LAMI observation

Hello blog world I realize I’ve been off for most of December but I was in ”study mania” during finals and then our family just got back from vacation to the great state of Texas.  I have so much catching up to do that I made a list.  Now that I’m on break I’ll spread out my blogs a bit so I don’t overwhelm you all too much.

www.medivisuals.com

In this blog I’ll mention my exciting time during my OR observation which happened at the beginning of December.  The patient was scheduled to have a laminectomy and discectomy for lumbar stenosis on the L5 region of the back.  The exciting thing about this experience was the fact that I knew the circulating nurse and specifically she requested that I follow her throughout my observation time.  I felt so excited to be asked to come back to see my friend, with her 20 years of experience, in her element. 

The patient was wheeled in awake and talking and then the anesthesia doctor did his thing and the patient was out within minutes.  The nurses, techs, doctor, and PA helped to flip the patient over on his tummy and prepared for surgery.  I was asked to step on a step-stool at the head of the patient so I could have a better view.  The anesthesiologist asked that if I felt woozy to fall backwards and he would catch me but not to fall forwards because I’d land on the patient.  I saw bone flying and just tried to not think of what was happening on a personal level but rather just stay in the moment which helped.

Another thrilling this was that the ortho doc asked me to come opposite of him on the patients other side,  gown up, and come share his double microscope to view what he was doing.  I felt honored and excited, even my nurse friend seemed shocked that I was asked to view the procedure.  The doc showed me the spine under the microscope and pushed it around like it was a rubber band. After he removed some stenosis he asked if I could see better blood flow and I agreed wholeheartedly that I could, even if I didn’t know for sure what I was seeing.

Ultimately the procedure only took about 2.5 hours including the pre and post op times.  While my experience was a positive one, the atmosphere was cold and formal and I don’t think the OR is the place for me because I love interacting way too much with the patients.

Strong Enough by Matthew West

After the week I've had this song sums up what I'm feeling the best!

You must think I'm strong
To give me what I'm going through

Well, forgive me
Forgive me if I'm wrong
But this looks like more than I can do
On my own

I know I'm not strong enough to be
everything that I'm supposed to be
I give up
I'm not stong enough
Hands of mercy won't you cover me
Lord right now I'm asking you to be
Strong enough
Strong enough
For the both of us

Well, maybe
Maybe that's the point
To reach the point of giving up

Cause when I'm finally
Finally at rock bottom
Well, that's when I start looking up
And reaching out

I know I'm not strong enough to be
Everything that I'm supposed to be
I give up
I'm not stong enough
Hands of mercy won't you cover me
Lord right now I'm asking you to be
Strong enough
Strong enough

Cause I'm broken
Down to nothing
But I'm still holding on to the one thing
You are God
and you are strong
When I am weak

I can do all things
Through Christ who gives me strength
And I don't have to be
Strong enough
Strong enough

I can do all things
Through Christ who gives me strength
And I don't have to be
Strong enough
Strong enough

Oh, yeah

I know I'm not strong enough to be
Everything that I'm supposed to be
I give up
I'm not stong enough
Hands of mercy won't you cover me
Lord right now I'm asking you to be
Strong enough
Strong enough
Strong enough

Med Error?

Last week I had my clinical on Tuesday and I knew I had three meds to give at 0900, but then I never checked the system on what time the next scheduled meds should have been given at.  You see our clinical times start at 0630-1130, and we (the student’s) are responsible for giving all the meds during that time frame.  The patient in my care was supposed to get meds at 0900, 1000, and 1100.  I only gave meds at 0900.  We’ve only be passing meds for three weeks up to this point. The first week I had my instructor watch me, the next week I had the nurse I followed shove me the med and tell ME to administer it while she checked in on another patient. 

So when my instructor sat me down in her office later that afternoon and asked what happened I didn’t have any excuses to give but the truth.  I guess she didn’t like my answer and told me that I shouldn’t have the idea in my head that if I don’t do something the nurse will catch my mistakes.  She said that I AM to be thinking that I am the “nurse” so I SHOULD HAVE given the med, not expecting the nurse I was following to do it.  My instructor then went on to say “I’m sorry this has to go in your academic file especially being your last clinical and all.” I was thinking what kind of a dork tells me this on my last clinical day?!  I get that it was my responsibility and that I shouldn’t have expected my nurse to do any of my work, but come on.  I mean if I were malicious in my intent or purposefully neglectful I could understand.  Or I could understand, if by my doing, the patient was given an extra dose or the wrong med, but my nurse gave the meds that I didn’t and she never mentioned that it was a problem to me. 

I think my instructor was trying to find someone to fault in our class this semester and I was that person.  Either way she teaches by intimidation which doesn’t sit well with most of the students in my class.  She also threatened informed me other instructors next semester will see the red flag in my file and pay close attention to my short comings, making sure I don’t make this mistake again.  Nice…  If I had any bit of confidence up until this point, I surely don't now.  I’ve officially been knocked off my perch, so-to-speak.

Other than that I totally bombed my oxygenation/perfusion exam Friday with a 68% for my score.  I know what happened, I poured all of my time in a 17 page paper and not enough time into studying.  I have to average 73% on all my exams, and so far I’m in the clear, but I really want to rock the final coming up so I can feel rest assured with my overall grade in the class.

On a lighter note I filled out my internship paper work for this coming summer.  I applied to four hospitals in my area that I get a chance to work as a nurse tech.  I’ll be paid roughly half the salary of a new nurse for eight weeks, being able to put to use my nursing skills.  I’m super excited, thrilled, and scared all at the same time.  I hope I do well, and I hope I get extended an interview and offer. 

Revivification Needed

I don’t know what it was this year that had me not feeling in the mood to be thankful?  Could it be the gloomy but warm weather, or maybe it was the fact that I wasn’t near my parents?  It’s not like we didn’t have a lovely time with my hubby’s family, and it certainly wasn’t like I don’t have a trillion things to be thankful for?  But I just felt in a funk, like I cheated my kids and hubby from a great time with me.  I don’t know what I would have done differently?  Maybe I could have tried to be in a better mood and done a better job of compartmentalizing my ever long to-do list? 

I have a massive paper due on Tuesday that I keep trying to push out of my mind and focus on family fun time but can’t.  I know that this paper isn’t hard work, but time consuming.  My school assignments seem to be lining up nicely as I close in on the last 3.5 weeks of school, but still are tedious.

My house is a mess and even though I want to put the tree up later tonight, I know the job will include cleaning up the front room and kitchen first. 

I want to play “Sorry Spin” with my son who bought this game yesterday morning in the hustle and bustle of Black Friday but keep putting it off.

Most importantly I want to take time and rejoice in God’s love for my life.  I want to get into memorizing scripture better so I can stand firm in the Word, when life gets me down.  I want to get out of the small minded thinking about my life’s up’s and down’s and focus more on the bigger picture of where my life is headed and what God has in store for me.  Maybe I’m just getting burnt out, and I think I need a revival.

Mexican Lasagna



Yummy goodness



Today I made one of my hubby’s favorite dishes, Mexican Lasagna.  He said it tasted perfect.  I thought this was a recipe my sister gave me, but after talking to her I guess it wasn’t.  I don’t know where I got the recipe from but I’ll post it on here for anyone interested.

Mexican Lasagna

2 T of EVOO (extra virgin olive oil)

½ of a red onion diced up

2 #’s of hamburger

1-1/2 C of frozen corn

2-1/2 to 3 C of medium salsa

1 can of black beans

2 T of chili powder

2 t of cumin

2-4 C of your desired flavor of shredded cheese

1 package of 8” tortillas cut in halves.

Handful of scallions or spinach leaves



First layer of tortillas (there's a layer of meat mixture underneath)



First brown up your hamburger then drain grease and put meat back in pan with diced up onion, and spices with the EVOO for approximately 5-7 minutes between medium to high heat. After you’ve cooked that for the duration, go ahead and add the corn, salsa, and black beans until heated throughout.  Next go ahead and put a layer of the meat mixture on the bottom of your 9X13 pan then a layer of cheese and lastly a layer of tortillas.  Repeat another time and finish off with your last layer of cheese and sprinkle on top with scallions or spinach leaves for color.  Enjoy!



Beef, corn, black beans, salsa mixture





Next sprinkle the cheese




Last layer includes leaves of spinach for color




Cooked until the cheese is melted and browned





What Does Normal Feel Like Again?

I had the evening off from work yesterday and I was extremely thrilled!  First let me tell you that I had a dickens of a week with all of my time devoted to studying for Exam 3 in my “big 7 credit foundational class”.  The content was majority on diabetes and although I felt fairly confident I still wasn’t able to walk away from the exam with a test score any higher than 78%.  Hummmm….not that great of a test score seeing as though I spent lots of time studying.  I think I have a great handle on the whole picture of what I’m studying but still struggling with application.  I wonder if it would serve me best to cut back on my study time and focus on the main points during lecture times.  This seems to be the suckiest part of school for me, ironing out what’s going to work for me and how I’m going to retain what I learn.  Also trying to figure a good way to come up with possible test questions that I could ask myself and using that as a helpful guide when trying to keep in mind the important stuff.

I haven’t given my Nursing Made Incredibly Easy Pathophysiology and Med/Surg. books a fair chance yet. I think these would be a great resource tool; either way back to my Friday break-down.  After I got home from my time at school, I went grocery shopping, and then back home to clean and get a few loads of laundry done.  Later I spent time making homemade pizza for me and the hubby.  Both our kids had previous plans to sleep over at their friends’ houses, so we watched TV and movies.  Nothing brought me more pleasure than feeling normal for a while.  So easily I get caught up in studying/working/thinking nurse-like that I forget to make time to just be me. 

Does anyone else suffer from feeling off kilter when it comes to being totally consumed by something?  I want to be the best nurse possible, trying to take care of patients and making them feel better, but if I can’t understand and get a grasp why the body does the things it does then I’m worried I won't be very helpful.

I Love You, My Sister

Friends by Michael W. Smith

Packing up the dreams God planted
In the fertile soil of you
Can't believe the hopes He's granted
Means a chapter in your life is through
But we'll keep you close as always
It won't even seem you've gone
'Cause our hearts in big and small ways
Will keep the love that keeps us strong

And friends are friends forever
If the Lord's the Lord of them
And a friend will not say never
'Cause the welcome will not end
Though it's hard to let you go
In the Father's hands we know
That a lifetime's not too long to live as friends.

With the faith and love God's given
Springing from the hope we know
We will pray the joy you'll live in
Is the strength that now you show
But we'll keep you close as always
It won't even seem you've gone
'Cause our hearts in big and small ways
Will keep the love that keeps us strong

And friends are friends forever
If the Lord's the Lord of them
And a friend will not say never
'Cause the welcome will not end
Though it's hard to let you go
In the Father's hands we know
That a lifetime's not too long to live as friends.

Flu Shot

This past week on Tuesday I gave my first IM injection on a real live person!  Actually it was a flu shot clinic, and I gave 6 injections total. 

WOOT-WOOT! 

What a scary time it was for me but after the first one down, the rest were downhill. 


ANYONE NEED A FLU SHOT??

Vivid Dream Details

Isn’t it funny that you can dream in such vivid details??

A few nights ago I had a really wonderful dream that had me literally crying when I woke up.  You see my grandpa past away a few years ago and he and my grandma helped renovate their summer cabin into their primary home once they retired.  With the help of my uncle and a few years of hard work they completed the project and it was a beautiful home.  My grandparents had a lot of pride in their home, and we grandchildren had MANY memories collected of the cabin.

My dream started off with me showing up at the dock inspecting how the new owners were taking care of my grandpa’s skilled artistry.  I was noticing small details like how the styrofoam protected blocks were connected to the dock to prevent the boat from scraping its wood.  As I moved up the walkway to the back of the house I could see small differences in what the new owners had done differently and wanted to let them know how to correct or fix them.  I let myself into the house and waited in the front room overlooking the lake, tall pine, and maple trees.  When the family got home I started explaining who I was and why I was in their house.  Then I tried to politely explain to the family that they could fix their house and make it look better if they just took my advice to get it back to the way my grandpa had it.  I don’t know why it was so important to preserve this home the way my grandpa had it, but it was.

Then out of the corner of my eye the screen door opened and my grandpa walked in and had a twinkle in his eye and bright refreshing smile on his face (like only my grandpa could) and took a seat on the couch.  The family just vanished away from us, as I sat down on the floor at his feet and just looked up at him in awe and was overjoyed to be seeing him.  I told him how much I loved and missed him.  I felt like a child again, when there weren’t any grown-up problems or responsibilities to deal with, and I was just excited to be there.

My grandpa told me that I shouldn’t have been so hard on the family who was trying to make this house their home.  He quoted a Bible verse about there being a time to build and a time to tear down (Ecclesiastes 3:3) and that I should have grace on this family. 

Then I woke up literally crying and wiping the tears from my eyes.  I’m not sure how to take this dream.  After I had woken up completely I looked up the passage this verse comes from and this is what it says:

Ecclesiastes 3:1-8

A Time for Everything

 1 There is a time for everything,
   and a season for every activity under the heavens:

 2 a time to be born and a time to die,
   a time to plant and a time to uproot,
 3 a time to kill and a time to heal,
   a time to tear down and a time to build,
 4 a time to weep and a time to laugh,
   a time to mourn and a time to dance,
 5 a time to scatter stones and a time to gather them,
   a time to embrace and a time to refrain from embracing,
 6 a time to search and a time to give up,
   a time to keep and a time to throw away,
 7 a time to tear and a time to mend,
   a time to be silent and a time to speak,
 8 a time to love and a time to hate,
   a time for war and a time for peace.

I called my mom on my way in to school that morning and through my tears again I explained the dream to her.  She suggested it was the enemy trying to make me feel guilty for being in school and not to listen to him.  That I’m doing the best I can and need to continue with school and the sacrifices I’m making.  Ugh, either way I’m glad I got to see my grandpa again.

Think Twice Before You Say What's On Your Mind

Last night I was working my eight hour shift at the hospital and my co-worker, grabs me by my arm and practically drags me into one of the charting rooms.  She has red eyes and tells me that one of her female patients she was taking care of, mistook her by accident as expecting…as in pregnant…as in looks big in the waist line such as looking pregnant. 

OH MY goodness people! 

My co-worker does not in the least bit look pregnant at all!  She was merely wearing a long-sleeve shirt (it is Wisconsin and cold outside already) under her scrub top and the pants she wore looked bunchy in that part of the waist because of the drawstring. 

OH MY GOODNESS people!

She was so upset that she must have cried about it.  I tried to calm her down saying things like “of course you don’t look pregnant”, and “I’m sure it’s just the patient’s anesthetic”, and “YOU DON’T LOOK BIG”!

But it was hard to change her mind, she kept standing there holding her tummy and sticking it out asking “do I look that fat”?  PLEASEEE!  I reassured her again that she looked beautiful and not pregnant or fat.

OH MY GOODNESS PEOPLE!

Please, for the greater good of all womankind, be graceful and wise (knowing that if the tables were turned, think of how it would make you feel if the opposite were said about you) before you ask a woman if they’re pregnant or expecting.  This is the most ignorant comment anyone could make to a woman who isn’t pregnant.  This is hurtful and hard to recover from especially, if like my friend, you’re trying to lose weight.  Please especially keep in mind people like me who are trying to get their work done in a timely manner, have to now put on their counselor hat and help build up their co-workers self esteem that has clearly taken a beating.

Fluid and Electrolytes Confusion

Three words had me in such turmoil this past week I can only begin to tell you about.

Those three words are FLUID AND ELECTROLYTES.  For any nursing student or nurse for that matter I’m sure we can all agree this is a difficult concept to learn.  This past week every day after class I spent until around 9pm at school studying the topic of fluid and electrolytes, including acid/bases and ABG’s with my strong close-knit study group.  Very few students in our class don’t seem to get concepts easily and I am one of these people.  I tallied up the amount of hours spent on these concepts and in all it came out being 16-18 hours.  That equals less time with my hubby and kids that I spent working through these units.

We were advised by one of our instructors that we should focus a good amount of our study time on the fluid and electrolytes because she would put more of those questions on the test.  So I didn’t spend as much time on tissue, burns, stomas/ostomies, enemas, or PICC lines. 

After finishing the exam for these units the 52 question exam only had two fluid/electrolyte questions.  WHAT???  Holy poop what was my instructor meaning that a good amount should be focused on this area if there were only going to be two questions?  How disappointing after adding up the amount of questions I got wrong.  I still passed the exam but barely.  Not only did she lead us astray in that area but she also made a point to mention to us not to bother bringing our calculators because since our med. Calc. exam was the week prior we weren’t expected to do any of those kinds of problems on this exam.  Sure enough we had two med. Calc. problems on this exam. 

I’m all for the idea of making us well educated on a broad amount of topics but if you, the instructor, tell us, the students, to focus on a certain area there darn well better be more than two measly questions! 

So after collecting myself and writing out a lengthy email to said instructor yesterday after class I asked my hubby to edit it for me so I could send it off as soon as I could.  Unfortunately because I had to work yesterday she probably won’t see my email until Monday, but I hope my complaint isn’t the only one in her inbox.

Does anyone out there have any helpful hints regarding fluid and electrolytes, acid/bases, and ABG’s?  I would take any and all help offered seeing as though these concepts are still foggy for me even after the 16 hours of study.

Chicken, Potatoes, and Muffins

A few weeks ago I decided that I would make a big helping of food on Sunday nights, so the family can eat their share throughout the week and always have a warm meal.  This has been especially successful in helping my hubby cook less especially when I'm not home.
This week's big meal was shake 'n bake chicken with oven roasted potatoes and for dessert...chocolate chip and cinnamon muffins.  Yum!

Chicken

Potatoes

Awesome all-in-one muffin mix

just add water

shake

and pour

finished product

cinnamon in Halloween paper liners

Disheartened But Not Discouraged

This semester I have seen a big difference regarding having more time to complete school work with less time working.  This has a lot to do with my hubby’s new promotion at work (thanks babe) which has taken my hours per week down from 24 to 14.  I can’t help but get my school work done earlier than usual and having time to pick up my house more often.  Unlike last semester I wasn’t a student who tooted their horn when completing assignments early because it didn’t happen much for me.  I was usually getting the assignments in on time but working quickly the night before they were due. 

I don’t mean to rub the fact that I’m ahead of the game this semester with my assignments in my co-students’ faces but I truly am happy and joyful to be on top of due dates.  Recently though I’ve decided to stop letting my closest school friends know when I’ve completed an assignment early because I’m not getting the reaction I expect.  There’s no true happiness coming from my co-students I guess because they wish they were done with their assignments too as I did last semester.

Either way dear readers I’ll divulge what is expected of me this week and what I’ve accomplished so far.

Monday 10/17	Tuesday 10/18	Wednesday 10/19	Thursday 10/20	Friday 10/21	Saturday 10/22	Sunday 10/23
Practice skills for tomorrow’s check off	Skills check off; wound care, IV, and donning sterile gloving	Medication worksheet due before class	Ethics survey due, Annotated Bibliography due, Blog posting due	Humongous EXAM for (7) credit class. __________ Work at hospital from 1430-2230	Work at clinic 0900-1500 Work on odds and ends of school work and spending time with the family	Go to church, watch football with family and finish up anything I missed

So far I’ve finished my blog posting, ethics survey, medication worksheet, and just have to edit my bib.  Tonight and tomorrow I’m going to work on reading over my power point slides so I’m ready to prove what I know regarding wounds and IV maintenance for my check offs on Tuesday.  This leaves me Tuesday night, Wednesday night, and Thursday night plenty of time to study for Friday’s HUGE exam.  Sometimes I don’t know what I would do without my to-do list so I can visually see what I have to do and what I have done.  I just wish my co-students were as excited about my new found time and organization skills as I am.

My First Poke

My first poke was with a butterfly needle on my hubby tonight.  He was such a great sport.  He said my technique was a little rusty, but my only other practice was previously on a dummy arm. 

I'm just surprised I got flashback.  Woo hoo!

Medication Calculation

Hello Y'all guess what???  I passed my med. calc. test on the first try!  WOO HOO!  Super easier than I prepared for, which makes me extremely happy and blessed that I wasn't one of the students who failed.  Thank you Lord!

Wound Care, Wound Sample, and IV Practice

Last week's skills lab included wound care, swabbing a wound to collect a sample, and IV insertion.

The only thing I practiced while at school was IV insertion and I used a butterfly needle. My first two attempts were unsuccessful but my last one rocked! I was able to get flashback on the dummy's vein. I just wish I'll be able to practice this skill on a live person. I know seniors who haven't gotten to start an IV on any patients yet. Maybe during one of my shifts at the hospital I'll be able to find a way to try out my new skill...

I promptly went home and practiced the other two skills on my hubby and kids. First I drew an oval on their sides representing a wound and took out my wound care kit and went to town step-by-step of what I learned to put a dressing on their "wounds".

I think I did well but forgot a few steps after re-reading my list of things to do. More practice is the only way to get past that. My official check-off lab will be next week for these new skills I've learned.

Tuesday will be a gigantic exam in my public health class, so I better get back to hitting the books.

Shingle Party Complete

Picture from the view outside my living room window. don't you just love fall colors

Last weekend we completed our fall project this year of reshingling our house and garage.  I know I asked you all your opinions on what color shingles I should pick to complement my house color and shutters.  While I kept all the suggestions in mind, my hubby and I decided price beat out looks and so I'm happy to announce that we chose a dark brown that looks simply beautiful.

Thanks to everyone that was involved.  We wouldn't have been able to get the whole job done without lots of help from my hubby's friends.

New Shoes

Disclaimer – Timberland PRO gave a free pair of Renova shoes for reviewing purposes.

When I first started nursing school I bought two pair of shoes the first one (New Balance all white) for clinical, and the second one was (Reebok Zig-Techs) for all wear/jogging.  As it turned out the New Balance shoes were horrible, I could barely stand on my feet for the first 3 hours of my clinical.  So I switched to my Zigs which were very comfortable but not something I wanted to wear at the hospital so I was on the hunt to find the perfect work/clinical/hospital shoe. 

After I got my CNA job on a surgical floor the “norm” was to buy those plastic type/durable shoes filled with holes known as Crocs for practical spillage reasons.  It didn’t take long to realize Crocs made my feet hot and sweaty, and my back painful after an 8 hour or 12 hour shift.  Quickly I changed my mind and went back to my Zigs.

On my most recent adventure I was nearly ready to buy a pair of Dankos that retailed at $120 and I nearly pulled the trigger but decided against it.  After trying them on in the store my feet hurt within minutes so I said forget it.  I settled on a pair of Nursemates slip-on shoes that were comfortable around the house but quickly became just the opposite after a few hours on the floor.  None of the supposed nursing shoes were working out for me, so guess what I went back to…you guessed right my Zigs.

A few weeks ago I was approached by Timberland, yea you know the company that makes the hard work boots, to try a free pair of their new shoes made especially for the health care field called Timberland PRO Renova.  I have to say at first I was skeptical because my record had been 0/4 but I kept an open mind and tried them anyway. 

Wowwie-wow-wow did they not only stand the test of a couple 12 hour shifts but they far exceeded my expectations with comfort and style.  The shoes are a pristine white slip-on shoe with a little heel but the comfort was amazingly supportive through my long shifts at the hospital.  Here’s what their website had to say about the shoes:  The Timberland PRO® RenovaTM series is care for the caregiver. Combining Anti-Fatigue Technology with stylish design, it delivers on the healthcare industry's unique needs and helps women stay on their feet all day long.   Did you read that readers…anti-fatigue technology could that even be possible?  Well I’m here to say yes, yes it does.  Also if I had bought these in the store, Timberland has a 30-day comfort guarantee that states: If during the first thirty (30) days following your purchase you believe your Timberland PRO® RenovaTM series footwear is not more comfortable than other brands you have worn, return them and Timberland will refund the purchase price of the footwear to you, no questions asked, provided you still have your dated receipt of purchase.

What a great incentive to go out and try a pair of your own right?  You can view the entire collection at the following website http://timberlandpro.com/#renova for yourself.

Now I can go back to wearing my Zigs for what they were meant for everyday/jogging wear.

DDDIRRT

Today I took a big exam that I have been cramming for the past week and a half; even though I got an 84% (which wasn’t as high as I wanted) I’m just glad to be done with the nervousness that inevitably comes with studying! 

My next big thing to prepare for is a medication skills check off demonstration on Tuesday. I will have a pretend patient and I will have a few medications that I have to give most are oral meds, but one is an injection and our instructor will be watching and asking questions the whole time. 

DDDIRRT

On the surface this seems like not a big deal to just give a mannequin a few pills and a shot and I’m done, but it’s so much more than that.  I have to triple check the 7 R’s which is verify the correct medication, the correct dosage, the correct route, the correct patient name and medical number, the correct time, while keeping in mind the patient has the right to refuse the medicine and following up with documenting that I did indeed give the drug.  I like this little acronym my friend taught me in class:  DDDIRRT = Drug, Dose, Document, Identify, Refuse, Route, and Time.  I have to give just the scheduled meds and possibly be aware of any prn drugs needed depending on what the patient is complaining of like pain or nausea.  Then I have to know the adverse reactions of the drugs and the common uses of these drugs and be able to tell the instructor when she asks why we’re giving the medication to the patient. 

Heparin

The injection is just a SQ of either insulin or heparin in the abdomen at a 90 degree angle without aspirating.  Sucky huh? 

I’ve practiced a few times so I feel pretty confident that I’ll get the procedure done, and I can bring in drug notes for when the questions from the instructor are asked, so all in all I feel good. 

But goodness gracious, I've had even less time this semester with friends and family that it's beginning to really bother me.

And for some oddball reason I agreed to working 4 days back to back, what was I thinking???

NCLEX

Which is better to study for NCLEX, Saunders or Kaplan?  And why?

Apple Orchard = Apple Crisp

My son was invited to go to the apple orchard with our next door neighbors and came home with 15 medium to small apples and asked what we could do with them.  I suggested Apple Crisp and my hubby did a little jump for joy!

First up, wash outside of apple and get to peeling.  These small apples were slightly difficult to hold without them jumping out of my hands every few minutes.

 Time to take out the core and slice thinly.

 Sorry for the brightness in some of these pictures, but here is the brown sugar/butter crumb mixture.

 Here I've coated an 8x8 pan with shortening, then I spread the apples, and started covering with the crumb topping.

 This is what the apple crisp looks like prior to going in the oven.

 And this is what the apple crisp looks like right after I took it out from the oven 30 minutes later.  YUMMY!

 And this was the first of a few helpings for my hubby, who agreed this was just the perfect consistency and tartness of the apples.  Oh how I love making comfort goodies when the weather gets cooler. 

Now I better get back to studying the immune system...

Tour of the OR

Tuesday after three hours of lecture it was finally the time we’ve (my class) all been waiting for this week…time for the big tour of the Operating Room.  Our clinical group headed down the long hallway from our school building to the operating floor of the connected hospital.  We stepped beyond the double doors of the Restricted Area where “authorized personnel” are only allowed to go, to see what really goes on. 

The first thing we saw were more hallways with office doors and at the end of that hallway we saw a cart that had rows and shelves of different size scrubs all the same boring color of a medium shade of blue.  We were asked to grab a size that fit us and go into an adjacent locker room to get dressed.  There were nine of us trying to fit into a small locker room and good thing we weren’t too shy because we had to get down to undies and bras next to one another.  After we were all dressed appropriately we grabbed a cap to pull back all of our wild hair and shoe covers. 

We were brought to the OR #1 where there was a robotic machine similar to a giant praying mantis with long arms.  I do not recall the name of the machine but it has the capabilities to do surgery guided by a surgeon behind two small pincher controllers on the other side of the room.  This machine does hysterectomies and prostatectomies just to name a couple.  I was surprised at the amount of questions I asked regarding the small details of what was involved with surgery of this sort.  I even asked one of the nurses taking us on this tour to get behind the controls to show us what it would look like if a surgeon was sitting there.  I like visuals.

Next we just walked up and down to show us what the scrub sinks looked like and then it happened…we walked past a room that had an actual surgery going on.  I must say after glancing through the window it looks nothing like Grey’s Anatomy, the top surgeon wasn’t standing there making light conversation with just a scrub top on and his chesty hair sticking out.  These people were dressed head-to-toe with very little skin showing.  The surgery that we pasted by and witnessed was a Left Total Knee Replacement, according the RN giving us the tour, she said the people in the room have to wear what looks like Hazmat face shields in case of flying debris like bone that could hit them in the face or head.  YUCK! 

What I saw was a patient’s left leg being operated on; the skin looked like an unhealthy tan color which later I figured was un-oxygenated skin flapped open while the surgeon was standing and doing his thing.  To the left of the surgeon I saw on a cart, three gauze rolls about 2” in diameter and 3” wide soaked with blood.  My girlfriend in class shouts out that it looks like when she goes hunting and the deer is “quartered”.  She had no problems, while I was second guessing my interest in the OR setting professionally.

Will I ever figure out what I want to do when I graduate?  Lastly we were shown the PACU with patients waiting in preop and patients who were recovering in postop bays. 

Ultimately the experience was cool, and I’ll be having MY time observing on 12/5.  What I thought was funny, was the preference of music that the nurse made mention to us.  She said that while the ortho docs liked Rock music, the cardiologists preferred no music all.  How funny that any professional doing work in a surgery suite has the option to listen to music at all.