Studying for the PCCN

Even though I’m 30, I’m really only 2

Oh-so-often I feel overwhelmed by how much I need to know and remember in my career. Before I graduated, I felt like I had a pretty good handle on most of the information and was hoping I would just kind of intrinsically “know” what to do.  I nonchalantly took the advice that people were scared to come in to work for a few years, thinking “I’ve worked in this unit for two years {as the unit secretary}. It should kick in faster for me.” Well…let me just tell you that I am really still scared to go to work. I have been a nurse for two years and am pretty sure that even though I started in critical care, I had little to no critical thinking ability and my unit was really taking a risk hiring me.  Apparently, that’s normal for most people.  But as my previous nursing educator said, if you don’t remember what to do, just do something and you might be surprised.

I’ve already laid out a plan of when to study for this PCCN exam, but I also need a system of study to really train my brain. Nursing is not about memorizing and repeating information, which honestly I’m pretty good at.  I can usually take and pass tests easily, but when I step on the floor, I’m not taking a multiple-choice test. I’m caring for a person and all the different working (and not working) parts of them. So…I need a system to ensure I’ve covered it all.  As I was trying to figure out what that would be my base that ties everything together, I realized its the the same thing my toddler needs to know. The ABCs.

abc-148020_1280My toddler has been talking for over two years now and he can sing the ABC song, but he doesn’t comprehend what the letters mean and how they work together to make life interesting. Similarly, I need to assess my patients with the ABCs and actively think about why it’s important to assess this way.  From ACLS I know to use CAB to treat when the patient is unresponsive, but the majority of the time my patients are responsive, so the ABCs are my aoli and bread and capers(?)…too much? Stick with the ABCS are my bread and butter?  I’ve know this is important, but I usually get caught up in knowing when to flush the drains or make sure the patient walks twice a shift and gets showered or bathed. The tasks. They are important and everyone has to get those down in order to be able to think critically when the time is right. But why is it more important for me to check and know my ABCs? If my patient isn’t ventilating or perfusing adequately, I will soon lose my patient. Flushing the drain will not save the patient in crisis.  If I don’t understand the basics of the ABCs, I won’t be able to do a thing for my patient. Since I’ve been a nurse for two years and am quickly moving out of toddlerhood, it’s time for me to grasp the full importance of my letters.

I started off my nursing career in a cardiac Step Down unit so most of my patients didn’t have trachs and none of them were vented. However, since last July in the Progressive Care Unit, I have had trachs and vents galore. Thankfully, I’m not nearly as ready to jump out of my skin when I have trached and vented patients these days.  Quite honestly, since I was so concerned with the heart in my first job, I kinda gave the lungs a back seat and feared anyone with an artificial airway. They seemed less stable…and now I freak out a little if my patient doesn’t have an airway. What if I can’t suck out those secretions!?!?! Aaaah! And I was also afraid of getting someone in respiratory distress or who started to trend that way because I didn’t have the table with the breakdown of how much oxygen you get with 1L nasal cannula, 2L nasal cannula, non-rebreather, partial rebreather, etc. memorized. Freaked. Me. Out. So my goal was to avoid the known pulmonary patients. Thankfully, there’s respiratory and I have come to appreciate respiratory therapists so much!  I also am realizing through my time in Progressive as well as through this studying, just how important the lungs are. So, next up: Ventilation and Perfusion but emphasizing first on ventilation.

Do you think lungs are amazing? What freaks you out about nursing?

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