tbear1206

Thank you. Yes, I had called my instructor ASAP. And was instructed not to go in, a make-up would be scheduled. Since then, I did the clinical make-up and was never late/absent to a clinical. That was the first and last time.

Yes, thank you. I had called my instructor as soon as I realized how late I was. I was told not to go in since I was more than ten minutes late but my instructor also said not to worry about it and that a make-up would have to be scheduled. A few weeks later I did my make-up clinical. This was the first and last time I was ever late/missed clinical.

Scenario: An 80 year old female presents to the ED with a 2 day history of persistent vomiting. She is lethargic and weak and has body aches. Her mucous membranes are dry and her capillary refill is >4 seconds. ABG results are pH 7.5, PaC02 25, HC03 17, and Pa02 90%. Regarding the preceding scenario, I understand the patient is experiencing respiratory alkalosis with metabolic compensation. My theory to the pathophysiology is that the patient is experiencing early hypovolemic shock due to excessive loss of body fluids. Hypovolemic shock results in tachypnea, leading to respiratory alkalosis. I am just wondering, is the patient compensating or worsening? I am aware that the body also has mechanisms to compensate and regulate the pH. However, hypoperfusion to organs (in late hypovolemic shock) will lead to lactic acidosis (metabolic acidosis). Since the patient's HCO3 leve is 17 (acidodic) is her condition worsening, or is her body compensating?? Or am I just making it more complicated?

Thanks everyone! I really appreciate all of your advice!! I will surely make use of it all and hopefully this doesn't happen to me again!

Thanks! I am so not relying on my phone anymore!! Gonna go buy myself a real alarm clock!

Yes, my school does allow clinical make-up. I'm going to have to figure that out with my instructor because she did not plan for anyone to have a clinical make-up this semester, since it is our last semester (God-willing). As for the floor staff, they actually were aware that I was going to be there because I had been there the previous day, and told the nurse I was shadowing that I would be there today (HOW EMBARRASSING)! I was so sure I would be there though.

Thanks, I'm just very embarrassed. Do you all feel this will give me a negative reputation as a future-nurse? Because I was really very interested in working on that unit.

This morning I was suppose to be in clinical. I woke up about 25 mins after I was suppose to be at the site. Apparently my phone messed up, because when I woke up my alarms (I have several just in case) were "ringing" but no sound was coming out of my phone. Anyways..My instructors say "If you're more than 10 minutes late, don't even bother showing up" because they will send you home.. I still called to make them aware of the situation. I am in my last semester of nursing school and have never missed a clinical before this and I am so distraught that this happened to me!!! Especially because I absolutely love the unit that I was scheduled to be at!! I feel like I just made myself look really bad at my prospective job-site!! What do you guys think?? Has this ever happened to you??

I dream that at least once a semester! I thought it was only me haha...

I will God-willing graduate in May!! .... but I continue to have the late to clinicals, missed a final, neglected a class that I forgot existed, forgetting to turn in assignments nightmares.. I have so many nightmares about school its not even funny.. I wake up several times a night running around my apartment making sure that the time on my clock is the same on all the other clocks. I feel paranoid, but that's what nursing school does to you!