Friday, October 03, 2008

Nursing school blah

Thursday and Friday are like one horrible, endless day. I know I shouldn't complain, because nobody forced me to go to nursing school, but if I'd known it was going to be like this, I might not have gone. I figured nursing school would like an easier, cheaper, shorter version of medical school, but it isn't like that at all.

On Thursday, I go to the hospital--noonish--and get my patient assignment. This week there was a note telling us to select our own patients. I picked mine based on the fact that she had a nice Irish name and that her physician described her as "very pleasant" in the H&P, and because I wanted to steer clear of the alarming number of GI bleeds and altered mental status patients on the floor this week. At this hospital, we are not allowed to print anything, so I spend about an hour and a half copying by hand all the information from her chart and filling out an assessment form. Once I get home, I must select five diagnoses that this patient has--whatever she's in the hospital for plus things from her previous medical history to make five things--and write a pathophysiology paper on EACH of her five diseases and relate my patients presentation with each disease. Each paper must have sources cited in correct APA format, and each usually turns out to be one and a half pages. Then I write a sixth paper called the pathophysiology synthesis, describing how her various diseases are interconnected and how they affect eachother, plus describe discharge planning, teaching, and follow-up care needed. This is usually one page. Next I must write up a description of each of her meds--the drug, its class, her dose, route, the usual dose, why she's taking it, side effects and nursing interventions necessary when giving each med. There are usually six-eight pages of writing about the meds. Then I have to assign "nursing diagnoses" to my patient. A nursing diagnosis, unlike a medical diagnosis, is a description of a human response to a medical or psychological problem. Something like "impaired gas exchange related to decreased pulmonary perfusion secondary to pulmonary embolism as manifested by cyanosis and O2 sat of 80%." Each patient has between 8-12 nursing diagnoses. Each diagnosis is paired with a goal we have for our patient to accomplish, such as "patient will manifest optimal gas exchange as manifested by nailbeds remaining pink and O2 sats >95%" Last is our intervention sheet, in which we list every nursing action we plan to do for the patient--meds, teaching, labs--for each diagnosis to help our patient reach the goals we've set.

All said and done, it's about 20 pages that you have to write, starting at noon on Thursday and ready to be handed in at 07:00 Friday. And if you don't have it--if you're missing so much as a single pathophysiology--you are sent home from the hospital in disgrace and given a "U" day. If you get more than two "U" days, you are kicked out of nursing school.

On Friday, you must be at the hospital at 07:00. If you are late more than four times, you are kicked out of nursing school. We have pre-conference for about half an hour and describe our patients, and what our plans are for them that day. Then we get out and care for our patients. We are expected to do everything the regular nurse would do, plus all the things the nurses' aides usually do, and you'd better not screw up in any big way because doing so will get you kicked out of nursing school. Today, my "very pleasant lady" was discharged by 10:00am, so I helped a nurse with some other patients and got to do some interesting things. When the day is over--2:30pm-- we need to evaluate our care plans, note if our goals were met or not and write up revisions to our plan if our goals were not met. We also need to evaluate each medication the patient took--were there side effects, did the drug do what it was supposed to do, how were vital signs and lab results affected by the meds. All this information is emailed to the instructor so that she can grade the total package of paperwork.

Grading is different from other college programs. It's not like you get a B and move on to the next week. You get "U", "NI" or "S" and you are required to get at least one S by the end of the semester or you are kicked out of nursing school. I got my "S" last week, thank God.

6 comments:

  1. Holy hell. Good luck with that.

    I think I'll just stay home and blog or something.

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  2. I could not take the pressure.

    Here's to not getting kicked out of nursing school.

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  3. Oh the pressure. I give you so much credit. And all nurses.

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  4. Sounds like there are many, many opportunities to get kicked out of nursing school. Holy Wow.

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  5. This is why, when my sister was going to nursing school, and my Mom said "Why don't you go to nursing school?", I said "HELL NO!"

    I did Med Lab Tech instead, just as much science, but I didn't have the additional stress of direct patient care. Instead of writing up 20 pages of patient info, I spent my days at a microscope until my eyeballs fell out of their sockets!

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  6. Holy crap. I thought I had it rough. Are you 3rd yr or 4th yr?

    I'm 3rd year and I'm already stressed out just writing ONE care plan and ONE diagnosis. I can't imagine writing 5-8. But I know I'll have to as I progress through the program (if I make it =/ )

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