Tuesday, April 26, 2011

Fluid volume deficit r/t dehydrating effects of caffeine

A fellow blogger named Grace posted this list of Top 10 Nursing diagnosis for nursing students on her blog.  I can relate to most of these especially 1, 6 and 10. 
Are there others of you that can relate to some diagnoses listed below?

10. Fluid volume deficit r/t dehydrating effects of caffeine 
9. Impaired social interactions r/t inappropriate topics of conversation discussing bodily functions
8. Anxiety r/t time constraints, threatened loss of social activities and anticipation of constant clinical quizzing
7. Functional constipation r/t lack of time to go to the bathroom associated with moving at speed of light and still not getting everything done
6. Impaired skin integrity r/t decubitus ulcer formation from sitting for long periods of time while studying
5. Ineffective breathing pattern r/t anxiety attacks before exams
4. Risk for self-injury r/t excessive carrying of 2,000-lb. textbooks
3. Sleep pattern disturbance r/t waking up at 4 a.m. for clinical after getting to sleep at 2 a.m. from working on care plans
2. Altered thought process: caffeine-induced psychosis r/t increased coffee consumption
1. Self-care deficit r/t being a nursing student

Saturday, April 23, 2011

Party Night

This has been a great movie and game night with my kids so far.  We're staying up until 2am, waiting for dad to come home from a much needed relaxing trip to the casino tonight.


Friday, April 22, 2011


My love affair with my fellow co-student has become too much.  I’ve been feeling overwhelmed by her to the point of being smothered.  Every time I start having a conversation with another student, she cozies right up to me and will ask what’s going on and what are we talking about.  She’ll call and text me frequently and seems possessive of me.  She likes to sit next to me in every class and at first I found this flattering, but then lately within the past two weeks I’ve been annoyed. 
Now I know I’m a class act (someone who shows impressive and stylish excellence), but this is too much even for me.  Has anyone ever seen that movie Fatal Attraction, well this situation is kind of like that but instead of an affair, it started as an innocent infatuation and there’s no girl/boy relationship it’s just two girls, and there’s no sex… so maybe this isn’t so similar.  Hahaha but you get what I mean right?

Monday after Easter we have off of school to observe a furlough day.  That means no lecture, no clinical, and no work!!!  I’m going to party like a rock star on EASTER (this won’t consist much more than watching a movie and junking out in front of the TV since I attended church last night) but it will feel like a mini-vacation to me. 
(Look for an upcoming post regarding the meaning of Easter to me.)

Lastly I have a phone interview scheduled Monday at 1100 for Extraordinary Hospital for a coveted CNA position.  So keep me in your thoughts and prayers that I can get my foot in the door with being offered this position.  In the city where I live there is only one hospital for miles around and competition is very stiff for said cherished CNA jobs.  My fellow nursing students are being advised to get a CNA job because after graduation Extraordinary Hospital hires new grads who are already employed there first.  This is a positive step because I’ve applied to over 10 CNA jobs already without being called for one of them. 
Plus my chances of staying living in this city, employed as a nurse, depends on if I get a job at Extraordinary Hospital.  Otherwise my chances grow drastically of moving down to Texas, where I may have a better chance of being employed with a wider job market.

Wednesday, April 20, 2011

Happy April 19th

This was the view on my way home from school yesterday.  When will it end?

Monday, April 18, 2011

A Day of Firsts

Today I was at the hospital by 6am and home by 6pm. Clinical for 4 hours, lunch for 50 mins, lecture for 2 hours, and started writing a paper that took 4 hours.

Also, I ran back and forth 4 times to the kitchen for water and ice chips. Why does the kitchen have to be at the other end of the hall from where my patient rooms were?

Today I felt my first hematoma, listened to my first heart murmur on a real patient, and gave my first bedbath.

Friday, April 15, 2011

Store Credit

Back in 2000, my husband bought me a tennis bracelet that was very beautiful.  Love you honey!  Unfortunately my clumsiness had it in the repair shop one too many times.  A few weeks ago, I decided to ask the jeweler what my options were because of the multiple repair problems and now I have STORE CREDIT!$$!

My ears are sensitive or allergic to cheap metal but I've never had fine jewelry to put in them so I'm leery to start now.
I'd love to buy a new ring preferably with a garnet colored stone on a simple band because I love the color.
For sure though I'll be browsing the necklaces, I want something I can wear every day that looks feminine on a thin chain.  Below are some pictures of some preliminary options.  I'm driving out of town at the end of April to pick it out, but I'm not even sure this is what I'm looking for. 

What do you people think?

Who couldn't use a good "mother/child" necklace

Kinda looks like a vine or waterfall of beauty

Who couldn't use a nice opal necklace

Thursday, April 14, 2011

Moment of truth

This Friday will be the moment of truth where I'll put to test my new study skills.  Recently I found a website that helps visual learners study differently than what I grew up knowing. VISUAL LEARNING WEBSITE
For instance instead of writing your outline in a bullet form on lined paper, try using a blank piece of paper without any lines and use a flow chart method.  This has been a more effective tool for me so I can break down an entire chapter to one or two sheets of paper.  Here are a couple examples (sorry for the fuzziness):

This is a list of terms for 5 chapters that is viewed at-a-glance format, easily read by me

This is my big white board and I'm transferring what is on the white board and putting it on to another sheet of paper

Then after I've put all the information in a much easier digestible format, I transfer the information to blank piece of printing paper and will pour over that during my study time for the test.  Let's hope this works so that I can get a score on Friday's exam that will rock my socks off!

Wednesday, April 13, 2011

Cath Lab

Monday was my second week on the cardiac floor for clinical.  We were assigned one patient to do an entire head-to-toe assessment, set of vitals, and chart our findings. 
As I began, my assessment was brief, because my patient had to go down to the cath lab to get an angiogram.  Once the patient and I got down to the waiting room in the cath lab I choose to ask more subjective questions.  My patient was a 35 year old female, only two years older than me.  I tried quickly to gain trust by talking about things that interested her.  Once in the cath lab I made sure to make eye contact and we exchanged glances throughout the procedure.  When she was done, we talked briefly and I felt a connection made, by being near her throughout the angiogram. 
Once we were back in her room, for my three areas of focused assessments I chose heart (because of the chest pains she was admitted for), lungs (because she is a smoker), and skin (because she just had an angiogram in the femoral artery that needed to be checked every 15 minutes).  During the heart assessment I felt awkward placing my stethoscope near the apex because I didn’t want to violate her privacy and go under her gown, but she didn’t seem bothered after I started so I continued.  While I observed my nurse doing a heart assessment later in the morning, I could she didn’t think twice at listening to those areas and I figured in time I’ll feel less intrusive.  What I liked about my nurse and different from the nurse I shadowed for an hour the Monday prior, was that she knocked on the door before entering.  I like this tactic and will use it in the future for my patients.
I was so impressed while sitting next to the CT Tech and listening while he explained what the doctor was doing during the angiogram.  He pointed out major arteries while the doctor pumped dye and the heart was visible on the screen in front of me.  I couldn’t help but gasp and say “that’s cool”.  As I looked out from behind the glass lead protecting windows I saw huge machines on tracks that moved around effortlessly.  Once in awhile these machines banged into each other and I wasn’t sure if maybe it was the doctor operated them or they did that on their own.  Either way I’m still pretty impressed with the cardiac floor.

Friday, April 8, 2011

Relaxation where have you gone?

See full size imageOnce upon a long time ago I use to read novels while I walked a mile to work, before choosing to go back to school.  My enjoyment was to escape in reading for true relaxation.  Although I knew what it meant to live a busy life, I moderately definitely knew how to relax. 

Today has been a whirlwind with activity.  The students in my class started in the skills lab with two events needing to be accomplished before noon.
1)      Do a head-to-toe assessment on the simman, while the instructor watched us cover each area of the body while listening to abnormal heart and lung sounds.  This wasn’t graded but we went in groups of four and it took nearly an hour and fifteen minutes per group. 
2)      We also had to get checked off on our abdomen, musculoskeletal, and neurological exams in groups of two, which for my partner and I took about 15 minutes per group.  However each group took FOREVER to thoroughly complete their assessments so when it was my partner and my turn we didn’t start until 1140. 

My partner and I were the last group to get checked off for assessments, and then we raced downstairs for lecture.  Thankfully I ate my lunch around 1030, so I wasn’t starving.  But I didn’t really have a moment to collect my thoughts like I usually get during lunch.
At 1400 lecture was over and optionally we were asked to stay an extra hour for an exam review.

When that was finished I walked to my car, briefly enjoying the sunshine and warm temperature and then drove to work.  I got to my work and ran to the bathroom, switched out of my sweatpants and threw on my jeans and got to my desk and started working. 
I’m scheduled to work until 2030 tonight, and I just had my second break for the day about thirty minutes ago. 
To say this day has been one of the longest days of my life would be nearly correct, yet in the back of my mind I can’t stop thinking about the upcoming exam I reviewed for today.  

Lastly as I sit and write this entry out I wonder if I’ll ever truly feel relaxation again…?

Tuesday, April 5, 2011

Cardiology - First Impression

Yesterday was my first clinical day in the hospital setting on the cardiology floor.  I was nervous and slightly scared because I didn’t know what to expect. 
There were ten nurses scheduled that day so each of us students got to shadow a nurse, even though we were only on the actual floor for about an hour.
My nurse’s name was Jessica, who had three patients under her care and one new transfer from the sixth floor.  During the hour I was shadowing Jessica, we went to get supplies for her to change an IV on one of her patients who had been there for more than a week.  This was the fourth day the IV had been in his vein and their policy is to change veins every fourth day, so I tagged along and watched. 
Jessica made light conversation with her patient who was a 57 year old male all the while she was searching and trying to insert a needle into a new vein on his arm.  With no luck, Jessica gave up trying to use the vein she was fishing for because she said every time she tried to inject the saline she kept coming up against a valve, so she was going to try his other arm in a little while. 
While I was looking at the patient’s skin I noticed discoloration probably from the many years of exposure to sun from farming and wondered how Jessica could find a vein at all.  I followed Jessica to the supply closet to get a warm blanket that she explained she would wrap around the patients arm to help bring his veins closer to the surface of his skin(kind of a neat trick but I wasn't there long enough to see if it worked).
While the blanket was warming the patients arm, Jessica and I went to see the new transfer patient.  The new transfer patient was a 68 year old female who had bypass surgery and was accompanied by her daughter and daughter-in-law. 
Jessica came in and did a QUICK head-to-toe assessment first starting with questions on the patient’s pain rating then moving on to her legs.  Jessica looked for swelling and supposedly felt the pedal pulse over the ted hose and slipper/gripper socks(I don't think I'd be able to feel them if I had tried).  Then Jessica listened for respiratory/heart/bowel sounds by only placing her stethoscope on four areas of the patient’s body (this was way different than what we’ve been learning).  Then Jessica finished off by explaining how to use the call light and tested the patient on what button to push. 

The patient was concerned with my lack of talking, which made her nervous and asked me, “Why don’t you talk?”  I answered, “I’m nervous too and don’t know what to say."  Then I went on to say "Never mind me; I’m just here to learn.”  Then because of my admitting being nervous, the room erupted in laughter and the patient winked at me.
I learned what a COW (computer on wheels) was and I’d say my experience was 90/10, meaning 90% of what I heard I didn’t know and 10% I think I knew.  LOL!
Overall, I love the fast pace environment of the cardiac floor, but not too sure I’m smart enough.  Can’t wait to see what happens next Monday when I believe I’m on my own as far as having one patient assigned to me.  I’ll have to do a complete head-to-toe assessment on the individual and document everything I found including vitals.  Please pray for me!

Sunday, April 3, 2011


My first clinical day in the hospital is tomorrow morning at 8am on the Cardiology floor. 
I'm super excited, but I'm sick of listening and working on the CBT's tonight which I should have done this sooner, but didn't (CBT's stands for computer based training for those of you who don't know what that means).
I don't know if I ever mentioned this before but way back when I was going through my pre. req. classes I had a dream that I would be a cardiology nurse, but who pays much attention to dreams?  I can't say, in my awake state that I'm as interested in this specialty, but you never know what the future holds for me. 

Saturday, April 2, 2011

Fun time tonight - KCAs

Guilty pleasure, I'll have to admit:  Nickelodeon’s 2011 Kids Choice Awards!  I totally was watching this show with my son tonight and just love all the hub-bub, and another guilty pleasure admission, I can't wait to watch iCarly next Friday to see if Sam admits she's in love with Freddie...

Pretty sad I know but this is what I find amusing when my nose isn't in a book studying!