Up here in the Northern Wastelands, we celebrated Turkey Day by eating steak and ham.

In keeping with post-secondary tradition, this holiday has been spent hunched over a pile of books trying to come up with a term paper for my N370 class.

The topics were assigned, and fairly uninteresting to me. So far, I have it narrowed down to 2 topics, which are very similar but *slightly* different:

A) According to King’s theory of Goal Attainment, the nurse and the client interact purposefully to set mutually agreed upon goals (King, 1992). Discuss pertinent barriers and potential strengths to mutual goal setting when a patient/family is coping with an acute alteration in health (of your choosing) and develop appropriate therapeutic nursing measures. Your paper should provide specific examples of nursing care to support your discussion as well as demonstrate a clear understanding of King’s concept of mutual goal setting.

B) Present an argument supporting two (2) strengths and two (2) limitations of the registered nurse utilizing King’s theory of Goal Attainment to guide nursing care in the acute care setting. Support your argument utilizing specific examples of patient/family experiences and nursing care/interventions related to a specific acute health alteration (of your choice).

The health alteration I am choosing is Acute Renal Failure, more recently known as Acute Kidney Injury. Even though there isn't a whole lot of nursing-specific information on it (compared to, say, burns), I have some interest in the topic for a couple of reasons. My g-ma has Type 1 DM and has recently been diagnosed with <30% renal function. Even though hers is more of a chronic renal failure, I need to do an acute illness and I figure there will probably be some similarities that I can draw on for those (ever more frequent) times that my family presses me for medical information. My second reason is that ARF/AKI is seen in about 30% of CCU patients and it has a 50% mortality. If my interest in CCRN continues, it will be a good knowledge resource in the future.

Imogene King was a pretty interesting lady. Never married, she spent her nursing career developing her conceptual theories and she defended them pretty much until she died in 2007. I think.

I'm still not sure what the practical point IS for a nursing theory. It still really, really seems like these Nursing Theorists took some common sense, put it into words, slapped a label on it, and called it a theory. And then it was passed through the ages in nursing school for snurses to cry themselves to sleep over. And then they graduated and made a theory so that they, too, could live on in academia.

Maybe I'm just missing the point. Is there anyone out there who has experience applying models to practice?

Last Friday we had labs again. Yup, still terrified for my eventual L&D rotation. N370 lab was fun, as usual. We were reconstituting meds and piggybacking them onto IV.

My battles with the Alaris pump rage on. I'm sure it's the easiest technology in the world once you get it. I still don't get it, and I blame that on the ABSOLUTELY USELESS simulation that we learned on, and the fact that we 'learned' it in 2008. Before I knew anything about meds or infusions.

So we were learning how to reconstitute powder medications. My lab buddy and I got a handle on that right away. There is a label *ON THE BOTTLE* that says if you add [this much] saline, then you will end up with [this] concentration. Pretty straightforward, no?

Then my lab instructor threw the whole class, save one dyad, for a loop. If you have [this] concentration, how much do you need to draw up to get [dosage in question]?

I.e. if I add 5.6 mL of NS to the bottle, the label tells me that will get me a total of 6 mL at a concentration of 500 mg/mL. How many mL must I draw up to get 2g of the drug?

Derp, 4 mL?

My ENTIRE CLASS was stumped. No really, *stumped*. Then we spent the entire lab going over this (zomg straightforward) concept over and over. I can only facepalm.

Sometimes I wonder if I'm smart enough to be a CCRN. Other times, like this, I feel surprisingly optimistic. ;)

Have a great week all!