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.

Quite bored

I haven't posted much on my blog lately because there hasn't been much going on. I've finished uni classes. I think my group presentations and assignments in the last week went really well but I haven't found out the results of those yet. I got 17/20 for the Community Nursing Test which was worth 20%, and now I'm just working on assignments and reading to prepare for my placements.

The two assignments I'm currently working on are a 2000 word essay about Community Health Needs Assessment and a 1000 word care plan about a blood transfusion (Acute Care). When I've done those I've got two more 1000 word assignments to do as well which I'd like to get done before my clinical placements start in two weeks from now.

I've also been adding to my reading some books about drug and alcohol (and other addictions, like gambling), to learn more before I go on my community placement.

So this is a summary of my learning for the last week or so:

Lectures:
• Nutritional Disorders
• Applying the Recovery Model of Intervention in Mental Health Care
• The Role of the Mental Health Nurse
• Analyse the impact of mental illness on the individual, their families and communities
• Mental Health Act 1986: relating specific mental health legislation to the provision of mental health care
• Mental Health Assessment and Treatment Planning
• Carer Perspective – this lecture was given by the mother of a paranoid schizophrenic and she talked about her experiences caring for her son throughout his life.
Reading
• Addictive and Risky Behaviours: Drugs, Alcohol, Inhalant Abuse, Smoking, Eating Disorders, Self Mutilation and Internet.
• The User: The truth about drugs and why people take them – this book is made up of factual stuff about drugs as well as interviews with recreational users, dependent users, parents, police officers and so on to get different perspectives on drug use.
• Drugs in Society: A History
• The Epidemiology of Australian Drug Use
• Ulcerative Colitis
• Peptic Ulcer Disease
• Crohn’s Disease

Tonight I'm going to a 30th birthday party of one of my primary school friends, looking forward to catching up with old Darwin friends, and according to the invitation "all alcohol will be provided", so should be a lot of fun, LOL.

What I did this week . . .

I'm really happy with how much I got done this week. I worked at my teaching job on Thursday and Friday and didn't do any study on those days so all of this was done on Monday, Tuesday, Wednesday and today - Saturday. I've now finished all the readings and lectures for Community Nursing, which I've been focusing on to prepare for the quiz. I've just done it and I'm pretty sure I will get a decent score. This coming week I have two oral presentations to do with my team (on Tuesday and Wednesday) and on Monday we have a 4 hour pre-clinical placement lab session. This week will be the last week of classes, and then it's just assignments, online lectures, clinical placements, and then exams. Once I've completed my assignments for Community Nursing and Acute Care (I have 4 to do), I will focus on the Mental Health content. I've hardly done anything for this subject so far because the assessment is 50% written exam (in November) and then 50% assignment based on my clinical placement which is not till January.

What I got done this week:

Online modules:
• Community Nursing Quiz (worth 20% of my final mark)
Reading
• Community Assessment for Health
• Wound Management
• Wound Care Products
• Wound Identification
• The Ottawa Charter for Health Promotion
• Screening, risk assessment, immunisation and surveillance
Lectures:
• Wound Healing Physiology – Acute Wounds
• Wound Healing Physiology – Chronic Wounds
• Wound Healing and Assessment
• Planning, Implementation and Evaluation in Health Promotion
• Health Education Promotion
• Community Nursing in Australia in this Era
Homework:
• Project Campaign Planning Sheet
• Team Education Session Plan and Evaluation Tool (worth 10%)
• Essay – Community Needs Health Assessment (worth 40%, 2000 words and about half done)
Videos:
• Wound Dressings – Topical Agents, Films, Foams, Hydrocolloids, Alginates, Cadexomer Iodine, Hydroactives, Hydrogels, Silver Dressings, Bandages.

End of week update

This is what I got done this weekend:

Online modules:
• Basic ECG Interpretation – I got 100% on this, although it was open book and the answers were pretty easy to find. This is actually a complicated skill that I don’t really understand that well yet.
Reading
• Spirometry in Primary Care
• Infection Control Standard Precautions
• Guidelines for the management of iron deficiency anaemia
• Assessing common endocrine abnormalities
• Preparing the Patient for Colostomy Care
• Assessment of Patient for Pressure Ulcer: Risk and Skin Asseessment
• Reviewing health promotion in nursing education
• Treating Pressure Ulcers
• Applying Dressing: Dry or Wet-to-Dry and Transparent
• Wound Vacuum assisted closure
Lectures:
• Effects of Immobility on the Medical Patient
• The Nursing Considerations of a Patient with Mental Illness in the General Ward
• Respiratory Disorders – Asthma and Pneumonia
Videos:
• Living with Asthma (Child)

This week I plan to work on assignments as much as I can. I have two individual essays due in the next few weeks and also two group oral presentations (both next week) to prepare for and a group assignment. I'm going to be working on Thursday and Friday so I probably won't have as much time get a lot of reading done like I have been doing on my days off, so I'm going to make the assignments my priority.