7/3 WILTW: Brain Development, Standardized Patients and Female Condom

Nurses General Nursing

Published

I am honored to be filling in for our beloved ixchel's WILTW thread once again.

As I continue adjusting to my new job as well as reaching the halfway point in my assessment class for my MS PMHNP progeam, I am glad to have this opportunity to reflect on what I have learned. I also really enjoy seeing what we can learn from each other and how our varying nursing roles result in varying weekly lessons.

Brain Development

I attended the third of my sexual reproductive health trainings this week, and learned a lot of new information about adolescent brain development and the translation of said development in various activities and education needs. I found it really interesting to learn a possible cause for the impulsivity, thrill seeking, and at times promiscuous behavior of many of the teens with whom I have contact.

The brain goes through a period of development during the adolescent period (ages 12-26) after which both the limbic system and prefrontal cortex ate completely developed. However, these two systems do not develop at the same rate. The prefrontal cortex develops more slowly than the limbic system. As the limbic system seeks pleadure, risks and reward and the prefrontal cortex is involved in logic and decision making, it would make sense that during adolescence teens seek thrills and rewards at a rate at which the prefrontal cortex cannot keep up.

Standardized Patients

As a student in a MS PMHNP program, I had a midterm in a OSCE environment and was required to conduct an H&P on a standardized patient. As I had used standardized patients in my RN to BS P

program I thought I knew what to expect. The experience was good overall.

However, I am short, barely over 5 feet. The standardized patient was 6'8". I had difficulty with the HEENT component if the exam because I could not reach the SP's face. This struggle got me thinking about how I would address this in an actual clinic. I had never encountered this issue (possibly because of the do I if setup). Any ideas?

Female Condoms

This week I found out that female condoms are still in use and provided to our clinic. We found this interesting because none of the nurses, PNPs or MDs have been using them in practice. When we got a new drluberyofcondoms from our DOH, there they were. We all has to figure out how to use them because we have not seen them or used them in quite some time.

What did YOU learn this week?

Specializes in OR, Nursing Professional Development.
I'd say the best part of the day was when they gave him some medication to make him all loopy & calm before surgery. He was acting so goofy. I don't know what medication that was but can I have a barrel of it? LOL!

Versed is a heck of a drug. I loooooooove it. Not for me personally, for my patients.

Sort of along that line, today reinforced the fact that I like my patients anesthetized. Trying to do a preop interview with my patient today and get a straight answer was like pulling teeth out of a shark's mouth. Ask a question that requires a short, to the point answer (can you confirm your name and DOB for me?) leads to a long, 5 minute drawn out life story. Same with each subsequent question. And then the spouse would interject even more not important information that I don't need to know (you had sex last week? congrats- didn't really want to know that and it's not going to change my plan of care). Oh, but once we gave Versed, how quiet he became...

Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Versed is a heck of a drug. I loooooooove it. Not for me personally, for my patients.

Sort of along that line, today reinforced the fact that I like my patients anesthetized. Trying to do a preop interview with my patient today and get a straight answer was like pulling teeth out of a shark's mouth. Ask a question that requires a short, to the point answer (can you confirm your name and DOB for me?) leads to a long, 5 minute drawn out life story. Same with each subsequent question. And then the spouse would interject even more not important information that I don't need to know (you had sex last week? congrats- didn't really want to know that and it's not going to change my plan of care). Oh, but once we gave Versed, how quiet he became...

LMAO!!!! I love this post more than I should.

Versed is a heck of a drug. I loooooooove it. Not for me personally, for my patients.

Sort of along that line, today reinforced the fact that I like my patients anesthetized. Trying to do a preop interview with my patient today and get a straight answer was like pulling teeth out of a shark's mouth. Ask a question that requires a short, to the point answer (can you confirm your name and DOB for me?) leads to a long, 5 minute drawn out life story. Same with each subsequent question. And then the spouse would interject even more not important information that I don't need to know (you had sex last week? congrats- didn't really want to know that and it's not going to change my plan of care). Oh, but once we gave Versed, how quiet he became...

I've had people start talking more nonsense when they got versed, more so the IV form than oral form. I was helping once with a TEE and the CRNA had just given him versed. He started confessing stuff he probably wouldn't confess otherwise. The anesthesiologist was also in the room, telling the cardiologist to hurry up.

Specializes in OR, Nursing Professional Development.
I've had people start talking more nonsense when they got versed more so the IV form than oral form. I was helping once with a TEE and the CRNA had just given him versed. He started confessing stuff he probably wouldn't confess otherwise. The anesthesiologist was also in the room, telling the cardiologist to hurry up.[/quote']

Oh, we give enough so that when we get to the OR and it's time for the patient to move themselves over to the OR bed, we have to wake them up. And sometimes we just give up and do it ourselves because they're lightweights! (All patients have sat monitor on. We don't act willy-nilly.)

Phew, this was quite a busy weekend.

Since I start in 1.5 weeks now, there's a lot to finish. All my references have been submitted, and my background check results should be coming in soon.

Looking for apartments is stressful, especially when you're out of state. When I was in college, I was never this thorough. This time around, I've looked at recent complaints, crimes mearby, registered sex offenders, etc. while choosing location and apartment complexes. And my friend has decided to terminate her lease, pay the fine, and room with me. We'll both be saving $300+/month by sharing, which is exciting, as we both have loans to pay off with that extra cash.

I've learned that going into oncology has made me research a bit into chemo and such. Apparently, as you D/C chemo Tx and are placing the IV tubing and bag in the specified bags for disposal, you do NOT squeeze out air, as some of the Tx may disperse in the air. I'll have to especially remember this, since I am that person who habitually squeezes out all the air from bags.

Specializes in long term care Alzheimers Patients.
My son's surgery went rather well. The tubes were put in in less than 10 minutes & I'd say the whole day was rather painless. All the nurses were so great & so nice.

I'd say the best part of the day was when they gave him some medication to make him all loopy & calm before surgery. He was acting so goofy. I don't know what medication that was but can I have a barrel of it? LOL!

Glad to hear your son ' s surgery went well.

Specializes in Renal, Diabetic.

This week, I learned:

Not all blood wants to flow out of someone, especially when I actually need it to.

That I can actually use a butterfly! I normally use a straight stick to draw, as I would always miss, but this past week I only have butterfly needles, so I got to practice. I'm in love, and I'm not sure that's a good thing. ;)

That you CAN get sick two times in the same amount of weeks. First an ear infection, a week of health, and now a sore throat/cough with body aches. Needless to say I am grumpy, as the husband is on a business trip and can't take care of me (That was NOT in the marriage agreement ;))

That I've decided that the doctor who told me the amount of sore throats I was having would reduce drastically once I got my tonsils out was a big ol' fibber.

Specializes in critical care.

However, I am short, barely over 5 feet. The standardized patient was 6'8". I had difficulty with the HEENT component if the exam because I could not reach the SP's face. This struggle got me thinking about how I would address this in an actual clinic. I had never encountered this issue (possibly because of the do I if setup). Any ideas?

"Excuse me, sir/ma'am? May I climb you like a tree?" :)

Another excellent OP, a&o! Thank you so, so much! I absolutely love it when students do these OPs because we get some excellent physio and patho lessons. I'm such a dork for physiology and pathology!

I really don't think I have anything to share this week. This coming week will probably be another "things I learned as a patient" OP. Busy days, today and tomorrow!

Alright - gotta catch up on last week and this week!

Specializes in OR.
My son's surgery went rather well. The tubes were put in in less than 10 minutes & I'd say the whole day was rather painless. All the nurses were so great & so nice.

I'd say the best part of the day was when they gave him some medication to make him all loopy & calm before surgery. He was acting so goofy. I don't know what medication that was but can I have a barrel of it? LOL!

It was probably Versed. Wonderful drug, especially for those little ones. The are so funny when it hits! Makes it so much easier to take them away from mom and dad. Sometimes I think some of the parents need it, too; some cry more than their kiddo. I miss doing the ear tubes and tonsils on the little ones. Was kinda nice to hold a tot for either transport or induction.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.
It was probably Versed. Wonderful drug, especially for those little ones. The are so funny when it hits! Makes it so much easier to take them away from mom and dad. Sometimes I think some of the parents need it, too; some cry more than their kiddo. I miss doing the ear tubes and tonsils on the little ones. Was kinda nice to hold a tot for either transport or induction.

I took a video of my son. OMG! He was hilarious!!! I showed my husband (because he was at work) he laughed so hard & kept watching the video. I think it's my favorite video of my son so far. [emoji13]

Specializes in OR.

What I learned this week... That a 15-week spontaneous ab fetus has tiny perfectly formed body parts... And that I can detach my brain into clinical mode when doing the d&c for it. (Warning...following statement is graphic: really helpful when you have to check that all the pieces are there). Otherwise I don't think I could have finished my shift.

Also learned that I do a decent job as a scrub nurse, even though it's been a while. Love the OR!

Specializes in CNA 8 yrs LPN 6 geri, chemical dependency.

Can't shorter nurses just have a tall patient sit down for HEENT?

+ Add a Comment