How is my clinical going?

Hey friends,

For today's post I thought I would share with you how my clinical is going. I am really excited about this clinical because it is my senior year leadership rotation. Which is just a fancy way of saying my preceptorship. For those of you who do not know, a preceptorship is sort of like an internship. I follow one specific nurse's schedule and complete 144 hours. That is a total of 12 12-hour shifts. My previous clinical rotations were eight hour shifts and the extra four hours really do make a difference. 

For my preceptorship, I was lucky enough to be placed on days at an ICU. I have never been in an ICU setting before and I am honestly loving it! I love that there is a multitude of learning opportunities. After each shift with my nurse, who is awesome, I ask her what I should look up to get better acquainted with the type of patients we see or with procedures that are common. Some items I have looked up so far are ventilators, COPD, ARDS, ABGs, and Arterial sheaths. (Maybe to piggy back off of my concept map post, I will create one on a typical patient I have seen in the ICU.)

Another great thing about my rotation this semester is that I finally feel appreciated as a student nurse. The unit I am on is so welcoming of me that I feel like a new grad who is getting oriented to the unit. I love knowing I am not being looked down upon. My nurse is also amazing in the fact she seeks out opportunities for me. I have been able to perform a new skill or see a new procedure each time I have been there. The first shift was in-line suctioning for a patient on a ventilator and placing a foley catheter on a male. (I previously have only inserted on females.) The next shift I got to see an arterial sheath removed and handle the extensive post removal monitoring. And for my last shift I got to see a TEE with cardioversion. This specific patient was in a flutter and we shocked with 50J then 100J to get back in sinus rhythm. Unfortunately the doctor did not let push the shock button, but it was still neat to watch on the monitor.

I have even grown as a nurse-to-be. My preceptor really pushes me to take a more hands on approach with my patient care. Because we are 2:1 nurse ratio, she has me focus solely on one patient. This means that I am receiving report, completing assessments, charting in the computer and on paper, speaking with doctors, administering medications or treatments, and giving hand off report at the end of the shift. I was nervous in the beginning because I have never learned how to give report nor did I feel comfortable speaking with a doctor. Now that I have done it once or twice, I feel like I am getting into a groove. 

I am excited to update you guys later on how it is going or how I am growing as a nurse-to-be. I hope clinicals are good for you as well. Feel free to share with me.

Concept Maps

Hey friends,

Concept maps are a very important part of nursing school. Not only do they sometimes look as chaotic as your life, but they demonstrate relationships between topics. Showing relationships or connecting ideas helps reinforce your understanding of topics. It forces you to actively learn by creating links...And we all know how important learning concepts is rather than memorization. 

Generally there are two types of concept maps: tree, circle or a flow chart diagram. Neither is better than the other. It is simply based on your preferences.

A tree diagram allows you to branch off of one main point and multiple sub-points. 

Source

A circle diagram has no visible ending. Think of this one like how communication flows...continually from one thing to the next and back again.

Source

The most commonly used concept map style is a flow chart. A flow chart allows you to list each step in the process as it occurs.

Before deciding which style to use, you must decide what is your main idea. Than brainstorm related information off of it...definitions, equations, important signs to look for, or lab values. After gathering all the related information it is time to arrange on the page. Remember to place smaller details further away from the main idea.

Hope this helps! Let me know if you want more elaboration or actual examples.

Sorry I haven't posted

Hey friends,

Sorry I have not posted. I have been swept up by the business of school and finding out that my mom might be diagnosed with temporal arteritis or vasculitis. She currently lives with Thoracic Outlet Syndrome so this is a challenging time for my family. 

Any prayers or special thoughts for my mother would be greatly appreciated. 

Thanks for continuing to look at the blog. I will have new posts soon.

Relationships and Nursing School

Hey everybody! Happy Hump Day!

So I don’t know about other schools or nursing programs, but mine and Megan’s school and nursing program seem to have a lot of people who are engaged. While we may have our own opinions on the idea of getting engaged/married while in college, I often find myself wondering how it is that people can even think about planning something like a wedding while in school.  I’ve been dating my boyfriend for about two and a half years now, and while we talk about marriage and what we want in our relationship, we both acknowledge that we are not ready to get married or even engaged. I have one year left in nursing school; I have to study and pass the NCLEX-RN, and find a job to start paying off my student loans. My boyfriend, who I’ll just call DC, is getting ready to enter his Master’s program in engineering a few hours away from me.

While we love each other, we both know that we simply are just not financially ready to get engaged. We are selfish in that we are working on building our careers and establishing the foundations for a successful and rewarding life. Luckily, we are able to do it side-by-side.

I know it would not be possible to maintain a relationship, especially one that was long distance across the country for nearly two years, if it were not for clear, concise communication. It was hard when we were both busy, and just did not have the time to talk. I wanted to be able to share about my day or my clinical experiences, but time zones and schedules did not always accommodate. Needless to say there were a lot of petty arguments due to the lack of communication. What was actually helpful in that, was that even though we were apart, we learned how we each fought. This actually made the time we did have together that much more meaningful. We could clearly express our feelings and frustrations, move on, and enjoy our time together, despite what little time we did have.

At the end of the day, I did not always get in the study time I should have because I wanted to skype or talk on the phone. However, DC knew I was busy with nursing school, so he understood when I told him I really could not take the time to skype, especially in the wake of an exam or final.

Patience and understanding saved us from a break up a couple times in the last two and a half years. I think like anything else, relationships in nursing school require time management and sacrifice. For me, that was a lot of sleep I missed out on. But looking back, it was all worth it because we were able to grow together, and I had someone outside of my nursing world to talk to about anything other nursing.

How do you maintain relationships in nursing school? Is there anything that has helped you find balance between an actual personal life outside of classes or jobs? Please comment and share, we would love know!

Dealing with difficult nurses during clinical

Hey friends,

As clinicals approach or have already started for you, I want to provide you some ways for dealing with a difficult nurse. As a student, clinicals are exciting. It is finally a time to practice your skills and interact with patients. We expect our nurses to be welcoming and provide us with great learning experiences. We wish that something exciting will happen like on Grey's Anatomy. 

Yet, there are times when your nurse will tell you that they do not want a student or do not allow you to do anything. They might even ignore you or make it impossible for you to stay with them. It is hard to imagine why they would not want to teach us. As nursing students we will soon join the work force alongside them. 

We have all had (or are going to have) a nurse who just does not seem to like us. Maybe we messed up during a procedure or did not know what that medication was given for and now it just seems that as a student we are a bother to them. But before you make any judgments on your nurse, take a breath and realize that you do not know about their life. It is impossible for you to know if they are having family problems, just lost a patient, or have worked for the past three days. Judging them as a person is not going to further your education so just do not do it. Likewise might occur with a nurse. They have their own expectations of what you should and should not know as a student. Clarify with your nurse in the beginning what you can and cannot do. If a procedure arises, inform them that it is your first time, but would like to try with their guidance and assistance.  

Other times you might have a "lazy" nurse. This is a nurse who does not seem interested in showing you anything or just wants to sit with other nurses and gossip. A good way to overcome a lazy nurse is by coming to clinical with objectives. Let the nurse know what skills you want to practice or come with a list of questions. Some good questions to ask a nurse are their time management skills, how they choose which patient to assess first, or tricks for anything you might be struggling with. 

Overall it is always wise to come to clinical prepared to learn, with an open mind, and have objectives. Objectives help your nurse have direction for the day. At the end of the clinical day remember to thank them for teaching you and allowing you to shadow them. They are not getting paid extra to have you, so really thank them. And remember to not judge your nurse as a person. Focus on your education while demonstrating a professional, respectful relationship. 

Clinical Simulation

Hey friends,

I have the amazing blessing of being one of the senior clinical lab assistants to the Sophomore nursing class this year. This means I will be one of the students helping teach them skills such as vital signs, head to toes, med math, and subcutaneous injections. I am also tag-teaming with another student the simulation days where students will perform these skills in a room with a two-way mirror and mannequin.

Nursing school simulations are nerve wracking. At my school you are in a room with a creepy, computer controlled mannequin performing skills under constant observation. We are also video recorded which allows us to critique ourselves if we so choose to watch it.  

Preparing for these simulations can help relieve some of those nerves. 

You will probably receive some sort of paperwork prior to simulation that informs you of what the day is actually about. Research the medical history for your proposed patient. Make a concept map to help your brain connect ideas and remember them for tomorrow. 

It is also a good idea to do a basic head to toe on one of your roommates because this is most likely what they will be watching you for. Hide your cheat sheet of what you are supposed to do during a head to toe and see how well you do by yourself.

One beauty of simulations is that you are not taking care of a live patient, so take a breathe, you are not going to endanger anyone's life. You may be comfortable taking care of patients, but performing in front of professors is nerving. Take a breath and remember that they are just there to help you strengthen your skills as a nurse. 

Really view this experience as something to learn from. Ask your professors about any concepts you do not understand. If your simulation did not go as well as you hoped, then ask your professor to go over it with you.

My first simulation was a pretty basic patient. My professors were only monitoring that we correctly knew a head to toe and how to take vital signs. The hardest part of the day was getting my ear to tune out the mechanics so I could listen to the bowel sounds. 

If my video is still saved on the computer on skill and if I get approval from my school, I might post it on here, but I have to see. 

Hope this helps!

Questions to help you prepare for clinicals

Hey friends,

This is just a list of some basic questions to help you prepare for clinical. 

• Who am I taking care of? What type of code do they have? Any allergies?
• What is their current chief complaint?
• How long has their current hospital stay been?
• What are their vital sign trends? Are they stable or unstable?
• Did they recently have a procedure or surgery? What are complications that can arise?
• Are there any pending orders that need to be reviewed or take action on? (Are they going to surgery on the day of care?)
• What are their current medications? What are the side effects of these medications? Are they safe and appropriate for my patient to receive? 
• What three main body systems are going to be my focus with this patient?
• What teaching points can I address with them?
• What is my role as a student nurse?

Hope this helps you prepare.

Staying Positive in Nursing School

Hey friends,

As we all know nursing school is challenging and there will be times when you feel like quitting. You may not always get the grade you want on an exam after studying for hours or maybe you even have to be held back a year. Whatever the reasons are for getting you down, I want you to remember to stay positive. Be proud of where you are and for actually pursuing a dream. Take time to recognize the gifts you have! Find delight in knowing that you will be able to take of others. Being a nurse is not about the grades you get. It is about following that echo of a voice that told you to become a nurse. 

Ways you can do this is by taking nursing school one day as a time. Focus on what you need to accomplish for that day and nothing else. Create and complete a reasonable checklist. You can not expect yourself to read five chapters of a nursing textbook in day, so space it out. Use your time effectively.

Also let go of all and every expectation now. Do not concern yourself with what others are doing as well. Worry about yourself and solely passing the class. 

Finally, make sure you take some time during the week to do something you love. Lately my friends and I have enjoyed taking the kayak out for an hour and two. Being on the water brings a certain peace with it that truly allows us to refresh for nursing school. I am also looking into one of those therapeutic coloring books. They keep coming across my social media and looks like it would be something nice to have.

Remind yourself of the end goal and remember that everything will be worth it. I wish you all the best.

P.S. I am thinking about sending some readers a little encouragement note in the mail. Let me know if this is something you might be interested in. 

Clinical + Networking

Hey friends,

I am sure you have heard that finding a job as a new graduate can be difficult (and it is true). So what are some things you can do now to prepare yourself? well, it is actually quite simple and begins with your clinical rotations.

Make sure you network at clinical!

That is your biggest advice. This means presenting yourself in a professional manner regardless if you like the unit or the nurse you are with. Some great things to start with are showing up on time (if not early and ready to begin the day) and being willing to help other nurses and aides as well. Additionally show confidence without arrogance. 

Take some time to talk with the nurse manager of the floor or the charge nurse. Get a business card or set up a meeting. Ask what type of things they look for on a new grad's resume. Or maybe ask what experiences and leadership experiences they require of a new nurse. If that is somewhere you would like to work, then ask about the hiring process. Some hospitals may have a nurse residency that will give you extra training on the unit as a new grad. Get all your facts, tips, and dates in order and make a checklist for yourself.

Most nursing programs have a preceptorship or leadership component to them in their senior year. This is one on one experience with a nurse. Sometimes you are lucky enough to get one on a floor that interests you, other times you are not so lucky. Regardless you should treat your time there the same. Making a good impression on your preceptor can lead to an amazing letter of recommendation based on your clinical skills. Sometimes your professors in theory may not be able to comment on your clinical skills for a letter of recommendation.

The more open minded you are about clinical experiences and how you use your time for skills and networking the better. Appreciate the time you have on that unit and the effort your nurse goes through with teaching a student. 

What I bring with me to clinical

Hey friends,

This post is going to be simple because it contains all the fun stuff that I bring with me to clinical. I know I have talked a little bit about clinical on the blog before, but I wanted this to focus on the things I have within my reach at clinical. 

One// White Coat Clipboards by MD Pocket
I recently got to try these amazing fold in half clipboards that do not crease your paper and feature tons of great nursing references on the outside. There is a pain scale, normal lab values, normal ABG values, injection sites, and a little bit about EKGS. MD Pockets also makes yearly stickers to place over the ones on your clipboard to stay up to date on information. I love having this with me at clinical because it is great to keep information private and all in one place. It also has my name on it so no one will take it! 

Two// Badge Reference Cards
These tiny cards are super powerful! Just like my clipboard they feature tons of great information on them. What makes them different than my clipboard is that this is directly at my finger tips at all times on my badge. The ones I carry with me are pain scale, temperature conversions, and  normal lab values.

Three// Nurse Born Stethoscope Holder
You guys have heard me talk about it before, but I truly love the product. It is light-weight, user friendly, and sits comfortably on my waist. Great way to keep your stethoscope off your neck. 

Four// Nursewatches.com's Nurse Watch
I can not rave enough about how functional this watch is. I am able to locate the time quickly without fiddling with my wrist. It also is nice knowing it is easy to clean and more out of bacteria's reach (or so I like to think sometimes). 

Five// Code Happy Tote
I love how cute my nursing tote bag is and knowing it is antimicrobial is even better. The handles are very durable and there is lots of room to fit my stuff. 

Other miscellaneous things in my pocket are my bandage scissors, some alcohol wipes, my bic multi-color pen, and a small notebook. I also have my very precious Littmann stethoscope and nursing practicum syllabus. 

As I am sure you can tell, I really like making use of the technology and great products around me during clinical. What fun & functional things do you make sure to have with you?

First day of Senior Year

Hey friends,

So I am currently FREAKING OUT as I write this. Why you might ask? Because I have just finished my last first day as an undergraduate. Freshman year feels like it was just yesterday. Feels like I am still stressing if nursing was right for me. I still remember the day that I knew I was exactly where I was supposed to be. It was one of the nursing department's pre-nursing social events. We were watching Call The Midwife and having some raffles. The big prize was a Stethoscope! We were able to pick raffle numbers that day and I went with my favorite number 3. I had already won a shirt for the raffle, but the Dean decided to put all the tickets back into the basket. Everyone was nervously waiting for the ticket to be pulled and shortly she read the number 3. I could not believe that I had won. I never win anything in my life!

Just hearing that story may not seem like a lot by itself. It is really was happened the morning of that gives it meaning. I was really stressed out with grasping anatomy and felt like maybe I should change majors. Up to this point I had a C in Anatomy which would have kept me from joining the program. I had prayed about it and asked for a sign letting me know if I was in the right place. Well God really did give me a sign with a raspberry Littmann Stethoscope. Whenever I am having a rough day, I remember this moment. 

Now onto how my first day went. I was really nervous prior to today. I am not sure if it was because I had not really heard what these classes were like, if it was the fact that we did not have a syllabus, or if it was because it is my senior year. Lately I have been thinking about how unprepared I feel to enter the "real" world. It is scary to know that soon my own license is on the line now as I care for patient. Regardless of the reasons I really did not need to be nervous. Today went great. 

I have an early morning religion class sort of about living a holy life and what that looks like as Christians. I love how quirky and young my teacher is. It also helps that he is sort of anti-traditional teaching methods. 

Following that I have my nursing leadership class. I have never had this professor before and upon meeting her all I can say is how awesome she is. Her attitude is uplifting and really makes you believe in yourself. I cannot wait to learn from her. This class is where I will learn what makes a great leader, what team work as a nurse looks like, how to present myself for an interview, and resume building. Essentially it is truly preparing me for the real world. 

I also found out that my preceptorship (12-12hour shifts following a nurse)on an ICU unit. I luckily also got a day shift. Must be another God thing because I actually work at night and this would have been a big conflict. I have orientation on Thursday where I will actually learn more about the nurse. 

My last class of the day was a general education history course that covers the beginning of time to the 1500s. I am not looking forward to this at all. For some reason I am just not a fan of history. 

Of course my schedule looks very different depending on the day. I think I have a total of five classes or 15 units total. I am so excited to see what this semester brings for me and cannot wait to share more nursing items from my life here. I hope everyone else has had a great first day. I would love to read about your days.