Practicing Clinical Instructors

For me, Practicing Clinical Instructors (PCI's) are just students. They aren't really clinical instructors. They are still learning to be one. They should admit that they aren't fit enough to be called a nurse yet because they still are student nurses.

But it really annoys me when some PCI's think that they are far more superior than us and that they are equals with our clinical instructor. But I beg to differ. They still have a lot to learn before they can be a CI.

There are PCI's thought that are very approachable and respectful. They treat us as equals rather than subordinates and they never say side comments that are not only useless but degrading too.

That is why I'm never happy when PCI's are around because they are just there to nag us around to do our jobs.

Wheezing In the Abdomen?!

I was really frustrated when I heard from my duty mate that a student nurse from another school interrupted their assessment.

It would have been ok if he just stopped with what he said, "Excuse me what are you doing here, that's my patient (in Cebuano)". If I were only there I would have replied, "I never knew that you were the patient's owner." We already asked permission from the nursing station if we could re-asses our patient for our case presentation and we were not on duty so we weren't "stealing" his patient.

Anyway I really got pissed of when my duty mate told me that he just grabbed the stethoscope and insisted that he takes the bowel sounds instead implying that we were dumb and didn't had the needed skills to auscultate the bowel sounds.

But look who's dumber now Mr. SN of "Fun"? I was on the verge of looking for this guy and giving him a piece of my mind when my duty mate verbalized what he said, "The patient has wheezing in the abdomen!"

I immediately had fits of laughter. Like what?! Come again? Wheezing in the stomach? Oh really? Because if we would review our respiratory system wheezing would be a high-pitched whistling sound associated with labored breathing. Wheezing occurs when a child or adult tries to breathe deeply through air passages that are narrowed or filled with mucus.

I wonder if Mr. Wheezing really auscultated the stomach or the lungs because as I know wheezing is a breath sound, how on earth would it become a bowel sound?

So MORAL LESSON Mr. Wheezing from "Fun": Don't ever think that you are better than us in skills or whatsoever because we all are still learning and XU Nursing students have the skills and KNOWLEDGE to match whatever your school might boast of. And, don't underestimate us if you can't even differentiate that wheezing is a respiratory sound and not a bowel sound!

There's A First Time For Everything

Never in my wildest dream would I expect to be late in my duty days!

And sadly my worst fear came true...

My duty would start at 5:45 AM and I woke up at 6:15 AM! Imagine that! I was 30 minutes late for my first day of duty at the surgical ward. Being late brought about a weird feeling. I woke up feeling tired and sleepy because I stayed up until 4 am to finish my requirements. At first I didn't think that I was late. I looked out my window and told myself, "Hmm... it's finally morning..." and then I suddenly realized that I had duty and I couldn't help but mutter the words, "Oh God, all the angels, and saints I hope that I'm not late!" Yeah right! I wish!

I was lucky though that a taxi just passed by my boarding house when I went out and boy the adrenaline rush didn't feel good at all. I was worried and I was sweating... and oh boy... I didn't take a bath.

My duty mates were already taking down their endorsements when I arrived. I was a mess and I expected my clinical instructor to shout at me or something but strangely enough he was very cool tempered, lucky for me.

Although I got 8 hours extension (which hopefully I won't have to serve) the day was quite good. I promised my self that I wouldn't be late for the next day but guess what, I was late. But I caught up to the pre-conference during the second day so it was ok.

So this time, I promise myself to always finish my requirements as early as possible and I should sleep early too so that I could still wake up!

NGT Feeding

It was quite amazing to have actually been able to feed someone through a nasogastric tube (NGT). To those who don't know what a nasogastric tube is, it is a tube that is inserted in the nose that passes at the back of the mouth, through the esophagus and opens directly into the stomach.

Tube feedings are given when a person is unable to eat or tolerate enough food and/or oral supplements to meet his/her nutritional needs.

It's quite easy to feed a patient via NGT. Just make sure that the tube is patent and is correctly positioned in the stomach by injecting air and auscultating (listening with the use of a stethoscope) the right upper quadrant of the abdomen for a whooshing or gushing sound. If there is the sound then pour the nutrient mixture or "bolus" into the asepto syringe and allow the bolus to flow through the tube. Just remember to kink the tube when opening or adding a bolus to the syringe to prevent air from entering the tube and causing stomach distention. And to finish the feeding, flush the tube with 30cc or 30 ml of water.

There's nothing hard with NGT feeding. It's just that your arms would really ache especially if the bolus would flow very slowly because it's too viscous or the patient requires frequent feedings.

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