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Nurse Mo wants you to ace nursing school!

WELCOME! Maybe you’re here because you’re starting nursing school, dreaming of nursing school or just getting ready to buckle down again for another semester. This blog is so much more than a blog, there’s also a ton of FREE educational resources!

At the top of the page, you see a menu bar with some headers…explore your heart out because this is where you’ll find notes related to nursing school, printable reference sheets, study aids, goodies to buy, a link to my e-book and loads more.

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TBT: Microbiology is done!

Screenshot 2015-05-20 09.05.35

For Throwback Thursday I am unearthing old blog posts from my nursing school days…care to travel back in time with me?

May I ever so humbly…brag?

Ok, I can’t resist! After reading through some not-so-recent posts, I realized I never provided closure to the whole Microbiology thing. Let’s just say there was a highest grade in the class and that I know this person VERY well. Was that modest enough? The really amazing thing is that I got a higher grade than Doogie Howser, this total science geek that sat next to me for all of two weeks before I had to relocate thanks to his constant muttering and criticisms of the instructor. So, toot-too…that’s one more horn tooting for moi! Who knew? (originally posted 1/31/08)

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Starting nursing school soon?

nursing studentIf you are one of the thousands of new students starting nursing school this fall, I have one word…Congratulations! I also have a few bits of advice, so if you’re looking for encouragement or a reality check…this post is for you!

My first piece of advice is to take a few deep breaths. Ok, more than a few. If you have been vying for a spot in a competitive program, then you have undoubtedly busted your hump to get excellent grades and rock that pre-admissions assessment. Now you can take a deep breath and just relax for a bit. If you’ve been biting your nails waiting to see if you’re one of the lucky ones to be admitted in a lottery system, then kick your feet up and give your poor fingers a rest. The unknown part is over, and while I won’t say it gets any easier, the pressure shifts from “will I get in” to something else entirely. For now, just enjoy the moment of knowing  you’re definitively on the path of realizing your dream. Do it with me…deep breath in….full exhale out. Ok, feel better?

The next thing I want to stress is that NOW is the time to start getting ready for next semester. The first thing you need to do is recharge those batteries. Sleep in if you can, take a vacation, spend time with family and friends, get outside as much as possible, watch trash TV, read for pleasure, go to the gym, be creative…do all those things that bring you joy. For the next couple of months, this will be your first order of business. Got it?

Since you can’t play ALL the time (I know it’s just not in you to goof off 24/7), some attention should be given to organizing your home and life as much as possible. You will have precious little time for feathering your nest while in school, so take care of those projects now. Go through closets, organize your desk area, get rid of that old can of baking soda that expired three years ago. Declutter and streamline your home, and you’ll find your stress levels drop drastically.

As the end of the summer draws near, start prepping for school by getting all your pre-semester stuff done ahead of time. Your school will likely be sending you all sorts of communication about vaccines, titers, background checks, equipment, uniforms, etc.. Take care of these things early so you don’t have to stress about them when the semester starts. In addition, take some extra time to make and freeze some delicious dinners…I always loved coming home at the end of a long day and having something good to eat with very little effort.

I talk in much more detail about how to get organized for school in my book Nursing School Thrive Guide, so if you’re into that sort of thing I urge you to check it out! The rest of your readiness will involve getting prepared mentally and emotionally. Nursing school is demanding on both your time and your sulci. And while this blog is titled “Straight A Nursing Student” the focus isn’t on just earning great grades…it’s about the attitude with which you approach your studies and always doing your absolute best for the sake of your future patients. Anyone who tells you to “relax” in nursing school because you “already got in” or “C’s get degrees” is doing you a disservice. Whether you get an A or a C is immaterial if you studied your tail off, understand the material, and are knowledgable enough to take excellent care of your patients. THAT’S what’s important. While I am the first to admit I was overwhelmingly obsessed with grades while in nursing school, I was obsessed for the right reasons…I used my grades as a yardstick against which to measure my mastery of the material. I knew that if I had studied enough to earn an A, then I knew the material…if I applied it well in clinical, then I  had a slam-dunk. Everyone is different, so I don’t want you to get caught up in the grade you receive, but HOW YOU GET THERE. Some people don’t test well, plain and simple. My point is…do your absolute best and forget the rest.

The next thing I want you to do is to let go of your competitive attitude. Many students striving to get into a merit-based program have a hard time with this. Let it go. You’re in. Now you can turn your attention and zeal for hard work into helping your classmates or collaborating together to figure out tough problems.

With that said, do not be too proud to ask for help. The nurse who never asks for help and never asks questions for fear of looking unknowledgeable is the most dangerous nurse in the room. If you don’t understand something…ask! If you need help with something, approach a classmate who can provide an explanation or figure it out with you. Reach out, explore, assist and collaborate…you’ll save yourself a ton of grief and probably make some lifelong friends in the process.

If you’re shy, you need to work on getting over this as soon as possible. Good nurses are not shy. They are personable, communicative and assertive. If you have a hard time when meeting new people or being in new situations, spend some time this summer practicing being more outgoing and confident. How on earth do you do this? One great way is to get a job that forces you to interact with the general public. I was incredibly shy until I started working as a waitress…that job forced me out of my shell and gave me tons more confidence than I had before. If you can get a summer job at a restaurant, retail shop, grocery store or coffee shop…go for it! You’ll get used to interacting with strangers and your people skills will go through the roof. If a job isn’t in the cards for you, then consider doing group activities (and no, hanging out at bars doesn’t count). One great resource is meetup.com…it’s a website that connects people for activities such as trivia nights, hiking, frisbee, wine tasting, dining, cycling, poetry writing…pretty much anything under the sun has a meetup group to go with it.

Another great thing to do is volunteer at a hospital. Not only will you gain some experience interacting with patients (even if it’s just “can I bring you a warm blanket?”), but you’ll get an introduction to what working in a hospital is like. If you’re lucky, you’ll volunteer on a unit that embraces your presence and offers up opportunities for you to observe procedures and whatnot.

You got this far for a reason…you are smart, capable and driven. You WILL succeed in nursing school as long as you are kind to yourself and care immensely about your patients. You will have moments of doubt, you will have moments where you just want to curl up into a little ball in a dark room and cry. Just know that these moments are temporary. They will pass, I promise. When you have a moment like that, the absolute worst thing you can do is push yourself even harder…pay attention to what your body and spirit are craving and take care of yourself. If you ever feel you’re on the verge of a breakdown I invite you to take a step back, close the books, and get away for a little bit. Take a walk, call a friend, go out with your partner. And if you ever doubt yourself, even for one little second, you can always email me and I’ll tell you how fabulous and wonderful you are.

Enjoy your summer, and be safe out there!

 

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TBT: Toot! Toot!

Screenshot 2015-05-20 09.05.35

For Throwback Thursday I am posting one blog entry from nursing school each week. This post takes us back to microbiology, one of the big nursing school prerequisites. So get in your time machine and travel back to the “good ol’ days”…don’t forget your seatbelt!

Toot! Toot!

That’s me…tooting my own horn again. I got a 98.8% on my last Microbiology exam. Whooo-hooooo! OK, I know it’s not cool to brag but I can’t help it! I am so darn amazed at how this whole school thing is turning out. Is this a sign that I am finally looking in the right direction? Science is just so fun (that’s the school nerd in me talking….the same school nerd that has an Excel spreadsheet so I can keep track of my A!). And now we’re finally to the section of the class where we learn all about nasty diseases. I am a walking encyclopedia of nastiness right now…a word to the wise: get your tetanus booster. You do not want tetanus. Period.

Happy Thanksgiving! (originally posted 11/23/07)

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Review: Nutrition Bars

Screenshot 2015-06-03 13.33.45If you’re a nurse or a nursing student, there is one thing I can be sure of. You are one busy bee. Sometimes your schedule doesn’t allow you the wonderful luxury of a delicious, home-cooked meal so you may find that you often eat “on the run.” Rather than reach for something naughty (salt and vinegar chips, I’m talking to you!), I’ve put together a quick review of some good and good-for-you nutrition bars to help fuel you through your busy days.

First a disclaimer…I don’t do fake food. These bars are all (for the most part) organic and contain actual real food as ingredients…not hydrolyzed soy protein or any other such garbage. As such they’re not the cheapest bars out there, but they are so much better for you than that junk that I can confidently say it is worth the extra expense. Plus, I tend to view these bars as a meal replacement (or maybe the core of a meal with something added such as a banana, hardboiled egg or small piece of grilled chicken), so if you look at it as a whole meal, the cost is cheap in comparison. I typically will have one of these as my breakfast while I’m at work…5am is much too early for food, so I will reach for one of these around 9 or 10.  In addition, I wanted to review bars you may not have tried…it’s always fun to try something new! So, without further ado…here are 7 bars for your tasting pleasure!

Kit’s Organic Cherry and Pumpkin Seed Bar
Nursing school snacksPros: Fresh, looked like actual food, not too sweet, good texture and substantial. Gluten free, soy free, dairy free. Overall, I really really liked this bar! It filled me up and tasted like real actual food…not like some of those “energy bars” that shall remain nameless! I had it with my mid-morning cup of coffee around 10am, and it held me over until my 2pm lunch break. Delish!
Cons: None
Rating: 5 stars
Cost: $1.79 at Whole Foods (available lots of places online!)

Quest Strawberry Cheesecake BarNursing School

Pros: Gluten free, soy free (not sure about dairy)
Cons: In a word, “blech.” I read online reviews for this bar when I bought it and people raved about it…but I just don’t get it. If you gravitate toward protein bars that are highly processed, then maybe you’ll like this. The overall texture was very grainy and synthetic. It was far too sweet and tasted unnatural. I didn’t even finish this bar, and that’s saying a lot. I love food. Not sure this qualifies as food.
Rating: 1 star
Cost: $1.99 various sources

Vega Snack Bar Chocolate Peanut Butter CupNursing school snacks

Pros: Plant-based, non-GMO, pleasant texture with little rice crisps, a sweet treat. Gluten free, soy free, dairy free!
Cons: Probably too sweet for a mid-morning snack (unless you like that sort of thing). I preferred this as a mid-afternoon pick-me-up…but it was pretty decadent, so not something I’d have every day.
Rating: 4 stars
Cost: $2.49 at Whole Foods (good deals online!)

Pure Organic Apple Cinnamon Bar
Nursing school mealsPros: Pronouncable ingredients, good texture with a little chewiness thanks to the dates. Gluten free, soy free and dairy free.
Cons: Super strong cinnamon flavor, like waaaay too cinnamon-y.
Rating: 3 stars
Cost: $1.79 to $2.29, various sources

SquareBar Cocoa Coconut Organic Protein Bar
Nursing schoolPros: Really tasty! Gluten free, soy free, dairy free, peanut free corn free. But not flavor free! I really liked this bar as an afternoon “dessert” for that 4pm lull that inevitably hits. And, with 11g of vegan protein, it’s not just a bunch of empty calories.
Cons: Very sweet, which is why I wouldn’t be able to deal with it first thing in the morning.
Rating: 5 stars
Cost: $2.49 at Whole Foods (bargains online!)

LaraBar Blueberry Muffin
Nursing school foodPros: Good flavor, nice texture, not too sweet and only a handful of ingredients. The Blueberry Muffin is my “go-to” LaraBar flavor. It’s gluten free, soy free, dairy free and vegan. I really like these bars and eat them all the time…not necessarily because they are my all-time favorite bars, but they’re pretty darn good, pretty darn inexpensive and available everywhere. I’ve seen these bars at places like Target, Trader Joes, Whole Foods and probably most other mainstream grocery stores…I feel like I see them everywhere. Love ’em!
Cons: None.
Rating: 4 stars
Cost: $1.47- $1.99 various sources.

Epic Turkey Almond Cranberry Bar
Nursing school nutritionPros: High protein, gluten free, savory and substantial. I call this bar my “meat stick” because that’s essentially what it is. This one tastes pretty much like Thanksgiving On the Run…I really like these bars! These are great for those times when you don’t want a sweet or fruity bar.
Cons: None
Rating: 5 stars
Cost: $2.99 at Whole Foods (slightly cheaper online)

So there you go! I hope you find a bar you like and avoid reaching for junk food to fuel you through those busy days. Enjoy!

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Setting up a CVP line

When you do your critical care clinical rotation, you will most likely be monitoring your patient’s CVP (central venous pressure). We’ll get into the what’s and why’s of CVPs in another post…for this post we’re going to talk about the basics of setting up the CVP line. With any luck you’ll get an opportunity to practice, so this should give you a wee bit of a head start. Note that I always say there is more than one way to skin a cat….if your preceptor sets up the lines differently, that is great…you’ll learn multiple ways and ultimately figure out the one that works best for you. Ok, let’s get going!

The first thing you’ll want to do is get your supplies. In the ICU where I work these are called “Sorensen Kits” but maybe that’s just what we call them. The kit includes a 500ml NS, a pressure bag (though not really a bag itself…it wraps around your bag to create pressure), a transducer and a mount so you can attach the transducer to your IV pole.

Here’s what our kits look like (except for the pressure bag)

Screen Shot 2015-06-02 at 6.26.10 PM

Open your transducer packaging and check all the connections. You don’t want to go through all the trouble of setting up your line, only to lose sterility when a piece falls onto the floor. So, check all connections first!

Pressure bag

Check those connections and make sure they’re tight!

Next, clamp your IV line so that when you spike your bag, you don’t get a bunch of air as things run willy-nilly through your pressure system.

CVP setup

Clamp that line, ya’ll!

Next, you will spike your IV bag and mount it inside your pressure device, like so:

RAP monitoring

Mount your NS bag inside your pressure device…ours have a little hook.

CVP setup

Spike that bag! Stay sterile!

Now this is when the big controversy starts. Some people swear by flushing your line without any added pressure, but I have found that I need at least some pressure in order to get the NS to run all the way through the line. Feel free to try it both ways and do what works best for you. So for me, my next step is to pressurize my bag.

CVP setup

Your bag has a pressure gauge…here it is at zero-ish.

CVP monitoring

Pump your bag up to 300 mmHg max.

You’ll notice that even though you pumped your pressure up to 200-300, removed the cap on the line, and unclamped your roller, nothing much is happening. That’s because there’s a little dohicky of some kind on the system that keeps it more or less closed. On our systems, that little dohicky is a blue “pigtail.” Make sure the open end of your pressure line is aiming into some kind of receptacle (I always use the bag the transducer kit comes in) and pull on that little pigtail. Voila! The NS should now flow through your line. Yay!

CVP transducer

This little piggy said “pull my tail” to prime your line!

The next thing you’ll notice is that your syringe is filling up with NS…fill that baby up! I didn’t take a picture of this part (sorry!) but you’ll get your syringe nice and full, then flush that NS through the remainder of the line. Look throughout your line for any bubbles. If you spot any, just flush some more by pulling on your pigtail. Once your line is clear of all air bubbles, you’re almost there!

The next thing you want to do is replace the cap on the transducer with what’s called a “dead-ender.” The cap on the transducer actually has a little opening…you need this to be a closed system, so check out that cute little bag of extra caps in your transducer kit. See the blue one? That’s the one you want. Before you put the blue cap on, turn the stopcock on the transducer so that you are OPEN to the white cap it came with…pull your pigtail and you’ll see NS squirt out through the opening on that cap. Cool, huh?

CVP

Turn your stopcock and flush through that open-ended cap.

Once that little tiny length of plastic is primed, take off the white open-ended cap and replace with a blue “dead-ender.” Like so:

It's blue and it's CLOSED. This is a "Dead End."

It’s blue and it’s CLOSED. This is a “Dead End.”

Now, all that’s left is to actually attach your setup to your patient. You’ll want to use a central line for this (obviously, that’s why it’s called CENTRAL venous pressure monitoring…haha). While you can technically use a PICC line for it, the PICC itself is so long it produces its own pressure, so I find I get the best and most reliable readings from a central line placed in the IJ.

Hang your pressurized bag on an IV pole, and attach your mounting device to the pole. Next, mount your transducer to the mounting device (was that redundant?) and connect your pressure line to your central line. Make sure the port on your central line doesn’t have any kind of valve device added to it…just screw the pressure line straight into the central line.

Now you’ll get out your trusty level and level the transducer to the phlebostatic axis…which is here:

The phlebostatic axis as depicted at http://ccn.aacnjournals.org/content/24/3/67/F1.expansion.

The phlebostatic axis as depicted at http://ccn.aacnjournals.org/content/24/3/67/F1.expansion.

Next, you’ll zero your system (which may be completely different depending on what kind of monitor you use, so I won’t go into that here) and you will see your CVP tracing on the monitor. Cool huh?

So those are the basics for setting up your CVP line…give it a few practices and you’ll be setting up your lines like a pro in no time!

Be safe out there!

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TBT: Surviving Microbiology

Screenshot 2015-05-20 09.05.35For Throwback Thursday I am re-posting a blog entry each week from my nursing school days…so travel back in time with me as we revisit the joy that is nursing school!

I survived my first microbiology test! 

AND I have it on good authority that Microbiology gets much better after all that icky metabolism stuff. So YAY! I counted up all the questions I totally guessed on, and that totalled about 9, so I figured I might, MIGHT get an A if I slam-dunked my essay questions AND my bonus question. Stay tuned! (originally posted 9/24/07)

It’s a Microbiology Miracle!

Who knew I would end up being a Microbiology Genius? I scored a 95.5% on the first test, and the class average was 75%…AND, this is even with me SKIPPING FOUR QUESTIONS. Not sure how those questions escaped my careful scrutiny, but I somehow managed to skip right over them in a rush to get to the essay questions. Assuming I had answered all four correctly, I could have had a 99.5%. So needless to say, I am feeling pretty good right about now. Let’s hope the genius-ness continues! (originally posted 10/1/07)

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TBT: Microbiology is kicking my macro-booty

Screenshot 2015-05-20 09.05.35For Throwback Thursday, I am re-posting my nursing school blog entries. Each week I’ll post one entry from the “good ol’ days.” Travel back in time with me as we revisit the joy that is nursing school! Here you go!

I am lame…I haven’t posted in almost TWO MONTHS…which is really pathetic. I started school at the end of August (which only partially explains my lameness) and have been a complete whack-job ever since. I have class Monday-Thursday nights and the rest of the time I am trying to get my freelance business up and running, help Tom with his business, take care of the house and three cats + one child (oops, I mean + one husband), and maybe squeeze in time to shave my legs once in a while.

Microbiology is kicking my butt. It makes Chemistry look like a walk in the park…and I studied my butt off for my A in Chem. I have my first test tomorrow night, so we’ll see….but from where I stand it does not look so bueno. Not so bueno at all. I am hoping that the semester will get easier now that we have Microbial Metabolism behind us, but the chapters ahead (Recombinant DNA Technology, Microbial Genetics and other exciting topics) do not bode well. If anyone has taken Micro please let me know if it gets better!!!! I am mainly looking forward to the section of the book where we see what kinds of nasty disesase people get from bacteria and viruses…icky pictures and all!

My lab though, is FUN! It’s really neat to see what kinds of disgusting things grow from our cultures. Plus my lab partner is really nice and every day I thank GOD that I do not have Annoying Guy as my lab partner. Annoying Guy is this major science geek that smirks all the way through class and corrects the teacher’s pronunciation and every little thing under his breath (and sometimes out loud to the whole class). I had the joy and pleasure of sitting near him for the first three weeks until I had HAD IT! I soooo wanted to tell him off, but instead took the path of least resistance and just sat on the opposite side of the room….”Take that you science geek!”

In other news, I am no longer working in the office…did I post about that already? I got “released” from employee status back to my independent contractor status (another thing I am thankful for every day), and am now back to my insane self-employed-ness. The kittens all got exceptional homes, my hair is long enough to put in hot rollers and I am still as fat as ever. I’m working on it though…I promise I am going to get on a schedule and start taking my morning walks again. PROMISE!

I’ll also promise to try to not be so lame and to update my blog more regularly. At the very least I have to let you know how easy my Micro test is…ha! (originally posted 9/23/07)

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Good nurses ask for help

I had a “moment” at work the other day, and while it left me feeling flustered and a bit like a spaz, I think there’s a valuable lesson to be learned. I was taking care of a patient who had a whole host of problems…one of which was pretty severe heart failure. He needed a powerful inotropic medication that I’ve never given before so I was understandably a bit nervous. Luckily, I had this reference sheet available, but I still had a nagging feeling about it. The dosage was ordered as follows:

Give 50 mcg/kg as a bolus; then give maintenance dose of 0.375 ml/kg/min.

Pretty straightforward, right? So I pulled out the good ol’ dimensional analysis method and proceeded to figure out my loading dose. The problem is, I kept getting really weird answers that made NO SENSE. So rather than go with the really weird answer I kept getting, I asked another nurse to do the calculation. Low and behold she got a different answer than I did…so I called pharmacy and they got the same answer my friend did. What had I done wrong? Dimensional analysis works every time for every calculation, right? I am telling you this was bugging me to no end…and the fact that it was annoying me made me even more nervous about giving this particular medication to someone so very very sick.

After taking a few deep breaths I realized what I had done to cause my calculation to be off…it was my conversion factor…I had written it as 200 mcg in 100 ml, whereas it was 200 mcg in 1 ml (the whole bag was 100 ml). This was a huge reminder that a simple thing like a conversion factor can muck up your calculations, mess with your brain and leave you feeling like a frazzled mess. We ended up confirming the correct dosage and all was well, but the whole experience served as a reminder that a good nurse must ALWAYS ask questions, especially of him or herself. I have always said the nurse who never asks questions is the most dangerous nurse on the unit…so even if you are worried about swallowing your pride and asking for help…do it! Your patient deserves it, and you will probably learn something in the process. What did I learn? I learned to sloooow down, check ALL my numbers before doing my calculation, and to always have another nurse independently do the math as well. Next time, I hope to not feel like such a spaz (do people still say spaz? I’m a product of the 80s!).

Be safe out there!

 

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Dosage Calculations Quiz

Last week I posted a tutorial on using dimensional analysis to solve any dosage calculation problem ever. As promised, here is a dosage calculations quiz that will put your knowledge to the test. Good luck and let me know what you think of having presentations on the website. If you like it, I’ll add more tutorials using a slide format. Good times! And be safe out there!

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Review: Compression Socks

If my first words about a pair of socks are “ohmygod,” then you know these are some awesome socks. I kept experiencing achy legs after my shift so I decided to break down and buy some compression socks. But, I didn’t want just any ol’ compression socks, I wanted stylish socks that would complement my boring navy blue uniform.

Compression socks

Super comfy socks!

Sockwell socks are amazing! They are made of a blend of materials, one of which is merino wool. I thought they would be too hot, but they are perfection! The socks provide a moderate level of compression (15-20 mmHg), which is great for nurses who stand/walk all day. Bonus…you can also wear them on an airplane or long car ride if you’re lucky enough to go on any fun trips anywhere!

One of the best things about these socks is that they are made with a little bit of spandex, so they stay in place all day…no saggy socks here!

The pattern I bought is the chevron, and I got them on Amazon for $25. Yes, much much more than I would normally pay for socks, but if it saves my legs and keeps me from getting nasty ol’ varicose veins then it’s money well spent. I initially thought they would be too bulky, but my shoes fit the same as they always do, and I never felt over-heated despite walking hither and yon for 12 hours.

And, maybe this was a coincidence, but I felt so good after my shift that I called a friend to meet up for a drink. I NEVER go out after work…I don’t even stop at the grocery on the way home. I typically head straight to the shower, then straight to the sofa. But, after a shift wearing my Sockwell socks, I had a couple o’ margaritas and some really tasty guac with a dear pal of mine. I can’t wait to wear them again!

Nurse Mo’s rating? 5 stars! Ask for a pair as a graduation gift!

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