It’s all over

School has finally ended!!

Amy and I were driving to the college to confirm my school year income for the student loan lady today when she commented that I had “purplish bags under my eyes”… I blame school- as it’s been probably the busiest couple of weeks I have experienced to date. I wrote five exams this semester and they seemed exponentially more difficult than the last time around. It seemed that many of the questions had a “pick the most correct” answer feel to them which is more challenging when trying to cover a ton of content. With that said, I think the exams went fairly well and I will be taking another swing at things next year in my fifth semester of this stuff. Amy and I are putting the final touches on the marriage plans… hard to believe that it’s only 22 days away. I’m pretty excited! We also went down to IKEA during exam time to purchase a whole bunch of furniture. We got an EKTORP couch, TV bench, side tables, and a kitchen table for our new apartment. I move in on the first of May; Amy moves in 17 days later. It will be nice to have a place of my own as I have been living at a flop house with a bunch of my church buddies… I’ll miss the guys as much as Amy will miss her family… Anyways, onwards and upwards I always say; I am definitely feeling quite blessed right now and plan to get caught up on some needed rest. In the pandemonium of exam time my domain expired, so I’ll be working sometime on that project- but I think I’ll take some time off from nursing web stuff to enjoy my wedding first. I also will be starting a new job at the end of this month as a PCA (basically as nurses’ aide) in a local acute care hospital. I am excited about this because it’s on a medical/surgical floor that I already had a rotation on—so it shouldn’t be too unfamiliar! Pay is pretty good too!

Thought I’d give you all an update, and I plan to do some critical care modules/learning I’ve found around the internet… I’ll post some if it’s worth taking a look at.

The cost of risky behaviour

Today I debated that people who engage in risky behaviour should pay more for health care. Here in Canada we pride ourselves on equal access to quality health care regardless of socioeconomic status so you can imagine the uproar we caused when my debate group proposed that people who smoke, drink, or engage in illegal drug use should pay more for their health care. Okay, before you jump down my throat about being “judgemental” about other peoples behaviour, I should tell you that this was an assigned topic. But here are some points of interest. Are you fellow Ontarians aware that only 57% of you are paying more for health care already? Yup, we discovered that with the Ontario Health Premium the 57% of Ontarians who make more than $20,000 a year have to pay up to $900 a year extra for health care. We thought this sounded a little unfair- especially because we pride ourselves on a system of equality and fairness. Maybe its fair that the more affluent in society take care of those who are less privileged… just a thought   

On a side note…. we also discovered that in 2002 the Canadian tax payer shouldered the burden of approximately $39.8 billion for health costs related to substance abuse (tobacco, alcohol and illegal drugs mind you) Food for thought eh!

 Anyways.. here’s a link to that last study I mentioned…..

My busy life

So, it’s been quite some time since I’ve written something here… so I thought I’d give you all a little update. The last two months of school have proved to be the busiest I’ve encountered in my post secondary education thus far; we have had a number of papers, clinical assignments and tests to complete, it seemed like it wouldn’t end for a while there… and it still hasn’t! Anyways, school is going well! I am now finished in orthopaedics, and I am on a Medical floor. Can’t say that I enjoy medicine though, a lot of people are quite sick and a turn can be subtle. I am told that many new grads tend to get jobs in medicine because no one wants to work there… is this true? I wonder how more experienced nurses feel about this.

The wedding plans are well under way and I am moving into our new apartment on May 1st. Should be fun, Amy and I have some furniture shopping to do. ISo much has happened in the last few months. I promise to start writing here more when I get a chance; only 1 month left of school.

Cheerio.

I don’t need to “live my classes”

After a little hiatus, I am back blogging about my experiences in nursing school. The last week and a half have been absolutely crazy! Last week my Dad experienced a heart attack. For those of you in the Nursing/Health profession, the more accurate term is Acute Myocardial infarction. He had been experiencing angina for a few days, but was not alarmed because he had felt this pain before. Of course, I was really worried about him and urged him quite insistently to go to the hospital (I tend to be a little bit of an alarmist because of school right now- a good thing this time!!!). As it turned out, Dads pain was getting progressively worse and was actually changing from stable to unstable angina. Apparently, and unknown to me, he had been experiencing some stable angina for some time and attributed this new bought of pain to problems with his CPAP machine. When the pain was finally too much to bear, he decided to go to the hospital- and just in time because he was actually experiencing the infarction when he arrived. The medical team put him on a thrombolytic TNK- which, from my understanding, breaks up the clot to restore coronary blood flow to the myocardium. It was amazing, after the administration of TNK he felt loads better and was resting comfortably for the next day or so. The doctors decided to do an angiogram to locate the occlusion and then performed angioplasty to open the occlusion and stabilize the artery with a stent. I live 2 ½ hours out of town so by the time I got down to see him the procedure was done and he was resting with a 10pound weight on his groin to prevent bleeding at the femoral artery access site. Dad has since gone home and is feeling good- he even seems to have more colour in his face! It has been a scary couple of days! To top it all off- we are studying the pathophysiology of cardiac problems and MI at school. One of my teachers told me to stop “living out the lessons”. I agreed!

Everyone should know this- and please don’t diagnose yourself or shrug it off based on this information- SEEK PROFESSIONAL MEDICAL HELP IMMEDIATELY!

Patient Presentation of Acute MI (Emedicine.com) READ THIS IT’S A GREAT READ FOR MEDICAL/NURSING STUDENTS.

There are two types of Angina:

Stable: Chest pain with a typical pattern- often induced by overexertion and alleviated by rest.

Unstable: Chest pain that is unexpected- resting or taking nitoglycerin may not help. This is characterized by pain getting worse, lasting longer, happening more often or occurring at rest.

Signs and Symptoms:

Most common = severe chest pain

Many people describe the pain as: discomfort, pressure, squeezing or heaviness in the chest; also look for the patient making a fist to their chest to describe the pain. Pain may often present as a spreading down the left shoulder and arm or other areas such as the back, jaw, neck or right arm.

People often experience these symptoms as well:

• Pain in the upper belly- often thought to be just heartburn
• Sweating
• Nausea and vomiting
• Trouble breathing or Shortness of breath
• A feeling that the heart is racing or pounding (palpitations
• Feeling weak or very tired
• Feeling dizzy or fainting

All of this information is taken from WEBMD and I encourage you to read the full article- which is far more in-depth.

Go to the WEBMD Article for full information.

Experiences in the Operating Room

The other day I had the opportunity to observe a number of surgeries in the operating room. It was quite the experience. The morning started off a little bit tumultuous because the lady at the front desk was expecting students from another program that day. After showing my identification, assignment and dropping my clinical teachers name she realized the mistake. She handed me a swipe card for OR scrubs (we have to do this because people were going home with OR greens too often). The card didn’t work, so the lady sent me down to another part of the hospital to retrieve a pair from the uniform department. After a short adventure trying to find this place, I ventured back to the operating unit to get changed. By this time I was late and the preconference had already taken place. I walked out into the unit and was overwhelmed by the people buzzing around everywhere. I approached someone and told them I didn’t know where I was supposed to be, but explained that I was a student observing for the day. The person quickly found the clinical instructor who was expecting me and we rushed to the operating theatre while I was trying to throw a mask and cap on. I walked into the room, all the nurses where busy organizing the room and various instruments for the procedure. The surgeon sat in the corner relaxing. He was scrolling through his IPOD to find the right music. He would be performing a WHIPPLE procedure which I have heard can take up to 10 hours to complete.

A WHIPPLE procedure (pancreaticoduodenectomy) is quite an extensive surgery from what I understand. It involves the removal of a portion of the pancreas, part of the duodenum and stomach. Surgeons will often take out the gallbladder at this time too because it is convenient. I believe this surgery was being performed as a palliative measure for cancer. I also discovered that they don’t perform this procedure very often, so you can imagine all the eager medical students trying to get a peak. From my point of view (the surgeons back) I couldn’t see very much. The medical students couldn’t really see much either because the attending surgeon and his two residents were huddled quite closely over the patient for this procedure. We relied mainly on the overhead monitors to get a closer look. What struck me most was how they prepare a patient for extensive surgery. A resident performed an epidural and the upper year medical student put in his 5^th IV. They also inserted a central line (for the quick administration of fluids) and an arterial line for monitoring blood pressure etc. After the patient was asleep the doctor let the medical student intubate- which he also did flawlessly. Apparently, on the admission of the med-student, intubation is actually easier on a live person compared to the dummies they practice on. I couldn’t help but think about how scary this must have been for the patient. The nurses were great; as the doctors and med-students were performing all of these tasks (quite well I might add) the nurse was explaining and reassuring the patient about what was going on. The patient was very brave.

I learned a great deal about the nursing roles in the operating room from this experience. There were two roles in this operating environment, scrub nurse and circulating nurse. The scrub nurse was responsible for working within the sterile field. The scrub nurse also organizes, anticipates and provides the tools necessary for the surgeon to complete the procedure. The two other nurses in the room were circulating nurses. These two were responsible for retrieving supplies outside of the sterile field. These nurses also anticipate the needs of the scrub nurse and monitor/record counts. This is an important task because you wouldn’t want to forget a sponge in someone.

This experience was definitely a highlight of my clinical time so far… I can’t wait to do it again someday.

The ethics of blogging patient interactions

It’s no secret that nursing blogs and the detailing of patient conditions and clinical experiences are on the rise. A quick Google of “nursing blog” returns a plethora of sites where nurses are eager to share crazy patient scenarios, stories of annoying or ignorant interns, and a myriad of personal gripes pertaining to the understaffed, overstressed environment in which we all work. And let’s face it, for the most part we like to read and wallow in the negative experiences of our colleagues citing “coping and venting” reasons as an excuse for eagerly consuming all this crap. Don’t get me wrong, I love reading about clinical experiences and I believe blogs are the best way we can learn from each other.

So this brings me to a recent thought. We all know that it is our duty to uphold confidentiality and the right to privacy for our patients. Does blogging about experiences violate this basic human right? I’d like to hear some of your thoughts.

In the mean time, here is what the Canadian Nurses Association has to say about Confidentiality.

Nurses safeguard information learned in the context of a professional relationship and ensure it is shared outside the health care team only with a person’s informed consent, or as may be legally required, or where the failure to disclose would cause significant harm.

Nurses must protect the confidentiality of all information gained in the context of the professional relationship, and practice within relevant laws governing privacy and confidentiality of personal health information.

A link to the document on the Canadian Nurses Association website can be found here.

A more complete review of the SAMSUNG SCH-r610

So it’s been a few days since I posted the first review of my new phone. After a week of use, I thought it might be helpful to post a little more information as I become more familiar with it. To be honest I am getting more traffic relating to this article than any other topic posted so far. I guess the “newness” of this phone is generating interest. Anyways, let me give you a more complete run down and then we’ll leave this subject alone for a while.

This phone, after a quick Google, is offered by Bell Mobility in Canada and Cricket in the states. I can only comment on the Canadian version which is offered through Bell.

Bell has released this phone with a new interface which is really quite cool. The new feature is called the Carousel. Along the bottom of the screen you will see a “joggable” carousel with all of the phones multimedia features within easy reach. This is a really aesthetically pleasing feature; however, many of the features are connected to the “web” functions on the mobile phone- so if you don’t have an unlimited data plan you could be raking up the charges. You will also notice a new feature called “bubbles”. These bubbles can be configured to display weather and news. As I mentioned before there is a very small number of Canadian cities to choose from for weather so I am hoping that they will add more soon. I had to settle with Toronto weather because it is the closest choice for me. With the news bubble you can select national, international, sports or entertainment news. The downside is that you can only choose one type of news at a time and it will only display one headline. If you click on the bubble for a more complete story beware…more browser charges will ensue.

This phone comes with a microSD slot so storing MP3’s should not be a problem. I do recommend getting a larger card though for serious music lovers. I believe the card included is only 64mb. You can download songs from Bell with their music service $$$ or you can transfer your own over with the included USB/charger cable. I choose the latter. Be forewarned, you can’t use MP3’s as ringtones and I think Bell frowns upon downloading free ones with your WAP- they may have even blocked the ability. With this phone you can easily transfer video and pictures back and forth. It was nice that they included a cable for this. You will also notice that the camera and flash are only visible when the phone is slid open. This is great because it protects the lens- however I did put my finger on the thing a few times which required a wipe to remove my greasy finger print. The flash helps, but it adds a ghostly blue hue to everything and is nothing really to write home about. It’s more like an under powered flashlight- which is all you really need- if you want a camera, you could buy a real camera.

The phone has a number of tools for daily use. You will find an Alarm clock (with the option for three different alarms- customizable for different days of the week), Calendar (with Scheduler, task list and countdown features), Calculator, Bluetooth, World clock, Memo pad and Voice memo.

The keypad is easily manipulated for text messaging- however I found it a little cumbersome with one hand because the working area is a little small.

To answer the phone you slide it open. When the phone is slid down the keys are locked. I think you can change this if you like to answer with multi-key. The ring tones are nothing special- infact I found the RAZR tones a little nicer. My fiancé commented that the ringers sounded a little high pitched. I don’t mind them.

So far I’ve been happy with this phone. The battery life is great-I left it unplugged for a day and a half and made a number of calls and only lost one bar of power.

Conclusion? I think if you buy this phone you’ll be happy. If you don’t have an internet plan I suggest one because you will be raking up the charges using all of the neat multimedia features. Did I mention you can watch TV, movies etc? I haven’t tried it though- too busy with school. I hope this made your decision a little easier.

Goodbye Motorola Razr, Hello SAMSUNG SCH-r610

The last few months with my Motorola Razr have been somewhat tumultuous. At the half way mark of my three year contract I was left with a cell phone exhibiting “Razr battery”. This syndrome manifests itself in a particularly ugly and unique way. After one call on a full charge, the phone begins to churp with a “low battery”. That’s right, after one call, regardless of length, I am left with a dead battery.

After a few months of struggle, I finally came to the conclusion that I needed to bite the bullet and get a new battery. After contacting my local Bell Mobility outlet I learned that new battery would set me back $89- I decided that I would get one off Ebay for a whopping 2 or 3 bucks. It was only two or three days later that I was attempting to learn how to “hockey stop” on ice skates for the first time. The result? A phone with a dead battery, broken screen and one graceful looking triple axel concluded with a belly flop onto the ice. I’m okay, really- the phone didn’t fare so well.

So, after all of this I decided to contact Bell to see if I had a hardware upgrade coming up. Thankfully I did, although it required me restarting my three year term. This was somewhat annoying; however I have been happy with my current plan. Anyways, I’d like to give a quick review of my new phone the SAMSUNG r610. It’s definitely a fashion phone, and because it’s new there is little out there in the form of review. Keep in mind that these are my opinions, and by no means am I an expert phone reviewer. I just want to highlight some of my experiences so far- in case you are looking to get one too.

Okay, so this phone has a number of cool features including:

1.3 Megapixel camera (picture and video with flash); Bluetooth; MP3/Video Player with expandable memory – MicroSD; Information bubbles on a customizable home screen (pictured); Data cable to charge and transfer files to the phone.

However, be warned that:

You cannot use your MP3’s as ringtones (Bell?); Mobile browser does not support YahooGO (again is this just Bell?);The bubbles are cool – but you can’t choose from a large list of Canadian cities for the weather (unless you live in a major city the weather bubble is useless) and can only have one type of news displaying.

This phone is pretty new, so I expect the support to increase. Sound quality is great- not noticeably different from my last phone; however I have been told that Samsung is better on batteries than Motorola- time will tell.

 

Orthopedics and Urology for me

We started our tour of orthopedics and urology today. It was fairly laid back- a breezy, two hour orientation to the increasingly familiar atmosphere of a surgery floor. Despite the growing familiarity, this floor should provide some interesting challenges for me this semester. First, I learned today that the patients on this floor require a high number of injections. While giving needles is not completely for me, the art of “jabbing” patients will resume in greater force this semester. Secondly, I discovered that ortho patients are up and about usually two days post-op. This should be neat considering my fear of dislocating a patients hip while transferring them to a commode. Despite my slight anxiety, I think this floor will provide excellent opportunities to conquer my fears and become comfortable giving injections. One final thought, my clinical teacher speaks quite adamantly about her negative experiences in nursing school-specifically the fear and inferiority her crusty clinical teachers imposed on her. I think its great when a teacher realizes that clinical practice is actually supposed to be a “fun” learning experience not laden with fear. It’s going to be a good rotation…

First day back

Now that I have spent an hour or two fiddling around here (instead of studying for a Clinical Chemistry test), I thought it might be fitting to waste a little more time blogging about my first day back. It was pretty routine as school days go, the majority of the day focusing on introductions and class expectations. This semester looks like an interesting one, especially because we will dedicating a great deal of time to nursing professionalism and pathophysiology. I think pathophysiology will be the most interesting because it focuses on the biological basis for disease in humans. Today we discussed tissue damage- most memorably gun shot wounds, de-gloving and stabbings- gruesome stuff I know- but really interesting. Anyways, I better get to the studying!

Cheerio.