What a Week!

Well, my week started on the worst note and ended on the best note - that is one thing I know for sure.

This was the week I had planned to move up to caring for 4 patients. I would have 3 on Thursday and
4 on Friday.

I always feel like clinical is going to be "so stressful" - but when I get there, I feel more like "it's just
another day." It is stressful because it's still so "new" and because I don't feel like I can just "zip"
though things yet. But the reality is that I have done a lot of assessments, taken a ton of vitals,
learned how to talk to my patients (unless I'm being watched) in a chatty "I really DO care about you"
kind of way..... However, giving medications is something that I have not let myself get used to - in the
sense that I have not let it become "standard" or whatever. You can't do that. You can't just open a
chart and go to the Pyxis (where all of the medications are stored) and pull things out without really
THINKING about what you're doing. If you DO that, you can kill a patient. BAM! Dead - and it's your
fault!

So anyway, I usually spend the evening before a clinical day kind of going over the next day in my head.
I spend time thinking up the "organizational plan" so that when I go in the next morning after just 3 or 4
hours of sleep, I can just get to work w/out having to remember what I need to do first. My thought
process helps me remember "ok, you have to go in, find out who your patients are, quickly go through the charts
to find out what brought them here, go in and meet them and take vitals, do an assessment, go to next patients
and do all that, no go get meds for priority patient, etc....." And in the meantime, take care of all of the
interruptions that have occured in the first 1.5 hours of the day.....

Well, I had all the right intentions on Thursday. I went in, got my patient assignments, and got to work.
The problem started when it took much longer to go through the charts than I had planned. This means
that it also took longer to get into my first patients room. And when I did get in there, I hadn't planned
for the interruptions. Well, DUH, Brandy! Interruptions happen ALL THE TIME in nursing! You MUST be
ready for them, and be able to come back to what you're doing and still have your head on straight. For
some reason, that didn't occur on Thursday.

And for some reason, I felt like I was the only person who'd ever had this happen before!

Thankfully, my Friday clinical went MUCH better!!!!! I had interruptions, but was able to deal with them just fine.
I think that so much of it is in the "mental preparation!" When thinking about how your day will go, you MUST
think about having interruptions so that when they do occur, and they WILL (!!!), you just sail through the process
and move on.

I also got to perform a bunch of skills on Friday that I hadn't done before. I pulled a JP drain (Jackson-Pratt),
pulled a Foley catheter from a female (I've pulled one from a male, but never a female), completely changed a
colostomy bag, removed a suture, and irrigated a percutaneous drain. fun, fun, FUN!!!
I also did a complex wound dressing change. I had done one on the same wound the previous Friday, but some
of the supplies had changed, and we were out of one product and had to "make due," so that was a good
experience.

I was really thankful to remember that, when one day goes really bad, we always know that a "new day" is just around
the corner!