Last week at LNRMC

My last week of clinicals was split between the hospital and the Health Department. My client at the hospital was in for a TKR and he was so ready to go home on Friday. I had a chance to do discharge teaching and enjoyed it very much. I changed his incision dressing before he left and gave his meds and as soon as he left the floor to go home I reported off. Very good week at the hospital. I enjoyed the health department but was blown away by the number of young women having their second and third babies before the age of 19/20. Nurses were great and busy, busy, busy. Loved the pace, the morning was over before I knew it.

LNRMC

Last week I had a patient with hypothyroidism. I thought it would help me a lot for the up coming test, but I was wrong. I did have a good week though and it was interesting.

LAST WEEK!!!

For my last week of this semester I had my SPA rotation and one day at LNRMC. My SPA rotation was okay...but not for me. Now for my patient at the hospital, he made my last day very easy. He was very easy to talk to and understanding that I was a student and I was a bit "slow". Anyways....thanks group and Mrs. Beaver!

LAST WEEK!!!!

I was blessed with a sweet man on my last week of clinical. He was not very needy and was willing to do what ever you wanted. He came in with anemia. He recieved 4 Units of PRBC. He also had a in and out cath that was done every 12 hours so I was able to do that and its alot easier than it looks. I was also able to start an IV on another lady that was not my patient. I got it the first time!!!

PEDS

Like most everyone at RRMC I was assigned an adult, and not only was she an adult she was a nurse. Thanks Mrs. Ward Haha!! This lady was very sweet she was legally bind and had a hole list of problems and allergies. She was in for SOB at this particular time. My main focus with her was her O2 sats at one time they were at 85!!!! She also had about 20 meds to give so that was to a focus for me, but I made it with no problems.

Bye Ms. Collins

First, I hope your blister is okay, Ms. Collins. Take care of yourself.
Second, I was pretty sick myself for clinicals. Don't get sick around nursing students. I might have had a heart attack thinking that I might be having a heart attack.
I was able to give insulin with the flexpen. That was very neat! I also got to use iodoflex (iodine soaked substance) when changed a dressing.
My patient had Diabetes Type 2, copd, cvd, pvc's, chf, and was in for osteomyelytis. In other words, a train wreak. She was very intelligent, but did not pay attention to her diabetes other than to say, "Boy that sore is all of a sudden causing swelling all the way up my leg". We talked about what she could do to help herself, and she had heard it all before. She was very knowledgeable, but sort of hopeless. I hope and pray that she can turn it around to prevent further damage.

Zimmerman wk 4

This week clinicals were great!! I have enjoyed it so much. Mrs. Zimmerman is awesome, she has helped so much. I had patient that was 89yrs. old with hist. of uterine ca. she also had dementia...and was just pityful!! She would talk a little but, most of the time she was crying and trying to pull her cath out. She was much better after some haldol. :) I got to dc her cath. and IV, I helped her with everything because I was scared to leave her. she was a risk for aspiration so she had thick liquid diet. The next day I was going to get to go to surgery but my patient went to ICU so I had to pick up another. She was a good one. She had back surgery on t3 and t4, she was very nice. I was busy with her all day, she was very sore...but overall she was doing pretty good. I have really had fun this semester in clinicals....I can't wait until the fall!!!

Amy Jones
NUR130

zimmerman 4

this last week of clinicals was good for me. I had a 83 yo man. He came in with a small bowel obstruction and had an NG tube. I had never delt with one and I got to check placement and clamp it off. This man and his little wife were so adorable. they had been married for 50+ years. I couldn't get over how young they acted. He told me the thing he missed most was going mountian climbing.....he said he has not been since he was 75......it blew my mind. I really enjoyed talking to him and he didn't seem like what the word elderly describes. it was great.

NEMC Renal

Had a great experience. My patient had Hyperkalemia caused by dehydration due to a recent surgery. On 06/25/07 he had his bladder and prostate removed due to bladder cancer. Instead of having an ostomy, Dr. Nordan constructed a new bladder out of part of his stomach. Too cool. He was very informative about the procedure and taught me a great deal.

Last week

This week went really well. My pt. was a 75 yo man who was admitted w/ fatigue & malaise. He had severe tremors w/ out etiology and a hx of CHF, HTN, A Fib, COPD and renal failure. The doctors were thinking that the tremors were a adverse reaction to his A Fib med. but he was still on it?!?!?! His tremors made caring for him very hard. He was hard to understand at times and I had to take manual bps and do pulse ox's on his toe to get readings. His pulse ox gave me a little scare. He bounced around from the low 80s to the low 90s based on his exertion level. He even had respiratory a little nervous! Anyways, he was very nice and I enjoyed my time w/ him. I am happy to have made it through another semester (the clinical portion anyway!!!)

NEMC-4G & SPA

This was splitt week for me.Thursday I had Pt. adm. with severe abd. pain, 6th day post-op of laparoscopic cholecystectomy. Her pain was most of the time 10/10. I gave her Q2 hrs. 4mg of Morphine Sulfate IVP.I started a IVPB of 20 mEq KCL to regulate her potassium loss. So finally doctors decided what they will do with her. A litlle stone stuck in her common duct and she had jaundice and itchy skin from high level of bilirubin. AST and ALT were high too.They will perform the second laparoscopic cholecystectomy.
First one was done at CMC in Charlotte.Poore,sweet lady.
Friday was my day at SPA. First 2hrs. I was observing Triage nurse praxis (Brenda, RN). She gave me so much info. about her job in detail and the jobs other employees.Last 2 hrs a followed Dr. Craighead. I saw Pt. from different backgrounds and different age. All Pt. were between 20 days to 2yo. Most of them came for regular check ups with small issues such as babies abd. gas etc. Dr. Craighead is excellent teacher, he explains so much to the parents that they can feel pretty comfortable when they leave the SPA. I felt comfortable too because all the personal was so receptive.
The last four weeks were so huge experience for me that I could just imagine. I thank all of you who help me to achieve my goals.
Thanks
Zdenka Duric

Week 4 and out with a BANG!

This week was easy but nice at RRMC. Thursday my patient was 47yo male with Acute Pancreatitis. He was a great experience for me in that I got to mix up some drugs for an IVP (Demerol with Phenergan) and also gave a pneumonia vaccine. Wonderful teaching experience because he has a hx of ETOH use and smoking (up to 1.5 ppd) We had an interesting discussion about his drinking being r/t exacerbations of his disease and he did admit that he had been drinking heavily when his abdominal pain started. Also I did some teaching about smoking cessation because when I did my assessment he had some wheezes. Overall this guy was VERY receptive to my information. That afternoon I D/C'ed him home (took out IV, did D/C record and teaching, etc).

Friday. My patient was in for bacterial pneumonia. She had a PICC line and a chest tube, which I'd never seen before and I got to see how it drained the fluid from her lungs to these glass bottles. This lady had an extensive hx and I was looking forward to talking with her about it since she was extremely knowledgeable about her condition(s) and care...but the day just wasn't long enough! I have to say though that this Med-Surg rotation was by far the best experience. The nurses were all so helpful and really into teaching and offering help whenever they were needed. Mrs. Zimmerman you are so AWESOME and thank you sooooo much for all the experiences (yes, ALL of them hehehe) and for making sure that I was getting everything. I certainly do feel like I am an expert at charting and everything is really coming full-circle.

I was on Womens and Peds at Rowan, and my week was overall very good. I had a lady who was having abdomen pain to start with, i was able to drain her jp drains which was new to me, she had recently had a tummy tuck and breast reduction. My 2nd pt. was a 13 yr old boy who came in with osteomyletsis. I was able to deal w/ him and his parents who were very nice. A good learning experience. Mrs Ward was also able to find me other things to do that i have not done before, I was able to start and IV on a 77 yr old lady and was able to do 2 central line dressing changes which i have not done either. Mrs Ward made me feel very comfortable in everything i was doing and was able to answer all my questions.

Last week of clinical

My last week was by far the most challenging. My client was a 46 y/o hispanic male. He was in for osteomyelitis in his toe, but also had IDDM, CHF, ESRD, hypothyroidism, GERD, seizure disorder, diabetic neuropathy, and was blind in his right eye. He didn't speak much English, so the communication barrier only made things more difficult. He was a very sweet man though, and enjoyable to care for. Of all of his health problems, he seemed to be preoccupied with the fact that the MD recommended amputating his toe. I really wished that I could have communicated with him more effeciently, because I'm not sure that he understood the extent of which the infection had progressed in his toe and why the amputation was necessary..... I think I might try to learn a little Spanish later on.... It could only help.

Adios Amigos,
Erika

MZ week 4

My last week was great! I had the opportunity to watch a PEG tube be put in, which was very interesting. They pull the peg tube through the mouth to the stomach and make an incision through the abd and pull it through. Really cool!
My little pt. got really sick Thurs. night so I wasn't able to take care of him per request of the family (no..I didn't do anything wrong;-) The family was called in and they were preparing for the worst. So I ended up Friday with a very nice lady who had back surgery. She was pretty easy to take care of and was d/c'd that am.

MMZ last week

My last week at Row Regional and I had a interesting day. My patient was a 42 y.o. lady who had a aleft knee replacement. She was receiving meds. from me and also self medicating herself which she was not suppose to be doing that. She really wanted us to keep pumping the IV Morphine in her on top of the 2 Percocet she was receiving but after the 1st time giving her the Morphine MMZ saw that she seemed a little out of it so we decided she was just wanting a little fix so no more Morphine for you. I didn't have clinicals Friday. I would like to thank MMZ for all the praise as well as the criticism I now know that it was for my own benefit and I am glad that she stuck it to me because I feel I am a better nursing student b/c of it. Good luck on the Test guys!

Last week of med./surg.

This week my pt. was an 84 y/o man with gastrointestinal bleeding/anemia. I gave meds on Thursday and on Friday I went down to endoscopy with him and watched a TEE. It was really neat. They were checking for endocarditis and I got to see all the valves in his heart working. It was a good week, but I sure am ready for a break.

Zimmerman- Week 4

This week in clinicals I was at 1 East at RRMC. My first pt had pancreatitis, gastritis, diverticulitis (sp), DM 2, GERD. She was a sweet lady who when she wanted things, it was right then and there. I got to go down for a sonogram of her abd which was okay but the technician was running behind and wasn't in the mood to be asked questions. The next day I had a sweet pt however her family was a different story. The pt was adm d/t vomiting episodes according to her and her family caused by a bad orange. The family were her three daughters that wrote down everything was said by dr and nurses. Question people's ability on how they were doing their job (even the dr), about each drug that was given (I was to push Nexium and stood there for five minutes to get everyone's approval before I pushed the med), and disobey orders that were given by the doctor. Overall, I am glad to have that experience so I will know what to do when I am out in the real world and have to deal with the patient's family as well as the patient. It was a great experience at RRMC especially with the 1 East nurses and M. Zimmerman. M. Z was so wonderful in teaching us and letting us get new experiences. I really enjoyed having her and really hate for the people who did not get to have clinicals with her. She is one of kind (in a good way)!!

Amanda O.

Peds week

On Thursday, Kristin and I shared a 6 day old that was born @ LNRMC and was discharged with GBS. She was getting IV antibiotics and went home on Wednesday morning. On Friday, I had an 8 month old that had had 2 seizures. Her father had epileptic seizure until 8 years of age. She was being observed for seizure activity and given a neuro consult. She showed to signs of seizure activity and was discharged home on Friday evening. I got to discharge her and discontinued her IV loop. I hated having her cry because of the tape pulling, but I was glad that she was ok and went home. She had 2 follow-up appointments - one with her pediatrician and one with neuro. She was sooooo cute and loved her mommy. I really enjoyed my experience in Peds this week. I learned what is was like being on the opposite side of the life...I had always been the mommy and not the caregiver...it seems so different being on the caregiver side...and even a bit easier being on that side than on the mommy side. I will definitely take this experience with me on my journey in my career and will remember what life is like on both sides.

3rd & 4th week of clinicals

I must have forgotten to do this last week. My 3rd week of clinicals was @ NEMC on the Jeff Gordon Children's Hospital floor! I had a 13 y.o. was sickle cell disease and a recent cholecystectomy, that had been readmitted for pneumonia. He was overweight and needed a low fat diet, which he was not happy with and refused to eat dinner, therefore his mom brought him some fried chicken. I felt so bad for this kid, because he's only 13 and he can't play any sports due to his sickle cell and his one great accomplishment of his life was being up to go through a whole season of baseball without getting sick, made me want to cry. Anyway, he got the pneumonia from not TCDB enough after his surgery, but while I was there he was using his incentive spirometer and improved a lot.

Week 4. I had a 48 y.o. this week that is diagnosed with breast cancer and came in with a fever. Her cancer has metastesized (s/p) to her bones and liver. I gave meds on Thursday and Brandon gave her meds on Friday. And Teresa was the "official" lung listener, b/c I like to confirm things before I char them!!! :] While Brandon and Teresa were in her room, confirming the crackles that I had heard and administering meds, the Dr. came in and talked with her about becoming a DNR. He explained to her what it was and that she would still be receiving great care, but if her heart were to stop they wouldn't bring her back. She then told him that's what she wanted. Teresa said that it was awesome the way he approached the situation. I tried to carry on some conversations with this woman to lift her spirits and it seemed to work. She generally acted like she wanted to talk to me and appeared to be in a better mood after we would conversate for a while! It's amazing how simply talking to someone can help!! :]

NEMC-RENAL and PEDS CLINIC

I was only at NE on Thursday. I took care of a lady who was in renal failure, but she was not on dialysis. She was very sweet. When I asked her to roll on her side so that I could listen to her lung sounds on her back, she looked at me and said "ok I will do my best". On Friday I went to the pediatric clinic. During the night clinic a young girl came in with a big gash on the back of her heel. If the mom took pressure off it would start bleeding again. I also met an interesting young couple who had a 4 yo boy and a 4 month baby girl. Every time the little boy would get up to see what was going on the dad would say "sit back down, right now." The dad also told the little boy that he was going to get the shots for his sister, and that upset the little boy. We gave the little boy some stickers and that made him really happy. I enjoyed going to the peds clinic.

last week

On wed, I went to the health dept. I met M Curran who is a NP and who use to be an nursing instructor. She asked me a zillion questions and if I didn't know the answer she made me look it up in one of her many many books. at first it was irritating, then after a while, she became pretty cool. Very smart and LOVES the aspects of learning. I mean, gets off on it. I liked her.

Friday, my pt was a 60 yo female who was admitted with personality changes. She went loopy one night after supper and was running a fever. Her daughter took her to the ER and they admitted her. She was a very depressed, very demanding woman. She knew all of her drugs and all of her illnesses. Some of her illnesses weren't in her chart. So I don't know if she really had them or not. She kept me pretty busy and it made the day go by fast. NO more 130 clinicals.......yeaaaa!

Christie Harris
Nur130

PEDS at NEMC

My patient this week was a 14 yo Hispanic girl with Hirschsprungs Disease. This is a congenital disease where part of the colon is missing nerves. Without those nerves peristalsis does not happen. The result is constipation and impaction with a distended abdomen. In an infant they may not pass meconium; if older and the section is relatively small they may only suffer constipation and bloating until things plug up. The Tx is removal of non-innervated section with a colostomy. Later the colostomy can be reversed. This was the case with my patient. She was 2 days post colostomy takedown. On thursday her IV and meds were D/C so I only gave Lortab PO. On Friday she was d/c'd. Peds is a slow floor after renal :)

GoodBye Mrs. Collins :(

Very good week at NEMC w/ Mrs. Collins. My pt. was admitted for intractable neck pain. I started an IV w/ Mrs. Collins help, gave an IV push, SQ injection, trans dermal pain patch, and PLENTY of po meds (mostly narcotics). He is post liver transplant x 12yrs d/t a tattoo on his R inner lower leg that caused hepatitis C. The MD's only gave him 3 months to live when he was diagnosed with hepatitis C. Mrs. Collins has been a WONDERFUL instructor. I have learned a great deal from her. Today I was able to give meds w/o Mrs. Collins being on the room. I have finally mastered the computer system. Hope all had a great week!

Casey Hinson
NUR 130

Final Week

This week I went to SPA on Monday. It was quite busy, and I got to see several different tests performed. Thursday, my patient was a 40 yr old female with ESRD and HTN. It was a little sad to see someone this age in such bad health. She has been dealing with renal failure since '88, has had 2 transplants, both of which she lost due to rejection, and she was also post- op cholecystectomy. She also had Lupus in the past. She was discharged after we left on Thursday, so I had another client on Friday with ESRD. She had sooo much edema it was hard to get her pedal pulses, (in fact, she had an IV in her right foot b/c it was hard to find a vein anywhere else)so the nurse showed me how to use the doppler. I enjoyed being with Ms. Holcomb. She helps you put things together regarding disease processes. It was interesting learning "which came 1st, the chicken or the egg". I have enjoyed the semester. See you all Monday!

No Peds on the Peds floor with Ms. Ward

Peds was interesting with Ms. Ward... there were no peds. Friday David got the only child on the floor. I had a 25 y/o patient who was in a motorcycle accident in May, she was hit by an illegal alien drunk driving, who ran from the scene. Her left leg and arm was crushed. She has bactremia now from being in and out of the hospital and having all kinds of problems. She had an external fixation device to her leg that got removed today. I really enjoyed working with Ms. Ward and Mrs. Phelps.

peds at rowan

I had a fantastic week! My pt I had Thur. was admitted for a GI bleed tests revealed she had diverticulitis. I gave po meds and got to hang her piggyback and use the pump, my first time! I then got to watch David put in his first iv on what i would have thought to be a hard stick, but he got it! Good job David. Friday i came in and my pt was d/c so i then got a pt who was in for a abdominal hysterectomy, needless to say this pt kept me busy which was alright, me with nothing to do is not a good thing! this pt had a contiuous pulse ox and std compression hose which i managed after the second time putting them on not to get them backwards and inside out or upside down. She also had a pca pump which i got to learn how to use and document. had a problem with this pt not being able to void for a couple of hours so i also got to do a bladder scan. i also got to do some real teaching with this pt on tcdb and use of the incentive spirometer. she was not happy with this or me ambulating her, thank god for the bathroom until we got in there and she says im dizzy and have a headache! how can you be in two places at one time when you need the machine to take vitals and cant leave your pt. Thank you Mrs ward for checking on me at that time. because this is NOT a good time to leave the pt. i wondered at that point is this where you yell help! and now i know what mrs holcomb means about bargaining with pts everything i tried to get this pt to do, she would do it if i got her either a milkshake or candy bar! and the nonpharmalogical imagery techniques or distraction method was me telling her that her clear broth she had for breakfast was really a steak sandwich. and the nurse i worked with (Leslie) was great. thank you mrs ward i really felt like i learned something this week and got to do some things ive been nagging to do. i loved it and wish every week at clinicals was like this week. everyone have a good week end and as usual study, prayer request are in affect im sure

4G & SPA

On Thursday, I was on 4G with Mrs. Collins. My pt. had come in with epigastric pain. He had a hx. of depression and DJD and back surgeries. He was on pain meds and the doc. tried takin him off. They thought the pain was coming from withdrawls because all his tests and labs came back normal. I was able to adm a IVP because he was NPO. On Friday, I went to SPA. I was able to watch pts come in with multiple problems. I was able to watch the doc. do a culture on a boil. I was also able to do my developmental assessment on a 2 month old.

WOMENS/PEDS @ ROREG

I really enjoyed having Mrs. Ward this week. My patient come in with ARF from a reaction to a med she was taking for her fibromyalgia. The second day we were in the lab and took our pt's from Thrusday and made clinical scenarios for the 1st year students. Overall, good week!

NEMC - 4G

It was amazing week for me. I learn so much that I could not imagine.
I had two patients. First day I had total care patient with cerebral palsy, mental retardation, seizures, contractures. He was admited to the hospital d/t pneumonia r/t aspiration. He lives in SNF. He was on PEG-tube, so I gave all meds. through feeding tube. This was completely new experience for me. To be able to clean and change him I needed help because patient was immobile and had contractures. Ashley Andrews helped me a lot to met my goal. I had a lot of meds. to give and managing PEG tube, so I thank Mrs. Collins for all teaching and help.
Second patient had ulcerative colitis diagnosis. He lost 40 lbs. in a month so he was on TPN and lipids.Again great experience for me. I went with him to radiology ( CT scanning). The nurses and care partner where great and helpful. I thank everybody who helped me in my achievments this week.
Zdenka Duric

SPA rotation / RRMC

Mon. - I attended clinical at SPA. I had a lot of fun during this rotation. It was nice to have healthy patients for a change. All of the patients that I saw that day were just there for routine check-ups.

Thurs. - I had a 57 yo divorced white female on 1E. She was admitted for a fractured R. humerus, but had quite an extensive medical history. Aside from her numerous physical ailments, she also suffered from panic disorder and was bipolar. She really touched my heart and I wish that I had more time with her. I was able to do my psychosocial assessment on her which indicated that she has really low self-esteem...not to mention that she would barely make eye contact.

Third week of Clinicals at LNRMC

Another great week of Med -Surg. My patient this week was a 37 year old man who was in for a surgical removal of a "Huge left flank hernia." According to the surgeon the hernia was the size of a basketball and protruded between the 10th and 11th rib. The incision was as if he had donated a kidney; he was cut almost in half. There was a JP drain and an on-que medication pump deep in the wound as well as a PCA and until Wednesday at 1130 hours he was on IVF at 100cc/hr. He had a great attitude even though he never rated his pain less than a 5 and his family was wonderful and extremely supportive. In his history it mentioned that he had suffered a gunshot wound to the eye at the age of 12. He was not completely blind but the eye did not/could not follow motion. I was able to change his dressing twice, administer meds and since I knew the doctor had D/C'd the IV I was waiting for the nurse to give me the okay before I left the floor. I was also able to start an IV!! YEAH!!!! Very cool stuff. The group of students at LN was also great this week. We all shared our experiences and offered to help each other out, of course we all had really interesting clients, so that made it all the better. Looking forward to the next round this up coming week.

Teresa

peds rotation

This past week i was at NEMC on peds unit. The new unit was awesome, there was so much stuff for the kids to do, and the nurses were very nice!! My pt. was a 10 y.o. boy who had an appendicitis with acute perforation. He had an open appendectomy. His incision was an open wound with steri strips and aqua seal dressings in each end. He was d/c on friday and i saw the nurse change his dressing and take out his central line, and then i gave his mom the d/c instructions.

ZIMMERMAN

This week was pretty good. I went to the SPA on Tuesday and was able to have Thursaday off from the hospital. Friday I had a nice Lady as my pt. She was very sick and only 57yo. She had came in with a broken humerus. They did surgery and had her arm in a sling. She had a history of smoking and copd......so after surgery she had lots of breathing issues. She was supposed to go to a Skilled nursing facility on Friday but im not sure if she did or not. It was a good week.

LNRMC

Jennifer & I shared a patient last week because we both had days off. However, Jennifer must have taken such good care of him Thursday because he went home before I could even see him. So, Friday, I helped Tracy with her little lady. I did the A.M. assessment & and her 10 o'clock meds. I also took out a Huber Needle from a port-a-cath & helped Brandon & Mrs. Beaver put in a new needle on another patient. I hope this week my patient will stay long enough for me to take care of him both days.

Pieds Northeast

This week at pieds I had 2 different children. The first child I had was a 2mth old baby, I didn't actually get to do anything with him b/c he went home after I had preped for him. So Thurs. morn I got a new child. He was a 6y/o little boy who came in with abd pain. Apparently he had already been to the ER earlier and sent home and came back to the ER and ended up having a ruptured appendix. He was for the most part sleeping, but when he did wake up he became combative. Friday about an hour or so before time for us to go he spiked a temp of 103.2 and his incision was starting to look red. For the most part pieds was pretty good, but it's still not my thing. I don't like seeing the children sick.

Week 3

This week was very fun, I was able to really work as a pt advocate. My pt was spanish speaking and she was very concerned about the side effects of the diff meds she was on and her family were being very influencial and I had to make sure they told her all of her options so she could make an informed decision

PNC and NEMC 4G with Ms. Collins

I loved the Health Department in Salisbury, at least the Pre-Natal clinic. I could really see myself working there. It is steady, interesting work with a lot of education and meaningful assessment. I told Randy's wife that she is a Saint because it wouldn't be a good day if I couldn't bust his chops a little.
My patient on 4G was discharged, so I got to DC an IV. He refused his IVP so I didn't get to do that. Just gave PO meds, anti-depressants and non-opiod analgesic. I did do a process recording. My concept map changed too much from the time I read the chart to my day of care as far as the meds go.

Sue Rigot

NEMC PEDS

This week at peds was awesome. I took care of a 16yo girl who was anemic because she had bleed from having her mensus from anywhere around 2 weeks to 1 month. This had been going on for about 6 months. I was able to teach her about iron rich foods because they determined that she was iron deficient anemic. Her Hgb was 5.1 and her Hct was 17%. She also had to receive a blood transfusion which helped her out a lot. She also said that she felt really good even before the transfusion, but they gave her the blood anyway. I could not believe that she felt so good with her H&H so low. She went home the next morning and I was able to help discharge a 15yo boy who had celluitis of his right ankle from being kicked during a soccer game. Luckily he spoke English because his mom only spoke a little. Overall it was a really good experience.

Zimmerman 3rd week

This week of clinicals was a good one I had a patient that came in for a simple retrobubic prostatectomy. He was a Baptist minister which is one reason why we got along so well and he did not like the fact that women had to look at his private parts. He had a 3 way irrigation system. I was able to change his dressing and he had a pinrose dressing draining. He only had 2 meds so he was otherwise healthy. I feel like I am the master of charting now after MMZ bite my head off (lol). I had a good week.

LNRMC

This week at LNRMC, I had a 67 yr old female that was a RTK. She was very easy to talk to and we talked about many things. She was a diabetic with hypothyroidism. The doctor was going to let her go home on Friday morning, but her blood counts were low, so he ordered her two units. That was a really neat process to see. Naomi helped me on Friday with her because her patient went home. I got to help Brandon and Teresa as well. I got to watch Brandon and Teresa start IV on his patient. I had planned on starting one on my patient, but they just used her existing 20 gauge IV for the blood, so I missed out. However, this was a real exciting week and I really enjoyed it. We had really great nurses last week and this week. I will really miss them...I go to Peds next week.

Zimmerman week #3

Thursday was my day off, but coming back on Friday I had a pretty good day. I worked with a guy who had MS and had came in with a UTI and MS exacerbation. He was drowsy at times and talking out of his head, but at others he knew exactly what he was talking about. His family was wonderful and I enjoyed working with them as well. I got to give lots of meds including a SQ injection. Overall this was a pretty good day.....and I will miss being with Zimmerman on 1 east.

renal NEMC

I found this week to be a real challenge. I had a 40 year old man that has end stage renal disease has Type I Diabetes Mellitus and was not on insulin. Apparently he was non compliant with his diet, and medications. He was blind, has just had an amputation due to gangrene setting in from having a toenail removed a couple weeks ago. His skin was purpleon all extremities and had small lesions. He has a stage III ulcer on his sacral area and had 3 kinds of insulin and about 17 other scheduled meds. His Creatine was about 7 and his BUN was 103. My heart broke for this man. I wanted to really take care of him but he was in so much pain it was a challenge to just move him. I was able to get everything done (thank you Beverly for your help) eventually but as i mentioned earlier it was a real challenge. Situations like these really make you stop and count your blessings! It was a great learning experience.

My last week on A2A

My patient this week was an 89 year old with a UTI and weakness. She fell 2 times at home and her family brought her in. Going over all her labs I found that her CPK levels were very high (666 day 1 and 682 day 2). I knew what the labs where based on but didn’t pertain to her. (I will say that working with the labs more and more it’s amazing what you find out!) So I looked at her history and she had hypothyroidism. Well I researched and found out that CPK levels are increased because of it. Also her H&H was a little low that showed possible mild anemia. Well that promotes weakness, which she had. And then all this leads to possible infections in the body. Well she had the UTI. So I feel that everything revolved around the hypothyroidism. So I felt pretty good about this week again. Thanks again Ashley for bathing her on Thursday for me!!!!

Jodi Shue

Pt. on renal floor at NEMC. She was a real hoot. She had everything under the sun. Main concerns were extremely poor circulation in feet. Had a fungal infection between toes which I had to apply an antifungal cream. Administered mostly po meds and gave Levaquin.

week 3 w/ Mrs. Ward

This week at womens/peds @ RRMC was short and sweet. My patient was a 77y/o woman in with a small bowel obstruction (how convenient considering the upcoming test). She was very sweet and easy to care for. I was even able to test the pH of her gastric contents to varify placement of her NG tube, which is now proper protocol at Rowan. I finally hung an IVPB, pushed a little Morphine, and that's about it.

Good Luck on the test everyone!

4G CMC Northeast

I had a great week in clinicals. On Thurday I had a 33 y.o patient with intractable vomiting, hepatitis, and jaundice. I was able to do my psychosocial assessment with this patient. On Friday I had a 69 y.o. patient in with GI bleeding. I was able to go to endoscopy with her and see an EGD performed. I also made an attempt at starting an IV.

Week 2

I was very happy to get my process recording and my psychosocial assessment done this week. The pt I had was great. I also went to the Health Dept. I observed in the prenatal clinic and I learned so much. I was able to see a few sonograms done and I was able to see how expectant mothers were monitored for different things throughout the pregnancy.

Week 1

This week was great on the peds unit at Notheast. I had a great deal of fun. I never really thought I would want to work on a pediatric unit but it really was not that bad. I did get a little attatched to my pt but I guess that I would have to get used to that if I work on that floor.

a2a

This week was my last week on A2A with Mrs. Phelps. I am really looking forward to Peds! My pt on Thurs had chronic pancreatitis d/t a birth defect of an obstructed bile duct... very sad, she has had exacerbations all her life of nausea, vomitting, surgery, and hospital visits with no relief. She was fairy nice, but then turned near the end of the day when it was getting close to her d/c. Friday I shared with Mishelle Flowers a pt with ESRD. She had so many meds to give that Mrs. Phelps had me help. This lady was very sick, and very sneaky. She was trying to hide pills! But, I was not about to let her get away with it.... I caught her. Anyway, interesting end to med-surg.

Zimmerman 7/12-13 add-on

I forgot to mention the help that Ms. Z has given to our group with the charting. Every week I am gaining more confidence in the fact that I am charting better. As well as the ability to be a nurse. She is there to help us with anything we need help even if she is busy she will make sure that we are okay at the moment. I have really enjoyed being in clinical group with her.

Zimmerman 7/12-7/13

I was at 1 East this week with Zimmerman. I had a interesting time this week. First of all, my patient had a spinal fusion surgery at the age of 36. Then when taking report from my nurse the next morning, I discovered his home meds consisted of 10-12 percocets along with a 12 pack a day. Then the really good news was that his Mom was his LPN for the two days that I was there. Nobody knows how she was able to be his LPN but she was. She crossed the line very much so by lining up his PT visits, ordering me to get his meds at a certain time, do his dressing right now, interfering with the dr's decision on d/c and ordered meds, and giving her son an enema that wasn't even ordered to be given. Since the dr allowed him to stay an extra day, he decided to give him a banana bag since he was probably going through DTs. The mom did not like this at all and cried when she found out that the dr thought her son was alcoholic and abuser of drugs. It was an interesting week!! I did get to give a suppository for the first and that was fun. While I was giving it, his wife was making fun of him having someone's finger up his butt. Yeah it was a fun week!!

A. Ousley

Week 3 at RRMC: Women/Peds

This week I was with Ms. Ward on the Women's and Peds floor at RRMC. I now have a new respect for the comment that Mrs. Walker made earlier in the year: "The patients in the hospital are really sick these days." Yeah, my patient was a 48yo female with ESRD, among other things. Her dx on adm was bleeding from her HD cath and she also had about a quarter sized ulcer on her foot. She was on isolation pending results of test for C. difficile- which I am about certain will come back positive. I got to watch the doctor do an I&D at the bedside and then I did a sterile wet-to-dry dressing (thanks Ms. Ward!!!). I gave some prn meds and also gave some insulin SQ and more POs. I had a good time (again) and I think that med-surg is beginning to be a great fit for me. But was it just me or did this week feel so weird though? I just could not shake this feeling on thursday... Oh well, three down, one to go!!!

-TSpeigner

split week

I had a split up week, as Thursday night I spent on the pediatric unit at Northeast, followed by a health department rotation on Friday. To be honest, both events were noneventful, and that's exactly what I was hoping for. I'm not trying to tell you that I didn't enjoy clinical this week. I did. It was just a welcome change that everything went so smoothly. That in itself was a learning experience, because I kept wondering what was going to happen, but nothing ever did. Oh well, mamma told me there would be days like this.

4G

This week was a great experience. I had two patients. My first one was a 89 year old woman in with cellulitis, she had a lot of meds. The next one was more exciting, she was a 78 year old diabetic in with a fever, she had a PICC line and a peg tube and very confused. She went to the OR for a above the knee amputation and I was able to go with her and observed the hole thing, her femur was the size of a quarter in diameter. I think that Mrs. Collins was a little overwhelmed with the amount of meds we had to give, she was always on the move.

RRMC

Med surg @ Ro- REg, I had a 33 yo female with Crohn's, she also had colitis and an embolism in the past. I found out that you use CA drugs for Crohn's. I know (now) we were told that in class, but I guess I wasn't paying attention. Having a pt, on what you're going to be tested on really helps.
She was on Coumadin so I now have a little better understanding of PT and INR. Her INR went up to 9.2 and Ms Phelps said she'd never seen one that high and that she thought it was probably a mistake, I told her that the nurse had the lab to verify it. They stopped coumadin and gave her a Vit K shot (one), the next result that came back was 1.2...........Ms Phelps was right, she said that what should have been done, is the nurse, instead of just asking it to be verified, should have called the Dr, got another order to re draw the blood and sent it again. I guess that's why Ms. Phelps makes the big bucks. One more to go!!!
Christie Harris
NUR130

Friday the 13th !

My patient this week had intractable nausea and vomiting. The etiology for this was unknown, and that in and of itself was strange. He said he has this problem about 3 to 4 times a year, but no one seems to know why. He was getting alot of pain meds and meds for the n/v. This wasn't my favorite week, because I felt a little uncomfortable not being able to address the "why" about his condition. Looking forward to next week.

SPA/Med-Surg RRMC

Thursday I had the SPA from 2-6. I was placed w/ a CMA and followed her for the afternoon. It started out pretty slow but the pace picked up and time went by fast until around 5. The CMA was very helpful and I was able to see her give immunizations, test hearing, test vision and many other things. I was able to sit in on several well visits (even a set of twins that had different last names!) Overall it was a good experience. It was interesting to see the other side. Friday a shared a 64 yo pt. who had ESRD, COPD, hypertension, osteoarthritis, depression... She was on PD but we did not get to observe it being administered. We did get to do a dressing change. She had a ton of meds! It was a good week. ONE MORE to go!!

SPA and Renal at NEMC

This week I went to SPA . There were well baby visits, vaccinations and physicals done for all ages. We could smell the abscess that David mentioned down the hallway. He described the draining for those of us females that couldn't go to see firsthand :) My client on the renal floor Friday had a bilateral lung transplant 10 yrs ago. Last November he had triple by-pass and then went into kidney failure. Unfortunately the long term immunosuppressive and inflammatory meds also contribute to renal disease. I was able to give po meds and learn first hand about his condition.

ZIMMERMAN 7-12/7-13. My pt. this week was a 53yr old male with spntaneous pneumothorax of the left lung with a chest tube. On my first day my pt. was very talkative and he had little pain. I did have to give him pain meds one time. Mrs. Zimmerman was able to go in and show me the pleura vac he was on and what to look for. On the second day upon my assesment i was unable to hear any left lung sounds so i went and got Mrs. Zimmerman who listened as well she heard very diminished sounds as well. We went and got his nurse Laura who listened and confirmed our findings. She then notified the Dr. of our findings. The Doctor then came in and examined him, he was able to find that that the clients chest tube had been dislodged so he was going to go back to his office and come back and try to minipulate it back into place. He also ordered a chest x-ray to determine the placement exactly of the chest tube. I was also able to watch a bladder scan and d/c several IV's. Overall a good day and Mrs. Zimmerman has did a great job in making me feel comfortable in my nursing roll and i fell she has really extended my knowledge of charting.

My SPA experience was rather intreresting i was able to encouter a lot of different things. I had ruffly around 5-6 pt. that day but 2 of them stood out. I had a 8 yr old little girl who had been sexual abused by her father and the Dr. was very knowelegable and showed how she new and was going to have furtur interventions. I also had a 18 yr old who came in with a sore on his rectum. It was very swollen and had A LOT of infection in it. The Dr. drained and drained and drained this place. This infection stunk a lot as well. Overall had a good experience.

my pt this week was a very sweet 58 year old woman who had ESRD and a few other problems, that were compounded by the fact that her daughter was also in the hospital, this did not help with her anxiety. I did learn a lot about the related factors of ESRD so I'm sure it will help on the test.

med surg

ok i cant remember if i blogged for the past 2 wks or not...my 1st week of med surg i was on 4G at NEMC and i had an interesting pt and i learned alot, my 80 yo pt had a GI bleed and had many scans and xrays and i was able to go to endo w/ her and saw an EGD and colonoscopy which showed ischemic colitis, she ended up having to have a resection of part of her bowel.....2nd week at NEMC on 4G i had a 54 yo pt who was there for possible pancreatitis, after all his tests and labs they confirmed that he had acute pancreatitis, he was an interesting pt, he was nice to me but irritable about being in hospital bc he was there for so long and it took a while for the GI doctors to figured out what was wrong and also bc he was npo the whole time he was there bc everything he ate made him throw up, once they advanced him to clear liq diet i ordered him some jello and he was estatic and kept thanking me, he was funny.... so far i have had 2 good weeks of clinical at NEMC medsurg and im looking forward to Peds this week at NEMC!!

RRMC week 2

I was again on the med-surg floor with Mrs. Phelps. I enjoyed this weeks experience, I was able to learn about new Dx like plural effusions. I was able to go down to observe a thorocenthesis. I was thankful this week because I only had 2 meds, last week I had 20!

A very late entry.

I had Peds with Mrs. Clay at NorthEast and even though it was kind of hectic Thursday it was much better Friday. I learned a lot about Juvenile Diabetes and steroid induced diabetes mellitus from my 9 y.o. client. She was very brave to be able to put together her own FlexPen and give herself her own shots.

I was at Rowan on Peds with Mrs. Ward. It was a great experience. I learned so much from her. I had a 17 yo pt. who had got his foot caught in the lawn mower and almost had to have an amputation of his left big toe. They ended up stitching him up and he went home the next day. My other pt. was a 38 yo women who had a tummy tuck. I was able to go in with the dr. and change her dressing as he explained the surgery to me. I was able to get experience with her PCA pump, IVF and IVP. I also got to teach her about her JP drains. how to empty, measure and record for when she went home. It was a wonderful experience. I loved Mrs. Ward and I'm going to miss her so much.

My second week on Med/Surg at RRMC was not quite as interested nor as busy as the first week....but I still had a good time. I had an older gentleman who had a lot of health problems and was very confused. I had to help him do everything from take a bath to eat. Poor thing he couldn't do anything for his self. He was discharge later on Thursday so I picked up a L4-5 lumbar decompression on Friday. She was a sweet older lady who really enjoyed my company. I got to d/c her IV, do a dressing change, and help do part of her discharge right before we left. Pretty good week over all. Learned lots of intersting stuff from Mrs. Zimmerman. I absolutely love being in her clinical group!!!!!!

Last week at NEMC was really good. I had a really nice man. He came to the hospital with fever and SOB but he also had ESRD, DM, and his WBC was 4 and then dropped to 1.8. That evening they did a cholesyectomy and his gallbladder was gangrene. I was able to explain to him that he needed to get up and sit in the chair so that he wouldn't develop pneumonia or atelectasis, because all he wanted to do was lie in the bed. I told him that it would also help him expel the gas that was in his abd. and he said that he would wait until he had a room full of people before he expelled any gas - he was kidding. He also told me that he was in the marine corps and himself along with 5 other men ran over a roadside bomb and their truck exploded - he was the only survivor. He had sandbags under his seat and he said that those were what saved his life. I enjoyed getting to know him and his wife, they were very sweet people.

My week at NEMC

This week I was at NEMC and I had areally awesome 2 days there. The facility is very nice. I had a 13 year old girl with high blood sugar. She went to the ER with dizziness, H/A, and abdomonal pains upon assessment her GBS was 500. She was a newly diagnosed patient and I helped teach her how to count her carbs. to find out how much insulin to give herself. She was really brave and learned to give herself her own insulin shots. Had a wonderful learning experience.

I was at NEMC in the Pediatric unit. What a very nice facility. My client was a delightful 13 year old little boy who was in for abdominal pain. Problem was a gallstone. Should have been easy enough but he also had Sickle Cell and has been in three times this year for SC Crisis. The Sickle cell could have been partly responsible for the gallbladder problems in the first place and then the surgery could have sent him into another SC crisis. Her received two units of blood the day before surgery and when I came in on Friday he was still pretty out and had a PCA to use for pain mgt. I went over coughing and deep breathing with him and his mother and he was extremely compliant as was his family. Before leaving I went over the importance of having him use the incentive spirometer with his mother and grandmother and he and I used the magic marker blowers before the end of my shift. Strict I & O, really strict and I was surprised how busy I stayed. Learned to document the PCA use, interesting machine. Good week, really enjoyed my time there, my staff nurse was great and how nice it was to be treated so respectfully.
I learned more than I really wanted to know about Sickle Cell and it hurts my heart for TJ and his family.

Teresa

My patient this week was very nice....he was retired military and had MS as well as post traumatic stress disorder. He couldn't do much for his self. His wife, who was a nurse, took complete care of him at home. He had alot of emotional issues and sometimes was very confused. Even with all of that he was a very plesant man and I couldn't help but feel bad for him to have lost his independence. I enjoyed taking care of him.......It made me feel like I was doing some good.

MED/SURG @ LNRMC

Another good week...I had a patient with a RTK replacement. He was only 47 years old, and seemed to be motivated and stubborn at the same time. He wanted to be independent but still needed help. He received a blood transfusion due to his decrease in his H&H. Of course I couldn't administer the blood, but I did get to observe him for the first 15 min. in case of a reaction. I guess that's about it....thanks for the help Jennifer!

FHS and CMC Northeast 4G

On Tuesday my observation was at the health department. My experience with FHS was boring. The nurses were very friendly and helpful. On Friday I was on 4G with Mrs. Collins. I had a 32 y.o patient who came in with hyperglycemia and possible MRSA. She had developed some boils on her left buttocks and perianal area, and she believed she may have had MRSA. Her daughter was in NEMC on the peds unit, also with possible MRSA infection. My patient slept most of the morning, at about 1000 she went to visit her daughter. Her daughters health was getting worse so she asked to leave AMA. When we left the floor she was being discharged.

Second week of med./surg.

Thursday I was on A2A with a patient with a DVT in his right arm. I was able to give him some meds and give his discharge instructions and wheel him out when he was ready to go. On Friday I was at PNE at the Health Department. It was kinda boring. There was only one appointment while I was there, so I escorted her to the different areas of the health department that she needed to go to. Next week I have peds. maybe it'll be a little more exciting.

First week of med./surg.

Well back to good ole med./surg. It was an okay kinda week. I got to go to surgery with my patient to observe his below the knee amputation. It was really cool. The charge nurse let me hold it and feel the muscles inside and I could see the tibia- which they cut through with a SAW! It was a little barbaric, but very interesting.

I had another renal pt this week, this one had a lot going on but not as much as last week. She had dementia on top of the renal failure and multiple myeloma which made assessing her pain difficult, she didn't understand the pain scale, she would just say "it hurts". she was admitted on the 19th for abdominal pain, she had been there for a while, and I don't think she'll be leaving anytime soon. Great experience it is helping to bring everything together.

Why won't this thing post my blog!!!

Okay guys, this is like the millionth time that I've tried to post my blog! I'm not sure what's going on this week but here it is again:

On thursday I was at SPA and although it wasn't the most exciting experience for me, it was still enjoyable. I was assigned to shadow Alicia, who was the supervisor of the nursing staff. We saw a couple of well-checks that day and I got to observe a two month old who had a hypospadias which is a genital defect. His penis was shaped abnormally and was kind of hooked down with the urethral opening on the underside of the glans. The doctor also discovered a slight murmur and scheduled a consult with the cardiologist. Overall, it was a nice observational experience.

Friday was a breath of fresh air for me! I was sooooo glad to be back on the floor and my client was a 38yo s/p lumbar decompression surgery. Friday she ambulated for the first time with PT and did very well with that. After I D/C'ed her foley she actually started getting up on her own and moving around so I was really amazed at her progress. Mrs. Zimmerman talked with me a lot about the PCA even though we couldn't do anything with it, and I got some much needed experience with IVPBs and IVPs. Thanks Mrs Zimmerman for all your help!

(Hope this posts this time!)

Lake Norman Med Sur

My first week at Lake Norman was good. My patient had a total knee replacement surgery. His hgb and hct counts keep going down each day after surgery so he required a blood transfusion. I was so nervous when they started the transfusion. It was an experience that I will never forget.

NEMC - 4G

It was for me very first week @ any NEMC med-surg. units. At first I was scered of new environment but everything turned to positive, good clinical experience.
I had each day new patient. First day it was patient with acute pancreatitis. I gave him SQ Lovenox and few PO meds.He was very receptive and communicative.He was D/C home that afternoon. I whished to see him next day but he went home.
On friday I had to prep. and to give care to 83 y.o patient with Alzheimer disease. She was very sweet but hard to care of. Her PT was 100 sec. and systolic BP belove 100 mmHg so one unit of fresh frozen plasma was administered. PT went down to 16.6 sec. which was WNL.She was not ambulatory, with big bruises on her right thigh and hip D/T fall day before. She was under constant monitoring of PT time and BP. I gave her 10 different PO meds. It was hard but interesting.
Zdenka Duric

Med-Surg RRMC week 2

Med-surg this week was short for me. I had my SPA on Fri. so I only went to clinical on Thurs, and with our little one day vacation on Wed., the week seemed pretty short. My lady on Thurs. was in for kidney stones. She was very nice and easy to deal with. She could do just about everything on her own so it made my day a little easier than the normal med-surg day. Friday, I went to SPA which was pretty good also. The first part was a little slow, I guess being a holiday weekend they didn't have very many pt's. After about an hour or so they began doing well child check-ups so I was able to follow the MD around and watch those. He wouldn't let me go into the sick visits though, I really would have liked to do that.

Clinics

Thursday at clinics, I was at LNRMC, I had a 70 yr old diabetic lady in with rectal bleeding with a colostomy and a history of metastatic ovarian cancer. She was pleasant and easy to help. She had had a fall in the shower just a couple of days prior. On Friday, I went to the FHC at the health department. I didn't get to see anything...we got the first patient ready for an exam for her 2nd treatment of chlamydia this year, but the nurse really wanted me to see the refugee physical because it would cover so many things, but as it turned out after the initial screening (hearing and vision test) and several phone calls, all she needed was a follow up for a positive TB test and clear chest x-ray. By the time we found out what needed to be done, it was time to go. However, the people in the office and the doctor I talked to were very nice and more than willing to teach me anything they could think of. Even though I didn't get to see anything, I really enjoyed the visit, I learned many things.

Peds w/ Mrs. Clay

Another great week at clinical. I was at the new Jeff Gordan Children's Hospital at NEMC. It is the nicest facility I have been at. My pt. was a 7mon old Hispanic girl that cried every time hospital personnel entered the room. I clustered my care to prevent undue stress to the child. Her reason for hospitalization was a temp of 105.2. She had a UTI and R ear infection. Both parents spoke very little English. The father was able to communicate some English so this made my job a lot easier. I took the child's VS when sleeping to get a more accurate reading. As we all know crying will increase the HR and Resp. She was D/C on Friday and I got the opportunity to use a translator for D/C information. I am looking forward to being w/ Mrs. Clay again for Peds next semester.

Casey Hinson
NUR 130

My clinical experience this week was on 1east at rowan regional. It was a little crazy b/c my first patient was on palliative care and she didnt like the fact that a male nurse would be helping her. She blamed me being a male for many of her complications. So as that being said i was moved to another pt. who had a appendectomy. He was much more understanding. Mrs. Zimmerman was very knowledgeable in all questions i asked and made me feel really comfortable in everything i did. She was able when i had down time to give me further teaching on some of the things on the hall such as the crash cart, and showed me how to work the IV pumps more in depth. Overall i had a good experience.

I had a good experience in women and peds at rowan. I enjoyed working with the nurses from this floor. I felt very comfortable and enjoyed the patient I had the pleasure of caring for and even though she had alot of needs I enjoyed all the experiences.

Women and Pediatrics

I enjoyed clinicals this week I had a 50 yr old female with pneumonia who had a history of recurrent pneumothorax. She had a chest drain which was very interesting it was sewn in under her right rib and was used to drain the fluid out of her lung. She was very nice and cooperative. I also got to hang a piggyback and do an IV push. Great experience!!! I too will also miss you Ms. Ward however you are not getting rid of us so easy. We will still be around to pester you on a regular basis. Remember we know where you are...............

med surg w/ Ms. Phelps was pretty cool. All except, I took care of my pt for 2 days, she was scheduled to go home about noon, I was talking to her about discharge instructions, when the CNA came in and said, she put isolation garb on the door, and did I want to tell her or should she tell her, she was positive for MRSA? I mean, does it take that long to find out the results of test or what? She had been there for 5 days and was getting ready to leave. I thought back, and I am positive I used standard precautions on everything I did, but it's kind of scary to think that the next person who enters her room has to gown up and I didn't. That is the reason why we always use standard precautions!

Christie Harris
NUR130

A2A @ Rowan

This week I really began to feel like I was becoming a nurse! The patient I had was 59 and was just admitted for hypoxia and they found a few spots of cancer. Since we didn’t have prep on Wednesday, I gathered all my info on Thursday morning and that made the day fly bye. I did my morning assessment on him and when I listened to his heart I couldn’t believe the murmur I heard. I was just going to get Ms. Phelps to listen to what I heard when an oncologist walked in so I stayed to hear what he said. He did his thing and listened to his heart and you should have seen his facial expression. At that point he told him how loud and strong his murmur was. So I was right! After he left I finished talking to my patient and did the rest of my assessment. He had +3-pitting edema in his lower extremities and had gained 37lbs in 3 weeks! When I got home that afternoon I started reviewing everything. His K+ was 2.5 and 2.8 for the 2 days he was there. He was getting 40mEq of K+ and it wasn’t helping. A lot of his other labs were out of whack. At that point I came to the conclusion he was having major heart problems. The labs, edema, SOB, and asities just all came together. Plus in his history he had rheumatic fever when he was 4. So I called Ms. Phelps at home to run it past her if I was on the right tract. I was! The next morning during report nothing was said about it so I brought it up to the nurses. They said that it definitely could be and they had just done an echo on him and something would be said to the doctor. I hoped he would have a consult with a cardiologist. I hate not knowing the outcome, but I really felt like I was there helping him! It felt great!!!!!

Bye Ms. Ward

I was on peds this week at RRMC. My 80 something peds patient was very unhappy about her progress. She was in for an absess in a wound from having a hernia repair. She just wanted to go home, but was probably going back to the Lutheran home to recover. She just about broke my heart. I tried to get her to work on getting involved in her care, but she was pretty weepy.

I had a lot of practice on skills. I packed my first wound, started my first IV, and started a PCA pump. What a wonderful experience!!! Ms Ward was very encouraging and I had a wonderful time. I got the vein on the first stick, but it blew right away. I wish that I could have tried another one right away, but at least I know that I can find the vein and the patient probably won't scream, "Stop, you're killing me!"

Ms. Ward gave us a lot of good tips on concept mapping. I feel more comfortable doing them now.
I'll miss you, thanks for all your help and support.

women's & peds

This week was a good experience. My client was an 89 yr old female who was admitted for diverticulitis. This issue was resolved, but she also had lung cancer. She was so nice, and had a positive attitude about her condition. Her lung sounds were very diminished, and although she had O2 at 2L via NC she still became very short of breath with having to go from the bed to the bathroom. (When I collected my information on her, her labs all pointed toward renal impairment, although there was no mention of it in her chart.) Hospice was called in due to the severity of her cancer, and she was discharged on Friday to her home under hospice care. I went out with her to assist the family in getting her in the car and she said,"Well, if you see my name in the paper, you'll know it was me." That just broke my heart!

After she left I stayed busy trying to help whoever needed me, and as a result I got to put in a foley - my first, and I was so nervous, but Ms. Ward walked me through it step by step, and it was a great experience! Hope next week is just as good!

This week I was at the health department on Thursday in the Family Health Services department. I had a really great experience, there were so many things going on. I went in while the nures did their initial interview and did the procedures for the physician. Everyone was really nice and very helpful in helping me understand what was going on why they were doing certain things. On Friday, I was back at LNRMC and I had a 76 year old patient that had recently been diagnosed with cancer. Randy and I were teamed up to work with him. I was allowed to hang my first piggyback antibiotic and changed the primary & secondary lines! Randy and I applied SCD's and changed him from a standard bed to an air mattress bed. Friday was definitely interesting!

Renal at NEMC

This week my patient was a 58 yo woman with ESRD (end stage renal disease). She was admitted with a fever and naseau. She was a great patient to have. She was on a heparin drip and about 13 PO meds. She had a Hx a mile long and talked alot! I was able to teach her about repositioning every 1-2 hrs. I also had a chance to talk to her about some of the side effects of her meds that she was not aware of (glad I had my cards in my pocket!). We also discussed the importance of not eating something on the tray when she knew she wasn't supposed to eat it. (she said she thought it was ok bc it was on the tray!!) All in all a good week.

Lake Norman Med-Surg week

My patient at Lake Norman was a 76 year-old man with recently diagnosed lung cancer. The cancer was discovered only four weeks ago, but it has already spread to his neck, shoulder, back, etc. According to his wife, he has gone downhill really fast, and they don't expect him to live more than three months. He also has a lot of other complications such as COPD, pneumonia, hypertension, and an extensive history of surgeries. As you might suspect, he was on a myriad of medications, so many in fact that it was a benefit vs. risk evaluation for the physician when making decisions regarding medical treatment for this patient. My patient and his wife were both really sweet to each other and everyone providing care. I really bonded with my patient and found myself becoming attached to him. Overall, it was a valuable learning experience.

Week at Peds

This week I had Peds with Ms. Ward. Hilary and I had the only Peds patient (if you wanted to call him that). He was a 17 yo who had got his left foot in the lawnmower. At first they wanted to do surgery on it but the Dr. decided it look good they way it was so they decided not to take off the toe. Or other patient was 54 yo with pancreatitis. I got to d/c her foley and give IV push for the first time. I got to do alot of teaching to they 17yo on the second day about foods he needs to be eating or not eating to get his stomach back under control. I did get to set up a PCA on another patient of ours. On the second day our new pt was in for a tummy tuck. I did get to watch the PT put on his dressing (Since I wasn't doing the way she wanted me to do it and she needed to leave in 10 minutes). All in all it was a fun week!!

Amanda Ousley

rowan medical 1 east

Today was my only day of clinical. I was at 1 east with Mrs. Zimmerman. I had a pt that was admitted for an I&D of his rt arm with possible wound closing. This man had either an abcess or spider bite, and was hooked up to a wound vac. I did a flush on him and gave out one po prn med. Felt a little better with charting, better than last week. This pt had a carpel tunnel release (faciotomy). Didnt do much for this fella girlfriend was in and out and helped him with his hygiene if you know what I mean. look foward to next week

spa & a2a

Well, my week was kind of laid back. Thursday I went to SPA and that was a good experience. Mrs. Norris's daughter Aubrie was very helpful and very nice. I really enjoyed teaming up with her. I saw many vaccinations and checkups and learned a lot about being in a doctors office. She had to leave early because of a doctors appointment so I then went up to Triage. What a mess! That poor lady had only been there since April and was there by herself that day. She had call after call of questions and was very frustrated.

Friday I was back on A2A at RRMC. I had a 81 y/o lady who was very emotional. She was in for CHF and pneumonia but had pantocytopenia. They did a bone marrow aspirate (interesting) in the chest. It was really hard for him to get any marrow out and they may have to do it again. She did well even though she was very anxious. I PUT IN MY FIRST IV!!! It was very easy and I did it on the first try! I was very excited and she was happy with my try. I d/c her old one and that's about it!!

Med/Surg RRMC

This week went well for me. On Thursday, my patient, who had a PhD, was admitted for febrile nuetropenia. By the time I got him he had been there for a few days so his nuetrophils were back WNL but he had kidney stones that his Dr. wanted to take care of while he was in the hospital. I was able to go w/ him to watch his laser procedure to break up the stones. That was pretty good. I didn't not do any patient care that day but I did learn some things. On Friday, my new patient was admitted for lower back pain. He was in 10 of 10 pain most of the time but there was speculation by some staff that he was there for the pain meds. He had left NE and came straight to Rowan where they say he is a regular. It was hard for me tell whether the pain was truly as bad as he said or if the staff was right.

Week two @ NEMC (Renal)

What an awesome week this was! I was lucky enough to keep my patient from last week. As a 51 y/o homeless, ex-alcohilic, and heroin abuser (with a college education---strange, huh?), he was absolutely perfect for my psychosocial assessment. I really enjoyed caring for this patient.... In fact, I will miss him next week. It's always enjoyable when you're able to connect with your patient and actually spend time talking with them (something that probably only happens in nursing school with a one-patient assignment). I also became much more comfortable with the charting, medication administration, and the floor itself. These are the sweetest, most helpful RN's I've come in contact with yet! It's really reassuring when your RN answers all of your questions as if they are valid ;)

Med Surg week 2

I really didnt get to do a lot this week as far as skills, but i did take care of 2 very complex patients; one who was 36 y/o and paraplegic and the other was a 76 y/o man with a uti who has had brain surgery!!! I didnt go for any procedures or testing so not much to talk about!! Oh yeah, I did sit in on K. McCarn's pt while she got a bone marrow aspiration!! ouch!!!!!!!!!!1

Ashley Linker

Back to good old med surg!!

I really enjoyed this week with Mrs. Phelps at RRMC, I was able to take care of a very sick man that was mentally retarted and it showed me a lot that people take for granted their lives. I got a lot experience with meds!! Thanks
Ashley Linker

Lab with Ms. Ward

It is really strange to say this but I think I learned more in the lab than I did in the real clinical setting. Ms. Ward did a wonderful job of creating real situations that required me to use my brain more than in the hospital, EVERYTHING WENT WRONG!! But Ash B and I did know cpr thank God so we did save our babies life!!! YEAH!!!

Ashley Linker

L &D

Well I coulnt get into my account until today, it said my account expired so i finally figured out how to get back in so i am blogging for the past two weeks. First of all I enjoyed my L&D and Mother baby experience a lot. I am not sure it is for me but as far as i know i would try it out and make sure, it is just a lot to take in at one time!! I think it is wonderful to see people bring new life into the world. For me, it was hard though because my 2nd week, I had a hispanic woman!! Thanks for everything Mrs. Holcomb.
Ashley Linker

RRMC med/surg

This week I was on 1E with Mrs. Zimmerman. It was great!! I got to do a lot of patient care including starting a foley cath., and flushing a saline lock, giving PO meds and hanging some IVPB antibiotics. I also got to irrigate a percutaneous drain....that was really cool. I haven't done that before so I was really excited. Mrs. Zimmerman was wonderful...she stayed with me the whole time and taught me a lot!! I had the same pt. the next day and he got to go home...which he was ready to go...I think he was getting a little depressed about being in the hospital. He was doing much better today and his wife was there with him watching everything. I must admit, I was a little nervous doing the foley with her watching but they were both so nice and everything just went so smoothly. I got to do discharge teaching with the both of them today..and also, DC his IV...we talked about using standard precautions, handwashing, when to call the dr., how to irrigate the drain...and how to empty it....using alcohol to clean the ports...signs of infection and follow up appt. with the Dr.
Overall, I felt really confident this week and really enjoyed working on 1E. The nurses were nice, and eager to help if you had a question. I'm looking forward to next week I'm sure I will learn something else new!!

Amy Jones
NUR130

MED SURG @ LNRMC

Hey all!

My first week back to med surg was great other than the waking up and the crack of dawn part(haha)! It's hard to say just yet, but Med/Surg is just where I feel most comfortable and needed thus far. I had a lot of meds to give including a PO's, SQ and an IVP. My client had come in with abdominal pain/ileus...but had a history of COPD, chronic bronchitis, emphysema, CAD, DM, a thoracotomy!, and a partial gastrectomy; which his oxygenation turned out to be his biggest problem. Bless his heart...he's in pretty bad shape. Anyways, I also got to take out his IV and help with discharge instructions. Thanks Mrs. Beaver for helping me out and being so encouraging! Y'all enjoy this 2nd week!

Week 1 Med- Surg

Well what can I say we're back in med-surd!!! I had a lady that crushed her knee, she had surgery, so I was unable to see the wound. She was D/C Friday. I went to FHS on Thursday, I think I would have enjoyed it much more but the FNP was out sick so all I got to see was 2 depo shots.

Week 4 OB

Sorry I have forgot to blog... I enjoyed my entire rotation of OB! This week I went to SPA, I enjoyed that! I got to see a newborn, 12month and school assessment. For postpartum I had a mother with twins, she knew how to handle them because she had 3 other children at home all below 8 years old!

LNRMCFirst week of Med Surg

I am happy to be back at Lake Norman again and I enjoy med surg so it goes without saying that I had a nice clinical experience. My client was an 81 year old woman in with a total knee replacement. She was doing very nicely considering that her knee was only one of many ailments (diabetes, colitis, osteoarthritis, prior DVT, prior pulmonary embolis to name just a few) She had pedi-plexis on her feet to help with circulation, a polar-pak on her knee to keep swelling to a minimum and PT had her using a machine that moved her leg for up to three hours at a time. Both days she sat up in a chair and requested pain medicine when she felt she needed it. We discussed not waiting until the pain got out of control and taking before PT. She was very compliant. While there I noted in the chart that she was listed as high risk for falls but had no purple dot on her door nor did she have a wrist band to let staff know so I checked with the staff nurse and applied both. Administered my first shot of insulin, watched while the doctor changed her bandage and noted on the chart the condition of the incision. Over all a good week.
Teresa

week 1-PEDS

I was at NEMC this week with Mrs. Clay. The new childrens hospital is awesome!! I was really impressed. The patients had their own private room and they also had seperate treatment rooms in a different area so that the children would feel safe. My patient was so sweet, she had a lot going on though. She had a ruptured appendix and a central line and she was recieving TPN. This was only my 2nd time with a pt. on TPN so I definatly learned a lot and Mrs. Clay was right there helping us. Still not sure that I would be able to work peds...expecially since I "lost it" while watching the nurse put down an NG tube in a 1yr old little boy. I just felt so bad for him. That was the 2nd time that I have cried at clinical. I had a pt. that passed away last year that I cried a little over but...the little boy....it was just different. The momma in me just wanted to go and pick him up and run... :)

He was much better the next day with the NG tube in. Next week will be Med/surg at RRMC!!



Amy Jones

Nur130

Week 1 in Med-Surg

On Wednesday I was at SPA, which was interesting. I followed the clinical mgr, Alicia around for the afternoon. We set up exam rooms, checked in the patients for their exams, and watch her give some vaccines. I got to see a 4 mo check-up with a little boy who had club feet and wore a brace that connect his feet together. Since being in the brace at the age of 4, his posterior fontanel has grown flat against his head. So the doctor told the mom she needed to put him on his stomach several times a day to allow the fontanel to grow properly. On Friday, I was in Med-Surg with Mrs. Z. with a patient who was in alot of pain. She had spinal decompression surgery and she would not move for nothing. She would not do her tcdb because it hurt, she did not want me looking at her dressing, she did not want me to remove her IV dressing b/c it hurt. She was pitiful. Nothing we could do would stop her pain.

Amanda Ousley

This week in Med/Surg, I had an 80 yr old lady that was in a car wreck and broke 9 ribs (4 on one side and 5 on the other) and an anterior process on L2. She was really sweet and still in a lot of pain...her wreck was two weeks ago. She was walking around the halls with her walker and had a really good appetite. Her family lived out of state and wasn't able to be with her, so when I got to spend some time with her, she had a lot to talk about. She was really funny and easy to talk to. She was also hoping to be able to go to rehab on Monday. I really enjoyed this week at clinics, and learned a lot from my nurse on Friday - Gwen. She graduated just last year and was really helpful and understanding. She made learning easy and more on our level than some nurses that have been practicing from many years. I hope to learn more from her in the future at clinics.

Tracy Campbell

Peds.@ RRMC-Mrs. Ward

I did not have chance to take care of a child but clinical week was very interesting. First day I took care of a patient first day p/s- R thyroidectomy.Incision care was primary goal.I used H2O2 and vaseline and also I explained to her how to do it and what to watch for ( S/S of infection etc.). Nutritional teaching was effective because client did not know that she is at risk for hypocalcemia but she is lactose intolerant which makes everything more complicated.She was D/C home at that day.
Second day I was taking care of a patient with drainage tubes from her right lower lobe. She is breast cancer survivor-left breast. I gave her Lovenox SQ and couple of PO meds.I had to give her an anti-infective IVPB but to start IV was impossible because her veins were just rolling.I gave her bath with help of Keisha and Jessica. Thanks so much both of you.
Zdenka Duric

my patient this week had everything wrong with him, history of chronic kidney disease, CHF, hepatitis C, hypertension, diabetes, peptic ulcer disease, anemia, GI bleed, cholecystectomy. He had never smoked, didn't drink, the chief complaint was no urine output. This gave me a run for the money everything was r/t everything, but I did learn a lot during this week and THANK GOD he was still alive when I left.

This week i was on 1E at Rowan Reg. and i had a great learning experience. I had a 65 year old male who had a colon resection. Mrs. Zimmerman was very helpful on any questions i had and made me feel really comfortable with the charting. She also showed me the defibrillator and the crash cart, if i ever need it. I was able to D/C a foley cath. and ambulate him though the halls. He had limited knowledge on his situation so i ad to do a lot of teaching and explaining. All in all i had a great week and look forward to going back.

Med surge clinical

This week in Med Surge I took care of a patient with a latex allergy and had to make sure we used all safety precautions with him. The 2nd day I had a lady with Atrial fib. and had to work with her with an increased BP and slow apical. I had a really good week.

1st week Med-Surg

Med-Surg was wonderful this week. I had the opportunity to finally do a foley, and assisted in another. I was able to DC 2 IV's and give med's on Thurs. I also had the chance to hang a bag of antibiotics (I've never messed with the pumps before) which I still don't think I could program it by myself yet. We all stayed pretty busy, and I REALLY like the nurses on 1E. They are all VERY helpful in everything we do and are very accepting of us being there. I appreciate that so much, cuz we all know how it feels to have a nurse that don't want a student.

Peds @ Ro-Regional

Peds with NO peds. I had a very interesting patient with hypocalcemia.....that was my gift from Ms Ward for telling my daddy I felled that test. I learned a lot, got to do a little teaching, and got to check for trousseau's and chovestek's signs. Peds at Rowan is a very nice unit. Doesn't seem like it would be a bad place to work.

Christie Harris
NUR130

3G with Ms. Holcomb

This week was a great experience! Having to get back into the swing of med-surg. It sure is different from L&D. My patient had MRSA, due to an infection he acquired from surgery to amutate the toes on his right foot. He also had a wound vac, so I observed the treatment team taking care of the wound. That was pretty cool! Ms. Holcomb is great! She really helps you think and put together why what's happening is going on. I learned a little bit about renal functioning, and look forward to understanding even more.