS AT APPROPRIATE HEIGHT

 

 

 (HEENT – head eyes ears nose throat/mouth)

  • Head

¨       scalp (dandruff)

¨       hair (thinning)

  • Eyes (PERRLA: pupils equal, round, reactive to light, accommodation) (pen light)

¨       accommodation- focus on near then far object, pupils should dilate

  • Ears

¨       Whisper Test (stand behind client and whisper word behind each ear)

¨       Insp- Look at

¨       Palp- temperature, pain, tenderness

  • Nose

¨       Insp- symmetry to face and side to side, drainage, incrustations (boogers), deviated septum, see if nares are patent/open.

¨       -Palp- occlude each nare and check for patency, sinuses for tenderness

Throat/Mouth

  • trouble swallowing? Thin/thick liquids?
  • -Insp- midline, drooping, color, sores, dryness, cryptic tonsils, uvula, tonsils, frenulum of tongue midline
  • -JVD- Jugular Vein Distinction – is it showing? (JVD is negative if you don’t see it.)

        Coratid- graded 1+, 2+, 3+ (quality of pulse, both sides), check for bruit (squishing sound)

 

         Oral Mucosa (tongue depressor)

  • -flacid (can be moved, but you have to move it for them)
  • contracture (rigid, fixed in place)

 

 

Integumentary System

DANGER SIGNS FOR CANCER ARE A.B.C.D.- Asymmetry, Border irregular, Color varied, Diameter >eraser

  • 1.Intact (clean and free from odor)
  • 2. Skin Color (pale/pallor, blue/cyanosis, red/erythemia, yellow/jaundice)
  • 3. Edema (pitting or nonpitting)
  • Turgor (check inferior to clavicle on older pt.)

¨       pull gently on back of wrist and see if skin returns or is “tenting”

  • Lesions: alteration from normal

¨       If found:

  • -document location and size

¨       look for drainage

Nail Assessment (free of polish and acrylics)

  • insp- lines, beau’s line, capillary refill ❤ sec.
  • Rashes
  • Temperature (esp. at joints)

 

v  Cardiovascular System (stethoscope)

  • Insp- short of breath?
  • Palp- for tenderness
  • Ausc-
    •  is it regular pulse or irregular? Any addt’l sounds?
    • A Point To Memorize!

¨       Aortic (S1 louder) – right sternal border, 2nd intercostal space

¨       Pulmonic (S1)- left sternal border, 2nd intercostal space

¨       Tricuspid(S2)- left sternal border, 4-5th intercostal space

¨       Mitral (S2)- mid clavicular line, 5th intercostal space

  • Count apical pulse for one full minutE

 

 

v  Respiratory System (stethoscope)

Insp- short of breath?

  • Check for diaphragmatic excursion (put thumbs together on spine, they should sep. approx. 5cm during inhalation and go back together at exhalation)
  • Check for tactile fremitus (put hands behing lungs and have them say “99” to see if vibrations are congruent)
  • Palp- for tenderness
  • Ausc-
    • What sounds are present?

¨       NORMAL

  • Bronchiole (neck area)
  • Bronchovascicular (near clavicle)
  • Vasicular (everywhere else)

¨       ADVENTITIOUS (Abnormal)

  • Crackles
    • Coarse (thick paper rubbing together)
    • Fine (record player popping, higher pitch)
    • Wheezing (tightening of airways)
    • Rochi (gurgles) – sounds like ppl talking in adjacent room (fluid)
    • Stridor (partial block of airway)

¨       ABSENT

  • Worsened closing of airway
  • FATAL if left untreated

 

 

v  Breast Exam

Insp- lumps and tenderness

                – raise arms and lower (looking for changes in swelling or nipples)

                -palms together and push (looking for retraction)

                – extend arm up and hand behind head, pillow under shoulder so breast is flat

                                – move in circular, star, or up and down pattern palpating for masses/pain

 

 

v  GI System (stethoscope) LOOK,LISTEN,FEEL!

  • Ask : passing stools regularly? When was last stool? Any pain?
  • Insp- symmetry, skin integrity, distension (bloated)
  • Check abdominal girth at umbilicus (tape measure)
  • Ausc- bowel sound in all four quadrants

¨       <5 hypoactive

¨       5-30 normal

¨       >30 hyperactive

  • Palp- for tenderness, lumps, or lesions

 

v  Genitourinary System

  • Urinary Output
    • Color, amount (30cc/hr), frequency
    • Continence
    • Catheter (is it draining urine)
    • Ask : passing stools regularly? When was last stool? Any pain?
    • Insp- symmetry, skin integrity
    • Palp- tenderness, distension (bloated)

Genitalia

                Insp- symmetry, rashes, odor, drainage

                Palp- tenderness, lumps, lesions

 

v  Musculoskeletal System

  • ROM
    • Full or limited?
    • Passive(you do it), Active (they do it)
    • Strength, Sensation
    • Termperature (warmth of joints)
    • Insp- edema, symmetry, tremors, deformities, color, bruises, rashes
    • Circulation/ Neurovascular Checks –IMPORTANT
    • Lesions, lumps
    • Pain,crepitus
    • Reflexes
    • Homan’s Sign (pull foot toward head, major pain in back of calf)

Testing at Dojo/Created a Study Group

Hello readers!

Thursday I made it a point to create a study group. I had intentionally acted extroverted all week to get to know my classmates and find out a little about them re: creating a study group!

 I had already planned on either having Nails or Napolean be in the group, seeing as this is their second attempt at this course (both failed by one point). Their general knowledge, albeit subpar, is more than what I have regarding the material, so that was a goal to use them as a reference, at least in the beginning. So I wound up having another member ask Napolean to join our group – and he agreed with the understanding Sasser could come too! So Napolean is the first member of my group and Sasser the second.

The first person I asked to join the group is Cowgirl. She’s got southern charm and has a camoflage and lime green purse – so she’s not all girly-girl. We sat together during the first part of Thursday’s ATI presentations, and after learning some of her likes and dislikes, stereotyping her intelligence based on how she answered (I know it’s wrong, but I was giving her an interview without telling her that’s what it was.)

Therefore our group, called the Angels, is made up of Napoleon (the only guy), Sasser (quiet girly girl who is scared of anything redneck), Cowgirl (the opposite of Sasser), and myself (a chubby intellect that prefers practicality and being a realist over anything else.)

With that being said, I had made a group at school, and now how to work as part of a group at Dojo Testing. We had several students (mostly kids) test for ranks from Hachi-kyu (8th grade – yellow… first color belt) all the way to San-kyu (3rd grade – brown… last color belt before black) and the others in between. (our ranking system goes from 10th grade backwards to 1st grade brown, and then on to 1st degree black belt, which progresses in years up to 10th degree black belt, which is denoted by the practioner wearing a red belt.)

Two adult candidates tested for brown belt, one being female. Few women have made it to brown, and even fewer to black, so I wanted the test to be thorough, and I feel that it was for the most part. I tested this female and while she had good technique, she lacked tremendously in power!

The other brown belt candidate broke a rib on the head instructor with a freak accident on a well executed side kick the instructor didn’t see coming in time to deflect. It seems to be that his humility, nor his control, is up to par… but more investigation into the problem (through watching him in class) is necessary before such labels can be assigned to the now brown belt.

—-

Conclusion: It was nice to be taught things, though not spoon fed, this first week in nursing school. Also, it was great to take a leadership role is forming a group that I think has a lot of potential. Then, I fell into another role as teacher and examiner during karate belt testing where I had to reference my decade of knowledge.

I enjoy all of these roles and hope that my teaching personality will allow me to serve in a teaching role regarding the subject of nursing someday in the future. It’s one of my options when I plan my future, but I’m a LONG WAY AWAY from having to make any kind of decision on that.

I’m off to study a bit more before bed, and it’s a full week ahead on the topic of Assessment – the foundation of nursing care!

Take care,

sandanrn

Post Navigation