Tuesday, February 22, 2011

Soooo....


I had my clinical orientation on Saturday and I am excited to say that I got placed with the clinical instructor that I wanted, on the rehab floor that I wanted, and now I am scared out of my mind!

There are only 6 of us that were placed on the rehab floor the other two groups have 8 each. In not so many words it was made known that the best, most competent in the eyes of our lead instructor got placed on the rehab floor, so I take it as a huge compliment and me working my butt off the first couple of weeks paid off.

So here is the break down of the facility:

Floor 1-high functioning elders (none of the clinical groups are on this floor with these residents, although my group goes down there one day to do vitals and transfers, since doing vitals and transfers on our patients will be difficult)

Floor 2- Not independent, but not total care residents, most all of them are wheel chair bound. (One of our clinical groups is on the floor.

Floor 4-Vent floor, everyone is on a ventilator to breath (no clinical group on that floor)

Floor5-Alzheimer's/Dementia ward residents (the other clinical group is on this floor)

And Floor 3 is the rehab floor. This floor is more of a med/surg floor of a hospital as we were told right of the bat from our instructor. The people here are not residents they are patients as they are hopefully rehabbing to get off of that floor and in the best case, home. These are the sickest people in the facility. Many on vents, many have trachs, tube feedings, isolation rooms, you name it we got it. My excitement quickly turned to fear once we hit our floor. Just as we got there they were transferring someone out to the hospital, our instructor had us listen in on the report to the EMT, crazy. Patients are in and out on this floor, to the hospital, to the morgue and if they are lucky home or to another floor in the facility.

We got a tour and did a scavenger hunt on our floor so we would get acquainted to where supplies and such are on our floor. We had a meeting and were told that a lot of what we are learning in class and lab will not apply or work for our patients. For example a nice relaxing bedbath won't be happening. You can't have a trach patient on their side for more than 5 minutes and in that five minutes we need to wash what needs to be washed and get that side of the bed changed...yikes. Our instructor said we need to by hyper valiant in observations when giving care as our patients can go down hill fast, we need to use a lot more critical thinking and problem solving than our classmates, but the upside is that we are gaining clinical experience that they won't get to on their floors, for example we learned about pulse ox (well I already knew all about that between my Dad's stints in the ICU and Logan's NICU days) and how to use the machine to measure them, something the other students won't get experience with. I will look much more attractive to a hospital (where I want to work) because of the population we are dealing with. Once I am working in a hospital I will get my phlebotomy training, more extensive training with catheter's where I will be able to take them and in some cases place them, accu checks, etc. SO working on this floor during clinical I will be getting a head start on some of that. (If you have been in a hospital and are thinking you have never noticed a CNA working that is because more hospitals call them PCT or NCT (patient/nurse care technicians) and all that is, is a fancy name for a certified nursing assistant with additional training in a hospital, just a bit of trivia for you.

I am freaked out and hoping I feel better after our first day of hands on work there, the other 5 students in my group our equally freaked out which is comforting. I think our instructor knew we all were freaking our a little, she sat us all down and went and got some apple juice and cups from the nourishment room and made us drink it LOL. We did a toast as well. I know it's going to be one of those experiences that change my life, but I am so afraid of doing something wrong with these critical patients, it's a long way off from dealing with L&D and Post-Patrum where I want to end up, but it will make me a better NA and if/when I go to nursing school I will be way ahead when we hit clinical.

We have a week off before we go back and I am trying not to freak out in that time. It is just so sad, the whole place is just depressing, but our floor even more so, these are not cute little old ladies, these are young people for the most part that had unimaginable things happen to them. For example a person from another country that came over to work and save money to bring the rest of the family over had a work accident, brain damage and hasn't seen said family in 4 or 5 years now. Many stories like this are on our floor. I know I could never work in a situation like this long term, my personality is not cut out for it. I think that most of us in the 3 1/2 hours we spent there on Saturday now have a new appreciation for life and this time in our life, there were many tears at our debriefing before we left. Things could be so different.

So any way, wow, that is about all I can say about that.

On a lighter note, I got 19.5 points out of 20 on our second theory test. I got docked 1/4 of a point on two questions, one because I miss spelled a word and another because I forgot somethings in the circulation of blood through the heart.

We had lab testing after orientation on Saturday and did pretty well. Admittedly I think myself and most other's were pretty mentally fried after our morning and I made one dumb mistake that earned my a 3.5 on my weight testing. I said the wrong weight out loud so my instructor had to cue me at which point I realized what I did but cues knock you down in points err, that is my lowest score so far, but still a B. On bedbath I got a 3.75 from my clinical instructor because I put the gown on wrong, even though I did it the way I was shown, not a big deal still an A and she complimented my on my workmanship, whoo hoo! Height and oral care I got perfect 4.0's.

Next up is vital sign testing, I am pretty good on temp, pulse and respiration, just need to practice blood pressure some more. My family has been great test subjects!

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