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Thursday, November 19, 2009

Well, I passed my skills test with flying colors. There were two portions: a medication portion and skills portion where I had to perform 3 skills.

For the medication portion, I was given a fake patient with several medical diagnoses and 3 medications. I then had 45 minutes to look up and take notes on the medications. Sometimes meds have more than one purpose, so one of the things I had to do was determine for which purpose, based on the patient's diagnosis, was the patient taking that med. I had to basically figure out anything about the meds that would be pertinent to my patient and make notes. After the 45 minutes was over, I then had to sit down with my instructor and answer 20 questions about the meds. I was allowed to use my drug book to look up anything I hadn't already written down. I passed with a 100%, which she said I was the only one so far who had passed with 100%, but we were allowed to miss 2 questions.

Next came the skills portion. First I would be asked to demonstrate one of a few skills dealing with an IV. The skill I was asked to do was back prime a piggy back. What that means is we prime the line with the IV fluid to get out all the air first before we hook it up to the patient. The piggy back is a secondary bag of IV fluid, usually something like an antibiotic that the dr. wants infused in addition to the primary IV bag. Back priming is when you prime the piggy back line with the primary IV's fluid instead of using the fluid from the piggy back. The next skill I had to do was draw up a med in a syringe and explain the technique for whatever type of injection she had asked me about and give the landmarks for the site, and demonstrate how I would give that injection into this injectapad thing. I was asked to draw up a med in what we call a Tuberculin syringe, which is a very small needle and holds a very small amount and is usually used when people are getting a TB test. The type of injection I was asked about was directly related to the med she wanted me to draw up, which is called intradermal, which is just under the skin, also usually used in TB tests. The last skill I had to do was a dressing change, and the instructor would tell me which type I had to do. The whole morning I had been saying silent prayers to do a CVC dressing change (which I will explain in a minute) and I was very happy to find out that was the dressing change I was told to do. A CVC is a catheter inserted right into a vein (subclavian vein usually) that leads right to the heart and its used to administer medication, its used for people on chemo or radiation (I think), it can be used to draw blood for lab tests, its used to administer intravenous-type nourishment. The procedure is a very sterile procedure because anything introduced to that area can cause an infection right in the heart. At any rate, I performed all 3 skills at 100%- anything less would have landed me an appointment next Tuesday for a reattempt.

I have a test tomorrow that I should go study for. I'll post my grade sometime tomorrow once they come in. Stay tuned.

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