Sunday, July 20, 2008

Ambling along.

An early Sunday morning. You know you're in school when 8:00am feels like sleeping in.
The infamous parrots woke me up this morning. Yes, parrots. In San Francisco. Apparently they like to summer in the Parnassus/Cole Valley area, and this morning I discovered that they love apple trees.
That was actually a novel alarm clock.

In any case, we're done with our 4th week, and into the 5th. By the end of this week, we're halfway through the first quarter. It's pretty amazing to see how much we are learning. Tomorrow we have another pathophysiology test (yay) and we have some relatively difficult homework in Pharmacology where we have to investigate a toxicology report for Ms. Vickie Lynn Marshall.
Then there's the usual reading, heaps of it.

The patient care is awesome - Friday was by far the most interesting day I've had as far as variety of problems, and alertness/communicativeness of patients. I saw my first pressure ulcers, which the wound nurse confirmed as stage I and stage II. The nurse I was shadowing is AWESOME, lots of experience, moves fast, and is by far one of my favorites to learn from. We got that patient taken care of, dressed the wound properly, and started ambulating the patient. I can see why it's such a problem though- when you have thin skin, a recent MAJOR surgery, and someone in pain, it's hard to turn the patient every 2 hours. Somehow, though, we did get the patient moving, which also got the lungs to clear.

Someone called a code that I got to cancel. Incidentally, someone decided that the code team members should wear all black. Not kidding. How morbid is that? Hmm, the "death angels" or the "pirate-ninjas"? I guess the person in arrest isn't gonna know one way or another, but I thought the decision was pretty morbid.

Friday was also a day of A-Fib (wild to listen to), learning more meds, checking vitals, learning about HIV, catching an infiltrated IV - Me: "I think it looks swollen, and the patient says it stings." Nurse: "Well, Medicine can sting sometimes." Nurse looks at the arm, and says, "It looks okay."
5 minutes later, Nurse: "You were right, good eye, it was infiltrated. Here's how we deal with it."
I thought that was really cool of her- for one, any praise we get we thrive on- and of course I'm going to defer to the judgment of a 20+ year nurse. What really got me was that even though she's been a nurse for two decades, she listened to my observations and took the time to double-check things- she didn't have to, but she values anyone's observation, including a brand-new student. I really respect that, and I told her so, "thanks for listening to me." Her reply, "when you stop listening, you stop growing and learning. Everyone's input is valuable, and when it comes to patients, it's better to double check then to let it be. Remember that."
I nodded.

That's probably the best advice I've had so far.

I also shook a patient's hand good-bye - she thanked me for helping her out, which made me want to help her more. When I left, she was just about to undergo a very very painful procedure, and I wanted to be there to hold her hand for it, but time didn't allow.
The conversations I had with that patient were some of the most intriguing I've had, but I have to save that story for another time.

MEPN is a constant balance of emotion, work, schoolwork, and time for self. The latter gets lost, so I'm determined to do a bit of that today.


PeterPlain&Tall said...

MEPN yearrrrrgh!

I went to UCSC...studied the sierra (heading off on a 6 night solo next week)....was a MEPN...AM a nurse at UCSF....and will be in the ACNP program Fall '09. Funny that. Good luck with this year. Just care is crazy, messy, astonishing, stressful and incredibly cool. You're an adventurer clued in to the human'll dig it. pedro.

nikibeanster said...

Thanks Pedro! I'm sure I'll meet you at some point. Rock on..
Nic :)