First Real clinical of 2nd semester....

[locolorenzo22, BSN, RN]

WOW!!! :trout: I was SOOOOO Worried over nothing last night about today's clinical!!! I stayed up late, researched meds over and over, organized clinical bag 3x, just staying busy....

I get to the floor today and find out from staff nurse(who was called in arrived at 7AM, got report with me on tape, and kept me from preconf) he's NPO for a CT needle biopsy rt a lung mass....

So, I get to go in, introduce myself and then say "sorry, you're NPO, so now you can't have much water or juice until after your procedure....."

His IV popped out, fluids soaking the bed (probably since 6AM-before I got there), bed still wet when I go in to do assessment so I get to change bed, then assess, get him an IV and get setup for transport....

Then, his doctor (the really silent type) shows up for rounds at 9:30 :trout:

Walks into room with me behind and charge nurse...he asks her 1 ? she gives answer, then gets paged out of room, and it's just me and the doc....in my head, I'm going "OH MY GOD, I'M JUST A STUDENT AND I HAVE HAVE HAVE TO ANSWER WHATEVER HE ASKS ME!!!!" So, doc asks why tongue appears white/yeasty, and I respond, "He's NPO due to 1000 CT procedure, he was in some pain 9/10 at 9AM, we gave him 650mg Tylenol and 5 mins ago his pain was a 1/10...." Then followed doc back to nurses station, he sits down to write orders then looks at me and says "his WBC are a little high arent' they?" I respond "Yes, sir....this could be related to his current immunosuppressive therapy rt cancer treatment or also the tumor itself.." He then gives me a 10 min lesson about what WBC "marginalization" means....wow, total 180!!!!

Took pt down for procedure, then got to position him on table, watch them do films to get site, reposition, monitor BP/o2/pulse, observe dr get the biopsy, then freak when the IV stopped working and kept beeping (occlusion in line) for the rest of the shift.....

then I got to go to X-ray, help position films under his arm...the new digital developed films are pretty cool..they pop up quick...

Then get back to flr, find out doc wants VS and O2sat q15minx4, q30minsx2, and q1hx2....after first two sets....EVERYONE ELSE GOES TO LUNCH!!!! I have to get pt water, order a tray, get first two VS sets, arrange for tech to take VS for me for the one I would miss, then chart my assessment (from 0800 that I never got a chance to get to a computer for....) wow.....long day....after lunch went a lot smoother...got to give his morning meds and sign MAR for 1330 for 0900 meds and let afternoons figure it out, according to staff nurse instructions....

all in all...it's a different world in the hospital folks!!! and next week we get to take 2 pts!!!! HOW WILL I SURVIVE?????

JK, I'M trying to take it day by day...bite by bite.....

all for now.

[beachbum3]

geesh. my clinical on weds was pretty low key. we were all practically begging her for a second pt. next week! And honestly, I wasn't nervous. It was really weird- all last semester I was ridiculously nervous before and during clinical. This time- nothing- complete calm. Don't know what gives but I hope it sticks!

[sacrdhazel]

wowwwww.. although crazy day, you will be happy you had it. there is no better teacher than experience. i did an externship this past summer and the preceptor nurse would leave me alone on purpose with the rotating med students in order to give report. I cant tell you the wealth of knowledge and confidence I learned from that experience.

all in all it sounds like you handle yourself spectacularly! good job! and good luck this semester. I am starting a new school tomorrow (after transferring from another clinical program) and i just about bit down to my cuticles.

[sddlnscp]

Wow! Awesome! Congrats, that is great! I am in my 2nd semester now and I start Med/Surg clinicals Feb. 3rd at the hospital. I am really nervous about it and hope I can fare as well out there.

[Chrissypa]

Hello, I started my hospital clinicals yesterday and loved it. My PT had a colon resection and had a JP drain and was on 2 IV med's. Had a catheter. I got to remove catheter, change his dressing, remove one of the med's from the IV. Which was a first for me. When we were at the nursing home our PT's only required bathing and feeding. So yesterday was a real change. I was so excited I got to do so much on my first day! The Dr. came in when I was in there myself and never asked me any questions at all. Good Luck! Chrissy

[SteveNNP, MSN, NP]

Good Job!

You just got a taste of what it's like in the real world.... just multiply it by 4-6 pts and you'll be ready!! No really, it's like running, where you have to gradually add distance until you're up to your goal. You'll find that out here you may not get to chart or "see" your chart until hours have gone by, get interrupted constantly, etc. It sounds like you are having a great clinical experience. My advice is to take a couple of hours before bed the night before and do something fun or relaxing. I remember the butterflies in my stomach the night before clinicals, but relaxing definitely helped. Good luck!

Stevern21

[locolorenzo22, BSN, RN]

Steve, I try, but between the research time and trying to get things organized, I'm lucky to be in bed by 10.....

However, this week went much better, got a lot of skills checked off on my program card...

Side note- Unfortunately, the gentleman I took care of the week I wrote the OP passed away later that same day. Completely unexpected, was doing fine when I went to postconference, then came out, bed was empty, figured he'd gone to another floor for procedure.....turned out he went to rehab, had dinner, slept, never woke up.....what a feeling to know I was one of the last people to deal with him...I can only hope I made a difference in his last 24 hours on this plain.....sobering thought.