Some of you Twitterians may recall that I ordered a Littmann Master Cardiology stethoscope from stethoscopes.com a few weeks ago. I had it shipped to my aunt in the States so that I could sidestep the $100USD shipping fee. I totally call bullshit on that cost. I had purchased a guitar on eBay and it was shipped to me from Texas for about $40USD. Then, unfortunately, after I placed my order, I started reading all of these bad reviews online about the store, particularly how the guy who owns stethoscopes.com also owns magnafortis.com and those are just crappy scopes, and there were a ton of unsatisfied customers. My distrust was heightened when I called to inquire WTF was going on with my order and I could hear the guy huffing and puffing for 10 minutes while he looked high and low for it. THEN he told me that my engraving would not fit well on the Littmann scope but - surprise! - would look amazing on a Magna Fortis and he would be happy to upgrade me for free. Lucky for me, I had already read some pretty sketchtastic reviews on the Magna Fortis and was in a good position to say Hellllll No, give me my Littmann. So he gave in really fast (he must get that response a lot) and said he'd ship it out. True to his word my aunt received it today and hopefully it will be in my hot little hands by Friday of next week because we are starting vitals (I think). 

So there you have it - I'm pretty sure I got what I wanted from him but I'm not impressed with the whole process and all of those bad reviews can't be imaginary.

So! Where did I leave off? Ah yes, clinicals of last week. It was, hands down, the best clinical I've been to so far. We showed up for morning report at 0700, which means my clinical buddy had to be at my place for 0600. It was a crazy early morning. I'm definitely an evening girl. Not good! So we arrive just in time for report and there was a ton of us all crammed into that teeny break room getting report. I'd never heard it before so I didn't know what to expect. I guess I thought that all the nurses would take turns explaining their pts but it was just the charge nurse rattling off about all of them. I think there were about 20 pts on the unit so it took a while to go through. I probably should have been taking notes on all of the pts but it's still so early in my education that I don't understand around 90% of what I hear. Most of what I do understand is what I've picked up from reading blogs! Boy, wasn't I hot stuff when I was interpreting charting slang for my clinical buddies. ETOH, SOB, Ox3, OT/PT, etc. - woo hoo!

So I got to shadow a nurse for 4 hours which was so great. I can't believe how far I've come since my first day. You may recall how I was hyperventilating over a patient asking - gasp - me for help. Or how terrified I was about going into patients' rooms and trying to get them to talk about their lives. Last Monday, man, I was charging into pt rooms like I meant business. I was looking at their charts in the rooms (okay, just the non-responsive patients) and getting stuff DONE! Oh, it was a glorious feeling. So I paired up with my (preceptor?) nurse and got ready to sponge-soak it all in.

The skills that I have to this point:

• Hand hygiene! Hand hygiene at every opportunity! No nosocomial infections on my watch!
• Taking health histories
• Giving hand massages!
• Repositioning and possibly ambulating but I haven't actually done that yet
• Making beds (woo hospital corners!)

These are the only skills that I'm allowed to engage in on the unit and by God I am going to do all 5 of them TO PERFECTION.

Or so I intended.

Our patients for the day were 1 independent man in for knee surgery, 1 nonverbal stroke patient in restraints (probably d/t confusion), 1 MRSA isolation, and 1 DNR middle-aged person dying a horrible (in my opinion - sorry if it's not PC enough for you) COPD death.

First order of business was to take vitals which is not something I know how to do but I watched with interest. Most of the pts we used a machine with a pulse/ox finger clip and a BP cuff. We also took temperatures with a thin disposable color-changing strip. The MRSA iso we took BP manually with the most ancient sphygmomanometer that I've ever seen. This was, fo-real, mm Hg. The dying person had a heart rate of 140 BPM. It was crazy seeing someone breathing so slowly have a heart racing like that - although I guess that makes sense. It was just so sad. He was like a little shriveled skeleton in the bed and his belly button practically touched his spine. He was gasping with every breath. It gave me chills and I am still just so honored to be in the room with him during his final days so I have to thank his family for not batting an eye when I introduced myself as UgRN, SN.

Okay, my bus is coming so I will continue this in a bit. I'll post it now, though, so look for part 2 later tonight or tomorrow morning.