About Me

undergrad RN
I'm a twenty-something Canadian student. After stumbling through a few years of college, I finally managed to get into the nursing school of my dreams, where I hope to graduate in 2012 with a nursing baccalaureate degree. I want to offer an honest look into how a modern nurse is educated, both good and bad. Eventually I hope to compare my education to my day-to-day career and see how it holds up. Whatever happens, it should be somewhat entertaining. Find me on allnurses.com!
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Friday, January 28, 2011

Cathy Crowe

Speaking about passion, power, and politics. What a great speaker!

-- from the cellular desk of undergrad RN

The illustrious Rob Fraser!

Fellow blogger and all around superstar, you may recognize him from such nursing websites as www.nursingideas.ca

-- from the cellular desk of undergrad RN

Dr. Boychuk-Duchscher

I love hearing her speak. She is so vibrant and engaging! She is addressing us about the idea of living our professional and personal lives with purpose.
-- from the cellular desk of undergrad RN
Thursday, January 27, 2011

We came, we saw, we debated

Wow, arguing for privately funded/delivered healthcare in a crowd full of nurses (and a model that I don't personally ascribe to) was probably the hardest thing I've done in school. But we went out there, we stirred the pot, we pissed people off, and people gave us death stares- but we defended it with all our hearts and received many congrats from attendees on our convincing arguments. We even earned a shout out from Linda Silas, president of the Canadian Federation of Nurses Unions (CFNU), who said we deserved academic credit for our work!! Wow, it was so intense. I loved it and it terrified me. More updates to follow once I am on my home computer :)

The view from our podium:

-- from the cellular desk of undergrad RN

Tilda Shalof!!!!

I read her books before I ever started nursing school, and here she is :)
-- from the cellular desk of undergrad RN
Wednesday, January 26, 2011

So far, they are feeding us

Noms galore! There are so many people here and it hasn't even officially started yet! We will be rehearsing soon and then later a wine & cheese charity auction. Rumor has it there's an iPad up for grabs.... I was just getting a little thoughtful over how 4 years ago today, nursing school was a pipe dream for me, and here I am now sitting with hundreds of like-minded future nurses in a profession I have become so passionate about. Life is amazing like that, I guess :)
-- from the cellular desk of undergrad RN
Tuesday, January 25, 2011

En route to CNSA National Conference

This past weekend was a total whirlwind, finishing up a CFAM assessment on my patient family, getting ready for the Big Debate, and getting absolutely slammed at work due to the huge snowfall we got this month.
I just wanted to check in and say I am still working on that post I mentioned, and OMG I'm in Toronto!!!
Will keep you posted on what the conference is all about. Stay tuned :)
-- from the cellular desk of undergrad RN
Thursday, January 20, 2011


Antepartum and L&D start tomorrow. Had my L&D orientation today.

I LOVED my last few days on postpartum. LOVED.

There is a post in the works about it; I want it to be thoughtful so I won't rush to finish it tonight.

I am SO tired. Exhausted. Run off my feet yesterday in clinical and then straight to a work shift, and a 5 hour sleep before I had to wake up to finish a 15-page review on fetal heart tracings, and back to the hospital to do it all over again.

Oh, nursing school.

Good night :)
Friday, January 14, 2011

Recap of Week 2 of Postpartum Clinical

First of all - THANK YOU to all the kind suggestions on counting apical pulses on infants. I started tapping it out and it helped me with the counting. Part of why I was so confused with the heart rate was, I think, because my stethoscope is so good. The Master Cardio picks up every little sound and I was hearing the lubbs AND the dubbs and I was having trouble initially telling them apart. I have got it now, though :) Also, when my instructor watched me do vitals, I saw her write in her little notepad that I was keeping a good count! Thanks again!

Let me see here -

Last Saturday, I was fortunate to attend a prenatal class at the hospital (it didn't feel very fortunate at 7 AM on my only day off, but I digress). The instructor was a PT, which surprised me, because she was so super knowledgeable I had her pegged as a RN/Midwife. It never occurred to me that PT/OT might actually function outside of the Ortho unit. Sorry, PT/OT, I was foolish to doubt you!

It was snowing like crazy here but luckily I made it and all of the expecting couples did too. The class was an excellent recap of pregnancy, labor, delivery, and postpartum. The instructor had some really good suggestions on mobility (PT shines through!) and pain relief. I was impressed to see her put the coaches to work. I always wondered how the dads felt in the delivery room. She gave them all jobs to do and made sure they understood! She provided LOTS of teaching on the pros and cons of epidural and c-sections. She made absolutely no doubt that labour was going to hurt but she also reinforced that she was giving the parents-to-be tools to deal with it too. She kept stating "You aren't SICK, you are HAVING A BABY. So, if the nurses tell you to do something for yourself, it's because you aren't SICK and you CAN!" We could have cheered :) It was a very good class to attend and I was grateful.

On Tuesday, we were back on the unit for another buddy shift (RN shadowing). I was assigned to the nursery, which is on the postpartum unit, and it's where the neonates come to be assessed after delivery before they rejoin their moms in their assigned rooms. The nursery was a very busy place. We had 2 or 3 infants in there all night. They come down from L&D "fresh from the oven", so to speak, and are weighed, measured, given initial assessments, Vitamin K, initial baths, and vital signs taken. I had just arrived in the room when someone parked a bassinet in front of me and told me to take the baby's vitals. Man - that was suuuuuch a gong show, I'm embarrassed to tell you about it.

Quick tangent - I upgraded my watch to the kind that pins on - which has been coming in extremely handy.

So I get the little bundle quasi-naked and get to work counting apical beats. I am excited to use my new pin watch. So there I am, stethoscope on this baby's chest, trying to count the heartbeats and remember which minute I started at and which "ten" I was on (90? 100? Wait, was that 80? I think it was 80). Of course when you take an infant's heart rate, you need to count for the full minute. So I kept having to start my minute over again and 5 minutes later I am proudly waving my notebook around saying I GOT IT!!! So the RN asks me for the vitals and I'm like.... oh.... I was so pumped about getting the HR that I forgot about all the other vitals. So another 5 minutes later I've got the axillary temp and I think I've managed to count resps but that baby kept making little noises and moving so who the hell knows. Then my instructor pops her head in and asks if those were within normal limits for neonatal vitals and I was so out of sorts I couldn't remember and I had to go check. FYI - they were! lol :)

My RN gave me an initial bath demo and then asked me for a return demonstration. The baby she gave me was a 9-10 lb behemoth (he was only 38 weeks! LGA? Um, yep) and, luckily, a total gem to work with. I had him stuck under an arm and he was so good in the bath - by good I mean screaming, but not too much - and omg my arm was getting so tired. Then I tried to get a C-hold around his scapula/neck/head and scrub some vernix with the other but he was so darn big that my hand started cramping. I have to say - washing vernixy baby was not my favorite nursing experience. Combing goopy mommy bits out of baby's hair was rating kind of high on my eeeeeeeuuuuuugggghhhhh scale. However I was very satisfied with the sweet smelling, cuddly result once he was clean and dry.

On Wednesday, I was assigned to my first patient - a mid-20s G5 P3 or something similar who was 3 days post C/S and due to be discharged the following morning. She didn't need much care at all, BUT I actually did get a chance to do some teaching. Probably two of my biggest hurdles to overcome were 1) actually touching and handling a neonate without dropping it, and 2) providing breastfeeding advice to a mom, having never been a mom myself.

This mom kept complaining of feeling engorged even though baby was feeding well. I managed to try some strategies with her including warm and cold compresses, manual expression, and pumping to a comfortable level. She actually listened to my advice, although it didn't work, and never made me feel like I was just some random student trying to tell her how it was (which is what I was worried about). I call that one a success. I am, however, having trouble assessing funduses (fundi?) on larger moms. Anyone have a tip for me?

Then I had my second assignment, Day 1 C/S first time parents. I was SO busy. I managed to do all kinds of things - my first initial bath witnessed by my instructor, infant assessment, Vitamin K injection. My patient family kept me busy too with PIH (pregnancy-induced hypertension) precautions (v/s q4h) and some voiding concerns. I got to d/c a foley, spike a new IV bag (3rd year skill, yippee!) and give teensy handful of meds including a Voltaren suppository, for which my instructor said I did a great job with good confidence(!). I did a full independent newborn assessment in the mother's room, which was scary because she kept asking me questions and she was a pretty intense first-time older mom, and I managed to provide some good teaching on Vitamin K and an overview of the infant assessment and things I am looking for. Then she wanted me to demo a swaddle. I think she was expecting some kind of pro-star super tight baby burrito but all I gave her was taco salad and I think she was a little disappointed, whoops :)

Today we had our first major project of the rotation, providing anticipatory teaching on various subjects and covering them from birth to adolescence. I did it last night, per usual, and was up all hours. My subject was on child learning and education in Alberta. It was an enjoyable topic, but like any project during clinical, effort is proportional to grade and the project was worth 10%, so... *shrug*

As an aside, I am still absolute crap at interpreting written orders. I don't know where physicians learned to use a pen but I don't understand how, if it takes close to the same amount of time to write legibly versus illegibly, this* isn't some kind of real patient care risk. I know it's kind of a laughable quirk for a lot of people, but it could really hurt somebody if they misread it. And I don't mean someone who's been practicing with that doc forever and knows what is ordered. I mean me, as a new RN in a year and change, coming onto a unit for the first time, or a float RN. Who the hell can read these? Don't we think that should matter a *tiny* bit more? Although it'll just be my fault if I fail to follow up with the doc. Because THAT takes so much less effort than just writing a tiny bit more legibly in the first place, right? {/soapbox}

*Add - I know this isn't a particularly bad example of illegible writing. But really, if I were to hand this in as charting, would my instructor call it okay and safe, best practice?

I am really happy with my clinical so far. I don't hate maternity. I don't know if I LOVE it, at least not yet, but it has definitely been a great experience for me. First day off since clinicals started tomorrow... we had a lot of snow fall here so I think it's a perfect day to go tobogganing! Have a great weekend, everyone :)
Sunday, January 9, 2011

Welcome to 2011, and welcome to the world, babies!

Wow, 2011. One year from now, it will be 2012, and I will be entering my final clinical placements. This has simultaneously been the longest and shortest 4 years of my life - mostly in that I haven't spent 4 years doing the same thing before.

I started my L&D rotation a few days ago. Okay, okay - despite how much I thought I would detest the idea of being an L&D nurse, I can see how it might grow on me... :)

We are placed at an inner-city hospital with a really nice new wing created specifically for maternity. It has assessment & induction, antepartum, L&D, postpartum, NICU, and obs surgery all in the same wing. I was surprised and pleased to see the focus on family-centered care. Most of the babies barely leave their moms, except for assessments and initial baths.

Being inner-city, the patient population reflects everything from wealthy, prepared, crunchy granola moms who have read every book on gestation published since 1980, all the way to homeless women with no prenatal care and whose babies are detoxing from street drugs. There are recent immigrants and teenagers and the physically and mentally ill. There are high-risk moms flown in from northern Canada. It is a MUCH more dynamic cross section of life than I expected - really.

On Wednesday, we attended Ye Olde Orientation at my school. It's the same stuff we've heard before. WHMIS videos and fire safety videos, per Alberta Health Services protocol. I then met up with my clinical group and instructor. She has been an L&D nurse for 10+ years (and is still!), which is super exciting, because my last 2 instructors haven't been at the bedside in 20 years.

We had our orientation onto the unit. We are starting on Postpartum. My orientating nurse was great! She was a younger RN and it was nice to be with someone who wasn't quite so practiced at it. Sometimes it is hard to pick up on techniques used by really experienced nurses. She was fun and really wanted to teach me, and with me being the sponge that I am, it was a very productive day.

There was a lot more teaching to be done than I ever expected. Some of the moms would ask question after question, especially just after the pediatricians rounded on them, so we could interpret med speak. Lots of questions about breastfeeding. LOTS of questions about breastfeeding. I have a lot of studying to do to, so I can answer all these questions with any degree of competency :)

We saw a mom who was afraid to supplement her 2 day old 37 weeker because she really wanted to breastfeed her, but her milk wasn't really coming in yet. However little babe was losing weight and was getting more lethargic, and sucking less. I saw my RN smoothly convince this nervous mom that she could supplement the baby without worrying about nipple confusion with just one resourceful remedy - the nurse cut the needle off a butterfly infusion set, leaving just the tubing, and used a 3 mL syringe to draw up some formula, and then she attached the tubing. Mom got baby on the breast and the nurse squeaked the tiny tubing into the corner of baby's mouth. She was then able to supplement the baby while the mom nursed. Baby got 10 mLs+ of formula and sucked with gusto once she realized she was getting the goods. Win-win-win - it was GENIUS. I am still telling everyone about it! I was so impressed! Even better, we taught dad to use the syringe at the next feeding. He really wanted to help and he did great. We worked ourselves out of a job in that room :)

Another mom got really sick. Failed vacuum, baby delivered with forceps, 3rd degree tearing and episiotomy. She spiked a 40° fever and raging infection and was put into an ice bath to bring down her temp (I didn't see any of this, but I heard about it in report). When we rounded on her, she was so, so, so tired and very apathetic about baby. Can't say I blame her. Her peri area looked really angry and the only thing she ever rang for was more ice packs.

Third mom was absent for most of my shift because she was up in the NICU with babies A and B.

We also toured the nursery area and I got to play with my very first baby, the tiny little girl who required supplementation. I listened to her heartbeat. I don't even know how you are supposed to count it....shiza.

Seriously, wrapping babies into a tiny parcel is harder than it looks. They stick their hands and feet all over the place. You swaddle one side and the other side escapes! I hope I get the hang of it, LOL :)

Lots of studying tonight, lecture tomorrow, and back on the unit with my own assignment on Tuesday!