Female Nurse Action Figure

Nicaragua Journal -- Monday, March 12

2007-05-21T14:39:00.000-07:00

Tea Camp was our first all day clinical. Our clinic was set up in a school building. Andrea, Romel, an RN named Joey, and I were in charge of scabies/lice baths, which he step up on the back side of the building. How these baths work is first strip them down and set aside their old clothes, scrub their skin with antibacterial soap and rinse, and then spray them with a high concentration of DEET spray (or something similar). After letting them drip dry, we would give them a new set of clothes and new flip flops. The little girls would get a new hair band too. Lastly we would tell them to boil their old clothes in water to kill the scabies and lice. (I really don't have any pictures from this. I felt bad taking pictures of naked children.)

Romel really took one for the team by holding the squirmy babies and little kids while Andrea and I washed them. He would be all wet by the time we were done. Thankfully scrubs dry fast in the sun. During breaks in the action, we would play bubbles while the kids ecstatically chased after the bubbles. I took a video on my camera of a kid using sticks and stilts. Every now and then when a family would see my washing someone else’s kids they would mob us to wash their kids, but we would try in the little Miskito and Spanish we knew that they needed to see the doctor/nurse first before they could have their children washed.

While we were washing kids, one girl limped out of the woods towards us. She had makeshift stitches on pad of her foot in the crease behind her toes. The wound was 2-3 inch cut was not approximated. We cleaned the dirt that we could get to on the outside of her foot and between her stitches.

I felt bad that towards the end of the day we were running short clothes that we had brought. Thankfully there were a few big t-shirts in the stash that we were able to put on them so that they could go home at least clean and not naked.

A funny event on the way back to Francia was that Tompaul almost lost his yellow cap. All the sudden someone yelled out “Stop, stop, he lost his hat!!” By the time we stopped we were already down the road a ways. Joe got out with Tompaul to look for his hat. Joe took off right away with Tompaul trying to catch up. We waited for a while for them to come back without success. In the meantime we backed up quite a bit in effort to not make them run back as far. The funny thing is that after they got back in and we starting taken off, someone spotted the hat on the side of the road.

Nicaragua Journal -- Sunday, March 11

2007-05-21T14:23:00.000-07:00

The first task of the day was to organize and clean our local clinic Tasba Raya—the base of our operations where all the meds and equipment are stored as well as children’s clothing and shoes. First we unloaded the supplies we brought with us that consisted of medicine, toothbrushes, medical supplies, clothing, shoes, crayons, and coloring books. New medications were restocked and expired medications (up to particular dates) were thrown out. Tylenol, children and adult vitamins, and mebenazole pills were sorted into small bags to be taken with us. The clinic was swept and counters washed off. Clothes and shoes were sorted by size and age group. Health care records were sorted and prepared for the half day clinic we were going to do that afternoon.

While all of this was taking place, families crowded around the clinic to see what we were up to and to come to see if we were open so they could be seen. I listened to Rilla taking to the children in Miskito. Whenever any of us would try to speak to the children in Miskito or Spanish they would laugh and laugh.

That afternoon we packed up supplies and drove 30 minutes away to the village of Santa Clara. It did not take long after we entered the village for many children and adults to take notice. The villagers followed us to a church building where we set up the clinic. There were different stations that we set up in the church building. First there was records where the pastor’s wife from Francia Sirpi found or made a family’s files. Second, we would have people doing intake of vitals and weight. Next they would be sent to one of three four groups where they would be triaged, diagnosed, and treated. Each group consisted of a nurse/doctor and student nurses. We also had a pharmacy area where two students would gather medications that the doctor or nurses prescribed for them. At another location, students would be waiting to give scabies/lice baths to little children. Each of our clinics over the next few days was set up similar to this.

All the children were lined up and given a mebenazole and vitamin to chew and swallow. After a child showed that they had chewed and swallowed a pill they would get a crayon and a coloring page to play with. Jessica and I were in charge of intake taking blood pressures, pulses, temperatures, and measuring weight. It was overwhelming at times with all the people who were coming in to be assessed.

Nicaragua Journal -- Saturaday, March 10

2007-05-03T14:16:00.000-07:00

We woke up early the next morning and got ready for church and ate breakfast. Some of the people in our group went to the village of Wisconsin for church, while the rest of us attended to local Adventist church in Francia. It is a tradition that guests to a church in

Nicaragua

perform a special music and/or the provided the sermon. No one volunteered to speak up front, but we decided that we could pull off a special music. Joe found a guitar to borrow and played for our song. At first we were not sure what song to sing, but decided on the song “Light the Fire.” Beth Ann wrote out the lyrics for people that did not know the words.

We walked down the road a ways to the wooden church that was already busy with children and adults. Sabbath school was split into three groups. One group studied the lesson in Miskito, the other in English, while the children went outside for their own program that included a bible story, music, and a craft. I stayed in with the English lesson, but would peer out a listen to what was going on outside with the children every now and then.

Our special music was broadcast on the Miskito Adventist FM radio station. We were asked to come up a second time later on in the service to sing another song. We decided on the spot to sing Kum Ba Yah, which we had earlier been joking about maybe singing when we were coming up with ideas of what to sing. It actually turned out very well and sounded great.

That afternoon we went on a hike through the jungle to a nearby river. The water was nice and cold after the long hike. After a while of wading, I decided to join some of the others who were swimming in the water. We swam across to the other side of the river, but did not stay there very long after Rilla mentioned that there might be crocodiles nearby. I was not sure if I believed her, but I decided to not take the chance.

When we got back to camp from our hike, a group of people who had been checking out the village drove up in the truck. The truck had hurried back with an American missionary that had been there longer than us (arrived before us) had been attacked by a swarm of fire ants and was having an anaphylactic reaction with respiratory symptoms and was near collapsing. Jessica, who is allergic to sesame seeds, had two epi-pens, and grabbed one for her.

Nicaragua Journal -- Friday, March 9

2007-05-03T14:00:00.000-07:00

For breakfast the next morning I had a croissant, cinnamon raisin roll, watermelon, white pineapple, and some really good peach juice. We ate outside on a covered patio. It took the time to relax and enjoy the nice morning breeze before another long day of traveling.

Back at the airport we boarded a regional flight across the country to Puerto Cabeza on the east coast of

Nicaragua

in Miskito country—and I’m not talking about the insect, it is the name of the Indigenous people who live on the east coast of

Nicaragua

and

Honduras

. Even though the plane we flew in was small, it was not nearly as crowded feeling as our plane from Omaha to Houston. It had the same seating arrangements though. I was likely enough to grab a window seat on the single row side so that I could get a good view of our trip. During the flight everyone was surprised by a short but obvious drop we took that woke most people up.

The last leg of our journey was on the back of a truck from Puerto Cabeza to Francia Sirpi—our final destination. Jeff said that this drive was notorious for being an 8 to 12 hour drive over bumpy and even hazardous roads. Once we left the airport we got our first taste of what e would be like for the next week. The houses and other buildings around us reminded me of Tamuín,

Mexico

where I went for two mission trips inlif academy. The main things that caught my eye was the stop sign “Alto” and the elaborate security system gates and fences lined with jagged glass pieces to keep intruders out that I had commonly seen in Mexico. These were use signs that we were not in Nebraska any more. Southern Adventist University met us at the airport with the truck that we would be traveling in. They had just spent their spring break in Francia conducting clinics and now it was our turn.

I did not truly realize how much luggage we had until we plied in onto the back of the truck. Everyone found a place to sit squeeze in between and on top of luggage. I sat with my legs dangling over the side of the truck next to a girl named Lesky who was a native Miskito who not only spoke Miskito, but also some English and Spanish. Her grandfather lived in Francia and when she heard about our trip she decided to come with us and help us with our clinics. She told us that she wanted to be a doctor or a nurse someday. A Nicaraguan physician named Dodanim J. Gurdián B. from Managua also joined us. Do not ask me to pronounce his name. The only way I know how to spell it is because he brought his signature stamp with he stamped on a piece of paper for me to see. We decided to just call him Dr. G or just doctor. He speaks Spanish and only a few words in English. Rilla was his main translator.

Thankfully the drive only took us about three and a half hours. By the end of the trip the dust and wind was really getting to my eyes. Contacts and dust do not mix!! Everyone and everything was very dusty specially the luggage and people in the back of the truck. Tompaul, Romel, and my backpack were very dusty.

Everyone was tired and hungry as we pulled into drive way of our new home. Cristina, who I believe is on the board of directors for the Tasba Raya clinic in Francia Sirpi, warmly greeted us and showed us to our rooms and where the showers, outhouse, and kitchen/dinning room was where food was being prepared.

Nicaragua Journal -- Thursday, March 8

2007-05-02T22:09:00.000-07:00

This is the first post of several reviewing the mission trip that I went on during spring break for my Frontier Nursing class to Nicaragua.

***

Thursday, March 8

This morning at 5:45 am my journey to a new country began. My Frontier Nursing class gathered at the Nursing Building to load up the coach with all our luggage and drive to Omaha. Our Continental flight to Houston was in a really small plane only 3 rows—1 on one side, and 2 on the other side. It was quite stuffy on the plane especially since they air conditioning was not working yet. I do not remember why it was working, but thankfully was not out of commission for every long. I sat next to Erica on flight who was very stressed out about the plane right. Apparently she gets motion sickness and I do not think the stuffiness at the beginning of the flight helped much. I was really impressed tough that we got a free snack pack. I was especially impressed because airlines have begun a nasty trend of not offering free snacks and have been threatening to stop complementary beverages.

During our layovers we taught people how to play Dutch Blitz. It soon became a smash hit with our group. While in Houston we met up with two more members of our team—a nurse named Craig and our videographer Tompaul both from Tennessee. Apparently this was the Spring Break for missions work in Nicaragua because we saw a Canadian non-domination Christian group that was going to help build an orphanage.
Our flight from Houston to Managua, the capital of Nicaragua, was a larger plane with 6 rows. For the first time ever I got to watch a movie on a plane!!!! I think at this point the fact that I was flying internationally was finally setting in. When we landed I would be in Nicaragua—the moment I been waiting for since my freshman year at Union.

Our plane came to a screech halt in the small international airport in Managua. As I stepped of the plane into the terminal I made a stunning realization as the cool air in the room breezed across my skin. This would be one of the last times that I would be in an air conditioning building until I would be back in the airport going home.

When I stepped outside for the first time, I was pleasantly surprised. Even though there was a blanket of humidity, the sun was set so there was no heat beating down on us, and a light breeze was blowing. I could also smell a hint of coconut in the air. The Best Western hotel we stayed the night in as located across the street. It was a very unique hotel—at least in comparison to hotels I’ve stayed in. I guess the best way I can describe it is that the hotel rooms were in cabin like buildings in groups of 4 or more, with outdoor pathways connected them to the main office/reception, two pools, and a dinning area. The rooms that the students stayed where very different from any hotel I had ever stayed in. Each room had 3 single beds. (The picture with the stain glass window was taken the next morning in the main office/reception).

After enjoying a swim in the pool, I took a shower, used the cyber café at the main office to send out my last e-mails and check myspace for the last time before we left “civilization,” then went to bed to sleep after a long day of traveling.

A Moment of Insanity to Keep Me Sane

2006-09-26T13:43:00.000-07:00

This is totally unrelated to any nursing subject except maybe some psychological disorder that you might study about in Psychiatric Nursing. Even so, it has helped me to release some stress by laughing up a storm.

Video clips were taken using only a digital camera. There is lots of goofs, but it was fun to create. I felt like busting out laughing during all my classes the day after we made this.

I hope that you find as much joy as I did making & watching "Buried Treasure."

Mission Accomplished!!

2006-09-08T11:25:00.000-07:00

Well, actually I haven't gotten to insert a urinary catheter in a real person yet, but.......two week ago I successfully started an IV on a classmate!!!!!!! This is big news because I've always had an incredible fear of needles, particular intravenous ones. The reason that I have been so afraid is that I have the worst veins to stick. I've always had traumatic experiences when even some of the most experienced nurses or phlebotomist tried to draw my blood. I actually haven't had an IV for many years. Insertion of an IV catheter is similar to drawing blood, but different in that even though you use a needle to stick the vein, only a plastic tube remains in the vein long term.

I was incredibly nervous and sick to my stomach about my IV therapy lab that was coming closer and closer. I didn't sleep well the night before. When I got to lab I tried to stay focused and calm. We first watched a few videos about how to insert an IV catheter and IV safety. Then we started practicing IVs on mannequins I could feel my stomach turn and my blood pressure dropping. I actually take to sit on the floor against the wall to recover from simply sticking a fake arm. After learning how to setup and spike an IV bag, our class got to take a break and eat lunch. I was afraid to eat too much because I have a history of vomiting while people dig around under my skin with needles.

When I returned from lunch, I paired up with my fellow classmate Harry to practice inserting IVs into each other. I decided to go first and stick him or I’d never get the nerve to do it especially after being stuck. I was really nervous, but thanks to Harry and Debbie’s patients and encouragement I survived. Harry’s veins turned out to be quite rascals. They kept rolling around and dodging the needle. I finally secured the catheter in Harry’s vein on the third try.

Last week I had two observations where I followed around a respiratory therapist and a short care/ambulatory nurse around for several hours. While I followed the respiratory therapist, I got to watch a surgeon insert a tracheotomy in a client. In short care/ambulatory the nurses’ job was to prep clients for surgery. I wasn’t very enthusiastic about it sadly. The reason was partially because I was still fighting off a cold/dealing with allergies (I’ve never figured out which is was), and in order to get a ride to be there at 6:15am I had to catch a ride with a group who had to be at the hospital at 5:45am for there regular clinical. Even though it was only 30 minutes early, what a wonder 30 minutes more of sleep can do!!

Next Monday & Tuesday are my first clinicals in the Oncology/Med-Surg unit. I also have a clinical conference where I present some sort of material to teach my fellow classmates. I’m not sure what I’ll each yet. I’ll have to come up with something on Sunday. But for now I’m just going to enjoy the weekend.

“The most beautiful thing we can experience is the mysterious. It is the source of all true art and all science. He to whom this emotion is a stranger, who can no longer pause to wonder and stand rapt in awe, is as good as dead: his eyes are closed. “ – Albert Einstein

Catching Up On Nursing

2006-08-19T22:17:00.000-07:00

Well....another semester has started at school. New classes, new challenges, and hopefully new blog posts. I will now attempt to catch you up on a few highlights from last semester and some interesting experiences I had during my summer job as a CNA.

After finishing up my on-campus training & passing my med-math exam I was assigned to attend clinicals at an Orthopedics/Joint Replacement/Spinal Care Unit at a local hospital from 5:30am to 11:30am. the night before each clinical we would met at the hospital with our clinical instructor to get our assignments and find out what medications would be given the next day. After taking notes from the client's care plan, initial assessment, & list of medications, we would introduce ourselves to our client then go home to look up the purpose, action, and side effects of each drug we would be giving. The only meds we were not allowed to give were IV meds. The most nerve-racking part of clinicals was when you first walk into the client's room and start taking their vitals. Many of the clients had just come from surgery the day before and hadn't gotten much sleep the night before, and there I was waking them up and bothering them.

I had 6 in hospital clinicals, a MRI observation, a home health observation, & a family clinic observation. During these learning opportunities I got to do several dressing changes, pull a knee drain, administer eye drops and oral meds, give several Sub-Q shots, give a IM shot, give several bed-bathes, and take lots of vitals.

This summer I worked at a nursing assistant at a nursing home in my hometown in Missouri. I was really nervous when I first started the job. There were so many things to remember and learn. Probably one of the most challenging parts was remembering the names of the residents and their preferences and quirks. I worked from the 2:30pm to 10:30pm shift. An average day consisted of filling residences’ water pitchers with ice, getting up residents up for activities and supper, passing supper trays and helping feed some of the residents, and put residents to bed. During all of this I answered many call lights, helped residents to the bathroom, helped residents dress, did a lot of peri-care, and watched out for residents who fall-risks who would try to stand up out of their wheel chairs—a chair alarm would go off if they tried to stand.

One time when I was putting to bed a lady, she asked me to tell her a bedtime story about Cinderella. I was surprised when she asked me. Even though I was kind of in a hurry, I decided to stay a little while and tell her a quick version of the story. Even though I wasn’t too impressed with my on-the-spot story telling skills, the lady seemed very attentive and even made comments about the story. I could tell she liked the attention and really didn’t want me to leave.

I got many comments on how pretty my hair and skin was, which I though was pretty funny because I was sweaty and hot after running around everywhere and my hair was usually in a frazzled mess. Apparently I surprised many of the gentlemen there too with my strength when transferring them to and from bed.

Another interesting moment I experienced was almost dumping a urinal that I was going to empty in the restroom. I forgot to step over the empty wheelchair’s foot rests and thankfully landed on my knees, not flat on my face. I triumphantly raise the urinal in the air to my relief that I had not spilled a drop.

Some of my most interesting stories are from the Alzheimer’s Unit, but that’s another blog post or too that I wait to tell about later.

So far this week in my academic world I have gone to each of my classes once. Classes started on Thursday, so we had a very short week, even though I did a lot this week. I arrived at school on Monday afternoon. My dad and cousin Sean helped me move everything into my room. I was able to get all my stuff organized by the evening of the next day. Registration was Tuesday & Wednesday. After battling the financial part on Tuesday, I finished up my registration on Wednesday. I had already reregistered for my classes, so after completing registration I bought my books. I am taking Pathophysiology, Med-Surg (my hardest class—8 credit hours!!!!!!!!), & Christian Ethics. Even though it is only 3 classes, they total up to 14 credit hours.

I will be keeping very busy this semester putting in 180 clincial hours split up into 3 areas: Med-Oncology, Madonna Rehab Hospital, & Orthopedics (same as last semester). I also am scheduled for several hospital observations (unsure yet of all specific locations): respiratory therapy, Lincoln Surgical Hospital, wound center, and operating & recovery rooms. I also have 10 exams each for both my nursing classes not including final exams.

I will try as hard as possible to keep my blogs up-to-date, but as you can see this will probably be quite challenging. I must keep plugging on, one day at a time with a hunger to learn the unknown.

A quick interesting quote for you to munch on: “Wisdom begins in wonder. “ – Socrates

What is Blogging??....I live under a rock!

2006-06-29T21:10:00.000-07:00

Dear Readers......if any of you are left.......,

Obviously you can see that I have neglected blogging. My life has been quite busy the last few months with Nursing School, a summer class, my cousin's wedding, vacation time with family & my boyfriend Brandon, and starting my new job as a CNA (nursing assistant) at a nursing home, so it's been hard to muster the creative strength to compose a blog piece. Therefore I have decided to drop-a-blog to let you know that I'm not dead.....yet.....

The month of July is dedicated to making money & taking care of elderly residents as a CNA. I'm hoping in a week to be settled into my job & can focus some free time towards blogging.

I need lots of prayers right now. I'm feeling somewhat overwhelmed right now with my new job, but I'm not too discouraged yet.

Check back soon for more blog posts and pictures!!

-- Michelle

Snow On The First Day Of Spring!!

2006-03-21T07:40:00.000-08:00

I arrived back at school on Sunday this week dreading school the next day. To surprise and delight, yesterday, March 20 was declared a snow day with all classes cancelled!! I could hardly believe it!!

Today my home health observation for my Fundamentals of Nursing Class was cancelled due to weather conditions despite the fact that my college is in session today. Therefore today is like another snow day for me !! There is about 6-9 inches of snow on the ground now and the snow is still lightly falling. I still have plenty to keep me busy though. I have a paper to write and a test to study for.

I hope everyone has a good week!! Be safe and have fun!!

Pictures soon to come....

Super Nurse!!

2006-03-20T14:22:00.000-08:00

http://www.nurstoon.com/

Welcome Back Student Nurse Michelle

2006-03-20T13:26:00.000-08:00

I just got back from spring break to nearly a foot of snow covering my college's campus and surrounding city. All classes and tomorrow's clinical have been cancelled!! I am actually scheduled to do a home health visit, so I need to call the nurse practitioner I'm shadowing. So now it's time for some major catch up.

I've been really busy this last month getting ready for clinicals. In the middle of February I finished up my on campus skills practicing and passed my skills tests. The different skills we had to practice 10 times each for the test were dressing changes, bed baths, bed makings, drug administration including Oral meds, IM & SubQ shots, folley catheters, NG tub feedings, nasopharynx suctioning, Oxygen Administration, applying restraints, a head-to-toe assessment (includes vitals), etc. I was pretty nervous during the skills test. I caught myself on a few mistakes, but told my instructor right away after I did it, and she didn't mark me off.

I survived hospital orientation and computer training at the end of February. Hospital orientation of the orthopedics, spinal care, and joint replacement unit, where my clinicals will take place, didn't take but a couple hours even though much of it was a blur. So much to remember!! Thankfully my instructor Amy is awesome and is patient and willing to answer questions and remind us on important details. Computer training was long and boring. It lasted about 5 hours on a Friday afternoon/evening. I missed lunch to get to the computer training on time, and almost missed getting to have supper because that cafe closed before I got back to school. Thankfully Jessica, my friend and fellow nursing student who I carpool with, took me to Chipotle--the most awesome fast food burrito joint. It was a nice reward after a grueling and tiring day.

The Monday before spring break I went to the hospital with Jessica and Harry to get our client assignment and do our pre-assessment. I looked through my client's charts including the doctor's orders, medicine prescriptions, initial assessment data, lab work results, and the most current assessment data. I wrote down important data on my clinical log sheet, and jotted down any extra info that I would need in some notes. I looked over the chart with Jerry, a fellow nursing student, who would have my client in the afternoon.

After the pre-assessment I buckled down in front of my computer with the list of meds and my Drug Guide to write down the actions, purpose, and side-effects of the drugs that my client was taking. It was crazy how many meds my client was on--over 20!!! About 8 or 9 of them were PRN drugs (given as needed). I took me a few hours to write them all down. It was about 10:30pm by the time I was done. I decided to lay out my uniform and gather all books and supplies I need to take with me the next morning, so that I wouldn't forget anything. My friend Amanda was kind enough to sew on my student nurse patch on my scrubs.
--
Sorry to interrupt this story, but I must get back to some studying. I'll fill you in on my first bright and early clinical experience later.

I don't really have any good advice right now besides GO TO BED!!! Sleep is good!! Don't stay up all hours of the night when you have to get up early the next morning. Therefore don't procrastinate so you don't have to cram all night long!!

Lost in Missouri (it's a good thing)

2006-03-14T00:21:00.000-08:00

Well actually I'm not too lost. It's thankfully spring break for me. I've just been doing almost nothing lately, which is qute different from recent events that have kept me from blogging entirely. Hopefully I will find the time to compose a blog or two of my recent experiences back at school--specially describing my first clincial experience!!

In the meantime I found this silly quiz thingy while I was surfing around in MySpace land.

Your Monster Profile

Infamous Chemist

You Feast On: Fingernails

You Lurk Around In: Swamps

You Especially Like to Torment: Emo Kids

What's" Your Monster Name?

Mucous, Feedings, & Vital Signs

2006-02-06T09:05:00.000-08:00

Check out what else I've learned lately in Nursing Classes:

In Fundamental of Nursing I learned how to suction mucous from the mouth, and from the nasopharynx and nasotrachea. The “naso” ones require us to “shove” a tube down the client’s nose, which looked quite uncomfortable on the demonstration video I watched. Thankfully we only practiced on the mannequins. With naso-suctioning I also practiced using the sterile gloving technique. I also learned a very similar technique for inserting nasoenteral and nasogastric (ng) feeding tubes.

A really important skill we also learned about was oxygenation, dealing with checking someone’s O₂ saturation and PaCO₂ levels. I got to practice apply a nasal cannula and oxygen mask to the mannequin.

Another skills in Fundamentals I learned were wound dresses. My fellow nursing student friend Joe and I assisted each other in a simple dressing, and two other more complex dresses, one of which including wrapping a foot with gauze and an ace wrap, and the other we had to pack in with strips of gauze. Now I don’t know if anyone reading this has ever tried packing a wound of a mannequin before, so I will let you that it is really difficult, especially if it is on the mannequin’s side. The gauze just fall out after you have tried to push it in with a long Q-tip and tweezers. Therefore our teacher pretended to be the wet oozing tissue (what a job!!) and held the gauze strips in until we were ready to apply the gauze 4x4 squares over the wound to be taped.

In Nursing–Physical Assessment my nursing buddy Misun and I practiced checking each other’s blood pressure, as well as practicing on a blood pressure programmable mannequin arm, and to hear what an auscultatory gap. We also tried out a mercury blood pressure, which are quite accurate, but are not commonly used anymore because they are an environmental hazard. Our teacher also had us try taking a thigh blood pressure, which really hurt—I now mostly understand what it would be like to have all the blood squeezed out of my leg.

Misun and I also took turns taking each other’s temperature with different kinds of thermometers, such as electronic axillary and oral thermometers, and a tympanic membrane thermometer for the ear.

Also, in connection with our foot care skills lab, we also had to check different kinds of pulses—radial, ulnar, brachial, posterior tibial (lateral edge of ankle), and doralis pedis (top of foot near big toe), and rate them on a scale of 0 to 4. Some of the pulses are hard to feel—especially the ones in your foot. Apparently I am a good lab partner, because when my teacher was using me as a demonstration, she was vastly impressed on how strong all my pulses were.

Another pulse we took was an apical pulse of the heart using our stethoscopes—counting the beats per minute, and listening to and counting the respiration rate of our lab partner.

Next month I will be volunteering at the Foot Clinic where I will be washing and assessing the condition of homeless peoples feet. I will also get to give them new socks. The homeless people who have signed up also get a new pair of shoes every six months. In skills lab we practiced washing and assessing each other’s feet, including palpating (feeling) those different pulse sites. I found it quite challenging to feel pulses with rubber gloves on. I was kind of embarrassed the entire time, because I hadn’t shaved my legs recently and they were quite prickly and noticeable hairy when I rolled up my pants a little.

Until my next blog entry, “Wash someone’s feet. It’s quite a humbling experience.”

Histories & Competence

2006-02-06T08:52:00.000-08:00

Well I knew it would happen. I would not faithfully keep up with this blog on a weekly basis, but maybe that's good. It's probably better that I spend more time studying then journaling anyways. During the last two weeks I have learned many new things in my nursing classes.

First of all I was proud of myself. At the end of last month—I finished and turned in all my health history forms I had to fill out for Nursing Assessments. The assignment was to do a long exhaustive health history on someone asking all the little invasive questions you can think about and more about the body. I also had to take one health concern from the health history report and focus in with a symptom analysis, and do a initial observation assessment on a person—evaluating their appearance, gait, consciousness, reporting complaints, and writing a brief problem centered history report. The last assignment I had to do was a Mini-Mental State Exam on someone. The mental exam was probably the most funny to hear stories about from different students who gave the exam. There was a list of seemingly easy questions you would ask that ended up being a more tricky then you thought, therefore it was quite funny when a college student who was seemly sane and healthy mess up on the exam.

Here are some of the questions on the exam. Test them out on someone to see what results you get. Make sure you do them in this order.

(5 pts) – Time Orientation:
1. What is the year?
2. What is the season?
3. What is the month of the year?
4. What is the date?
5. What day of the week is it?

(5 pts) – Place of Orientation:
1. Where are we now?
2. What is the state?
3. What is the city?
4. What part of the city are we in?
5. What building are we in? What floor?

(3 pts, 1 per word) – Registration of three words: Listen carefully, I am going to say three words. You can say them back after I stop. Ready? Here they are…. PONY, QUARTER, ORANGE.

(5 pts) – Serial 7s As a Test of Attention and Calculation: Subtract 7 from 100 and continue to subtract 7 from each subsequent remainder until I tell you to stop. What is 100 take away 7………? (continue 4 times)

(3 pts, 1 per word) – Recall of Three Words: What were those three words I asked you to remember?

(3 pts) – Comprehension: Listen carefully because I am going to ask you to do something: (1) Take this paper in your left hand, (2) fold it in half, (3) and put it on the floor.

(1 pt) – Reading: Please read the following and do what it says, but do not say it aloud:
Close your eyes.

There was also a Drawing section where they had to copy a picture of two overlapping pentagons, which is trickier then it appears.

Until next time: “Don’t feel too stupid if when recalling the date you say or write 2005 instead of 2006—we all do it.”

Mission 2000 Hz -- Screening Your Growth

2006-01-19T09:06:00.000-08:00

This morning was the most fun I've had for a class in quite awhile. Today was my Nursing Physical Assessment skills lab, and my group did the screenings for height, weight, eyesight, and hearing for the elementary school nearby. We tested students ranging from little 1st graders to 7th graders.

I was in charge of checking their hearing. I was set up in the principal's office that had a dense glass window in the door (one that you would have to stick your nose and eyes against to try to see anything on the other side). As students came into the office, I asked them to sit down in a chair, then explained that when they heard a beep in their right ear, to raise their right hand, and when they heard a beep in the left ear, to raise their left hand. Simple right...well with little kids it's not quite that easy. I usually made sure to point or touch their hand and corresponding ear so that they would understand, especially after one little 1st or 2nd grader said, "I don't know my left and right hands." I wanted to giggle, but decided to be quite and not to come across as if I was making fun on him.

Next I helped them place this monstrous old-fashioned looking headphones over their ears. I felt bad because if they weren't placed just right, they really pinch and dig into their heads. I had to stop and readjust them a couple times, when they were complained of it hurting, and made sure to ask them if they were still hurting. After headphones were firmly, and as comfortably as possible, in place, I began the hearing test. The headphones were attached to this old blue box that had dials and buttons on it. One dial adjusted decimals and the other dial adjusted frequencies. The decimal that we were suppose to test was 20 HL, and the frequencies were 1000 Hz, 2000 Hz, and 4000 Hz. As the student signified that they heard the beep in their ears they would raise their hand, and I would circle the R or L on their sheet for each frequency. Every now and then I would throw in a 3000 Hz to mix things up a bit.

One 2nd grade one commented, “That’s one strange looking contraption you have there!” I smiled big and was amazed at his extraordinary vocabulary, "You're quite right, it is crazy looking."

Sometimes the students would raise the wrong hand, so after testing other frequencies, and I would go back a test that ear again, and if they raised a hand I gave it to them. As time went on, I felt more comfortable to reaffirm them, and explain my instruction gain. When they couldn't hear a beep at all, I would raise the decimals some and test again. Usually it didn't need to be adjusted much, but I would test back at 2o after testing at a higher decimal. If they heard the beep at a higher decimal, I indicated on their check sheet. It was noisy in the hall when people passed by, so sometimes I tested an ear again if there was no response. Another challenge I encountered was when I switched back and forth between left and right, the buttons made a clicking sound. I caught a couple students raising their hand before I had pushed the button knowing that I had just switched ears.

During the tests it was funny to hear and peek over at the students waiting outside the door. They would be whispering (or talking loudly, which required me to ask them to be quite) comparing weight and height, and announcing that they were going to have their hearing tested next. Sometimes they would press their bodies up against the window to try and see inside.

One student commended to my professor as she dropped a student off in my line, "So there is two at a time in that office right?" My professor responded, "No, only one. That's my student nurse who's testing your hears."

I felt proud and special sitting in the principal's office as Union's student nurse. To some extend I feel old when I look at these young students, but at the same time, I don't feel very old. At one moment, I almost felt like skipping off when one of the little girls after testing her to go outside for recess. It was also cute seeing some of the little ones helping direct other students showing them where they should go next.

The time really flew by—the screenings only about an hour and a half. I have nothing much else to say other than that I really enjoyed that experience and it was fun imagining being a little kid again.

Now, don’t be a stranger to my blog. Come back again soon. My advice to you this time is: “Sometime this next week take time to play with little kids, or go out to a playground and swing on the swings, and climb on the jungle gym.”

Sidekick:

2006-01-18T09:22:00.000-08:00

Meet my new buddy & sidekick:
Neal the "Male Nurse Action Figure."

He is my insipration for the title of this blog. My dad is a nurse in the ER, and one of is co-workers gave this to him. My dad then decided to give it to me. It is thumb-tacted to my bulletin board watching over me as I study (lol!!).

Notice he comes with stethoscope and x-ray clipboard. If you look closely the x-ray is of a person's skull speared with a fork!!

Early Tuesday Morning

2006-01-17T08:26:00.000-08:00

I just got back from my first Fundamental's skills lab. Overall I think it went quite well. I definitely learned a lesson in humility.

I woke up this morning, and the still dark hour of 6:15am. After stumbling into my swimsuit and clothes, and getting ready to leave, I gathered my granola and milk for breakfast, as well as my toothbrush and toothpaste to be used in our skills lab. Today we practiced feeding, teeth brushing, bed bath, and bed making skills.

Our first skill to be practiced was Hand Hygiene. After watching a video about hand washing, everyone lined up to have skills lab assistant squeeze this neon-orange goo onto our hands. After rubbing it around, we took turns using the hand washing skills we had been taught. After a through wash, rinse, and dry, we proceeded over to have our hands judged under a black light. If there was till glowing orange spots on our hands we had to go back and scrub some more. My first test showed that I had a little left in my knuckles and around the cuticles of my fingernails. I must remember to pay extra attention to those areas.

The next skills to be practiced was feeding and Oral Care. My friend and fellow student Jessica and I decided to pair up. I went first, treating Jessica like royalty. She didn't have to lift a finger (lol!!). The meals consisted of cereal with milk. When I finished feeding her it was time to estimate the amount and percentage of the meal that she ate. It is important to chart Inputs--food and drink going into the body, and Outputs--waste, vomit, wound secretions exiting the body (aka Is & Os). After that was completed, I brushed her teeth. I used a small narrow curved bowel called an Emesis Basin to catch drips, and for her to spit out the excess toothpaste, and rinse water. Something I learned from the experience that I need to remember, when serving fluids, particularly with cereal, to estimate or measure the liquid before I add the other food to it.

The next set of videos showed us oral care for the unconscious client, bed bathing, and perineal care. Thankfully we only had to watch a video demonstrating perineal care, but honestly it doesn't seem too bad. I just feel embarrassed for the client more than anything, but it will definitely be awkward the first time I have to provide that kind of cleaning.

After an unoccupied bed making demonstration by Prof. H, it was our turns to practice bed bathing and bed making an occupied bed. The interesting thing about making an occupied bed it that you end up making half of the bed at a time. You have the client lie on their side on half of the bed, then remove and tuck the old linens under the client, then making half of the bed, and tucking the clean sheets under the old ones, then have the client roll over to the made side, and removing the old linens completely, and so on. The main two considerations that I must remember is: keep the side rails up on the opposite site that I am standing on to prevent the client from rolling off, and to adjust the bed high enough to avoid having to bend and strain over the bed while washing the client and changing the bedding.

I am definitely relieved that I have learned those skills. I will be returning to the lab room through out this first half-semester to demonstrate these skills. I must have a list of skills checked of 10 times each before I am allowed to participate in hospital clincals.

The rest of today I plan to read for World Lit and Dev. Psych, and possibly take a nap. Until next time, remember: "be humble when serving others, because someday you may be the one in need."

In the beginning.....

2006-01-15T21:34:00.000-08:00

So here I am, after my first week of 2nd semester, sitting at my computer reminiscing...

Week In Review

Sunday: I remember arriving back at school the night before Nursing Orientation. I was excited and nervous; soon I'd been starting nursing classes. After I set up my computer in my room and hooked up the internet, I knew I was at home to start another semester. The only set back was that I had a cold. My nose was running all over the place, and I was losing my voice.

Monday: First order of busy was to buy my books. I only have four classes this semester--Fundamental of Nursing, Nursing-Physical Assessment, World Lit, and Developmental Psychology--but I will definately have lots studying to do. I bought about $600.00 in books. I had to buy 8 books for Fundamentals. Walking back from the bookstore was definately a work out. My backpack was crammed full, and my arms piled high. My arms were so sore.

Nursing Orienation took place from 1:00pm to 7:30pm. Bascially we got our pictures taken for our ID cards for clincals, recieved our stethoscopes and blood pressure cuffs that we had ordered before break, listened to the nursing faculty explain the Department's handbook, watch a history video about the college's nursing program, and listened to nursing students and professors tell us what to expect and how to be successful in our classes and clincials. Best of all was that we got free pizza. In the end, I was quite overwhelmed. There was a lot in store for us. Even so, I was reassured that I would get through day-by-day.

Tuesday: Classes the next two days were out of the ordinary. Since we'd be getting the next Monday's class off for Martin Luther King, Jr Day, we were going to have Monday clases on Tuesday then following the normal schedule the rest of the week. Tuesday's class periods were consumed with analyzing syllabi. I had my first Physcial Assessment class--it look like a lot of fun, but I'm still kind of confused, but our teacher reassured us that it's normal at first (thanks!! rolls eyes). I don't know yet what time my clincal for that class will be, but my skills labs will be at 8:30am-1:00pm on Thursdays (1st half of semester). By lunch, confused and disoriented, my brain was about to call it quits.

After work in Admissions, and a quick supper, I sat down at my desk chair and tried to refocus. I opened my enormously huge nursing class syllabi, as well as the ones for psych and world lit, and wrote out my schedule in my planner. I also devised a homework to-do list. After that I got right to work on reading "Gilgamesh" for World Lit, and Unit 1 for Physical Assessment.

Wednesday: More classes.....first Fundamentals class period--not bad.....I like that Prof. H has all her powerpoint presentations already printed off for us in outline view for easy note taking and studying. But more on the challenging side, I found out when my clincal for that class is (starting in March)--5:30am to 11:00am!!!! Yikes!!! It's going to be sooooo early!! The skills lab in the class won't be too bad though, going from 7:00am to 11:00pm Tuesdays (1st half of semester).

Thursday: As I mention before, normally my skills labs for Assessments is scheduled to start at 8:30am, but this week it was changed to 7:00am and everyone in the class was required to attend (not just my section). I went to the cafe at about 6:30am to discover that it didn't open until 7. I was a little upset, but decided I coudn't do much about it. Thankfully Prof. K provided us with a little breakfast of delicious breads, some sort of melted pretzel mix, and orange juice. During the class we mostly discussed how to take health histories and about our skills lab the next week--doing the academy, elementary school, the the educational department's lab school's screenings. We'll be weighing them, measuring their height, and testing their eyesight and hearing. My group is going to mainly work with the elementary's school's screenings.

That night I vigorously did up my Med-Math homework and finished my Developmental Psych take-home quiz . For Fundamental's we have to take a Math test focusing on Medicine related calucations and terminology. We are required to pass the test 100%. Thankfully there are retakes, but I think I'll be ok. I just have to study a bunch of abbrevations and review some terms. The math part of the test shouldn't be too bad.

Friday: I worked two hours in admissions that morning, because Fundamentals class is only an hour on Fridays. It was definately the busiest 2 hours of work I've had in quite a while. If you already didn't know, I'm the Admission's Mailroom Team Leader. I've been doing a lot of organizing that last week trying to get everything squared away while working on a project for my head boss Rob. It just so happens that morning that I needed to make copies of an important form. The bad part was that the file on Quark was missing. I had to then take an older verison and reformat it with this year's info. Ok, not so hard, but time was slipping away from me. I almost done editing it, when Buell informed me that he needed 80 copies of the by Monday, and I only had 5 minutes before class. After printing off a copy, I rushed it over to Paula (my supervisor), to have her look over it for any mistakes, and explain to her that the file was open on the computer if there was any mistakes, and that I didn't have time to make copies. I also let her know that Buell needed copies too.

After my last class of the day, I crash for a few minutes in my room. Awwww!! But it's not time to completely rest yet. I decided to get a head start, and finished one page of skills labs about Hand Hygiene for Fundamentals. After that I cleaned up some clutter around the room, then chatted on the internet with my boyfriend (who is going to school in Washington) until supper.

Vespers was nice, I wasn't too highly impressed, no offense, but I enjoyed the praise service and the resounding presence of God and His peace as we welcomed the Sabbath. After vespers I decided to go back to the dorm--I was done for the night....at least I thought.

I almost forgot to mention--I have a new roommate named Natalia. She is from Paraguay. I think she is a really sweet and nice girl. We're getting along fantastically. That night we stayed up until 3:00am laughing and talking. The most fun was her tour of her home town via Google Earth, and her trying to teach me to roll my "r"s correctly in spanish.

Sabbath: Rest!! I was amazed, I slept until about 12:30pm. I totally missed Sabbath Experience and Church. I got up in time for lunch though. I'm kind of ashamed, but I think I put the sleep to good use. Thankfully my cold was almost over, I only had a few sniffles left. Through out the rest of the day I hung out with a few friends in the dorm, then decided to head up to my room at work on some blogging and e-mailing.

Suppertime on Sabbath/Saturday means one thing (specially to my friend Tim)--STIR FRY!!! It's my favorite meal of the week. After miraculously getting through line quickly (thankfully to a kind student who was talking to some friends), I had a nursing moment. I sat and quietly ate my stir fry for a moment or two with friends Claudia and Todd, until they asked about how my classes were. We somehow got talking about urinary catheters, and I told them a story my ER nurse dad told me about. There are some urinary catheters that have balloons attached to them that are inflated in the bladder to hold them in for prolonged periods of time. Usually that needs to be done for elderly that are ill. Well, in a few cases these elderly clients are disordiented and confused when they come into the ER, and have actually pulled out the catheter's while the balloon is still inflated!!!! OUCH!!!

That night I watched some episodes the first season of "House" with friends Liz and Shelley. I think the series is great, even though at times I find it a little unrealistic. I do enjoy it's medical style mystery feel, with a touch of "CSI" suspense.

Sunday: Today consisted of watching the end of the long programs of the men's, and the short program's of the women's National Figure Skating Championships, and doing homework--a common trend you'll find about my student life. I finished my skills lab quizzes, and a paragraph about why I have chosen Nursing as my future careeer.

Quite an interesing week I think. If you've made it to the end of all this....here's a pat on the back I'll try to keep everyone posted on my weeks, and hopefully be able to share some interesing stories.

Sooo until next week remember--"Don't pull out urinary catheters while the balloon is still inflated!!"