Friday was not too challenging from a treatment/medical standpoint but was rather interesting from a holistic nursing standpoint. I had a patient with an acute change in mental status from baseline dementia. Interestingly enough the patient had undergone a demeanor change from coarse and rude to pleasant and cooperative - it usually happens the other way! The patient was brought to the ED by a family member the night before with the suspicion of a CVA (a stroke) because of previous history. CT scan revealed no acute changes (no recent brain injury) so that was ruled out. It was like trying to put together pieces of the puzzle to figure out what was going on. I collaborated with a med student and we were able to put our heads together to come up with a potential diagnosis. I really liked collaborating with the med student (he respected me as a student nurse where the attendings don't really give us an recognition) and sharing info from my assessment of the patient. I was even able to order a social work consult based on my suspicion of "caregiver role strain" (meaning the family member seemed overwhelmed and no longer able to provide care). It was a really rewarding day and I got back some confidence I had lost the previous week while being swept up in check lists!
I also just got my paperwork this week for my "Transitions" Seminar next semester. This is a preceptorship that is designed to transition you into practice. Sort of like a Novice Nurse program. You are assigned one nurse at whatever agency you attend and you work with them one on one for the whole semester. It's an exciting thing! We had to choose 4 assignments based on #1 through #4 choices. The process is done by lottery -- there are only a limited number of spots for each assignment (8 is the max for each one). I believe there were 10 altogether. I wound up choosing Maternity as #1 (afterall, that is why I went to nursing school in the first place!) followed by an ED/Critical Care unit, followed by two different sections for Critical Care/ICU. I think I will be happy wherever I wind up but I am still really praying and hoping for Maternity. The paperwork really tried to discourage students from choosing maternity by saying it required super flexible hours including evenings and weekends, and also by saying that labor and delivery were remote possibilities for assignments (which I don't believe to be true). Anyway, I trust that God will put me where I need to be. The decision is not mine to be made. I trust Him and look forward to seeing where I am placed! I will find out on March 22. Any prayers are appreciated as I wait for this assignment!
I also found out this week that I have been invited to join Sigma Theta Tau which is the nursing student honor society. The induction ceremony is at the end of April and I feel like this is a much deserved and well earned distinction. It's hard to believe that all of this is starting to wind down and that graduation is less than 10 months away. HOLY COW!
My words of wisdom this week are " Go with your gut. Always look at your patient but don't let what you see distract you from what you think. Sometimes the picture doesn't match the description."