Medical and interview coming up soon for the Forces. Don't know what to make of it, but I'll get through it. Also I passed my CFAT and physical test earlier.
School, same old same old. Oh, but btw my clinical instructed told me that I was top of my clinical group and I'm the only one getting two patient assignments now, if permitting! :D
Friday, October 18, 2013
Wednesday, August 7, 2013
1st Year Nursing in Review and Looking Forward
My summer intercession course ended 1 week and 3 days ago, which I believe marks the end of my first year, yay! So now that I finally have a break I shall present to anyone reading this my reflection on my first year of Nursing and thoughts moving forward.
The school year was hard, full of idiots, administration problems, and other stuff. First off, to get cleared for working all students in Windsor (not just my school though i.e. Western) had to get cleared through a company called Paramed. We had to gather easily over 20 pages of documents including TB testing, immunization forms, police clearances, and other formalities without any real help or direction. This left many of my first year classmates disoriented and pissed off as missing documents were common among many, leaving them to fail to be cleared. The real thing that gets people going is that to schedule another appointment to get cleared, it costs 25 buckaroos. Fortunately I passed the first time around so I was merely watching my classmates in agony.
Frosh week. A week of faculties banging each other both literally and figuratively. Showing off their unofficial motto's and their pride. As a "murse" (male nurse) I was a minority, though a bigger minority then previous years consisting of 20/150 students as male. Still, because of murses are a minority the nurses were still being paraded by the engineers with "WE LOVE NURSES! WHOO HAA WHOO-WHOO HA!" I responded with four words. Where are the "femgineers (female engineers)?"
Now onto the actual school year curriculum. Nursing in Windsor has a 100% course load which means it consists of 5 courses per semester and 20+ hours of lectures a week, although 6 hours is devoted to clinical placements in first year. It's not as hard as 1st year engineering, because their course work is hell on earth mode, but it's more difficult than Human Kinetics by far! Like their schedule is empty. Their exam period is relaxing. The students in the program openly admit it and show it off to us in the face.
Exam period was hell as both semesters consisted of 6 and 5 final exams in 1st and 2nd semester respectively. The midterms were just as brutal which flat out doubles those numbers. The most brutal of which are probably the OSCEs. I don't know what they stand for but it's basically testing students in simulated environments in a non-scripted manner. Anything can go wrong i.e. your die. Yes, I am joking.
Volunteer work in the Emergency Response Team (ERT) was a highly rewarding experience. It taught me you can always sleep more and that life can be lost in an instant. Nuff said. Though my best memory was working from 10 PM to 6 AM with no sleep and then writing a final exam at 7:30 AM and getting 93% on it.
My clinical placement at a Long Term Care facility was equally rewarding in its own sense. Taking care of our elders in an interpersonal way has taught me that you gotta YOLO (you only live once), but do it responsibly. This video speaks for itself.
The school year was hard, full of idiots, administration problems, and other stuff. First off, to get cleared for working all students in Windsor (not just my school though i.e. Western) had to get cleared through a company called Paramed. We had to gather easily over 20 pages of documents including TB testing, immunization forms, police clearances, and other formalities without any real help or direction. This left many of my first year classmates disoriented and pissed off as missing documents were common among many, leaving them to fail to be cleared. The real thing that gets people going is that to schedule another appointment to get cleared, it costs 25 buckaroos. Fortunately I passed the first time around so I was merely watching my classmates in agony.
Frosh week. A week of faculties banging each other both literally and figuratively. Showing off their unofficial motto's and their pride. As a "murse" (male nurse) I was a minority, though a bigger minority then previous years consisting of 20/150 students as male. Still, because of murses are a minority the nurses were still being paraded by the engineers with "WE LOVE NURSES! WHOO HAA WHOO-WHOO HA!" I responded with four words. Where are the "femgineers (female engineers)?"
Now onto the actual school year curriculum. Nursing in Windsor has a 100% course load which means it consists of 5 courses per semester and 20+ hours of lectures a week, although 6 hours is devoted to clinical placements in first year. It's not as hard as 1st year engineering, because their course work is hell on earth mode, but it's more difficult than Human Kinetics by far! Like their schedule is empty. Their exam period is relaxing. The students in the program openly admit it and show it off to us in the face.
Exam period was hell as both semesters consisted of 6 and 5 final exams in 1st and 2nd semester respectively. The midterms were just as brutal which flat out doubles those numbers. The most brutal of which are probably the OSCEs. I don't know what they stand for but it's basically testing students in simulated environments in a non-scripted manner. Anything can go wrong i.e. your die. Yes, I am joking.
Volunteer work in the Emergency Response Team (ERT) was a highly rewarding experience. It taught me you can always sleep more and that life can be lost in an instant. Nuff said. Though my best memory was working from 10 PM to 6 AM with no sleep and then writing a final exam at 7:30 AM and getting 93% on it.
My clinical placement at a Long Term Care facility was equally rewarding in its own sense. Taking care of our elders in an interpersonal way has taught me that you gotta YOLO (you only live once), but do it responsibly. This video speaks for itself.
Not only should you be healthy, you also have to live life to its fullest and don't throw your aspirations and dreams away. Life is as beautiful and fragile as a stained glass window.
Participating in the Nursing Games was also fun, got to have a little pride in my own school and a little appreciation to my future fellow coworkers. My last post has more details. http://ramblingsofanursingstudent.blogspot.ca/2013/03/a-good-year-at-nursing-games.html
Besides my boring summer course that's pretty much it.
Now looking forward...
Second year is going to be full of new stresses and surprises. I'm going to be placed on the 4th floor of Western Regional Hospital in Windsor. Which means I get to deal with medical patients! I would've opted for trauma, but ERT lets me see enough of that! Also shifts are now extended from 6 to 10 hours long.
Also 2nd year runs from September 2013 to mid-June 2014. That's 1 1/2 months longer! NOOOOOO!
In addition to that I am joining the Canadian Naval Reserves, hopefully as an Naval Combat Information's Operator (NCIOP). It seems like a radical step away from nursing, but I've considered serving Canada ever since I was a young boy. Taking a lesson from my elders I am going to YOLO. My parents are not to happy about it, but if there's one good thing about my decision it's that I've been getting physically fit. If everything works out then I'll ship out to basic training in July 2014 for 2 months. Summer 2014 will be practically non-existent for me as school ends in June 2014 :(.
Originally I wanted to be a medical technician for the 23rd field ambulance but there are no positions available. The only positions available was supply technician (I think). The Army unit in Windsor had only Infantry (soldier) and Armoured Reconnaissance (tank guy I think). There was no Air Force unit in Windsor either. Being highly discouraged, one of my class mates introduced the Navy back to my life. I honestly almost forgot about its existence. Anyways they had a career I wanted and now I'll be living the dream in Summers/Weekends. To be honest my dream is to be Infantry, but I want to know what military life is like and to be a little older (so that I'm less naive) before I go into the Combat Arms.
I'm also thinking about starting a Vlog for my military experiences to document before and after basic training; and before and after deployments (either on ship during the summer) or volunteering to go in Land Based missions such as Afghanistan, Bosnia, and etc. Anyways, logging off for now.
Next blog, stay tuned for more about my emotions, training, hopes, and reasons for joining Canada's Navy.
Thank you for reading. Good night and good luck.
Kevin La.
Participating in the Nursing Games was also fun, got to have a little pride in my own school and a little appreciation to my future fellow coworkers. My last post has more details. http://ramblingsofanursingstudent.blogspot.ca/2013/03/a-good-year-at-nursing-games.html
Besides my boring summer course that's pretty much it.
Now looking forward...
Second year is going to be full of new stresses and surprises. I'm going to be placed on the 4th floor of Western Regional Hospital in Windsor. Which means I get to deal with medical patients! I would've opted for trauma, but ERT lets me see enough of that! Also shifts are now extended from 6 to 10 hours long.
Also 2nd year runs from September 2013 to mid-June 2014. That's 1 1/2 months longer! NOOOOOO!
In addition to that I am joining the Canadian Naval Reserves, hopefully as an Naval Combat Information's Operator (NCIOP). It seems like a radical step away from nursing, but I've considered serving Canada ever since I was a young boy. Taking a lesson from my elders I am going to YOLO. My parents are not to happy about it, but if there's one good thing about my decision it's that I've been getting physically fit. If everything works out then I'll ship out to basic training in July 2014 for 2 months. Summer 2014 will be practically non-existent for me as school ends in June 2014 :(.
Originally I wanted to be a medical technician for the 23rd field ambulance but there are no positions available. The only positions available was supply technician (I think). The Army unit in Windsor had only Infantry (soldier) and Armoured Reconnaissance (tank guy I think). There was no Air Force unit in Windsor either. Being highly discouraged, one of my class mates introduced the Navy back to my life. I honestly almost forgot about its existence. Anyways they had a career I wanted and now I'll be living the dream in Summers/Weekends. To be honest my dream is to be Infantry, but I want to know what military life is like and to be a little older (so that I'm less naive) before I go into the Combat Arms.
I'm also thinking about starting a Vlog for my military experiences to document before and after basic training; and before and after deployments (either on ship during the summer) or volunteering to go in Land Based missions such as Afghanistan, Bosnia, and etc. Anyways, logging off for now.
Next blog, stay tuned for more about my emotions, training, hopes, and reasons for joining Canada's Navy.
Thank you for reading. Good night and good luck.
Kevin La.
Saturday, March 23, 2013
A good year at the Nursing Games!
End of the Nursing Games 2013!!!
So this is how all of the schools that attended placed in the Simulation Lab, which was the only nursing related event.
The Simulation Lab was placed in an ER setting with a 45 year old female patient experiencing an open tib-fib fracture and a fall down her porch due to ice resulting in a loss of consciousness. Teams had to do their best to stabilize the patients without doctors helping, just like in real life!!!
The scenario was 50 minutes long consisting of two 20 minute sessions with the patient and a 5 min session with the doctor to report findings and request further treatment options using SBAR.
:D
1) McMaster
2) Western
3) Windsor
And a hand to the schools that tried!
Toronto, Ryserson, and Ottawa.
So this is how all of the schools that attended placed in the Simulation Lab, which was the only nursing related event.
The Simulation Lab was placed in an ER setting with a 45 year old female patient experiencing an open tib-fib fracture and a fall down her porch due to ice resulting in a loss of consciousness. Teams had to do their best to stabilize the patients without doctors helping, just like in real life!!!
The scenario was 50 minutes long consisting of two 20 minute sessions with the patient and a 5 min session with the doctor to report findings and request further treatment options using SBAR.
:D
1) McMaster
2) Western
3) Windsor
And a hand to the schools that tried!
Toronto, Ryserson, and Ottawa.
Thursday, February 7, 2013
Can you have Identical twins with two different genders?
These are one of the questions that make me facepalm throughout my day and throughout the night because it is not possible.
Identical twins, or monozygotic twins, are babies that come from the same egg. The same cell. Because of this, they have exactly the same DNA.
*This is about normal situations, abnormal situations would result in one of the babies getting Turners syndrome or have some unfortunate congenital condition happen to them.
Identical twins, or monozygotic twins, are babies that come from the same egg. The same cell. Because of this, they have exactly the same DNA.
*This is about normal situations, abnormal situations would result in one of the babies getting Turners syndrome or have some unfortunate congenital condition happen to them.
Tuesday, January 22, 2013
Feeding
Feeding is a very important skill in nursing. Make sure you do these things with all patients.
1) Make sure the client is facing and mid line to the food
2) Do not tower over the patient for it is intimidating and makes them feel uncomfortable/violated.
3) Try to make the patient as independent as they can by getting them to feed themselves. It makes them develop confidence and feel empowered.
4) Tell the patient everything that your gonna do,
"now I'm going to raise the spoon to your mouth"
"please open your mouth, I will place the spoon inside your mouth"
"now please close your mouth and I will remove the spoon, alright"
5) Please do not continuously shove food in their mouth. You laugh now, but it is something that has happened time and time again in the work place. It is considered abuse and shall not be dealt with lightly as you greatly endanger the lives of those you treat with the possibility of choking, aspiration of foreign objects, pneumonia and infection. All of which can lead to death.
6) Patients are scared and vulnerable they will not complain and when faced with such abuse in fear that they will be left for dead as health care providers hold a lot of power (I am serious). You are playing with life and death in a matter such as this.
Overall. Get someone to feed you with your eyes blindfolded and you will feel how a patient feels when they are being fed. They feel uncomfortable, scared and timid. Understand their position and be patient.
1) Make sure the client is facing and mid line to the food
2) Do not tower over the patient for it is intimidating and makes them feel uncomfortable/violated.
3) Try to make the patient as independent as they can by getting them to feed themselves. It makes them develop confidence and feel empowered.
4) Tell the patient everything that your gonna do,
"now I'm going to raise the spoon to your mouth"
"please open your mouth, I will place the spoon inside your mouth"
"now please close your mouth and I will remove the spoon, alright"
5) Please do not continuously shove food in their mouth. You laugh now, but it is something that has happened time and time again in the work place. It is considered abuse and shall not be dealt with lightly as you greatly endanger the lives of those you treat with the possibility of choking, aspiration of foreign objects, pneumonia and infection. All of which can lead to death.
6) Patients are scared and vulnerable they will not complain and when faced with such abuse in fear that they will be left for dead as health care providers hold a lot of power (I am serious). You are playing with life and death in a matter such as this.
Overall. Get someone to feed you with your eyes blindfolded and you will feel how a patient feels when they are being fed. They feel uncomfortable, scared and timid. Understand their position and be patient.
Bleeding Walk Through (this won't be lame!)
Okay after my EPIC fail walk through that had little flow what so ever I have decided to try my hand at it again by request. I shall do my best, behold! This is a walk through on how to handle arteriole and venous bleeds.
Check this out for the first few steps in the tutorial.
http://ramblingsofanursingstudent.blogspot.ca/2013/01/basic-steps-before-i-post-any-tutorials.html
Check this out for the first few steps in the tutorial.
http://ramblingsofanursingstudent.blogspot.ca/2013/01/basic-steps-before-i-post-any-tutorials.html
These steps takes place during the ABCs or step 3 in the link above.
1) AVPU
The patient is currently Alert, meaning he consciously knows where he is and what is happening to him. This proves him to be mentally sane and means that he is unlikely to cause any intentional harm to himself and others.
2) Cervical Spinal Injury Consideration
It seems that he has not endangered his spine.
3) General Appearance of the Patient
He seems pale and in distress with rapid panicked breathing.
4) ABCs
Airway is fine since there is no obstruction
Breathing is compromised as he is taking inefficient rapid breaths, in addition his skin looks pale which suggests that he is going into shock or having hypoxia (which is basically shock). We give him non-rebreather mask (NRB) hooked up to an oxygen tank and feed him 10 to 15 L/Second of oxygen to combat shock.
Circulation is compromised as he is suffering a deep gash on his arm resulting in huge amounts of blood loss. Place some dressings on the wound and ask the patient to hold it there for you applying pressure onto the wound. Later wrap it in a bandage (in any way you can, though there is a proper way to do it) directly on TOP of the wound as much as possible. If there is bleeding through the bandage, add another layer of dressing and bandages on top of the previous wraps. Never remove a dressing or bandage once applied.
5) Now call for an ambulance. If you are working with a partner than this step should be done after the General Appearance of the Patient.
6) Take vitals and monitor the patient. Retake vitals periodically to make sure that your patient is getting better or worse as time goes by waiting for the ambulance. Save your vitals in a report and hand it off to the ambulance team.
7) Take history if you have time.
Finished!
Basic steps before I post any tutorials
Know these things whenever you go to a patient! Use the acronyms provided
1) Scene Survey
EMCAP-PE
E - Environment
M- Mechanism of injury
C- # of casualties
A - Additional Assistance (if necessary)
P-PE - Personal Protective Equipment (gloves, mask, hazmat)
2) Patient Communication and Consent
- Introduce yourself
- Obtain patient consent
- Obtain event history (you should always find an answer to, what happened?)
3) Primary Survey (the actions done in all acronyms happen simultaneously) and Treatment.
AVPU (level of consciousness/mental status)
A - Alert
V - Verbal
P - Pain
U - Unresponsive
Cervical Spinal Injury Considerations,
General Appearance of the Patient
ABC (are there vital parts compromised?)
A - Airway - Treat it as needed
B - Breathing - Treat it as needed
C - Circulation - Treat it as needed
CLAP-STICD (evidence supporting ABCs)
C - Contusions
L - Lacerations
A - Abrasions
P - Penetrating wounds
S - Subcutaneous Emphysema
T - Tenderness
C - Crepitus
D - Deformity
Head to Toe examination* see bottom of blog
4) Determine if Transport is needed. Is it too much for you to handle? Find a sufficient reason why and call the ambulance.
5) Take Vitals (if possible)
- Heart rate
- Respiratory rate
- Blood pressure
- Blood glucose
- SPO2%
- Temperature
- Pupils
- Skin
- Glasgow Coma Score
*This is when Medications can be administered or assisted with after pronouncing the 5 rights.
The 5 Rights to medication is in the acronym TRAMP, however I'll teach you TRAMP-E.
T-Timing (is it taken as needed, interval between dosages, can it be taken at this time?)
R-Route (is it by oral, spray, injection?
A-Amount (is it the right amount?)
M-Medication (is it the right medication?)
P-Patient (is it the right person?)
E-Expiration date
If you cannot find answers to ALL of the 5 rights above than you cannot administer or assist someone with their medication.
6) Take History
SAMPLE and OPQRSTU
S - Signs and Symptoms
A - Allergies
M - Medications
P - Past medical history
L - Last meal (this is not a joke)
E - Events leading up to
As part of Signs and Symptoms
O - Onset of sign/symptom
P - Palliative/provocative (what makes it better/worse?)
Q - Quality/Quantity
R - Region/Radiating
S - Severity (on a scale of 0-10)
T - Timing
U - Understanding of what is happening
You're done!
*The head to toe examination may be placed at the very end here since it is unnecessary most of the time and yields little information for most patients. Use it to provide supporting evidence for what you already know.
*Update Jan 25, 2013. Added 5 rights to medication. Grammar fixes in head to toe disclaimer.
1) Scene Survey
EMCAP-PE
E - Environment
M- Mechanism of injury
C- # of casualties
A - Additional Assistance (if necessary)
P-PE - Personal Protective Equipment (gloves, mask, hazmat)
2) Patient Communication and Consent
- Introduce yourself
- Obtain patient consent
- Obtain event history (you should always find an answer to, what happened?)
3) Primary Survey (the actions done in all acronyms happen simultaneously) and Treatment.
AVPU (level of consciousness/mental status)
A - Alert
V - Verbal
P - Pain
U - Unresponsive
Cervical Spinal Injury Considerations,
General Appearance of the Patient
ABC (are there vital parts compromised?)
A - Airway - Treat it as needed
B - Breathing - Treat it as needed
C - Circulation - Treat it as needed
CLAP-STICD (evidence supporting ABCs)
C - Contusions
L - Lacerations
A - Abrasions
P - Penetrating wounds
S - Subcutaneous Emphysema
T - Tenderness
C - Crepitus
D - Deformity
Head to Toe examination* see bottom of blog
4) Determine if Transport is needed. Is it too much for you to handle? Find a sufficient reason why and call the ambulance.
5) Take Vitals (if possible)
- Heart rate
- Respiratory rate
- Blood pressure
- Blood glucose
- SPO2%
- Temperature
- Pupils
- Skin
- Glasgow Coma Score
*This is when Medications can be administered or assisted with after pronouncing the 5 rights.
The 5 Rights to medication is in the acronym TRAMP, however I'll teach you TRAMP-E.
T-Timing (is it taken as needed, interval between dosages, can it be taken at this time?)
R-Route (is it by oral, spray, injection?
A-Amount (is it the right amount?)
M-Medication (is it the right medication?)
P-Patient (is it the right person?)
E-Expiration date
If you cannot find answers to ALL of the 5 rights above than you cannot administer or assist someone with their medication.
6) Take History
SAMPLE and OPQRSTU
S - Signs and Symptoms
A - Allergies
M - Medications
P - Past medical history
L - Last meal (this is not a joke)
E - Events leading up to
As part of Signs and Symptoms
O - Onset of sign/symptom
P - Palliative/provocative (what makes it better/worse?)
Q - Quality/Quantity
R - Region/Radiating
S - Severity (on a scale of 0-10)
T - Timing
U - Understanding of what is happening
You're done!
*The head to toe examination may be placed at the very end here since it is unnecessary most of the time and yields little information for most patients. Use it to provide supporting evidence for what you already know.
*Update Jan 25, 2013. Added 5 rights to medication. Grammar fixes in head to toe disclaimer.
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