Blech.

I can't believe it, but I missed my first class today. I wonder how many hundreds of dollars that cost me?

I probably could have stuck it out if I didn't have four hours in between my morning and afternoon classes.

Looks like I've finally got that icky cold that has been making its way around the Puget Sound area. My throat is sore, my nose is runny, I've been making stupid mistakes all day, and am having the occasional chills.

A two hour nap and some hot tea made me feel much better but that doesn't change the fact that I hate being sick -- and I missed OB!

Evening clinicals are a tricky thing

I've discovered I really enjoy the evening shift. It has a different flow than the day shift. As long as I save my caffeine fix for the afternoon, I'm pretty alert and thinking clearly from beginning to end.

Turns out I like Adult Med/Surg nursing, too. We have more responsibility now as "Senior I" students, which is both exciting and downright scary. We have access codes to the medication administration system and can give certain medications independently. The medications we take out of the system are double-checked by the RN we're working with, but I'm proud to report that I've now given three subcutaneous injections all by myself. It's exciting, because I feel like I'm finally getting to practice my skills.

I continue to be impressed by the breadth of knowledge the nurses on my floor have to have to do their job well. I'm also impressed with their speed and efficiency -- having a student to mentor can really slow them down. On Monday, though, I was responsible for the primary care of two patients. I've never cared for more than one patient at a time, so it was exciting to take on more responsibility. By the end of this clinical experience, I will hopefully be caring for up to 3 patients per shift.

That whole being alert at night thing is a real problem though. I'm alert for my drive home, and I'm alert when I should be sleeping. I've turned into an insomniac! For some reason, I didn't have any trouble taking naps and sleeping soundly when I got home from my morning clinicals. It makes me miss them.

And now for something completely different

I've switched to evening shift clinicals. That means I start work on my adult medical-surgical unit at 3 PM and work until 11 PM. It makes for a TOTALLY different clinical experience... and it means I don't get home from the hospital until after midnight.

This is the first time I've been on a true medical-surgical floor.  Admittedly, I'm more than a little bit concerned.  Why, do you ask?

A:   Parking at the hospital stinks in the afternoon.  I park my car at a friend's house, which is just about a 20 minute walk away.  It's great in the afternoon, but not quite as much fun after 11 o'clock at night -- especially when you have to pass through parts of a neighborhood that has a reputation for being slightly unsavory.   

B:  The unit has one of the worst reputations as a clinical site among nursing students, due to tension among the staff.  

C:  It utilizes a "team nursing" approach, which means one nurse can be responsible for up to 6 patients at a time.  The care for those six patients gets shared between different staff members: CNAs take vital signs and perform primary care, like give baths and help with ambulation; phlebotomists take patient blood sugars before and after meals; nurses pass meds and do charting... and so on down the line.  

It's very fast,  and seems very task-oriented.  I'm trying not to have any sort of expectations  -- so I guess we'll just see how it goes!