Clever genius or Evil genius?
I have learned that sometimes in nursing, you have to trick your patients to help them. I know this sounds awful, but it is for their own good. Here is something I saw a few weeks ago, and I must admit, although it was slightly evil, it was extremely clever. My patient's roommate had severe Alzheimer’s. She was weak from not eating, but didn't like any of the hospital food. The nurse sat down by the woman's bed, took the lid off the food tray, and showed the food to the woman. "Hmm... what's that?" the woman asked. The nurse told her it was macaroni and cheese, and then offered her a bite. The woman put the food in her mouth, started chewing, and said, "Eww.. this is awful," but ate that bite. She refused to take another bite. As I mentioned before, she was weak and needed food, so it was important to get her to eat, but she was being stubborn and refused. So the nurse put the lid back on the food and left the room. She returned a few minutes later and sat back down next to the woman to do something else, when the woman pointed at the tray of food and said, "What's that?" The nurse lifted the lid and said, "Macaroni and cheese." The woman motioned for the nurse to give her a bite. The nurse obliged, and right on cue, the woman said, "Eww... this is awful!" So the nurse put the lid back on the tray, finished doing what she entered the room to do, and left. A few minutes later, the nurse sent an aide into the room to feed the lady a bite, leave until the woman had forgotten that the food was gross, and then return to feed her another bite. In my opinion, that is great nursing!! What do you guys think? Would you do the same, or fight the woman and possibly let her go hungry?
My boyfriend, the killer
Choices
Study for my huge final ~or~ Relax and watch TV
Winner: TV!! Was there really ever a doubt? ;)
Temporary insanity
If I were a monkey......
The nurse I was working with today let her patient lay in poop for forty-five minutes because she did not want to clean it. She explained to the man, who is paralyzed, that she would not clean him up because she wanted me to have the "learning experience." She knew that I would not be back for forty five minutes (my group was at lunch), but apparently thought that since he had no feeling, laying in poop wouldn't bother him. When I discovered what had happened, I wanted to take a handful of the stuff he had been laying in, walk up to her, and throw it in her face. From there, I would somehow tie her up for forty five minutes until I could find a student willing to clean it off her. But since I am not a monkey at the zoo and I am not allowed to throw feces, I had to keep my cool and behave. I also kept my mouth shut, except to explain to her that the patient was reasonably upset and yelling because he had been waiting so long to be cleaned. I'm glad I didn't say what was really on my mind, because this very mild comment was enough to send her running down the hall to find my instructor so she could tell on me for "disrespecting her." Why should I respect someone who is so cruel? I don't think I actually disrespected her. What do you think? What would you have done? I explained the whole situation to my instructor, and she understood where I was coming from and acknowledged that I had not said anything upsetting, but she still asked me to go apologize to the nurse because we are still at this hospital for another week and she doesn't want any bad blood. That was difficult to do, but it is amazing how you can make something sound like an apology when it really isn't. I said, "I'm sorry you feel like I disrespected you." I wanted to say, "I'm so sorry for any unfortunate patient who ends up with you as their nurse," but decided that I might get in more trouble if I added that apology clarification. Now that I think about it, I don't remember ever reading in our school regulations that I am not allowed to throw feces..... Next week might get interesting.
Confessions of a soon-to-be-ex-student nurse
Different paths
Path 1: (stairs) Path 2: (free fall)
Can you guess which path Isis took today?
My little brother sent me an instant message that said, "Katie, your cat jumped off the loft." I know Isis is not that stupid, so I thought Michael was just kidding. A few seconds later, another message, "I think she hit the door on the way down." Just in case he wasn't kidding, I ran downstairs and saw Isis sitting on the floor, looking very confused. The hallway door was half closed, so my wonderful cat had indeed hit the door on her shortcut downstairs. She seems ok, but I hope she learned that jumping off the loft onto a tile floor is not the wisest path to take!
Clinical instructors
1. I understand where you guys are coming from right now. I didn't graduate that long ago, so I remember how scary this really is.
2. I won't let you hurt a patient. I will never make you do anything you aren't comfortable doing without me right there guiding you every step of the way.
3. When you are doing something for the first time, if you are doing it wrong, I will stop you right away and we can go over the correct method. I will not wait until you are right about to mess up and then shout and startle you.
4. After clinicals, go home and rest! I'd rather have you well rested and ready to work tomorrow than have you do concept maps (yay!!!).
5. I will never sit and do crossword puzzles or read a book. I will always be with one of my students.
The worst thing a clinical instructor who has said #1-5 can say to her students:
1. I will only be working with you for two weeks. :(
As I think you can tell, our new clinical instructor, Rebecca, is wonderful. I have liked all my instructors (they have been nice people), but Rebecca seems to completely understand us and has her priorities straight (no concept maps)!!!!
Importance of gloves
When dealing with an infant with Rotavirus, even if your only job is holding the baby down so another nurse can change his diaper, WEAR GLOVES!!!
It went where?!
During the first few weeks of nursing school, the instructors told us several humorous stories about mistakes previous students had made while in clinicals. Listening to these embarrassing stories, I knew deep down that in a year, they would be telling some sort of story about me. Unfortunately, I think I was right. This event happened awhile ago, and I wasn’t going to post about it because I thought it was inappropriate or would make you guys uncomfortable. But several of my classmates who read this site have convinced me that you guys are mature enough to handle it, so I will share it with you.
We had a female patient who had been constipated for almost a week. She refused to let the nurses give her a suppository because she knew it would hurt. I went in to talk to her, and after explaining exactly how it is done (or should I say, is SUPPOSED to be done), and that it should not cause any pain, just a little discomfort, she agreed to let me do it. I found my instructor and was getting ready to give her the suppository. I put on gloves and opened the little package of lube. I squeezed it all over the suppository so it would go in easier. This was a big mistake. Apparently, you should only put a little bit on the tip, because when you cover the whole thing with it, you lose any sort of control over where it goes (see the foreshadowing here?). My gloves were slippery, the suppository was slippery, but the woman was nervous and asking me to hurry up and get it over with. I should have changed gloves, but I thought it was better just to get moving. What could possibly go wrong? It was difficult to get her on her side, so I couldn’t get her in an easy position to do what needed to be done, but I thought I would try my best. She was also extremely nervous and tense, which just added to the problem. I tried to put it in, but she was just too tense. I asked her to relax, and then tried pushing again. As I was pushing, I felt the suppository slip out of my hands. Crap! I looked down at the bed, but didn’t see it. I knew for sure that it didn’t go in where it was supposed to go, so I was thoroughly confused. I had her roll over a little just to make sure it wasn’t on the bed. It definitely wasn’t. That’s when the awful truth occurred to me: it had gone in the wrong hole. Not far in, but it was far enough to stay where it had landed. I stood back up and made eye contact with my instructor. “Is it in?” she asked. “It’s in,” I replied, giving her a helpless, concerned look. She didn’t catch on and started walking towards the door. I had to speak up now and swallow all of my pride, so I just blurted out, “It’s in. But I think it’s in her vagina!” My instructor froze for a second, and then unable to control herself, burst out laughing. “It’s what?!”, she shouted, still laughing. The patient, unaware of what was going on, said, “It’s in? I didn’t feel a thing!” My face burning red, I had to explain to her that she didn’t feel a thing because it was in her vagina, not where it was supposed to be. Unfortunately, a suppository won’t do much good there, so I had to get it out. I do know my anatomy, so it’s not like I accidentally pushed it into the wrong hole (which did happen to one of our classmates a few months ago, and yes, I did laugh at him), so it wasn’t far in or hard to retrieve. It was just incredibly embarrassing. We tried again, this time without as much lube and with clean, non-slippery gloves, and forty five minutes later, she was no longer constipated! Although the outcome was good, I can already hear my teacher next August talking to the new nursing students, “I had this one student named Katie, and you would not believe what she did……” Well, at least they’ll never forget me, right?
Needle phobics- skip this one!
Like most other skills, my classmates and I did not get to practice this on an actual human. We practiced on hot dogs. Why hot dogs? Because like humans, hot dogs have skin. Therefore, it's the same exact thing, right? Ha.
During the lab, I tried to be serious and give a hot dog a TB skin test. My lab partner Natalie was watching as I inserted the needle at the perfect angle into the skin of the hot dog. Holding my breath, I carefully started injecting the fluid. It looked beautiful as the blister was beginning to form. Then all of the sudden, the skin popped and the fluid leaked out everywhere. Ewwww... if that were a human, I would have just caused some serious pain!! Natalie tried next, and formed the perfect little blister. Punk. I tried several more times, but just ended up with a hot dog full of fluid but no perfect blisters. I left that day feeling pity for the first person who I had to do a TB test on. I met that victim yesterday. The hospital wanted to make sure she did not have tuberculosis, so they ordered a skin test. My friend Trisha was supposed to do it, but since she has done it many times before, she offered the opportunity to me. I agreed, and when I was in the room getting the supplies ready, the patient asked me, "Have you ever done this before?" This is the point where I should have lied. I could have told her that I had done it before, because her question did not specify that it had to be on a human to count. Or I could have just said "no." However, sometimes when I am nervous my brain fails to function at the optimal level. What came out of my mouth was, "Yes, I've done this several times to a hot dog." That was professional and comforting, right? For some reason, my response seemed to frighten the woman, but she let me go ahead and do it anyway. It ends up that human skin does not burst as easily as hot dog skin, so the injection went perfectly!
Ads gone wild
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Elevator: 2; Katie & Rachel: 0
Welcome!
In the hospital, constipation is very common. People's routines are thrown out of whack, they aren't walking around enough, they are too uncomfortable doing certain things while sitting on a bedside commode with their roommate just a few feet away... whatever the reason, it seems like a good portion of our patients go through this uncomfortable event. I am always surprised by the creative solutions my patients come up with to cure their problem: my guy several months ago requested a stick of dynamite, and recently, a woman asked for a poop-C-section. Those were funny, but the patients were outgoing so it didn't shock me when they said these things. However, a few weeks ago, I was taking care of this adorable elderly woman who had been constipated for several days. I gave her a suppository and it didn't seem to be working. While giving her the medicine, I could tell that she was ready to go, it just wasn't coming out yet. I explained this problem to her, and even drew a beautiful picture of the intestines to describe what I was talking about, including an arrow indicating where her BM was waiting. After going over everything, she nodded her head and said, "Ah... I see what's going on. It's just waiting to be welcomed." "Welcomed?," I asked. She replied, "Well yes, of course, we need to draw some welcome signs and invite it to come on out!" On the back of my drawing of the intestines, I wrote "Welcome!" and gave the paper to the woman. I left the room and shortly later, her call light was on. She had to go, NOW! I guess it truly was just waiting to be invited (how polite)! I know, you are probably thinking, "The suppository finally started working." You might have a point, but life is much more bearable in a hospital when you use your imagination. I think I'll bring her some markers tomorrow so she can make a pretty sign so this doesn't happen again! And maybe we can work on a "Stay out" sign for the bacteria in her lungs....
Broken printer
Is that water?
Rachel and I learned an important lesson this week: always put lids on everything. As I was walking down the hallway, I heard an elderly woman calling for help. I went into her room and she asked me for a glass of water. You are not allowed to give anyone anything unless you know they can have it (even water can hurt someone), so I told her I would ask her nurse and then come back. As I was leaving her room, I looked back at her and noticed she was reaching for something. I paused to watch and saw her grab a bottle of baby powder. "Is this water?" she asked me. "No," I replied, "that's powder." Before I had time to react, she tilted her head back and brought the powder up to her mouth. She started shaking the bottle to get the "water" into her mouth. Thankfully, the lid was closed, and no powder came out. I ran over and took the bottle from her and put it out of her reach. She got angry at me and started chewing on the oxygen tube running to her nose. I took that out of her mouth and decided I needed backup. I looked into the hallway and saw Rachel doing some charting, so I ran over and asked her to watch the woman while I asked her nurse if I could give her water. I found the nurse and was told I could give her a drink. When I walked into the room the look I saw on Rachel’s face was priceless. She was standing there in shock as the woman was licking the side of a stick of deodorant. Once again, we were saved by someone remembering to put the lid back on. We ran over and took the deodorant from her, and she shouted, “Don’t take my water!” I brought her a glass of real water and sat with her for a few minutes. She kept on telling me all about the %#!@ nurse who stole her water. Some days you just can’t win!
Bubba the Guard Spider
Update: Bubba the spider is dead. I don't know what happened to him, but have a feeling Manny gave Skitzo some spider-killing tips. Look what happened:
"I'm going to eat your contact case. Mmmmm...."Huh?
That's some heavy paper!
Go NOT Lytely
Signs you are becoming a nurse
2. You start rating everything on a scale from 1 to 10.
3. When someone farts, you almost start cheering.
4. ER isn't as fun to watch anymore. You just spent all day at a hospital, why would you want to watch other people in a hospital?
5. When hanging out with friends, you start noticing how good their veins are, and deciding which vein you would start an IV on.
6. You realize you walk twice as fast now.
7. You start diagnosing strangers with medical conditions. "That woman has really big eyes- she had better see a doctor about her hyperthyroidism."
8. When you are asked, "How was your day?" you respond, "How was YOUR day" to avoid talking about it.
9. People start showing you their moles or ask you to look at their tonsils.
10. People in your life are now much more comfortable telling you very personal things, and you aren't embarrassed by it.
11. You are allowed to say "SOB" to your boss. (shortness of breath)
12. You can recite all the normal serum lab values, but forget your own phone number.
13. You begin to appreciate the little things in life, such as being able to breathe.
14. When driving, instead of humming a song in your head, you are humming the respirator alarm signal. "do do de da da"
Heroes
The Katie Seal of Approval
We have a big test tomorrow in our Health Management class. Our instructors in this course are well known for having awful test questions. The questions are not too difficult in an "I should have studied this material more" sense- they are just poorly worded and poorly asked questions. If I were to say to my instructor during class, "Pick any female student in this room," and she were to pick Danielle, I would say, "Yes, Danielle is a female student, so you are correct, but I can't give you credit because that is not the student I was thinking of." What would they respond? Probably something like, "Well, you didn't give me enough information to narrow down which student you were thinking of! There were too many 'right answers'" Only then would our instructors understand how we feel about their test questions. They are trying to imitate the NCLEX (our licensing exam), which has several options that seem right. However, the NCLEX questions are written by professionals who are able to give you enough clues to figure out the correct answer. Our teachers leave us at the "pick any female student" part of the question, and forget to give us the rest of the necessary information.
If my teachers were smart (which we have established is definitely not the case), they would ask me to proofread the test before they give it to the class. This way, I could tell them which questions would have a better of chance of people getting the right answer if they change the wording to, "Pick a letter, A, B, C, or D." With the Katie Seal of Approval on the test questions, the students who studied and know the material would actually be the ones who do well on the exam. Isn't that a crazy concept?
Wish me luck tomorrow guys!
The gift
Skitzo's favorite toy somehow ended up inside my backpack. What a pleasant surprise! :)
The Heart
How stuff works - animation of heart
HSW - Coronary Artery Bypass Graft (CABG) animation - I saw this!
HSW - Coronary artery disease animation
HSW - basics
HSW- heart disease
HSW - Aspirin and the heart
HSW - Congestive heart failure
HSW - Heart formation animation
HSW - Reading EKG animation
HSW- list of all animations- check this out- there are tons of things to learn about!
My sister sent me these links- cute songs to help you remember the blood flow through the heart:
Aspirin commercial
Lyrics with picture
Good luck Eve!!
John's Lesson
John's patient had an ostomy bag, and John was instructed to "burp the bag" which means to let the gas out of the bag. John had never worked with an ostomy bag before, so he got down close to it and opened the bag very carefully. Still leaning down looking at the bag, John squeezed it, pushing all of the gas right into his face. Lesson for the day: point ostomy bag AWAY from face before squeezing.
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