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Nursing School week 3/#5
Sep. 21st, 2012 03:13 pmA slightly less exhausting week, but I'm looking forward to sleeping in this weekend!
I had Community/Non-Acute Clinical this week. As I think I mentioned, we do three of these total. I had thought we'd have one for each of the 3 weeks of Community clinical on the calender, but as it turned out, some of us have 2 one week (Tuesday and Wednesday) and then a week off some other time. I had 2 this week--one at an inpatient substance-abuse rehab, and one at an assisted-living agency.
The substance-abuse rehab was interesting, though my preceptor didn't do a very good job of actually teaching me what the nurses do there. She just sent me off to the sessions that the patients were doing. Patients usually spend 2-4 weeks there. They can do detox there (not true for every rehab--some of them you have to already be detoxed before you get there), and then they can start their rehab there. This facility has a 12-step-based program for alcohol and drugs (and people who are addicted to both). They treat people age 16 and above--I'd bet that the oldest people I saw were in their 60s or 70s. It feels, in a way, like the worst summer camp ever--all the staff are really nice and supportive, but at the same time there's a strict dress code, you can't wear too much makeup, you'll get written up if you horse around or don't keep your room clean, you can't bring any means of contact with the outside world, and men and women are not allowed to interact outside of official group sessions. They eat in the dining room together, but at separate tables on separate sides of the room--staff also eat in the dining room to keep an eye on them. So, imagine being an adult, for goodness sake, and not only do you know you're in trouble because you've hit rock-bottom with a drug or alcohol addiction, but now you're voluntarily allowing a bunch of other people to tell you how to spend every minute of your day. I understand that this method is believed to be effective, and I guess it probably is--I heard a lot of stories about patients who felt really out-of-control in their lives (which led to the substance abuse, which then became a self-replicating problem)--maybe it's a relief just to hand over the reins to someone else for a while. Every moment of the day is scheduled for them, from 6am to lights- out at 10pm. I attended group lectures/educations sessions, and small-group therapy sessions. The nurses seem to spend most of their time taking vital signs, assessing withdrawal symptoms, and handing out nicotine lozenges (it's a smoke-free campus).
The assisted-living organization was also interesting. It's actually a managed-care organization, which meas that patients receive all of their services (except emergency room visits) through them. They have their own fleet of doctors, home-care nurses, aides, podiatrists, dentists, optometrists, etc... If they don't offer a service, then they're required to pay the cost of the service to the provider--so it's in their best interest to offer as many services as possible. Their goal is to help older people live independently for as long as possible (though "independent" can include 'living in a group home with 24-hour aide service but it isn't technically a nursing home.') I spend the morning with a home-care nurse, and then the afternoon in their health clinic which is attached to their day center.
On Thursday, my group in the Community class presented our project. The purpose of these projects was to have us perform an assessment of a part of town (treating that community as the "patient"), and then identify strengths and weaknesses, and use these to come up with a nursing diagnosis. We then needed to come up with a plan and interventions to address this diagnosis--fortunately, it's a paper project, so we don't need to actually do the plan! We won't have our grades on the project until the last week of the term...but at least it's turned in and finished!
On Thursday in pediatrics, we learned about musculoskeletal disorders in children (ranging from fractures to muscular dystrophy). On Friday, we had our 2nd exam. I did fine, though not as well as last time!
Now, weekend! I'm feeling the urge to clean the house. I wonder if it will go away if I stall long enough? Perhaps I should just get on with it...
I had Community/Non-Acute Clinical this week. As I think I mentioned, we do three of these total. I had thought we'd have one for each of the 3 weeks of Community clinical on the calender, but as it turned out, some of us have 2 one week (Tuesday and Wednesday) and then a week off some other time. I had 2 this week--one at an inpatient substance-abuse rehab, and one at an assisted-living agency.
The substance-abuse rehab was interesting, though my preceptor didn't do a very good job of actually teaching me what the nurses do there. She just sent me off to the sessions that the patients were doing. Patients usually spend 2-4 weeks there. They can do detox there (not true for every rehab--some of them you have to already be detoxed before you get there), and then they can start their rehab there. This facility has a 12-step-based program for alcohol and drugs (and people who are addicted to both). They treat people age 16 and above--I'd bet that the oldest people I saw were in their 60s or 70s. It feels, in a way, like the worst summer camp ever--all the staff are really nice and supportive, but at the same time there's a strict dress code, you can't wear too much makeup, you'll get written up if you horse around or don't keep your room clean, you can't bring any means of contact with the outside world, and men and women are not allowed to interact outside of official group sessions. They eat in the dining room together, but at separate tables on separate sides of the room--staff also eat in the dining room to keep an eye on them. So, imagine being an adult, for goodness sake, and not only do you know you're in trouble because you've hit rock-bottom with a drug or alcohol addiction, but now you're voluntarily allowing a bunch of other people to tell you how to spend every minute of your day. I understand that this method is believed to be effective, and I guess it probably is--I heard a lot of stories about patients who felt really out-of-control in their lives (which led to the substance abuse, which then became a self-replicating problem)--maybe it's a relief just to hand over the reins to someone else for a while. Every moment of the day is scheduled for them, from 6am to lights- out at 10pm. I attended group lectures/educations sessions, and small-group therapy sessions. The nurses seem to spend most of their time taking vital signs, assessing withdrawal symptoms, and handing out nicotine lozenges (it's a smoke-free campus).
The assisted-living organization was also interesting. It's actually a managed-care organization, which meas that patients receive all of their services (except emergency room visits) through them. They have their own fleet of doctors, home-care nurses, aides, podiatrists, dentists, optometrists, etc... If they don't offer a service, then they're required to pay the cost of the service to the provider--so it's in their best interest to offer as many services as possible. Their goal is to help older people live independently for as long as possible (though "independent" can include 'living in a group home with 24-hour aide service but it isn't technically a nursing home.') I spend the morning with a home-care nurse, and then the afternoon in their health clinic which is attached to their day center.
On Thursday, my group in the Community class presented our project. The purpose of these projects was to have us perform an assessment of a part of town (treating that community as the "patient"), and then identify strengths and weaknesses, and use these to come up with a nursing diagnosis. We then needed to come up with a plan and interventions to address this diagnosis--fortunately, it's a paper project, so we don't need to actually do the plan! We won't have our grades on the project until the last week of the term...but at least it's turned in and finished!
On Thursday in pediatrics, we learned about musculoskeletal disorders in children (ranging from fractures to muscular dystrophy). On Friday, we had our 2nd exam. I did fine, though not as well as last time!
Now, weekend! I'm feeling the urge to clean the house. I wonder if it will go away if I stall long enough? Perhaps I should just get on with it...
