This week I had practicum day two and three.  I had trouble getting to sleep the night before day two and I yawned all day.  Despite this it was still a good day. I did more patient care today but still no charting.  I have all the med’s I was allowed to give to all four of our patients and learned many things during the course of my day.  Including how aspirin prevents Niacin flush reaction.  We had a patient who brought it to our attention that he needed to have the PRN aspirin that the doctor prescribed prior to receiving the niacin dose we were trying to give him because he had a severe flush and itching reaction to the Niacin. We asked ourselves how that would work so after we have the prn dose of ASA we sat down at the computer and Googled it.

“There are five cardinal signs of inflammation: redness, heat, pain, swelling, and loss of function of the affected part. The niacin flush reaction fulfills three of these criteria to suggest that it is certainly related to the inflammatory process…. In addition, clinical observations indicate that various anti-inflammatory agents,especially aspirin, can attenuate or block the niacin flush.”  From “The Action of Aspirin in Preventing the Niacin Flush and its Relevance to the Antischizophrenic Action of Megadose Niacin”

I also got to give a drug that was new to me,  to a cancer patient, Neupogen (filgrastim).  This patient had a very very low white count. I had heard of procrit for anemia but I’d never heart of that drug that could stimulate production of white count.  Really interesting to me. I cleaned incisions, dressed a chest tube, and I also had the privilege of giving a suppositiory, this day.  (my first)

I managed to get out on time on day 2.

Day three, was a little more busy.  We only had three patients but they needed lot’s of stuff. We had a pain problem and a no poop problem to deal with.  My clinical instructor was in to see me relatively early.  I had many things to report about all things I have been doing and about the new drugs.

I left the floor at 11:45 to go to the cafeteria and scarf down a lunch of chicken salad on croissant and  french fries before booking it over to IT Sunrise charting training which I was required to go to even though I had been at this particular hospital from September  to December in 2011.  I had difficulty finding the place and made it barely in the nick of time after walking much of the campus.  about 40 minutes in we got a break and I walked over to Winnie and got something to drink because I was so thirsty.  While trying to get a drink Sprite got spilled on my iPhone.  My brand new iPhone.  I wiped it off best I could and went back to class.  I only had to stay another hour (instead of another three hours) because I already knew how to do what he was teaching me how to do.

While walking back to my nursing floor I tried to call my husband and discovered that the earphone part of the phone did not work.  I could not hear anyone speak except through speaker phone.  Damn, a brand new phone shot to hell.    Five hours later when I got to the parking garage my phone worked again and has worked ever since.

I gave report for the first time as a nursing student to an RN on one patient.  My preceptor said I did good.  I was nervous I would forget something.  I was there until 8pm that night and got home around 9pm.   It was a good experience although,  I got home exhausted and ate some dinner watched TV for a while and went to bed.

Which I must do right now. Good night all.