Posted in Nursing School, organizing, Stress Prevention

Confidence

It has been way too long since I wrote last. Over the last couple weeks, I lost my confidence. I received a poor grade on my pathophysiology exam (the one I described in my last post) and it shook me up pretty bad. I started to question if this was the right path for me. I am working on having confidence in myself because I know this is my right path when I am in the hospital and I have a strong feeling that a lot of this is second nature for me.

This semester has been very difficult for me and my fellow students. However, we are all getting though this difficult time together and have each other to lean on when we need it. There were a few days I went to class when I felt like I couldn’t do it anymore and thanks to a few women in my class I made it through the week without completely losing my mind. This goes both ways, I have had a few friends come to me and tell me the same times I’ve told them before. We all need a little reminder that we can do it, we can make it though this hard time.

Organization and Study Time

Head to Toe Assessment

So, as I just said we all need a little reminder that we can do this; if you’re feeling like you can’t do it, questioning if this is the right path, this is me reminding you, you can do it, you can make it through this. It’s going to be difficult and stressful but we can learn together how to manage that stress together. Writing these blogs and helping other people to not feel stressed helps me to destress.

Assessment

A head to Toe assessment is a little intimidating. I created a skit that covers everything (on our checklist, make sure to customize this to your own checklist or liking). I organized mine in a head to toe direction.

I start by introducing myself to my patient, I wash my hands, educate them on what I’m there to do, I provide them privacy, ask them their two identifiers, if or what they are allergic to, make sure the bed is locked, and move it up to my working height.

Vital Signs

Assess:

Pain Level

Temperature

Heart Rate

Blood Pressure

SpO2

Respirations

Head

Then I assess their LOC by asking the patient if they are oriented to who they are, the time, where they are, their purpose, and speech. I assess their central nerve VII by asking them to make facial expressions such as raise their eyebrows, squint, scrunch their forehead (to assess upper aspects of the face) and smile, bare their teeth, pucker their lips (to assess lower aspects of the face)

Skin

While they’re doing this I am assessing their skin on their face for: color, contour, symmetry, moisture, turgor, lesions, rash, bruising, trauma, or piercings.

Eyes

I’ll check their eyes, by using the acronym PERRLA (Pupils are Equal Round, Reactive too Light, and Accommodation.

Neck

Lay the patient flat on the bed (remove all pillows) in supine position. You should be able to see their interior and exterior jugular veins with a pen light. Start to raise the bed until you can no longer see the veins and note at what degree of the bed they disappear (should be between 30-45 degrees)

Thoracic

Skin

Again, I’m going to inspect the skin: color, contour, symmetry, moisture, turgor, lesions, rash, bruising, trauma, or piercings.

Cardiac

All Patients Take Medication

I’m going to auscultate (listen) to the valves of the heart starting at the aortic valve (right of the sternum, 2nd intercostal), pulmonic valve (left of the sternum, 2nd intercostal), tricuspid valve (left of the sternum, 4th intercostal), and the mitral valve (mid-clavicular, 5th intercostal). I’m listening for the rate and the rhythm. I will also asses S1 (heard louder at the apex of the heart mid-clavicular, 5th intercostal) and S2 (heard louder at the base of the heart (second intercostal)

Abdomen

I’m going to inspect the abdomen just by looking at it at eye level, looking at: contour (flat, round, protuberant, or scaphoid), AP:T ratio (should be 1:2 or 5:7). Inspect the aorta just left of the xiphoid process for heaves, lifts, or pulsations. Then switch my stethoscope to the bell and listen for any bruits or thrills happening in the aorta.

I’m going to listen to the abdomen in all 4 quadrants, I want to be able to hear bowel sounds in all 4 quadrants. I will then percuss the abdomen for tympany (dullness over visceral organs, i.e liver).

Lungs

Auscultation Positions

In total for the lungs I’m going to listen to 14 places, 6 on the posterior, 6 on the anterior, and 2 lateral. I’m listening for resonance in the lungs.

Peripheral Assessment

Skin

Again, I’m inspecting the skin: color, contour, symmetry, moisture, turgor, lesions, rash, bruising, trauma, or piercings.

Palpate

I’m going to assess the CRT of their fingers and toes (should be less than 2 seconds). I’m also palpating the pedis & posterior tibial pulse, the symmetry of the radial and ulnar pulse. Assess the strength, symmetry, & any edema in the limbs in addition, hair distribution.

Other Assessments

If the patient as any tubes, lines, or drains, I will inspect them and make sure they are clean, dry, and intact.

Lastly, I will asses their gait. I will have them walk their normal gait, then walk heal to toe.

Exiting the Room

The patient has their call light

They don’t have any questions for me

They have their call light

Their bed is lowered and locked

End Assessment

Posted in LiFe, Nursing School, organizing, Stress Prevention

Staying strong

This past week I had two exams, back to back. I had health assessment Monday and patho physiology Tuesday. So, the weekend prior I studied for both tests. I will admit I studied for my health assessment class a bit more thoroughly. However, that doesn’t mean I excluded my patho physiology test material I needed for Tuesday. I felt as though I needed to spend more time preparing for health assessment because I do not know the material as well as I feel I know patho. Rationally, I spent 2/3 of my time on health assessment and 1/3 on patho. I also attended a study session for patho, needless to say I didn’t neglect it (nor am I encouraging to neglect one subject over another). It all about time management.

The health assessment exam went well, I felt good about the material I know and I was able to work through most of the questions I struggled with. Patho however, I failed. While taking the test I remember thinking, “I feel good about this exam, I know this material like the back of my hand.” Next thought, “stop, every time I think that I don’t do well on the exam.” I didn’t listen to that thought as much. I know the material that was on that exam, possibly too well. After going through the questions I got wrong I realized a few things. I need to cover the answers while I read the question.

Rationale: I was creating ways the wrong answers could be correct by going down a rabbit hole. Everyone with a type of test anxiety knows what I’m talking about. When you think to yourself, “ok if I have someone who is respiratory acidosic, their kidneys will start to compensate because even though they’re probably hyperventilating……. and it keeps going and going until I’ve made it possible for just about every answer to be correct when all the question was asking was, “if someone’s CO2 is low what is happening,” they’re hyperventilating.

So, I made my exam so much harder on myself and failed it because it wasn’t that hard. Why? Because I know the material so I wasn’t taking the time to read what the question was actually asking for, because I “already knew the answer,” to a question that wasn’t even being asked.

TAKE YOUR TIME.

Posted in Nursing School, organizing, Stress Prevention

Studying Tips

THE BEST STUDY AID
Saunders Comprehensive Review for the NCLEX-RN (Saunders Comprehensive Review for Nclex-Rn)

This book is going to be my best friend throughout nursing school (I love colors so I thought it was a must to have my hair match the book in the picture). Every time I’ve needed clarification on anything thus far this book as been able to answer it in the most simplistic forms. I’ve used it for my Intro to Med Surg class (first exam is tomorrow, I’ll write how that went and how this helped me). I’ve used it for my first Patho exam and received an A and felt very confident. Side note, about feeling confident. A fellow student came up to me today and told me why she didn’t do very well on our first Patho exam even though she studied her butt off. This has happened to me and multiple fellow students of mine. A little advice, don’t go in over confident. I have made more mistakes on exams when I go in overly confident. I tend to skim the questions instead of thoroughly reading them; therefore, missing what the question is actually asking. This is exactly what my friend did. So, slow down, ESPECIALLY when you know the information.

Studying Techniques

Fluid & Electrolytes

This is the beginning of my Fluid and Electrolyte notes for my Intro to Med Surg. This lecture was over 100 slides, it was a lot of very necessary information but I had to condense it. It ended up being 5 pages. Yes, this is still pretty long but like I said, it’s a lot of necessary information. This is one of my longer sets of notes (it’s also covering almost half of my exam, so it makes sense).

I have gotten asked a few times this week at school what I do to study so I thought I’d post this blog to help anyone else who may be confused out there. I must say this is how I study and I do not guarantee good grades or anything along those line. I am giving recommendations, everyone learns differently and I recommend molding this however anyone might need.

For this particular chapter I made sure to make my main topics the different diagnoses and made sure to describe signs/symptoms, clinical manifestations, and nursing considerations. If there were any tid bits that my teacher said I would write that in a different color on the side of the paper because those are usually pretty important details. IMPORTANT: MAKE IT COLORFUL!! My eyes are drawn to my notes (I’m a huge nerd, I know) nevertheless, my brain likes looking at my notes, it helps me learn. I use the same colors or color palate according to each class. Purple for Med Surg, pink for Health Assessment, blue for Patho, and green for Pharm. This helps when I’m looking at my agenda and what I need to get done. For things like Normal Ranges I usually put in another color and outline it with a highlighter. I usually refer back to these multiple times throughout the semester and sometimes even in later semesters. If I have any acronyms for diagnoses I will also put those in a stand out color in the margin next to the term.

Use whatever resources possible. There’s a lot of information and there is not one perfect way to understand it. So try different things, this one helped me.

Posted in Nursing School, organizing, Stress Prevention, Wedding Planning

2nd Week

Alright. Second week down. First couple exams this week in addition to make up classes. This week was another full week. But I did it, I did well on my exams, I don’t have any missing assignments, we’re getting the internet system figured out. I think the positives of this week override the negatives, the stresses. I must admit, I had a few anxiety break downs; but what I quickly realized was, I’M NOT ALONE! Every corner I turned Tuesday morning, I heard another person telling their friend about their break down! At that moment I took a GIANT breathe, obviously not because these people were also having anxiety but because I wasn’t alone in how I felt. I’ve said this 100 times in the last two weeks. “This program is difficult, it should be difficult! We are taking care of lives, of human lives. I would be more concerned if it wasn’t difficult.” So, what do we do about it being difficult? We adjust.

This past weekend I probably studied for exams, and finished homework assignments for approximately 12 hours. From Saturday to Monday. I was trying to get as far on homework as I possibly could.

Organize and Set Yourself up for Success

One thing I do to help myself and organize myself is finish as many assignments (especially ones that don’t take a long period of time to complete) as I possibly can, more importantly I do it at the very beginning of the semester. I don’t know about anyone else but when I start to come up on the end of the semester a lot of assignments are due, I’m trying to study for finals, and let’s be honest at this point of the semester I am beat. I’m physically and more understandably, I’m mentally exhausted. I just studied almost everyday for the last 16ish weeks.

So, I help myself out for later in the semester. I am more able and willing to study even when mentally, I’m ready to throw in the towel. I do better on finals because it’s the only thing on my plate.

Alright, that was my speal about getting stuff done early and honestly that could go for just about anything in life. Easier said than done, right? Yes, BUT one at a time makes everything easier. That’s all I know I can do. I can multi task, yes, however I can only complete one assignment at a time.

So, I put them in order of urgency just as I would if I was a nurse in a hospital setting. My primary urgency is anything that is due the next day. My secondary urgency is anything that is due that week. Finally, my third urgency is assignments that are due the next week and then the following week and so on and so forth. Then, I could break it down even further and look at which ones are going to be difficult and time consuming and which ones I can knock out quickly. The ones I can get done fast I will finish first then work on the longer ones. TIME MANAGEMENT, boom!

Organized chaos
Redi-Tag Divider Sticky Notes, Tabbed Self-Stick Lined Note Pad, 60 Ruled Notes, 4 x 6 Inches, Assorted Neon Colors (29500)

This is my study station. I like to spread out. I put just about everything in front of me so I can see it and grab it if I have a hot train of thought going. This looks like I just threw a bunch of stuff on my bed but I know where everything is and I know what I need to get done. My agenda is one thing that is right next to me.

Color coded
HARDCOVER Academic Planner 2019-2020: (June 2019 Through July 2020) 5.5″x8″ Daily Weekly Monthly Planner Yearly Agenda. Bonus Bookmark, Pocket Folder and Sticky Note Set (Pink Marble Triangles)

It’s almost as if I have two agendas in one. I write down the daily assignments and such that my teachers mention. Then, I have my list on the right that has what I need to have done for each class that week. I have had nightmares about forgetting assignments or exams or being late and missing an exam. Other type A people, especially nursing students know exactly what I’m talking about. Well, this has stopped those nightmares.

If It Takes 5 Minutes…

A wise man once told me, “If you’re afraid of forgetting something, write it down. Save yourself even the slightest amount of stress just by writing it down.” Simple right? But, I did it just last night. I had a great idea for my blog today and for the life of me I can’t remember what it was. So, instead of taking the time to even type it in my phone I forgot it and now I’m beating myself up for it. I don’t need any/or want anymore stress so why didn’t I take that wise man’s advice? I was being just a little bit lazy. It would have taken me 1 minute max to type it in a note. This is something that I too have to continue to work on. Good rule of thumb: if it takes less than 5 minutes to get it done, just do it and get it done. You’ll spend more time thinking about how it needs to get done then the time the task actually takes.

Wedding Planning

Amongst all the chaos I made time for myself to finish up our Save the Dates. To make my life easier I bought clear address labels that I can place right onto the Save the Date postcard. I decided on postcards for our Save the Dates. This way I dont have to worry about or pay the money for envelopes, or take the time to write out everyone’s address. In addition to not having to spend the time hand writing the addresses, I have all of the adresses saved for the Wedding invitations and Thank You cards. I’ll just have to print them out. I am all about making things less difficult and less stressful.

Posted in Nursing School, organizing, Stress Prevention

First Week of Nursing School

So, my first week of nursing school is just about over. I have to admit it was a bit rough. Just about everyone knows that nursing school in and of itself is intense. Well, to make things just a bit more difficult, my nursing school’s entire system was down. This has made it quite difficult to communicate with teachers. Not only that, none of the students had their schedule going into the first day of class. So, to say the least, it was a frustrating, diffcult, and an extremely stressful week. However, I’m trying to think on the bright side. So, here’s the bright side, I have one week of nursing school under my belt. I am here. I am in it. I CAN do this.

As one might image, this was an uncomfortable week for a type A person like me. I like order, I like organization, I love having things planned. This might be a reason why nursing is a good fit for me. Anyway, what I did to help my mind, my body, and let’s be honest, my sanity was to get everything in some kind of order. For starters, my nursing schedule is pretty hectic, it’s different on a weekly basis. So, I layed out my agenda, my Med Surg calender, my Patho calender, my Health Assessment calender, and finally my Pharm calender. I wrote in the notes section of my agenda, and color coded it to each class: For example, pink is Health, purple is Med Surg, light blue is Patho, green is Pharm. I also color code my notes according to this. I’ll go into more detail about color coding and organizing my notes in another post.

Monday: (Class times & room #)

(obviously, only if you have the room number, just in case, I have a lot of times, dates, and numbers to remeber so sometimes I forget)

Tuesday: (Class time & room #)

Wednesday: (Class time & room #)

Thursday: (Class time & room #)

Friday: (Class time & room #)

Then, I went to the monthly calender of my agenda and wrote down all of the days I have exams. I dont know about anyone else, but I like knowing when I’m going to have a hectic week so I can plan around it. See there’s that plan word again.

Now, there’s a little bit of order. That’s how I calmed my brain down after such a stressful, unorganized week. I will admit this week was tough, it was very overwhelming and I’ll also admit that I started to doubt myself. When these thoughts started to arise, I had to remind myself, “this IS what I want to do,” “I AM going to be a great nurse.” These are things that I have to remind myself and will continue to remind myself because I will get stressed and discouraged throughout this journey called nursing school. However, it’s about I acknowledge it, use it to my advantage (having some stress is good, it means we care) and move through it. Just because something is difficult doesn’t mean we should give up; it means we are going to have to try that much harder and put in that much more effort. This is why we remind ourselves, “this IS what I want to do,” “I CAN do this.”