How many hours did I sit this week?

Between my regular lecture time, orientation at the two clinical sites, plus a special lab session I calculate I spent about 16 hours on my but last week for nursing school. The problem with this is that I did not spend enough time with my knee stretched out, so it got swollen and sore. Ugh. Will have to do better this week. Though I have a feeling that though I know I can probably take 2-4 hours off that time, I'll still be spending a lot of time sitting.
More later on this week.

Tips dealing with Knee Surgery

I'm writing this post about the tips I've come up with dealing with ACL surgery. I've read a bit beforehand, have my own ideas about what helps.

• Working out before surgery really helps. I had about 2 months before surgery and spent some time walking, weight lifting and on a stationary bike. Though I was miserable, because my knee was unstable, the extra time really helped. I noticed the first couple of days that the extra strength helped me get around.
• Find a surgeon who believes in putting weight on your leg right after surgery. I get the impression that some don't. But I never would have gotten around on crutches without putting some weight on the bad leg. I was on one crutch by the third day post surgery and could get around without a cane or crutch a couple of days afterwards.
  
• Use a cane. And get one with a flat head. I was a little stubborn after I got the brace off and tried to get around with one all the time. But my pain was easier to deal with when standing around and walking when I had a cane to put some of my weight on.
• Ice is good. Those ice paks that you put in the freezer are better. Get at least two big ones. Though I didn't use the ice pak much until after I had the brace off.
  
• Too much ice is not good. Be careful of leaky bags. Also now that I'm more mobile ice can make my knee too stiff.
• Trigger point therapy is a good idea. I just got a book from the library about it. The symptoms for the sartorious muscle pain are exactly my symptoms - pain in the front of my knee that does not feel like regular myofascial pain and numbness in my thigh. It makes sense since it was that muscle that was moved around to get to my hamstring. Just massaging the points in my thigh and also in calf has helped.
  

Surgery - Done!

So I'm finally posting about my surgery. I've been fuzzy headed since then for a week with the pain killers and since then with the pain. I'll be a lot more understanding about the pain they are in.
It's funny how just having the surgery has renewed my interest in nursing. I was worn out after last semester, and had not been looking forward to this Fall.
And I can attribute my interest to the kind nurses at the hospital I was at. I admit I might have been distracted, because I was not only thinking about myself, but also about what they were up to. I had to look at the IV to see how they set it up. Which reminds me that I have a question. When I woke up they had a bag of Lactated Ringers instead of normal saline. I was wondering why they used that. I would think it would be more expensive. I don't think I've seen someone with LR during my clinicals.
Comparing this operation to my other two, I found this a much better experience. When I woke up I was not as groggy as my first operation on my wrist. I remember being so groggy I practically pushed myself out of the hospital to get home so I could sleep. The second time to take out my gallbladder I was nauseous afterwards. And I had more difficulty with my asthma acting up. I also think that abdominal pain is harder to deal with then knee or wrist pain. (In fact the first surgery, what bothered me most was my hip - where they took a bone graft from.)
I was impressed with the anesthesiologist. Not only did we talk about my previous experience with anesthesia, he explained to me what he was going to do - that he was going to give me something via IV to make me sleepy and O2. (The last thing I remember was him applying the mask.) He did a femoral block and warned me about the numbness afterward. I think that really helped with the pain. Before the block wore off the only pain I had was behind my knee. Though since then, my main problem with pain has been in front. And no asthma problems or nausea. Though I do remember the nurse in PACU giving report to the nurse in ambulatory care that I had some sinus tachycardia.
I can't wait to see surgery done. I want to know what happens after I fell asleep. And since I'm blind without my glasses, I also have not really even seen an OR.

Catch up on last semester

So I thought I'd write on the best and worst of last semester.

Lets start with the worst (in no particular order):
1. Doing badly on the first patho test & the final. I got a B. I would be fine with this if my mother wasn't so obsessed with A's.
2. Tearing my ACL. It interfered with things like clinicals. That first clinical back was bad. My patient that week had a bed alarm. So I was often walking really fast to get to him. That must have looked funny. I was lucky that the week I tore my ACL was a holiday, so there were no clinicals.
3. Paperwork and nursing care plans. It's crazy. I'm still having a hard time remembering I need to write with verbs and stuff when I'm not writing for class. Paperwork just seemed to go on and on and I know it'll get worst with every semester.

And now the good stuff:
1. Getting an A in fundamentals. Any A felt good.
2. Getting a 98% on that one test in patho.
3. Getting an A on the critical reasoning paper. This was our first big care plan/case study/paper that we had to write. It didn't help that the patient I wrote about was not the easiest. You would think that would make it easier to write about, but not when your patient is confused and you need info from him for the paper.
4. Clinicals in general. I loved them. I liked doing new skills and seeing new things. I also felt really good when I was able to connect to my patient and talk to them.
5. Being able to say that I now have only 2 more years of nursing school.

I have to admit that I'm already getting bored with break and having nothing to study. But I was inspired wonderfully going to the "recognition" or pinning ceremony to help out as an usher. Only two more years and I'll be there. I was disappointed that they did not do the actual pinning. Apparently it was hard to find a place to pin people at last semesters ceremony, so they went with the lei presentation. I can't wait.

Do you like Discworld too?

You scored as Carrot Ironfounderson. You are Captain Carrot Ironfounderson of the City Watch in the greatest city on the Disc – Ankh-Morprok! A truly good natured, honest guy, who knows everyone, and is liked by all. Technically a dwarf, but only by adoption. You’d rather not be reminded that you are the true heir to the throne, but that does explain why people naturally follow your orders… Carrot Ironfounderson 94% Lord Havelock Vetinari 69% Commander Samuel Vimes 56% Rincewind 56% The Librarian 50% Gytha (Nanny) Ogg 38% Death 31% Cohen The Barbarian 25% Esmerelda (Granny) Weatherwax 19% Greebo 6% Which Discworld Character are you like (with pics) created with QuizFarm.com

Update on Knee

So I've been bad and haven't written at all. I was just very busy and then very brain dead.
I'm trying to decide if I want surgery on my knee. I can even write this up like I was giving report.

Pt tore lt ACL 1 month ago. MRI confirmed diagnosis. Pt developed allergy to Celebrex & Aleve. Has regained 90% of ROM. Current exercising 2-3x week and walking 20 min/day. Pain currently rated as 4-5/10. Pt states pain usually occurs in the morning on waking and when "overuses" or "injures" knee. Pt describes" sliding" movement in knee and medial joint line pain. Takes 1-2 tab of Tylenol when pain rated over 6/10. Uses "white flower" and ice to relieve pain.

Ok, that wasn't perfect, but I'm learning to write "medicalese." But you get the idea.
So my main problem right now is that sliding thing my knee does and that joint line pain. Basically the joint line pain is probably torn cartilage, but the sliding is definitely from the torn ACL. My MD says that I will probably adapt and learn to avoid movements that cause pain. However, my knee will continue to be unstable. I can choose to have the surgery, but have to be absolutely willing to do a lot of rehab afterward. I'm thinking seriously about it.

And have you ever noticed that there are a lot of exercise machines that you have to get off on the left side? Even when I can get off on the right, it's sometimes easier to get off on the left. Sigh.

And then I head something pop

So I was coming back from the bathroom during a break in class. For at least the second time I twisted my ankle and fell down. This time I twisted my knee and I heard something popped. I spent about 5 minutes in extreme pain. It doesn't help when someone asks if you can move your leg and you can't even contemplate moving your hand. Argh! So it felt ok after the initial pain went away, but started to get worse once I got myself home. Luckily my Dad had the car, so he took me to our friendly orthopedic surgeon. We're lucky to have one that is a family friend. He said I probably have torn my ACL. But since I'm not into sports (not even vaguely) I don't need surgery. But I am having a MRI on Thursday to check out my injury. That will be exciting.

Now I just hurt and am limping around with crutches. May I just say those are hard to use. And thanks to them I have discovered that I did really tweak my other ankle. Luckily no clinicals this week so I have some time to heal. And I'm never going up those stairs again. I don't know how I'll get to the bathroom, but I'll think of something.

I'm back

So I haven't been blogging. I like to think I have a good excuse, but mostly I've just been sick.

I've also been busy with school. Started clinicals 4 weeks ago. That keeps me busy. We have a fair amount of paperwork to do, but I think I'm stressing less then some of my classmates. It helps that we're not being graded, but clinicals is a pass/fail class. I do spend a lot of time working on the patho part. Though it helps that 3/4 pts have had cancer as their main diagnosis.
Clinicals are fun, but sometimes boring. The thing is that we're limited in what we can do. I'm enjoying having pts and learning new things. I realize that as I'm typing this I keep on wanting to abbreviate everything. And I feel funny adding all the verbs in. It goes to show that all the writing I've been doing lately is for clinicals.

I did much better on the last round of tests. It just generally improves my mood. Though I barely passed the medication calculation test. Ugh. I'll work on that.

Not the greatest post, but I just wanted to update the blog.

How's 2nd Semester

So far I can say that 2nd semester is very different from 1st. Both of my classes require time to study and lab is much more involved. I had several students from other semesters, plus on of our 1st semester instructors saying that 2nd is a lot harder. I didn't believe them that it could be that much harder, but what they said is true.
Just think about what I've been through the past week. Last Tuesday I had my first Fundamentals test and Wednesday was my first clinical skills test. Then Friday was action-packed. We went over the template for the care plans we will be doing every week for clinicals. Plus we got to play with Sim Man for the first time. Everyone was telling us how much fun Sim Man would be and none of us believed them. It was fun, but it required a lot of critical thinking.
This week we had our first Patho test. That went well. I realized I like this semesters classes a lot better because it seems logical to me. We're finally getting some of the background of why we're doing something. Last semester we learned all these assessment techniques, but didn't know why. Then at the end of this week we have orientation to the hospital for next week's first clinical.
I think I just need some sleep, and then I can start on this week's work.

Nursing School Bloopers 2

So it is now required that when I have some kind of orals/skills test that I become a total klutz. I dropped the NG tube twice. Plus at the same time the tape went rolling out of my hands, under the bed. I think it stopped before it went under the bed at the next station. Luckily my instructor was very nice about it. It helped that as soon as I dropped the tube I would say, "I dropped the NG tube and would need to get a new one." I can't believe that I blanked out about washing hands after taking off gloves. It's just when we practice we don't always go wash our hands. And I forgot clean gloves. Sigh. At least I remembered pretty much everything without any prompting. And I passed.

Another Allergy

I don't think I've written about it before, but I have asthma and allergies. Believe it or not it was adult-onset asthma and it was only after I as diagnosed with asthma did I realize how bad my allergies were. I have the general allergies to dust, pollen, etc. And I have recently discovered (last summer) that I'm allergic to peanuts.
Now I've added another allergy to the list this week - latex. You're wondering how I survived one semester of nursing school without figuring this out. Well the only time we used gloves was when we were checking patient's mouths. And I usually used non-latex gloves and if I used latex it was on and off within minutes. So we were practicing putting on sterile gloves and my hands started itching. No rash, but I never had them on that long. I really need to see an allergist. Who knows what else I may be allergic to.

Lab is going great. We had a lot of fun today practicing our wet to damp dressing changes plus NG tube insertions for next week's skills test. I'm not as nervous as I was, but that may be because I have a test to do before I do my skills test. It was disconcerting the first time I did the dressing change. It was so awkward pushing the wet dressing into the wound.

Back to studying.

Skills Testing

It's been longer than a week since I last posted. But I actually have an excuse. I'm fighting some kind of virus. Not really bad symptoms, except I'm really tired and have been having the full body ache.

This week we are learning about wound dressing. We're supposed to know this and NG tube insertion/feeding for skills testing next week. I was really nervous before we did NG tube insertions. But I've come to realize that it is not really hard to do it on the mannequin. The problem is to remember to do everything in the right order. And we have know why we do something. For instance, do not pack the wound too tightly, because it prevents wound contracture and capillary growth.

Plus we the first two tests for Fundamentals & Pathophysiology coming up in the next few weeks. Ugh. I'm going back to bed.

Loving 2nd Semester

I'm enjoying 2nd semester. I'm starting to feel like a real nursing student on my way to being a real RN.
What I love:
1. I'm really enjoying our "Clinicals." They are now just all in dry lab and we won't go to the hospital for a couple of weeks. But we're doing real "nursing things" like toileting, bed changes and moving patients. Next week we do our first real procedure - NG tube insertion and tube feedings. Everyone is having fun. Even though we're three sections, we're all doing lab together. It's great because we all feel that we're getting the same education. (This is compared to last semester, when there was a difference between what the different clinical instructors were teaching.)
2. Fundamentals class is interesting. Our instructor is really knowledgeable about nursing. She doesn't teach a clinical section, but is often in lab giving us her "pearls of wisdom." She can be really intimidating, but is very nice about telling you what you're doing wrong. And she has a great sense of humor.
3. Finally I'm taking pathophysiology. It's still at the stage where it's all overwhelming. But it's nice to finally learn this stuff.

Next week we learn about nursing diagnosis. Some of it seems silly, since we were told right up front that hardly anyone uses them anymore. But I think I will find it helpful to help organize my thoughts.

Note: If you have a skinny butt, sitting on a bedpan isn't that uncomfortable. But if you butt is bigger like mine, they do start to cut into your butt.

Advice for 1st semester students

So every semester, the 2nd semester students host a lunch for the 1st semester students. And last semester, for our lunch, some of the SNO officers came by and talked to us. They all gave us advice. Unfortunately I had lab this morning during the lunch, so I wasn't able to give them my two cents. This is what I would have said:
1. Clinicals are what makes it all worth it.
I loved clinicals. I found them very stressful, but it reminded me weekly why I'm in nursing school. It was amazing at the end of the semester how much I had learned. I felt comfortable doing all the skills on that long list. But more importantly, I felt comfortable talking to patients. I didn't realize this until after my final for clinicals: Even though I get so nervous, I've gotten good at developing that rapport.
2. Nursing school is more than studying.
I'm not just saying this because I'm my class president. I'm saying this because your classmates are your support system. You're with for 3 years. You'll be studying together, doing those horrid group projects together and eventually working with them. So now is the time to get to know them.
I doubt I would have said exactly that, but you get the point.

Nursing Bloopers

At the of November, I took my clinical exam. This was in two parts. During the first part, we examined a "real" patient, and then for the second part we wrote up our findings. We were in the new medical school, with their nice new examination rooms. You know those stools that you see in doctor's offices that roll around. Well, I tried to sit down to take a health history and fell down - twice. Both times my equipment fell out of my pockets. I finally got smart the second time and took out the heavy stuff. It also helped that I put the stool further down and did my best to keep it from rolling. Those are dangerous.
The exam itself went ok. My patient did have a leg cramp when I was doing the abdominal exam and I was running out of time. I was trying to be nice and let him recover. But at the same time I wanted to get him up so I could complete the exam. I did run over time in the end.
The story does not stop there. I was writing up my results, but had not thought that I should be writing in black pen. So my pen ran out of ink. I then borrowed a pen from someone else and her pen ran out. Luckily the 2nd pen I borrowed lasted until I finished. It's a good thing, otherwise my instructor would have gotten a report in her choice of pencil, blue or red.

So what have I been up to?

...other than not blogging at all.
I've been enjoying my break. Saw 3 movies, went to lots of Holiday parties, and generally caught up with life. I'm finally at the point where I stopped clenching my teeth all the time. My one New Year's resolution is try to start running again. I'm using coolrunning.com Couch to 5K plan. I'll let you know how it goes.

Classes start up again tomorrow. I'm taking Pathophysiology and our fundamentals class with the accompanying clinical. One of the reasons I was clenching my teeth was because I was stressed out with registration for clinicals. We get to choose our section with registration, and for a variety of reasons I'm one of the last to register, so I get no choice. I was so worried about choosing the right clinical, but then realized I had no choice. That realization helped me get over it, but still upsets me.

So I'm thinking of starting reading for tomorrow. I checked the class website and we're starting Pathophysiology with fluids & electrolytes. Ugh. I did ok with that in A&P and chemistry, but it's not my favorite subject. But don't think I'm some kind of great student reading before classes start. I had some classmates, who said they were reading as soon as exams ended. Crazy.

2nd New Year's resolution - to blog once a week. We'll see how that goes.