Well it was a crazy ride this weekend! On Friday we went up with CA, she was amazingly sweet and made us all feel very comfortable. We got 15min to walk around the lab stations and look at everything...(make sure you OPEN the wound up and see how it's situated, and at the IM/SQ check NEEDLE LENGTH and syringes and play with everything!) So then it's test time! First station was IV PUSH...walk up, get started, hands shook a little bit but i was good and finished in 7min- got 1mL over 30seconds! Then went to IM/SQ, got an IM injection...i DROP the damn thing on the floor...no sweat, just grabbed another needle and kept going. Located spot to give injection, buried it to hub and aspirated then heard "STOP" from the CE...****...well silly me didn't check needle length on my second syringe and luck of the draw i selected a 1.5in needle and not a 1 in needle...ugghhh...FAIL...ok, step out of room, shook it off and splashed some water on my face....back in the room i hit secondary piggy back...25gtts/min...NO SWEAT...done in 8min! PASS...finally wound...Had the wound packed and completed in 8min =) PASS...so 3 labs down, one make up on saturdy...no problem. Got to meet my first CE (and she was sour puss looking...ugghhh, i swallowed back my anxiety and got my 1st assignment, checked chart, and headed back to the hotel. PCS #1- Med dx was Ascities, Cirrohsis, and chronic kidney diseas- AOC's Abdominal Assessment, Peripheral Vascular Assessment, Medication (heparin sq injection and aspirin po), fluid management I&O's, VS- apical pulse, resp, man bp, oral temp, pain 0-1: having NO pain, Ambulates independently (i am to escort while walking) pedal pulses palpable, abdomen distended but having bowel movements and bowel sounds in all quads...AGGGHHHH so i have NO idea what to use for my care plan...i went with ineffective peripheral tissue perfusion, thankfully he had edema and i used ambulate and administer heparin sq for my care plan...PASS! Next patient was a 29yo man, 2 days post inguinal repair; O2 managment, respiratory managment, pain management, I&O's, and VS...ended up being a CRAZY pcs...he was medicated 1hr before i hit the floor with IV push morphine...so i used acute pain and ineffective airway clearance for my care plan...i walk in the room and he is CRYING out in pain and rating 10/10...crap! I have NO meds to give and i have to try my other 3 interventions...he was so sweet though and muddled through participating until we got to I&SX10..he tried 1 time and couldn't do it due to pain! I used CDM and stopped my respiratory management! hunted down the nurse and had her medicate...crap...30min i have to wait to re-assess before i can re-attempt resp mgt...well 30 min go by i rush back in the room he's 4/10 YEAH! did resp mgmt with I&SX10...literally finished charting as she walked up to get my paper! PASS...back to the lab...got SQ, PASS in 5 min (i had to pull up a total of 14 units...easy!) so i just had the one PCS today which was a 5yr asthma...and he is WHINY...BIG TIME...only thing i'm assigned comfort managment, medication: prednisone po, VS, Intake only, and respiratory assessment...uggghhhh used ineffective airway clearance and impaired comfort...kiddo is ONLY wanting a video game system to "distract" him- BUT i can't get one until 945a when someone gets there to open the play room up! aaggg...TV distracted somewhat, took me 15 min to get meds in him, didn't want to color or draw, refused to walk with me, let me reposition him and nodded his head when asked if he felt better...then trying to get vitals and he is squirmy and whiny and talking....grrrrr...CE was great though and kept shhhhing him for me! lol...coaxed him into meds for me too! lol...so breath sounds were abnormal lower clear upper, and to get my "patient" response for the evaluation form i asked mom if reposition him upright helped him to breath easier (she answered yes) and if she noticed that since he has been taking the prednisone if he was breathing easier 'yet" woo hoo had my care plan, turned it in and was walking out of Grady Hospital in Atlanta by 1015am! =) so there is my weekend! It wasn't bad at all, i was a little nervous, but honestly the patient care is JUST like you do it every day at work, just do it the WAY EC WANTS YOU TO! as long as you memorize your critical elements and understand how EC wants you to write a careplan then you are golden...2 of 7 (me and another girl) passed with no PCS repeats- we both took the same workshops, 1 passed but had repeat labs and 2 repeat PCS's. the rest failed out on sunday during repeat PCS's.
