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Nursing School week 3/#13
Woohoo for Thanksgiving Break! And not a moment too soon, apparently, because the seemingly minor headcold I was getting on Monday/Tuesday is now trying really hard to turn into a sinus infection. Or maybe it'll just keep moving down my trachea and turn into bronchitis. I would prefer neither of these options.
Anyway, this week I was back in Mental Health clinical, but only for one day. She gave us the other day "off" in exchange for the support groups that we're visiting. Our first week of MH we were really just supposed to focus on getting comfortable on the floor talking to patients. We were supposed to practice things like the Mental Status Exam (which consists of our observations of the patient's affect and thought process, and the patient's answers to 2 questions: "How are you feeling right now?" and "Are you having any thoughts of hurting yourself or anyone else?") and work through the 'therapeutic relationship' conversation. We learned about that last year--it's a specific conversation in which the patient identifies a cause of concern, then identifies their thoughts and then feelings about that concern, and then comes up with ideas of how they could solve or reduce the problem. It's kind of like cognitive-behavioral therapy, I guess. This week we were supposed to use all of those skills (the MSE and the therapeutic relationship) to talk more in-depth with a patient and then create a big write-up and care-plan targeting one of the patient's issues. So, we did all that and turned them in on Friday, and then also wrote up our lengthy self-assessments.
Thursday and Friday were lectures as usual (with no exams!). In Mental Health we learned about schizophrenia--the disease one day, and the medications and treatment the next day. In Maternity/OB, we learned about complications in the 2nd and 3rd trimesters of pregnancy (such as placenta previa--when the placenta grows over the outlet of the cervix, causes bleeding, and usually necessitates a C-section birth), then moved on to learning about the specific adaptations the newborn goes through in the first few moments and then hours of life. These are really pretty cool--it's stuff like "the ribs/thorax are compressed by the birth canal, which not only squeezes out a lot of the amniotic fluid, but then causes them to recoil open when the baby's torso is born. This recoil creates vacuum pressure in the lungs and in the blood vessels surrounding them, so all of a sudden blood starts flowing to the lungs from the heart because now it's suddenly the path of least resistance (which it never was during the pregnancy; most of the blood bypassed the fetal lungs and circulated to the body). The vacuum pressure also draws in air via the nose, so then oxygen can begin to be exchanged in the lung tissue." Also, the withdrawal of certain maternal hormones causes other changes to happen, and in relatively short order, a baby which has never survived in the outside world before is ready to do so.
This weekend, as I mentioned last week, friends visited and found themselves an apartment. We've now pretty much gotten the house ready for PoC's family to visit starting on Wednesday--just one more bed to make up and a last round of cleaning to take care of. And, I guess, a bunch of food to start making! So, I'm going to try to be good and drink a whole bunch of fluids and get some homework done in the next two days!
Anyway, this week I was back in Mental Health clinical, but only for one day. She gave us the other day "off" in exchange for the support groups that we're visiting. Our first week of MH we were really just supposed to focus on getting comfortable on the floor talking to patients. We were supposed to practice things like the Mental Status Exam (which consists of our observations of the patient's affect and thought process, and the patient's answers to 2 questions: "How are you feeling right now?" and "Are you having any thoughts of hurting yourself or anyone else?") and work through the 'therapeutic relationship' conversation. We learned about that last year--it's a specific conversation in which the patient identifies a cause of concern, then identifies their thoughts and then feelings about that concern, and then comes up with ideas of how they could solve or reduce the problem. It's kind of like cognitive-behavioral therapy, I guess. This week we were supposed to use all of those skills (the MSE and the therapeutic relationship) to talk more in-depth with a patient and then create a big write-up and care-plan targeting one of the patient's issues. So, we did all that and turned them in on Friday, and then also wrote up our lengthy self-assessments.
Thursday and Friday were lectures as usual (with no exams!). In Mental Health we learned about schizophrenia--the disease one day, and the medications and treatment the next day. In Maternity/OB, we learned about complications in the 2nd and 3rd trimesters of pregnancy (such as placenta previa--when the placenta grows over the outlet of the cervix, causes bleeding, and usually necessitates a C-section birth), then moved on to learning about the specific adaptations the newborn goes through in the first few moments and then hours of life. These are really pretty cool--it's stuff like "the ribs/thorax are compressed by the birth canal, which not only squeezes out a lot of the amniotic fluid, but then causes them to recoil open when the baby's torso is born. This recoil creates vacuum pressure in the lungs and in the blood vessels surrounding them, so all of a sudden blood starts flowing to the lungs from the heart because now it's suddenly the path of least resistance (which it never was during the pregnancy; most of the blood bypassed the fetal lungs and circulated to the body). The vacuum pressure also draws in air via the nose, so then oxygen can begin to be exchanged in the lung tissue." Also, the withdrawal of certain maternal hormones causes other changes to happen, and in relatively short order, a baby which has never survived in the outside world before is ready to do so.
This weekend, as I mentioned last week, friends visited and found themselves an apartment. We've now pretty much gotten the house ready for PoC's family to visit starting on Wednesday--just one more bed to make up and a last round of cleaning to take care of. And, I guess, a bunch of food to start making! So, I'm going to try to be good and drink a whole bunch of fluids and get some homework done in the next two days!