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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Showing posts with label equipment. Show all posts
Showing posts with label equipment. Show all posts
Tuesday, August 9, 2011

Check, check, checking out

4:05 PM | Edit Post
So it was SO FREAKING BUSY the other night. The back was stuffed full of sick people and new ones were coming in the door so fast we had two nurses out double-triaging for almost 2 hours. The theme of the night seemed to be chest pains or lacerations secondary to kicking glass/tables/sports equipment.

There were the usual WTF visits, like the mom who ABSOLUTELY had to get her kid "tested" for celiac disease in the middle of the night. At the ER. Where people were practically hanging from the rafters in the waiting room. The urgency? Well, she Googled a new diet and wanted to start him on it the next morning... "Can't I just see the doctor real quick?"

"No. I'm sure the other 25 people in the waiting room would like to see the doctor 'real quick', too." Then, after lipping off the triage nurse, she stormed out. Bye...

Anyway, I had a patient who was recovering from an infected cat bite**. She was on IV therapy q daily and this was to be her last dose.

I pick up the order - Gentamicin 480 mg IV and a PO dose of Cipro.

Go to Pyxis. Look up Gent. Go to withdraw vial.....

.....wait, we only have Gent vials that come in 80 mg/2 mL concentrations?

I check the order again. Yes, 480 mg.

Now, the nurse's cardinal rule in pharmacotherapy is that if you need more than one vial for ANYTHING you're probably doing it wrong. You know, the "thou shalt not overdose the patient into serious complications and probable death" idea. The manufacturers pre-package them in the normal dosages as one step of the safety chain.

I do a quick calc and see that I'd need..... six..... vials of Gent to make the ordered concentration.

I re-check the order and the vial about 500 times. I get an RN to check it. She laughs and says, "Yeah, that's normal for Gent. Don't worry about it!"

Easier said than done. I get to work drawing up the vials and mixing them up in N/S.

Then I go to the patient and start programming the smart pump. Smart pumps have "guardrails" on certain drugs to prevent nurses from accidentally giving unsafe dosages or infusion rates.

So the guardrail pops up with the amount of Gent that I'm planning to infuse. It also pops up with the rate I want to set. The smart pump actually wants me to infuse the 100 mL bag in 30 minutes. I'm all like "screw that, Alaris, you'll run it over an hour!". It's weird that the guardrail cautioned me running the med longer than the time allowed. Usually it's running it too fast that causes phlebitis. But I digress.

So after bypassing 3 red flag safety checks, I was feeling pretty unnerved by the whole experience. I mean, it was only 480 mg of an IV antibiotic, not 48 grams. I was pretty confident that I was giving a safe dosage, and I cleared it with 2 RNs during prep and administration. I also checked my drug guide to verify it was a safe dosage.

Seriously, manufacturers of Gentamicin and Alaris, put guardrails where you need 'em, cuz you just about gave this nursing student apoplexy!


medscape.com
** Who'd've thunk it, but cat bites are among the most common reasons I've seen for people to get cellulitis. Those things just get NASTY! Swelled limbs and purulent drainage. And they usually happen to the nicest people (cat people are usually nice, or nice-crazy, IME). Cute cuddly kitties need to come with a disclaimer.
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Tuesday, December 28, 2010

Happy new year, nurses!

4:58 PM | Edit Post
I hope you all had/are having a great holiday! I got to spend some time with my fella's family over Christmas and that was wonderful. They have grandkids so they did the whole Christmas Is Magical thing. I absolutely love Christmas. I'm not really into gifts, exactly - the best part for me is hanging out, enjoying family, and listening to carols.... really! I've decided that next year I will, in lieu of gifts, sponsor a needy family.

I did buy myself something a special something yesterday. I've been wanting one for a long time, now, and I wasn't ready to make the plunge..... until I saw they were on sale for 60% off, and I almost-simultaneously got an email from Skyscape giving me a $50 gift certificate for participating in their scholarship contest. I guess some good came from it after all :)

So, when the planets aligned - I bought a BlackBerry. It's a Curve 8530 - last year's model, I think - hence the sale (see below... like my Link wallpaper? ;)


I know, I know, you can all pick your jaws up off the floor - it's not an iPhone.

Reasons I did not buy an iPhone:

-They are ungodly expensive
-They are slightly less expensive if you choose sell your soul to a carrier on a 3 year contract......and I don't do contracts, anymore
-iPhones will be a nice upgrade from this one when I am ready/employed, unless Android makes me happier with less money
-I still love QWERTY!

So far I am quite pleased with it, except for falling prey to the dreaded Disappearing App World Icon. Luckily, there is a metric TON of BB resources around the interwebs and I was able to get it resolved with a few Googlin's and some wasted time setting up the settings I'd lost.

I'm impressed with the integration with just about everything. I had a Palm about 7 years ago, and I spent ages getting it all set up. Then I let the battery die one day.... losing everything. The BB software sets my mind at ease with the Desktop Manager (for Mac, hooray!) and the syncing and the backups. Lesson learned in syncing more frequently AKA before major un/installs or after extensive setting changes.

This model has WiFi and whatever wireless network Koodo offers. It's not 3G, I don't think, and not superfast, but I am new to the idea of mobile browsing so it works for me.

So far, I've installed apps for both of my banks, Dropbox, KeePass, Facebook, Google Mobile,  and Skyscape. I am also SO PLEASED that I can handle my email without being on WiFi or within range of a public computer. It made me twitchy staying over at my boyfriend's house and not being able to instantly access my email. I think I am an email junkie.

I spent quite a bit of time browsing Skyscape trying to decide how to maximize my gift certificate. They also had a deal going that, if I purchased by Dec 31, I would get an additional 25% off. They also suggested I share the link, so here you go: www.skyscape.com/share25off.... offer expires March 31, 2011.

I ended up purchasing a few titles:
They threw in a med calculator and the International Classification of Disease as well.

So far, I am happy with Skyscape. I emailed them a problem with my order last night and they had it resolved by noon. I was NOT thrilled with the installation process, which could use an App World update, because it was hunt-and-peck 24 digit serial numbers to install each title. I'm also not thrilled with the setup of the Skyscape app. For something that I paid for, it sure does spend a lot of time trying to convince me to download other free software.

Anyhow, I am pretty excited to use my BB in clinicals! There is a TON of information in my pocket. The drug guide seems a lot handier than my hard copy - search for drug names and the info is there, no holding books open required. RNotes also has a good mix of L&D resources in it. The med calculator is pretty good too, it has everything from IV infusions to Apgar scoring.

More reviews and from-the-trenches stories of using my BB in clinicals to follow in the new year :)

Best wishes for 2011, everyone!
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Thursday, March 26, 2009

Meme: What does your stethoscope look like?

9:00 PM | Edit Post
I've been tagged by Student RN Tiffany!

Here are the rules:

1) Post a picture of your stethoscope

2) Tell what you love about it

3) Tell what you hate about it

4) Tell me what your dream stethoscope would be

5) Does it have a name?

6) Tag all your nursing friends (Including the one that tagged you) and dont forget to leave a comment on their blog telling them that you tagged them!

______


1) I already posted a picture of it :) I love my engravings. They're so me!



2) Mostly, I love the fact that it's got the horse engraving and my name/school/grad year. It keeps me connected to the idea that some day I will graduate from this chaos! I also love how loud it is as I can sometimes be a bit hard of hearing. Probably due to my extensive telephone work and the iPod usage that I enjoy whenever possible :) I also love how heavy it is. Shocking, I know, but when things feel flimsy in my hands I just don't feel as confident with them. This guy is NOT flimsy!

3) Bah, the only thing I hate is being the only person in my whole freakin school who doesn't have a bell AND a diaphragm. Everybody's like dude, wtf is wrong with your scope?

4) LOL, I don't have enough experience with them to know what I would change. I like mine. I would REALLY like one that could magically shrink down into my back pocket when I didn't need it!

5) Not yet, but I'm sure it will. We've only had them on the unit twice now! I've called it "My Little Pony" a couple of times. Maybe that will stick. Or how about, "Damn this thing in my pocket digging into my leg!"

6) Oooh I totally tag back Tiffany, little d, Lou, Somnambulant (if you're still blogging these days!), and Wardbunny. I'll comment on your blogs tomorrow to let you know. But for now... I am off to bed!
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Monday, March 9, 2009

My stethoscope is here!

9:31 AM | Edit Post
Over a month after placing the order, I finally have my 'scope in my hot little hands. It's a burgundy Littmann Master Cardiology over which I hemmed and hawed for a couple of weeks. I read all over allnurses.com and the overwhelming majority of students seemed to prefer the Master Cardio over the other ones, and if you look after it you shouldn't have to buy another one. So I splurged on it (it was just under $300 CAD - $221.82 USD because I got it engraved).

I already detailed my experience with stethoscopes.com a few weeks ago. Would I deal with them again? I don't know. They were very timely about getting my scope shipped out, but it really does just sound like some guy reselling stethoscopes out of his basement. Also - the whole Magna Fortis thing. And $100USD to ship to Canada? LOL! We share a border! It wouldn't cost that much to ship to Russia! They did, however, engrave my scope just like I wanted, with a horse on the chestpiece and my name/school/grad year on the earpiece. So I got what I was after, anyway.

I listened to my heartbeat in various locations for like half an hour already. I don't know how to do anything else. But it sounds cool :)

Yesterday I was at the University library from 1300 to 2300, and I only got through one chapter. It was urinary physiology. Although I accomplished like 1/10th of what I wanted to, I'm glad I was able to work through the chapter because I started it not understanding anything and I methodically worked through GFRs, Na+ cotransport mechanisms, leak channels, aquaporins, medullary countercurrent multipliers, aldosterone and vasopressin, and now I kind of get it. So no, didn't accomplish much in terms of quantity, but I feel pretty good about the chapter that I *did* spend 10 hours on :)

Heading to clinical today at 1300. Probably not going to class tomorrow morning so I can study Micro instead - midterm tomorrow at 1400! Scary.

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Monday, September 29, 2008

Last break I'll get for a while

5:41 PM | Edit Post
So wow, my road trip was fabulous. I shall detail it shortly... But first, the information you nursing-students-to-be are clearly dying to hear about: how the N95 mask fitting went!



Ok, so this isn't a pic of my group, but it was essentially the same thing: standing around with spaceman bags on our heads, with the masks on. There was a hole in the front of each head-bag that the tester would spray some Bittrex (super bitter airborne chemical) into, and she instructed each of us to breathe deeply through our mouths with the masks on.

There were 3 different sizes to choose from. I originally had the medium sized one on, but it was really hard to get a seal around my nose and my glasses kept fogging up. It was weird, none of the other people had an issue (or appeared to have an issue) with their masks, so I felt a little self-conscious with all my trouble. I just kept in mind that one day I would be caring for a TB/SARS/H5N1 patient and I would be sorry then if I wasn't honest now!


So the tester downgraded me to the small mask, 3M 8110S. That was a much better fit and I was able to wear my glasses comfortably. And I didn't taste any Bittrex, hooray!

So here's my $40 mask. As in, it's technically worthless now that I've worn it, but they let me keep it, and I paid $40 for them to spray chemicals in my face. Cool, huh? The warning label is a little scary: Misuse may result in sickness or death.

Now for the road trip details: I went to work until 9, and came home to pack my bags. The list was a little exhaustive, what with the changeable weather in the mountains, but I have a gianormous backpack that I used while traveling through Europe. It can fit pretty much my whole life in it when packed correctly. Well, I ended up taking so long with the packing that I didn't get to bed until midnight. I had to set my alarm for 0345!! We had to meet at the school for 0430 and the city buses weren't running that early, so I ended up taking a cab. The cabbie was really nice and I was kind of pumped so I kept chatting away and I'm sure he was just thinking God, I hate college kids.

There ended up being 30 students on the trip, and we took a charter bus to the teeny-tiny-town of Nordegg, where we dropped off half of the group to go rafting and the rest of us headed to the rock climbing place. Turned out there was a good hour's hike to get to the actual spot, which I was sooo not in shape for but was game anyway, up through a canyon and along a mountainside. It was incredible how the weather changed so dramatically. When we were in the canyon I literally was dripping sweat from under my helmet, but we then got up to the rock face and it was raining and hailing and freezing in general. I had a lot of fun with the canyoneering part but when it came to do the actual climbing, I wasn't so into it. The rain and sleet made the rock face slick and freezing cold, and even though I was wearing triple-layer snow gear complete with toque and skidoo mitts, I was drenched and pretty much miserable. I did give it a fair shot though; I belayed someone up a climb even with hail falling into my eyes. I also took a stab at the easier climb (I am deathly afraid of heights, and climbing a real cliff is not quite the same as a climbing wall) but I slipped while making a big step and fell. That was a good enough try for me :)

That night at the hostel, there was a great deal of drinking and rabble-rousing by most of the students but I pretty much hung out in my room and studied Anatomy. I crashed at 2230 and that was all I remember, except one girl in my room (who, interestingly, is also in the Nursing program) somehow rolled off of the top bunk, over the rail, onto the floor. She was pretty drunk, lucky for her.

The next day it was a little warmer and we went rafting down the mighty North Saskatchewan. The water was pretty much hypothermic and, even though I love rafting (in the summer), I was not feeling it. We went down once and I was in the front, which is splash central. The run took about an hour and we got back to camp, where there was a fire and a picnic. They wanted to go again but I stayed at the camp and had a nap in the sunshine on the beach - somewhere along the way, it got super nice and sunny outside! I was there watching some kayakers and snoozing for a couple of hours until the group got back and said the water was way better now that the sun was out, and I should go for the third and last run. I agreed and got all of my gear back on, and down we went again! It was so much fun when I wasn't freaking about the water temperature! Our two raft crews were feeling pretty goofy and we had a guy on each raft stick his head out the front and bashed them together. They then went face first into the rapids. It was really fun and a great way to end the trip.

All in all, I can't believe that only cost me $50 because it was a fantastic escape from the city and cheap-cheap-cheap.

Anyway, I have midterms coming up in a week and I'm pretty much just going to study hardcore for the rest of the week.

AND, I thought I was all ready for class today because I stayed up last night, after getting home, in order to finish a paper for English (yes, that English). Picture my expression when I discovered that I missed one of the five online reading exams for my Discipline of Nursing class!! It had closed at 0700 this morning. I am so ashamed - that is 2% off of my final grade. Believe me, that's not a mistake I will make twice.

Forgotten test notwithstanding, I hope your weekend was as good as mine!
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