Tuesday, November 25, 2008

One down

I had my first exam today and hopefully in the next hour or two I will know my results, it was a multi choice exam of 70 questions.

I also have received the three assignments back, I got 88% (A) for the physical assessment assignment. 82 % (A-) for the Cystic Fibrosis essay and boo hoo only 63 % (c+) for the ethics essay. Worst mark yet. But I think I will still get a B - for the paper when the grades average out.

It is pretty depressing so far I know I will not get an A for two papers (as the exam I did today I would have had to get close to 100% and that is highly unlikely), so fingers crossed I do well in pharm exam tomorrow and get an A for that paper (that is the paper that I got 88% in the essay, it was worth 50% and the exam tomorrow is worth 50%, and A- in NZ is 80%)

So my marks should hopefully be an A, B+ and a B-. Im still annoyed I did really well in year one, going to try really really hard next semester to pull my grades back up.

On a brighter note I had my mentor meeting on Monday, and she was really impressed with my work on clinical placement, especially with the babies and children, so she is recommending me to SCBU (special care baby unit), this is the place that I chose for my placement but seeing as it is so popular, the chances of being picked are unlikely. However if your mentor sends an email to the practicum manager then you should get put there, fingers crossed.

Also my mentor gave my name to the learning hub (extra support , tutoring service) to become a student tutor, and you get paid for it. I did really well in anatomy and physiology last year, and she thinks that I would be a good tutor for some of the students that are struggling with it.

Anyway I am at tech till 7pm, big S is picking the kids up from school and doing dinner, bath, bed so I can study for tomorrow, so better go.

Tue 3:45 pm

Monday, November 24, 2008

At tech studying

My exams start tomorrow and I am a tech studying, well trying to anyway, I get so distracted. I have really bad hay fever too and it is driving me up the wall, I use tablets and eye drops but they are not working. I have contacts in and my eyes are so itchy.

So far this morning I have been revising trauma, and shock.

Glasgow Coma Scale:
A score of less then 8 means a likely severe head injury.
The lowest score that you can get is a 3 and this would mean a very deep coma or death.
The highest score is a 15 and that is fully awake.

For a Trauma call to be made (this list is not complete, I have only picked out the main things)
It would have to be a status 1 or 2
Physiology would be: RR less then 10 or more then 29, BP less then 90 mmHg, GCS of less then 13.
There may be multiple casualties.
Injuries: of head, neck, torso, Flail chest, complicated pelvic injury, major crush injury.

Shock Types:

Cardiogenic and this includes obstructive
Circulatory, and this also includes septic, neurogenic and anaphylatic

Better go, sorry for mistakes and bad grammar.

Mon 12:02 pm

Thursday, November 20, 2008

Maybe of interest

Just found a list of Drug and their herbal interactions, so i will list a few.

Agrimony decreases the effects of Insulin.
Alfalfa increases the effects of Warfarin.
Garlic increases the effects of Insulin and Warfarin.
Stinging nettle increases the effects of Diclofenac and perhaps other NSAIDS.
Rhubarb increases the effects of Digoxin.
Chamomile increases the effects of Hypnotics.

Goodnight Thurs 8:19pm

I'm finished :)

Today was my last day, I cant believe I was there for a month. I think that must have been the fastest month of my life. I know I was moaning a bit a while back about how I was not really enjoying it, but I have to say that today I was quite sad to leave and when I think about it, I did enjoy myself. Sure there were a few times when I was over the whole thing but overall I learnt heaps, gained confidence in my clinical skills and now feel much more confident in my ability to become a future RN. The biggest thing I learnt in the last month was that I really love working with children, especially babies. They even said in my evaluation that I show great ability with children. This has strengthened my thoughts in specialising in pediatrics when I graduate. I have applied for clinical at the special care baby unit next semester and fingers crossed I get it, this is the one place that I have always wanted to go but heaps of people are asking to go there as well. I just pray that I get picked.

So anyway next week I have my final exams and that's me for about 10 weeks. What am I going to do with myself? I have decided that I want to make a start and get through a big assignment that we do next semester. I have got all the info for it , so know what I need to do. So hopefully I stick to that idea, as that is my goal for the summer holidays.

Tuesday, November 18, 2008

Time flies

I have only two days left of my practical placement, I cant believe I have been there for a month, it has gone so fast.

Life has been pretty hectic at the moment on the family/ home front, hence the reason I have not been posting much lately.

While I am here I will provide the most common adverse effects of drugs on the human body( hopefully it is a question in my exam next week)
1. Respiratory depression
2. Anaphylatic shock
3. Dizziness
4. Constipation
5. Hypertension
6. Hypotension
7. Oral candidiasis
8. Rash
9. Dry mouth
10. Nausea
11. Drowsiness and sedation
12. Fever
13. Photophobia
14. Stomatitis
15. Diarrhoea
16. Anogenital candidiasis
17. Vomiting
18. Blistering
19. Photo sensitivity
20. Postural hypotension

Tue 7:32 pm

Wednesday, November 12, 2008

almost through week 3

and then only one more week to go, this week has been my best. I am really enjoying the work and absolutely loving all the babies that come in :)

Study is not going to well at the moment but still have a couple of weeks to go, at the moment I am eagerly waiting for the marks back from the three assignments I did a few weeks ago. Fingers crossed it is good news.

Well, this is going to be short, no word of the day, I just want to go and hop into bed, I am sooo tired.


Wed 8:09 pm

Monday, November 10, 2008

I am tired,

and dare I say this but abit bored of the health centre. It is starting to feel like all everyday is, is CVD assessments, diabetes checks, blood tests, vomiting children, leg ulcers, blood pressure checks, vaccinations (which I am not aloud to do). At least now I know I definitely want to work in acute care, don't get me wrong, I have enjoyed it, but I just feel like I will need something more in my career as a nurse. My friend is also in a health centre, and she is absolutely loving it, primary health is her thing, she does not want to ever work at the hospital.

Another thing that I am finding is that depending on which nurse I work with, depends on what kind of day I will have. Today was pretty good, my nurse let me do heaps and she just stood back and watch, but a couple of the other nurses, seem to forget that I can do it and just seem to go on automatic. So my new goal for the next two weeks, is to jump in and say would you like me to do this or that for you.

Words of the day:

Post - ictal: The state immediately following a seizure.

Postprandial: Occurring after a meal

Paraesthesias: Abnormal sensations such as burning, creeping flesh or tingling.

I have been studying antibiotics (for my exam) and the four ways that they stop bacteria, this is:

1. Inhibition of cell wall synthesis
e.g Penicillin, Cephalosporans

2. Disruption of the microbial cell wall
e.g Polymixin/ colistin

3. Inhibition of DNA replication, DNA synthesis and protein synthesis
e.g Tetracyclines, Aminoglycosides

4. Interference with metabolic processes
e.g Sulphonamides and Trimethoprim

Mon 8:19pm

Wednesday, November 5, 2008

Tonight is

Guy Forkes (is that how you spell it), but because it does not get dark untill about 8 pm and the kids go to sleep at 6:30, they will not see any. We are still wondering if we should get them up to have a look, but there are not really any down our street. Big S brought some but I think we are leaving them for the weekend.

I have been having a pretty good time at clinical, most of the nurses are pretty cool. The one that I worked with today, was pretty much letting me do most of the things needed in the consultations. The only things we are not permitted to do are Vaccinations, Smeer tests and Bloods.

In three weeks I have my final exams. One is for the adolescent and young adult paper and that is 70 questions, half will be mental health and the other half will be medial/ surgical. Then I have another exam which is 70 questions also and it is half pharmocolgy and half physical assessment.

So I think I will focus on pharmacolgical type things for my words of the day.

Because I always get these two mixed up:

Antagonist: A drug that is attracted to a receptor but does not activate it. Sometimes the word blocker is used to describe this action.

Agonist: A drug or naturally occurring substance that stimulates a receptor.

And one extra one:

Intrathecal: A route of administration where a drug is injected into the cerebrospinal fluid.

Well I started this ages ago but we got the kids up to have a look at the fire works, O didnt like them and went straight back to bed. It got quite windy and started to rain, so then we put S back to bed and they are both asleep again.

Anyway better go

Wed 9:06 pm

Tuesday, November 4, 2008

Off to clincial

but had a few mins to spare and thought I would do my word of the day:

Stegnosis: A stoppage of any of the secretions or excretions or A constriction or stenosis.

I hope I have a good day, I really want to get as many things done as possible, so I hope it is busy.

Fingers crossed

Tue 8:19 am

Monday, November 3, 2008

New Idea...

I am bored the kids are having a rest, so I thought I would start a new word of the day type thing, but I will only use nursing or medical words or conditions etc. I will refer to Stedmans Medical Dictionary for the Health Professions and Nursing.

The page I opened was v's, so the condition I learnt today was:

Vernet syndrome: A syndrome characterized by paralysis of the motor components of the glossopharyngeal, vagus, and accessory cranial nerves as they lie in the posterior fossa; it is most commonly the result of head injury.

Sick Kids...big sigh

Well, at 5:30am this morning, S threw up, it is policy that children do not go to school until it has been 24 hours since the last time they threw up. So I had to miss my clinical today, if my partner big S had been home, he said he would have stayed home to look after her, but he left for work at 4:30am.

As S was staying home, I though O could as well, well its only 9 am and I am slowly regretting that idea. He wants to play with S but she is in bed, as her tummy is still hurting and so he is very bored.

I had to make 4 phone calls, one to the health centre where I am working, one to my lecturer, one to S's school, and one to O's centre. If I have to make up the day, I Can do it on a Friday, as we have Fridays off, so that is not a problem.

I hate tummy bugs, I get so paranoid about germs, I clean the toilet, taps etc after they have been used by the infected person, with bleach. I had a tummy bug when O was a baby, it was horrible, I could not walk, and I was breastfeeding him, I wont go into any more detail but you can just imagine how horrible it would have. So now I go a little over bored on the whole cleaning thing. I do not want to take any chances.

Since I have the day off, I will be able to get a start on the study, as O will have a rest at some stage, and I do not think S is going to be up to anything much.

Fingers crossed that she is better by tomorrow, big S will take the day off work, but I would rather it did not come to that, as that will mean another sick day being used.

Mon, 9:23am

Saturday, November 1, 2008

I passed

I passed the physical assessment yesterday, I drew cardiovascular system out of the hat, not one that I was really confident with but I passed. So that's it, all that is left is 3 weeks at the health centre and two exams. One is worth 20 % of my end of year mark, that is for the adolescent and young adult paper. The other is worth 50%, and that one is for pharmacology and physical assessment.

Completed my first week of clinical, its good and interesting. But I don't think primary health is really for me, don't get me wrong, I would enjoy working there but when I compare it to the work I have done at the hospital, I felt 100% more happier at the hospital. This might sound a bit strange but when I was working at the hospital, it almost felt like I was at home, I am sure that will pass the more work I do there. But I know that is where I want to start my career as a nurse. In New Zealand primary health is becoming really big, that whole thing about prevention, and there are more and more jobs starting in that area, they are even starting new grad programmes now. Which is good, as they only use to be in the hospitals.

One of the annoying things about NZ is that we do not get taught to cannulate and take blood etc, until we have graduated and become RN's, which I think is stupid. Anyway my lecturer told me last week, that if the RN's and patients are happy, I can learn to take blood, even though we are not really aloud and if the Head of Nursing found out, I do not even want to think about what would happen. Anyway I have not yet said this to any of the RN's I am working with, they all seem to pretty much follow it by the book sort of people and I do not know what response I would got if I mentioned that I would like to learn as my Lecturer said I could. My friend who is at another health centre, got to take blood last week. She is having the best time and said that she did more things in her first day then in her whole hospital placement, while it has been the other way round for me this time. I suppose you cant get fantastic placements all the time, and this centre was good for me, in the fact that I start at 9am which gives me time to drop S off at her new school (the school starts at quarter to 9, all the other placements start at 7, 8, or 8:30) and it was really important to me, that she was settled in properly.

Going to go and watch the new Indiana Jones movie, it just came out on DVD here, so we hired if for the night.

Sat 8:37 pm