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Nursing School week 4/#4
Feb. 10th, 2013 09:02 pmWe had our first Lab class of the semester this week. We learned how to give medications by IV Push. We learned in the 2nd semester how to give meds and fluids via IV--hang a bag of medication, connect it to a pump, program the pump for the rate ordered by the doctor, etc... The medication travels through about 36" of tubing and most medications infuse at a rate of 100-200mL per hour. Fluids are similar, though they might infuse at a smaller rate. But there are situations in which a patient would need to receive medication more quickly than it would take to get through all that tubing and/or the patient might need to be monitored as the medication infuses. For these, we can draw them up in a syringe, remove the needle from the syringe, and screw it onto the tube very close to where it enters the skin. Then we have to manually squeeze the syringe and time it so that the medication does not go in too quickly. Most IV Push medicines seem to go in at 1mL per 1-2 minutes...so you might be standing there pushing the syringe along gently for several minutes.
On Tuesday we had our math exam, which I passed. I know of a few students who didn't pass, but they have 2 more chances and most of them seemed to know what they had done wrong (failing to label units correctly in your answer will cause you to fail, for example). Then we had a theory lecture on management, prioritization, and delegation. One of the things an RN needs to be able to do is to delegate certain tasks to LPNs or nursing assistants--but only certain types of tasks can be delegated, and only under appropriate circumstances. For example, an RN could delegate feeding a dementia patient to an NA if the patient had no recent changes and was a 'known quantity.' But an RN should not delegate feeding a patient who was just admitted with a stroke, because this patient might be prone to choking and the RN needs to assess for this risk. Only RNs are allowed to assess a patient. Likewise, only RNs are allowed to teach, but LPNs could reinforce teaching.
Our Wednesday theory lecture started a 3-class series on the kidneys, which will make up the bulk of our 2nd exam. We learned about benign prostatic hyperplasia and kidney stones. Next week we'll learn about kidney failure.
Thursday and Friday were devoted to clinical, as usual. In past semesters, we have had to do fairly extensive write-ups about our patients as we learn to tie all of their secondary and primary diagnoses together with their treatments and nursing interventions. This semester, we started off by doing a similar write-up, but after 2 of them have been deemed 'successful,' our instructor lets us know that we don't need to do them any more. Woo hoo! My first 2 were successful, so for the next 4 weeks I don't need to do them (but I still need to know the information that would have been included in the packet). I'm not sure about the 2nd 6 week rotation--we move to new instructors on new floors, so no one is sure if we do new packets as well. For now, though, I'm not complaining!
On Tuesday we had our math exam, which I passed. I know of a few students who didn't pass, but they have 2 more chances and most of them seemed to know what they had done wrong (failing to label units correctly in your answer will cause you to fail, for example). Then we had a theory lecture on management, prioritization, and delegation. One of the things an RN needs to be able to do is to delegate certain tasks to LPNs or nursing assistants--but only certain types of tasks can be delegated, and only under appropriate circumstances. For example, an RN could delegate feeding a dementia patient to an NA if the patient had no recent changes and was a 'known quantity.' But an RN should not delegate feeding a patient who was just admitted with a stroke, because this patient might be prone to choking and the RN needs to assess for this risk. Only RNs are allowed to assess a patient. Likewise, only RNs are allowed to teach, but LPNs could reinforce teaching.
Our Wednesday theory lecture started a 3-class series on the kidneys, which will make up the bulk of our 2nd exam. We learned about benign prostatic hyperplasia and kidney stones. Next week we'll learn about kidney failure.
Thursday and Friday were devoted to clinical, as usual. In past semesters, we have had to do fairly extensive write-ups about our patients as we learn to tie all of their secondary and primary diagnoses together with their treatments and nursing interventions. This semester, we started off by doing a similar write-up, but after 2 of them have been deemed 'successful,' our instructor lets us know that we don't need to do them any more. Woo hoo! My first 2 were successful, so for the next 4 weeks I don't need to do them (but I still need to know the information that would have been included in the packet). I'm not sure about the 2nd 6 week rotation--we move to new instructors on new floors, so no one is sure if we do new packets as well. For now, though, I'm not complaining!
