Wednesday, January 23, 2008

New Job, New Semester

A New Job

My new job is cool! Luckily, my training manager didn't tell Nurse Evil that I didn't want to be precepted by her. I could see immediately why she might have had a problem at the county. She runs her mouth constantly, is a bit of a gossip hound but is a very skilled nurse. The whole precepting thing is going much smoother having an basic understanding of labor and delivery. I guess I need to understand what they do when emergent things happen. For example, if I had a patient with a fetal heart rate in the 60's at the county, we would watch the first brady and doing the basic interventions. By the second brady we would be pulling the bed out of the wall and running to the Operating Room. By the third brady we would be getting ready to cut. At this institution, they wait to see if it comes up. If it does, they continue as usual. If it doesn't, they check to see if the Mom is ready to push. If she is, they try to deliver a baby and call code pink.

This new relaxed way of looking at a tracing is foreign to me. If I just turned the patient and put on O2 with the first late deceleration and only called the doctor on the second late, I would be in huge trouble. Huge. They would be talking about me in the break room and the doctors and nurses would not trust me to watch a patient. Seriously. The county was a hostile work environment. Not here, at least not yet. They only come if you call for help. I appreciate that. And when they do come, it is not in the spirit of making you feel inept, it is truly to help. This time, I am adjusting my attitude. I am approaching this job as a skilled, experienced nurse. I am confident in the things that I know. I am not going to have a negative outlook, I am going to leave my past behind me and look forward to the learning opportunities that exist. Besides, I am only going to be there three days a month. I believe I can do it.

A New Semester

This past week I had more intensive courses. I am taking classes to prepare me to be a clinician. This is where I am not as confident. When we were learning about how to prescribe insulin it hit me that I am going to be responsible for diagnosing and managing patients with chronic health conditions. What if I prescribe a medication and my patient gets hypoglycemic and has to be hospitalized. Scary thought! I know that I will be supervised in the beginning and I will not be turned out into the wide world of medicine without passing a certification but it is still a bit daunting.

This semester I am taking advanced pharmacology, my clinical course and theory (boring). I am supposed to be working on a paper. This week and next week are going to be devoted to getting that together. I am already a little bit behind on my reading. In my clinical course, they don't assign chapters, only subjects and it is your responsibility to read the chapters that pertain to that particular subject. We had our first quiz. This particular quiz they gave us a patient's information, demographics, symptoms etc. and then we had to organize and prioritize the information, develop a differential diagnosis (what you think they have), develop a real diagnosis, a plan of care and then follow-up. All of this using no resources. No books, no medication guides, nothing but your mental mind. I don't think I did too bad. Clinicals at this point are at a standstill. My preceptor is on vacation until February which means I will be going to clinical almost everyday.

Well, I should try to get back to work. The kids will be here in a few hours bugging the heck out of me!

DiVa...suffers from study inertia

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