I was brought down to the SICU by my instructor and paired up with a nurse. My initial reaction was, she really doesn't want a student following her all day. Luckily, that couldn't have been further than the truth! We started our day getting report from the night nurse. We only had one patient for the day. (Typically the ICU nurses have 1-2 patients because of how critical they are) The night nurse was great. He was so thorough and clearly values his job and really cares about his patients. He set up the next nurse to be able to walk into her shift, prepared and the patient stable, clean and properly cared for. After report, we went into the room to check on the patient. We checked his IV sites and settings, his ventilator to make sure it was set to the right settings, and the overall status of the patient. Once that was settled, we went to the computer to see what morning medications we wold give. This was great to see and to experience. The nurse I was following questioned medications that didn't make sense to her. She then followed through with these questions and went to the team of doctors (which is convenient because the doctors are on the unit majority of the time). The medication orders were cleared up and we went to administer the medications. I was the observer for morning meds. We then had to turn the patient and assess his skin integrity and do a full head to toe assessment. The nurse stressed to me the importance of seeing every inch of ICU patients skin. Most of them have numerous tubes and wires and are in bed, lying flat most of the day. If a patient is laying on a wire or tube, this can cause skin breakdown which leads to a pressure ulcer (bed sore). This is quite the job for a nurse with a patient who is not fully alert and oriented. We spent a good while turning the patient, moving his gown and checking in every crevice to make sure there were no signs of skin breakdown. If there is a spot on a patient, it has to be documented and interventions are taken to prevent it from progressing. I was very impressed with this patient's care. This patient, although very sick and bed and chair bound, was very clean, very little skin breakdown; clearly well taken care of. It was very nice to see. Throughout the day, the nurse I shadowed, allowed me to partake in patient care. I was able to administer a few subcutaneous injections, draw up medications, suction a trach tube, and change dressings. It was great to have the opportunities to help with patient care. I also was pulled into a couple other rooms with other nurses to observe different procedures. It was a great learning experience and I felt very welcomed by the staff and nurses. My day flew by, which was nice because it was a 12 hour day!
During this advanced med surge clinical, I have decided that critical care is probably not for me. With that being said, after a day in the ICU, I wouldn't completely rule it out. I also realize I had a very exciting day with a lot of support, so maybe that had something to do with it. It's on the back burner, along with about 2040359 other things at the moment ;)
This week was also my first med surge exam. I was beyond nervous! I studied most of the weekend. I actually didn't leave the house from Saturday evening until I left for class on Tuesday afternoon. Sunday and Monday, I literally spent the day at the table, in my sweats, studying. I discovered on our course website, we have the ability to not only listen to the lectures (which I have done previously) but they also videotape the lectures, so I can re-watch lectures, see the power point AND see myself front row center (yeah, I sit in the front row, always). It was really weird at first, but overall very helpful and beneficial. I am pretty sure I spent a good 8+ hours were listening to these lectures. My brain hurts again.
Today, is our pup's 7th birthday! I am currently making him some homemade pumpkin biscuits. The house smells wonderful! Jackson is passed out in his bed snoring away. Such a life.
Our sweet pup!
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