Archive for August, 2008

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First up: Med-Surg

28 August 2008

Well, orientation is complete. 82 GEPNs have been talked at for three days, with the presentations alternating between the tedious and the terrifying. Classes begin next week, clinicals disturbingly soon after that.

This first year is kind of oddly organized, with some classes lasting only a few weeks, some lasting a normal semester, some carrying on partway into the spring semester. But we all begin with Biomed (basically a crash phys/pathophys course), Intro to Pharm, and Med-Surg, which has both a clinical and seminar. About half of us (myself included) will also be taking Anatomy over at the med school.

GEPNs have classes two full days (MTh) a week (plus Fri afternoon if you’re in Anatomy) and two days of clinical (TW). We haven’t yet been given our clinical placements for the med-surg rotation, but we were given some idea of what the possibilities are and are aware that we have about zero chance of getting what we might think we want. But there’s a good mix of possibilities, all guaranteed to kick your ass and make you cry. We’ll be in groups of six students to one preceptor, and we’ll have six weeks at one site, and then six at another.

I can already see the fear in some of my fellow students’ faces. And I’m sure my hands will shake the first time I have to insert a foley or place an IV. But I am thankful for the experiences I’ve had that give me a little bit of confidence already, and take a lot of solace in knowing that hospitals are comfortable places for me. I’ve read hundreds of charts. I’ve interviewed scores of patients. I’ve drawn blood and sent labs. I’ve seen very sick people doing the gross things that sick people can’t help but do. I’ve seen death and trauma and anguish and I’ve watched great RNs handle all of these things with the utmost professionalism, grace, and humor.

So I’m ready to get my hands dirty and help them out. Let’s roll.

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ER 101

24 August 2008

The move is complete. Orientation starts tomorrow. And although I am technically staying on per diem, I really have ended my tenure (ha!) in the ED. So before I have tons of nursing-school hijinks to write about, I wanted to share just a little of the wisdom I gleaned from 2 years of semi-controlled chaos in your friendly neighborhood Level I Trauma Center:

  1. Don’t run from the police. That rarely turns out well. Doubly true while on a motorcycle.
  2. Remember, cartoons are for entertainment purposes only — Gunpowder is not a toy.
  3. Don’t get your octogenarian mother completely, totally, shit-faced drunk and then wonder why she’s having gait instability and slurred speech.
  4. The Vagina: Not an approved storage device. For anything. Like, say, drugs. Or glass drug paraphernalia. Cuz that shit *does* show up on X-ray.
  5. If you’re an IV drug user, don’t inject other things that might have once contained drugs. Like month- old wads of cotton.
  6. If you’re an insulin-dependent diabetic, don’t embark on a solo multi-state road trip without any.
  7. If you’re allergic to peanuts,  don’t get drunk and have a Butterfinger.
  8. If you’re male, intoxicated, and your wife/girlfriend/sister/mother/any female bystander says “I don’t think that’s a very good idea”, cease and desist, immediately. Particularly if your plans involve firearms, sharps, fire, or a moving vehicle.
  9. Parents, don’t drag your child in to the ER for a low-grade fever that they’ve had for all of three hours. It’s called Children’s Tylenol. And a phone call to your pediatrician.
  10. Oh, and moms, the ER is not free daycare, and RNs aren’t babysitters. If you do bring your child in, expect to be with them the entire time. And if you really have to have that cigarette, don’t expect the nurses to be cordial when you take your toddler outside with you for your nic fit. Especially when she’s here for an asthma attack.
  11. And finally, it’s never a good idea to threaten ER staff. For some reason the huge guys in suits ALWAYS take our side.

Alright, all joking aside. If I learned anything I’d really want to share, it’s this:

Your PCP’s practice always has someone on call. Trust that qualified professional to decide whether you need to come to the ER at 3AM for your hemorrhoids or sore throat or the back pain you’ve had for eight months — because maybe, just maybe, it can wait until Monday and a routine office visit.

Because the ED is for (gasp!) Emergencies. The MDs and RNs there are trained to manage crises. It is not their job to solve all your medical problems, diagnose and treat all your possible ailments, and update all your medications in three hours. It is their job to determine if the symptoms you are having are life-threatening or require immediate medical intervention, and once they’ve decided that is not the case, you will get the ‘follow up with your PCP’ dispo and shown the door. You may not have any answers. You may still feel like shit. You may feel like you wasted a whole day and a large copay for them just to tell you what you don’t have. But that’s how they manage to save lives and still keep one or two beds open for the MVAs and the heart attacks and strokes. Just something to remember next time you come for a visit.

Oh, and one other thing.  Use car seats.  Wear helmets and seat belts.  And for the Love of Bob, people, don’t drink and drive.