Adventures in New Nursing

Hilarious Night

2012-03-08T08:57:00.000-06:00

First story We roll into our patient's room and ask how they're feeling, etc. The patient (with an accent) starts off with:

"I have a cough and I die. I have a cough and I die. I die! I die!" (Can someone say Drama Queen?)

Us: "Ok, patient. The nurse who just left gave you some cough medicine. Now, we're going to take a quick look and listen and then we will see what else we can bring you."

Patient: "I cough! i sick! I die! I cough! I sick! I die! I cough! I sick! I die!"

Us: "Patient, could you just roll on your side so we can listen to your lungs?"

Patient rolls over and commences moaning so much that we can barely hear their lungs. I say "Patient. We want to help you feel better, but we can't do that unless we can listen to what's happening. Could you quiet down for a minute so we can listen?"

Patient: completely ignores me and continues moaning. Lung sounds barely heard.

Patient then continues to repeat the same thing. "I cough, I sick, I die. I need doctor." "I cough, I sick, I die. I need doctor." "I cough, I sick, I die. I need doctor."

Us: "Patient, we are good nurses and will take good care of you. We are going to go get you medicine for your cough, and you are not going to die."

Patient: "I cough. I sick. I die."

Second story

Needy, needy patient calls out on the call light for the 999567th time that night. Not our patient, but we were helping.

My student goes into the room to help the patient. The patient says: “Can you change my TV to channel 9? I need to answer the TV’s questions.”

Third story

There was something else that was really funny that happened, but I can not, for the life of me, remember what that was right now. That’s how busy I was.

Truth!

2012-03-06T08:51:00.000-06:00

Overheard...

2012-03-04T11:59:00.002-06:00

Extra large patient, on all fours, in bed, talking in their sleep, hospital gown off.

"Rub my butt! Rub my butt! Rub my butt!"

Then snoring.

Can't make this stuff up.

Luck of the Draw

2012-02-28T08:52:00.001-06:00

One of the first things I do each night when I arrive at the hospital is check to see what patients I have been assigned. It's always a little bit exciting and kind of the "luck of the draw." The nurses all try to do it as evenly as possible, but if everyone is getting an admission overnight, there's really no telling how busy it will be.

Well, the other night, my old preceptor got a CRA-ZY patient. I know what you're thinking: why am I blogging about a patient who wasn't mine, that wasn't even on my unit? This patient was that CRA-ZY, that's why.

It started off similar to all our shifts. My preceptor popped over to say hi, and told me she had a crazy one, then I didn't see her for several hours. At some point overnight, I popped over to her side to say hi, and she updated me.

At that point the patient had locked them self in the bathroom and was refusing to come out. Obviously, this is a problem, but in this patients case, it was a bigger problem then normal because they were seriously sick. In fact, the doctor was on the floor discussing whether or not this patient was going to have to go to ICU.

How was this patient able to lock themselves in the bathroom if they were that sick, one might ask? Well, many patients around the hospital have chronic conditions, and function fairly well with lab levels that would have you or I flat on our backs. It's one of the human body's amazing coping mechanisms.

Anyway, after about 45 minutes of persuasion, and being unable to convince the patient to come out of the bathroom, they unlocked the door and got the patient some vital IV fluids.

At some point during these IV fluids, the patient disappeared. Completely. Off the floor, off the heart monitor at the desk. This was when I started helping. I went to look in all the normal hiding places while my preceptor called security. Not surprising to anyone who works at my hospital, we have a written protocol for situations such as this.

And, yes, you read correctly "normal hiding places." After working here for a matter of weeks, you learn that patients have places they like to go to smoke and such. When they disappear, you go look in those places to see if you can convince them to come back to their rooms. I live a charmed life at this hospital, let me tell you.

So, the patient is essentially a ticking time bomb due to not only their chronic condition but very serious blood clots as well. Additionally, they have some serious IV fluids hanging that require constant monitoring.

How did the patient leave you ask? Well, we have other patients to take care of, and we can not force a patient to stay in their room. That is a form of restraint, and is against a nurses scope of practice.**

**Unless the patient is a risk to harm themselves or others. In which case, the doctor has to put in the appropriate restraint orders, etc.

So, in cases like these we do a lot of "education." Like "Patient, you have the right to accept or refuse any medical treatment we offer you. However, if you don't have this medication, XYZ may happen." (I usually say like "explosive diarrhea" or something equally terrible like "death" which is never outside the realm of possibility around here, especially when the number one complication of a condition, is actually, death.) Anyway, this patient had been educated out the wazoo and still walked off the floor.

Protocol was followed, and excessive documentation was commenced.

Eventually, the patient showed back up. In fact, I saw them walking down the hall and followed them to make sure they made it back to the room. Clearly, the patient was still alive, but there were a few minutes there where we wondered.

Around here, patient assignments really are the "luck of the draw."

Some funnies

2012-02-20T00:12:00.001-06:00

1. I am in love with Pinterest. If you haven’t checked it out, you totally should. It’s amazing. I pin things about nursing there too. Check it out here.

2. I really am going to write an actual post, soon. Things have been kind of calm lately, and calmness doesn’t lend itself to funny…but that’s never really stopped me. Fear not, I have a few ideas perculating that might turn into something. I take my responsibility of helping you waste time very seriously.

3. This is SO funny and 110% true. It’s like they are sitting in on my conversations with my patients. **There is a bad word or 2 in the video.** However, if you skip to the 1:30 mark and watch the “seizure” you will laugh.

A Rescue?

2012-02-15T09:58:00.000-06:00

I'm in the middle of a long stretch of work, followed, of course, by a long week of not working. For some reason the not working week always goes WAY faster then the week of working. I guess that's why they call it adulthood. (Overrated, by the way. I've decided the perfect age is 5--big enough to do stuff, read books, but too young for school aka math. I digress.)

Here's a quick funny story for you.

The other night I had a patient at the very end of the hall. Of course, this patient would be the one who gets sickest. It ALWAYS happens that way. And, once again, I got the gem of the assignments and had both ends of the hall. I actually kind of like it because I get some extra exercise.

So, true to form, in the middle of the night, my patient started bleeding. Not uncommon, we are a hospital after all. However, this was A. Lot. of bleeding. And it was spurting out with their pulse. And it wouldn't stop. I have a nursing student with me this semester doing her senior semester capstone, and after I held direct, hard pressure for oh, 7 minutes (some of the longest minutes ever, by the way), I had her go find another nurse for a second opinion.

While I'm holding pressure, I'm chatting with the patient to make sure they are stable and not losing consciousness, etc...I mean I would categorize the blood loss as small to moderate, but it just wasn't stopping, so I was concerned.

The patient says, "Don't worry about me. I'm not going to bleed out. Just slap a bandage and tape on it, and let me go back to sleep."

I ignored the patient and was like "Yeah, you're not bleeding out on my watch, which is why I'm standing here holding this until the bleeding stops."

They rolled their eyes and covered their head with a pillow. Love it.

Anyway, another nurse comes in to help me and 20 MINUTES LATER the bleeding FINALLY stops. I bandage everything up, get a blood pressure, etc and go call the doctor.

Our conversation went like this:

Me: "I'm calling about patient X. Their [body part that was bleeding] started bleeding again, and I had to hold pressure for at least 20 minutes before it stopped. They soaked [a bunch of gauze, but the medical term for it]. The patient's vitals are stable, but I thought that 20 minutes was a bit excessive to hold pressure. Obviously, I'm watching the patient quite closely now.

Doctor: "Wait, how much gauze? And the blood pressure is ok? 20 minutes is a long time. Keep me posted and if the patient starts bleeding again, we'll come and rescue you."

My question: But will that potential rescue involve a white horse and armor of some kind? And, possibly, a sword?

Luckily for all involved, there was no more bleeding that night.

What a night!

2012-02-06T14:23:00.001-06:00

So, I've been LOVING my schedule recently. After 2 schedule cycles of experimentation, I've finally hit upon a rhythm I enjoy...it mostly involves an intense stretch of working, followed by at least 6 days off. Sometimes the nurse life is awesome.

However, earlier this week, I would not necessarily classify my job as awesome. After 6 glorious days of being off work and 60+ degree weather, I returned to a plethora of needy, sick patients.

After report, I roll into my first room and low and behold I walk smack into a Code Brown (see picture at top of post for explanation.) It was a sight to behold, let me tell you. We're talking floor, Foley catheter bag, bed, patient, everything. Even worse than the Code Brown, was the fact that the patient, who couldn't get out of bed, was sitting on the very edge of the bed almost falling off. I have no idea how the patient managed to get all the way down there, but they did. It took 2 nurses, a full container of our high powered sani-wipes, about 6 packages of patient wipes and a few other tricks to get this mess cleaned up.

Oh, did I mention the patient was in special precautions for a super serious infection?!? SO GROSS!

It was 1 hour into my shift and I had already basically decided that I wanted to fire hose myself off at the end...just to give you an idea of the grossness of this whole thing.

Anyway, that set me back a bit and the night was busier then some but by midnight or so I was pretty much caught up.

Of course, that didn't last long because sometime in the middle of the night, my "easy" patient suddenly got quite sick. This was particularly concerning because they had a surgery previously and had an open wound that was healing as a result. (And by open, I mean you could literally have a biology lesson on tissue, muscle, etc...it was pretty stickin' awesome.) Anyway, sickness combined with an open wound is, you know, not good. Then the patient vomited, and it was not a normal color...because when it comes to vomit, brown is good. Anything else? Bad. And, the patient was pretty much at the end of the hall so I did a lot of power walking.

At one point, I was pretty sure I was going to drop an NG tube (goes through the nose down the back of the throat, into the stomach. Pleasant.) down the patient. Thank goodness by this time it was close to my shift ending!
Anyway, by the end of that shift I was tired, dirty and pretty sweaty. It was so glamerous. But, hey, all my patients were breathing and their hearts were still beating so it must have been successful.

For me? Since it was a little chilly that morning, so I decided against a fire hose and hit the shower instead.

Another funny

2012-01-30T23:56:00.000-06:00

Since I somehow managed to get my schedule under control, (for those of you keeping track, it's been 6 months of experimentation), I have been off for several days again. I'm back tomorrow. In the meantime, I hope you continue to enjoy this series.

There is no question that I have taken care of this patient and their family. No question at all.

Funny, Frustrating, and Flummoxed

2012-01-24T08:44:00.000-06:00

I recently took care of the same patient for 3 or 4 nights in a row. (Things tend to run together. I can’t remember exactly how long, but it felt like for-ev-er.)

Every night around 3am the patient would call out and starting yelling “I can’t breathe! I can’t breathe!”

Naturally, when a patient says they can’t breathe, one takes this very seriously. Something about oxygen being combatable with life and such… Well, after a couple of nights of this Actually, weeks of this. The patient has been on our floor for like a month. And this patient is rude, demanding and yells at everyone. All the time. It’s such a delight. I digress.

By the 2^nd or 3^rd night of this, I walk into the room and I was like “[patient name] what’s going on?

Patient: “I CAN’T BREATHE! Get the doctor on the phone, and do something about this.”

Me: “Ok. Why don’t you put your oxygen back on, and I will check your oxygen sats.”

Me: “Oh, well look at that. Your sats are excellent. Everything looks good.”

Patient: “EVERYTHING IS NOT GOOD. I CAN’T BREATHE.”

Me: “Why don’t we try your BiPap machine.”

Patient: “IT’S NOT WORKING.”

Me: “Ok. Well, I will call respiratory and get you a breathing treatment.”

Patient: “THOSE FOOLS DON’T KNOW WHAT THEY’RE DOING EITHER. I STILL CAN’T BREATHE.”

Again, keep in mind that this patient has been on the floor for A MONTH. This happens EVERY NIGHT. And the patient, who can’t get out of bed due to their condition and generalized weakness, is refusing to go to rehab or any sort of assisted living situation until they can take care of themselves. Frustrating to say the least…

Back to the story.

Me: “Patient, I’m not sure what else to suggest, but it’s clear by the way you’re yelling at me and the fact that your oxygen sats are fine that you are having no problems actually breathing. Why don’t you go to sleep? It’s 3 am.

Patient: Speechless.

And, success!

Funny, funny people

2012-01-21T23:23:00.001-06:00

More funnies from my life at the hospital…

Coworker walks into room and finds the patient sitting in bed with both fingers up his nostrils.

Nurse: “What are you doing?”
Patient: “I’m checking my temperature.”

Enjoy!

2012-01-18T17:15:00.003-06:00

I've been off work for a couple of days, but am headed back tonight. Hilarity is sure to ensue. In the meantime, enjoy this video. I'm pretty sure I've taken care of this patient.

It was a mini tent revival meeting

2012-01-10T17:18:00.000-06:00

A few weeks ago, I floated to my sister unit. And by floated I mean walked the 12 steps through a set of double doors to the other side of the hallway.

The main difference between floating unit and my home base is that the other unit has double rooms.

So, I roll in and there are 2 really cute ladies in the room.

One of the lady’s family was visiting and the two patients were chatting. I did my assessment, etc and went to check on my other patient.

A while later when I went to check on the 2 ladies they had whipped out their church programs, gospel tracts and Bibles. There was a lot of “A-MEN” and “PA-RA-ISE the Lord” happening. I’m not sure what exactly had happened, except that one of the patients was experiencing a lot of anxiety surrounding her hospitalization.

The next time I walked into the room there was an impromptu prayer meeting taking place with even more “thank you Je—SUS.” It was like walking into a gospel tent revival meeting.

Not gonna lie, it was one of my most favorite rooms so far.

Overheard...

2012-01-07T15:39:00.002-06:00

All of these are actually true—some from my patients, some I overheard from co-workers. I can’t make this stuff up.
***************************************************************************

A newly admitted patient: “I’m having a little bit of pain. I’m sure Morphine would take care of it.”

Well, yes patient, Morphine will take care of it...as will Tylenol, Advil, Tramadol, Toradol, and probably Aleve—all non-narcotic, non-addictive options. But yes, let’s go ahead and give you a high powered, highly addictive narcotic that can shut down your respiratory drive. That sounds great.

***************************************************************************
Long-term patient: “What do you mean I can’t get out of bed?!? I own this place!”
Nurse: “Sir, you are at [name of hospital], and you do not own it.
Patient: “I know where I am, d**n it. I work for the FBI!
Nurse: “No sir, you don’t. Let’s get you some medication.”

Time for someone to transfer to a rehab facility.

***************************************************************************

Another long-term patient on call light: “I need my nurse.”

Me: “Can I have her bring you anything?”
Patient: “Yes. I need her to rub my feet.”

We missed the memo that included spa services as part of our comprehensive medical care, apparently.

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Patient: “Give me Dilaudid [5 times stronger than Morphine] or get the hell out of my room, b****.”

Nurse: “Such a pleasure to take care of you, too.”

I love my job sometimes.

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Patient: “I can’t go get a CT scan. I’m too anxious.”

Nurse: “We will get you some medication for that.”
Patient: “I will only take the stuff you give me through the IV. I want Ativan. But I still won’t do it. I’m scared.”
Nurse: “Ok. Well, a CT is not a MRI. With a CT a round thing slides around you and you can see the ceiling the whole time. The MRI is the tube you go into. And you only get the Ativan if you actually do the test.”
Patient: “I know what a CT is. I’m still scared.”
Nurse: “You do realize that your condition is VERY serious, and you could die VERY quickly, right?
Patient: “I’m scared of the CT scan. I’m not going to do it.”

You, sir, are a ticking time bomb. May I suggest “manning up” and getting a non-invasive, non-personal space invading test that does not require you to lay still in any type of enclosed space, and could actually save your life? Again, excellent decision making skills.

Pain Scale Education

2011-12-27T14:38:00.000-06:00

When I was in nursing school, we talked a lot about pain. Let me summarize 2 years worth of pain knowledge for you in a couple sentences.

1. Pain is whatever the patient says it is.

2. The most widely used way to judge pain is on a scale of 0-10 with 10 being the worst pain you've ever experienced.
3. One of the hardest parts of nursing is figuring out legit pain that needs better management and people who's pain in primarily made up in their head (or drug seekers, or addicts, or people who want to get high for a while, or any combination of the above.)

Note what I just did there? I saved you all thousands of dollars and painful hours of lecture. You’re welcome.

Anyway, I recently had a patient who needed some pain scale education, apparently.

After I got report where I heard that this patient was constantly demanding IV pain medication (the beez-neez of meds...gets you nice and high real quick), and the doctors had determined their condition required a different form of pain management because of a couple of underlying disease processes. I read through the most recent doctor’s note, where it is also noted that the patient is not to receive any further IV pain medicine, but to use several other pain pills to manage the pain.

Armed with this information, I roll into the patient's room for my assessment. Sure enough, the first thing the patient tells me is that he/she's pain is "10 out of 10 and the doctors told me that I was going to get my IV pain medicine this morning, but they never ordered it, so can you go call them and get it for me. Even a one time dose."

Actually, this wasn't the first thing the patient did. The first thing they did was have me talk to their mother because their pain was too "severe." The mother is appropriately freaking out on the phone so it took a minute to calm down both the patient and the mother, who was a hot mess herself.

I explain to the patient that the disease process they have is better managed with various pain pills and per the doctor's note, and that's what they told the patient that morning. The patient then says, "But that's not what they said. They said I could have my IV pain medicine." I say, "So you're telling me that not only is the note wrong, but every doctor your nurse talked to all day was also wrong?" The patient says, "Yes." Then I said "OK. Let me call the on-call doctor and ask about it."

I think the patient thinks he/she is so brilliant for pointing all of this out to me and will get what he/she wants. HA HA HA.

A while later the patient's pain meds are due, and the patient is resting in bed with their eyes closed, looks quite relaxed, and is chatting on the phone. (I mention this because when one is in some sort of pain closer to the top of the pain scale, they are rarely relaxing in bed, chatting with friends on the phone.) I bring them in and ask "what number would you give your pain right now?"

The patient says "10."

I reply "You're telling me right now, in this moment, the pain you are experiencing is the most excruciating pain you've ever felt?"

The patient says, "Yes."

I say "Ok."

A while later I go back in and check on the patient. I ask what their pain is now, after the medication. The patient wakes up enough to say, "10, and when am I getting my IV pain medication?"

My clinical note then said something along the lines of: "Patient states pain is 10 out of 10. Patient is resting in bed with eyes closed. There is no guarding, grimacing, or diaphoresis (sweating). Patient vital signs stable." I chart all of this because those things are physical indications of pain and we use those indications just as much as what the patient says in some situations.

This situation pretty much repeated itself for the rest of the night. Every 30-45 minutes the patient would call out asking for IV pain medication and every time I would explain that they wouldn't get any. I offered heating packs, ice packs, warm showers, snacks (of which the patient ate abundance), various positioning techniques, and several other things. All of which the patient refused because "nothing works except my IV pain medicine." To which I reply, "Have you ever tried these things?" To which the patient replies, "No." To which I reply, "Then how do you know they don't work?" Because at this point I am just enjoying myself because the patient is being ridiculous. The patient says "I just know it won't work."

At one point the patient told me they were "constipated." I asked if they had had a bowel movement that day. The patient said, "Yes." I said, "Well, I'm happy to give you a laxative, but if you are already pooping, it could give you explosive diarrhea. Do you want explosive diarrhea?" Much to my surprise the patient said "no." I replied, "Well, I guess you won't be getting a laxative then."

*Disclaimer: taking a laxative will not necessarily give you explosive diarrhea, but there is a remote possibility that it could. I "might" have been "embellishing" for the patient.

So, by the end of the night, I was having a great time dueling it out with this patient in a battle of "who will win the IV pain medication war." I'm pleased to say the patient received all of their non-IV pain medication, including every PRN medication I could give in a vain attempt to bring the pain down from a “10 out of 10,” the vital signs remained stable for the entire shift, they slept for several hours (in spite of what they told the doctor in the morning about how they couldn't sleep because of the "pain"), and there were no other clinical indications of pain.

That’s what I call winning.

A little blogging insider tidbit

2011-12-23T23:26:00.000-06:00

The other day I found out that there's a little stats thing you can check out on the blog to find out how many people have read the blog, how they got there, and searches that led to the blog.

Know what the #1 way people found the blog during finals? This post, "Can. Not. Study. Anymore."

This is just so awesome. I love that my misery has helped someone else who can't study anymore.

What an awesome way to waste time. For those of you who have finished finals and are on Christmas break, I salute you.

My co-workers

2011-12-21T16:50:00.000-06:00

I work with a lot of nurses from Africa. They are awesome. They are funny, helpful, smart alacky, sarcastic, and have some good 'toods with even better accents.

My favorite thing is when they get all upset and are telling each other a story in English, then in their language, then back in English, then back in their language. All the while getting more and more animated. So. Awesome.

It's even better when they are talking to me. Take last week for example. A co-worker was explaining how difficult a patient was. I heard, "because" "and then" "so" "the" "crazy." I nodded like I pretended to understand. But the more the conversation went on, the more I understood because I had taken care of the same patient previously.

Who knew crazy was a universal language?

It's such a multi-cultural experience around my hospital.

No grabbing!

2011-12-16T08:58:00.000-06:00

Recently, I was helping another nurse reposition a male patient in bed. He was a little bit older and bedridden. As he was rolled on his side facing me, I suddenly felt a hand going up places it shouldn't be going.

I looked at the patient and was like "I don't think so! Sir, you may not grab me. Unacceptable!" The patient just looked up at me and similed a toothless smile.

I was like "You just keep your hands to yourself where I can see them!" Then for the rest of the shift, I had to forewarn him. I would roll into the room and be like "Ok, Mr. we are going to turn you. Now don't you be getting grabby or anything with me." I think he thought it was funny.

That little dude has quite the reputation on the floor now. Apparently, he attempted to or grabbed at every single nurse who took care of him. Just another one of about 1,000 issues not covered in nursing school.

Perv.

Finding my Groove

2011-12-05T08:06:00.000-06:00

I have almost been in my new job for 6 months. 6 MONTHS, people!! Where does the time go??

Here are my observations:

I've only forgotten to take down the IV bag before I switch it twice, both times resulting in IV fluid soaking my scrub top. Lesson learned.

I almost always remember my medication documentation device before I get to the patient's room now. When I still forget it, I tell the other nurses I just wanted more exercise. They think I'm funny.
You can tell you've been here a while when you are taking care of the same patient again. You know cause they were here, got better, went home and got sick again.
Other nurses ask me questions! I almost never know the answers, but I pretend to be helpful anyway.
There are new orientees on my floor, and I'm pretty happy to not be the newest person around here. I'm super nice to them. I remember what it's like.
I still have to breathe through my mouth all. the. time. when patient's have stinky medical conditions.
I hate poop. Everybody poops.
Hated adult mucous in nursing school. Still hate it. Have to go to my happy place when patient's get all gaggy and such.
Trust your "gut" feeling. If a patient seems sicker even though nothing says they are, they are probably about to go downhill. Get some backup in there.
When in doubt ask. If one nurse's answer doesn't seem right, ask someone else.
Never be afraid to ask a patient a hard question. Their life could depend on it.
Sometimes when resident's ask what I would like for a patient I tell them "medicine would be a good place to start." Some nights they think this is funny.
Considering I can take of 4 patients and they are generally breathing and such at the end of my shift, I would say my efficiency has definitely improved.
They did not lie in nursing school when they said that nurses really care about bodily fluids--like pee and poop. It's true. We do.
I have definitely "encouraged" a patient to urinate by telling them the consequence would be a "tube stuck up where the sun don't shine" because "urine is the main measure of your kidney function, and if they're not working, that's a much, much bigger problem, and I will have to call the doctor ASAP." They pee'd within the hour.
Homemade heating packs are the bomb.com
When in doubt, ask again.
Night's aren't bad...especially the 3 o'clock hour. Incidently, this is when most of my blog writing gets done these days. How did I ever squeeze studying into my schedule?
Blackout curtains rock. my. world. So does my sweet Vornado fan.
Finally realized my lack of having an internal clock of any kind is awesome and not just because I've never had jet lag. I can literally sleep anytime of the day. Too bad there's no record book for this. I would win.
Nursing is pretty freaking cool and pretty freaking difficult all at the same time, often in the same moment. I get to see people at some of their best moments (getting good news) and some of their absolute worst (devestating, end of life news and death). I get to provide support on both ends.
Advocating for your patient looks way different then I thought it would during nursing school. Should probably elaborate on this one, but I'm still figuring it out.
When another nurse asks you to help turn a patient, try to get on the front side of said patient. No telling what will flow out the back when they're moved.
Humor is indespensible in 94.32% of the situations I'm in.
Finally, never, ever wait until the last minute to do anything that has to do with anything about your nursing license.

I've come to the conclusion that time flies whether you're having fun or not. Fortunately for me, I have fun most of the time.

On Death and Dying...

2011-11-27T03:35:00.000-06:00

A few weeks ago, I took care of the cutest little, older patient. This patient had been in the hospital for a couple of days and had a grim prognosis. That evening their family came to visit, I got the patient all cleaned up, bed changed, and room tidied. The patient was chatting with me a little bit, and was just really nice and stinking adorable.

36 hours later the patient was dead.

I actually knew this was coming. Or at least I figured the patient's days were numbered. Early in the morning on the night that I took care of him/her, the patient took a decided turn for the worse. I had to increase their oxygen, get a bunch of other respiratory stuff done quickly, and had the doctor come up to look at them because their breathing had changed so much in such a short period.

I left the hospital that day knowing that I had given the patient excellent care, but that the patient probably wouldn't survive until Christmas. I didn't give the patient a second thought until I came back to the hospital 36 hours later and heard they had just died.

I always knew that nursing had life and death ramifications, but somehow it seems different when there is a face attached to the dying--when you realize that your care actually made a difference in a patient's life span.

Sometimes, you are able to detach yourself from the death of a patient. You assume care knowing that your role is to make the patient as comfortable as possible and provide the family with as much support as you can. Sometimes, it's a code and you get caught up in the adrenaline rush. Sometimes, though, it catches you off guard. One day the patient is chatting with you and the next time you work, they are dead. It's final. There is no other solution.

It's inevitable that death will happen to all of us someday--really the only question is when? The Bible says, "Oh death, where is thy sting? Oh grave,where is thy victory..." (I Corinthians 15:55) I'm grateful that when death stares me in the face, it won't have the victory, because mine has already been won.

I promised a blog about all my experiences as a new nurse, death is one of those. The funny returns with the next post.

Some patients...

2011-11-23T08:07:00.002-06:00

Over the weekend, it got a little nuts around the hospital.

Take patient #1 for example. This patient apparently didn’t understand or didn’t care what appropriate social boundaries are.

We had to call a special response because the patient became irate after we asked their significant other to leave because they were attempting to get it on in the patient’s room. The patient was on special observational status, so this occurred in front of the sitter who was ensuring the patient’s safety.

I am not kidding.

It was one of those “who am I?” moments. I just can't believe this wasn't covered in nursing school. Thank goodness it wasn’t my patient for a change, and I only had to provide backup for the nurse.

Truth

2011-11-16T17:17:00.000-06:00

Quick funnies

2011-11-12T08:16:00.000-06:00

I'm off to bed for a couple hours since I've worked the past three days...enjoy these in the meantime.

Actual clinical note:
"Patient was advised against using PEG (tube used for feedings that goes directly into the stomach) tube for beer upon his/her discharge."

Actual patient statement:
"This heart monitor sucks away my life force while it's on me. But see if I hold it out here, I'm much better."

I don't make this stuff up people.

Crazy Happens

2011-11-02T22:55:00.000-05:00

For all my regular readers (mom, aunts, and siblings), sorry for the lack of funny content. To be honest, the last several weeks have been, well, rather normal. At first I liked it. I mean it’s nice to have a break from the crazy that is my life at the hospital. However, after one night of normal, I was really bored. Twelve hours is a really long time to find ways to waste time in between patient care. I mean a REALLY long time. I’ve definitely become a blog stalker extraordinaire.

Well, my friends, that all changed earlier this week. You know what. I’m just going to quote the conversation so you can enjoy it as well.

Scenario

A report was made to a nurse (not me) that a patient was seen taking pills from home in their room. Clearly this poses a threat to patient safety. I mean there are A LOT of drug interactions, and this particular patient was on some pretty strong meds apparently.

It should be noted in this scenario that the patient I am talking about had already faked not 1, but 2, seizures this particular evening. That’s right. Patients do that regularly to try to get the “good drugs” Ativan being one of them. (Makes the cartoon at the beginning of the post funnier, doesn't it?) Just another joy of my life at the hospital—it’s not enough that I have to try and figure out what a real seizure looks like (which I have, thank goodness) I also have to figure out if it’s fake because they want the “good” meds.

Anyway, earlier in the night the nurse who had the patient was annoyed because of the faked seizures and I told the nurse “Just tell her it’s like the ‘hokey pokey’ and the patient should ‘shake it all about.’” We had a good giggle over that one.

Back to the story…

So after we had a report that the patient was taking meds in their room, we called security to have a witness and roll into the patient’s room and ask for permission to search for the pills. We explained to the patient why this was for their safety, etc. The patient is higher then a kite at this point and agrees. We looked through the patient’s things and of course found the pills…many of which were extremely potent and have very dangerous side effects.

As we’re finishing this exchange occurs:

Patient: “Do you need to search under my mattress also?”

Me: “Do you have pills hidden under your mattress?”

Patient: “No.”

Me: “Nope. We’re good.”

Also, remember security has this whole exchange on tape.

Thirty minutes later…

The sitter in the room with the patient calls out and says that the patient needs to speak with whom ever is charge ASAP. I can hear the sitter panicking a little bit, so I run right into the room because by some stoke of something, I am in charge that night.

Anyway, the patient yells at me and tells me to “get out of my face” even though I’m standing at the door and the patient is sitting on the bed. And the patient isn’t going to talk to me because I “violated their rights, and I am going to lose my job for it.”

So, the people who are really in charge are called and they come up to try and talk down the crazy patient. And here’s where it really gets good.

After several minutes of the patient rambling about how their rights have been violated and how armed police (security) stood in their room and that was a violation of their rights, etc, etc, etc…the best exchange takes place.

Person in charge (POC): “What can we do to fix this and make it better?”

Patient: “Well, I don’t really know. I’m having a little trouble remembering my name night now, and all I know is that my rights were violated.”

POC: “Do you think, there might be a chance, that since you’re currently having a little trouble remembering your name, you might not remember consenting to having your room searched?”

Patient: “Oh NO you didn’t! You did not just go there.”

POC: “I did just go there. Now are you going to answer the question?”

Patient: “My rights have been violated. Get all their names (a friend was sitting in the room) I’m calling the news. You ALL are losing your jobs. Now get out of my room. I’m going to sleep.

People, I am not exaggerating. That is what happened.

Oh, and security was standing outside the room the whole time this was exchange took place, and was just cracking up because they were there the first time, and none of this had happened.

Now I’m off for about a week for a little vacation time. I’ve heard the holiday’s can be CRA-ZY, and I can’t wait to tell you all about it. Stay tuned.

Ode to the 3 o'clock hour

2011-10-29T23:50:00.000-05:00

Oh, 3 o'clock hour, I heart you. Patients finally fall asleep. Call lights cease to ding. I get a minute to chart.

I like that I can get out my iPod and jam to some ‘toons while charting occurs.

The calm and serenity you give is not overrated.

Why do you only last an hour?

But can't you go faster?

Because after you comes 4 o'clock, and if I make it to 4 o'clock...

I can make it until 5, and then the shift is almost over.

In fact, 3 o'clock hour, one might say you are a turning point.

Reflections, Part Deux

2011-10-16T13:42:00.001-05:00

Recently, there have been a lot of HIV/AIDS patients on my floor. I've noticed that things kind of come in runs around here. You get a run of tracheostomies. (Holes in the throat. Not my favorite thing.) Or high acuity (really sick patients), or crazy (I mean we always have some level of crazy, but sometimes it's almost every room), or lots of diabetic ketoacidosis.

I'm always super honest on my blog. (I get this from my mother. Big time. Smile.) Sometimes, these HIV/AIDS patients cause me to pause and face the risks of what I do. It's not often that one faces, daily, people who are inevitably starting at death at some point in their near future. (Yes, I know that not everyone who has HIV has it progress to AIDS, but the majority of these patients are non-compliant, meaning they don't take the medications they need to keep the HIV in check, and they have progressed to full blown AIDS.) Literally, some of the patients are marking time. So this sobers me.

They will not be having happy endings. Around the hospital we like to try and "fix" our patients by the end of the shift so we can send them home. What do you do when really, there's no "fixing" of these patients?

I recently took care of one of these patients for several days, and while I hope my care is excellent, I’m the one who walked away changed.

It's funny the things that happen when you are taking care of the little details in nursing. This patient had particularly dry skin. It was flaking off, tenting (when you pull the skin up and it stays rather than flattening out), and itchy. I had helped the patient up to commode and asked if he/she would like me to rub some lotion on their back.

I don’t know about you, but as a follower of Jesus, I’ve seen Him show me deep things of His heart at what seem like inopportune times. Apparently, this was one of those times because tears started to run as I was rubbing lotion on this patient’s back. In that moment, I think I got a glimpse of what it looks like to Jesus’ hands and feet, and I was humbled.

It was a still, small voice speaking to my heart saying, “Corrie, I have reached down and rubbed lotion on people’s backs because I am about redeeming broken situations.”

All of a sudden compassion overwhelmed me and I saw past a disease to a broken person, and I got a small glimpse of Jesus’ heart for them. And I’m the one who walked out of that room changed.

(Wondering why this is part deux? Here's part one. Also, I feel fancy using French.)

A day in the night...

2011-10-11T23:21:00.001-05:00

One of the hallmarks of my favorite sports columnist are his running diaries of major sports events. These crack me up. I'm not nearly as creative as he is (this is primarily demonstrated by the fact that about 30 people read my blog, and he has 1.5 million Twitter followers. I digress.) Anyway, a running diary was the inspiration for this post.

For all you non-nurses/medical readers, here is a day in my night:
6:35 pm Race into building, up elevator, and onto floor only to discover I still have 4 minutes before I'm allowed to clock in.

6:36 pm Wander leisurely into nurses station/break room area like I haven't just rushed around for the last 45 minutes to get to work on time. I'm confident I'm fooling everyone, heavy breathing or not.

6:37-6:40 pm Load up pockets. This is a thing, people. I have a pen, a red pen, a highlighter, a dry erase marker, a Sharpie, my stethoscope, alcohol pads, tape, and my scissors. And I have a just so way of putting my pens into my pocket so I can effortlessly grab the one I need when I need it in the patient's room without pulling all the other ones out of my pocket. (As cool as this system sounds, it inevitably fails me at least once a night. Sometime I should invent a better way to keep pens organized for nurses. I should have added this to my poll as a way to spend my free time. Oh, wait, it's already happened they have a 4-color pen. That's going on the Christmas list.)

6:41 pm Walk into conference room for mini-staff meeting. This is where the charge nurse tells us things we probably already know from email, but it's the important stuff he or she doesn't want us to forget. They also remind us to; you guessed it, check our email. Also, they tell which patient's are causing trouble--always a fun part of the meeting. We have a code for this, it’s “PIA.” (Pain in the a$$)

6:58 Report starts. For all you non-medical people, this is where the day nurse gives you the low down on what happened with your patient's, what needs to happen with your patient's, and oh by the way, I didn't get it all done, so here's your "to do" list. (Not really, but sometimes.)

7:14 pm Whenever report finishes; I look up my patient's and set up my computerized list for the night. By look up, I mean check the doctor's orders, look at the last couple days of lab results, read the most recent progress notes, and check out their medications. This gives me a pretty good idea of what's happening and also helps make sure stuff isn't forgotten from shift to shift.

Side note: the older nurses love to tell me how things "used to be" before computer charting. My mother would probably appreciate these stories. I think they are strange. The computer is wonderful. It makes my life easier, and it's so much faster to click through one's assessment instead of actually writing it down. Then again, I'm writing a ridiculously long blog post about all this, so I might have liked paper charting...

7:30 pm Acutal patient care begins. I start out with checking vital signs, asking pertinent questions like "do you have pain?" and do my assessment. What's an assessment you ask? I will tell you. It goes from head to toe, and checks out all the major body systems. This is always where I look like I know something because I use my stethoscope, and patient's automatically assume you know what you're listening for/to and then clearly, you know what you're talking about.

So, I start by checking pupil reaction, move down to listen to heart and lung sounds, then bowel sounds, then I check the pulses in the wrists, capillary refill in the finger tips, palpate the abdomen, ask embarrassing questions like "are you passing gas," check the pulses in the feet, look at the heels and toes, and ask a few more questions about their various medical conditions.

Small tangent: Question asking can get me into trouble because I don't always know the answers or know what I'm looking for. I hope to figure all this out someday. But in the mean time, I'm going to keep asking and "fake it until I make it." Comforting, isn't it.

8:00 pm Charting time. Because I only have 2 patients (I'm waiting for the 3rd to arrive), I finish a little earlier then normal. This is good since I will have an admit at anytime, and I have to start handing out meds in about 30 minutes. In nursing school they taught us "if it's not charted, it didn't happen." So true, so true. Ironically, I find a lot of what they taught us actually happens. (I say ironically, because how many people get a degree and never use a thing they learned?)

8:17 pm A patient asks for help going to the bathroom. I run down the hall to help.

8:26 pm I decide to start passing meds so I don't run late. Plus my charting is almost finished, and it will just take a few minutes more. (I am fast at charting. I am slow at giving meds. You know, meds can kill people. I like to triple check.)

8:27 pm "This is easy," I think to myself. One of my patient's only has 1 medication, and the other only has four.

8:31 pm New lab results pop in for a patient. This means I pause to look up the protocol so I can make the appropriate adjustments to the IV fluid in the room. I, of course, triple check because this medication is strong and I don't want to mess it up. All these protocols still confuse me a little bit, so I'm super careful.

8:38 pm On my way with my meds to patient #1. Meds are given, IV infusion adjusted.

8:45 pm Off to patient number 2 with meds. As I'm about to walk down the hall, the phone rings with report for my new patient. I pause to take report.

8:58 pm Finally get meds to patient #2. It's a sad story, so it takes a while even though it's only 1 medication because the family has lots of questions about the patient's medications. For the whole day. I am not well versed in the patient's medications throughout the day, but I explain them anyway.

Side note: There's this super handy thing I discovered on like the 2nd day I worked here. If you right click on the medication in our computer program, it pulls up the reference material for that med and tells you everything you need to know. I love technology. Paper charting couldn't do that for you. And, apparently, neither does two semesters of pharmacology.

9:07 pm Finish charting.

9:15 pm Third patient arrives.

9:17 pm I head into the room of my new patient and do my assessment, check vitals, etc. This patient comes with a sitter to watch over him/her, so I chat with the sitter briefly.

9:23 pm Check new patient's meds

9:25 pm Give new patient's meds

9:35-9:58 pm Give a patient Jell-O, help another patient go to the bathroom, give the same patient pudding, give the new patient more blood pressure medication, answer a sitter's question.

9:58 pm Go to McDonald's.

Long tangent: Yes, you read that correctly. There is a McDonald's. In the hospital. It seems counter productive, but I view it as a good business model. Eat too much McDonald's, go to the hospital for your heart, or intestines, or liver. And it's convenient because it's IN THE HOSPITAL. I like Diet Coke. I drink one almost every shift. The caffeine helps propel me through those crucial hours from 3-5 am. Tonight's not that busy at McDonald's. There are only 2 people in front of me. And, there are 3 people working...again a shocker. Normally, there are 7 people in line, and 2 people working and it takes FOR-EV-ER. Actually, the McDonald's experience should be its own post. Noted.

10:07-10:35 Eat lunch/dinner—whatever meal this is. I'm starving, who cares.

10:36 Catch up on the drama that is letting a family member visit after visiting hours are concluded. Talk to security about family member visiting.

10:39 Sitter comes to complain about family member visiting.

10:40 Go talk to family member

10:42 Begin charting again

10:44 A patient needs pain medication. Go get it and give it

10:53 Back to charting

10:54 Ooops. Go check a patient's blood pressure to follow-up. While I'm at the end of the hall, reassess the other person's pain so I can chart on that too.

10:58 Patient blood pressure still too high. Can't give more BP meds for an hour. This must be one of those "gray areas" they talk about in nursing school all the time.

11:00 Go ask a more experienced nurse what I should do about the high blood pressure.

11:02 Do what that nurse tells me.

11:05 Chart some more

**At some point while I was writing this, I got distracted, and then I couldn’t remember what else happened that night, and since my shift doesn’t have a DVR (thank the Lord!) you guys are stuck with only a half shift. At some point in the future maybe I will do a running diary of the 2^nd half of the shift. Prepare yourself, there will probably be an “Ode to the 3 o’clock hour” in there, because it is rapidly becoming my favorite hour of the day.

Jail Inmates

2011-10-09T08:01:00.000-05:00

Yes, you read that correctly. At my hospital we treat jail inmates. It's no big deal, they're just shackled to the bed and have 2 guards with them every hour of every day. One just hopes they're not a too violent of an offender and that they don't decide to take it out on you.

I'm not going to lie, sometimes, before I walk into the room for the first time, I have to take a deep breath and put on my game face. You know, the professional one, where I pretend to be totally cool and not afraid that some prisoner will reach up and choke me as I reach across the bed to listen to their heart while I'm doing my assessment or something.

Also, these are the conversations I have with my fellow nurses:
Me: "Do I have to chart that skin breakdown under the shackles?"
Fellow nurse: "Nope. Just mention in your note that it's there. Nothing we can do about it."
Me: "Cool." (But inside I'm thinking "WHO AM I?")

And the male patients, particularly, are always excited to have a girl nurse. Hypothetically, the following conversation might or might not have happened recently:
Me: "Good evening. I'm Corrie and I'll be your nurse tonight."
Patient: "How YOU doin'?" (In a very good Joey from Friends way.)
Me (thinking to myself): "I love my life. What could be better then getting hit on by a violent offender? But seriously, dude, you're shackled to the bed 3 different ways. You've got no chance."
Me (out loud to patient): "I'm good. How are you?"

And professionalism reigns.

Self-Scheduling

2011-10-04T01:05:00.000-05:00

(This has absolutely nothing to do with my post, I just think it's hilarious, and I'm going to buy one for myself.)

When I was growing up, one of my mom’s favorite things to say was “be self-governed.” By that I’m assuming she meant “please, for the love of pete, clean up the dishes the way I taught you…including washing the plastic bags.” I have found when you’re an adult the same kind of thing applies…except in this case, I buy my plastic bags at Dollar General so I don’t have to wash them.

Anyway, at my hospital we get to self-schedule. This means that we get to pick any three days in a 7 day period to work. I love it. Except that I have to plan my life 6 weeks in advance. This is hard. I also have to remember that the week starts on Saturday and ends on Friday. This is also hard. I can not, for the life of me, figure out why. In my previous life (see Politico Recovery) I used to schedule major public figures with no problem. It is so much more difficult to do it for yourself. I see now why they liked it so much.

Here’s what happened:

I thought that I set myself up for the standard 3 days. So I picked up an extra shift to make some extra money. I mean, I have rediscovered my love of all things shopping and it’s so much more fun when you have money. Also, Trader Joes came to town. Wow, I love that place. And Charming Charlie’s. And The Legends. And Dean and Deluca’s. And Crate and Barrel. And Costco. I digress.

Thinking I would be super clever to pick up an extra shift to make money to support aforementioned shopping preferences, I emailed the powers that be and said I would pick up an extra shift. Then I asked a friend to switch a day with me, so I added another day this week. Then I looked at the schedule and I somehow scheduled myself for 4 days, plus the day I picked up, plus the day I switched, plus getting moved to the 1^st day of the new schedule.

All of this equals 7 out of 8 days at the hospital. I mean I’m not complaining about the bank I will make, but it’s a little daunting to think about.

Good thing my previous life prepared me for this. I mean I once worked for 6 straight weeks with no day off, so this stretch is totally tolerable. Right?????

Catch you all on the flip side… (i.e. 8 days from now)

A little funny...

2011-09-29T16:14:00.000-05:00

This week, one of patient's (who I will readily admit is not 100% with it, but is super adorable), told me the reason he/she was sick was because their "bed was too close to the floor." The patient then proceeded to explain how germs jump from the floor to the bed and get patient's sick.

Funny, must have missed that lecture in nursing school.

A little while later the same patient told me that he/she was also sick because they "hadn't had any coffee today." Then the patient says, "I knew there was a reason I was sick. I need some coffee!"

While I share my patient's affinity for coffee, I again had never realized it could cure illnesses.

I learn something new everyday. ;-)

The conversations we have...

2011-09-28T22:29:00.001-05:00

These are the things we discuss during the night at the hospital I work at.

Me to fellow new grad: "How's your night?"
Fellow new grad: "Good. My admit told me he/she uses crack all the time."
Me: Really? When was the last time he/she used?
Fellow new grad: Today.
Me: Hmm...I wonder when he/she will start to withdraw?
Fellow new grad: Good question. I don't know. What is crack anyway? And what's the difference between crack and cocaine?
Me: I have no idea. Let's Google it.
Fellow new grad: Ok!

Google commences. Problem solved.

Fellow new grad: Wow. For a suburban white girl, I sure know a lot about drugs.

Things Overheard

2011-09-19T22:10:00.000-05:00

I heart the overhead paging at my hospital. At least twice a week I hear something hilarious. A night last week was no exception...
Page: "Mr. Daddy, please return to your area. Mr. Daddy, please return to your area."

5 minutes later...
Page: "Mr. [the patient's real name, incidently not Daddy] return to your area. Mr. [the patient's real name, incidently not Daddy] return to your area. Thank you."

The nurses and I looked at each other and cracked up.

I know what you're asking yourself..."why would you have to page a patient to return to their "area" aka room?" I'll tell you. Our patients struggle with a little thing called compliance. You know, doing what one is supposed to do to take care of one's health. And the hospital I work at is not a police state. So, patient's wander around, go outside to smoke, go eat at the McDonald's that is in the hospital, (Yes, you read that correctly. There is a McDonald's in the hospital.), and occasionally pick up a little "somthin, somthin" at the bus stop outside the main entrance. (By "somthin, somthin" I mean an illegal substance. Yes, that also happens while a patient is admitted around here.)

The hospital I work at has 5 different policies detailing what to do if a patient leaves or you can't find a patient to administer treatment. They are things like:

Elopement and Patient Absence Without Therapeutic Reason
AMA (Against Medical Advice)
Patients who may not leave AMA
An entire color coded system to indicate a patient may not leave AMA
Sitters
Security to convince a patient they may not leave AMA

Oh, and patients may leave their rooms for 3 hours before these policies can be implemented. My favorite is when they leave their rooms to go down to the Emergency Room to try to get more medication. You know, cause the hospital gown and associated paraphanila doesn't give it away...

So, we hear pages like the one at the beginning of the post regularly. Sometimes they're even for my patients.

Flying Solo

2011-09-16T08:20:00.000-05:00

(I kid you not, this was what popped up in Google when I looked up solo and I love. it.

I doubt I will ever be as cool as Hans Solo but at least I have something to aspire to. You know, the medication thing I use kind of looks like his ray gun aka blaster...if you squint and close one eye and look at it from down the hall.)

After 2 years of school, countless clinical hours, and 12 weeks of orientation where I had an experienced nurse watch my every move, I was finally thrust upon my unsuspecting patient population this week. I was a little nervous and kind of excited. During my last week of orientation, the other nurses on my floor had been telling me horror stories of what happens during one's first week of being alone. I mean, HORROR stories. Like a patient started spewing #2 out of their nose and died within hours kind of horror stories. I. was. stoked.

I roll in for my first night and get ready for report. (I have a running diary of a day in my night almost finished. Then you'll understand what I mean by "get ready for report." It's complicated and involves filling my pockets. Prepare yourself.) I sit down with the first nurse of the night. She says, "Get comfortable. This is going to take a while." Never a good sign, FYI. And she wasn't exaggerating. This particular patient had 6 different medications going through the IV into a central line. (Note: a central line goes directly into the heart and into circulation. Even less room for error then normal.) They also had a critical medication that we only stock in small bags, so it had to be changed every 30 minutes.

To top it all off, the patient was at the end of the hallway. That's some excellent planning by whoever the bed planning people are around the hospital, I tell you.
I'm thinking "well, at least I'll get my exercise tonight." Let me tell you, I got that and more.

I was keeping up with everything pretty well in spite of the fact that my patient at the end of the hall was becoming more and more needy and as it turns out sicker.

The doctor kept ordering more labs to be drawn, more meds to be hung, etc. This was not a problem at all, except that approximately every third time I walked into the room, the patient would need to use the bedside commode and this would take at least 15 minutes. And when you are hanging meds every 30 minutes anyway...well, you can imagine that I wasn't left with much time in between for my other patients. At some point when I'm doing all these things, I start asking myself "Who am I?" Also, "Where did I get these mad skills?" [Apparently one does learn something in nursing school.] I mean I was even using fancy medical words with the doctor like "hypovolemia" and "supra ventricular tachycardia" and such.

Around 2 am, things took a turn for the worse. I was in the room once again helping the patient up to the commode, and thinking to myself "I need to call the doctor and tell her that the patient's heart rate is not returning to baseline. I don't think this increase is good." As I'm thinking through this, I look up at the monitor in the hall and see that my patient's heart rate is like 170 something. (Note: that is what I shoot for when I'm trying to get some good cardio in during a workout. It's problematic when one is sitting still and the heart is beating that many times in a minute.) I walk back into the room and ask the patient if they are having any chest pain or shortness of breath, etc.

This time, the answer is yes. At that point, I'm pretty sure my heart rate was matching my patient's beat for beat. I leap into action and grab a vital sign machine while hitting the call light. I get that blood pressure cuff on the patient in record time and another nurse comes in the room to help me. She goes and calls the doctor while I stay with my patient. Considering I had already talked to the doctor no less then 5 times that night about the same patient, I think she literally ran up to the room. They were already concerned about this patient hence the quick response. Thank goodness for that!

The doctor decides the patient needs a STAT (i.e. right now) transfer to ICU. Of course, first a bunch more STAT labs and tests have to be done. I'm pretty quick about that at this point, so I get those done with super efficiency.

I call the charge nurse, she comes up to help me and to make a long story short, we move my patient to ICU...on my first night flying solo.

So, I got to walk like 5 miles in my super awesome Shape-Up shoes, (hello toned backside) 2/3's of patients didn't go to ICU, and everyone was still breathing when I left in the morning.

That's what I call success.

So, I'm a night owl

2011-09-12T19:44:00.000-05:00

When I was hired, the only job offered to me was the night shift. These were my thoughts, in no particular order.

“Sa-weet! I’m not a morning person. This will be great. Hmmm…I wonder if I can stay up all night regularly. That night differential will be A-W-E-S-O-M-E. I’m going to be rolling in the dough. Maybe I will buy a house and fill my swimming pool with dollars instead of water. Oh, wait, I have this little thing called ‘student loans’ the pool filled with money will have to wait a while. Hmm…I wonder if there will be any cute, single doctors who work nights. Swimming pool with money instead of water back on. Wait, I can’t look cute at the end of (or really at any point during) a 12-hour shift that runs through 3 am. Pool with money off. I can’t believe someone actually offered me a job! With a real paycheck. I hope I don’t kill a patient. Is it ever going to warm up so I can go swimming. Water or money…I need the pool.”

Never having worked a night shift before, I need some advice. So I talked to several different people, most notably my sister-in-law who had just finished residency. She’s pretty much an expert at not sleeping and working through night since she’s done it for the past three years, so I thought she would be a better resource then Wikipedia. (Also, more reliable…hence “better source.”)

Her advice was to just stay up for 24 hours for the first shift, then of course, sleep during the day and repeat. Then when I was done working, come home and take a little nap, get up do some light activity, and try to go to bed at a normal hour.

This was good advice…except for the whole “stay up for 24 hours thing.” I am, apparently, too old for this, so I actually stay up late the night before I work, sleep in as long as I can the next day, and then go to work. Otherwise, I follow her advice.

Of course, a key part of this is when to eat. I’m not going to lie, I really like food. I particularly like Mexican food, but I should probably leave that whole discussion for my other blog that will be completely devoted to my love of Mexican food, and cheese dip, chips and salsa in particular. (That might be a little dream I have, that I just thought of as I was writing this…Don’t get too excited.)

There are two things that are extremely lucky for me with this whole transitioning to nights thing.

1. I love breakfast. Any time. Any where.

2. I have no internal clock. I can sleep any time, any where. Seriously, I can.

So, to make a long redundant post, shorter, I wake up in the afternoon, eat breakfast and bring a dinner. When I come home from work and I am starving around 8 am, I eat yogurt, or a banana and peanut butter, or crackers and cheese, and then I sleep. Or sometimes, I just sleep because I can barely keep my eyes open.

In conclusion, I like nights. They’re more laid back. I have more time to talk with my patients. You have a minute to catch your breath while your patient’s sleep, and people ask me to be their baby momma. What more could I ask for?

Never Forget...

2011-09-12T00:01:00.000-05:00

The 12-steps: An update

2011-09-09T16:25:00.001-05:00

As many of you know, after about 10 years in politics, I went into political recovery 2 years and 3 months ago. This resulted in me enrolling in nursing school and has now led to my life as a registered nurse. (I’m not going to lie, it’s a life I love.)

Since all good recovery programs have steps, and it’s been a while since I’ve updated mine, I thought it was time to check in again with my recovery process. (Also, in case anyone is keeping track 2012 is a presidential election year. It’s kind of like having your biggest temptation within arms reach 24/7 for a year. Good thing I’m checking in on my recovery.) My comments are in bold below.

1. Admit you are a politico

Done

2. Quit

Nursing school was a pretty good indication of that.

3. Remove all political paraphernalia from on/in your car. i.e. bumper stickers and yard signs that are 2 elections old.

Done—2 years and 4 months ago, and it’s stayed politically clean. My car is a mess right now, but it is free of political paraphernalia.

4. Find a sponsor who understands and will quit too. Don’t be afraid to call said sponsor when the urge to engage in meaningful political activity comes upon you. Someday, you will return to being a civically minded citizen. Today is not that day.

Done, done, done. Used to have to call about once a day when I felt the sucking, black vortex of politics wooing me, but I made it. Now I just call when I’m hungry and want someone to eat Mexican food with me.

5. Don’t show up for any political events. Ever. No parades, no literature drops, no debates, no informative meetings, no fundraisers, no organizational meetings.

2 years, 4 months and counting.

6. Stop reading 17 news blogs a day.

Down to 1 plus Twitter. I did limit the number of politicos I could follow to 50 or less—1/4 of the total people I follow. Seems reasonable. I also decided that since it’s a Presidential election year, I’m going to follow all the candidates I think are curious. (You can check out my Twitter followees here if you’re curious as to who I think is curious.)

7. Unsubscribe to at least 5 news lists/discussion groups.

Done. I only belong to one and I only read it about once every 2 weeks. How’s that for progress?!?

8. Un-friend or stop following half of your political contacts on Facebook and Twitter—simply because they are contacts not friends.

Done. Friend count went down a lot. And I stopped friending people who were political in nature since that sucking, black hole vortex is consistently threatening to suck me back in. It's called boundaries.

9. Read a non-political book. Author’s that may not be read: Limbaugh, Beck, O’Reilly, Coulter, and Gingrich; books that have the words “Liberals,” “Are,” “Destroying,” “

America

” in the title may not be read either. Try a novel.

Read several actually, the most recent was “The Weight of Glory” by CS Lewis and “Arms Wide Open” by Patricia Harmon. It’s the story of a hippie midwife and her commune living days. Could this be any different then my political philosophy? I think not, but I really enjoyed her life story.

10. Get a hobby. Preferably one that includes at least one of the following: copious amounts of glue, tape, or fabric or Fantasy Football.

I now knit and I play fantasy football. Just a warning for my brother’s…last year was my warm up. I plan to bring my A game, so you guys better Watch. Your. Backs.

11. Do not, under any circumstances text former political contacts to “check in” and “see what’s going on.” They will suck you back in.

Only did it six times in the last 2 years and 4 months. That’s good right?

12. Write a book or movie about your experiences.

Maybe when I’m done learning Spanish. I have some prrrrety good ideas and stories that really should be shared. Of course, all identifiable features will be scrubbed…like my patient stories.

Whew! Feels good to check in with recovery. What about you? Anything in your life you need to recover from?

What to do with my free time...

2011-09-04T22:29:00.000-05:00

Soon summer will come to an end, and I will be unable to spend my free time at the pool. As a shout out to my former life, I’m taking a vote. What should I do with my 3.5 days off a week?

And because I'm an HTML dummy, I could only figure out how to add a poll over on the right side of the screen. So leave your vote in the comments or over in my sweet little poll, or both. Vote early, vote often people. I will release the results in about a week.

Learn Spanish
Learn how to knit more then 1 stitch
Get better at fantasy football
Update your blog more often
Read an ambitious (i.e. greater then 300 pages) book. (If you vote for this, you better leave me some suggestions in the comments.)
Get another job so you can have more spending money

Also, I'm sorry for the delay in my postings. I've been moving. Expect a plethora of posts over the next 2 weeks to make up for it. Stuff has happened my friends, stuff has happened.

I see things that textbooks talk about

2011-08-19T22:17:00.001-05:00

During nursing school, we were taught about many different diseases. Much of these seemed hypothetical. Then we started clincials, and the serious stuff was still far off in the future. Somewhere, in the back of my head I was thinking “I will never have to see/smell/deal with that.”

I laugh at that thought now and it’s only been a couple of weeks. I have already seen oh, about 347 things I thought I would never have to see/smell/deal with.

Recently, I had my first experience with gangrene. It is gross. And the smell is grosser. (I don’t even know if that’s a word, but I’m going with it.) And it was oozing. I was even impressed with the strength of my stomach. The sad part about it is that the only way to treat it is by amputation.

About the same time, I had a patient who had overdosed on a potent street drug, one who was withdrawing from narcotic use, and a couple of patient’s withdrawing from alcohol use.

There have also been more “total care” (patients who need turning every 2 hours, who can’t feed themselves and who are incontinent) patients then I count. (Like toothless man who loved chocolate pudding.)

They also talked about patients who would be “hard sticks” in nursing school (i.e. many renal patients have collapsed veins and it’s impossible to draw labs on them), well that’s true also. In fact, I saw a nurse try to draw blood from a vein in the finger…the FINGER, people! It was impressive. I will have to try that myself sometime.

Oh, and cellulitis might just need its own post. It's a skin infection that is super serious because if it goes into the blood stream a person goes septic (septic=infection in the bloodstream and you're headed to the ICU and I sure hope you make it). Anyway, I've seen more cases of that then I can count and it ranks up there with gangrene in the smell department.

You know what else smells REEEEEEEALLY bad? C-diff. It's a digestive problem. I will leave the rest to your imagination or Google.

But that’s one of the whole reasons I picked the hospital I’m working at—sicker patient’s with more advanced disease processes who need more health education.

Baby momma...what?

2011-08-16T23:53:00.002-05:00

The other night I was admitting a patient, and he was a talker! The admitting process is a little bit daunting at first as it requires a 10-step database process where you ask the patient everything you could possibly want to know about their health history, etc and a few things you wouldn't think of and wonder how they actually apply. I don't mind this at all, but I hate it when patients come in at 3 am and I have to go through this whole process and they just want to sleep, but I digress.

As I mentioned, this patient was a TALKER. I mean, he would not. stop. talking. And I could barely get my questions in. Over the course of whatever he was saying (I'm going to be honest here, I wasn't paying a lot of attention, because he was rambling and he thought he was funny, but he wasn't. At all.) All of a sudden he says, "Well, I come here because the nurses are cute and they give me good meds. Hey, I want you to be my baby momma. Will you?"

I didn't even look up from the database and said, "That's never going to happen. So, have you ever had a flu vaccine?"

Funny!

2011-08-09T00:20:00.001-05:00

A couple of quick funnies that happened over the last week...

Nurse 1: Overhears a patient yelling out of his room for his nurse. (Not uncommon. They forget how to use their call lights) "What's your patient's diagnosis?"

Nurse 2: "Craziness"

Nurse 1: "Figures."

********************
I took care of a little old man who had no teeth. He was super hungry and I told him he could have a snack after his bath. This was our exchange:

Patient: "But can I have chocolate pudding after my bath?"

Me: "Sure."

Patient: "You are the sweetest nurse I've ever had." And then he smiled his big, toothless grin. Could. Not. Be. Cuter.

*********************
Me: "I'm going to have to get another EKG for the doctor."

Patient: "You're cute so I'll let you. This time. But don't you try any of that other handholding stuff from earlier. You're gonna have to buy me dinner first." (That "handholding stuff" occurred while I was trying to draw some blood from some veins in his hand.)

People, whatever it takes.

It was like communicating with Helen Keller...

2011-08-01T17:12:00.001-05:00

Recently, I treated a patient who was blind and Spanish speaking only. I don’t think this patient understood a word of English—not even “yes” or “no.” It was quite an experience. Because something like 33% of the patients we have at my hospital are Spanish speaking, we always have a Spanish interpreter in the hospital. Sadly, during the night there is only one, while during the day there are seven or something.

The first night the interpreter came right up for the assessment and it went great. I’ve learned that when you have a Spanish speaking patient, it’s best to tell them what will happen during the night so you don’t have to call the interpreter for every little thing. We also have these sweet Spanish “cheat sheets” that have commonly used phrases like “I have to draw your blood now” typed out so the patient can read them and know what’s going on. Naturally, this poses a problem when your patient is blind.

I’m just guessing here, but having never taken a Spanish class in my life, I’m assuming my pronunciation of said phrases on the cheat sheet is not even remotely accurate.

The 2^nd night, I had the blind patient again and my other patient was also Spanish speaking. I paged the interpreter. She called back about 20 minutes later (which is a really long time for her. They usually get back with me right away.) Of course that night she had a mom in labor and a trauma in the ED. My people’s assessments were a little lower on the priority list. So my night started off with a lot of confusion in spite of my attempts to use my cheat sheet and the blue translation phone.

At some point during the night as I was trying to do something for my blind patient I realized that this must have been what it was like to communicate with Helen Keller. I felt bad for the patient because he/she couldn’t express their needs, and I was frustrated because I couldn’t meet them.

Well, later that night I noticed that the blind patient’s blood sugar had dropped quite a bit—not enough to cause a problem, but enough that he/she needed to drink some juice to raise it up a bit. Naturally, this patient has no appetite and doesn’t want to eat or drink and I have no idea how to tell them it’s important that they do so.

Insert Google translator.

I pull it up on the computer and type out what I want to say and listen to the pronunciation a couple times. Then I roll into the patient’s room and proceed to completely butcher the pronunciation and tell the patient “Por favor beba jugo.” Then I put the straw up to their lips and stick into their mouth hoping they will get the idea. The patient did and took like three little sips then mumbled something in Spanish which I’m assuming meant “stop forcing this horrible substance down my throat and let me sleep. It’s 3 am for heaven’s sake.” (Again, just speculation on my part, based solely on the tone used.)

Anyway, it was pretty comical. And, it was only after that interaction that I realized I should have just pulled out one of our blue translation phones and it would have made the interaction A LOT easier.

Did I mention that that night all my patients spoke Spanish? Around 4 am I decided this not speaking Spanish was for the birds, and decided I will learn some this fall. Should be fun...

Patients are funny people

2011-07-09T17:06:00.002-05:00

Recently, I took care of an older man who really, really wanted to shave. Unfortunately for him, he was on oxygen. The tubing made it impossible to get to the bathroom and he wasn’t very steady on his feet. Also, he didn’t speak English, and I didn’t speak his language.

I tried to explain that he couldn’t shave because of the oxygen using a variety of sign language, the 5 words I actually know in his language and a lot of charades. (In the process, I might have inadvertently created one of the most awesome group games ever. Stay tuned.)

Somehow I thought we had come to an understanding so I start to leave the room. As I’m turning the corner, I see him pull off his oxygen and sit in his chair. I’m thinking “awesome, it’s my second day and my little patient is going to desat (oxygen levels dropping) to 85% and I’m going to have to call a rapid response all because he wants a smooth face.”

But then I decide if he’s taking his oxygen off anyway, I might as well let him shave and stand by him with a machine to make sure he’s breathing ok while he does so. This is exactly what I end up doing.

At the end, he was fine and extremely happy about his smooth face. In fact, he gave me a little pat on the cheek to say thanks. It was pretty dang cute.

Patient #1

2011-07-05T13:37:00.002-05:00

One of my patient’s came into the hospital via the Emergency Room with complaints of nausea and vomiting. While the patient is in the Emergency Room, they noticed a large dehisced (medical speak for surgical wound that has split open revealing the inner part of the body) wound. Apparently, the patient felt that this wound was “normal” but the nausea and vomiting was unacceptable. (High comedy right there, people.) Obviously, the patient was going to have to have some wound treatment, and spend some time on my floor.

I end up taking care of this patient for my first 4 nights on the unit, and I kid you not, every other phrase out of the person’s mouth was, “Aw s***, gu-hrlll.” (That’s girl, but spelled the way my patient pronounced it.”

Here’s a conversation we would have:
Me: “How’s the pain?”
Patient: “Aw s***, gu-hrlll. It hurts.”
Me: “Can you give me a number between 0-10?”
Patient: “11.”
Me: “Are you passing gas?”
Patient: “Aw s***, gu-hrlll, I’m tryin. Whatca doin here anyway?”
Me: “Any shortness of breath?”
Patient: “What’s that?”
Me: “Are you having a hard time breathing?”
Patient: “Aw s***, gu-hrlll, this pain. It so bad. Can you bring me something?”
Me: “I can’t yet, it’s not time.”
Patient: “Can’t you call the doctor and get me something else. My pain is so bad.”
Me: “I just talked to the doctor. There’s nothing else they can order.”
Patient: “Aw s***, gu-hrlll. Call him anyway.”
Me: (Ignoring that) “Are you dizzy at all.”
Patient: “Only when I try to get out of bed.”
Me: “Ok. Make sure you call me before you try to get up. I will help you.”
Patient: “Aw s***, gu-hrlll. It’s meh [body part that has the wound]. It hurts so d*** bad.”
Me: “Do you know where you are?”
Patient: “In bed.”
Me: “Good. Where’s that bed located?”
Patient: “[Name of hospital where I work]
Me: Do you know what day it is?
Patient: “Aw s***, gu-hrlll. Same day as this mornin’ and my [body part] still hurtin.”
Me: "Correct. But what day of the week is that?"
Patient: "[Names day of the week]
Me: “Ok. I’ll bring you your meds as soon as I can. Can I bring you anything else?”
Patient: “I want some pudding.”
Me: “Ok.”

I probably repeated this exact conversation about 10 times over the course of 4 nights. And that, my friends, is how I spent my first nights of orientation on the floor.

Professional Responsibility

2011-06-23T17:30:00.001-05:00

During nursing school, several professors drilled into my head the concept of professional responsibility. Basically, I am responsible for my nursing license and making sure I am following the Nurse Practice Act of the state(s) in which I practice.

Contrary to what you may think, I actually took these lectures very seriously. There are all sorts of penalties for not following the rules up to and including losing your license. Believe me, after spending a ginormous amount of money (via loans) on my nursing education, I’m interested in keeping the job that will pay it off.

So, my job is not in the state where I got my original license. No big deal. Once you get one license, you simply fill out the paperwork, get fingerprinted for the background check, get your paperwork notarized, send in the information from your school, and your money to get a license for the state you will be working in. There is, of course, a timeframe for all of this to occur or it’s considered “working without a license” and you get in BIG trouble. You know, like Bueller would have been in, if his vice-principal was every smart enough to catch him.

Anyway, I get an email from the hospital telling me I have 30 days to get the license thing taken care of. “No problem,” I think. I’ve already sent it in, and I don’t even start my job for another couple of days.

Fast forward to my first week on the job…

I find out at 4 pm on a Thursday that by “30 days” they mean 30 days from the time my original license was issued by my home state. I start to panic a little bit. I don’t even know when that was, but it was definitely the middle of May sometime. One would think this wouldn’t be such a big deal except that you can’t even go to orientation if you don’t have this little piece of paper saying you can sit in a classroom all day. I didn’t know any of this. I’m thinking, “Awesome. Here’s my first test of professional responsibility and I’m failing it because I didn’t even KNOW ABOUT IT! WHAT ELSE AM I NOT DOING THAT I DON’T KNOW ABOUT?”

So I call the board on my way home, and the woman was very nice and helpful and tells me she will start working on it. “Whew!” I think, “crisis avoided.” Then I go home and look at my original date of issue. It’s earlier then I think! I have even less time then I thought.

Thankfully, the woman I spoke with was true to her word, and when I called back on Monday to ask 17 other questions in case it didn’t get done in time, they told me I was good to go. Later that day the official piece of paper came in the mail.

Now I have a sweet little “RN” tag added to my name tag, and people think I actually know what I'm doing...Ha. Ha. Ha.

The First Week—a recap

2011-06-15T20:12:00.001-05:00

Someone should have prepared me for an ENTIRE week of classroom lecture for 8 HOURS a DAY, with only TWO 10-minute breaks, and a short lunch break.

My head hurts.

Also, everyone was absolutely impressive and so gracious and welcoming—except for one presenter. I mean, I understand that we are new and that makes us a little scary because we don’t even know what we don’t know, but telling us this FIVE times during your presentation doesn’t engender confidence. So, dear presenter, thanks for making me more nervous then I already was. I will prove you wrong.

And, I'm SUPER excited about getting my first real paycheck in about 2 years!

Occupational Health

2011-06-11T15:47:00.000-05:00

I am convinced that the first test of employment is the ability to find the occupational health office at the hospital you work out.

Let me explain:
First, the hospital I will be working at (which shall remain nameless…forever) is HUGE. I mean it’s like 2 big buildings that cross a major street connected by a tunnel, a tube, and I suppose pavement. Regardless, driving up to it is a little intimidating.

So, when I got my job offer, they told me to go to Human Resources to get directions to go to occupational health and to fill out paperwork. I’m thinking to myself “No problem. I’ve spent 3 semesters in hospitals. Of course I can find this place. How hard can it be?” I roll into HR and get the directions. They are as follows: (not word for word, but you get the general idea)
• Turn left out of this office
• Go to first set of elevators
• Take elevators to 3rd floor
• Turn right & follow signs for DTCCCXWUBY (not the real initials, but something it was something like that)
• Cross over street in tube structure
• Continue to follow signs for DTCCCXWUBY
• Go past the 1st set of elevators
• Take 2nd set of elevators to 4th floor
• Office is on your left

I managed to find the office, but I totally got lost trying to find my car. Took me a while to get un-lost.

Anyway, I get to the office and I am patting myself on the back because I remembered all of my immunization records since nursing school. (I’m sure somewhere I talk about being a human pin cushion, and I’m also protected from like everything.) I sit down and fill out 17 forms where I am asked about any and all infectious diseases I may have been exposed to. At this point I’m thinking “good thing I went to nursing school, or I wouldn’t even know what these are.”

Then I get to the inevitable “Have you been exposed to tuberculosis? Yes or No” To which I write, “maybe?”

Fast forward:
My meeting with the occupational health nurse is going swimmingly until she asks for my shot records dating back to childhood! (And here I thought I was prepared.) Then she sees my TB answer and we have a little chat about that. She does a TB skin test, which I had to have anyway, and I am praying that it’s negative so I don’t have to have a chest x-ray. (Not that it’s a big deal, it’s just crazy inconvenient and I’m not a huge fan of exposing myself to radiation on a regular basis.) So I explain about my Haiti trip, etc. I love my life sometimes.

(Note: TB test ended up negative. Thank goodness!)

I do a few other things with the occupational health nurse, and then she gives me the info to go to my drug screening.

Now, I had been at occupational health all morning, and hadn’t really had anything to drink. I also forgot my water bottle. I know when I go to the drug screening I will have to go potty in a cup. I’m getting a little nervous. I’ve never tried to go on command before, and I don’t have to go. So, I do what any normal person would do. I stop at the drinking fountain and drink a. lot. of water. I proceed to the drug screening place down the street.

I get there, check in, and head to the back. The guy gives me the cup, shows me the bathroom, and says “you have 4 minutes.”

I’m thinking “Great! I’ve never had to do this under pressure before. I hope I don’t have a shy bladder.” And, honestly, I sat there for a minute.

Eventually it all worked out, I passed, and I was able to start my job.

It's coming, it's coming...

2011-06-08T23:00:00.000-05:00

People. I will blog about my new experiences as a nurse just as soon as I finish my compliance training and this little thing called HIPPA.

You can count on my occupational health experiences, as soon as I decide they're funny. (Kidding. The experience really was. I've just been swamped.)

Also, the next 2 weeks are about as close to a normal schedule as it gets--roughly 8-4:30 or 5 each day. I don't know how you 8-5 people do it. This blows. So glad I signed up for the 3-12 hour shifts for the long term. :-)

New Beginnings

2011-05-26T16:11:00.003-05:00

(Story behind this picture: I Googled "new nurse" to see what kind of pictures I could find for a new look for this blog. Low and behold, this was the first picture that popped up. It couldn't be any funnier if I tried, so I hope you giggle as much as I did when I first saw it.)

Before I left on vacation, I told you there would be exciting things ahead for this blog. (I hope you define exciting as “new look” because that’s about it…I digress.)

One of the things that was drilled into us during nursing school was that our first year on the job would prove just as valuable a learning experience as our years in school. As such, how could I not continue to blog about my adventure? So, that’s the exciting news…I plan to keep blogging at the same address, but with a new title through my first year of nursing school.

It’s my hope that you will continue to enjoy reading this as much as I enjoy relating my experiences to you.

Up first? My very first visit to occupational health at the hospital I will be working at. I’m excited people.

Coming in the near future? What is it like to work nights and switch back and forth? Not being a morning person, I’m sure this will be “exciting.” (I’m hoping that staying awake will cause the abject pain I feel at 5 in the middle of the night 30 to not be there.)

That, and I’m sure other topics I find funny will be in the future. Thanks for reading, and I hope you still continue to do so.

End of an Era

2011-05-10T23:38:00.003-05:00

On Wednesday off last week, I finished nursing school. As much as I had dreamed of this day since, well since the day I started, it came upon me really suddenly. This semester I barely had time to breathe, let alone think about what life would be like after nursing school was over.

Fortunately, my previous life prepared me well for things careening downhill at 110 mph only to come to a sudden, complete stop. I know just how to handle this…Mostly by laying on the couch, feeling bored, wondering what book you should start reading, and watching a movie instead because your brain just can’t quite function yet.

Of course, now I have the added addiction of Bejeweled and I can waste entire hours without blinking.

However, all good things must end, and I am going to figure out how to be “normal” soon. Really.

Until that happens, I will blog about the end of this era.

Without further ado, here are the top 20ish things I learned about nursing school: (in no particular order. And, honestly, I learned WAY more then this, but I can’t think of any others and I’ve been thinking about it for 3 days.)

1. Wearing scrubs of all the same color makes me look like a blob of color…in this case a blueberry because my nursing school scrubs were royal blue.
2. There really are things that come out of the back end of patients that are colors and smells you can’t imagine.
3. Textbooks don’t always lie. A lot of things actually happen exactly that way.
4. Clinical instructors are awesome. Why won’t they always be around to double check the medications I will be giving?
5. Yes, you should study. A lot. And, yes, it does pay off when you get to take your NCLEX early and pass it. Then you can walk across the stage and be finished, with nothing hanging over your head. It’s totally worth it, trust me.
6. Friends who are in nursing school with you are vital to survival. No one understands the wide spectrum of emotions—good and bad—quite like them.
7. Try to find a friend or two who is smarter then you so you will do better on tests because you studied with them.
8. Always ask questions. Even if you think you understand it, double check. It pays off to not kill a patient. ;-)
9. When you’re getting ready to start your first IV, take a deep breath and go for it. Even experienced nurses miss sometimes.
10. Try not to stab your patient too hard when starting an IV. They will jump and make it worse.
11. Care plans blow, but they make you “think like a nurse.” A little bit, sometimes.
12. Walk into a patient’s room like you’ve done it a hundred times, even if it’s only your third time ever. And,
13. When in doubt, ask the question, than “fake it until you make it.”
14. When in doubt, bring room freshener in with you. You’re never sorry.
15. If you’re not a morning person, set 2 alarms for clinical days.
16. Wear comfortable shoes everyday you are at the hospital. Your back will thank you the next day. And, always wear socks with said comfortable shoes because blisters are a b*****
17. Always be honest with your patients, and if you don’t know the answer, go find it.
18. Bring snacks
19. Eat said snacks
20. Never be afraid to hold a patients hand, play peek-a-boo, or give a reassuring pat on the shoulder.
21. Always remember that there is no way your day could ever be worse then the patient for whom you are caring. They are in a hospital bed. That wins, every time.
22. When unsure which end the tube goes in, ask.
23. Always be nice to the nursing aides. It will save you needless headaches.
24. Compassion and understanding go a lot farther then having all the answers for a patient
25. When a professor tells you a test is going to be hard, believe them.
26. If you’re wondering if you’ve studied enough for a test, you haven’t. Go study more.
27. It’s always airway, breathing, than circulation. It doesn’t matter what the heart is doing if the patient can’t breathe. No breathing=dead. Dead=bad.
28. Believe your professors when they say you have "only begun to learn."

That, my friends, is an extremely short summary of what I learned in nursing school. In reality it's incredibly difficult to sum up what the last two years have been, all they have meant, and the amount of I have learned. But, that's the beauty of this profession, it's always changing and growing providing you with more to learn. I'm excited about where my journey started, where it's going, and what is still to come.

I’m off for vacation later this week for a while, but when I return, there will be exciting news about what’s happening with this blog since I’m no longer a student nurse.

Thanks for reading and enjoying this journey with me.

It's coming...

2011-05-09T16:49:00.002-05:00

I officially finished nursing school last week! Stay tuned for my end of nursing school reflections, and exciting news about the status of my blog.

A stunning revelation, 2 years in the making...

2011-05-02T16:35:00.001-05:00

It just occurred to me that I am in the midst of my very last study session of nursing school! How's that for time flying? It also occurred to me that you all, my faithful blog readers, would like to get a glimpse of my thought process during this session. (Also, I don't really want to study. Last session or not, some things never change. No, I haven't freaked out about finals. Yes, they start tomorrow. Am I worried about the lack of freak out? Not really. My grades are excellent in the remaining 2 classes, and so I'm doing a courtesy review.)

"Maybe if I get some classmates to study with me, I will actually study. This is a good plan, I'm going to text some people...Great, no one can study. Well, maybe if I go to Panera and get delicious Hazelnut coffee I will study. Where's that study guide for my first final again? I better bring my laptop so I can look up the study guide. Hey, I haven't checked Twitter in 20 minutes, I should do that real quick. Oh, this is an interesting article, I'm going to read it before I start studying. Great! Now I'm hungry what should I get. Where are my books? Are these all the notes I've printed. I think I'm missing some. I wonder if they have blueberry scones. Wow, I really love scones. I should have been British. If I was British would I have gotten an invitation to the Royal wedding? Great, what in the world are 'housing issues for the elderly?' What chapter am I supposed to be reading. I'm still hungry. It's time to get a scone--which I love.

"Ok, Corrie. Get serious. You have to pass this test or you can't graduate. Open your book. Oh, hey, I wanted to listen to that podcast. I will listen to it while I study. I can't listen to this podcast and retain any of this information at the same time. I should just play Bejeweled 3 until this is over then I will definitely study, definitely. You know what this is my last study session of nursing school. I should Tweet that. You know what would be better, a blog post. Yeah, I'm definitely going to write a post, then study."

And, there my friends is the amazing process that led to coffee, a scone, this blog post, and now some actual studying.

4417

2011-04-26T14:49:00.003-05:00

Throughout the semester, I’ve been commenting on my progress doing NCLEX questions. The NCLEX is the cloud that has overshadowed every class, test, and project of the whole semester. Really, my entire 2 years of nursing school boiled down to this one test.

I’m happy to say that 4,417 test questions was the magic number, and I passed my NCLEX last Friday!!!

I would have blogged about freaking out about the test, but I was, well, too freaked out to even put it into (hopefully) funny words.

Actually, I was surprisingly calm until I got to question 68 of the test. (75 is the minimum number you can take and pass.) For some reason when I looked up and saw question 68 I started to psych myself out. “What if I’m doing terribly, and fail in 75 questions?” Followed closely by, “What if I have to do all 265 questions?!?”

This of course led to having to read the final 7 questions about 12 times each because I couldn’t concentrate…and then me continually telling myself to concentrate, followed by less concentration. People, it was a vicious circle. Thank goodness it only lasted for 7 questions.

Here are a few other random thoughts that went through my head while testing:

“Wait, what does that word mean?”
“You can critically think. Stop messing around.”
“Did I even know that was a medical problem?”
“This is so easy. Wait, is this computer trying to trick me?”
“How come none of these answers make sense? What was the question again?”
“It is airway, breathing, circulation, right?”

If you’re wondering how in the world I passed this test with thoughts like that, you’re not alone. I am too! Apparently, 4,417 test questions paid off.

Signs you might have lost it at the end of nursing school and are suffering from extreme brain fatigue

2011-04-18T21:57:00.003-05:00

• You can only think of a title and this lame point—and the next lame point

• You lack the creativity to come up with a more interesting blog title summarizing your thoughts

Bittersweet Endings

2011-04-17T12:01:00.001-05:00

This week I wrapped up my senior internship with the tiny, little humans. As excited as I am to be done, (and make no mistake, I am crazy excited to be this close to graduating), I loved being at the hospital and was a little bit sad to be done with that part of my learning experience.
My last day was C-R-A-Z-Y! My preceptor and I admitted three surgery patients in three hours. It’s crazy because surgery patients have to be checked on quite often (like every 15-30 minutes) and a couple of them were stay-over’s so we had to do full admission paperwork on them. One of the patient’s was a little person, so it took a lot longer to get him/her settled down. You know those days where you feel like you can’t even take a break to run to the bathroom? Yeah, that was me on Thursday.

Funny story. At one point I was standing at the monitors at the front desk trying to admit my patient so they would show up and I could monitor the heart rate. All of a sudden the red alarm went off. (Red alarm=bad, just FYI.) It showed that one of the patient’s in one of rooms heart rate had dropped to like 44 beats a minute. This is WAY to slow for a little person. It’s a condition we call bradycardia. (I know my impressive use of medical terminology is, well, impressive. No need to comment on it. I’m aware.)

In about 0.5 seconds the following thoughts went through my mind:
1. “Is that my patient?”
2. “What bed is my patient in again? A or B?” (It’s how double occupancy rooms are described.)
3. “Holy crap! Who cares? That patient’s heart might be stopping. I’m going in.”

So I start to run into the room and have the following other thoughts:
1. “What happens if his/her heart rate doesn’t come up after I rub their chest?”
2. “What was that code number again?”
3. “And what are compressions?!?!”

Never fear, the patient was fine. It was a little bit of a machine connection malfunction. But still…it’s always exciting when the red alarm goes off.

To summarize: great experience, learned a lot, had a blast. Now, if only I could find a job...

Some clinical cuteness

2011-04-11T14:58:00.001-05:00

Obviously, working with children has some advantages. The main one being the inherent cuteness of said children. Here are a couple of gems from the last few weeks.

1. One of the nurses was having a really busy day, so when her one of her call lights went off and she was in the room with a different patient, I answered it. I walk into the room and see that the patient (approximately 15 months old) has puked. Everywhere. I mean this little person just nailed his/her parent. It was down the front of the shirt, all over the pants, the chair, and in a puddle on the floor. I walk in, take in this huge mess, and check the patient to make sure he/she is o.k. The patient just looks at me and gives me this little smirk that says, "Oh, yeah. I know what I just did, and I think it's awesome."

I did not think this was awesome, but I cleaned it up anyway, and the parent and I had a good laugh about how thorough the puke job was.

2. Recently, one of my patients was a little African-American child. When I walked in to do my assessment in the morning, said patient ran up and gave me a HUGE hug, so I'm already thinking this kid is about as cute as they come. Later in the day I was starting an IV medication while the patient was playing on the floor. I knelt down to hook up the IV, and the patient starts stroking my hair. I was kind of having a bad hair day, so I felt like the patient was trying to console me with this stroking by implying "It's o.k., lady. I have bad hair days too. Don't feel bad." Either that or they were just fascinated because my hair was so much different then theirs, but I'm pretty sure it was because of my bad hair day. So, I pretty much wanted to take this little patient home by the end of the day. He/she was just that cute.

3. One of my favorite parent interactions just happened recently. The parent's child had been readmitted for observation because the doctor was concerned he/she might have a really serious respiratory disease, and the child was only a couple of months old. They had been admitted for several hours, and the mother calls me into the room. Here is the conversation:
Mother: "My child just threw up. I am really concerned."
Me: "O.k. When was his most recent feeding?"
Mother: "Just now."
Me: "Were you burping the patient?"
Mother: "Yes."
Me: "How much did he/she throw up?"
Mother: "At least 2-4 tablespoons."
Me: "Did it come out of the side of his/her mouth, or was it more projectile?"
Mother: "No, it just oozed out the side of the mouth."
Me: "Does this happen at home?"
Mother: "Yes."
Me: "Does it concern you at home? Do you feel like it's excessive compared to how much the patient eats?"
Mother: "No, not really. But we're in the hospital now, so I'm worried about it."
Me: "O.k., well that is something that is a totally normal occurrence for a little baby. It's not something that you really need to worry about at this point. Just let me know if you feel like the patient is spitting up his/her whole feeding or if it's more projectile then out of the side of the mouth."

Nursing school is so. much. fun. sometimes.

Part III: Diapers vs. bedpans

2011-04-05T11:50:00.001-05:00

Continuing my series of Tiny, little humans vs. Adults. You can find part I here and part II here.

Let’s be honest. If you had the choice what would you chose—changing a diaper or messing with a bedpan? I mean it's hard to believe this is even a question. :-)

(This probably shouldn’t be it’s own post, but I really wanted a “mini-series” and it’s my blog, so I made it one.)

36 days!!

2011-04-03T21:15:00.001-05:00

I will graduate from nursing school in 36 DAYS!!

I will graduate from nursing school in 36 DAYS!!

I will graduate from nursing school in 36 DAYS!!

Get excited people.

So, here I sit on my couch, once again tired of studying, so I decided to count down the days until I graduate. I know you're thinking "How come it has taken you this long?" To be completely honest, I counted down at the beginning of the semester, but I just lost track while I was in Haiti.

Also on the horizon? The dreaded NCLEX exam. I have officially taken 2,798 practice questions, so I only have 2,202 to take before my board exam. I know, that's not many--whatever is talking me so long? I DON'T KNOW! Believe me, if I could do this faster, I totally would.

Look for my mini-series on "Tiny, little humans vs. Adults" to resume this week.

This has been a delightful, rambling post but I don't think I can procrastinate any longer. I must continue studying for the 2 tests I have this week. After all, I still have to pass my classes this semester to graduate.

Haiti

2011-03-26T18:07:00.001-05:00

I know you all have been anxiously awaiting my Haiti update. Apologies for the delay—it’s been a busy week.

Here’s the quick recap:

• Clinics conducted? 5. Two in tent cities, 2 in rural communities outside of Port-Au-Prince, 1 church congregation
• Patients treated? 1,400
• Orphanages visited? 3
• Babies delivered? 1
• Hours in the tap-tap? 26 minimum. Still have a bruise across my lower back from the metal bar I banged against all week.
• Bug bites? 1
• Beaches visited? 1
• Sunburns? 0
• Number of roosters needing to be eaten so they would stop crowing between the hours of 10:30 pm and 4 am? 4
• Number of moments I thought “How is it possible I am here, doing this?” Every day, all day.
• Experience? Priceless
• Going back? Definitely

So there you have it. My trip to Haiti in 111 words.

But since my mom and aunts read this, and they like details, I will write a little more.

We arrived on Saturday and held our first clinic on Monday. On Sunday, we attended a Haitian church that had a 3-hour service. In Creole. Suffice to say, I understood 3 words during the whole service: Amen, hallelujah, and Facebook. (Apparently, the pastor told a joke about Facebook. Missed the joke, understood the word.) We also visited an orphanage up one of the mountains, and saw some of the earthquake devastation around Port-Au-Prince.

Monday was our first clinic day. We overlapped with another team, so we did the clinic together in a small community call Thomeauz. That’s where the baby was born who was named after my Obstetrics and Women’s Health Professor, Louise—who delivered him. Talk about crazy day! We saw around 200 patients that day. I think. It was kind of a blur. All I remember is at one point I went to find my professor because I was pretty sure my patient had some bleeding in her brain. Yes, that’s right, I remembered the questions to ask to attempt to figure out if she had a brain bleed. Apparently, I know things.

Tuesday, Wednesday, and Thursday were very similar minus the delivering of babies.

Friday stands out a little more simply because it was a day where we saw more patients, and probably because we were all tired from the week. However, that was the day that I saw more serious medical conditions. I found 2 masses that were likely cancer, a case of stable/unstable angina (basically a heart attack waiting to happen), and a potential case of tuberculosis. (Which is a kind of funny, in a serious way story, that I may tell at another time.)

But, when Friday ended we got to go to the beach! It was a great way to end the week.
Here are a couple pictures from my trip.

Tent cities really are everywhere.

Part of the Catholic cathedral that was destroyed during the earthquake. Haunting beauty.

The beach!

It's really a beautiful country.

The tap-tap

Clinic site in Thomeauz. House on the left is where the baby was born.

Some of our patients.

Group photo

I'm Back!!

2011-03-21T13:24:00.001-05:00

Sorry for the long delay in postings, but I've been in Haiti for a spring break medical relief trip. It was an amazing experience! I plan to share some of the highlights and post pictures later this week.

Before that happens, I have to write 2 papers that are due tomorrow. Ahh...the life of a college student.

Boy, was I wrong

2011-03-08T21:51:00.001-06:00

On Wednesday, September 9, 2009, I wrote a blog post entitled "This is what freaking out must look like." Ohhhhhh...what little did I know and how wrong I was.

Since that post, I have actually discovered what freaking out looks like. The good news is after tomorrow, I will only have to do it one more time--when I take the N-CLEX. I'm just going to warn you now, all of my "freak outs" have simply been preparation for what happens before the N-CLEX. Conditioning as it were, for the marathon that will be the N-CLEX.

In the meantime, the predictor is tomorrow. I'm going to relax until then...for exactly 14 minutes and then try to fall asleep and hope I wake up calmer. :-)

Tiny, little humans vs. Adults, Part II: "Peak-a-boo" vs. "Please wake up"

2011-03-08T13:50:00.002-06:00

This is probably one of the best parts of my day. I walk into a patient’s room and sometimes they are asleep in their cribs, but often times the parent’s are holding the baby.

You tiptoe in, and kind of wake the baby. He/she looks at you and is a little scared, but then you get down on the child’s level. You wave a little and say “hi.” Then you start a game of peek-a-boo. Suddenly, their day and yours is so much better. All because of “Peek-a-boo. I see you.”

Anyone who has stayed in the hospital knows that you don’t really get a lot of sleep. In fact, resting doesn’t really happen until you go home. So, when you have to go in and wake an adult, it’s likely that they’ve just been asleep for a couple of hours. It’s really tough to wake them and even tougher for them to be awake, so it’s not the most fun way to start the day. And, adults don’t really appreciate “peek-a-boo.”

Ahh, clinicals...

2011-03-06T20:24:00.002-06:00

This week a sibiling who's brother/sister was in the hospital for a particularly smelly issue and I had this exchange:

My beeper goes off indiciating a room needs something. I poke my head in the door to find out what's up.

Sibling: "This room stinks. Will you spray room freshner in my area?"
Me: "Only in your area, not the whole room?"
Sibling: "Yep. It stinks bad right here."
Me: "O.k." (I hated to tell him that spraying his area wouldn't make a bit of difference, but hey, I'm not one to crush a young child's dreams. Stick them to get blood or start an IV, maybe, but not destroy their dreams.)

Also, I had one of the cutest little people, ever. I walk into the room to do my morning assessment and the patient (about 6 months old) greets me with the biggest smile and super cute little dimples. It was absolutely precious. The patient was also breathing about 80 times a minute (most children at this age breathe 40-60 times a minute.) I smiled back at the little guy and said, "I am going to suction you now." The patient smiled back. I don't think he/she knew what was coming. Still, what a great way to start the day.

Unrelated, I leave for Haiti on Friday. Get excited people.

I leave soon...

2011-02-27T11:31:00.002-06:00

I leave for Haiti in less then two weeks! I feel a little bit like a pin cushion because I've gotten so many immunizations. I have all the medications you have to take for Malaria, and a Costco sized bottle of sunscreen.

My classmate has the Port-a-Prince weather on her phone and this week, the average temperature has been in the low 90's, with humidity at 107%. (I actually made that up. It was only 98% or something equally absurd.)

But, before I leave, I have three tests and a paper due, so it's back to the books.

How many more test questions are there???

2011-02-22T19:49:00.002-06:00

As of today, I have done 1,677 test questions. That is exactly 3,323 from my goal of 5,000 questions before I take my NCLEX exam.
Suffice to say I am SICK OF PRACTICE QUESTIONS. Here’s the “it would be funny if I weren’t so worried” part of the whole thing.

It’s getting worse.

That’s right. The more questions I do, the worse it’s getting. It’s almost like information is leaving my brain the more I study. How is this even possible? Seriously. How is this even possible?!?!?!?!?!?

If I weren’t so concerned about actually passing my board exam, I think I would have a good, long giggle about how badly this is going. But, I really, really want to pass this exam the first time, so I keep doing practice questions, and I hope against all hope that somewhere in my head is the information I need.

Tiny, Little Humans vs. Adults—the series

2011-02-21T13:33:00.000-06:00

I’ve recently been thinking about why I prefer caring for the little ones as opposed to adults. Since there are several reasons, I decided to write a little mini-series for the blog. (But mostly I like the sound of “mini-series.” Makes it sound like I’m a serious writer or something.)

Here's the first part:

Bubbles vs. Feeling Helpless

It is amazing what bubbles will do for a child’s discomfort. I had a little person who was a little over a year old, and needed an IV. The child-life people came in and played with bubbles while we started the IV. The child stopped crying and watched the bubbles, then proceeded to only cry during the poke. After that, we gave the parent some bubbles for the room, and they provided a consistent relief for the parent and helped the child stop whining because he/she felt so sick.

During one of my summer clinical rotations, I took care of a patient who had broken part of their leg. Due to a previous injury and the nature of the break in the leg, the doctor was unable to cast the leg and it just had to heal on its own. As a result the patient was in quite a bit of pain every time he/she had to be moved. (And, we had to move he/she quite often due to the fact that they couldn’t move around and were at great risk for skin breakdown and pressure sores.) We managed the pain as best we could with a variety of medications and other treatments, but the patient still moaned all the time. It was a pretty helpless feeling.

So, I realized that bubbles make the day more fun then feeling powerless to help someone feel better.

12-hour shifts = Priceless

2011-02-14T10:31:00.001-06:00

First, you must understand that one of the reasons I chose nursing was because of the schedule. The concept of three 12-hour shifts sounds awesome. I dislike mornings so the opportunity to only have to get up at 5 in the middle of the night 30 for three of them each week is incredibly appealing.

Second, during my politico alcoholic years, I worked 12, 14, 16, 18 hours days regularly—in heels and dress clothes. Surely doing 12 hours in essentially p.j.’s and tennis shoes would be much easier, I thought.

I did not, however, take into account the desk versus running around on a floor aspect of my initially brilliant plan. Somewhere, in the back of my mind, I remember thinking “I will do three 12’s in a row and have four days off every week.”

Well, let me tell you. After two 12’s back-to-back for clinicals the last couple of weeks, I understand why people don’t do three in a row very often. You get t-i-r-e-d. I mean I probably walk like 5-6 miles during the course of my day, and I’m bending over, moving things around, holding little ones, holding down bigger little ones for procedures, and walking in circles because I’m not quite sure where everything is yet. There’s not a lot of sitting that occurs.

I am beginning to understand why one of my professors said that nurses are always on the lookout for the latest and greatest in comfortable shoes. You really, really need them. (That being said, thank the Lord for Sketcher’s shape-up shoes. They are a total life saver. Seriously. If they ever need an endorser besides Joe Montana or Kim Kardashian, I’m totally in, and definitely cheaper.)

So, bottom line, feet hurt, legs tired, shoes save my back, three days a week=priceless.

5 in the middle of the night 30 is still really, really early

2011-02-07T10:09:00.001-06:00

Here’s what I’ve learned during my first week of my senior practicum:

• I have chosen the only profession known to man that doesn’t have snow days. Did you know nurses are considered “essential personnel” in a blizzard? I feel like this should headline brochures for nursing school.

• In case you were curious 5 in the middle of the night 30 is still really, really early. Especially when the actual temperature is -7. And, I am still not a morning person.

• I love being a senior.

• I don’t love the NCLEX prep, which might just actually, kill me. Interesting fact: the more I study for this test, the less I think I know. What have I been doing for the past year and a half?!? Why didn’t I start studying for this test sooner? You know what…this freak out deserves its own post.

• I really love the tiny, little humans and I am an awesome holder downer of them while they are getting IV’s put in. Pretty sure my brothers are somehow to thank for that particular skill.

• I can. not. wait. to be a real nurse. It’s going to be exciting people!

March 9

2011-01-31T22:01:00.001-06:00

March 9 is the most important date in my semester so far. Why is this date so important you ask? I will tell you.

March 9 is the day we take our N-CLEX predictor exam. This is the test that determines if we can take our board exams before we graduate. Taking boards before I graduate has been my goal, since well, I started nursing school.

The professor said we have the best chance of passing this exam and the subsequent one that gives us our nursing license is if we do 4,000-5,000 practice questions. So, there are 4,534 practice questions between myself and this exam. It’s a full-on sprint to spring break and Haiti. I’m excited.

Who doesn't love pancakes?

2011-01-23T14:48:00.000-06:00

Consider this your official inviation to come eat pancakes at Applebee's next Saturday, January 29th from 8-10 am.

My fellow nursing students and I will be raising money for our Haiti trip by serving you good people pancakes. I've heard they are delicious, so you should definitely come try them.

Contact me (click here) for more details.

Hope you all can make it!!

Intership aka Practicum aka Externship

2011-01-20T22:35:00.000-06:00

Exciting news people!

I found out yesterday that I got a tiny, little human (Pediatric) internship for this semester! That's exciting because my favorite kind of nursing so far is taking care of the kids. It's also exciting because, well, I really wanted it and worked hard to get it.

So, this means I will be spending approximately 196 hours at a local Children's hospital, working with a preceptor, and learning about the art of nursing and caring for little patients and their worried parents. Can. Not. Wait.

In other news, my full scale beginning of the semester freak out is upon me. Mostly because a professor said yesterday, "One of the best ways to ensure you pass your N-CLEX exam (boards to be licensed) is to do 4,000-5,000 questions before you take the exam. In this class, you will do almost 1,000." Yay.

The Beginning of the End

2011-01-17T14:41:00.000-06:00

Get excited people! Tomorrow I begin my last semester of nursing school! That's right, only 16 weeks and 1 day until I am a nurse and will launch myself upon my unsuspecting patient population.

I've already purchased my books while grumbling about the incredible rip-off it continues to be.

There was no need to negotiate enrollment because I finally found and remembered where the registrar's office is. (Not CCTSRN, but always an accomplishment.)

There's not much anxiety since I've already had classes with all of these professors. (Heh. Bet that will last at least through my first class tomorrow.)

And, I have the Best. Schedule. Ever. Finally!

Can't wait to start so I can finish.

Haiti Update

2011-01-13T14:07:00.004-06:00

These pictures are from The Boston Globe "Haiti, one year later."

With people around the world remembering the one year anniversary of the Haiti earthquake this week, there have been some great articles written that discuss the rebuilding efforts and the challenges that surround it.

Here's a great article on the "spiritual temperature" of the nation:

I am in Haiti with Pastor James MacDonald and Churches Helping Churches on the one year anniversary of the quake. We are hosting a church service in front of what remains of the Capitol for at least 50,000 people according to radio reports. The city remains in ruins and hundreds of thousands of people remain homeless. Most Americans cannot fathom the degree of poverty and complete lack of infrastructure and resources. On top of that, the average person has only a 3rd grade education.

Over a million people in and around Port Au Prince are living in tents, many of them simply made out of old tarps. Haiti literally needs everything and a government that can plan long term as this is not a short fix. The talk on the street among the people is a mounting sense of frustration with the lack of government, but it is not yet turning angry or violent. Amidst of this, the sweetness of the people is amazing. With next to no functioning government military or police force there is peace and kindness among the vast majority of people despite the fact their is garbage everywhere, piles of building rubble remain, virtually nothing is getting rebuilt, and they are bathing with buckets of water in tent cities.

The spiritual response in Haiti has been incredible. The pastors are reporting that more people are becoming Christians, attending church, praying etc than ever before. Because people are so displaced getting accurate data is impossible but many credible leaders say Haiti is experiencing a revival. Many church buildings were destroyed so congregations are meeting outside and organizations like ours are building new structures to meet in. The streets are filled with people carrying Bibles, singing songs to Jesus, and in the tent cities covering the parks a night impoverished homeless people gather to spend the night singing worship songs filling the air with a sweetness and joy that one would not expect."

Here's one from the BBC:

"One year on from the earthquake that devastated Haiti, the massive aid effort has yet to bring stability to the country as cholera, rape and despair take hold.

Some $11bn (£7bn) worth of aid has been pledged to the country over the next 10 years, but much of that money has yet to arrive following concerns about government corruption and ongoing riots after November's disputed election.

In the centre of Port-au-Prince, the presidential palace still lies in ruins.

What was a large, green open space just beyond the palace grounds is nothing but a sea of tents.

After all this time, the piles of rocks, wood and mangled metal that were once homes and offices still line the streets.

Mountains of it fester between the homes that were spared, like rotten teeth.

For many, the blame lies firmly at the door of the estimated 4,000 international aid agencies operating in the country.

Some argue aid agencies are giving incentive to people staying in camps "Nobody knows what they are doing, nobody knows who is sending here, nobody knows how much money they have, nobody knows in what field they are intervening," says Haitian sociologist and university lecturer Daniel Supplice.

"They are all over the place."

He also blames the Haitian government for doing little or nothing to speed Haiti's recovery, but his special ire is reserved for the 12,000 UN peace keeping - or stabilisation - troops, which cost more than $600m a year..."

You can read the whole article here.

Here's another perspective from the ONE Campaign:

As we look back over the last year in Haiti, we must acknowledge the critical role water and sanitation has played in the country historically and in the aftermath of the devastating earthquake that struck one year ago.

Before the earthquake, 45 percent of the population lacked access to safe water, and a staggering 83 percent of the population lacked access to sanitation. The consequences of not having access to safe water and basic sanitation are enormous for the Haitian population. Even before the earthquake, diarrhea — which can result from consumption of contaminated water — killed one in five Haitian children each year.

The earthquake exacerbated the problems of an already weak infrastructure and highlighted the need for serious investments in the water and sanitation infrastructure in order to achieve health and economic gains. It is estimated that the earthquake caused $235 million in damages to water and sanitation facilities, and 437 settlements currently lack adequate sanitation. Even more disturbing, a severe and deadly cholera outbreak — which started in October and continues to plague the country today — has led to 171,304 cases and claimed the lives of 3,651 Haitians.

Although numerous challenges persist, there are many groups working hard every day in Haiti to bring clean water and sanitation to communities. While the task at hand is enormous, it’s encouraging to see the work that is being done across Haiti, including the installation of family latrines, promotion of hygiene practices and repair of water infrastructure systems. InterAction’s Haiti Aid Map provides an overview of all water and sanitation projects in the country and a description of each.

I will be there March 11-20, 2011.

Reflections

2011-01-05T11:47:00.001-06:00

As a follower of Jesus, I have always thought that there is beauty in brokenness. This semester, I saw brokenness without Jesus. And I think it changed me. Somewhere in the midst of hating my schedule, not really liking my classes, and being ambivalent about my clinical rotations, compassion arrived.

I’m not sure when and I’m not sure how. Maybe it was the look on the face of the single mother when she saw her baby for the first time. Maybe it was the glow on the face of the homeless man who was sober for 15 straight days. Perhaps it was through the tears of anxiety from a mental health patient as I felt powerless to break through the fog that is her life, and comfort her.

Somewhere, in one of those interactions—maybe in all of them, I saw life in its brokenness. And I was changed.

Somewhere, somehow, compassion arrived, and a transformation occurred.

And that is my semester summary.

Testing Panic

2011-01-03T14:31:00.000-06:00

**Note: continuing with the half-finished until after finals posting. Enjoy!

I know what you are expecting here…a post about how much I am freaking out about finals next week. Well, guess what? I like to shake things up sometimes, so that’s not what I’m writing about. Yet.

Around Thanksgiving I promised that I would break down the levels of testing panic. Without further ado here they are:

“On a scale of 1-10, I’m at a 3…until I start the test” level
This is where you feel like you understood the content pretty well during class and have been able to apply some of the concepts. You probably can’t go into detail, but you know enough words to trick people into thinking you know what you’re talking about. Basically, you’re studying for the “A.” Hard to get motivated at this point. Interestingly, with this level, the panic doesn’t really set in until your sitting in class, staring at the test thinking “What does this word even mean? WHY DIDN’T I STUDY MORE?” Also, this automatically puts the next test for this class into the quality studying category. There will be no more messing around or cursory review. It's hardcore, baby, hardcore.

"Let's get worried cause I'm going to have to rock the final to pull down a B" level
This happens about 1/3 of the way through the semester. You've had at least 1 test in every class, maybe 2 tests, and the dreaded comprehensive assessments are right around the corner. If the assessment test goes badly, you're going to have to get really worried, but right now the panic is more of a gentle reminder to get your act together and study. It always seems worse then it really is, and if you don't do well on that assessment, you really will have to rock out that final to get a "B" in the class. This hasn't ever happened to me, but I was somewhere between these 2 levels at least twice during the past semester.

“Definitely going to have to squint and do some deep breathing while checking my grade” level
Generally, this happens with your hardest class of the semester. You know you have to give the test its due diligence because it will be hard, but for some reason you just have trouble grasping the core concepts. (Note: This happens every time I attempt to think about Chemistry.)

As you’re taking the test, you start to get a funny feeling in your stomach. This is followed by the feeling that you swallowed rocks, followed by a cavernous pit forming as the test progresses. You may even break out in a cold sweat. However, by the end you have pulled it together somewhat and convinced yourself that it wasn’t as bad as you thought. That’s why you squint and breathe when you check the grade—to avoid that stomach feeling.

“Get up before class and study” level
If you have read my blog for like 5 minutes, you know I am not a morning person. Suffice to say this is the highest level of panic I can think of—realizing that I have to get up before a test and do a final review to reassure myself that I will not bomb the test. It doesn’t get any worse then this.

Living with mental illness

2011-01-02T14:46:00.000-06:00

**Note: One of the many posts that got started, but not finished in the rushed panic that is the end of the semester. Enjoy!

I just finished my mental health rotation, which incidentally, is my final rotation of the semester. Whopp! Ee! (A mere 16-17 clinical days stands between myself and graduation. I need to find a countdown clock for this blog.)

The final part of the rotation was at a state run mental hospital. Many of the patients are there as a result of a court order or because they were an immediate danger to themselves or others. These patients are far more unstable and more acute (fancy medical term for sicker). It was quite different from the long-term care facility where I spent the first part of the rotation.

I’m going to be honest, I was not entirely sure what to expect from this rotation. I know that I had a couple of preconceived ideas about mental illness, depression, and bipolar disorder—but mostly I was dreading this whole rotation.

I realized two things. First, living with a mental illness like schizophrenia is really, really difficult for the patient, the family, and other people in the patient’s life. For those unfamiliar, schizophrenia is most commonly known as the disorder that makes people extremely paranoid and has delusions and hallucinations (you know, people talking to themselves and having imaginary friends). The medications the patient has to take are powerful and have difficult side effects. Often times, the medications don’t control all of the voices and the paranoia.

Imagine, every hour of every day you have the constant noise of the voices in your head or having the feeling that every shadow on every wall or noise around every corner is coming to get you.

Second, a lot of patience is required. Brain chemistry is tricky stuff. Medications take time to work. The first one may not work. The fifth one may not work. It’s hard to remember to have patience sometimes.

I just got a small glimpse into what it is like, and I was once again blown away by the compassion I felt growing for the people and their families who suffer from this and other forms of mental illness.

The Christmas Break of Doing Nothing

2011-01-02T14:41:00.000-06:00

Be forewarned, I have several blog posts that I started but was too distracted to finish throughout the semester. I will be posting all of them for your reading pleasure concluding with my semester reflections.

As for my Christmas break so far, I did nothing school related until 10 minutes ago when I looked at my school email real quick for a thing about Haiti. It has been awesome.

Alas, all awesome things must end, and tomorrow I begin the search for gainful employment (hospitals start interviewing new graduates in February and March), trying to get a jump on the HUGE senior portfolio I have to turn in, and do some delightful medical-surgical (the foundation of nursing practice) review for the NCLEX exam I will be taking later this spring. (It's the GINORMOUS board exam that all nurses have to take to prove they can safely take care of patients. Anxiety already setting in, I assure you.)

[My trend of long, run-on sentences clearly wasn't part of my New Year's resolutions. As the previous paragraph indicates. Oh, well.]

Haiti Update

2010-12-18T14:31:00.000-06:00

I successfully survived finals. Again. Always surprising. I will have complete wrap-up later.

Several weeks ago, I mentioned that I'm hoping to go to Haiti over spring break. Here's a little video about where we will be staying, and a little bit about the organization we're going with. If you're interested in more information or helping me raise money, let me know.

It's happened!

2010-12-14T12:01:00.000-06:00

Heading into finals this year, I was surprisingly calm. "At last," I thought, "I've taken enough tests to trust the process, and not freak out so much." Ha! Was I wrong.

The official time of finals freakout for this semester? Monday, 9:53 am, while sitting in a review session for my hardest class.

After my last test in that class, I was feeling pretty good. But the longer the review session went the more I was thinking "What in the world have I learned this semester?!? Why don't I know any of these ANSWERS?!? WHAT HAVE I BEEN DOING WITH MY TIME? WHY DIDN'T I START STUDYING RIGHT AFTER THANKSGIVING?" And so forth...

Just thought you would want to know.....And, now, I will resume studying.

Finals Week is Upon Me

2010-12-10T23:54:00.000-06:00

John Paul Jones (Navy Captain during the Revolutionary War) once told a British Captain during a battle "I have not yet begun to fight..."

So to paraphrase, "I have not yet begun to freak out..."

(Guess I just outed myself as a nerd. Oops.)

Well, not studying...

2010-12-06T21:07:00.000-06:00

My house doesn't look a thing like this, but it does look a lot more like Christmas. That's the thing I dislike the most about my finals schedule...well, besides the studying...postponing Christmas decorating stinks. So, I decided to take a couple of hours and transform my house. I will definitely be able to study better now, definitely.

Naturally, a blog post...

2010-11-29T17:41:00.000-06:00

It is, by far, the busiest week of my semester thus far, so naturally the best way to spend my time is by writing this...

Actually, I was super productive over the weekend, so I have the three...count them 3...papers done that are due this week. All that awaits me is studying for the comprehensive Mental Health assessment test on Thursday. Have I mentioned I hate them?

In related news, I found out today that my Mental Health grade is 8 points higher then I thought. That's right, 8 WHOLE POINTS. Turns out the professor I don't particularly care for (cough...strongly dislike...cough), entered my grade wrong. So this whole time I've been needlessly worrying about my grade, when it was professor error! Thank goodness, and it's time to fill out my end of the semester survey. ;-)

Oh, and just because I know you all (hi, mom) are waiting with baited breath for my "Levels of Testing Panic" post that I promised, it should be up at some point over the weekend or early next week. Unless, of course, I start to feel EX-tremely confident about Thursday's test in which case I will finish and post it sooner. (Doubtful considering I'm on the "Glad my grade is 8 points higher then I thought, but it's still comprehensive, so I have to keep studying level." Kidding that's not a real level. I just like to make up long titles.)

Thanksgiving Break!?!

2010-11-23T00:37:00.000-06:00

My Thanksgiving break officially started at 9 am on Monday morning. My "cleaver" professor scheduled a major test in my 8 am class. Thank goodness I'm a fast reader. I sped through that bad boy so my break could start earlier. (Paid off, got an "A." I'm in shock. Seriously. It's a hard class.)

Since I've been super excited about my break, well, since the semester started, you can imagine my feelings of excitement today. And, that lasted all of 3 hours and 34 minutes until I realized I have to write, not 1, not 2, but 3 papers and finish a project by Monday, and I should probably start studying for my Mental Health assessment test that is 10% of my grade. Not a lot of wiggle room in that class right now. (And, by not a lot of wiggle room, I mean that my test grade average is dangerously close to "let's get worried cause I'm going to have to rock the final to pull down a B" level. Watch for further definitions in an upcoming post.)

So, 3 hours and 35 minutes into my much anticipated Thanksgiving break, I realized that once again my professor's are little evil geniuses. They led us to believe we were getting a break, but instead we are simply getting time away from class to fulfill our paperwork quota for the semester.

Happy Thanksgiving everyone!

Creative Writing?

2010-11-21T13:15:00.002-06:00

For one of my classes last week, actually for my hardest class this semester, we had to write a paragraph using 10 research terms. I looked at the assignment, read the terms, and thought "What do those even mean?!" aka Days 1-52 of nursing school again.

Nonetheless, I completed the assignment. Following is perhaps one of the most unintentionally funny paragraphs you could read.

By using a phenonmenologic research tradition, the researcher hopes to develop an emic perspective—that is to get an insider perspective of the lived experiences of adolescents who have mothers deployed overseas. Using the researcher as the instrument for this study, the plan is to immerse the researcher into a local military community after-school program for adolescents, thereby gaining entrée into the group, prior to a unit being deployed. Once entrée is established, the researchers are hopeful that a grand tour question, the broad question that will provide a general overview of phenomenon to be studied, will be established based on casual discussions with the adolescents. Once established, the researchers will present the initial process consent to the participants per IRB protocol, with further process consents being presented as the study unfolds. As the study progresses, the researchers hope to remain open to the direction and meaning the study takes, maintaining an intuiting approach, until data saturation is achieved. As this is a phenomena that is under investigation, the researchers are convinced that the direction of the study will be based on emergent designs depending on what has already been learned. In order to avoid any preconceived ideas or beliefs (bracketing), the literature review will be done at the end of the study.

You heard it here first!

2010-11-15T16:25:00.000-06:00

I teased about it over the weekend, and here's the scoop.

I am hoping to go to Haiti over Spring Break in March!!

The college I attend is taking 12 nursing students to go and minister amongst the earthquake devistation. The purpose of this trip is to provide medical treatment to the orphaned children and the poor and needy near the capitol city of Port-a-Prince.

Because of the earthquake devastation, many of these people have little to no access to any type of health care. The treatment will include a complete physical exam, treatment for intestinal parasites, and all other primary medical care within the capabilities of the team, including surgical interventions when necessary. The trip is in conjunction with God’s Chosen Ones Ministry based in Indianapolis, Indiana. They have been working in Haiti since 2003, and we will be assisting them with their medical relief efforts.

Following the earthquake last year, over 1,300,000 people are living in tent cities with little to no privacy or sanitation. Over 80% of the population lives in abject poverty, and most people live on less then $2.00 per day. In the last several weeks, there has been an outbreak of Cholera due to the poor sanitation and living conditions. Reports on the ground indicate that many of the Haitians getting this disease are dying within hours of exposure.

Here's how you can help:

Pray. I'm excited about the opportunity, but it will not be an easy trip.
In order to go, I need to raise $2,100. The money is tax-deductible. If you're interested email me, and I will send you more details.
If you want to help with supplies for the trip, contact me and I will provide you with a list. We are hoping to bring things like children's Tylenol, hand sanitizer, multi-vitamins, and a host of other supplies.

Here's a great photo documentary of how the country has been progressing since the earthquake.

Here's one of the tent cities where over 1,000,000 Haitians live.

Keep reading for more updates and information as the time approaches.

Tiny, Little Humans

2010-11-13T20:24:00.000-06:00

I heard once that there are no original ideas left in Hollywood, or apparently, my head.

Here's a fabulous little clip about why I love "tiny, little humans." My favorite part starts 22 seconds in.

In other news, watch for some super exciting news about next semester coming very soon.

So, awesome?

2010-11-09T22:53:00.003-06:00

I’m still in the middle of my community health clinical rotation. One of the things I like the most about this rotation is that you never know what you’re going to see each day.

Take today for example. My classmate and I are on a roll cleaning out and organizing the clinic we’re working in. All of a sudden I realize that the nurse is talking to one of the clients. I hear her say “Well, let me take a look. [pause] Ok. You’re going to need to head straight to the hospital.”

At that point I poke my head out and she says to the client “Have a seat.” Turns and looks at me and says, “will you clean this, while I go find a ride for our client to go to the hospital.”

Naturally, I say yes, cause I love cleaning stuff (And by stuff I mean wounds. I do not like cleaning other stuff, like my room or the kitchen. Just to be clear.) So, I grab a pair of gloves, turn around, and check out the wound. What I see it very possibly a stab wound that goes deep, very deep into the patient’s abdomen. Somehow, this patient is sitting up in a chair, in the clinic, with blood running down the tummy, asking if we can put a Band-Aid on the wound. Heh.

Let me reiterate, this wound was deep—like almost perforated the stomach deep. I have no idea how the patient was sitting in the chair, walking, or really coherent. Particularly, when the patient stated that the wound had happened about 12 hours before they came in.

Suffice to say, he went straight to the hospital, and I realized I was having an awesome day.

Privileged

2010-11-04T18:29:00.000-05:00

A few weeks ago, I blogged about how amazing it was to watch a tiny little human come into the world, and it is. Then, my clinical rotation changed.

Right now I’m in the middle of my Community Health clinical rotation. The school placed me at a downtown rescue mission that has a free health clinic. It mainly serves the homeless population in my city.

The mission has several different programs for the people it serves to try and help them transition back into society, help them reconcile with their families, and help them stay off of drugs and alcohol. In order to qualify for the program, the person has to detox and stay clean for a certain period of time.

Recently, one of the people came into the clinic for a quick check-up. There are a number of questions we ask every patient—one of these is “When was your last drink?” This person looked me in the eye with an unfathomable expression, and said, “15 days!”

For some, 15 days is a lifetime, and it is worth celebrating. That experience was almost as amazing as watching a tiny little human be born, and just as priceless.

How to drive a nursing student crazy (aka the diabolical plan to break the will of the nursing student, part II)

2010-10-27T20:11:00.000-05:00

Scene: a nursing class at a local university during the last few weeks.
Professor at the beginning of the class, “All you need to for the test is the notes you take from my lecture. I cover everything in class that will be on the test. Study your notes.”

Later, during that same class…

Professor “Make sure to look up SAGE in your book. This is going to be on the test, you guys, you need to know it.”

Student “What does that mean?”

Professor “I said look it up in your book. That’s why you buy books people. I can’t cover everything in class.”

Need I explain why this is designed to break our will?

3/4’s of Nursing School Left

2010-10-24T17:39:00.000-05:00

Drum roll please…

I only have ½ of a semester plus 1 semester of nursing school left. (How does this equal ¾’s you’re wondering. I’ll tell you. I started with 1 year of nursing school left, and I’ve completed ¼ of a semester, thus, ¾’s of nursing school left. I said I hated math, not that I couldn’t do it.) I’m pretty excited about this fact, if for the only reason it means that I will once again beat my study buddy at something. (Hi, Suz. You know I'm super proud of you. Love you!)

Here’s a quick update about how my semester has been progressing.

• I’m playing fantasy football for the first time. It’s super fun to play, but even more fun to have conversations with my brother’s each week about how awesome my team is. (To be honest, my team is only a little awesome, more awesome then a couple brother's, less awesome then my dad and another brother. But still. I realize this has nothing to do with my semester, but it does explain my lack of blogging. I’ve found a whole new way to waste time. Awesome.)

• It seems like this semester is moving at a snail’s pace…partly because the summer was crazy busy, and partly because I don’t like any of the classes I have to take.

• It’s not that the classes are boring (Well, I am taking a research class who’s only saving grace is the fact that I like the professor. I digress.) it just that I have no particular interest in any of the topics and/or the professor is TERRIBLE. Seriously. During a recent test the professor forgot an entire page of questions. I cooled my heels for 10 minutes while she went back to her office, printed the page she forgot, and brought it back to the classroom. By that time, my entire thought process was interrupted. Definitely cost me points. Definitely. (Had nothing to do with only studying for a couple hours the night before. Nothing.)

• Speaking of TERRIBLE professors. I have one who generally lectures for 15-20 minutes of the 2-hour class period. The rest of the time is spent discussing current “gossip” like which Hollywood star is in trouble now, discussing tangents loosely related to the subject we’re studying and/or making up stories about “Grandma Emma” and drug abuse in nursing homes. Don’t get me wrong these would be fascinating topics if they had anything to do with the actual class or test. I mean, if we were tested on current Hollywood gossip, I would ace that bad boy. Oh, well, I have had really amazing professors to date. I guess they can’t all be awesome.

• Along those lines, watch for an upcoming post on how a professor can drive a student crazy.

• Did I mention I have the worst. schedule. ever. Seriously, I don’t know how I manage, but each semester my class schedule is getting worse and worse. If I actually subscribed to a routine, this would bug me more. (I thought I had a post about my stunning lack of routine, but I can’t find it and/or I only thought about writing it, so no clever link as a memory trigger for you.)

Did I mention that I only have ¾’s of nursing school left?!?

Diabolical plan to break the will of the nursing student, part I

2010-10-12T22:52:00.000-05:00

Step 1 “Setting an achievable expectation” The diabolical plan to break the will of the nursing student begins with a seemingly innocuous explanation of a seemingly simple set of clinical paperwork. This is step 1 of will-breaking—manageable paperwork.

Step 2 “Making the ‘achievable expectation’ seem reasonable”
This is even more insidious. The professor tells you that you don’t have to fill it out all the way ... “Just come up with 3 problems instead of 4” they say as they continue to mislead you. Again you think to yourself “this is manageable. I can do this.” Self-talk is the next phase of breaking your will.

Step 3 “Soul-Crushing work load with a smile”
This is when you, the student, begin to realize that all of this has just been preparation for the soul-crushing moment. It starts off with an innocent exchange...

Student: “My patient is going home later this afternoon.”

Instructor (smiling): “Really? That’s too bad. I’ll have another assignment for you before we leave for the day. Come find me.”

Step 4 “Paper work will break your will”
This generally occurs towards the end of the day, and goes something like this...

Student: “Who’s my new patient?”

Instructor: “Mr. X. Don’t forget you’ll need to do another complete set of paperwork for this patient. Also, this patient is a little more complicated. It’s likely that you will need a full 4 problems on your care plan.”

Student: “So you want a complete set? Care plan, meds, lab sheet, and patient history?”

Instructor: “Yes. Oh, and I noticed the patient has 17 medications which you will need to research. Sorry about that. Better NCLEX* prep for you!” [*NCLEX—the set of tests that all RN’s have to pass in order to get their license. Similar to the Bar Exam for lawyers...you know, except that ours deal with how to not kill people, etc.]

Step 5—The final attempt to break the will of the nursing student aka “When soul-crushing commences”
You lug all of your stuff home at the end of an 8-12 hour shift and begin the 2-4 hour process of completing your second set of paperwork for the week. If you’re one of the lucky ones, and I have been more then once, you get to do three sets for the week.

At some point during this process, a strange phenomenon occurs—you decide this is not going to break your will, and the self-talk resumes. “What doesn’t kill you will only make you stronger.” “Pain is simply weakness leaving the body.” “Why isn’t there a demotivator for this?” “Hard work never killed anyone.”

Finally, and most importantly, “I have paid thousands of dollars to do this. I’m not quitting over three sets of paperwork in a week”—regardless of how soul-crushing it may be.

Quite the day...

2010-09-29T21:56:00.000-05:00

In addition to the 2 tests I have this week, I am on the Labor and Delivery clinical rotation. Today, I got to see 2 babies being born. It's pretty amazing. Really.

Such a nice little respite from Mental Health. Now, back to the books.

Good Grief

2010-09-23T23:41:00.000-05:00

I do realize it's been forever since I've blogged about my nursing school experiences. Considering the fact that I have two tests and two papers due next week, it's safe to assume that there will be more blogging taking place as I look for ways to procrastinate. Sadly, my study budy is heading out for a girl's weekend. Who will imagine my "alternate universe" with now?

In the meantime, this is true...

Around this time, two years ago, in my previous life, I was here...

Yes, that is the Republican National Convention with John McCain and Sarah Palin. By far one of the coolest experiences. Ever. And I hadn't slept in days...so really, being short on sleep is not limited to the college student.

Is it too soon to start counting down the days until I'm finished with nursing school?

2010-08-30T21:41:00.002-05:00

Today was the first day of orientation for my senior year of nursing school. Whoop. Ee.

I am woefully unprepared to start the semester. I haven't even contributed to the racketeering that is college book buying yet. (Note: I did. 20 minutes ago. Still a racket, and still expensive.) Regardless, orientation arrived. Funny thing about orientation. What was billed as an "open house" some how became a mandatory event over the weekend. Good thing I decided to check my school email late Sunday night just in case something came up. If I hadn't, I would have missed a 1 1/2 hours of introduction to the nursing program. Again, Whoop. Ee.

Oh, and I was reminded that I had a drug calc test on Wednesday. They say people have the capacity to block painful memories. Must be true, cause I had no memory of that test approaching. (Guess that will be one thing to address with my mental health professor this semester.) I hated drug calc last spring, I hated it this summer, and I still hate it. Two practice tests later I realized I was better at it. Small comfort. Oh, and they scheduled the test for 8 AM! One can only assume it's a little "welcome to the semester, smash your head into the desk, now" test. And I am still not a morning person. Apparently, the school missed that memo.

We have 2.5 days of orientation this week. So much orientating. I don't even know how to contain my enthusiasm.

In case you were curious, I had a fabulous vacation. Here's the photographic proof that you should be jealous.

Vacation!

2010-08-16T21:12:00.002-05:00

I'm roadtripping for the next week. Blogging will commence once school restarts--on or around August 31.

Clinical Experiences

2010-08-10T12:25:00.001-05:00

I know you all have been waiting with baited breath for my “going to rock your world” awesome clinical stories. I hate to disappoint, but there haven’t been any really earth shatteringly awesome experiences. Nonetheless, here are a couple of nuggets. I hope you’re not too disappointed.

• Had to irrigate the bladder of patient because of bleeding. Ended up having to put in 4 catheters because they kept clotting. Suffice to say, there were a few tense moments in that room that day.

• One of my patients had a broken leg that could not be fixed due to a hip replacement. Every time I came near the bed to do anything, the patient would say “Don’t you touch me.” Sadly for this patient, he/she had to be turned every 2 hours. After turning he/she would say “I don’t like you.” By the third day of caring for this patient, he/she’s disposition had improved when they said “I want to kick you when I get better.” I thought it was hilarious. The patient’s family kept apologizing.

• Had a patient whose heart rate dropped way too low for about a minute. The patient was a full code—meaning CPR with compressions, intubation, meds, everything. Naturally, when this occurred, I stayed with the patient and hit the call button and asked for the nurse to come down. I assure you, the time between asking the nurse to come, and the time he walked in the room was an eternity. Believe me when I say, the slower the patient’s heart beat, the faster mine did. Don’t worry everything ended up just fine.

• Had a little moment with some mucous. It happened the first day. I think I decided at that moment that old people were not for me—especially old people with no teeth. Got some good practice with some deep breathing exercises. Guess that one Yoga class I took worked.

• Had a teenage patient with Thyroid Storm. Actually saw a thrill (when the heart beats super fast and causes the chest to vibrate.) The patient’s heart rate was about 160 when sitting. Crazy awesome.

• On the last day of clinicals my classmates and I had this kind of experience in the elevator.

Finished!

2010-08-05T15:07:00.000-05:00

As of 9:45 am today, I am DONE WITH SUMMER SCHOOL! Even passed my final with no remediation in sight. (In case I forgot to mention, my professor threatened us all with remediation in the fall if we did not get a certain score on the final. Evidently, Medical-Surgical nursing is the foundation for nursing practice. Allegedly there is also a correlation between getting an adequate score on this test and passing boards next year. Either way, I rocked it, so I'm good.)

Can. Not. Study. Any. More.

2010-08-04T18:26:00.000-05:00

Tomorrow is the big day...the end of summer school. Crossing my fingers that my grade is high enough to avoid remediation in the fall......

Al-most-done

2010-07-29T19:34:00.000-05:00

I am thisclose to being done with summer school.

1 day of clinicals

1 day of lecture

1 online quiz

2 tests

Can't come fast enough. Off to bed, 5 in the middle of the night 30 is still crazy early.

Classifications of Study Time

2010-07-26T19:05:00.000-05:00

When I signed up to go back to college, I knew there would be some hard core studying involved...especially after the first day when the test grade average rule was announced. What I have discovered, however, is that there are several classifications for the time one studies. Allow me to elaborate.

Quality studying
“Quality” studying is defined as: an act of complete concentration when all distractions are turned off, headphones are in, appropriate study music is playing, and notes are being read and/or the study guide is being filled out. In order to pass a test, 2-6 hours of this type of studying must occur. Unless you are feeling lucky—in which case stick with level 2 & 3, and wear your lucky shirt. (Don’t knock it. I have one. It works.)

“I have no motivation, but must start the process” studying
This generally includes turning on a favorite sporting event and/or movie one has seen several hundred times in the background as you begin to fill in your study guide. One typically spends small bursts of time concentrating, just stopping to watch a favorite part or a great play every so often. This studying is rarely effective for passing tests, but as long as it is combined with a couple of hours of quality studying, you will be able to pass the test.

Weak-Sauce studying
Weak-sauce studying is the act of opening your book and/or notes, placing them next to you, and writing a blog post about how much you hate studying. It may also include random internet searching, and the discovery of the top 63 ways to waste time on the internet and/or awesome YouTube clips.

Countdown to the end...

2010-07-26T18:36:00.000-05:00

The countdown to the end of summer school...

3 days of lecture, 3 days of clinicals, 2 tests, 1 online quiz

Yes!

Guess who's crazy?

2010-07-16T21:00:00.000-05:00

Me.

I promise clinical experiences are coming, but they may not come until I've finished clinicals. Between now and August 5th, I need to write 3 papers, study for 4 unit exams, and finish clinicals. At some point, studying the 700 page book they gave us for our Med-Surg final will have to commence as well.

Of course, if the crazy comes between now and then, you will find out first.

See you in August.