Nursing School week 4/#6
Feb. 24th, 2013 02:28 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
pantsheadNot too many things to write about this week. We had our exam on kidneys, which went okay but there were some questions I should have done better on. (It's easy to 'put too much in' to a question and over-think it.) I shouldn't complain; I got a 90 which is probably near the top of the class. The new on-line class gradebook doesn't post our ranks any more, which means no one knows--in a relative sense--where they fall. I wish they'd post the average, at least! We didn't have any new theory content this week.
We did have a simulation, which we do in our lab on a computerized mannequin-patient. These sound like a good idea, but I'm actually finding them to be frustrating. They are operated by an instructor in a remote room, who can see/hear the whole simulation room by a camera and microphone. In theory, you can take a pulse and blood pressure on the mannequin. In actuality, both the pulse and blood pressure sound different and are harder to find than they are on a real patient. So, we wind up wasting a lot of time (IMO) dealing with that rather than moving forward to the 'meat' of the simulation (which, in this case, would have included watching the patient's heart rate drop as his potassium level rose because his kidneys weren't eliminating it, and then requesting orders from the doctor to treat the problem). Fortunately, we don't get graded on the simulation itself, just on the preparatory write-up we have to do.
In clinical this week, I was in the Emergency Department. I'll be back up on my normal floor next week, but we each get assigned to one week in another department each rotation. The ED was definitely interesting! I can't talk a lot about what kinds of stuff I saw (too specific), but overall there were a lot of patients with chest pain (but no heart attacks), respiratory distress, cold & flu symptoms, altered mental status (from "just not acting right" to "I got dizzy and fell down,"), alcohol intoxication, patients requesting detox (this hospital has an inpatient detox unit), and bumps/sprains/etc... In NYS, RNs can't work in an ED until they have at least 1 year of medical-surgical experience. Because both days I was there were relatively quiet, the RNs had pretty relaxing days, it seemed. However, all of them must be Advanced Cardiac Life Support certified (regular nurses are just Basic Life Support certified), Pediatric Advanced Life Support certified, etc... Although there is a larger trauma center in another hospital in town, any hospital may receive almost any type of patient and must be ready!
We did have a simulation, which we do in our lab on a computerized mannequin-patient. These sound like a good idea, but I'm actually finding them to be frustrating. They are operated by an instructor in a remote room, who can see/hear the whole simulation room by a camera and microphone. In theory, you can take a pulse and blood pressure on the mannequin. In actuality, both the pulse and blood pressure sound different and are harder to find than they are on a real patient. So, we wind up wasting a lot of time (IMO) dealing with that rather than moving forward to the 'meat' of the simulation (which, in this case, would have included watching the patient's heart rate drop as his potassium level rose because his kidneys weren't eliminating it, and then requesting orders from the doctor to treat the problem). Fortunately, we don't get graded on the simulation itself, just on the preparatory write-up we have to do.
In clinical this week, I was in the Emergency Department. I'll be back up on my normal floor next week, but we each get assigned to one week in another department each rotation. The ED was definitely interesting! I can't talk a lot about what kinds of stuff I saw (too specific), but overall there were a lot of patients with chest pain (but no heart attacks), respiratory distress, cold & flu symptoms, altered mental status (from "just not acting right" to "I got dizzy and fell down,"), alcohol intoxication, patients requesting detox (this hospital has an inpatient detox unit), and bumps/sprains/etc... In NYS, RNs can't work in an ED until they have at least 1 year of medical-surgical experience. Because both days I was there were relatively quiet, the RNs had pretty relaxing days, it seemed. However, all of them must be Advanced Cardiac Life Support certified (regular nurses are just Basic Life Support certified), Pediatric Advanced Life Support certified, etc... Although there is a larger trauma center in another hospital in town, any hospital may receive almost any type of patient and must be ready!
