What Color Is Your Puke?

I'm reading up on "ileus," which is a bowel obstruction, because my patient yesterday had one, and I didn't know anything about it. I learned that when a patient vomits, what their puke looks like can tell you a little about where the bowel obstruction might be. For instance, clear liquid means it's probably right up by their stomach, and if it's bile-colored and liquidy, that means the obstruction is in the upper small instestine.


Then I got to this:


"Feculent vomitus indicates bacterial overgrowth proximal to the obstruction and is a poor prognostic sign."

It made me laugh. It's terrible, but that statement might be the world's best understatement. Yeah, I would think that if a patient is puking up feces, that probably is a pretty bad sign, prognosis-wise.

Letter to the Charge Nurse: Clinical Day 1

Dear Charge Nurse,


Today was my very first clinical day as a student nurse. Please, in the future, do not ask me to change the bedsheets on a woman who has an unsplinted broken arm that is just wrapped up in a soft bandage because she is having surgery on it tonight. I know you gave her some kind of painkiller, but it didn't work, and her shrieks of pain as I attempted to roll her over in bed to get the new sheets on were extremely distressing. For all of us--me, her, the people passing in the hallway, and the other nursing students who were helping me. That shit could have waited until she went to surgery and her bed was unoccupied.


Sincerely,
Queenjulie

One Down, 62 to Go!

We don't have class on Fridays, so I've officially survived my first week of nursing school! Today I learned how to tell patients that "I'm just going to put this pretty bracelet on you," while actually tying them to a chair. Nice.

How to Sit

I just reviewed several videos that came with my nursing textbooks. They show the ideal way to position a patient in a hospital bed. I now want to go check myself into a hospital! For instance, it took the nurse in the video five full minutes and six fluffy pillows to move someone from lying down in bed to sitting up in bed. Seriously! The patient ended up sitting up, tv remote in hand, snacks on the bedside table, and six freaking pillows: one behind her head, one under each forearm, one under each knee, and a little one at the small of her back. She looked like a queen.

Simulated Urine and Head Lice

Today was our first official lab day of nursing school. We all dutifully laced up our tennis shoes and slipped on our crisp new lab coats and trooped into the fake hospital ward next door to our classroom. Yay! Let's review what we learned today:

1. Changing diapers! On grown adults! Not nearly as fun as changing diapers on a tiny, cooing baby.

2. How to wash your hands: "Sing the happy birthday song to yourself twice to make sure you wash long enough." And ruin every birthday for the rest of my life? No thanks. I'll sing the alphabet song.

3. It was only two hours, but my feet were killing me by the end. How am I going to survive a 12-hour shift?

4. Astonishingly, I was not the person who knocked over an entire bottle of simulated urine and splashed it all over the floor. Given my insane level of clumsiness, this is amazing.

5. I got head lice a few months ago from the hospital beds we used for one of our prerequisite classes. It was revolting. I will not be lying in these beds, I hope. Not without a disposable pillowcase, anyway. Thank God the mannequins don't have hair.

6. Did I mention my feet hurt after two hours? And I was starving? Because we have a three-hour lab tomorrow. Off to soak them in the tub.

The first day of nursing school: Liveblog

8:00 a.m.: Class in one hour. This evil strep throat is killing me. Taking 800 mgs of ibuprofen from the prescription my husband got for tearing cartilage in his arm.

8:45 a.m.: Wow, feeling much better! Turns out taking ten times the recommended dosage really works! I'm definitely going to use that knowledge as a nurse.

9:00 a.m.: Here comes the professor! "Welcome, RN class of 2012!" Big round of applause! Yay!

9:30 a.m.: Introductions, introductions. "Hi, I'm Queenjulie, and I have strep throat." :classmates recoil in horror

9:15 a.m.: "Here's a copy of the syllabus! Don't panic--it's only 48 single-spaced pages long!"

9:20 a.m.: Professor is reading the syllabus. The whole thing.

9:45 a.m.: I do not understand the difference between Medicaid and Medicare. At all. I should probably look that up or something.

10:10 a.m.: Oh God, I have to pee.

10:30 a.m.: Break time! PEE!

10:40 a.m.: Resume dramatic reading of syllabus. My God, this is boring. "Blah, blah, blah, you must wear closed-toe shoes every day, blah, blah..." Wait, what? No flip-flops what? :stares in horror at happily unencumbered, be-sandaled feet.

11:30 a.m.: Lunch. Ingest caffeine. A lot.

12:20 p.m.: Done reading the syllabus! Attempt to wake up and pull face off sticky puddle of drool on desk.

12:30 p.m.: Tour the lab, which is a mock hospital ward. Marvel at freakishly realistic mannequins that actually have heart beats, blood pressures, injection areas that you can poke needles in, and voices that talk to you out loud.  Be incredibly creeped out.

1:00 p.m.: Learn about fire safety. "And now we're all going to go outside, where the fire department has set several small fires in the parking lot, and you get to put them out with fire extinguishers!" Holy crap. Nursing school just got 98% more interesting! Please God, let the firemen be naked.

1:03 p.m.: They aren't naked, but there are actual fires in small metal boxes in the parking lot. Crazy. Using a fire extinguisher is remarkably fun. If I ever get divorced and start dating again, I'm totally using a fire extinguisher to break up with people.

2:00 p.m.: "I hope you enjoyed your first day of nursing school! You have 56 pages of textbook reading to do before tomorrow at 9:00 a.m.! Enjoy!"

Of Course

Nursing classes start in roughly 40 hours, so of course I have a temperature of 99.4 degrees.