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Last Saturday, I have had the most shameful experience so far being a student nurse.

My patient is a 10 year-old male with a provisional diagnosis of T/C CNS Infection. He has body weakness, episodes of vomiting and he was very irritable. However, he still is conscious, coherent and oriented in three spheres (person, place and time).

During the shift, I took his Vital Signs, I noted that he had fever with a temperature of 38.2C so I performed Tepid Sponge Bath for my nursing intervention, then I rechecked his temperature after 30 minutes and it was 36.8C. I took his blood pressure though he is just a pediatric because of his episodes of high blood pressure. True enough, I noted 120/90 mmHg for his BP and it’s really high for his age.

For about 5 minutes later, a medical intern (or is she?…hmmm I don’t know) rechecked my patient’s Vital Signs, she copied the temperature I got but she, on her own got the cardiac and respiratory rate. Here comes the problem. When the doctor checked his BP, at first she didn’t got it because of the patient’s constant movement and noise and do she pumped again. I observed what she was doing, she pumped at 140 mmHg then release. She read the measurement and relay a 140/100 mmHg reading.

I was shocked. REALLY SHOCKED.

What the HELL happened there? I was really definite of my reading few minutes before. The mother was also shocked because I said to her that her child’s BP is just 120/90 mmHg. I didn’t take any move.

The doctor explained that the other doctor endorsed that the patient has consistently high blood pressure since admission, he even had a reading of 160/140 mmHg (as far as I can remember). At the back of my mind, I was battling with her statements I mean, that BP reading was before the client got medical management for his condition. If she could review the chart, which I thoroughly reviewed, his BP now was ranging from 110-130 systolic and 80-90 diastolic.

She even tested for Kernig’s and Brudzinski’s sign roughly. She didn’t asked the patient face to face if he experienced nuchal rigidity even if he can answer it directly, she just asked the patient’s mother to do it for her. What’s the point right? What kind of assessment was that?

Minutes after that “i-don’t-know-what-kind-of” doctor, the mother approached me. She said “Minuto lang ang nakalipas, sabi mo 120/90 lang, ngayon ang taas na…” I just said in a low tone of voice, “yoon po talaga ang nakuha ko… 120/90 po talaga yon…” then I left.

If ever I’d be assigned to the same patient again next week, I don’t know if I still have the face to render care to him. I was on shame at the same time I was pissed.

FEU Student Nurses are trained to get Vital Signs accurately without altering the results (well at least for my group). It is our forte considering it is what we do almost all at the time during clinical rotations especially if the hospital is benign (non-toxic) with matching NCP and Drug Study making. It has become our routine and our specialty. Sad but true. To be questioned in what I know I do best is a big slap on my ego.

I reported this incident to my clinical instructor and she just said “Hayaan mo yang mga yan, mga insecure lang yang mga yan. Ganyan talaga yang mga yan.”. I still can’t move on with what happened. I just said “Sige, kaysa naman yung doktor yung mapahiya, ako na lang kasi estudyante lang naman ako…” even though I know I am right.

Altering Vital Signs is crucial for the well-being of a patient. It can kill. If you would refer to my previous post.

I hope health care providers will possess the virtue of veracity because it is life that we are dealing with and not just a toy which you could by another if broken.

So yeah, after I have finished one module in our E-Learning, here I am today enjoying myself in our cozy home at the same time, being absent for my E-Learning schedule. Yes, my mom knows about it. I actually asked her permission regarding my absence. LOL!

For the past 2 weeks, I have been on straight duties and lectures. No free day, as in no time for rest.

Here is what happens when you are sleep deprived.

taken at Q.I

He is really sleeping...

2 in a row! LOL!

Student Nurses, if given the chance (even if there is no chance…LOL!) would steal even just a minute for sleep. Yeah, I am dead guilty. I have actually learned a skill for that— Sleeping in anywhere (be it on public transportations or in the hospital itself) and in any style you want as long as you don’t get caught. The best part in that skill is I can sleep with eyes OPEN. LOL!

I just realized, taking stolen pictures will help me not to have sleeping pictures. LOL! My skill in taking such unique photos is another story…=D Beware…LOL!

Oh wait, I still have loads of things pending to be done… arggghhh!

Free day is the new “Do-My-Schoolwork-Day” *sniffs.

*Now this would make me a good student. (Sarcasm again. tsk)

I am sure every one of my batch mates would agree to me if I say we are…

B.S in Nursing Major in Rizal and Speech!!!

Why?

In Rizal’s class, we were asked to create a dramatic play of the characters in Noli Me Tangere or El Filibusterismo as our Final Exam… (how demanding right?)

I played Maria Clara

In Speech’s class, we were asked to formulate our own product and advertise it to the whole class as for our Midterm Exam. This Finals, we were asked to act dramatic speech for our Final exam and a news reporting for our Finals Recitation grade. Whew!

Sorry for the rough shot...

I feel the need to prioritize them for they entail much time for practicing. But that’s not the case right? I should be focusing more on my NCM 103-B subject because it is a 16-unit subject and definitely on great weight with my future career.

You could just imagine how much students would do just for grades, you will see them doing crazy stuffs just for a 3 or 4-unit subjects. Meeen! That’s rough. If you just watched our performances with each class… Some of them are in my YouTube account. It’s fun but if you would look at it closely, it’s not of great weigh with our course.

My Classmate, Jojo (selling deodorant)

Mon as Maria Clara and Jo as Tiya Isabel

Good thing I finished the Rizal’s play and the Speech’s product endorsement.

However, THERE’S MORE TO COME!!! *horror tune…

Good luck to all of us…

Honestly, when I learned that our clinical exposure for our communicable disease is at Quezon Institute, I was dismayed for I really wanted to rotate at San Lazaro Hospital, where there are grave cases of different communicable diseases. However, I knew that Quezon Institute is also a tertiary hospital, which caters not only Tuberculosis, one of the most common communicable disease but also other respiratory diseases. In that case, I can appreciate my communicable disease concept.

Before entering the ward, I envisioned of the normal room setting and everything for a tertiary hospital. My expectation was right. The beds where side by side with each other with enough space for each client and a window. This is not to belittle the hospital because honestly, I really want to be exposed to the real scenario of hospital setting in the Philippines. Quezon Institute, at least though, in just a small span of time opened my eyes to what at real hospital set-up is.

Compared to my previous clinical exposures, the difference of Quezon Institute is the personal protection equipments that are being used by the care providers. This fact, in my own point of view, is a hindrance for building rapport with the client and providing the proper nursing management for them. If only I would not put myself at risk for acquiring the disease, I would not wear those. It is also true with the stigma attached to the tuberculosis patients, which made them receive less nursing interaction and management because of fear and disgust— for some.

Honestly, I am not afraid of the TB patients because I believe I have the knowledge as my tool in proper approach and management for them. I was just not at ease with the PPEs we wore. Good thing, my clinical instructor really assured us that we are safe. She really assisted us with everything that we do for our patients. That, made me confident enough for I can see her handling patients with just a mask as her protection. I admire her for that (not to be a teacher’s pet or what so ever…).

When it comes to the care I gave with my patient, my assessment skills was improved though there are some observations that I wasn’t sure of. I proved that with the proper knowledge, you can never go wrong. I also learned that, nursing profession is really a risky job. Nursing is not just a job and you don’t do it just for financial purposes. As from what I can see, it is like a vocation, which entails passion and dedication. You have to take care of your patients but not compromising yourself.

In Quezon Institute, my learning is pure realizations, which I know, will never be placed into my unconscious mind…=)

I would just like to share my sentiments regarding our clinical rotations during this semester. Yes, I know its only the middle of the semester to conclude about our clinical rotations but I am a bit frustrated because we we’re informed that our rotations this semester will be on specialty areas, specifically, National Center for Mental Health (which we have gone through), San Lazaro Hospital (NOT and I believe we are the only one’s who haven’t had our duty there) and the Philippine Orthopedic Center (NOT again but instead, we had our duty at FEU-NRMF our base hospital but only in a medical ward pfft! I can’t find any connection!).

We had the most boring rotations we have ever had (except for VINES). I want action. Honestly, I can’t feel that I am on my senior year except for the fact that my Rizal and Speech classes demands like a dramatic play and a commercial endorsement for our midterm exam. LOL! Our rotations last for only 4 days with just plain vital signs and NCP( Nursing Care Plan) making. It’s like we are just paying for nothing.

I want to voice this out to our coordinators but I don’t even know their names, only their faces. We once had an Open Mic with our Dean but sadly, they just gave reasons that only made us nod and pretend that we’re fine with that. In that case, I proved that nurses are really good at giving RATIONALES. I can’t blame them because of the big population of nursing students at FEU (we are 2000+ in our batch).

With our rotations, nothing’s new except for the infection exposure we are experiencing (I don’t think that’s a great thing). But being a nurse, the positive side of that is we could strengthen our immune system and be resistant to those diseases.

This week, we are going to have our exposure at the Quezon Institute, which is known for respiratory diseases which make me conclude for the aforementioned statement again because our concept is now on Communicable Diseases.

Timing is just so busted because I currently have Coryza, which made me immunocompromised. My mom advised me to take vitamins but I hesitated because the last time I tried to double the dose of my Vitamin C, I turned out to be out of my mind. I constantly forget things and I become clumsy. I hate those adverse effects. To testify to that, my group mates also share the same experience as mine. LOL!

Anyway, I hope few rotations that our group will going to have will be at least fruitful just to feel that our tuition fee is worth paying and just to feel that we are in our senior year. I hope somebody’s listening to my concern.

Please bear with my SARCASM.

I always envision myself as a registered nurse since I took up B.S Nursing. I even affix “R.N” after my name (which is indeed a violation) and see if it sounds good. Also, I always put the phrase “Future RN” in one of my accounts on the web. To my delight, yes, it does fit my name so good. It even feels good.

However, during my VINES rotation, there was a sudden change of cold weather.

It brought deaths of my patients… (dummies considered as real patients)

Then, I found a new profession…

“RM” a Registered Murderer (instead of RN, which is a Registered Nurse)
(We joked about it but on the other side, it isn’t funny)

From Day 1 to Day 4, I wasn’t able to save lives. All the patients who needs resuscitation was left not resuscitated despite of all the efforts because of a few little mistakes.

I killed Hal (refer to my previous post)
I killed the baby with a case of cord prolapse (but I saved the mother, being a high-risk pregnant)
I killed another baby who coded after delivery (it should be Pedi Blue but he wasn’t available during our simulation)

Fatality with just simple mistakes pffft! Mistakes that I won’t elaborate anymore.

I REALLY NEED TO STUDY AND IMPROVE MY CRITICAL THINKING

(during simulations and not just on theories)

My time being a student is not getting any longer. Oh well, at least I learned. Next time, I will be very careful with my actions because in the near future, DUMMY TIME IS OVER.

One thing I learned at our VINES exposure yesterday:

Never compromise the experience you can have into something lighter just to avoid or prevent frustrations. Let the worse comes to worst because with the worst, you will gain the best learning you can ever possess.- dianne

It’s just sad that some of the experience that I should have experienced was not met because (I don’t want to talk about it. Conflict just around the corner…LOL!) Maybe that experience will happen again years from now and it sucks (I feel our group {just the 6 of us} are the only ones who didn’t experience it). It’s so disappointing because I really want to experience everything into its fullest even if there are frustrations rather than experiencing a little with no frustrations (with the same learning) because it’s harder to accept the learning if you are not satisfied with your experience.

Now I am only left to count years… *sigh

I killed a person today.

I thought what I know was enough to revive Hal but I was wrong. I let him die— well, our group let him die.

Our group was assigned to the FEU-VINES (Virtual Integrated Nursing Education Simulation) Laboratory for our duty on Acute Biologic Crisis concept and with this concept, we will going to simulate a cardio-pulmonary resuscitation to the mannequin named HAL. The scenario was, the client was coding (with our clinical instructor controlling his status) and we should revive him the best way we could according to what was taught to us.

During the simulation, we have given too much epinephrine to Hal without the interval of 3-5 minutes that made him more critical and so, still with constant compressing and hyperventilating, at times defibrillating, our clinical instructor just said, ok Post Mortem (meaning, we didn’t revived him.) Then, stopped and pronounced the time of death.

My critical mind tells me, “We we’re used to our AHSE (Associate in Health and Science Education) days to just assume things and not “really” do the procedure that is why we forgot to say “After 3 minutes blah blah blah…” which killed Hal. I learned that “To assume is a mortal sin.” Also, our adrenaline rush and increase of our excitatory neurotransmitters leads us to forgetting things. — That was I, using Rationalization.

Though Hal is just a mannequin, he was still my patient and I was frustrated because our efforts was not enough to revive him as much as we do want him to survive. (In VINES laboratory, mannequins are treated as “real” persons).

I was on mixed emotions because I felt like a real nurse (we are even called “junior nurses”) in that scenario but I was saddened by the fact that we didn’t revived him. I enjoyed the simulation because I learned a lot of things but I was dismayed for the little mistakes we’ve made. Nevertheless, this will make me to bear all the things I’ve learned today in my heart and not repeat the same mistake over again.

Don’t worry. I am Ok now. =)

Today was my second time entering the newest and only-in-FEU laboratory for nursing education because we are assigned there for our duty. The first was during my level III first semester revalida but it was not yet fully functional. You may often hear FEU nursing students saying:

Duty kami bukas sa VINES…
Nakapunta ka na sa VINES?
Ansaya sa VINES… the best!
Wow, sosyal… sa VINES kayo…
Excited na ako mag-VINES…

Which leaves you clueless about what you just heard. Worry no more because I am here to orient to on what is a VINES Laboratory.

VINES is an acronym for Virtual Integrated Nursing Education Simulation. It is the first and only full operational virtual nursing laboratory in the Philippines. It provides a realistic, state-of-the-art, joint commission compliant, and controlled safe environment for the students to practice safely in supportive environment before the students can enter the real world of healthcare. It is designed to replace the healthcare setting and facilities development of skills by using a simulated healthcare setting.

So in short, this is a hospital-like laboratory wherein it is divided into different areas: 6 bed wards, Medication room, Clean Utility room, Nurses’ lounge, Ante room (I am not familiar with this), Isolation/Private room, Control room 1&2, Intensive Care Unit 1&2, Emergency room, Operating/Delivery Room complex, Holding area, High Risk Pregnancy unit/Post- Anesthesia Care unit, Nursery and Central Supply room.

There are also mannequins (GERI for geriatrics, MIKE and MICHELLE for pediatrics, NOELLE for maternal and neonatal birthing, PEDI BLUE for neonates, CPR SUSIE for CPR, HAL for Acute Biologic Crisis) on which most nursing interventions can be practiced and variety of equipment that can be found in the hospital setting including a hoist, patient monitors and infusion pumps, a bedside sink and table.

If you want to view FEU’s VINES laboratory you can watch this video:

Before I forgot, VINES laboratory is equipped with cameras and microphones to monitor the activities in the laboratory. It is something like the “Big Brother”. Cameras are capable of zooming-in and zooming-out and rotating 360 degrees.

Our laboratory was also featured on GMA 7’s Saksi. Here’s the video:

No wonder why FEU is being branded as the Fastest Earning University LOL! It is good to know that our tuition fee is going to something, which could be of great help for our learning. We will be oriented on hospital settings in which at times we aren’t able to know or experience with the “real” hospitals. Lucky for our batch because we were able to utilize this laboratory when it is fully-functional already. During our simulations, our Clinical instructors would tell the prices of each mannequins and equipments for us to take care of those things and believe me, our tuition fee is not enough to pay for those just in case.

VINES laboratory have a high tech simulators that will make you say “Wow!” “Bongga…” “Sosyal!” “Wala sa bundok nito…”. It really facilitated my learning very well. I enjoyed it very much. I appreciated nursing procedures, which was discussed to us and I was able to practice it (in nursing, you will not know how it goes if you don’t perform it). This I believe is FEU’s edge among other nursing schools mushroom-ing (LOL!) nowadays and I am definitely proud of it (because I paid for it. LOL! Kidding…).

My source is from the VINES Code of Professional Behavior— Student Information handout. This is not a sponsored post. LOL!

*the video is from feuvineslab

Far Eastern University, Institute of Nursing has this rotation of schedules for duties and lectures. They shift schedules every grading period to rotate the students equally in their clinical exposure and not to come in conflict with their lecture days. Two days will be spent for lecture, three days for clinical exposure and one day for our rest day.

Last preliminary period, I have a Monday-Wednesday duty days and Friday-Saturday lecture days which make Thurdays a rest day for me which I haven’t felt because of busy schedule.
Now that we are on the Midterm period, my schedule is now Monday-Tuesday lecture days and Wednesday-Friday duty days, which make Saturdays my rest day. It’s a good thing for I can rest for two consecutive days considering that the next day is Sunday.

If you would connect this blog entry to my “E-learning Blues” post, Saturdays are now my E-learning day and I was able to attend it. Finally! Though I arrived late, I was able to finish at least 2 topics. I was somewhat dismayed when I learned that the E-learning people closed the module that I am previously doing which means that I can’t continue it anymore and gives me a 0(Zero) mark on each quizzes in that particular module. Poor me! Anyway, I will try to finish the module that I am into right now which is about Acute Biologic Crisis.

Congratulate me for I have attended my E-learning the second time! LOL! *claps for me… I have my e-learning schedule on all Saturdays of August. Hopefully (Again…) I can attend to all of those.

Inkling:
What a long introduction… BOW!