Wednesday, May 30, 2007
Out of character, again
I am so homesick that I have taken to watching basketball because Detroit is in the playoffs. New Haven has driven me to watching sports. What's next, sitting on a sailboat eating olives and licorice while handing out chewing gum?
Below the belt
So, I am finally in Maternal Newborn Nursing! Unfortunately it's not my most favorite class ever. I'm sure it's got something to do with the fact that I am exhausted and homesick. The reality of the accelerated 11 month program has set in, mostly due to the fact that it is summer and we are still in school. And school is still in New Haven.
My clinical is in a community hospital in Middletown, which is in the middle of CT. I am enjoying being in a smaller non-teaching hospital - there is no house staff so the nurses get to do more, which is a better learning environment for student nurses. Without residents and med students around we aren't trumped when it comes to doing a lot of things.
The hospital has a 40% c-section rate so I was warned that I would not get to see a lot of babies coming out of vaginas, but I got to see a vaginal birth my first week. It was a vacuum assisted delivery so the poor thing was pretty much sucked into world. He really didn't seem to happy about it, but he also wasn't happy with the labor (late decelerations) which was the reason the vacuum was used. I can only imagine what it must be like to be taken out of your warm, cozy bath you've been in for 9 months by some one putting a big suction cup on your head a pulling like all get out. Especially considering he hadn't decided to come out yet - it was an induction because mom had gestational diabetes so they didn't want him to get too big.
I am happy I have seen a baby being born. Hopefully the first of many.
My clinical is in a community hospital in Middletown, which is in the middle of CT. I am enjoying being in a smaller non-teaching hospital - there is no house staff so the nurses get to do more, which is a better learning environment for student nurses. Without residents and med students around we aren't trumped when it comes to doing a lot of things.
The hospital has a 40% c-section rate so I was warned that I would not get to see a lot of babies coming out of vaginas, but I got to see a vaginal birth my first week. It was a vacuum assisted delivery so the poor thing was pretty much sucked into world. He really didn't seem to happy about it, but he also wasn't happy with the labor (late decelerations) which was the reason the vacuum was used. I can only imagine what it must be like to be taken out of your warm, cozy bath you've been in for 9 months by some one putting a big suction cup on your head a pulling like all get out. Especially considering he hadn't decided to come out yet - it was an induction because mom had gestational diabetes so they didn't want him to get too big.
I am happy I have seen a baby being born. Hopefully the first of many.
Saturday, May 05, 2007
A short history of pediatrics
As usual I planned to write about my patients (with-in the confines of HIPPA, of course) every week, and as usual that didn't happen. So here's the synposes:
My favoritest patient ever! She was a 9 month old with a tracheostomy and on a ventilator. She is such a trooper - she has gone through more medical procedures in 9 months (3 of those months should have still been in-utero) than I have in 28 years. After leaving the NICU she was only home for 2 weeks before being re-admitted with RSV. She had full respiratory arrest, spent 2 weeks on ECMO, 2 weeks on a oscillator, and had been vent dependent ever since. I learned a lot from her including what to do when a respiratory patient desat's. Oxygen is so important in those formative years.
My reintroduction to life as a teenage girl: She has a stomach cancer than is very rare in children. I had her twice. The first time was when she came in for her surgery which basically amounted to a gastric bypass, except then were bypassing her stomach so much as removing it and doing there darndest to leave some of it there. The second time was when she was re-admitted for a possible bowel obstruction. I learned that teenagers still play truth or dare, and spin the bottle, never want to do anything you suggest entertainment wise, and that hospitals should really have myspace and MTV in every room.
The power of three: One week I had three patients - almost like being a real nurse, or at least half of one. Two were neutropenic (one with aplastic anemia, one post- bone marrow transplant), and the other one I don't really know where to start.
The neutropenic patients were pretty easy mostly due to the fact there parents were there and seeing that they practically live in the hospital were extremely comfortable there and very helpful. The other patient was really interesting. She had severe scoliosis with a failed surgical repair who also had a trach and was on a vent. The most interesting part was the behavior issues. She likes attention and has figured out how to make her ventilator alarms goes off. When her tutor was there she had 3 disconnect alarms; every time a few of us would go rushing in only for everything to be fine. After her tutor left she was alarm free for the rest of the night. One of the most important things I learned is that the ability to cough up your own phlegm is highly underappreciated.
All-in-all I LOVED my pedi rotation. Not only did I get to learn a lot of actual nursing skills, but I also got to work with kids, which I absolutely adore.
My favoritest patient ever! She was a 9 month old with a tracheostomy and on a ventilator. She is such a trooper - she has gone through more medical procedures in 9 months (3 of those months should have still been in-utero) than I have in 28 years. After leaving the NICU she was only home for 2 weeks before being re-admitted with RSV. She had full respiratory arrest, spent 2 weeks on ECMO, 2 weeks on a oscillator, and had been vent dependent ever since. I learned a lot from her including what to do when a respiratory patient desat's. Oxygen is so important in those formative years.
My reintroduction to life as a teenage girl: She has a stomach cancer than is very rare in children. I had her twice. The first time was when she came in for her surgery which basically amounted to a gastric bypass, except then were bypassing her stomach so much as removing it and doing there darndest to leave some of it there. The second time was when she was re-admitted for a possible bowel obstruction. I learned that teenagers still play truth or dare, and spin the bottle, never want to do anything you suggest entertainment wise, and that hospitals should really have myspace and MTV in every room.
The power of three: One week I had three patients - almost like being a real nurse, or at least half of one. Two were neutropenic (one with aplastic anemia, one post- bone marrow transplant), and the other one I don't really know where to start.
The neutropenic patients were pretty easy mostly due to the fact there parents were there and seeing that they practically live in the hospital were extremely comfortable there and very helpful. The other patient was really interesting. She had severe scoliosis with a failed surgical repair who also had a trach and was on a vent. The most interesting part was the behavior issues. She likes attention and has figured out how to make her ventilator alarms goes off. When her tutor was there she had 3 disconnect alarms; every time a few of us would go rushing in only for everything to be fine. After her tutor left she was alarm free for the rest of the night. One of the most important things I learned is that the ability to cough up your own phlegm is highly underappreciated.
All-in-all I LOVED my pedi rotation. Not only did I get to learn a lot of actual nursing skills, but I also got to work with kids, which I absolutely adore.
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