Friday, October 27, 2017

Nursing Chronicles: An Ode to Nursing School


When I was still thinking about nursing school but not actually in it yet I used to wonder what being in nursing school was really like. Based solely off of what google told me I came to the conclusion that it was difficult and anxiety-inducing. Notoriously so.

Then the time came where I went to the very first day of nursing school, and it seemed in the moment that all that I had read was true! All 30 people in my class were shaking in their chairs, worried if they made one wrong move they'd be booted out of the program forever.

I wish I could say I was exaggerating a little bit, but seriously I'm not! For some weird reason nursing schools like to scare the crap out of you and they tell you that if you're 5 minutes late for class or you don't bring your badge to school or if you paint your nails that you will be fired from nursing school.

I'm serious too, all of those are like, legitimate rules.

Despite the intolerance for painted fingernails and tardiness, any grade below 80% is a considered a FAIL. That gives you a very narrow margin for passing.

I suppose I can see the reasoning behind the strict rules however, you don't want perpetually late, unreliable people who don't understand the material taught to become licensed nurses who are supposed to be taking care of people.

So thus it is.

If you are considering nursing school as an option for yourself I must give you a warning. For those two years it will completely and utterly overwhelm your life and schedule. If you are not thoroughly dedicated to the task of becoming a nurse and committed to school as your top priority you probably won't pass and if you do by some miracle scrape by and pass you definitely won't be a good nurse.

However if you're committed and dedicated you will find that nursing can be an extremely rewarding career. As difficult, crazy, merciless and anxiety inducing as it has been, I am grateful each and everyday for my experiences. I get the low of the lows but also the high of the highs and that is worth it I think.

Besides riding a roller coaster of emotions and experiences, what else is nursing school like?

A nursing program consists of four semesters. You first two semesters are considered your LPN year. This is the time you learn all the basics of nursing. You learn skills such as placing a foley, giving injections, passing medications, dressing wounds, doing basic assessments, etc. You usually have a couple days of lecture each week, one day where you go to 'lab' (this is where you learn and practice your skills) and one day of 'clinical'.

I feel like most people have no clue what a 'clinical' is so I'll explain that a little more! Clinical day is where you go with a small group from your class to different areas where nurses work. Obvious places like hospitals of course, but also you may go with a home health nurse for a day, pediatric long term care facilities, clinics, psychiatric/developmental facilities, Rehab facilities and nursing homes, etc. Clinical is an opportunity to expose nursing students to the real world of nursing, to see what happens down in the trenches! It's also an opportunity to practice your skills on real life people, instead of just mannequins.

I will never forget the first time I ever gave a real, breathing patient a shot at clinical. My hands were shaking so bad, my brow dripping sweat. I was praying that the patient didn't notice how nervous I was! Luckily since that time I have gained a lot more confidence in my shot-giving abilities.

After your first two semesters you can take the NCLEX-PN and obtain your practical nursing license. This allows you to go to work as a licensed nurse and you become an LPN. In the last 15 or so years however LPNs have started to become phased out and you really won't see very many of them anymore. There are still a few places that hire LPNs but it seems to be becoming a lot more rare!

Third and fourth semester are considered the 'RN' year. Which essentially you are building off of the foundations you built your first year of nursing school. You're learning more focused assessments, learning how to take care of more critical patients, learning about scarier drugs, etc.

LPN year is kind of like hell on earth and then you get to RN year and you feel a lot better about your life, haha. At that point I think you've kind of figured out how to be a nursing student and *hopefully* have developed better coping mechanisms for stress.

Third semester you do all that you did your first two semesters, lecture, lab, clinical, etc. Then your fourth semester you get to do what is called a Preceptorship! In your third semester you apply for an area that you would like to learn more about/perhaps someday work in. You have to turn in a letter of recommendation as well. Your instructors then send in your applications to different hospitals and try to get you a spot for your preceptorship. Once you've figured out where you will be precepting you are assigned a nurse and for a set amount of hours (usually around 130 or so) you follow that nurse in that unit around. It is an opportunity for you to practice your skills and learn what it is like to really be a nurse a little more independently (but also with supervision).

Then you graduate and take your NCLEX-RN and if you pass, you get your RN license and you go to work!


Of course there are more options for advancement after that, you can go on to get a BSN which is a bachelor's degree in nursing and from there you can go on to become a nurse practitioner or a nursing professor or even get a doctorate in nursing.

That's one of the things I love most about nursing is there is always a push to learn more and become more. Your education should never stagnate, even (and especially) when you are practicing as a licensed nurse. Medicine and the way we practice nursing is constantly changing and evolving with the more we learn about the human body and how it works. You need to constantly keep yourself up to date so you can take better care of your patients.

One nurse I worked with had been a nurse for like 40+ years and she would tell me about how when she began practicing they used to REUSE their needles/syringes!! Of course they would sterilize them in between patients but STILL!! I mean can you imagine having someone give you an injection with a needle they used on some Joe Shmo from who knows where??? Nowadays we discard every single needle after use.

The point is, things change, and you need to stay up to date with those changes.

This post is now getting to be extraordinarily long so I will conclude. But there is a small snippet of what nursing school is like. If you have any questions please ask and I will try to answer!

Maybe this topic doesn't even interest any of you guys in the slightest... but I always like to learn about other careers and how people came to be what they are! So ask away if you have questions :)

Wednesday, October 4, 2017

Nursing Chronicles: A Day in the Life of a Rehab Nurse

I've decided to start a series (and an inconsistent one, I'm making no promises as to how often I'll actually post) about what it's like to be a nurse/nursing student, and to share some of the knowledge I've gained and the experiences I've had.

I've always felt like it's fun to hear about what others do for their careers and how it has shaped them as a person. We spend so much of our time at work, and it really does become a huge part of who we are. That's why it is so important to do work that you feel passionate about, and I feel passionate about nursing, and I want to share that with my 1, maybe 2 readers (Hi, mom!).


Let's start with a little background. Hi my name is Hannah and I've been a licensed practical nurse since February 2016, I'm currently an RN student set to graduate next spring. Since obtaining my nursing license I've worked as a floor nurse at a skilled rehab and nursing facility.

OK so what is a skilled rehab and nursing facility?? Basically my patients are individuals (mostly old people) who are too ill or too weak to go home after a hospital stay. Maybe the had surgery, maybe the had a severe illness, in either case they are not well enough to take care of themselves yet, but the hospital doesn't want to keep them anymore. So they send them to us! I have a love/hate relationship with my job. I LOVE it because of the great variety of patients and diagnoses that I get to see, and I get to use a lot of different nursing skills. My patients vary from those who had some type of orthopedic surgery (knees, hips) who don't need a whole lot of nursing care, but are there more for the rehab/therapy (those are my easy patients!), to some patients who are still pretty ill and require round the clock IV antibiotics, nasogastric tube feedings, wound dressing changes, etc. etc.

My day starts at 0600 in the morning when I sit down for report with the NOC shift nurse. We go down a list of all our patients, discussing needs, changes, orders, etc. It is the time for the previous nurse to hand off the patients to me so I can take over their care for the day.

I'm then given the keys to the nursing cart and at that point I'm the one responsible! A typical patient load for me on a given day varies from 12-16 people. That's 12-16 people I have to administer all their medications to, follow up on labs that are drawn, coordinate their care with any specialists they may go see that day, do their wound care/treatments, complete head to toe assessments on and follow up on any new needs, orders or issues that may come up that day. Not to mention any skin assessments I have to do, or admissions that may come in, and of course all the charting! Oh the charting! I'm not going to lie, that amount of work for that amount of patients is extremely overwhelming. I think I can count like 2 shifts total out of my almost two years working that I have actually left work ON TIME.

Here's more of an hourly breakdown.

0600-0630: Report, count narcotics.
0630-0700: Look up labs to be drawn that day, treatments, and appointments with any specialists my patients have.
0700-1030: Review vital signs, morning med pass (my LEAST favorite part of the day!!) If I'm really on top of it I will get my head-to-toe assessments done during my med pass, but that's only if all the stars align, which they typically don't. 
1030-1200: Charting, following up on new issues and problems with patients. More assessments. Treatments. Lunch time insulin.
1200-1400: Rounding with physician, NPs, inputting new orders from rounds or from outside specialist appointments. Treatments, charting.
1400-1600: Treatments! Charting, afternoon medpass.
1600-1800: Dinnertime medpass. Treatments, charting.
1800-1830: Report
That would be a perfect ideal day.
A REAL day would also have this added...
1800-????? Catching up on charting, inputting orders, finishing admissions, completing anything else I may not have had time for earlier in the day.

That my friends, is a very simple breakdown of what a typical day looks like as a rehab nurse! I wish it truly were that simple, haha.

Hopefully that wasn't the most boring post of all time for you guys, I promise I will post more exciting things about disease processes and stuff for future installments.

My goal for this series is to educate and inform people about what a nurse is and what they do, and also to share cool stories (while being HIPAA compliant, of course) and to share interesting information about disease processes and the human body!

Let me know if there are any questions you guys have too and I will try to answer them as best I can :)