Sunday, December 5, 2010

Critical Care

I am already 4 weeks into my final term of nursing school. I can't even believe it! My classes consist of critical care lecture and clinical along with a course called Integration of Nursing concepts. All I have to say's alot of work! 

I truly like critical care but it is challenging. I usually am able to grasp concepts right away but this stuff I study for hours and I still can't comprehend it! I am just waiting for the day when it all just "clicks". ( It hasn't yet, lol) My lecture instructor is a hoot. She is straight from the south and her accent is amazing. Alot about her reminds me of my mom from her pixie hair cut, her animated stories, and more.She has been a flight nurse, trauma nurse, cardiac nurse, and the list goes on. She knows her stuff! Thankfully, she keeps class moving at a good pace but she keeps us focused and enthusiastic. Aside from her brutal test, I look forward to Tuesday morning with her.

Critical care clinical is at Placentia-Linda, this tiny little hospital hidden on Rose Drive. I love it! It's small enough where you don't feel lost as a nursing student but yet a handful of the nurses are willing to teach with a joyful attitude. We are rotated through units such as tele, ER, GI lab, outpatient surgery, ICU, and a day as team leader. After having a break between terms when we finally stepped into the hospital for the first day of clinical, I sighed a sigh of relief. I love hospitals. I love the shiny floors, the beeping call lights and IV pumps, the hustle and bustle, and constant changing. It's just the right place for me. :-)

Integration of nursing concepts may be the death of me. We are set up with an online virtual classroom where we had to take a predictor test for the state boards and based off our initial scores we are assigned a calendar to prep for these next weeks. I was given a 5 week one which entails practice exams after practice exams. And if you don't meet the bench mark score you are given remediation assignments and yes, more practice exams. I'm killing my eyes from staring at a computer taking tests all day....I'm also going to give myself some serious skin breakdown from sitting on my bum on the bed all day to do so! On top of that we have exams to take through HESI, Kaplan, and evolve case studies. Whew.

Last but not least, Simulation lab. I take back what I said before because THIS will be the death of me. I have my first testing this week on Wed/Thurs. Last week, they failed everyone on the first day. At least I won't have high expectations going in. This is where they see what we are made of. We have a whole suite on our campus for Sims. It is set up just like a hospital inside. In each room is a dummy, computerized charting, med carts, monitors, O2, and more. On one side of the room the whole wall is a one way window...that way our classmates can sit on the other side and critique us. In the corner is another one way window that leads into the control room where multiple instructors sit to evaluate you and control the situation. We each get 20 minute scenarios. We are given report, assigned a classmate to be our CNA, and that we must perform our head to toe assessment and enviroment checks within 5 min. Should you miss one thing, you miss it all. They grade us for technique, teaching, delegation, and the list goes on. At some point in the scenario our patient changes. He/She may have an MI, stroke, seizure, pneumonia, allergic reaction, pulmonary embolism, GI bleed, hypovolemia, A-fib, and undergo respiratory depression. They may go into V-tach/fib and need to be defibrilated which in that case we call a code and run through the whole thing, with a live, working defib machine. 

They want to see our focused assessments when something changes, nonpharmacological interventions, how we contact physicians, how we order labs and take med phone orders, how we chart, hang blood, push IV meds, and more. One of the instructors does the voice of the patient so that they actually respond to what we say. They are the doctor or pharmacist or charge nurse or whomever we call. There are cameras on us the whole time so they can zoom in to see the smallest of details. They record it so we can watch ourselves after and see what needs to be changed. The dummies are like live people. They sweat, cry, become cyanotic, have sputum, snot, they pee, they vomit, the poop, they seize, they show all physical signs of a stroke, and their pupils react to light. All sounds are there too. Every heart sound, lung sound, and bowel sound can be assessed. Pulses can be felt and their chest rises when they breath. You can get a real blood pressure reading too. And our instructors know if we touched the pulse in the right spot or listened to the right locations on the heart because it shows on their monitors.

Can you see why I am nervous? I want to throw up just thinking about it! I'm just praying I don't blank on Wed and I pray I don't kill or harm my fake but real patient! I can't believe these are the final weeks. I'm so ready to be done but seriously lacking the motivation to get there. I'm a breath away from being burned out. So please pray for strength and motivation to push through till the end!

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