Tuesday, November 24, 2009

Weeks 11 & 12!!!!!!!!!!!!!!!!!!!!!

Hey everyone,

So I wanted to combine these 2 weeks into 1 blog because this week was only 2 days long because of Thanksgiving week! Saturday the 21st was my birthday so it was really nice to celebrate with my friends and not worry about a lot of things due for school the next week! I'm definitely looking forward to a nice break from classes and some Turkey and family time this week! But first, I'll give a little review of these weeks.

Most of Monday was spent preparing for the professional nursing exam on Wednesday. A lot of material was to be covered and there wasn't enough time to cover all of the material in lecture. Therefore, my professor went over the most important chapters in class (including oxygenation, circulation, and IV therapy) and put notes on a couple of the chapters on blackboard so that we could review for the exam feeling prepared. All in all, it went well and a majority of the questions asked ended up being from the material covered in class. On Tuesday in lab, we were tested on injections and I was assigned to administer "insulin and NPO", which was really just sterile water, into the arm of the sim-man. The best way to feel comfortable about being tested on injections is to feel calm and confident. Talking your way through this out loud is a great way to keep on track and remember all of the steps! Luckily I passed and I will be giving my first injection during the next clinical on a patient!

Another paper is due in Health Assessment following Thanksgiving break. It is a pediatric health assessment. I chose to do mine on my 6 year old cousin with Down Syndrome. Although I know this is going to be a lot more hard work, I feel like it will be a very interesting paper to write. I will be working on this, as well as a teaching and learning paper, studying for pharmacology and health assessment. On Friday in clinical, the patient that I was initially assigned to did not return back to the floor for the rest of the day. Instead, I was reassigned to an elderly woman who had undiagnosed pain localized to her hip, back, and chest. Although the doctors couldn't pinpoint a cause, she was in pain anytime she moved or needed to be touched. It was tough working with this patient because I was always so worried that I would hurt her. I felt bad that we needed to move her. However, in order to promote healing and prevent loss of function, she needed to be repositioned regularly.

The 2 day week this week was very relaxing! Although I had classes, there was not much work due and the teachers were a lot more laid back due to the approaching holiday. That's basically all for now!

Have a wonderful Thanksgiving and enjoy all the yummy food!

- Katie : )

Friday, November 13, 2009

Week 10!!!

Hello everyone,

So I did it!!! I made it through the past 2 stressful weeks!!! We had an overwhelming 5 assignments due this week!!! It all started out with our second pharmacology exam on Monday. I stayed in most of the weekend in order to study since I knew that there was a ton of information that was going to be piled onto this exam. I went through each chapter, or drug classification, and broke down the individual medications to reflect their effects on the body. Naming the drugs based on the sympathetic and parasympathetic nervous system allowed me to understand their effects on the major organs. Then, I was able to take each specific medication and learn the clinical uses and side effects based on their effects on the body. I hoped that this would be enough for me to pass the exam. I even thought of several mnemonics in order to help remember each drug. After going over the exam once, I felt really confident. Most of the material that I studied was the information placed on the exam. I felt like I finally could say that I understand how to study for pharmacology exams.

Next up was a lab quiz and case study due in lab on Tuesday. The case study was to be on a fake patient and we were to come up with the appropriate nursing diagnoses as well as expected outcomes, interventions, and rationales for 2 diagnoses. This was not too difficult since we have some practice writing them from clinical. The quiz was a little challenging. There was some controversy after the quiz when we all discussed some of the questions amongst eachother. Everybody thought they had a reason as to why they thought they had gotten certain answers right. Based on this, I'm not exactly sure how I did on this. We will see next week!

Wednesday, all that was due was our full subjective history and physical assessment paper in health assessment. I did this one on my boyfriend, who didn't understand why I had to ask so many questions haha... This was a lot of work during this already busy week. However, by managing my time, I was able to get it all done.

Finally, our very last assignment was due in clinical today. It was a functional health patterns paper on a previous patient we were assigned to. This paper was helpful because it allowed us to complete the entire document and ask the appropriate questions to get feedback from the patient. This was mainly based on the patient's subjective information provided in quotations throughout the paper.

Clinical was a very hectic day for me as well as the other girls. The morning was chaotic because they were short staffed with both nurses and CNAs. I, along with another friend, were asked if we could obtain the morning vital signs for a number of patients on the floor. This was stressful because we got a late start on working with our own patients. My patient was a very nice man being treated for severe abdominal pain. By the end of the day, I was so busy helping him that I was only able to look at his bedside chart for the last 15 minutes! However, I was able to administer my first oral medications with the help of the nurse and my clinical instructor. I was nervous that I was going to make a mistake, but it ended up being a lot easier than I anticipated. It was exciting to feel like a crucial element to patient care and I look forward to doing this again!

That's all for now. Some of the other GMs and myself are getting together tonight for some bonding time! I'll let you know how that goes next week!!!

- Katie : )

Friday, November 6, 2009

Week 9!!!

Hi everyone,

Wow, first of all I can't believe it is already November!!! It is crazy to think that 9 weeks in the program has already flew by!!! This week was the first of 2 weeks packed with work. This week, we had a math meds assessment on Monday, oral meds testing on Tuesday, and a health assessment exam on Wednesday!!! Next week will also be rough with a pharmacology exam on Monday, lab quiz on Tuesday, case study on nursing diagnoses on Tuesday, full health assessment and physical due Wednesday, and a functional health patterns paper due Friday in clinical. Needless to say, this has been a stressful week and will continue to be until the end of next week!!!

I ended up doing really well on both my math meds assessment and health assessment exam this week. However, the health assessment exam was very challenging! I spent most of the time while in the exam trying to decide between two choices that both seemed correct! Following the exam, we began the musculoskeletal system in lab. Since this is the section of the body that I am most comfortable with from undergrad, I felt confident performing a musculoskeletal exam in front of the class. It was exciting to realize that my skills as an athletic trainer would really come in handy in this section. I am also very happy to say that I am now able to give oral meds in clinical. We might only be able to do this once or twice, but this is a very exciting skill that I am eager to perform in the near future. I believe that each of the ladies that I am in clinical with would have to agree with me on that.

Finally, today in clinical, I was assigned to the nicest patient. She was admitted for hyponatremia and dehydration which was being treated with NaCl and normal saline. She was feeling much better today and maintained high spirits throughout my day with her. She had been feeling dizzy when standing and after a visit with physical therapy, they were going to make the call whether or not to discharge her that afternoon. She was so excited to finally have the possibility of going home! With a visit from her husband, she was feeling better than ever. I got so much information talking with her throughout the day, I determined that I would be able to write my functional health patterns paper on her. I was happy to have such a lovely woman as my patient!

That's all for now! Off to a pharmacology review session... Wish me luck with next week!!!

- Katie : )

Friday, October 30, 2009

Weeks 7 & 8

Hi everyone,

Sorry it has been so long since my last post. It has been a crazy 2 weeks, both in school and in the graduate admissions office. We have spent most of the time preparing for upcoming tests and quizzes. Last Tuesday was our second professional nursing lab quiz. I did not do as well as I thought I did on this quiz and I don't really know why. We will be going over the lab quiz on Monday in class. After the quiz in lab, we got to spend our first time slot practicing oral medications. This was probably one of my favorite times in lab. I am excited to begin administering oral medications in the clinical setting on a regular basis after being tested. We got to practice reading an individual patient's MAR and checking which meds to administer and which ones to discontinue. It was helpful to look up the meds and their most common doses, routes, etc.

In Health Assessment, we began to study sections of the body that I am most familiar with. We began the nervous system, which I was able to study mainly in undergrad. It was nice to feel comfortable with a full section of a full health assessment. After practicing cranial nerves for almost 2 years, I feel like I can do them in my sleep!

Last Friday in clinical, I was assigned to a patient who had broken the neck of his femur. He was especially interesting because he did not understand that he was injured. Whenever I asked him if he was using his inspective spirometer, he replied that he did not understand why he needed it. I explained that after being on bed rest for even a few days, his lungs could start to lose their respiration strength. He replied with “I’m not on bed rest”. Although it was completely evident that he was injured, he could not understand this. He slept through most of the day and it was difficult talking with him due to his confusion.

Today in clinical, I was happy to be assigned to a very pleasant woman. She had a past medical history of a bilateral mastectomy and was admitted with a chief complaint of abdominal distention and pain. It turned out that she had cancer of the appendix and had a hemicolectomy, in which they also removed a part of her ascending colon. This was interesting because I had never heard of a patient having cancer of the appendix. She was a very easy woman to work with and very willing to do what it takes to be discharged. This included participating in physical therapy, despite the pain that she was in.

Finally, in professional nursing this week, we had our 2nd professional nursing exam. This exam was on an excessive amount of information. Since we were behind in class throughout the past few weeks, there was a lot of information provided very quickly. This information included fluid and electrolyte balance, acid-base balance, pain management, medications, diagnostic testing, urinary/bowel systems, etc. Although this was a lot of information, I did feel prepared for the exam. I studied a lot for this exam and concentrated most heavily on lab values of electrolytes and on the larger chapters.

We will be receiving the test and quiz on Monday in class. Hopefully we will see a positive outcome from this!

HAPPY HALLOWEEN!!! (Oh by the way, at clinical today, most of the nurses were dressed in costume… including an x-ray technician who was dressed as a giraffe!!!)

Thanks for reading!

- Katie : )

Friday, October 16, 2009

Week 6... almost 1/2 way!!!

Hello everyone,

So ever since my blog has been added as a link on our program's facebook page, I have been hearing from a bunch of the students in my program that they have checked out my blog!!! I guess I feel somewhat like a movie star ha-ha. Anyways, I wanted to thank you all again for checking out my blog and following the life of a first year in the accelerated masters program! I also wanted to give a shout-out to my newest supporters, my clinical group!!! <3 the 7 west ladies and Mary!!!

Ok now back to my week. Since Monday was a holiday and there was no school on Tuesday, we only had 2 classes on Wednesday and clinical on Friday. This was definitely a much needed break!!! Since we began the program in September, we have had assignments and exams just about every week. When there wasn't, we spent a majority of the time preparing for the next week's exams. Since I had a whole week off from class, it was finally nice to catch up on some necessary rest and relaxation!!! After a fun-filled weekend with my friends, I was able to catch up on homework and sleep all day Tuesday.

Monday, I was asked to work the Tufts 10 k for women for the graduate admissions office. This was such a fun race and for a great cause. There were over 8,000 runners participating in the event and even more family members and supporters there to cheer them on. It was a great way of promoting the graduate programs that Regis has to offer. Also, this became my motivation to become a more serious runner and hopefully participate in some road races in the future.

Wednesday's classes went well and we were able to learn some of the information for the lab quiz we will be having on Tuesday. Some of the information we covered included urinary and bowel elimination in Professional Nursing and the ears, nose, mouth, and eyes in health assessment. With practice in the lab, I believe I am becoming more confident with assessing patients in clinical.

Clinical this week was very helpful. I was assigned to the same nurse as last week which was helpful because she already knew me and talked me through the procedures in detail. My patient was also extremely helpful. She was a pleasant woman who I will be using as the subject of my process recording paper due in a few weeks. She was being treated for a pnumothorax that had been caused during a lung biopsy. She was a very friendly and thankful woman who made my job that day extremely easy. One problem I did encounter at the end of my shift was with family members. A niece asked me about an aspect of her medical records that she didn't want to ask her aunt. However, due to HIPPA and patient confidentiality laws, I was unable to reveal any information regarding the patient to her. However, I explained that she could ask her aunt her question and she could personally explain it with her. Although it was tough to tell the niece that I could not help her, the patient's rights always come first and confidentiality should always be maintained.

That is all for now! This weekend, a group of students in my program have planned a get together to go apple picking. I am very excited because we will be able to get to know each other on a more personal, out of the classroom level. Since we will be spending the next few years together, it will be really nice to start getting to know each one of them personally. I'll let you know how it goes next week... maybe I’ll even have some pictures to share : )

- Katie

Friday, October 9, 2009

Weeks 4 & 5

Hi all,

Sorry I was unable to write a blog last week. I got very busy with studying and with different projects while working in the Graduate Admissions office. Boy, this grad school thing sure does keep you busy. Anyways, I will give you an update on the past 2 weeks!

So week 4 was filled with exams! I was signed off on the remainder of my vital signs in order to perform these tasks in the clinical setting. I had my first clinical pharmacology and health assessment exams on Monday and Wednesday. I spent the weekend studying for pharm and the beginning of the week focusing my attention on health assessment. Clinical pharm was basically an intro to the detailed information we will be learning throughout the year. Health assessment included everything we learned in class on the interview with the patient, abdomen, heart, and lungs. I ended up doing well on both of these exams. However, I did feel like I had a justified argument for a couple of the questions I got wrong on the health assessment exam. However, when I asked about the wording of these questions, I was told that they were actual questions taken from past NCLEX exams. Although I still feel like these questions should be worded better, I need to stop thinking too deep into questions and adding information and just answer the question based on the information provided.

Week 5 included 2 more assessments! Basically every week until the end of the semester is going to consist of studying for an exam or writing a paper!!! This week included my first math meds and professional nursing exams. The math assessment included a majority of the conversions that we have gone over in class. This is essential to every nurse in order to properly obtain the correct amount of medications prescribed to the patients in a clinical setting. The professional nursing exam covered everything that we have learned up until this point, including topics ranging from legal aspects and communication to mobility and skin integrity. I felt very prepared and I thought that Janine did a great job preparing us for this exam. All in all, I was very pleased with the results from these exams as well.

During both Friday clinical rotations, we were assigned an individual patient to care for throughout our day at Lahey. I was pleased to find out that both of my patients were extremely compliant and willing to help me in any way possible. Since it is a teaching hospital, the patients and staff at Lahey have become accustomed to helping out the nursing students. I am especially grateful for the nurses that I was paired up with throughout each day. Both of the nurses that I was paired up with were in the process of teaching 2 relatively new nurses (both who graduated from undergrad this past May and passed the NCLEX exam). Since I spent the majority of the time with the new nurses, I felt like we could connect with me on an even greater level. I felt comfortable with them because I knew that they were in the same position that I was in preparing for the NCLEX exam only 1 year ago. I definitely feel like I am learning a lot while at my clinical rotation. While there, I get to learn the ins and outs of the hospital as well as the daily routine of a nurse. As the weeks go by, I find each day to run even smoother than before. I am getting better at reading charts, taking vital signs, evaluating patients, finding items in clean utilities, etc. I am very grateful for this opportunity and I look forward to learning more in the future!!!

That's all for now! Next week is a short week, seeing as I only have 1 day of class and my clinical rotation. But I will let you know how that goes next week!!!

- Katie : )

Tuesday, September 29, 2009

Week 3

This was a very exciting week for the GM program. Every class was preparing for the first exams starting up during week 4. We had our very first Professional Nursing lab quiz. It turns out that my whole class did very well on the quiz and we felt very prepared for the material. This quiz covered material including: vital signs, hygiene, methods by which the spread of microorganisms can be prevented, restrains, etc. We also began the process of being signed off by our professors to perform vital signs on our patients at our clinical settings. Unfortunately, although I felt prepared, I was only able to complete blood pressure since our group was too large. I would need to be signed off on temperature, heart rate, respirations, and apical pulse next week.

In health assessment, we needed to catch up on a lot of the practical material in lab since we have mainly been doing lecture. After the lecture portion of the class, we began to do abdominal evaluations, heart sounds, and lung sounds in lab. I found it extremely interesting to hear the different heart, lung, and bowel sounds. Although I have practiced a lot of evaluation skills since undergrad, we never really concentrated on these sounds. I did, however, feel prepared for the abdominal evaluation. More practice is definitely necessary for distinguishing between different heart and lung sounds. Next week, we will have our first written exam next Wednesday on all the material learned up to date.

Finally, in clinical, we were each assigned to a Certified Nursing Assistant (CNA) due to the fact that the nurses were learning how to use the new handheld electronic documentation. This is when I realized just how necessary CNAs are to the nurses in a hospital. We began the day by going around to her assigned rooms, delivering breakfast, and feeding the patients if necessary. The rest of the morning was spent making beds and giving patients bed baths or preparing them for partial baths. Although we did come across one incompliant patient, most of the patients were very willing to have the CNAs do their job. Finally, I spent the rest of the day researching the medical records of a patient in order to create a Functional Health Pattern worksheet. Although HIPAA prevents me from revealing any information about the patient, I can tell you that you can learn a lot from their individual charts.

Well, that's all for now!!! I'll let you know about the tests next week!!!

- Katie : )

Monday, September 21, 2009

Week 2!!!

Hi everyone!!!

So I have just finished my 2nd week of the program! Now that we are done with all the general introductions to the classes/instructors/ etc, it is time to get down to business! Due to Labor Day cancelling our first Monday classes, I finally had my first Clinical Pharmacology class. The professor seems fun and will try to make the information as interesting as possible. Right now, the material covers a lot of introduction to biochemistry and organic chemistry. This is also my largest class due to the fact that every student in my program is registered for this time slot. Thankfully, after recently taking nutritional biochemistry at Merrimack College, I do not feel too overwhelmed.

Since there is so much material to cover in such little time, we found ourselves behind in the syllabus in both professional nursing and health assessment. In order to cover all of the material, we had only lecture and no lab in health assessment and need to come in 1 hour early next week in order to make sure that everything is discussed. I found the health assessment lecture to be extremely interesting. We learned about the respiratory system and got to see demonstrations of lung sounds. This was my first experience with the highly advanced technology we have here at Regis. There was an electronic board with a diagram of a torso on it. This was connected to a microphone and when a stethoscope was held up to it, you could hear the different sounds of the lungs and heart. You could also change the settings to mimic different disorders. Another highly advanced piece of equipment I became familiar with was the simulation dummies, Annie and Regis Jim. These could simulate a majority of disorders and even talk to you throughout practicing evaluation skills.

Friday was my first day at Lahey Clinic in Burlington. The day was spent orienting ourselves with our wing and with the tools we will be using throughout the semester. My favorite part was getting to see the Pixis machine. This machine is used to obtain medical equipment and medications for patients on the floor. We were signed in to the system and will be able to use it once we begin working with patients. We were also able to familiarize ourselves with the paperwork process in the hospital. As of now, everything is written down. The patients' medical records were complicated and we were allowed to look through them to get practice extracting information from them. However, each of the nurses were being trained to use handheld devices in order to record data about each individual patient. This might take a while to get use to for most nurses who have become accustomed to using paper and pen. However, this shows that technology is advancing in the medical field.

That should be it for now... Next week will have my first professional nursing quiz and I will be tested on vital signs in order to get signed off in lab.

Thanks for reading!

- Katie Kefalas : )

Monday, September 14, 2009

First Week!!!

Hi everyone,

Thank you for taking a look at my blog tracking a year in the life of a first year Accelerated Nurse Practitioner program at Regis College. First let me start by introducing myself. My name is Katie Kefalas and I received my B.S. in Athletic Training in the Spring of 2009 from Merrimack College. After 4 years of undergrad and numerous opportunities by major requirements to observe nurses in local hospitals, I realized that I wanted to switch careers and become a Nurse Practitioner.

Prior to the first day of school, I have to admit... I was pretty nervous!!! I felt like I was a freshman all over again!!! However, after stepping foot onto the Regis campus for the first day, I knew that I was going to be OK. My very first class was my Professional Nursing Lab. Everyone in the lab was very friendly and very enthusiastic about learning. There was a good amount of students in the program coming directly from undergrad. I was suprised to see so many career changers, and students of all ages and educational/professional backgrounds. Several students are juggling families and part-time jobs as well. I’m hoping to keep my part-time job for 10 hours/week…we’ll see!Since it was the first day, most of it was spent getting adjusted to the blackboard website (where assignments, class documents, etc. are posted) and an explanation of the semester. We were also taught the proper way to remover protective equipment and thoroughly wash our hands. Although that may sound trivial, this is actually one of the most important aspects of nursing due to the fact that it is just one way of preventing the spread of germs and disease.

During the first week, I also took Professional Nursing and Health Assessment in Nursing. Both classes seem very interesting. Coming from a health science background, most of the information was review. However, I could tell that this was just setting up the more in depth information we will be learning later on in the semester. Vital signs are an essential component of the nursing profession. We were taught the proper technique for taking blood pressure, pulse, and respiration. These skills will be necessary for a successful career in nursing. On Friday, we had our clinical orientation. My clinical location is Lahey Clinic in Burlington from 7am to 3pm, and my clinical advisor is Mary Gardner. I, along with 5 others assigned to this clinical, learned that we will be observing the 7 West Wing and that most of our day will be spent on the Oncology floor. Having an aunt who recently underwent stem cell treatment at this very hospital, I was very excited for clinical to start and to begin learning.

That's all for now. Stay tuned for next week's blog!!!

- Katie Kefalas : )