Kissing Nursing Assessment Goodbye!

I'm done with Nursing Assessment! Wooooooooot! Next week we start Theraputic Interventions I, our clinical class. I'm really excited about that one since we had one of the professors as a guest lecturer in Assessment - he was pretty entertaining. Kind of reminded me of Jay B and made me miss his dry humor :( I made it through another Pharm exam and now I just have to finish our clinical paper (which is a task and a half!) and I'm done!

It's been really really nice this week! It's hot and muggy and I'm soaking it up. My legs are finally free from pants! :) Brit was totally right - I miss SoCal weather and I totally took the ocean view for granted, even if I didn't always get there. The Erie Canal just isn't as pretty (even if it's just as dirty as the Malibu beaches, haha). Maybe my view will change when fall rolls around.

I met with one of our program directors this week to talk about advanced practice nursing. She told me the different between a DNP and PhD and then told me a little more about what each of the faculty's area of research was. Even though it's before clinicals, I think I'm leaning toward an NP in Acute Care and a PhD on top of it. U of R has a combined masters/PhD program, but for Acute Care or NICU I'd have to have at least 2 years of experience - fine with me! I need a break from book learning and some hands on stuff. As for my research project, I'm really intrigued by the research being done in the pediatric sleep lab and also the facial expressions of pain for babies. I'm do some further investigating this weekend (since I'm free!!) into some of the faculty that were suggested to me - translation: reading papers - and then email my advisor back to see what else she could tell me. I'm so excited to try this! I loved being in Jay B's lab, but I haven't figured out how I could do that type of research and apply my nursing skills to it. I hope to learn that sometime this year :)

I still really like my program, and even if I get super stressed out and cranky, I am still ridiculously happy. It's starting to make me sick how much I'm enjoying this.

I made it through my final demo! As long as I do well on my written part for that exam, I'll have gotten a pretty good grade on it :) It was very nerve wracking, but my examiner was much more relaxed and practical than some of the other ones that were also testing students that day (or so I've heard). Either way, it's over! I have two tests this week and a clinical paper due on Friday (which I have no idea how to start let alone actually write) so it should be okay. Next week is when we start our class associated with our clinicals. One of the professors was a guest lecturer for nursing assessment last week and he was very entertaining. I think his class will be just as fun, or at least I'm hoping so.

Two of my roommates and I went to karaoke on Thursday night to celebrate being done with our final demos. It was kind of a weird bar, but we sang one song and then watched for about an hour. People were really into it - a lot of them picked songs that they were good at and fit their voice. It was almost the polar opposite of any other karaoke experience that I've had. We did get a lot of high fives for our performance, but that was probably because we were three girls, not because we were good at it. Anna tore it up though, so you never know!

We had a picnic on Friday which was kind of fun. It has been raining a lot, but it cleared up Friday night and was really nice out while we were in the park. People brought their puppies and kids and we all hung out and had some food. There were the cutest 11 month old twin girls there, so I got my fix of cute kids for awhile :)

I suppose I should start studying again :( I have already procrastinated today by laying around in bed and then working out. Boooo!

In 12 hours I will be my roommate's final demonstration patient for nursing assessment! In 13 hours, I will be going myself. We've been practicing a lot (probably why I have disappeared off the face of the earth?) so we are pretty comfortable with the assessment part of it. Reporting back to our examiner, though, might be tough. We are able to bring in "cheat sheets" listing whatever we want. As long as you don't read directly from it, you're golden. Mine has spaces for the symptoms of whatever problem she is given (we draw something like a headache out of a hat and we have to ask certain questions about it) and spaces for BP, HR and all of the vitals. I made mine more of an outline so when I look at it during the exam I'll know what comes next or what I've missed. Plus I added some jargon on there so I'll report back with the right terms. It's scary, but I think that we are both prepared. Everyone so far has done well - we think the only way you can really do poorly is by reading off the sheet word for word or just missing half of the systems we're supposed to assess. We will see!

We also had to take the CNET which makes sure we know enough about drugs to go into the clinical setting. It's a national test that nurses take when they go to work at certain hospitals, so if I apply to a place that requires it, I'm done! We went over all the answers in class since there was no way we would've known that stuff, but it was still kind of scary since we were hanging in the balance.

Speaking of clinicals, I will be in the med-surg unit for my acute care clinical for July/August! One of my roommates is in neurology and another in oncology. It seems like everyone is somewhere different for our acute care setting. I will be able to walk to that one, but my other one I think I will have to drive since it's about 2 miles away. We start our course that our clinicals fall under in 2 weeks! I'm really excited :)

Off I go to practice a little bit more. We tweaked our cheat sheets and now just want to see how they work!

It's gotten more intense, but I am exerting a herculean effort to make myself not stress out about all of the tests, demonstrations and activities we have coming up. My lab instructor for nursing assessment yesterday told us that getting an A on every pharm exam isn't what actually matters, it's if you can use your assessment skills on a patient and if you can document your findings. So, since she is a grad of my program, I will be trying to live by her advice. I still am reading and frantically studying, obviously, but if I want to take a break I will (ie root for the Lakers for an hour and a half before getting frustrated, giving up and going to bed). Cooking and working out has helped me to decompress and I've learned how to cook salmon, even if it's not always perfect. Blackened is actually how I would describe some of my "experiments".

We had a guest lecturer on skin assessment today so we got to see pictures of pressure ulcers. I decided that I'm not a fan of them. Please don't Google them if you haven't seen one - in stage 3 they're holes in the skin that make it so you can SEE bone and tendons. Spare yourself! I'm sure that after some exposure to them I won't be so freaked out, but for now I will choose to believe that I won't have to see a lot of them next month in long term care. They make me sad since they look so painful. :(

This week's lab was on breath sounds and I think I am well on my way to being a stethoscope pro. It's a little awkward telling your partners what you're doing (since they already know), but it can only get easier. We drew on ourselves with marker to outline the lobes of the lungs and I didn't really think about washing them off before I went to the gym between lab and class. When I was walking out of the gym, I realized my white shirt had purple splotches all over it where the lines had been drawn. Apparently, my fellow worker-outers now think I can sweat Kool-Aid. I decided it just own it like Regina George does with the holes in her shirt (end Mean Girls reference).

I recently became a fan of Pandora. The I put it onto my iTouch and it played ABBA for the first 20 mintues of studying on Sunday so that's probably why, but it also reminded me just how much I loved the hits of the 90s. I didn't realize my life was so empty without a daily play of "Bitter Sweet Symphony" by The Verve until I had it available. My Liz Phair station is also pretty entertaining, but I like it since now I'm not so stuck in my music rut.

When Kevin said I hadn't updated in awhile, he was right! I had pharmacology and nursing assessment exams on Monday as well as an online genetics exam that opened up. After completing all three, I am exhausted. Unfortunately, I have another pharmacology exam Friday and a nursing assessment exam on Monday. At this point, I just would like to remember everything they're telling us! It all seems useful, but it's just a lot to remember. Nursing assessment is pretty straight forward - they want you to tell them what response to a physiological test is normal or abnormal and what you would expect to see in a patient certain symptoms. In lab this week we are doing musculoskeletal and cardio exams. I figured out how to count down intercostal spaces on myself, (kind of) but I hope it's easier on someone else especially after we put all the anatomical landmarks on in washable marker. Pharmacology is more difficult since we don't have a time to "practice" what we learned in lecture like we do in assessment lab. It's nice that we don't have to memorize 12478904 drug names, but all the side effects are overlapping for me at this point.

Audrea and I watched some Grey's Anatomy on Sunday night before our tests to relax and see what we could find that they do wrong. It was kind of fun! We knew a little bit more about the patient care aspect (obviously not a lot since we've been here almost 3 weeks), but we had a good time :)

I finally went to the medical library(!) for a tour and it's really nice right now since it's not very busy. I'm sure when people come back in the fall it will be a zoo, but the "lobby" outside of the library has skylights and comfortable chairs to study in. There's a reading room that used to be the old hospital lobby, but the ceilings are so high that I'm not sure if I would feel comfortable studying in there (I'm more of a study nook person). Anyway, the reference librarian that works with the School of Nursing was really sweet and asked us about ourselves (there were 3 of us on the tour when I went, haha) and explained everything about the library to us fairly quickly. The librarians can even do a search on a topic for you and email you the results, which I thought was a nice tool for when I have to do a research paper. The only thing is that you have to pay for interlibrary loan documents. I hope that they have a LOT more resources than Pepperdine did because I used ILL all the time.

Team Sansillo is enthusiastically doing the NikeFit app for iTouch (and I guess iTunes?). Some of the exercises they want you to do are a little ridiculous, and since I can't access the internet in the gym I have to remember to watch them before I go into the hopsital. It has a schedule of when you work out and a timer for each exercise. You get points for whichever ones you complete (or tell them you did). If I have no idea what I'm supposed to do, I'll do another one that I know that's not on the list for that day instead. The only weird thing about this app is that if only gives you 10 exercises that are usually 2 minutes each. I thought by setting it on intense cardio it would give me mileage or an amount of time to bike/run/elipticize, but it doesn't. Hmmmm...

Mini-mental assessment = bad idea

We learned how to do a neurological exam in Nursing Assessment today and one of the questions you're supposed to ask to judge the person's cognitive function/general awareness is, "Can you tell me what day it is?" Wrong question to ask. I have no idea. I had to remind myself it's Wednesday, and I had NO idea what the date was - that's why Word automatically finishes that stuff for you. I've been so engrossed in following the APNN calendar that I don't look at the date, just what I have to do and when. It's a little better now that I synced my Google calendar with my iTouch since that has the date right at the top of the column, but other than that I just go from house to class to lobby to lab to class to lobby to class to house (or some variation).

In lab yesterday we got to draw all over our partner's face with markers to help us remember where nerves, lymph nodes, sinuses and muscles were. Luckily "washable" really means "washable" for the markers we had. The coolest thing I got to see so far was probably the tympanic membrane. You never really wonder about how the inside of your ear looks until you have to carefully stick something into someone else's ear to look at it. Usually it looks nice and flesh colored and the membrane is shiny and pearly gray. You can even see one of the smallest bones in the body. Super cool, even if it was a little stressful and awkward at first.

There is a path that goes along the Erie Canal that I explored yesterday in the drizzle and a little more today. It's pretty nice and I've heard it's really really long. You don't miss green plants and trees until you don't have them anymore. I am more than happy to be back in the northeast and to jump in/avoid the puddles on my way to and from class.

Our study break tonight is a trip to Abbott's for some (apparently amazing) custard. Reward time! Our first assignment, dosage calculations, is due tomorrow and our first tests are on Monday. The stress level hasn't increased too much, but it's probably because I'm still in the honeymoon phase - I'm not bored in class! My roommates are great! Maybe by our first clinical I will feel differently. But for now, I love nursing school! :)

I can't find my brachial artery.... Am I dead?

We got our stethoscopes and iTouches this week, so we have all been playing around with our new toys. In lab we learned how to take blood pressure, heart rate, and temperature as well as do a patient assessment. The hardest part so far has been finding brachial arteries and learning the adjectives used to describe a patient's appearance. "Normal" means nothing (unless you're talking about head shape), so "symmetrical," "adequate nutrition," and "skin appears to be age stated" are now floating around in my head while I wander through Target, Best Buy or the gym. In class I'll make sure I can still find my own brachial artery when we get a break. You get over feeling weird about touching people pretty quickly since you're feeling their arm for 10 minutes trying to find their pulse or cutting off the blood supply to their hand since the gague on the little pump up ball is stuck on their blood pressure cuff. Isn't it great we get this all out of the way on each other and not on our patients?


Everyone that we (we being my house) are friends with are really fun. One of my friends was at the men's NCAA lax championship this weekend in Boston (bummer) but the girls that live down the street came out with us. I forgot what it was like to have fun with your roomies! Audrea took pictures to document our ridiculousness, but I don't think they do us justice. The club was actually pretty big with a huge deck- who knew Rochester had a night life? Unfortunately, going out Friday night ruined a lot of our Saturday since all we wanted to do was sleep. Nic and I went to go get printers and covers for our iTouches so at least we were out in the world a little bit. Audrea, Anna and I watched a movie from Ghana, which was funny but didn't have an ending, and then Step Up so Anna could see just how cute Channing Tatum really is. While Nic went to the gym, Aundrea, Anna and I went for a walk around our neighboorhood and found a little strip mall that has Chinese, Thai, pizza and BBQ places in it. Obviously, we went home, got wallets and got dinner at the BBQ and Chinese places. Delightful.

I think I have figured out Skype. I've video chatted with Cassandra and typed to Seedling, but now I have made a call to Stuart! I was proud of myself. Instead of reading or working on taking blood pressures, I talked to Stuart and had way too much delicious food. I think it's a solid way to spend a Saturday night.

I suppose I should go try to read about pharmacology or something. Maybe I'll just listen to my heart with my stethoscope instead.