Three System Oral Exam (CCNC) Continued

I passed!!!!!! We all received our grades today after the last person presented. The stress is off. I can finally relax and enjoy this next week of clinicals at INOVA Hospital. Friday, August 8 is graduation. If you are in the area you should try to come. Let me know if you want to come and I will get you more information. Thanks for all your prayers!

Three System Oral Exam (CCNC) Continued

Still no news about the results of the presentation. Talk about frustrating! I guess no news is good news...

Three System Oral Exam (CCNC) Continued

I spent the day in the OR with my patient for clinical. The surgeon was really cool and allowed me to scrub in so I could better understand what the procedure was all about. (Military medicine rocks!)

After clinical I tried to find out what my Three System grade was from yesterday and got shut down. I am not sure if they just don't want to tell us until everyone is done ( we were told we would find out the day after we presented) or if they haven't sat down to discuss my grade yet. Either way I will keep you posted as I continue to wonder (and now starting to freak out) how I did. Stay tuned!

Three System Oral Exam (CCNC)

Today was the day I had been dreading for the past 12 weeks. It was the day of the Three System presentation. This presentation is a 3-4 hour oral final exam. While caring for patients in the WRAMC ICUs we were able to learn about different disease processes. This presentation is designed to help us bring everything together and present it to our instructors. The patient each student presents (HIPAA is maintained) must have three body systems that have failed. My patient had an liver failure that progressed to renal and neuro failure. So this morning I had to present my assessment of the patient including history, labs, and medications. I then had to review (all without notes) the normal anatomy and physiology of the three body systems before discussing the disease processes that caused the systems to fail. My two lead instructors sat in the middle of the classroom while I faced the dry erase board and drew pictures and diagrams to help present the systems. That is the first 65% of the project.

We also have to submit three RN care plans for an amazing 35% of the final grade. Thankfully the APU School of Nursing had pretty high standards so it was not a huge stretch for me to produce some pretty good care plans.

My grade is now in the hands of my two lead instructors. I am sure by now they know how I did but I will not find out until sometime tomorrow. As soon as I find out anything I will be sure to post it here so you will know too. Thanks for the prayers to get me through this one. I could feel them as I was able to remain pretty calm during the whole presentation.

Week Twelve of CCNC

This week was spent at INOVA Hospital in Fairfax, VA. Inova Fairfax is home to Northern Virginia's only Level 1 trauma unit, which means it can treat any type of injury, no matter how serious. It is a 833- bed facility meaning it is huge! The education department has generously allowed the Walter Reed CCNC classes to come follow their RN staff for eight hour shifts in different units throughout their facility. We will spend time in the Emergency Department, Trauma ICU, Neuro ICU, Cardiovascular ICU, and Coronary Care Unit. As Walter Reed is no longer a Level 1 trauma center we have been able to see and do things that we would not get to do at our own facility.

So far I have spent time in their Neuro ICU, CCU, Trauma ICU and two evenings in the Emergency Department. I had a blast in the ED. While I could not directly participate in the traumas that came in, I was allowed to watch and help out as needed to roll the patients and remove clothing prior to taking them to CT. I was assigned to Jaime for both nights. She was great as she took time to explain things that I either did not understand or had the long-term thought process in my head when I needed to be thinking short-term for immediate treatments. Not that I am promoting them, but if I were to stay in this area for a while I would consider moonlighting as agency in their ER or Trauma ICU for further education and experience.

This weekend will be full of preparing for my final project. It is called the "Three System". It is a 3-4 hour oral presentation on a patient who had three body systems fail. I have to discuss the normal anatomy and physiology of the body systems then discuss the disease processes that eventually caused the failures. I have to present the patient as if I was the MD in rounds discussing my assessment, all labs, all diagnostics, all meds, all fluids, all treatments. And while the MDs get their notes when they make their rounds, I will be doing this without notes. I will have a dry erase marker and a dry erase board with my two lead instructors in the back of the room grading me. I am freaking out!!! I sure could use some prayers. I present this Monday morning at 0730 east coast time. Pray, pray, pray. I don't think I have ever been this nervous before.

Week Eleven of CCNC

This week started with what we called the "One System". Each student was required to choose a patient who had had a body system fail to then present to the class. (Don't worry, HIPAA was maintained.) My presentation reviewed the anatomy and physiology of the liver and then focused on how the disease process my patient was experiencing had progressed into liver failure. While we (the class) know the information it is far more difficult than I had expected to have to present it to them and two of my instructors. Thankfully I passed! And now I know a little bit about primary sclerosing cholangitis.

This weekend will be focused on the RN care plans for the "Three System" tha tis coming up in two weeks. The three system is similar to the one system except that I am speaking about three body systems that failed in my patient. I have to present them individually then demonstrate how they influenced each other. All this without notes on the day of the presentation! I will keep you updated on that one and know that I could use all the prayer that I can get. When I find out the actual date of my presentation I will let you know.

Week Ten of CCNC

This weeks big focus was the Trauma Nurse Core Course recertification. While none of our certifications were close to expiring, the Emergency Nurse's Association updated the cirriculum so our instructors thought we should update our certifications. The class prdviously lasted for three days and has now been cut down to two days. It was fat and furious to get all the lectures done. But I am again certified with TNCC! (The US ArmyNurse Corps has made TNCC a mandatory requirement for all of its Nurses as we will need to think in that manner when we are deployed.) The rest of the week was spent in clinicals.

Week Nine of CCNC

This week was shortened with the 4th of July weekend. We spent four days in clinical preparing for our big presentations next week (more to come on that).

For the weekend, I flew home to CA. I spent the 4th of July in Mission Springs. It was so great to spend the weekend away from work and school and catch up with friends and family. Keeping with tradition my Dad and I were in the marching band (I have played with the marching band since the 6th grade.) As a side note, for those that know Mission Springs, the Frontier Ranch lawn was green! Yup, in the middle of the summer it was actually green! As California has temprarily prohibited all fireworks my friend Amy and I decided to head to the beach. There is nothing like the beaches on the West Coast! We walked around the Santa Cruz Boardwalk watching plenty of illegal fireworks being launched from the beach. The night sky was full of different colors. It was gorgeous!

The next night my parents invited Amy and I to watch the San Francisco Giants beat the LA Dodgers! We sat front row right behind the Giants bullpen! I had never been to the new Giants' stadium so it was really cool to go for the first time and watch the home team win! It was really fun to watch and listen to all the drunk cheering fans from both teams.

On Sunday, Amy and I went to the Winchester Mystery House in San Jose. Neither one of us had ever been there before so we thought it would be fun to check out. After hearing the story of Mrs. Winchester's life I felt reaaly bad for her. But she sure did build a really interetsing house!

My flight back to DC was a little on the adventurous side. Before evening reaching the runway in Oakland our plane broke twice. We finally exited the plane and sat around the airport for a little while as we waited for a new plane. Once we finally got near Baltimore we were put in a holding pattern as there was some bad weather between us and Bhaltimore. It was no big deal until the Captain came over the loud speaker informing us that we may have to land if we are continue to hold as we would need more fuel (such a confidence builder!). We finally landed in Baltimore without any further incident. I have not had the best of luck with flights to and from CA since moving to the East Coast. I might need to rethink my choice of location...