22-1 day / Master of Arts in Nursing

May 28th, 2009 von Stephan

Today is my 21th consecutive day in hospital, inculding 5 nightshifts from which 2(3) had a high workload + a high care internal medicine ward now.

Though it is lot of work and a lot of dependent patients (24-30 patients, 6-8 high dependent, 3 registered nurses + 1 student nurse + 1 intern) it is a lot of fun. My mentor which is a old school nurse with 30 years of experience and a lot of knowledge. She is the true master of arts in nursing. I cannot describe how good she is at her job and how good she is in any aspect of nursing. She is a true master of ARTS and I have a lot of respect of her and she treats me with a high ammount of respect.

Today I had a practice nursing lesson, with a specialy trained nurse which is with me through a shift and gives me the opportunity to reflect what I do. Today I had a room for myself and all the work done for every patient (three, highly dependent patients) I had a room with a difficulty level of 9/10 which was…not well planned because my clinical instructor had severel critique points because of the high diffucult level.

With a room delegated to me in five shifts in a row, I now truly learn what nursing is beyond doing only one thing at a time delegated by a registered nurse. You have to organize every single bit in 7 hours and you are responsible for doing this. With a tough and good instructor I cannot meet the criteria every time, but I try to use that time of high instruction.

My instruction started very shitty…these fucking narcotic protocols broke my neck because I had a difference between the ammount of narcotics going out and actually beeing in the lock up. The reason for this was poor and filthy registration of the incoming and outgoing narcotics. Though the strict regulations for this, I had to check this problems which was 20min of searching through paper sheets with my clinical instructor and counting the morphine over and over again. The outcome was: Everything allright, check out 10mg of morphine.

I have the Miss CPR in my care now. I really like it. I can deal better with patients who are highly dependent, very sick and in critical condition than with patients who are mentally disturbed and need constant supervision. I really like it and enjoy it and I have no fear in actually caring for them.

Clinical instruction is a break for my enthusiasm, because I now have the feeling after two weeks of actually doing it good that I’m a mess up, but I’m not. Under realistic conditions (and clinical instruction is not realistic) these patients had the best care in weeks from me, I’m proud of it, and despite the fact that I have to learn things more I won’t let my archievements go out of focus and I won’t let a clincial instructor tell me that I have no clue about what I’m doing.

Nursing is a true art, period.

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]


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PR on weekends is bad PR for PR

May 24th, 2009 von Daniel

First lecture on a Saturday went actually quite smooth. To my surprise the campus was busy like a bee hive, thanks to the part time students as I got to know later on. The class itself started with the usual technical difficulties that to no surprise have also not been fixed by the IT guys. The lecturer’s love for Apple computers seemed to be to blame. I saw the same guy already coming and messing around with the IT systems during Law classes. However, this time is unique because for the first time since three semesters I saw the return of the overhead projector as a plan B. It had to be cleaned with a tissue that I offered (whether I get extra credit for that remains unclear ;) ), so one can imagine that it has been a while since it saw some action. Similarly the use of a TV set, as a replacement for the projector, reminded me of the good ole school days. Overall the lecturer (the rock’n'roll type of 70s lecturer, emigrated from Socialist Poland to the US and teaches at a Minnesota College now… which is why we have weekend classes) seemed to be prepared for that as we went through an extended version of “getting to know each other” by means of presentation sheets, including pictures of his dog. Despite only being 13 out of 25 that were supposed to be present this phase lasted 70 minutes until we actually started to talk about “Public Relations”. Not that I dislike the informal approach, but that is a little bit out of the regular league.

Interestingly the first thing we discussed was the question of ethics as PR is popularly described as organised lying. Well, another explanation was the selective publication of truth. A good example was this one, given by the lecturer:

Who is this? Here are the characteristics: Vegetarian, a careing oncle, faible for art and contributed to the decrease of unemployment and economic development.

Somebody shouted: Wałęsa! On which the lecturer replies: Adolf Hitler!

I am curious about Sunday’s class!

Extension to captain’s log: On the way home, while crossing the Wisła river I see a pair of newlyweds being photographed and filmed. Just some 100m behind them a model does some posing for another photographer. There must be something hip about the train level of the “most Gdański“…

Daniel




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A week in Warsaw

May 22nd, 2009 von Daniel

Before rumours start I better give a life sign!

Exams and module classes! Corporate and Business Law demand their tribute I was partly refusing to give. And now I pay the price… long days, the ever so popular short-term learning marathons and the confidence to not have missed out on too many social events - which are as it should be widely known the main mission of every student on exchange.

Thursday
It was Star Trek day… I gotta mention this because the movie made me finally proud again to be a Trek follower!

Friday
It was one of the last Juwenalia concerts, hosted by the Warsaw School of Economics (SGH). Originally invited by the cousin of my cousin (met them all last week after … err three years?!), I went with other friends who also happen to study there and, surprise surprise, encountered more familiar faces from my university there. The main act was also kind of a surprise – Wawa Muffin, one of - if not THE - first Polish Raeggy Combo and ironically the only band I ever heard of before from the entire week’s concert line-up. I remember hearing a song from these fellas on a “Popolski Show” special on EInsLive to which I was listening to via Internet stream while being in London. Hooray to the blessings of Internet! Lots of fun there, great atmosphere on this fairly big concert, with the occasional Mary Jane smell in the air (stereotype conformity!) – For me the student friendly beer prices counted more ;) .

 A week in Warsaw

Saturday
…then a bit more sophisticated, with a free Chopin meets Jazz meets Rock concert in Łażienki Park. It rained all day, but the situation remained amazingly dry in the evening. The whole event could have been also named “How Chopin defeated Communism” due to the elevated patriotism level during performance. Being already on the way back I got a sudden “You comin?” call to a flat party. The timing was excellent, the instructions very confusing (These French ^^, but you could also blame the loud busses). A text made it all clearer and the journey continued to Praga Pólnoc – kind of the equivalent of the spooky area in London (Elephant & Castle) I used to live in. A definite highlight was the presence of an acoustic guitar and the performance of awesome volunteers who played some famous English, for me not so famous French and later on also Ukrainian and Russian songs! While the girls were sighing during the play of my fellow student Adrien, it was all guys when the girl took over (all very melancholic, especially the Red Army song about Afghanistan). Another cliché about impressing the other sex with music has been reaffirmed! PRAGA Pólnoc (please pronounce it street language like!) was easy to reach by tram and surprisingly easy to leave as well
as this Saturday was the night of museums and the trams have been kept on the road. So the whole event continued in a club environment of inner city Warsaw, where I have to admit the DJ pulled out a couple of goodies (a “I am horney” remix… you remember that shit from the 90s :D ?!). It kind of helped to distract from the fact that the place was mostly filled with wanna-be bourgeoisie guys that were hitting amateurishly on the girls present within our bunch (One guy actually accidentally hurt his cheekbone when he threw himself into a group picture, not stopping and crashing with a girls shoulder… with his cheek… how stupid is that?!). For me it was enough to see that it was already bright at half past 4, so I retreated with a friend while some hit another bar. They made us feel old! ;-)

 A week in Warsaw

 A week in Warsaw

Sunday
Piano!

Monday
Herr Köhler has arrived, our man for Corporate and Business Law, as well as Intellectual Property Rights. This sets off the second week of intense legal teachings. Strangily I am once again hearing every once in a while about the German civil code, whilst being in a lecture room outside of Germany. I actually find it interesting, but even honest curiosity reaches its limits when you have law lectures over half of the day, starting in early morning. Nevertheless I mobilized my reserves to meet two fellow Fontys students on my way home. Both are also doing a semester abroad and came up from Nowy Sącz for a surprise visit to the capital. I had no success in explaining where Rotunda is (a distinct piece of socialist architecture), so we met by the Metro Station Swiętokrzyska, right in front of the first McDonalds that opened in Warsaw. It is actually not our first meeting, as we already met coincidently, by pure chance and with mutual great surprise in the Old Town of Kraków a couple of months ago - the best random meeting since the humble writers of this blog bumped into girls from our high school not too far away from Trafalgar Square in London. After some semi-confused walking we manage to get to the Old town (it’s somewhat separated from the city centre, a big minus of the city actually). We found a great place that serves pierogi and in brotherly agreement and adoration for this national dish we sat down in the terrace area, exchanged our impressions of the country and the life as a student here. The pierogi were delicious. I had the first time some with spinach, while Sebastian and Jakob went for an oven version. After watching a cat on a nearby tree, clearly exposing its rear as if getting ready for some rainmaking on other restaurant guests it actually really started to wee…errr rain. We wished each other farewell during the first -
very rainy - summer-like storm, and I flew soaking wet to the Metro.

Tuesday
Once again it was studying til down to make up for slacking in the evening (or eating pierogi with friends on the day before). I finished up the last chapter on psychological motivation for helping or to put it into more technical terms about “human prosocial behaviour”. Armed with 60 pages of difficult to read handwriting notes I boarded the bus and learned on my way to the final exam in social psychology. Worries that I could have done more were luckily groundless as it turned out to be more of an US style pop quiz, consisting only of multiple choice and true false questions. Appears like the open questions have been deleted for us non-native speakers. 1 hour 45 minutes are much too long, 30 minutes would have done it actually too if necessary. Marvellously wrong answers on the true / false part are not count against us, which I am deeply thankful for. During my freshman year I managed somehow to collect negative points on a T/F part, beating the odds of “achieving” at least zero points.

Wednesday
During Corporate Finance I get the confirmation that I did poorly on the midterm. In fatalist laziness I had started only days before the exam, and when it was finally exam day I suffered a bad case of “never ending cold”. Ah, did I mention that my home school abolished Excel exams to return to plain pen & paper? At least I still remember from yesterday’s Psychology test that I rely on external attributions, blaming the outer environment for my failures and thus, achieve an improved self-image. Thank you Freud :D ! In general I decided to put the role model life aside and be a proper slacker by skipping Intellectual Property rights today. Come on! Four hours of lay-over and waiting on campus! And then ending up in a class with not even 10 people, rather half the amount, being fuckin’ tired after repetitive sleeping of less than four hours and commuting by bus, metro & tram from 7am on.. not even being able to hide behind my peers because half of them bluntly play games on their laptops, while the other half has to ensure the interactive lessons doesn’t remain a lecturer monologue. No thank you! I nearly fell asleep on the way home and actually took a nap while legal issues were discussed 10km away. This week is not typical as it is the third time within 7 days that I turn down a flat share party invitation from a bunch of guys that just returned from their trip to Southern Europe and Morocco and seem to enjoy themselves well since being back. Instead I study… despite the wanna-be-Erasmus student that I am!

Today
1410 words… if this article would only be my research paper on “Globalisation, Transformation & Development”. Then I would already have finished ¾ of it. Unfortunately I have too many words for this article and too few (replace by none if you please) for the paper. But there is still time til Wednesday right? Probably sometime between 10am on Friday, when I finish my last Law class and the Public Relations class that has been put on this Saturday and Sunday! Let the rush to the finish line begin!

Daniel




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Resus on the street

May 18th, 2009 von Stephan

I had a patient today, around 60 years

She had a arrythmia after a shopping trip home, in the middle of a crowded street

After all of a sudden, her heart stopped which can happen to all of us and she fell from her bike
The Paramedic on scene counted around 40 people standing around doing nothing…the Medics need around 3-5 minutes to be on scene…so at all there will be a number of 100-150 people who at least witnessed the cardiac arrest.

No resuscitation, no CPR, no chest compressions…nothing.

The emergency physician on scene had a torsade de pointes which went over to a complete asystole

He got her back….after 40 minutes

But the brain wasn’t able to compensate the 4 minutes without oxygen, she had convulsions, she vomited, she had the lungs full of fluid

Let’s summarize it: Everything she does and will do is to blink with her eye for the rest of her life, no hello, no goodbye…

Patient Medical History: No signs or documentation of past illnesses  or conditions
Hospital admissions: Nothing, except her birth
Patient future: Unknown !

Future Costs: Patient has care-level 3+ which means 480 minutes of continous care is needed which means 8 hours per day 24/7 also at nighttime. If a nurse recieves a salary of 15€ per hour this means 120€ per day/3600€ per month/43200€ per year and this calculation is WITHOUT materials needed.

This is the price of a few pricks watching a show on the frontline which they only know from TV

Be different, learn CPR NOW!!!

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]


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Summary: Last Nightshift

May 17th, 2009 von Stephan

Gyn/Obstretics:

2x HELLP - Syndrome
2x Spontaneous Vaginal birth
1x Sectio cesarae
1x Acute pain, uncontrollable by NSAID

Pediatrics

1x Admission to neonatal intensive care center in Duisburg  due to unknown fluid in chest
1x Admission to neonatal intensive care unit due to hypogycaemia
Internal Medicine:

2x Estimated Myocardial Infarction (which one was gastric/oesophageal pain due to hiatus-hernia or cardia-insufficiency and one non-elevated ST-Elevation infarction which is pretty tricky)
2x Hypertensive syndrome
1x hefty GI Bleeding (!I assisted during the emergency-endoscopy…fucking hell!)
1x Patient dying at 3:17 (terminal lung cancer)
General/vascular surgery

1x  Admission from normal to intensive care unit due to excessive fluid loss
1x Pissed off patient unable to sleep because I was working my ass off beside patient number 1 (Can’t you do this on a floor? People trying to sleep here)

Trauma Surgery
1x Fell out of bed, sings of upper femoral fracture

Infectious diseases:

1x Uncontrolled vomiting

Orthopedic Surgery

1x brief reactive psychosis –> need to restrain patient due to exzessive violence going out of him, restraining him with 3 nurses and one doctor
1x organic psychosis due to unpredicted side effect of oxazepam

One hour before going home, the patient with the reactive psychosis went into an sub-awake status with foamy white experative fluid and severe respiratory problems, pulseoxymetry revealed no present problem due to oxygenation

Nursing Staff:

One damn sick and pretty dumb nightwatch-nurse with no clue about certain aspects and a acute lack of skill to organize herself –> Making my shift pretty shit!

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]


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Nightshift of Hell

May 15th, 2009 von Stephan

My feet hurt everytime I step on them, my eyes burn like I got vinegar in them, my legs think that I ran a marathon because they hurt and I feel like I have a nasty flu but I’m healthy.

I really liked the night-shift in my hospital. It was nice to work at night because it is more “cooperative” than the day shifts, you actually have more time to deal with patients and the best thing is: You work “mostly” for yourself and alone.

The previous night-watches were easy going, you got enough room between doing something to have a nice chat with your colleauge, to help a nurse-student-comrade with their care plans. Most of the patients kept they needs to the very basic things and suprisingly most of them slept very good except for my interruptions or in some rare cases, emergencies.

The flipside of the nightshift is, that you have to know what you are doing, you can’t delegate things to another nurse, you can’t ask someone that easy (of course it is possible, but ther is more effort behind this) and you are first-responder. And I really liked it, I was not un-supervised but I had my freedoms and I could do whatever I wanted to do.

Two days ago, I had the most boring night I could imagine. I was alone on the internal medicine emergency ward for two hours and there was NOTHING to do…no admissions, no emergencies, no trouble nothing.

Today was way different, I started running at 2000 MET and my first stop was at 0030 MET, but only for 10 minutes then I had to go down to the emergency ward a hell of admissions and another ward calling for assistance. I said I’ll be back in 10 minutes…in the end there were 360 minutes.(1) with a hell of emergencies, one person dying and actually feeling his last moments.

BUT it’s good to know that I actually did and improve something this night…once upon a time;)

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]


  1. I was responsible for obstretics and internal medicine this night as a “freelancer” or “jumper” []

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Direful moments of our past part 2: MGS-RADAR.DE a few years ago

May 8th, 2009 von Stephan

Ein Web-Archiv Eintrag zu MGS-RADAR.DE

http://web.archive.org/web/20050526023138/http://mgs-radar.de

Ich gestehe folgende Fehler zu dieser vor-Version der Seite zu

1) Unsere Texte waren naiv
2) ” -” schlecht recherchiert
3) ” -” journalistisch absolut unbrauchbar
4) “-” stilistisch aufgesetzt
5) “-” uninteressant
6) “-” pseudo-journalistisch-wertvoll
7) “-” absolut subjektiv

Betrachten wir die jetzige Situation haben wir

a) Kurioserweise viele Besucher, die anscheinend immer etwas von uns lesen
ALLERDINGS NIE KOMMENTARE HINTERLASSEN
b) Treffen die Punkte 1-3 und 5-7 nach wie vor zu
c) Haben wir die journalistische Fassade über den Jordan gejagt

Es ist so als ob man Müll in eine neue, andere und stilvolle Mültonne tut.

Und soll ich euch was sagen? ES FUNKTIONIERT!

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]


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Message to Daniel

May 8th, 2009 von Stephan

Check new StudiVZ friends;)

Old, but familliar  faces will wait for you;)

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]


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Another Jeff Koyen piece

May 6th, 2009 von Stephan

Another piece of one of my favourite writers, Jeff Koyen about one of our greatest sex-archievements in our past (despite strange,filthy porn)

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]


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Command & Conquer Tiberian Dawn…Almost 12 years ago

May 6th, 2009 von Stephan

I still love these cutscenes as they were a great improvement for the strategy game genre and in general the whole gaming scene back in 1995

Also the Red Alert Scenes…beautiful!!

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]


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