Thursday, April 30, 2009

OB ATI Grade:

75%, Level 2!

Yay! ATI is over. Now, it's time for the finals.

Pharm is tomorrow from 6-8 pm!

Last One

Here goes nothin'!

OB ATI starts in one minute...

Wednesday, April 29, 2009

Med/Surg ATI Grade:

Yep. Level 1.

No surprises there. No big deal, either. Like I said - priority is Pharm Final!

And tomorrow - OB ATI.

Round 2

I'm back in the same chair, at the same computer, waiting to start my Med/Surg ATI test.

I haven't studied.... not one bit.

I have been way too concerned about studying for my Pharm final on Friday to study for this test, or for tomorrow's. We'll see how I come out of this one.

I just had someone say to me "Don't say you're gonna fail. All the right answers are in front of you."

No, one right answer is in front of me, in the midsts of 3 wrong ones!

Tuesday, April 28, 2009

Pharmacology ATI Grade:

70%... which is a Level 2!

This means that I keep my current test average; I don't add or subtract 5 points. This is fantastic because I expected/prepared myself for a Level 1, which would have meant needing at least a passing grade (76% or higher) for the Pharmacology final in order to pass the class. Now, I still have an 80.6666667% test average and can handle getting a grade that is a little lower than passing on Pharm.

But let's hope for a grade that is higher than 76%.

Thanks for your continued prayers. That's 1 tests down, 6 to go.

Ready, Set....

I'm in the computer lab room, waiting for the test to start!

Catch 'Ya On The Flip Side

3 hours, 43 minutes... and counting....

Saturday, April 25, 2009

Update

I just finished a day that started at 9:00 am with studying for Pharm ATI. I took a break at 2:30 to get a TB test read (negative!), then came back to study some more.

At 9:00 pm, I enter the kitchen to find that there are more ants than I've ever seen; scurrying along in our sink, on the walls, on the window, under platters, and inching their way near the stove. No thanks, they aren't getting to my pantry. I had to use 3 wash rags to wipe them all up after drowning them in insect-killer spray, which doesn't really say is useful for killing ants, but it still works; it's not meant for humans either, but I'd probably stop moving if someone sprayed it in my eyes. Then I used 2 more wash rags to clean the walls and countertops with clorox and soapy water. Then I went to start the dishwasher and found more ants. What's going on? "We're being invaded!" (name that movie).

In other news, I took a break from studying yesterday to go to lunch at Ci Ci's Pizza. I cheated on my diet! The reason for the lunch was to get together with next year's Liberty Nursing Student Association board to talk about next year's events in the nursing program. My friends are the presidents for next year and they recruited me to be the photographer! I am so excited for this position! I'll document all of LNSA's events through photos. I'm thinking about getting a new camera (I think my mom is rolling her eyes at me through cyber space). The way I see it, I wanted to get a new camera for graduation anyway, so maybe I could get it a year early? I don't know, I'm running through my options.

Anyway, after that study break, my friends and I went over Pharmacology a bit longer then hit up Blockbuster for an educational movie (it really was). And wouldn't you know it, there was a question on the ATI practice test that I got right because of watching that movie! I probably could also have studied the information, but a movie is much more fun.

I can't study anymore tonight. I feel like I need to go shower and get the feeling of "ants crawling all over me" washed away.

*shiver*

Finalized ATI times:
Tuesday - Pharm ATI 12:30
Wednesday - Med/Surg ATI 11:45
Thursday - OB 10:30

Please pray specifically for my focus and concentration while I prepare for the Pharm ATI and final. This is a big thing that I have lost over the past few years, but am slowly getting back! Thanks to some Acetyl L. Carnitine and Phospholipids! :)

Thursday, April 23, 2009

New House.... Again. For the Last Time.

This.... is the house I will be living in next year.

The Lake House fell through when the city of Lynchburg learned that there would be 5 unrelated girls living there; to have more than 3 unrelated girls in a house in Lynchburg is not allowed. So, about a week ago, we split up, and 3 of us started searching for another place to rent in the middle of having to study for OB and 6 finals. In the nursing world, this would be considered "a stressor". In the nursing student world, it's considered "AAAHHHH! NO TIME! NOW I'M GOING TO FAIL EVERYTHING!"

After searching around and looking at many houses, we finally found the one that would be our home for the next 12 months. It's in a quiet neighborhood just 10 minutes from campus, if you hit all the red lights, and probably 10 minutes from the hospital as well.


Here's the house:



As you walk into the living room, there's a cute little shelf that is also a door to the attic. One of my housemates will have her bedroom up there.


There's even a small porch off the attic (with no stairs off of it) and plenty of storage space. Here's a picture taken from the porch looking towards the bedroom and stairs to the living room.
Down the hallway from the living room is my room.

If you walk straight out of my room, you'll head into the kitchen. (No pictures of my other housemate's room just to the left of the kitchen door.) We'll get to the kitchen later. First, if you turn to the left and go into the room next to mine, there is a spare room that leads into the laundry room. The laundry room leads into the sun room, and the sunroom has a door to the back yard.

Sorry about the strange dots from the flash. I was taking quick pictures. The doorway there to the right goes to the laundry room.

Here's our (one and only) bathroom: (if you looked through that window, you'd be looking into the sun room.)

Here's the kitchen. The colors in this house are so nice!

The other door off of the kitchen goes into the dining room:

We were thrilled to see that it was a swinging door :)

The dining room:

And we're back to the living room!

That's it! It's a beautiful house and it will be nice to live in next year. But for now, it's time to put my nose back into my ATI book!

OB Test 3 Grade:

94!

That's an A!

(First ATI test on Tuesday - Pharmacology)

Wednesday, April 22, 2009

Mother Baby Week 3

The last Mother Baby clinical!
The last clinical of Junior year!

This week, my patient was a new admission, straight from Labor and Delivery. She was rolled over to our floor with Dad strolling along behind her, pushing their little bundle of new baby joy in the crib. And boy did they look tired.

They had been laboring (I should say she had been laboring) for over 24 hours. With an admission, you simply slide mom over from one bed to another and get report from the L&D nurse. Yay! You're admitted! Welcome to Mother Baby! Estimated time of discharge: 3 days. My name's April, I'll be working with your nurse today and I'll be taking care of you!

Everything went on as normal from there; vital signs, mommy assessment, pain rating, check the belly. Quick Chart every 2 hours. I set dad up with some fresh sheets for his bed and explained that I would be doing an assessment on baby. Again, like all new parents, they looked at me like, "You have to take the baby away?". I had to perform a Dubowitz as part of my assessment, but I decided to postpone that until the afternoon; so I took baby's vitals and checked his fontanels, skin, belly, muscle tone, heart, lung and belly sounds, etc. where mom and dad could watch.

Another question you ask frequently on the floor is when and for how long the baby fed/how the baby did feeding. This baby was a champ. I had a hard time keeping up with my charting of the "Intake and Output"! And all that milk has to come out the other end. Poor dad got a lot of practice doing each sticky diaper change (you remember how the first few stools are meconium? The sticky green/black stuff?). It was fun to watch a first-time dad with a diaper. His exact words were, "They said we could expect maybe one bowel movement today." - that was with the 4th or 5th diaper change of the morning/afternoon. I got a couple, too, while doing assessments. The baby also wet the bed a couple times, soaking through most of the things in the crib, and I was able to encourage dad and cheer him on as he learned to change the baby's clothes (which really is a lot of fun to be able to do).

When the afternoon rolled around, the mom and dad had some visitors. Handling babies can stress them out, changing their heart rate and making them really tired. I debated whether or not to take the baby out of the room to do the assessment real quick before having baby get passed around to the first-time grandparents... so my nurse and I decided it may be best to get the assessment over with (so it would be accurate), then give the family time with the baby without needing to disturb them farther. As I walked into the room, mom was handing the baby over to grandma, and I had to take the baby away. I felt so bad! But they were very understanding.

I rolled the baby to the nursery and did a second assessment and the Dubowitz. The Dubowitz scale measures the baby's neurological and physiological development compared with his/her gestational age. A premature baby would have a lower score than a term baby. The assessment takes a while for a first-timer like me, and every so often I'd see dad waltz by the nursery window and smile.

**EXCITMENT!** I was able to autonomously practice something I learned while on the floor - while listening to the baby's lungs, I could hear gas bubbles stirrin' up. I also saw that the baby was trying to swallow the gas bubbles (and baby sure had been eating, but I hadn't seen any burping). So, I scooped the baby up into a sitting position in the crib, put one hand on the chest and cheeks while my elbow was resting in the crib, and gave some productive pats on the back and rubs on the head (which helps the baby to relax so they can get the bubbles out). I've burped babies before, but it just felt so... "nursey" :) haha.
Dad walked by while I was doing it, and when I later took the baby back into the room (I felt terible at how long I deprived those grandmothers the pleasure of holding their first grandchild) I mentioned that the baby was a little gassy and may need to be burped more. I was able to teach them how to recognize when signs of needing to be burped and the best way to do it.

Then the baby had another meconium stool.

Tuesday, April 21, 2009

Schedule

Keep the LU Nursing class of 2010 in your thoughts and prayers:

Tomorrow: OB test, 7:40 am
Tuesday 4/28: Pharmacology ATI test, 12:30 pm
Wednesday 4/29: Medical/Surgical ATI test, 8:30 am
Thursday 4/30: OB ATI test, 10:30 am
Friday 5/1: Pharmacology FINAL
Monday 5/4: Medical/Surgical FINAL
Tuesday 5/5: Bible and OB FINALS
Done-ski.

It's so mean. 7 tests in a row.

ATI tests are like NCLEX practice tests (the NCLEX test is what you take after you graduate to get your nursing license). Our grades on the ATI tests count as a test grade in our classes. Grading for the ATI is divided into 3 levels, Level 1,2, and 3. If you get a Level 1, you take the average of all your test scores in the corresponding class and subtract 5 points; that becomes a test grade. If you get a Level 2 on the ATI, you average all of your previous tests grades, and that becomes your score. A Level 3, you add 5 points to your average.

For example, I have a 90% test average in my Med/Surg class from my 3 previous tests. If I get a Level 1 on the ATI, I'll take 90 minus 5 points, and my 4th test grade for the class will be an 85. If I get a Level 2, my 4th test grade will be a 90, because that's my current test average. If I get a Level 3, my 4th test score will be a 95. I'm not worried about this class, there's no time for that.

Why do I not have time to worry? Because the medicines I'm taking are suppressing my sense of worry and stress? Maybe, but no.
I've no time to think about Med/Surg because I'm worried about Pharm. If you read below, you'll see I only got a 72% on my last test, and I'm still trying to get over it. It's like a paper cut, and the thought of that test is the lemon juice. My average in that class is an 80.6666667% (OUCH! I found another paper cut!). So a Level 1 would put me at a new test average of about 79%. This would mean I'd have to at least pass my final (passing is a 76%) to pass the class. People don't generally do well on Pharm ATI. I was building a nice cushion with my test grades so I could handle a Level 1 on ATI, but last week's test blew that cushion right up, blew it into smitherines, outta the water, into oblivion. *POOF* - - - need I elaborate more?

*KA-POW*

I'll know where I stand with OB tomorrow. I'd like to get above an 85% on the test tomorrow. People generally do well on OB ATI.

Matthew 6:34 "Do not worry about tomorrow, for tomorrow will worry about itself."

:)

Friday, April 17, 2009

"Here We Come, Dorothy!"

There were a lot more Dorothys than she expected.

"Be gentle with Dorothy."

"Take Dar-see out?"
"No, Dorothy needs her water!"

"And then we walked inside, and we had to find Dorothy out of a million fish. And then we put her in a bag and the guy wrote on it with a marker. And Uncle, guess what! We saw blue and green birds. And then I held Dorothy and shook her bag out of excitement! Then Poppy and Bryce put her in her house! And then I fed Dorothy and she ate it!"

Thursday, April 16, 2009

Rats!

Was it Charles Schultz that said there is no reason to ever have to say anything other than "Rats!" when something bad happens in life? The quote goes something like that....

Let's apply this principle to my day:

5:17 am after deciding to sleep for another hour - "Rats! My phone alarm is going off again, I thought I set it to only go off once."
6:00 am - "No time for a shower this morning. Rats!"
7:20 am - "Rats! My car won't start, I wore out the battery.... RATS!"
8:40 am - "We can use our Bible for the Bible quiz? Rats! I don't have my Bible!"
10:00 am - "Rats! My Pharmacology test is in half an hour!"
10:30 am - "This test has nothing to do with what I studied. RATS! RATS! RATS!"

(current time) - "I got a 72% on the test."


"Rats!"

Tuesday, April 14, 2009

Mother Baby Week 2

Yesterday was my second of three 12 hour shifts on Mother Baby. I had "couplet" responsibilities, which meant I took care of both Mom and Baby. Last week I only had a Mom and helped with a new baby admission while I had some time.

I was again responsible for vital signs and a complete assessment of my Mom in the morning; this meant waltzing into a room and having, not just to wake up a sleeping new Mommy, but her husband, a brand spankin' new Daddy, as well. But I'm always pleasantly surprised at how well the new parents take to being woken up around 7:50 am. This is a good sign, because just wait till you get home, new parents!

This Mom was a C-section because of Failure to Progress, meaning that she didn't go into spontaneous labor on her own. She was 40 weeks and 3 days, so just past her due date. She was induced with Pitocin and taken to the OR. I think she was a section because the baby was 9 lbs. 12 oz.... but I don't know. I probablly should have. Since she was a section, she needed a second assessment in the afternoon in stead of just one in the morning. Between assessments I quick charted on her, which I think I've mentioned before?... it's basically just a quick check to ask about pain and make sure the patient is safe. I was able to give Mom some Motrin throughout the day for pain.

Her Baby was rolled from the nursery by the doctor before I could do an assessment and taken to Mom so Mom could try feeding. I wasn't able to do my first assessment until 10:00, and I did it in the room with Mom and Dad watching because I don't think they wanted her taken away to the nursery. You could tell they just wanted her to stay in the room so they could hold her and get to know her.

I felt the fontanels, or soft spots, listened to the heart, lungs, and belly, took her temperature, checked out the umbilical cord, felt the little soft tummy, noted that the baby was pink, checked her diaper (poor Dad found the "blow out" before I got to do the assessment, he was such a sport. He picked up the baby and I heard "Eeaaaa" (how do you spell that noise?) and he revieled a poopy finger), and noted a little Sacral Dimple at the bottom of her spine. I also cleaned the Dimple out, there were leftovers of the "blow out" in there. The doctor wanted to do an ultrasound later to check for any spinal cord abnormalities. I also checked the baby's muscle tone and movement (she moved just fine, so there probablly wasn't anything wrong with the spinal cord). And one perk of the job was that I got to pick up the little one. That's only everything I've been waiting for! It's fun to be the one to pick her up, wrap her in two blankets, and deliver her to Daddy's waiting arms. So cute. Baby got three full assessments during the day and at least 2 "quick charts". I got to give her Erythromycin gel in her eyes twice during the shift because she was having some yellow discharge.

Another great clinical day. One more to go, and clinicals are over until next year! That's the Senior year, by the way ;)

Saturday, April 11, 2009

Happy Easter!

"And in case I don't see ya, good afternoon, good evening, and goodnight!"

Friday, April 10, 2009

Beautiful Creation

The best feeling comes after taking a nursing test. I step out of the classroom and I feel like Dorothy, coming out of her house after it landed in Munchkin Land (taking the test would be a twista! a twista!). It's like seeing color for the first time. Everything is beautiful. You see little munchkins sleeping in giant flowers, giant round lollipops, pink bubbles that turn into good witches from the North.

I drove home after my test on Wendesday (84%... good, Mom!) and started doing the mound of dishes flowing from our sink and countertops. But outside the window the sky was so blue, and the clouds seemed much more appealing than the bee I almost grabbed that was hiding on a dirty spoon.


As I was walking back inside, I stopped to take a few shots of some pretty flowers outside our house. The colors were amazing, and they were just beginning to open.


The next day, I had to run home before heading to the hospital to get my patient information because I had forgotten my lab coat. On my way back out to the Jeep, I noticed that the flowers had opened up completely, so I ran back in the house, and got my camera.



I was on my way out this afternoon to turn in an assignment for OB class when I noticed that it had rained. The flowers had closed back up, but still looked so pretty.


The little rain drops looked like bits of sugar, which may be why I'm so drawn to them. I miss surgar, but we have a love-hate relationship at the moment.


There's something about flowers. It's like they draw you close to them so you can appreciate their intricate beauty. You can't take a picture of a flower without making it a close-up!

Tuesday, April 7, 2009

Mother Baby

Yesterday was my first of three Mother Baby clinicals. For 3 consecutive Mondays, we spend a 12 hour shift taking care of both Mom's and Baby's needs.

Yesterday, I was only responsible for my Mom (next week I'll care for a baby, then the third week for both Mom and Baby). At 8am I took her vital signs, checked her belly, rated her pain, changed her sheets, and charted my assessment. This was her third baby, so she was pretty self-sufficient. I "Quick-Chart"ed on her (re-assess and document her: pain and where the pain is/how it feels, location in the room, what she is doing, who she is with, if her call bell is in reach, bed low position, IV site is working, ask if she needs anything to drink) every 2 hours and whenever I entered her room. Later in the afternoon, I checked her belly again.

Since my patient was doing just fine, I was able to help with the admission on a newborn. The Labor and Delivery floor was packed with 5 C-Sections, one of them being twins! We got a section baby and a few of us got to help our instructor assess the baby for admission. Since it was a section baby, her lungs were a little "juicy" because she wasn't squeezed coming out (like normal delivery babies are). She had a couple short periods of respiratory distress where she was grunting and flaring her nose, but she was okay. We listened to her heart and lungs, took her temperature, blood glucose, head circumference and length. We also had to rate her on the Dubowitz scale, which assesses her gestational age and neurological function: we look for her reaction to light and sound, movement and muscle tone, reflexes, and behavior. We could see how she sat in Mom's tummy; she was most comfortable on her back with the legs both to one side, right leg crossed over the left. She was such a lady. We had to re-take her vital signs every 30 minutes. A few of us got to bathe her, and I was able to measure her head and length, take her foot prints, give her a vitamin K shot in her leg, take a blood glucose, and put on her first little diaper.

All babies get a natural increase of Vitamin K on their 8th day of life. Vitamin K helps your blood to clot. Do you know what else happened on the 8th day of life in Biblical times? That's when the little boys would be circumcised. God made sure they would have a surge in the clotting factor for that day! I love learning little things like that.

All in all it was a fun clinical experience. It's neat to get the babies in the nursery fresh from a C-section, then have Mom rolled up to the window when she is out of the OR and see her expression as she looks at her new baby for the first time! I am looking forward to these next two Mondays!

Wednesday, April 1, 2009

Hopkins Update

So last night, I get another call from Johns Hopkins. Again, it was the NICU nurse manager that interviewed me for the CNA position. He called to say that, because of the economy, most of the floors in the hospital are having budget cuts and are therefore required to cut back on new hires. This wasn't too much of a surprise for me (except for the fact that I was already told that I got the job) because the floor that I was on last year isn't hiring any new people... at all.

This doesn't mean that I no longer have a job, but it does mean that I may be transferred to another floor that is able to hire more CNAs. Right now, they are going through all the applications of the people they have already hired (like me) and are going to pick 6 people to work during the summer in the NICU.

"So you're telling me there's a chance...?"

I'm guessing I will get a call later on in the week, or sometime next week, to let me know where I'll be this summer. It all depends on what the other applicants look like on paper, or whether they were previously employed by the NICU.

I'm okay with wherever I end up, as long as it's at Hopkins. I'll put my time in anywhere in the hospital, then work my way to where I want to be once I graduate.

I've nothing to say, except:

APRIL FOOLS!!!!!! HAAAA HA HA!

It's so literal! Has it ever been so literal?

Was that mean? I didn't mean for it to be mean. Matt once told me it was snowing outside on April 1st when I was little. Then he laughed at me. THAT was mean. But this?