The Big Picture

Wednesday night was a challenging, but also a good day.  I decided to challenge myself and take on the responsibility of full care for three patients.  This included all vital signs, assessments, charting, medication administration, interventions and shift report.  I focused on making sure to try and be more independent of my nurse, and doing things myself.  Making sure to use time wisely and being focused is so important to have time to do everything.

I'm starting to understand larger concepts, which is difficult.  Understanding the diagnosis the patients have, how they got it, how it is affecting them now, and why certain interventions are implemented.  For example, a patient who was not producing much urine.  We gave her Lasix (a diuretic to make you pee) and had her drink lots of fluids, but there was still no more urine output, since she had kidney failure.  After calling the doctor about the low urine output, a BMP (Basic Metabolic Panel) was ordered for the morning.  The patient's kidney failure was related to complications of diabetes, which the patient had, and her finger blood glucose tests ran in the the high 200's, for which a dosage of insulin was given to her, based on a sliding scale of how high her blood sugar was. 

Understanding what the problem is, what caused it, and how to resolve it, is key to improving patient care.  Performing all the tasks for patient comfort and care is important, but understanding the big picture is critical to becoming a competent practitioner.  I am glad my preceptor gives me opportunities to learn, and that she is challenging me to work to my full potential.  I hope to take on more responsibilities as I complete my capstone semester.

You Are My Hero

My final semester of nursing school has begun, and clinical had been going surprisingly well.  When I started this semester I was terrified of what was I, as a student supposed to do?  Would I get a bad preceptor?  Would the nurses like me?  Would the patients like having a student?  After five days of clinical, I can confidently say, “Things are going well.”  Yesterday, a nurse needed to remove a foley catheter, so I asked if I could do it.  I went into the room, introduced myself, and proceeded to remove the foley.  After I was finished, the patient told me, “You are my hero!”  It was a good feeling I got, knowing I had helped someone feel more comfortable.  It’s the little things like these that reassure me it’s all worth it.