This week has been kind of stressful for me. I had Clinical hospital orientation last Tuesday. We spent a lot of time sitting in various conference rooms for 8 hours listening to the enormous list of expectations they are placing upon us. When I say enormous I mean ENORMOUS, I don’t exaggerate. I found myself getting anxious while I sat there.

We have to go the night before to get our patient information. There is a bunch of information we need to get.  Then after we go there to do that (estimated time 2 hours) we have to go home, look up the pathophysiology on the patients primary diagnosis.  and since we are going to be on surgical floors as opposed to medical floors we have to talk about their surgical procedure. This includes Signs and symptoms, causes, medical treatment, surgical treatment. I also have to discuss nursing care for the pathophysiology (care plans) and surgery.  Then my medication sheets for scheduled medications only up to 10.  We have sheets we have to fill out for the medications which I am already familiar with and should get easier as time moves on because I’m sure medications will be repeated with multiple patients.

We have to present this in pre-conference in the following format:

• Room#/ pt name (or initials)/ age/ doctor
• Admit date/ Diagnosis. Hospital progression (for patients who have been there a while), surgery/ date/ POD (post surgical days), incisions, drains and tubes.
• Previous history
• Labs (abnormals) and Tests (imaging, ekg, etc)
• Assessment findings (abnormal)
• IV’s / IV fluid/ PCA  (patient controlled analgesia)
• PRN meds given last shift. (last pain med)
• I&O values
• Discharge plan (who will take care of them at home)
• Diet toleration and activity tolleration
• Last Bowel movement (super important in surgical patients and patients on narcotic medications)
• Other info:  ie EKG rhythm, dressing changes.

We will assume all care for our chosen patient.  (yeah we get to choose)

This includes: head to toe assessment, checking labs, all medication administrations (except those that need to be pushed)., All AM care which includes, bed making, mouth care, dressing changes, baths,  ambulation of patient and much more. We will give lunch time insulin, and afternoon, order checks, afternoon meds,  etc.

I will be at MD Anderson cancer center however, I have chosen to be on 10/11 LP which is trauma setpdown.  The other option was surgical cancer care and I wasn’t into that, really, lots of maxilofacial surgery and trachs.  I get enough trach’s in my own job so I chose to go to trauma step down. I will be on that floor with 4 other classmates, including Tiffany who I will go to the hospital with each monday to pick up our patient information.  We also spent some time on the actual floors themselves doing a scavenger hunt to make sure we know where everything is.

Then we will have post conference from 1700 – 1830 in which we have to present our patient and revised care plans..  We will have two breaks and an hour long lunch.

I was a little panicky because I am scheduled to work a couple of Mondays and getting off at 7pm does not jive with 4-5 hours of work with a 35 minute one way drive (70 minutes round trip) .  That would be (assuming I get out of work ontime) – arrive at parking garage 7:40 (assuming no traffic on road),  a 10 minute walk to the hospital (8pm), 1.5-2 hrs gathering patient information (10pm) 35 minute drive home. 10:40pm,  and about 1.5 hours work (midnight).  then up at 5am to be at clinical by 6:20-6:30.  It just would not work.

I was, thankfully able to work with my employer to fix that. So now I don’t work on any mondays anymore.