Wednesday, September 26, 2007

critical care

My day in the CCU was so awesome! My preceptor was a male, which I have never really had before, but he was totally cool and you could tell he loved to teach, etc. We had two patients who were stable and self-sufficient, so he said it wasn't a good picture of his normal patients, but I didn't mind because it gave us a chance to discuss a lot of the going-ons of an ICU. Since I thought the ICU was a place I'd like to be, but I was still waiting until I actually went to know for sure, this definitely helped to reiterate this is the place I want to be. However, as I've mentioned in previous posts, lately I've been debating whether I should do the year MS experience or just go straight into a critical care internship program. I know everyone has a different opinion on this, but for me personally, I don't think I would be ready or safe as a new grad in the ICU. Another option that my preceptor brought to my attention yesterday was starting in progressive care first (step-down unit) and then applying for the CCIP!
For some reason I thought these internship programs were only for NEW GRADS, but I was wrong.
I think this is an awesome idea! The reason I am not so keen on MS is because I am going to school for all this time, learning all this neat stuff, but once you go to MS, you're just so busy that it doesn't even give you a chance to honestly learn everything about your patient and apply all the concepts we've learned. All you have time for is passing meds, dealing with paperwork, doctors, and that is pretty much it. The reason I like critical care is the fact that you have to know everything about your patient and you actually get to apply the things you learned in school. HOWEVER, in MS, I could get a lot more experience with time management, brushing up on my skills like foley's, IV's, NGT's, etc. If I can start in a progressive care unit with tele, etc., then this will most likely give me the chance to do all of the these things, as well as not lose all the crap I am learning now. OH, and the hospital I want to work in has a Progressive care course internship program!
I am worried though because I graduate in August and I bet those internship programs begin in May since a lot of people graduate then. I need to look into this.

Monday, September 24, 2007

First MS2 exam

I got an 88%.
pft. It is decent, but considering I stayed on top of reading and reviewing everyday after class, I expected a lot more out of myself. I mean, there isn't much else I could have done. I was studied out, but it would just be nice to see a grade in the 90's again. However, even a 92.4 is a B, soooo.
I wish I could just be happy with my B grade, but I'm not. I have high standards for myself. I don't want to know that I can pass; I want to know that I can kick ass and truly understand this information. 88 means I missed 6 out of 50. The average was 84.9.

Friday, September 21, 2007

Semester 3

I need to be much more frequent with my posts!!!

I am officially in my 3rd semester of 5 and things are moving along quickly! This semester I am taking Med-Surg 2 and nursing inquiry (a research course). The summer was good, but a bit boring, which explains my lack of updates. Let's see...
This semester is not as difficult as the previous ones, as far as course load goes, but the content is still hard, as always. I have my first exam on Monday and it covers Hematology and GI. I feel that my work as a PCT on a MS GI/telemetry floor has helped somewhat, but probably not as much as I would like. A classmate and I have been reviewing after each class, so I feel pretty prepared. Usually I am freaking out by now, but I do feel like I have a good grasp of the information; not that I won't be studying my ass off the rest of the weekend, but at least I know I can relax somewhat.
For clinicals, we only spend about 7 weeks on the floor, with the other weeks being filled up with rotations in the heart cath lab, Main OR, CCU, ER, PACU, MSICU, and CSICU. So far I have been to the cath lab and main OR. My regular floor is an oncology MS, but they pretty much get everything, which I like the best. Also, the nurses have been helpful and friendly, which is always great. The best part is the view. The floor overlooks the beach, ah. And when it comes close to 5pm and the sun is lowering, it looks beautiful.
On Tuesday, I was in the OR. I saw: right colectomy with hernia repair, a laproscopic gallbladder removal that turned into an open cholestcystectomy because of too much scar tissue/fat. And please don't hold me to the spelling because I am too lazy to look this up right now. Following that, a quick drainage of a breast abscess. After this, I heard there was going to be a LEG AMPUTATION. This excited me beyond belief. All of my teammates who went into the OR pretty much saw a bunch of gallbladder removals, nothing too exciting, so leg amputation? Pretty exciting stuff! I saw a stent put into an artery and then FINALLY the leg amputation. It was so cool. This guy already had a below the knee amputation, so they were just removing what was left plus above the knee. I was amazed by how quickly it was done. They just cut it open, and pretty much electrically sawed it off. The surgeon handed the stump to the nurse and he put it in a what looked like a bucket that you used to play with on the beach!!

So, I've been contemplating the future A LOT lately, especially in regards to what area of nursing I want to work in. In 4 more weeks, I am in the ICU and I honestly feel like that is where I would like to be. However, I have such conflicting gut feelings about getting experience first in MS or going straight to ICU through all the great orientation/internship programs that are offered. I honestly do not think I would be ready or safe for the ICU, but if that is what I want to do, then I will be trained. However, if I go straight to MS and then to ICU, I would have missed out on a cool critical care internship.
I still have 4th semester, which is OB/Peds/Women, so who knows? Maybe my entire choice will change, but I highly doubt it.