Only 2 days left!

My clinical placement is just flying! It has been going really well, I'm enjoying it so much. All the nurses and doctors in the ward I am in are just so friendly and helpful. The patients have all been really different and I've been learning a lot about the pathophysiologies of their illnesses as well as getting the chance to practise new skills.

Goals that I've already achieved are: taking blood, giving showers/baths to patients with limited mobility (like stroke patients), taking out drainage tubes, performing an ECG, transfering a patient using a hoist, PEG tube feeding, urinary catheter removal, lots and lots of injections, nursing care planning and time management, and increasing my drug knowledge.

Every day after handover and before I give the 8:00am meds, I make a timeline plan for the whole day for the patients I am helping my buddy look after (usually 4). Then I look up all the drugs the patients are on (if I'm not familiar with the drug), and write it down in my notebook. So far I've familiarised myself with 58 new drugs!

The wide variety of patients this week have included: an Indonesian student - so got to use my language skills with him of course(actually about a quarter of the patients are international or have a low level of English), a Collingwood supporter, patient with bipolar disorder who can be really lovely one minute and abusive the next, patient with incontinance due to a stroke and who required full nursing care including spoon feeding, and young guy with dystonia. Dystonia is a neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures. He can't swallow so is fed through a PEG tub in his stomach, and he can't talk either. Unfortunately there is no cure but his symptoms are being treated with a special drug that had to be ordered from the US and costs over $1000.



Another interesting thing that I had never heard of before but have seen a lot of on this placement is the artereovenous fistula that renal dialysis patients have on their arm for a good strong, long term, access point to their blood (for the heamodyalis). One of the nurse's jobs is to feel it and listen to it with the stethescope to make sure it's working properly. They come in different shapes and sizes but look to me like a little mountain, or range of mountains, under the skin. When you feel it, the pulse is really strong. Actually you can even see it pulsating, and when you listen with the stethescope it makes a whooshing sound.



Today was my last early shift, so tomorrow I get a sleep in - YAY! and I can stay up late and watch TV - YAY AGAIN!

Fantastic first week!

My first week of placement has flown fast and been really good. I've had a different nurse buddy everyday and they have all been so nice and good teachers and gave excellent feedback about me to my clinical educator, so I passed the first week assessment with flying colours.

I've had a really interesting mix of patients including: 3 different kidney transplant patients at different stages, an HIV positive African refugee, alcohol and drug addicts who are going through withdrawal, suicide risk patients, and stroke patients.

Some of skills I've had a chance to practise are: lots of injections (including morphine), removing drainage tubes and urinary cathether (on a male), bed baths and showers, and sterile wound dressings.

Looking forward to next week but nice to have a break this weekend. Today I'm going over to my nan's house to watch the AFL grand final with her - GO PIES! Tomorrow I'll do yoga in the morning and then going to a baby shower for a friend from work in the afternoon.

Time to update my blog

I have been pretty absent from this blog for the past month, so apologies if you have been checking it for updates . . . but this week I started my clinical placement! so now I have things to write about. I am at the same hospital as last semester but this time I'm on a different ward and as far as I know I'll be on the same ward for the whole two weeks. It's the renal, neurology and stroke ward so very different patients from my last placement.

Yesterday we just had orientation and because I've been at this hospital before I knew most of the stuff already. Luckily in my group there are two other girls that I'm already friends with and our clinical educator is really really nice.

Today with my buddy nurse (who was also really really nice, so hopefully I will get to work with her again) I looked after 3 patients who have had strokes and one who has just had a kidney transplant after being on dialysis for three years. I think stroke patients are quite interesting because the stroke can affect people in different parts of their brain or body. For example, for some it is more their psychomotor skills that are reduced, while others could be affected in the language part of their brain which makes having a conversation with them confusing, for both parties.

Within the first hour, I gave one patient a shower and did an injection, as well as doing the standard morning vital signs obs, medications, blood sugar level testing and so on. Most of the patients have an indwelling urinary catheter and their fluid intake and output needs to be measured. For the kidney transplantee that needs to be done hourly. Also, looked up lots of medications that I didn't know (that the patients are on)

In the afternoon, there was an education session for graduate (first year) nurses about tracheostomy care and I went along to that which was very interesting. We haven't studied that at uni yet but it's a good opportunity to learn because the teaching is a lot better and easier to absorb in the clinical setting than at uni.

My big blunder today (well, not that big but stressful at the time) was that I failed to get up early. I was so organised, went to bed at 9:30 (after taking a sleeping tablet at 8:30), set two alarms for 5am with the plan of having a full shower (ie, including hair wash), making my lunch and being at the hospital by 6:45am for 7:00am start. But no, I completely slept through the alarm and woke up at 6:30!!! I literally put on my uniform, quickly fed manny, ran out the door and to the train station. I arrived 7:10 which is pretty fast but I didn't feel very 'fresh' when I arrived. Ended up spending $20 throughout the day on expensive coffee and food. Oh well. Hopefully will do better tomorrow.

2 assignments down, 2 to go

Finally finished the two assignments I have been working on this week. I had forgotten how long it can take to write an essay and how many times it needs to be re-checked and edited.

The first one was a 1000 word scenario for Acute Care about a patient having an adverse reaction to a blood transfusion. That one is due today and I just submitted it online. The second one is a 2000 word essay about community health needs assessment. I've managed to get it down to the right amount of words, and now I just need to read over it again a couple of times over the weekend to check for errors. It's worth 40% so I hope I do well on it. I'll hand that in next week on the due date.

Now I have just one more week "off" before my acute hospital placement. I've got two more assignments of 1000 words each that I haven't even looked at yet. Next week I'll try to get as much of those done as possible so I don't have to do them while I'm on placement. If I don't get them finished though there's no need to stress as they're not due for another month or so.