First assessment out of the way - only 8 to go

This week as well as being on clinical for 5 days straight, which made me very tired indeed by the end of the week, I've been focused on preparing for my first assessment task for the semester, an online multiple choice quiz made up of 30 questions based on a set of journal articles that we were given. It's worth 10% of the total mark for the Managing Chronic Conditions subject. Some of the readings I mentioned in my previous post, and these were the rest of them:

• The emotional context of self-management in chronic illness: A qualitative study of the role of health professional support in the self-management of type 2 diabetes
• Evaluation of a primary care nurse case management intervention for chronically ill community dwelling older people
• The patient’s vulnerability, dependence and exposed situation in the discharge process: experiences of district nurses, geriatric nurses and social workers
• Prioritizing Illness: Lessons in Self-Management Multiple Chronic Diseases
• From the sidelines: Coaching as a nurse practitioner strategy for improving health outcomes
• Motivational interviewing-based health coaching as a chronic care interventions
• Nurse Coach: Healthcare Resource for this millenium
• Patient empowerment: reflections on the challenge of fostering the adoption of a new paradigm
• What skills do primary health care professionals need to provide effective self-management support? Seeking consumer perspectives
• Chronic illness self-management: taking action to create order
• Nursing Science and Chronic Illness: Articulating suffering and possibility in family life
• Youth Health - sex, drugs and chronic illness: health behaviours among chronically ill youth

I didn't actually read every word of all the articles because I ran out of time. I read about half of them trying to understand the main gist of them. But the some of the questions in the quiz were quite detailed so for those ones I had to go back and find the answer. Some questions could just be answered by common sense and elimination. Anyway, I just completed the quiz and got 9.67 which means I got 29/30 right! Woo hoo!

One down, eight to go.

Other things I've got done this week:

Lectures
• Communicating around dying and grief
• Advance care planning

Also this week, I attended a 2 hour workshop for Communications in Nursing subject, then met with group to plan our topic and division of work the Managing Chronic Conditions nursing care plan assignment. There are 8 people in the group and we each have to write one nursing diagnoses and interventions. Because there are so many of us we only have to write about 300 words each. We decided to do it on Chronic heart failure, and my nursing diagnosis is activity intolerance.

Next week I need to start and complete a 2000 word essay worth 50%. I've decided to do it on schizophrenia so I can learn more about it in preparation for working as a psychiatric nurse next year. I've already done a bit of research and found some interesting articles. That will be my focus this week along with 3 more grad program interviews. Another very busy week ahead! Need to make sure I get at least 8 hours sleep as many nights as possible.

Group interview experience

The semester is well under way now. In the next four weeks I have 3 more job interviews (already had one this week), one online exam, one 2000 word essay and one group assignment, as well as 2 or 3 days a week of clinical placement. From Saturday to Wednesday I will have five days in a row of clinical placement and then work at my teaching job on Thursday and Friday, AND do an online exam by Friday. In that time I also have to study the material that the exam will be based on because I've only read about a quarter of it so far. I'm getting stuck into that tonight and will continue over the weekend whenever I get a chance. Hopefully get some of it done while I'm on the ward as I still only have to look after 1-2 patients at this stage in the semester.

So the grad year interview I attended earlier this week was with my current number one choice. It was a group interview and I wasn't sure what to expect with that. There were 6 of us doing the interview together and we had to introduce ourselves, interview each other a bit and handover to the rest of the group and the panel about the other person and go to a table to select cards which represent our strengths and 'things we want to work on' and then explain them to the group. I chose reliability and kindness for strengths, and capability and bravery for things I want to work on. There were a few clinical questions about time management and prioritisation of care of a newly admitted suicidal patient. Then we each were interviewed individually which wasn't too harrowing or very long. I felt good about how the whole thing went and I like the 3 people who conducted the interview. For now I will keep them as my first choice, but I still have 3 to go.

Study done so far this week (not much) . .

Lectures
• Chronic Conditions and Models of care
• Psychological aspects of chronic disease
• Culturally appropriate communication

Reading
• Assertiveness skills
• Conflict resolution
• Clinical Practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers

Called in sick

I called in sick for my second night duty tonight. I'm not grossly unwell, just feeling rather run down with a sniffle and sore throat so I thought it would be best to stay away from the patients and try to recuperate at home. I slept from 9:30am till 5:30pm today. I heard about research that has shown that even if you are getting sufficient sleep during the day, working nights is not good for you. The body needs to be asleep during the wee hours (2am to 5am) to tap into the universal energy that assists the body to heal and recover. There is a higher incidence of diseases like heart disease, common colds, and depression amongst people who work nights or early morning shifts. Something to be aware of . . .

I've got a good chunk of study done in the last couple of days:

Lectures
• Time Management and prioritisation of care
• Delegation
• Managing Chronic Conditions: Arthritis

Reading
• Awareness of the other
• 'Other’-centred communication
• Non- verbal communication
• Ethical communication
• Assessment of Digestive and Gastrointestinal Function – upper gastrointestinal tract imaging, lower gastrointestinal tract imaging, CT scans, MRI, positron emission tomography, scintigraphy, gastrointestinal motility studies, oesophagogastroduodenoscopy (try pronouncing that one!), proctoscopy, sigmoidoscopy, fibreoptic colonoscopy, small bowel endoscopy, endoscopy through ostomy, defaecograpy, gastric analysis, gastric acid stimulation test, pH monitoring, laparoscopy, and psychological considerations.

Tonight I'm going to relax and probably watch a movie, drink lots of fluids and eat some nutritious food then get to bed by about midnight so I can back onto normal rhythm tomorrow. Tomorrow I'm planning to get a half hour massage. Hopefully that will be what I need to be fighting fit once more.

Night shift

End of week two . . .

This week I did two night shifts on Monday and Tuesday night. They're pretty long shifts, from 9pm till 7:30am so I needed Wednesday to recover. At this stage in the semester I only have to take one patient, but it will increase gradually up to a full load as the weeks go by. One patient on a night shift is very boring! Because there's not much to do between 10:30pm and 6:00am. However, I made good use of time and got heaps of reading for uni done and got a couple of tasks out of the way for my clinical learning portfolio which will be worth 55%.

This week I also finished my job applications for next year. I've already heard back from two of them for an interview in the next couple of weeks. I've applied to four different psychiatric grad nursing programs. It was so hard to narrow it down to just four places, and also choose whether I wanted to do general medical/surgical or psychiatric, or community. In the end I chose psychiatric because it's what I'm most interested in and enjoy doing, I can increase my qualifications during the program, and there are opportunities to work in acute inpatient care, community, teenagers, emergency, drug and alcohol . . . there's a lot of choice within psych so I don't feel as though I'm limiting myself by choosing that path.

Here's a summary of what I've been studying this week:

Lectures
• The impact of chronic conditions
• Promoting comfort_and managing symptoms

Reading
• The social construction of chronicity: a key to understanding chronic care transformations
• Healthcare providers’ perspectives : estimating the impact of chronicity
• Chronicity and complexity: is what’s good for the diseases always good for the patients?
• Clinical Practice Consolidation subject guide
• Ward Orientation
• Journal article case study: An 81 year old man with massive rectal bleeding – this was related to one the patients I had on the ward.
• Journal article: Nurofen Plus misuse, an emerging cause of perforated gastric ulcer – again this is related to a patient on the ward who had been abusing a packet a day of nurofen plus, which is ibuprofen plus codeine. They abuse it for the codeine and you don’t need a prescription to get it. The problem is because it has the ibuprofen it wears away the lining of the stomach over time.
• Assessment of Digestive and Gastrointestinal Function – anatomy of the gastrointestinal tract, chewing and swallowing, gastric function, small intestine function, colonic function, waste products digestion, age related changes in the gastrointestinal system, assessing pain, indigestion, intestinal gas, nausea and vomiting, changes in bowel habits and stool characteristics, physical assessment, foods and medications that alter stool colour, stool tests, breath tests, Australian guidelines for colorectal cancer screening, abdominal ultrasonography, genetics and gastrointestinal disorders.

This week I have two more nightshifts again so I'm going to get as much reading done as I can while I've got the chance.