I really have to apologize for the dearth of posts lately. I've got no good excuse except for the usual premium on spare time that comes with nursing school. So that aside...

A Summary: I really want to talk about my experience as a UNE (student nurse extern) in the ER over the summer. I freaking LOVED it. On speaking with some of my classmates, it seems that I got pretty lucky in my placement, because my particular ER is small and ultra-inclusive - there simply wasn't enough help to go around, so I was always considered part of the team, and like an extra set of hands. Turns out some other people placed on Med-Surg/postpartum were viewed as subpar RN stand-ins. As student nurses we are mandated to take a smaller patient load and lower acuity than staff nurses - which makes sense. Yet some of the staff nurses took the perspective that the UNE had it easier and so made their jobs harder, where other nurses saw us as a bonus to the existing staff and as lightening the load by taking a patient away from each of the other nurses.

So I am even more grateful that I had such a positive experience this past summer. I was on the unit from May through the beginning of September. My scope was pretty big. There were a few things I couldn't do at all or without RN supervision, and some of my meds needed to be cosigned, but I worked really hard and helped out a lot. I almost never sat down except for a quick charting session. It got to the point where I was starting to anticipate the flow of the ER and what might be done for certain patient presentations. I asked questions and clarified interventions. I saw several urgent presentations and maybe even a couple of emergencies, although I still haven't witnessed a code or done CPR on a human. I made real differences to several patients. I learned how to work as a team, contribute, and COMMUNICATE. I made more money on shift differentials then I ever expected (woo night shift!!) - but, most importantly to me, I gained so much experience in the nursing role and, like, quintupled my comfort level with all the psychomotor skills that made me so nervous in lab. I saw so much this summer.

Some of my coworkers were more difficult than others to really learn from. One in particular struck me as an exceptionally competent nurse, very confident and knowledgeable, but she was like a prickly pear to talk to. I guess like your typical Type A ER nurse (for the record, I'm pretty much a Type B introvert, and I still enjoyed the ER, so don't let anyone tell you otherwise). I got a lot out of shutting up and watching her, but forget asking her any questions, she didn't have time for students. Or so it seemed. And there was the charge nurse who wasn't the best teacher. But the overwhelming majority of my RN/LPN coworkers were super kind and patient with me. They all made such an amazing difference in my practice and I told them so!

Would I recommend Alberta nursing students be a UNE during the summer after 2nd and 3rd year? Unequivocally YES. It's like nursing school on speed. You'll start making sense of the theory in ways you didn't expect. You'll gain the psychomotor skills to actually do lab skills on real patients without your instructor hovering over your shoulder, and while you do those skills you'll start to work patient teaching into your practice. Then in 4th year you'll have real-world examples to back your shit up when you write papers. Or blogs.

A Conference: I was the fortunate recipient of a travel bursary to the CANO annual conference in Halifax, NS. There was supposed to be another student who went, but I never met her.

In a nutshell, Oncology Nurses are seriously knowledgeable. They are also awesome because, from what I experienced at this conference, they are valued as collaborative and worthy team members even by physicians (kind of a hard status to come by, it seems) and are extremely supportive of complementary/alternative medicine (CAM), not so much because of the evidence surrounding CAM but because patients want it and find relief from it, and they need their primary providers to be open and knowledgeable about it too.

The conference was 4 straight days of learning. Corporations sponsored almost all of our meals, and during each meal there was a presentation on some new wonder drug or different approaches to patient care. There were also a multitude of workshops to attend, where nurse researchers would present their latest abstracts and findings.

I had a lot of difficulty integrating myself into the conference because, as specialists, the presentations were operating at a pretty high level of comprehension. The conference attendees were almost all advanced practice nurses - NPs, CNSes, and tons of nurses in research and academia. They would debate different chemotherapy drugs and weigh the pros and cons, and things like that, which was kind of meaningless to me as a student. There was some stuff I did learn a lot about, such as a yummy dinner symposium at which we learned about treating clogged CVADs. I don't remember learning much at all about CVADs in class. The dinner was beef and chicken. The beef was served medium-rare, and pretty pink/fleshy in the middle. It was at that moment the presenter posted some photo examples of blood clots extracted from CVADs. They looked eerily similar to my beef dinner. At which I thought, "Only nurses would be totally cool with watching this as we eat..." mmmmm :)

Another challenge I found was the huge jump, not only in experience, but in age between myself and the other attendees. Being as they were almost all out of bedside nursing (and with the commensurate experience), I'd peg most of them as 40+. Not that there's anything wrong with being 40+. It just didn't give me much to talk about with them. So most of the time I would sit down with a new group of people at a table, introductions would be made, and they would ask me where I worked.... when I would say "Oh, I'm a student".... and the conversation would awkwardly shut down or divert amongst the RNs. It made for kind of a lonely time at the conference although I did meet and network with lots of people. I even met the lady who does the clinical placements for our local Cancer Care centre, where I am hoping to get a placement for my preceptorship.

The CANO BoD contacted me after the conference and wanted to get my perspective as a student attendee. I think I will recommend that they try to designate a "Conference Guide" for future conferences, who can assist the students to really understand the presentations and kind of bring it all together. I think I would have benefited from some kind of debriefing.

On a totally positive note, several of the nurses I sat with were really pleased and happy to help me understand the presentations. I could see that a lot of them were probably involved in teaching. So that was really kind and super helpful. I got a ton of notes from all the presentations, so I might be able to review them once I am practicing and maybe they'll make more sense. :)

A Project: Through my work with CNSA as Informatics Officer, I have been working with CASN and CNA on developing informatics competencies to add to curricula for undergraduate nursing education. I think it's cool that I'm working alongside some heavy hitters in academic and professional spheres on a project that will impact the future of nursing education in Canada. At our teleconference in August, we needed to elect a chairperson for our committee, and some of them suggested that it would be a good experience for me. I think so too, but I really don't know what I'm doing as a chairperson. I told them that if they were patient with me I'd be happy to take on the role. Part of this means I will be presenting our findings to a stakeholders' symposium in Toronto at the end of November. At our last teleconference I discovered who would be considered a stakeholder. I'm super pumped/terrified to meet these people, but wow, what an opportunity.

An iPad: It's no secret here or anywhere else that I have a special fondness in my heart for Apple products. I was one of the original hires to help open the first Apple store in Western Canada (which was a pretty fun day! :). The love is waning a little bit with Apple's continued pricing structure, surging popularity, and militant control of how I enjoy my products, but, on the whole, I still can't beat the user-friendliness of iOS/OSX. Can't argue with the fact that after I convinced 4 of the family members who called me all the time with computer issues, I don't really have to troubleshoot anyone's crap anymore, because it doesn't need troubleshooting.

So when I saw the reading list for this semester, and noticed how much of it was PDF academic articles, I winced and wished there was some way I could read these in a more comfortable manner. I really try to avoid printing anything because I am cheap and scatterbrained. I also hate reading articles on my laptop because of i) the searing pain in my lap once my computer's been on for >20 minutes, and ii) I am way too easily distracted by Spaces.

So I started checking out some different kinds of tablets. Initially I was intrigued by Samsung's Galaxy 10.1 since I might be converted to Android. I certainly am willing. Anyway, after lots of research and playing with tablets at Best Buy, I decided the extra $50 or whatever was worth the negligible decrease in performance/portability/resolution in exchange for an exploding App Store and seamless integration with my existing tech setup.

Anyway, I bought the iPad last Saturday on an extreme trial basis. I had very specific criteria in order for any tablet to be superior to my laptop. I was/am ready to return it if it didn't work for me:

1) It had to be incredibly easy to integrate with my cloud server on Dropbox
2) Accessing and editing documents on Dropbox had to be seamless
3) Accessing and editing PDF articles and class notes had to be comfortable and realistic (nothing too complicated)
4) Google Calendar had to play nice with iCal or an acceptable equivalent
5) There had to be apps out there to make it superior to my browser-based existence
6) OSK is just not realistic for me, so I wanted a great/portable Bluetooth keyboard

Today is day 5, and honestly, I don't know how I got by without it. I LOVE curling up in bed, locking out the rotation, and reading/annotating my PDF articles or even just web browsing or watching Netflix. I am beyond impressed with how most software seem to integrate with Dropbox or other cloud servers.

Right now I have been using Goodreader to read/annotate PDFs, Quickoffice Pro HD to view/edit my Word/Excel docs, and iProcrastinate to manage my workload. Unfortunately iProcrastinate only has an iPhone app at this time, but it syncs up with my Macbook so it's all good. So nice to be able to see what's coming up next between all my classes.

Tomorrow I will try AudioNote especially in my Philosophy class. The prof is very much a talker, and doesn't tend to summarize her points in any logical fashion, so I think recording her lectures and having them timestamped to the notes would be a great thing. We'll see how it goes.

I have been finding a lot of apps that might be suitable to nurse-types, so I was thinking I might do a review of these in the future so you can get a feel for it without shelling out money.

As far as the keyboard setup, I was heavily swayed by NNR's review of ZAGG's keyboard. I checked out Future Shop and found one open box, missing the USB cable. Since I have a few of those anyway, I sashayed up to the sales guy and asked him to "make me a deal" on it complete with flirtatious lashes. He knocked off another $20(!) for me, dropping the price from $100 to $75. Excellent. I love the keyboard, too, although it's good that I don't have man hands, because the keyboard's certainly petite. Together with the iPad, it still weighs roughly 2/3 less than my Macbook, not including the charging cable, and it definitely takes up much less valuable space in my bike pannier.

So altogether, between the cellular data, the apps, the cloud integration, and the ZAGG keyboard, I am quite pleased with my setup. Bonus points for form factor, weight, battery life, and lack of hard disk drive. I will continue evaluating right until Saturday of next week which is the end of the allowable return period.

Anyway, I have been blogging away from yet another new app - Blogsy. I really like it. Even better than I like Blogger's old back end. I used it to write this blog post - I am hoping that the improved mobility will make it easier for me to blog when I have the desire instead of waiting for when I have time at home with my computer.

I guess that about covers everything. For now. :)

0612 Begin head to toe assessment: listen to lungs, heart, bowels, check pulses—radial and pedal. If pt alert, ask if they have pain, how they slept, follow-up with concerns. If ventilated and sedated, make note of ventilator settings, suction the patient if needed, tidy up the room (!!), check pupils. Zero any alines, cvp’s, ScVO2 monitors, check alarms on monitor, adjust to personal setting. Check room, make sure ambu bag, enough flushes in the drawers/make sure room is stocked for a code! 

0620 if patient or family does not need anything, such as blanket, ice, bed pan, water, etc. then begin   to chart assessment on flow sheet (approx 3 pages). Go through chart and if not already done, update special treatment pages, education, graphics for IV access, treatment/plan of care, remove 234234 extra papers that do not belong in the nurse’s chart, reprint patient id stickers.

0630 Onto patient #2… chart 0600 vital signs, including: blood pressure, HR, Rhythm, sats and O2 %, temperature, RASS scale, dump urine for the hour and note milliliters.

0632 Begin head to toe assessment: listen to lungs, heart, bowels, check pulses—radial and pedal. If pt alert, ask if they have pain, how they slept, follow-up with concerns. If ventilated and sedated, make note of ventilator settings, suction the patient if needed, tidy up the room (!!), check pupils. Zero any alines, cvp’s, ScVO2 monitors, check alarms on monitor, adjust to personal setting. Check room, make sure ambu bag, enough flushes in the drawers/make sure room is stocked for a code!

I am a 25 year old woman who has never given birth.

My intention with this project was to better understand my cycle and the changes in my cervix throughout the month. As a doula and student midwife, I used this project to help me see how a cervix might look different throughout the cycle in the absence of vaginal infections and to understand speculum exams. You may notice on the right side of some photos, some jagged looking skin, which is the remnants of my hy me nal r ing. [UgRN in: I've broken up this phrase to hopefully help slow/stop the amount of creepy traffic I get from it]   My os (opening to the cervix) is round because I have never given birth; the os becomes more of a slit after childbirth.

Each photo was taken at approx 10:00 pm every day starting the first day of my menstrual cycle. I re-used a plastic speculum and macro function of normal digital camera (and a very talented boyfriend with a headlamp). For the duration of this project, we used condoms as our birth control method so as not to introduce semenal fluid into the photoshoot. I did not use tampons or mooncups during my bleeding time either.