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!
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. 
