Tuesday, April 1, 2008

Tune In, Turn On, Clean Out Your Backpack

Remember time capsules? If you don't, I'll tell you it's part of some of the 60's stupidity that people thought would turn out to be the wave of the future, along with communal living and EST. But if you read the Wikipedia entry, there is mention of unintentional time capsules, and it turns out that I have one here in front of me.

Yesterday was my absolute last hospital clinical. I will celebrate this event by dismantling my clinical bag. Join me as I open this capsule and take a peek into 18 very interesting and stressful months of my life.

I remember putting it together thinking ever so carefully about what I might need when I would start hospital clinicals. I remember asking for advice at allnurses.com about what the well-prepared student should include in her pack. Now as I pull it out in reverse I'm laughing at what seemed like a good idea at the time, and nodding with self-knowing at what was really useful.

*RN Notes. Not useful at the time, but very useful as a review for HESI.
*Drug book. If I had it to do over I'd use a Palm Pilot or Blackberry.
*Basic Skills and Procedure Manual that I bought this last semester. I wish I had it first semester because now I don't need it.
* A clinical binder. Somewhat useful. It has folders and pockets for keeping stuff organized.
* Stuff in the folders and pockets in the clinical binder.
-A table of IV compatible drugs. Never used.
-A list of NANDA approved nursing diagnoses. Glanced over once or twice.
-An EKG rhythm strip to practice identifying rhythms. Still can't identify it.
-Pulseless VTACH algorithm. Very useful when I was getting ready for ACLS. Now that I'm certified, who cares?
-A colorful chart of most commonly abused pharmaceutical substances. Never used but might come in handy if I don't pass HESI and need to find some street drugs of my own.
-A Powerpoint presentation given by one of my classmates on Marfan syndrome. Was I even there that day? I don't even remember this.
-Some hastily scribbled post-conference notes. Might come in handy if I could just read my own writing.
-A thick sheaf of looseleaf notebook paper that I thought would be more useful than a wire-bound notebook. What the hell am I going to do with all this looseleaf notebook paper?
-An ominous list of instructions for a community clinical from first semester. Oooo, have your clinical care form with you OR ELSE!!!
-A checklist for my instructor to use when I was checked off for Foley catheter insertion........first semester? Wow. Did I get checked off or not? Will the board of nursing find out?
-A Wong faces pain scale. Lest I ever forget how to use it or I can't remember that 1 is no pain and 10 is the worst.
-Step-by-step instructions for various procedures that if you held a gun to my head I couldn't do correctly and neither could anyone I spent any time in clinicals with.
-Ten photocopied patient care worksheets that I created for when I took care of more than one patient at a time. Those actually came in pretty darn handy. I'll keep those in case I ever work in a hospital again.

This is fun. What else is in here?

A cosmetic bag with two compartments that contain.....
*A penlight. Used, oh, five or six times. Pupils never moved on anyone I ever looked at.
*Bandage scissors. Very useful.
*Pens, pencils, erasers, a small rule, write-on page tabs. All very useful.
*Ear plugs. Very useful for studying in noisy libraries. Before you were born libraries used to be quiet places where people could read in peace, and someone would come from behind the counter and shush you if you didn't whisper. I swear I'm not making it up.
*Batteries for MP3 player. First year I recorded all our lectures. I think I listened to one or two of them. This year I didn't bother.
*Breath mints, travel-sized deodorant, anti-gas tablets - all stuff that shows I care enough about my classmates to not subject them to my BO, bad breath or noxious emissions. Trust me. You get so busy in nursing school that sometimes you forget to put on deodorant before leaving the house.
*Feminine hygiene products because menopause did not visit me this year as I had hoped.
*A stick of Carmex lip balm and a travel-sized bottle of hand lotion. Probably the most-used items in the bag.
*A beaded badge holder necklace that I made myself to match our school uniform. It was completely the wrong length so as when I was putting a Foley in a patient, the ID badge got caught in the bedrail and snapped off. But hey, the necklace didn't break! That's the important thing.
*Band-aids and alcohol prep packs that I probably emptied out of my pockets during post-conference.
*Hemostats. Never used. Now, if I just knew a pothead that could use them.
*Change. Hey! I could buy a candy bar for the pothead!

Also in the bag I find.......
*One blood pressure cuff. Bought that for an assignment the second week of school where I had to interview an elderly person and take their vital signs. I never used it again.
*Candy wrappers. Those aren't mine. I swear!
*Trauma shears. These were part of a lab pack that we used first year and I took them out and put them in my bag when I lost my first pair of bandage scissors. When I overhead some nurses laughing at my trauma shears behind my back, I went out and bought some new bandage scissors and threw those shears to the bottom of the bag.
*A small plastic retractable tape measure. I can't remember what I thought I would use this for. Never used.
*A stethoscope. Oh, I remember the first time we had lab and me and my classmates marching proudly into class with our stethoscopes around our necks, looking all nursey and legit. I remember how the stethoscope was an outward symbol of all the hard work and sacrifice that went into getting ready for nursing school. Yes, it's a powerful symbol and probably the second most-used item in my bag.

*A small spiral-bound notebook to write notes about my patients. Let's see what I have in here. Hmmmm.
-Clinical instructors' cell-phone numbers. I'll keep that for future drunk dialing. Just kidding!! I don't even drink.
-Door codes to the patient nutrition room. Might come in handy. Next time I'm in the hospital visiting a friend I can raid their snack drawer and help myself to coffee.
-Some vital signs. Some lab results.
-Phone numbers for people who might be able to put in a word for me in case I want to work on a certain unit. Naaah.
-A tiny drawing explaining osmosis. Not bad!
-Pick up gift for Tara's baby shower. Shit! That was last year! The kid's probably driving now.

Sure was fun exploring my nursing school time capsule. To summarize, the most useful things to pack in your nursing bag is anything that keeps you odor free, your skin soft and prevents chapped lips. Next is your stethoscope and a little notebook to write cryptic notes that you will laugh at later.

Thank you for attending this time capsule ceremony with me. Refreshments will be served in the back. One slice of cake per customer, please.


Kathi said...

wheeeee!! I know what that rhythm is!!! It was one of my favorites to say. It is a mobitz type II (second degree block) aka the wenckecbach block (winkie back block). The easiest way to decide if it is a I or II is...is there a progressively longer PRI before the dropped ventricular beat or does the beat just drop.

ooooo sorry. I loved cardiac rhythms....so I tend to go on and on. Mazel Tov on the time capsule ending :)

License Pending said...

Oh yeah, THAT one is Wenckebach. The one in my clinical folder is not. I think it's a third degree AV block or something. For some reason Wenckebach is the easiest for me to recognize. Hell, normal sinus rhythm even escapes me from time to time. Oh, and I can spot atrial fibrillation too. That's about it though.

I marvel at people like you who have a cardiac rhythm mojo. Lots of my classmates are awesome at it and they are so passionate about it. I keep hoping it will click with me one of these days.

Kathi said...

scan the one (or take a picture of it) and let me see it. let's see how rusty I am after 7 plus years of not reading a monitor. 3rd degrees are pretty easy to figure out....the atrial beat and the ventricular beat work at their own speeds and are not correlated at all. Easiest way to figure that out is using calipers, measure the p to p width and then measure the qrs to qrs. if they are different width then it is a third degree....man I just confused myself ROFL.