Clinicals

I had my first day of clinicals last Thursday! It was incredible. I have clinicals one day a week at New York Presbyterian Hospital, which is on 168th Street, waaaay uptown. It's right next to Columbia's medical campus, which is nice because I am familiar with the area, but not nice because it is 50 minutes from my current apartment.

I work on a med-surg floor, which is basically a recovery floor for geriatric surgery and illness. I love working with older patients. They have really great stories to tell, and they are often used to being in hospitals so they are more forgiving of nursing students. I got to use many of the clinical skills I had learned in skills lab, including changing bed sheets, changing diapers, and moving patients from one bed to another. I also learned how to clean a colostomy bag.

I have my second day of clinicals tomorrow. Here's what I learned this week in skills lab. I don't know if I will get to do any of it tomorrow, but I will get to watch at the very least!

-How to suction a tracheotomy
-How to clean a tracheotomy
-How to give oxygen to a patient
-How to examine ears, nose, and throat

Next week is actually what I am most nervous for. In skills lab, we will learn how to insert a urinary catheter  I'm not looking forward to it, mainly because it just seems like it would hurt the patient so much. Luckily, we have mannequins to practice (and practice and practice and practice) on.

cranial nerves of sight

We have twelve cranial nerves, and they are all great. They line up in pairs down our brain, and each one has a massive impact on our body. From our sense of smell to the feeling on our face, all the way down to digesting our food, each one is incredible. I learned the very basics while in Anatomy and Physiology, but now I am learning about each one in great detail while learning how to give a physical exam. This week, while learning about how to do an eye test, we learned about cranial nerves II, III, IV, and VI.

Cranial nerve II is our optic nerve. It helps us process sight, and allows us to actually view the world around us. It projects upside down on the back of our brain, and then that gets flipped around to help us create an image of the world around us. It's all done on the occipital lobe, which is on the very back of our head. That's why you see stars if you hit the back of your head. Cool, huh?

Cranial nerves III, IV, and VI are for moving our eyes around. Cranial nerve III is the workhorse. It moves our eye all around. It doesn't really get enough credit. Cranial nerves IV, and VI, though, are specialized. Cranial nerve IV, our trochlear nerve, is ONLY made for looking down and in towards your nose, and cranial nerve VI, the abducens nerve, is only for moving your eye to look out to the side. I think that is amazing. We have twelve nerves in our brain to control almost everything in our body, and two of them are solely for moving our eyes in one direction each. Incredible, right? So much goes into us being able to see all around us. We're lucky.

Well, I started nursing school. That's right- I started nursing school. Officially, I am in an entry to practice program in nurse-midwifery, and I just finished my first week. It's crazy how fast we are learning things! I have 38 hours of class and clinicals a week, and then I come home and study for about five or six hours a day. I keep reminding myself that I have friends who are working 80 hours a week doing things they hate, so I should be grateful that even though I am busy, I love everything I am doing. Here is a list of clinical skills I have learned so far.

-How to give a sponge bath

-How to wash a patient's eyes

-How to transport an obese, immobile patient from one bed to another (lift with your legs!)

-How to take vital signs

-How to change (heavily soiled) sheets on a bed without having to move the patient from the bed

-How to take a sterile urine sample

-How to put anti-embolism stockings on an immobile patient (it's harder than you would think!)

-How to do range of motion exercises on immobile patients

I am learning about the nervous system in physiology, and about how drugs travel through the body in pharmacology. In my physical exam class, we learned about how to communicate with a patient, and the general process of the physical exam and history taking. I need to be able to give a complete physical by the end of the summer. Thursday, I will go to the hospital for the first time. Holy cow. Let's see how that goes!