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Monday, March 29, 2010

So I took my first Peds exam today, and boy, did the day not start out right. We had one of the worst storms this morning, and while I love thunderstorms, I do not love having to go out in them. I woke up at 6:30am to go over some of my notes and it was already going. Pouring like crazy. Thundering like crazy. Lightning like crazy. Roads flooded. Just insane. Good thing was the kids spent the night at Grandma and Grandpa's. Grace is on Spring break and it would not have been a fun morning trying to get them Grandma and Grandpa's dry. Luckily, by rolling up my pants, carrying my flip flops, bringing a towel and having an umbrella, I didn't get too wet. It wasn't such a pretty sight at school for some others, though. One girl was in the bathroom, socks and shoes off, wringing out her socks. People were soaked left and right, mostly because the parking lot was flooded like I've never seen before. Just crazy. And there was a tornado close by this morning, too, on top of it all.

So, we're sitting in class waiting for the teacher to come in with the exams. There's a lady who comes in on Mondays who is doing her preceptorship to become a Nurse Practitioner. She came in with the exams along with the teacher who teaches Cardio (that class I will take as my second to last class) and advised us that our teacher would not be in today because she is sick. She said she would grade the tests and bring them to our teacher later tonight. Ok, so we have to wait longer than expected. We took the test, met in the hallway after as we so commonly do to compare answers and then headed home. I wasn't sure how I felt about the test exactly. It certainly wasn't easy but it didn't seem super hard either. Well about 7pm I decided to check my grade and there it was. An 84. A "B". I was so excited. I am beyond thrilled. I sooooo want a B in this class. I just have to get at least an 82 one one and an 83 on the other to get my B.

So there you have it. My first B in peds. Now I have 2 projects to work on, 2 exams left, and 4 more clinical days to complete. Next up: clinical on Wednesday.

Thursday, March 25, 2010

Yesterday was my first Peds clinical in the hospital. We had 2 campus lab days already, but yesterday was the first actual day in the hospital. We started off at pre-conference, where we meet, talk about the day ahead and anything else that needs addressing and then get our assignments. Our instructor had us go around the room and say our name and if we had any children of or own or any experience with children. We actually don't know more than half of our class because in specialty classes, we are mixed with different graduating classes. This is my class's first specialty. The class that started the semester before us is on their third specialty. When I start my third specialty in the fall, we will be with the class that started the semester after us. (Then for the last three courses, I will be back with my graduating class again.) After that, she talked a little bit about some things she expected of us. Then she handed out our assignments. I was assigned a 7 month old boy who was having fevers, gastro issues, and of all things, gallstones. Yes, he did in fact have gallstones, confirmed by u/s. How that happened, I have no idea. Anyway, he was a pretty easing going child. We are allowed to do axillary temps (under the arm) in kids under 4 unless you get a reading over 99. At 8am, his temp was fine, but at 12 his temp was taken and it went up to 101.8 axillary. Now I had to take it rectally. But I have never done it rectally. So, I had to enlist the help of the PCA to assist me (the instructor told us that if we have never done it before, have someone help). Yes, after two kids I have never taken a rectal temp. I prefer the mom method of chin to forehead temp checking. I know thats not a reliable method.....I have always done that to see if they felt warm, and then used the ear thermometer (although at first with Grace I did the axillary route for a while). I used the same brand my pediatricians office uses- so I assumed it was fine to check that way, and would always confirm the fever. Eventually, I upgraded to a temporal scanner thermometer, and that was more accurate than my ear thermometer, until it was dropped on the floor by one of the kids and has never worked right since. Now they are old enough to do oral temps, so thats what we do. I have always found that even though the ear was inaccurate, it was always on the lower side and not the higher side. And the only time I've ever dealt with an extremely high temperature was when Grace had strep throat. But she didn't have any symptoms of being sick, was not acting sick at all, and the only way I even knew to take her temp was because we were changing to go to swim class and she was the hottest I had ever felt a person to be. Her ear temp was 104. I didn't even call the pediatrician, I just hopped in the car and took her straight there. Sure enough, the doctor looked in her throat and was amazed that it didn't hurt her because he said it was a mess.

Wow that was a tangent if I ever saw one.

So anyway. I assisted the PCA with the first rectal temp. And man, are babies who are getting rectal temps squirmy. Now I know why I never opted for this route. Once the kids run a fever and get meds for the fever, we have to recheck the temp in about an hour. Which meant I needed to recheck the temp. Rectally. Sigh. I tried my best to hold down the little squirmy baby, but I don't think I did the best job. He squirmed quite a bit, but I could tell he was cooler and the thermometer didn't get nearly as high as it did earlier. Actually earlier, it almost immediately went to 102 within a few seconds, and now it was barely reaching 101 the entire time I was trying. An hour or so later, it was time for 4 pm vital signs and his axillary temp was way down.

It was a pretty uneventful day otherwise. There was one thing though that really bothered me. Actually, it bothered just about all of us, and especially us with kids. There was a 6 month old little girl who was in for an infection in her toe. She was alone. I tried as hard as I could in my head to give the benefit of the doubt, but at the end of the day, I just got mad. And sad. One of my classmates was taking care of her, and fed her around 11:45am and then the parents showed up. Then at 4 or 4:30 they left. They didn't bring her clothes. Or toys. And they didn't feed her the entire time they were there, saying that she was sleeping when other students had seen her awake in their lap in the chair. And then they said they wouldn't be back until tomorrow. Sigh. Seriously? I get that people have jobs or extenuating circumstances or whatever. But you can at least sleep at the hospital, right? And then the mom comes in all done up....her hair, her makeup, her clothes. She obviously had time to take care of that. I will stop there. I can't say more without getting angry. Poor baby. We left the floor at 5 and the unit secretary had the student nurse put the baby in the stroller to keep with her at the nurse's station because otherwise the baby would be alone. The nurse's have about 4 patients each to take care of, so its nearly impossible for someone to just sit with her in her room. The best that could have been done was to check on her often. At least the baby was able to be at the nurse's station for a bit. I couldn't help but think of her today.

So that was my first Peds day. The jury is still out on whether or not Peds is for me. There's still 4 more clinical days to try to figure it out. Stay tuned......first exam is Monday. Oh boy, I am so unprepared........

Wednesday, March 3, 2010

So Wednesday was my last clinical for GIGU. It was a light day, starting at 8am for pre-conference and 8:30am on the floor and then leaving the floor at about 1pm for post-conference and our final evaluations. I was given two patients. One was older, having gastrointestinal issues and getting ready to have some tests done. My other patient was younger, nearly 60, in with an infection in her leg. About sometime late morning, I stopped in the latter patient's room to check on her. After talking to her for several minutes, she started to cry. She was tired of being sick- this was the seventh surgery and she's kept getting recurrent infections in her leg. She was just worn down from it all because its affected her physically and understandably so. I spoke to her with comforting words, or what I thought might be comforting because I really didn't know what to say exactly. Whatever I said worked, and she pulled herself together and I was glad because I felt like for the first time I could see the fruits of my labor. I could see that what I am doing IS helping and IS somehow making a difference, even if only for a few minutes.

I didn't realize that last part until one of my instructors brought up something else I did that day in our post conference. Another patient, not mine but another classmate's, was getting a chest tube put in (more about that in a minute). Both the doctor and the patient allowed us to watch, and so next the bedside we stood. As the doctor was finally putting the chest tube in, I started rubbing the patient's arm to give him some sort of comfort. It wasn't much, but as my instructor put it, it shows the patient that we are there, and that we are giving them support and are comforting them.

When we were getting off the floor, I spoke with my nurse and then went and told the patients I was leaving. My second patient stood up and gave me a hug and thanked me for being there when she needed someone to talk to. It was the first real time that I was with a patient and started to tear up. It felt good to know she felt better. It was definitely a good day.

Now about the chest tube- there was a patient on the floor who had a lot of fluid accumulating in his chest, so the doctor decided to put in a chest tube. I cannot even begin to tell you how excited I was to watch one of these for the first time in real life. Aside from that, I actually got to hold the tube for the doctor, open it for him and give it to him. I know its not much, but it was something, and a lot of doctors aren't nice enough to even do that. But man, was it cool.

So now its Spring Break and Peds begins in a week. I am really excited and can't wait for it to begin. Until then.........

Tuesday, March 2, 2010

So, after leaving my exam, I felt pretty good about it. I actually felt like I knew a good amount of the info and I felt like I at least did better than my last 2 exams. I needed a 92 on the final to get a B for my class and I only needed 63 to pass. I did really well, but not well enough to get a B. I got 85 and while I didn't get a B, I am very proud of my final grade. I changed up a little of my studying, and while I did slack a bit at the start of the content for this last exam, I did work hard at the end. Also, I think it helped a little that this class had some very interesting topics, such as Diabetes and Endocrine disorders, both of which I really like.

At any rate, I am thankful to have passed and move on to my next course- Peds.

On another note, I have applied for a hospital scholarship, which essentially means that if I get it, they will give me money for school and I agree to work for them for 2 years after I graduate. There were 3 different hospital scholarships- each from a different hospital organization. There was one organization that I REALLY want to work for, so I applied for only that one and not the others. You can increase your chances of getting a hospital scholarship by applying to all 3. This is because we have 3 campuses, all with roughly an average of 50 people at each campus. There are only 10 spots for each hospital scholarship total, not per campus, so it is fairly competitive. Anyway, I really didn't want to get stuck getting a scholarship for a hospital organization that I really didn't want to work for, so I applied for the one and am hoping for the best. I think we may start getting calls for interviews pretty soon, so I will keep you posted as soon as I hear anything. I think we might even know by April sometime if we are recipient of a scholarship.

Speaking of scholarships, I will be applying for one in April that is REALLY cool. Its a government based one, I believe, that pays for school and gives you a monthly stipend on top of it. The only thing they want is for you to work in a hospital that has a shortage for 2 years, and that can be anywhere in the country. However, this one is EXTREMELY competitive. There was around 180 people selected and about 5,000 people applied, so that tells you just about how competitive this scholarship is. 3.6% of the applicatants received a scholarship. Can you say, "Slim Chance?"

Tomorrow is my last clinical and my final evaluation. We have a short hospital day and then we will be meeting to complete the evaluations, and then Spring Break will officially begin!

Monday, March 1, 2010

Today is my final for GI/GU and man, I am soooooo very glad its over. My professor, while a PhD, is not the greatest teacher in the world. The content was interesting, though, since we learned a lot about the kidneys and the endocrine system, both of which I really like a lot. But up next is Peds, and I am EXTREMELY excited about this. Two out of our three specialty rotations are areas I have had great interest in and am very excited to see if I am still interested in them once class begins. So from March until the beginning of May its Peds time. Then from May to Mid-June I will be taking Psych, something I am not so interested in. In the fall I start OB, and out of everything, I am most excited about that rotation.

Even more exciting? Once I finish Psych, I am over half-way done! Can you believe that? Its really flying by. Well I am off to bed, because its actually 1am and my final is in 12 hrs. G' night!
 
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