week 6. almost done.

my brain is officially full and has closed for business. weeks 5 & 6 have been insane. i do not have the time nor energy to share much more than that. i will try and write a true update sometime in the near future.

fun fact for the day ...

cancer has a smell

ending week four

.... the hospital/campus @ ucsf (my house too) ....


.... in short ....

i have competed three major exams. passed two clinical assessments. have kept up with all "a" grades.

i have gotten to remove IVs and a foley catheter (the one that goes up your urethra). i can take care of tracheostomies. and i now know how to navigate a crazy computerized charting system.

.... people i have worked with ....

- a 2o something with a pleural effusion. fluid around his lungs. with a chest tube to drain it. caused by a cancer that has spread throughout his entire body. he was just as interested in the ucsf blood delivering robot as i was.

cool video of a similar drain.

- a 30 something with a crazy syndrome called churg strause. it can be mild. but this case was all over the place.

- a few patients with pancreatitis who have undergone endoscopic retrograde catheterization of the gallbladder. most of them have to get this procedure done often. they are comfortable in the hospital and very open to student nurses.

- an incarcerated patient. they remain shackled to the bed as we care for them. we are told to turn our badges so they do not learn our last names. we are not supposed to talk to them about anything other than care. they each have two guards with them at all times.

- a 50 something with a urinary tract infection that spread to his kidneys. then produced emboli (little moving pieces) that infected his spinal column and its bones.

- several patients with a bundle of comorbidities that render them unable function. and are not compatable with survival. pallative care is wonderful to be a part of. but the closer the patient is to my own age, the harder it is for me to feel okay.

.... i love patient care assistants ....

on the floor they are called pcas. in other places they are called certified nursing assistants (cna). they are the greatest people to be friends with in the hospital. they do most of the "dirty work" and give patients diginity when it can easily be lacking. they show me the best ways to comfort people and constantly remind me that everyone working on the floor is of equal importnace. this is often forgotten.

.... the new medical teams ....

just around the time we started on the floor so did a fresh batch of medical students. they are great to have around. whenever we turn into chickens without heads we gain confidence by knowing that they feel more lost than we. they are all very fun to watch. when codes are called they run so fast it is funny. it is weird that in a hospital the best way to learn how to save people is to watch them almost die. i too try and hunt down procedures and all the excitement. i just don't run. my favorite thing this week was that the medical students kept asking me questions like i have been a nurse at ucsf forever. sometimes i would make up completely random things that were obviously fake just to make them laugh. othertimes i straight up told them that they were talking to the wrong person. still got laughs.

pharmacology exam 1

drug "rights." pharmacodynamics. pharmacokinetics. absorption. distribution. metabolism. excretion. pharmacotherapuetics. receptors. agonists. antagonists. drug routes. first-pass effect. therapeutic index. protein bound drugs. drug metabolism. p450s. allergice reations. pregnancy categories. age related issues. aloe. echinacea. garlic. ginko biloba. kava. st. john's wort. isotretinoin. minoxidil. hydrocortisone. acetaminophen.

people and places

.... brain time ....

my first couple weeks at ucsf have flown by. i have already learned so much that it leaves me in awe of the human brain. i never knew that vast amounts of information could be shoved in there if you just push real hard.

i love what i am doing.

.... the people ....

the people in my program are amazing and inspire me on a daily basis. each time i hear their stories i have the urge to ask them to transfer all their wisdom straight onto me. i loved sarah lawrence because while there i felt like i was finally part of a community that thought about eduction in the way i did. at ucsf i have found a community that thinks about life, service, health and love in the same way i do. it is incredible.

my professors and clinical instructors are also unbelievable. long time nurses are the most knowledgeable people on earth. they are hidden libraries. full of greatness that most do not see. they are the best of both worlds. balancing scientific understanding and compassion in a way that makes it seem effortless.

my class

we did team building in the park on our first friday of classes. this picture was taken in front of the ucsf medical center prior to our day of bonding.

.... my floor @ ucsf medical center ....

i am working on a medical floor at ucsf. we are also an overflow floor. a cancer research floor. a palliative care floor. and a floor that gets incarcerated patients. this means that our patients have just about everything. some wear chains and have guards. some stay in "suites" where their family can be/sleep/eat with them as they live out their final days/weeks. some are cancer patients that are in the hospital being treated for symptoms or comorbidities. it is a great place to be because i have the chance to learn about several different illnesses, treatments, methods and situations.

Palliative care - "medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than striving to halt, delay, or reverse progression of the disease itself or provide a cure"

being on a palliative care floor is hard but very natural. few people get to work with these patients. i am very grateful to be one of them.

.... pathophysiology exam #1 ....

- normal cell function
- homeostasis
- stress response
- cell injury
- adaptation
- aging and death
- genetics
- inflammation & healing
- immunity
- hypersensitivity
- autoimmune diseases

got an A. hope to keep it up. later this week... clinical assessments testing. in the hospital. pharmacology exam #1.

week 2 scope of practice

1. Admission Assessment
2. Bed baths/grooming/hygiene
3. Linen change
4. Ambulating patients
5. Assist in transfers/lifting/positioning/restraints
6. Wound care and simple dressing changes
7. Musculoskeletal and Skin assessments
8. OBSERVATION of any procedure except operating room procedures