NRS 420 Final Entry

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Does anyone else ever find themselves thinking about how they would hypothetically medically treat someone?

 

Like, if you’re watching a movie, and someone gets hurt in the movie, and you start thinking about what you’d do to help them? Or even just a story on the news, or an experience your friend tells you about. My brain immediately starts to think about medical care that would be involved. It’s weird, but perhaps it’s a good sign.

The closest thing I can equate it to is when I took a film class in high school. We were to watch the movie Casablanca nearly frame by frame to understand the composition, camera work, setting, lighting, etc. . After finishing watching the film like that for a few days, my teacher said, “now, when you see things on TV or in the theater, try not to analyze it like you did here.” I think a similar thing is happening to me with nursing, in that I’m thinking about it constantly instead of just thinking about it when applicable.

Maybe I’m just really itching to start working. Either way, my experiences in this class and in the attached clinical have been phenomenal this semester, and I feel like they’ve really helped to get me motivated for what’s to come. Being in the critical care, DOU, emergency, and operating room settings have helped me to really apply what I’ve learned in class to my patients, and I can’t wait to start doing that as a real nurse.

 

Cheers!

-Carl

The Future…and Beyond.

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      The medical industry is in a period of rapid transition. The technological advances that have occurred in the last ten years is astounding. One can only imagine what is to come. The rapid advances in technology along with health care reform and the millions of aging “Baby Boomers” is a heavy cocktail for not only the amount of change forthcoming in nursing. As the “Baby Boomer” generation ages and the patient population continues to rise, physicians are unable to meet the demands. Therefore, healthcare is relying heavily on nurses and the scope of practice for nursing is increasing. This emphasizes the reasons that the healthcare industry is pushing to produce better educated, and well rounded nurses that will have the ability to take on more responsibility in their care. This will be crucial with the shortage of primary care physicians as nurses will need to step in. The National Center for Health Workforce Analysis estimates that by 2020, the U.S. will experience a shortfall of 20,400 primary care physicians. Furthermore, only 12% of American medical students focus on primary care, while 85% of nurse practitioner students prepare to offer primary care of family medicine. Lawmakers are discussing the expansion of the role of nurse practitioners to make them more autonomous and care for the inundating patient population. However, in order to fill the primary gap, nurses need more education. As the healthcare industry will increasingly rely on advanced practice nurses with MSN degrees to provide primary care for patients, hospitals are also increasing their standards and requiring nurses to have a BSN.

      This only solidifies my desire to continue my education in nursing and achieve my MSN. Through my nursing school career, I have learned the importance and the value of knowledge, research, and evidenced based practice to improve and advance the nursing profession as a whole. I hope that I can some day contribute to our expanding profession as we work to deliver exceptional patient care. As of now, I have not decided what direction to take or where my true passion lies in nursing. However, I do know that whatever I do, I want to make an impact on the lives of my patients and an impact on the nursing profession.  

http://blog.pharmadiversityjobboard.com/prepare-for-the-future-of-nursing-earn-an-msn-today/

Graduation, here we come!

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Getting out of clinical this past Sunday, I knew that it was the last day of clinical ever, but for some reason it didn’t really hit me as the end of nursing school. I went to class on Monday and still, it just felt like another regular week of school. It wasn’t until Tuesday night, when I sat with my group to finish up our presentation that it really hit me, this will be the last assignment, no more late nights, no more coffee runs before school, and no more class time. As I sat there, I couldn’t help but remember the first semester during pathophysiology. The room filled with unfamiliar faces, strange personalities, and now, three years later there is nothing weird about sitting with my group members, expressing our opinions about which direction we want our project to go. The change is unreal. We have come so far, overcome boundaries, shared tears, worked on countless projects, called each other during joyous and stressful occasions, and to think this will all be over soon is so bittersweet.

 

This class has been such a learning experience. It was more than just focusing on all the critical care content, using technology and blogging came as a pleasant surprise. I never knew how much I would enjoy blogging; it sure does make blackboard discussion board look bad. Thanks Jaime! I think this was a great way to end our nursing education, venturing into the vast world of technology, which can be scary and so beneficial at the same time.

 

Coming in three years ago I knew it would be challenging for me, as I am not the most outgoing or loudest person in the room, but I thank the instructors and above all, my classmates for making me feel at ease with them. Now, there is nothing I am afraid of, we came together for this experience, shared failures and successes, laughter, and that is something I will always cherish. Cheers to the memories that have past and to the memories that are to come! I love you all!

Last blog

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I am excited to see the light at the end of the tunnel! It has been three years of hard work and dedication. I can’t wait to be a nurse and start working. Nursing is such a rewarding career because you can feel good about yourself when you care for someone and make their day a good one.

In respect to this course, I enjoyed it a lot because it allowed me to think more critically. Also, I was able to see many of the medical conditions presented in the book in the actual clinical setting. This enabled me to remember the disease process better by having witnessed the disease. Also, I enjoyed the presentations of several of our guest’s speakers; they were all informative and gave real scenarios which allowed me to  learn the concepts better. For instance, the speaker on mechanical ventilation was great and I applied what he said on my clinical days. I was able to observe my patients who were on a mechanical ventilator and with a respiratory therapist I was able to review the settings of several of my patients. Moreover, this course was fun because it was structured a little different. We were able to blog homework assignments. I definitely recommend this course structure for future cohorts. Lastly, I enjoyed working on the voice thread project with my group. First time I used this format to present and I really enjoyed it and find it fun to learn this way!

Last Blog

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Wow! I can’t believe we are here and the pinning ceremony is only 3 days away. I think this is the semester, for me, where everything clicked. We have been training for three years to graduate with a BSN. I can honestly say that I am ready for what the future has in store for me when it comes to nursing. I remember so clearly studying for days to understand pathophysiology, pharmacology, med-surg, OB and pediatrics and all those hours of studying are coming together now. Throughout the semester I was able to strengthen my assessment skills, improve communication with patients, connect the pieces of the puzzle together (labs, patho, assessment, diagnostics) and gain a certain level of confidence that I didn’t have during other semesters. I absolutely loved critical care nursing and the independence that comes with it. I felt like there was a greater amount of collaboration in the ICU and that is something I really value in nursing practice. Seeing people from many different fields work together was amazing for me to experience. I also loved being able to focus all of my attention on two patient’s which allowed me to better grasp the full patient picture. One day I can definitely see myself in critical nursing.

If I could see myself at the beginning of this journey I wouldn’t have believed the person that I see today. Jaime, you told us at the beginning of the semester that the goal was for us to be ready and I think that goal has been achieved. I know I don’t know everything there is to know about nursing but I know that I have the tools to find a solution to practice safely.  The learning never stops and every day I will find a way to become a better nurse.

 

Image Reference

https://s-media-cache-ak0.pinimg.com/236x/11/55/98/11559822d0543bf0214c0c89a086eb30.jpg

 

Final Blog!

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Wow I can’t believe it’s the last blog post! This class has been a great learning experience. Lecture and clinical have really helped me grow in my nursing skills and critical thinking. Learning this final piece of the puzzle (critical care) has reiterated concepts that we have been learning through this whole program and solidified them. One example of a concept that I have finally understood is ABGs. In patho especially, it was hard for me to distinguish respiratory verses metabolic acidosis/alkalosis. In saying that, it surprises me, knowing how well I understand it all now. I also really enjoyed learning the different types of dysrhythmias and their treatment. ACLS is a really important class to take to reinforce the concepts of heart rhythms and how to treat a patient in a critical situation. My passion for cardiac disorders and treatment has also grown this semester. I hope to start off working on a telemetry unit and continue to learn about the heart while I grow as a nurse. I am so thankful for this program, the faculty, and the students. I truly feel blessed to have gone through this program with everyone and for everything that I experienced and learned!

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Finishing Strong

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This semester learning about critical care has been my favorite semester throughout all of nursing school! It has definitely begun to feel like everything is clicking into place in regards to truly applying all of our knowledge. I have never felt more excited to go into clinical rotations than I have this semester, knowing that I will be learning so much in the short amount of hours available in clinical. My confidence in my clinical skills has skyrocketed, my assessments have improved, and my ability to piece together the whole picture with each patient has exponentially grown. My passion for critical care has shown itself as well, and I know that one day I would love to be able to call myself a critical care nurse. The potential knowledge, wisdom, autonomy, and critical thinking skills gained are incomparable. This rotation has overall strengthened not only my nursing skills but my goals as well. My goal includes becoming a nurse on the intensive care unit, whether that happens as a new graduate or later on in my career. That being said, I honestly cannot believe that three years of nursing school have come and gone. We have all grown so much since we started and will all in turn grow to be amazing nurses when beginning our careers! I cannot wait to see how it all turns out for us, even just a  year or two from now (at the reunion we will be having…right?)

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Day 1 – E.R.

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BP: 100/58
HR: 120
O2: 78%
Temp: 102.4
Resp: 9

WBC: 18.0
Bands: 14%
HgB: 14
HCT: 50%
PLT: 350
Glucose: 250 mg/dL
BUN: 20 mg/dL
Cr: 2.4 mg/dL

pH: 7.30
PaCO2: 68 mmHg
PaO2: 45 mmHg
HCO3: 26 mEq/L

Sputum and blood sample positive with S. pneumoniae

 

JA is a 68 yo male pt who came into the ED via ambulance this morning. JA was found to be SOB and difficult to arouse by his wife prior to coming to the ED. His wife reported JA has been complaining of fatigue, chest pain, SOB and fevers for the last 2 weeks. VS are as follows: BP: 100/58; HR: 120; RR: 9; O2: 78%; T: 102.4. Pt is difficult to arouse; responds to painful stimuli. Pt is sinus tachy on the monitor with HR in the 120s. S1S2 is present. Cap refill is 3 seconds. Skin is tenting. Upon auscultation, crackles are present in the upper lung lobes and the right lower lobe. Lung sounds in the left lower lobe are diminished. Respirations are labored and nasal flaring is present. RR is 9-10 with sats at 78% on RA. Pt put on 2L nasal cannula, which increased the pt’s sats to 85-87%. Venturi mask 4L applied; the pt’s sats increased to 89-90%. Pt has a productive cough with thick, yellow sputum. Chest x-ray taken. Abdomen is soft and non-tender. Bowel sounds are hypoactive. Wife reports that pt’s last BM was 2 days ago. Pt’s wife reports he is continent of urine and voided last night before bed. Pt’s skin is intact, warm and dry. Awaiting lab results and chest x-ray results.