Nursing Doubts

I really hate it when I'm not doing anything and I just sit and do nothing because it's the perfect opportunity to re-examine one's life and I don't want to re-examine mine. But since I had no choice and had nothing better to do I looked at myself and where I am going to go now.

I know that I want to be a nurse but there is something within me that says that I could be anything I want since I'm starting all over again. But I have already begun nursing and it's a waste if I'm just going to let go of my nursing career when I already have started building knowledge, skills, and experience in nursing.

Maybe this is just a phase I'm going through because I don't have any nursing stuff to do. But when I start my studies again I'm sure that my nursing spirit will kick in! ^_^

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Operation Tuli

I was quite shocked at first when my very conservative friend who happens to be a girl sent me an SMS yesterday saying that she was able to touch 30 or more penises in the span of 4 hours. And she was quite proud of herself and happy with the whole experience. At first I was quite scandalized by what she said and all sort of naughty thoughts came running into my head.

It was a good thing though that she clarified what she told me and said that she just had the most wonderful experience in "Operation Tuli". Operation Tuli is an annual project of the Department of Health - Philippines to have young boys circumcised (Tuli in Tagalog) in their own towns and municipality. I'm kind of jealous because I too want to experience an Operation Tuli which I doubt would exist in Canada. In Operation Tuli, several young boys wait in line for their free circumcision.

Circumcision has been a ritual for many religions and culture. Circumcision paves the way into adulthood and manhood while it is also a ritual in the Judeo-Christian Tradition to strengthen the covenant with God. Medically speaking, circumcision (the removal of the foreskin of the penis) is for hygienic purposes as dirt and secretions tends to accumulate in the foreskin and will result to urinary tract infections (UTI).


In other countries though male circumcision is done 2-3 weeks after birth. And if you're wondering there is also a female circumcision which I will post about later since it deserves to be discussed further.

For more information on circumcision I recommend this very informative site, kidshealth.org.

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Nurstoons

(just click on the images to enlarge)

I just want to share these comic strips about student nurses from Nurstoon.com. They may be insanely funny but they somehow hold some truth. That what makes Nurstoon.com's comic strips very interesting.

As a student nurse I also had and will continue to have many bloopers and interesting experiences and I would really love to share all of them.

So to all of you student nurses never stop dreaming and believing in our selves. Someday we will be registered nurses, I just know it. And if ever we had made some stupid mistakes along the way let's just charge it to experience and try not to make the same mistakes twice. Remember, you never learn unless you make a mistake.

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Nurse No-Duty

Oh boy! Good thing that I don't have to go to class this summer. I went to Xavier University to get my recommendation letter (which my CI did not give to me yet huhuhu, but it's ok ^_^) and I met some of my classmates and friends. They were just from duty and boy did they look so haggard and stress looking.

Imagine 4 days straight of duty and on two days of those days you have to sleep late into the night to finish requirements for the next day. So you get to sleep at around 1:00 am and you have to wake up at 5:30 am. I know because back when I was on duty I also experienced that.


Oh well, but it beats staying at home and being intellectually stagnant and bored.

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Harsh CI Love

As a student nurse I have encountered so many kinds of clinical instructors (CI's). There are CI's who are very friendly, there are CI's who you admire so much for their intelligence and skills, but the CI's that you might want to get away from are the "terror" CI's with matching tiger-looks hahaha!

Who are these "terror" CI's? They are the ones who will not hesitate to shout at you in public, fail you, and even throw heavy steel patient charts (you must evade to avoid serious injury hehehe). But I understand why CI's may sometimes be strict and uptight. This is because their hard-earned professional license is on the line. So if ever students become lax in the hospital student nurses might do more harm than care to patients. and who would suffer the consequences? Not the students but the CI's because what will you take away from student nurses they don't even have any license yet. So if you hate your CI go kill a patient, joke. ^_^

But if CI's are not strict with their students the clear line that marks authority is broken and student nurses won't show respect and won't follow the instructions of CI's. Plus if our CI's don't care about us then they would just leave us making a lot of mistakes. If CI's don't inform us of our mistakes then we would never learn.

But at the end of the duty or class CI's are more friendly because they don't have to be the authority after class hours, they are now our friends. I'm really going to miss my clinical instructors especially Ma'am Asne who has always been a mother figure to us. She has always been so generous with us in terms of time and food (hehehe). I will try to be like my clinical instructors and I will make them proud me, their student nurse who gave them trouble once in a while...

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Deciphering the Doctor's Handwriting

We all heard about the Da Vinci Code right? But there is something more difficult to comprehend and very difficult to decipher: the doctor's handwriting... it's a great mystery why Doctor's handwriting is illegible. There is also this study conducted by the British Medical Journal to check if doctor's handwriting were legible. Guess what the result is? Doctors Fail Handwriting Test!

For years now I have always been told that my handwriting is like a doctor's. This is meant to be a joke of course, but can also be misunderstood for an insult. It is true that I had my own share of horror and eye strain from trying to read and make sense of the scribbles and marks written by doctor's on their Doctor's Order.
In fact I always have to team up with my other duty mates to help me break the secret of the doctor's handwriting. But we always end up making mistakes. It amazes us though that my clinical instructors are able to understand this foreign handwriting. We always ask our CI's in wonder how in the world do they understand those scribbles and doodles? Their answer? Lot's of experience with doctor's orders. But even the experienced staff nurse also makes mistakes because there are doctor's handwriting are so encrypted to the point that deciphering it is no use. Just a thought: Doctor's should get into the date security business.

But what is so important about doctor's having legible handwriting? Simple, a misunderstood order could lead to death of a patient. Don't believe me then take some time to read this article from BBC News: Health Doctor's Scrawl Blamed For Patient's Death. As the article shows a poorly written order or prescription could lead to a patient's death.

But let us not flame our doctors because it is not their fault too that they have such illegible handwriting. We also have to think that they have a lot of patients to take care of that is why they have to do their charting very quick. But how come nurses are able to have more legible handwriting when nurses are the ones who are with the patient 24/7 and are always documenting every procedure they do for every patient?

But there is nothing we can accomplish with complaining that we can't understand the doctor's handwriting. What we can do is look for a solution. The best solution with this problem is electronic orders or prescriptions. The orders and prescriptions are just flashed into the monitor with beautiful and neat computer generated text. This may be already true to First World Countries like USA, Canada, and the UK. But in the case of the Philippines? We can't do anything but pray that the doctor writes in print or we nag them to death to interpret their handwriting or our license is on the line. Wait, I don't have a license yet.

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Skipping a Meal Leads to Brain Death

Hypoglycemia is the medical term for a level of blood glucose (blood sugar) that is too low to meet immediate energy needs of the body. Glucose is a sugar that our bodies use for energy. A normal level of glucose in the blood is between 60-110 mg/dl . If you are hypoglycemic you will encounter the following symptoms: sweating, feeling warm, dizziness, difficulty speaking, inability to concentrate, hunger, drowsiness, anxiety, confusion, nausea, trembling and headaches.

There are two types of hypoglycemia. And these are:

• Fasting hypoglycemia can occur when a person goes without food for eight or more hours. It can be caused by certain underlying diseases (tumors of the pancreas, severe liver disease, adrenal failure) that upsets the body's ability to balance glucose.

• Reactive hypoglycemia is when blood glucose levels fall too low within a few hours after eating. This type rarely has a serious underlying cause. and is not easy to diagnose.
  

But I guess that the type of hypoglycemia that students are more associated with is Fasting Hypoglycemia. Nursing students are guilty of skipping breakfast especially if the duty is very early in the morning and don't expect them to eat lunch either. My duty mates said that they don't want to eat because they want to finish whatever they are doing first. But I wonder what makes them so busy that they don't eat lunch? But I can never go on if I don't eat lunch. I can skip breakfast (I'm used to it) but I can never skip lunch because if I do I'll just end up very grouchy because as shown in the symptoms above, I get a headache and my body weakens because there isn't enough energy being created because of a rapid decrease in blood sugar.

But skipping a meal is not the only cause of hypoglycemia. Other causes are: alcohol on an empty stomach, taking too much insulin, exercising hard without eating a snack first, eating excessive amounts of carbohydrate foods.

But if you think that hypoglycemia can only lead to headaches and body weakness, think again! Hypoglycemia an lead to the decrease supply of glucose as fuel to the brain, resulting in impairment of function (neuroglycopenia). Derangements of function can range from vaguely "feeling bad" to coma (rarely) permanent brain damage or death.

So never skip a meal guys! If you do skip meals because of uncontrollable circumstances then always bring food with you that are high in sugar like candy or chocolates so that you can have something to munch on even when you are on duty.

***
SOURCES:
University of Iowa
Wikipedia

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Nursing: Back To Basics

Today I have heard what I have feared the most... It's bad enough that I have to transfer to another school and lose my chance and my dream of graduating from Xavier University - Ateneo de Cagayan. But my fear had been realized. My mom has told me that I might have to take some 12th Year Subjects and then go back to 1st Year College just like what a friend's child had gone through...

I was at first at denial and I was rationalizing, a defense mechanism, that I would not actually have to go back to the very beginning because I already have an Associate in Health Science Education and I had already been capped and badged... but then I realized that the education system in Canada is different from the Philippines and that some of my subjects might not be credited at all.

It's sad but if you weigh the pros and cons, going back to first year in a new country and a new life might not be bad at all. Here are the pros and cons that I have thought of:

the CONS:

• my batch mates will graduate ahead of me
• I'll finish my Bachelor of Science in Nursing when I'm 23 or 24 years old
• my 3 years of studying, hardship, and turmoil will be all for nothing
• If I fail the challenge exam/placement exam I might go back to high school (darn I forgot my high school concepts already)
  

the PROS:

• starting fresh will give me a chance to master the Nursing concepts and theories
• I have an edge over my new fresh high school graduate classmates
• better quality education and clinical exposure [I'm sorry XU, but studying at University of Alberta (hopefully, fingers crossed) is being in the real thing, the ideal nursing setting]
• I can easily land a job in Alberta and I'll be prioritized over foreign nurses
• I'll be with my family and will not be left alone in the Philippines

Oh my, I'm like a newly hatched chick that will have to go back to my egg shell and start the process of hatching all over again. But I have made my decision, I will study in Canada so that I can be with my family even if I have to go back to 1st year. The pros seems promising and when I graduate I won't really be that old.

Besides, I don't want to shift to another course because there is no other course that I would want to shift to. My dream and my goal is to be a Registered Nurse, and that is what I will become.


***
Photo belongs to cameradude

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XU @ 75!!!

Xavier University Jubilee Music Video in celebration of its 75th founding anniversary.


GO ATENEO!!!

Words can't tell how proud I am to be an Atenean! For 75 years, XAVIER UNIVERSITY - ATENEO DE CAGAYAN have been forming men and women for others who are competent, committed, and compassionate.

XAVIER UNIVERSITY, the first Jesuit University in the Philippines and the first university in Mindanao. Celebrating its 75th year of truth and excellence! From being literally demolished during World War II it now rises in it's shining glory as it is now. Rooted in history and I know will continue to go on strong and build better leaders for our country, the Philippines.

Again, I am PROUD to be an ATENEAN!!!

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Nursing Garage Sale!

Hi everyone! Let me invite you to my garage sale! Please check out my Nursing Garage Sale for used nursing books at very reasonable prices plus more nursing stuff! ^_^

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Leaving on a Jet Plane

Today I went to the city to get all my papers done. I gave the secretary of the Dean of the College of Nursing at Xavier University (XU) a letter requesting for a recommendation letter stating that I was indeed a student in the College of Nursing and that I am eligible to enroll in a nursing program in another school.

Yup, you heard me right. I'm transferring to another school. But I'm not transferring to another school because I failed or anything and definitely not because I kicked out or I dislike XU. I'm transferring schools because my family and I are moving away to Canada this May. It's quite sad really that I won't be able to graduate as an Atenean nurse. But I'll always be an Atenean in my heart and in my actions... as I told my clinical instructor, at least I won't have to worry about being the cause of a non-100% passing rate on the PRC Nursing board exams.

My God, this is one big hell of a step for me and my family. I'm very scared but at the same time excited because I sure do want to travel and experience something new once in a while. It's not like moving to a new place is a daily happening right?

I will sure miss my friends, my clinical instructors, and of course my beloved school. I'm also quite concerned that I might have to go back to 1st year college because my subjects might not be credited, but this fear is allayed by the fact that an Ateneo school is widely known and recognized in the Philippines as well as in the international field. Oh well, if i do go back to 1st year that would be fine with me since I really want to study again because I'm afraid that I'm forgetting some of the concepts that I have learned.

I just hope that everything turns out for the best.

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I Passed My Exams!

I'm quite happy that I got through my exams and passed both my nursing lecture and related learning experience final exams. I'm quite confident that I will also pass in the final grade (well I'm still hoping at least). My quizzes aren't that good but my term exams are quite ok.

On the other hand, my block mates and I were able to pass our grand case study/presentation of a 47 year old male with acute coronary syndrome and pulmonary embolism likely with hypercoagulable state secondary to polycythemia vera. Our grand case presentation may have a lot of corrections and errors but it was quite amazing that we even passed.

In nursing research my group's thesis proposal of "Factors that Influence the Adherence of Delivery Room Nurses to Sterile Technique in Cagayan de Oro" has been accepted even if there were also errors and corrections starting from the cover page to the last page.

But you know what's ironic? I may have passed my major nursing subjects but I have doubts if I passed English. Oh my gosh! Imagine what were discussing in English! Art and it's history! The exam is harder than our medical-surgical nursing exam, imagine that! Oh I just hate history. Like what use do we have for knowledge about art and sculptures in the medical field? Is it needed so that we could have something to talk about with our patients who are inclined to art?

Anyhow I really thank God for aiding me in passing my exams! Like I didn't study for our exams and I still passed! I am really so happy!

At last! No more Medical-Surgical Nursing! Yehey! Welcome Summer 2008!

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December 2007 PRC Nursing Board Exam Results

I didn't know how to react when I've heard that Xavier University-Ateneo de Cagayan College of Nursing didn't have it's normal turn out of 100%. Ever since the opening of the College of Nursing, it had always garnered a 100% passing rate (well except for one time when it had a 99% passing rate). But never the less, Xavier University has once again proven that it's graduates are not to be looked down at. Nurses who graduate from Xavier University are certified to have the 3 C's: Competence, Commitment, and Compassion...

I am proud to announce that my school is the 2nd Best Nursing School in the Philippines as of the December 2007 PRC Nursing Board Exams. XU had a passing rate of 98% (still close to 100%) with 229 passers out of 233 examinees. I pity the 4 who failed because they not only carry the burden of failing but also the shame and the pressure of being the cause of XU's decreased passing mark... but we cannot blame them because the board exam is not easy. Imagine out of the 67,728 board takers, only 28,924 (or 43.42 percent) passed!

I am also proud that there are topnotchers from my school namely:

Top 6: Katrina Victoria Luceno Akut, Xavier University, 86.00 percent.
Top 8: Hernessa Torralba Hernandez, Xavier University, 85.60 percent.

There are also topnotchers from a sister school, Ateneo de Davao University! But I won't be amazed because it is Ateneo of course.

For more info and proof that I'm not making this whole up please visit this link: Inquirer

Or you can go to the official site of PRC: PRC Board Exam Results

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My Definition of Doom

Doom as defined by Answers.com is the following:

1. Inevitable destruction or ruin.
2. Fate, especially a tragic or ruinous one.
3. A decision or judgment, especially an official condemnation to a severe penalty.
4. Judgment Day.
5. A statute or ordinance, especially one in force in Anglo-Saxon England.

But in my own personal life, doom is my inability to manage my time effectively and mismanaging my priorities. So what happens next? My work and responsibilities piles up and I am unable to prepare for these responsibilities well enough resulting in massive and successive failures.

Time is not on my side here people. I still have a lot of things to do and I am panicking already. It's quite handy though that I have an excuse for being tardy and lazy. And this excuse is the nursing life is hard and difficult. This is even manifested by the great number of casualties in the college of nursing at Xavier Universirty...

But I have no one else to blame but myself... at least I'm not failing in medical-surgical nursing but I could have received a higher grade than C if only I studied. Anyway, it's too late for regrets now and I've gotten over it already. At least my RLE is a B-.

I have a lot of things on my mind that I want to blog right now but I just don't have the time so I'll go back to my studies now and I'll be sure to update my blog as soon as I can. Maybe this coming Saturday or so...

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The Proper Handwashing Poem by Ms. Ansay

I was searching the net for guidelines on proper hand washing when I stumbled upon a poem by a fellow nursing student, Ms. Danica Ansay, who studies at University of the East Ramon Magsaysay (UERM)., Here is a link to her poem: Proper Hand Washing!^_^

At first I was wondering why it sounds like a poem until I realized it is a poem. After reading the whole thing I was quite amazed how Ms. Ansay was able to incorporate the nursing procedure of handwashing into a delightful piece. The poem is very witty and funny. Why don't you read the poem for your self:

*Assuming that I did demonstrate the Hand Washing to you

Upon opening the door

You first stole me with your machong-machong body

Standing beside the sink located beside the door

Waiting for me, ay shit! Joke lang!

I mean waiting for the next student to demonstrate

the Proper Hand Washing

Suddenly after we sat,

I heard you call my name, Ms. Ansay!

OMG! I can’t believe I hear you call my stolen name

Walking towards the sink while stealing your sight

Preparing the materials upon preparing my heart

While starting the demonstration

I started to explain the meaning of Asepsis

As a freedom of my friendship with you

The purpose of Hand Washing is to prevent

the shyness I feel inside of me

And thus, I will now perform the Proper Hand Washing

First I will get a tissue to dry your tears and make you smile

Then I will open the faucet just enough to my satisfaction

Throwing the tissue away to the waste receptacle

Wetting my arms from elbow to fingers

Placing my hands lower than my elbow

I will get again another tissue to wipe my drool

while looking at you

Then throw again the tissue away from me

Rubbing the soap from palm to palm

Like kissing each other from cheeks to cheeks

Next is the interlace, then the dorsal part of my hand

Now the spider with my fingers rubbing my palm in circular motion

together with my eyes looking at your posture cephalocaudal

Then my fingers with five strokes each

while saying, ‘my-chu-va-chu-chu’

Lastly with circular motion rubbing my arms from wrist to elbow

Dreaming and wishing that you’re standing right next to me

holding my arms and together we will go to paradise

Now I start rinsing my arms from elbow to my fingers

Feeling the warmth of your hands embracing my coca-cola body

Picking the last tissue to dry my tears of loneliness

before saying goodbye

Throwing the tissue of my tears away from my sight

Getting the towel to pot dry my arms from hands to elbow

Wishing that you were the one who dries my tears

and makes me feel special

Preparing myself for the evaluation

A little spray of perfume and a touch of powder

I think is enough for him to notice me

Feeling nervous while standing in front of you

Listening to what you say and do

Rejoicing for what you’ve said

Giving thanks for passing me

And specially for your time and cooperation.

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Weekly Evaluation

This week of duty may perhaps be the most exciting and memorable as compared to all the other rotations. This may be because of the fact that this week is the last time that we will have to sleep late at night for the following day’s requirements, wake up early in the morning to prevent being late and incurring extensions, and be stressed out from the day’s duty. But it was quite sad that instead of rejoicing we were reprimanded because we were not courteous to the patients and staff nurses, I don’t really know much of this issue because I was late for the post-conference because I wasn’t informed that we were going to have the post-conference already.

This was my first time to handle three patients at a time. Thank God we didn’t have to administer meds for this day, or else it would be quite a mess. I have to prepare the meds, do a drug study with my PCI then CI, and then administer them, and finally document the procedure. I was also quite lucky that I didn’t have to take in the newly admitted patient into my care since we were already about to go home at the time she was admitted. I admit that there are still areas that I need to update myself and be more familiarize with like the IVF for example. I need to learn how to be more accurate in reading in reading my IVF levels and be more mindful of the input and output values of my patients.

For this rotation, I give myself 7 out of 10 with 10 as the highest. Although I wasn’t able to make any serious mistakes or errors in this day I am not satisfied with my performance and I know that I could still improve in the future.

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Why Am I Always Late?

$Aah! Is it me or do I really lack time management because once again I am late! Well at least this time I won’t get an extension because I’m only late for an assessment but still it’s so frustrating to be late. It’s also quite a shame because of all people, a nurse should never be late. It has been reiterated over and over again back in RLE 2 that a nurse should never be late because every minute is important for the life of the patient. Plus one should also think of the other nurse on duty that one should from her/his 8 hour straight duty. Darn it!

Well at least I wasn't late for the medical rotation. It was really great that my colleagues and I agreed to carpool to save money. We meet at Dunkin Donuts 30 minutes before our pre-conference so that we could then share a taxi and split the fare. It's also a good motivation too since I don't want anyone waiting for me... and I don't want people to make me wait... hahaha! I sound like Sasori of Naruto!

Anyway, lesson learned and I'll never be late again. Hahaha!

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Take the Stairs Instead of the Elevator

It's quite frustrating when the elevator doors are locked. Like my class is on the 6th floor and it's so tiring to climb those stairs especially when you're carrying my big and heavy Medical-Surgical Nursing book.

What's even more frustrating is when you find the first floor elevator closed, the second floor elevator closed, the third floor elevator closed, the fourth floor elevator closed, the fifth floor elevator open! What?! Like I'm going to the sixth floor! Might as well take the stairs...

But despite all of my frustrations I finally got over them and realized that it's actually really better to take the stairs because it's a form of exercise which I really need since I have a sedentary lifestyle.

I just have to make sure though that I won't be late for my class. So I got to go now, I still have to take the stairs to my room...

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Weekly Evaluation: Medical Rotation

This week was a full of firsts for me. It was my first time to have ever go on duty at Madonna & Child Hospital and it was my first time to have been under my current clinical instructor and practicing clinical instructors for this rotation.

Although everything was new to me, I was able to adapt and carry out my nursing responsibilities. I was also blessed to have been assigned such wonderful patients who were very cooperative and very welcoming. I really did not feel awkward as I stayed in their rooms for the whole day as their student nurse. I was also quite glad that I didn't have to chart any nurse's notes (because it takes so much time, not to mention effort ^_^) and all that was required of us was a sample nurse's notes.

For this week I had two patients. A 6 day old baby girl with septicemia neonatorum and a 51 year old woman with pneumonia. I am glad that they are not that toxic and that they are already getting well.

For both case, it is important to note the presence of a bacterial infection. So basically the medications that I have administered had a common factor, which of course is being an antibacterial medication.

The baby girl had to have continuous phototherapy because she had jaundice caused by hyperbilirubinemia. I of course had to protect the eyes by securing an eye shield. I'm glad that the baby's vital signs were all normal during my shift. I am very edgy when I am with babies (especially newborns) because they are so delicate and one false move from me like failing to regulate the IVF properly could cause serious complications like hypervolemia and cardiac overload.

For my patient with pneumonia, I made sure to position her in a moderate high back rest to promote proper lung expansion and I taught her deep breathing and did chest physiotherapy after nebulization to promote removal of secretions.

So all in all this week was a very productive week for me. To add to my enjoyment is the fact that I wasn't late for this week of duty! Yeay me! I made sure to have set my clock at least 1 hour before the pre-conference and I agreed to carpool with my dutymates so that I would have more reasons to wake up early. ^_^

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Being A Nurse

Being a nurse isn't about grades.
It's about being who we are.
NO book can teach you how to cry with a patient.
NO class can teach you how to tell a family that their parents have died or are dying.
NO professor can teach you how to find dignity in giving someone a bed bath.
A nurse is not about the pills, the IV's and the charting.
It's about being able to LOVE people when they are at their WEAKEST moments and being able to forgive for ALL their wrong and make a difference in their lives today.
NO one can make you a nurse...

JUST YOU

This is a very nice message that our beloved clinical instructor, Ma'am Asne, has given us. It really has made an impact on me. Truly, being a nurse is not easy. The job itself is stressful but you also have to deal with patients who are in pain and who needs understanding even if they mistreat you out of their frustrations of being sick. It's very demanding indeed. But I will try my best to meet the expectations of a nurse who is compassionate, competent, and committed to my career and vocation. I pray to God that He may give me the strength to move on even if my body and mind are almost at it's limit...

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