A Lesson in Gratitutde

This weekend, nothing related to school was accomplished.  

But I did decorate the Christmas tree.

I also discovered this lovely tune by Ingrid Michaelson (one of my faves), and though we haven't had much snow in Denver yet this year, it seems rather appropriate for the season.

Isn't it nice!?

As I was randomly decorating the apartment this weekend, and admiring the various beautiful angels I have gracing our presence, I was reminded of the last real angel I met - sent to me in the form of a stranger.  As my classmates and I were leaving our table in the hospital cafeteria, she and her mother were just sitting down to eat.  I smiled politely and started to follow my classmates back up to the floor when she touched me timidly and said, "I'm jealous."  Not really sure what she meant, I asked her why.  She said, "because you're in nursing school," pointing at the university logo on my black scrubs.  Not really knowing what to say, I asked why she couldn't also be in nursing school if that's what she wanted.  Then she explained to me that she was a single mother to a special needs child who was very sick.  Incredibly humbled and still not sure how to respond I thanked her for sharing her story, told her that I thought she was brave, and that I thought she could probably be a nurse anyway with all of the experience she had caring for her child.  As we smiled and said farewell, I felt so touched by that woman's story, and so very grateful for the opportunities I have been given.  

We must remember not to overlook opportunities to share the love we have been given and to express our gratitude for it.

Now I am simply struggling to get a start on my nursing research paper that is due next week.  We have to write either an evidence based practice proposal, or a research proposal.  I would love to write an evidence-based practice proposal related to oncology nursing, 

but I am having a lot of trouble narrowing it down to a simple topic.  I am toying with ideas about using evidence to support an Oncology Nurse Navigator position to improve patient satisfaction outcomes, or developing a sexual health nursing assessment tool to improve quality of life outcomes for patients before, during and after their cancer treatment.  I am extremely interested in the survivorship aspect of oncology nursing care, so that is the direction I am pursuing.  

Any thoughts on these would be appreciated.

***

I hope you all are enjoying the holiday season and finding time to love and to be grateful amidst all of the rush and stress.

Burned Out

I haven't been too inspired to blog lately...and I've really been slacking in the department of pictures and visual interest.  Sorry...all my creative juices have been sucked up by care plans and research papers!

But now I am finished with my actual clinical days for Med/Surg I and just have a perioperative/ER day to get through, a QSEN project to complete, and a cumulative final exam for the class.  Ugh!!  I am feeling the burn - burn OUT, that is.

Don't get me wrong, I am still learning like crazy, and I love being a nursing student, but I am so ready for a break.  I just have until December 17...which is just about two weeks away!

If you are wondering if you have ever experienced such a thing as burnout, here are a few of the signs and symptoms:

Don't panic, the syndrome is curable with a little rest and relaxation!

***

ON a positive note, I had a GREAT clinical experience.  I got to practice a lot of skills, including my  

first successful IV start!  

My patients were wonderful, as were their families.   

They taught me so much; 

I hope I was able to convey my gratitude.

Give Thanks

I meant to get this post up before the Thanksgiving holiday but as we move on I know that it is never too late to be thankful...so here you go - happy Thanksgiving! I hope you all had a wonderful holiday.

I am very very blessed.  I have so much to be thankful for.  But for the purposes of this blog, I thought I would sit down and list a few things that I am grateful for that pertain to nursing school, and the profession of nursing.

I am thankful for my loving, understanding and supportive family who remain so even through my second go-round of being a poor college student.

I am thankful for the opportunity to keep learning and improving myself.

I am thankful for kind and patient nurses who remember what it was like to be a student, and who are glad to share their knowledge and passion.

I am thankful for patients who are open to sharing their experience with a student, to facilitate my learning as well as theirs, and to let me participate in their care with confidence and trust.

I am thankful for great examples who love being nurses even after years in the profession.

I am thankful for wonderful friends who keep in touch and never hesitate to ask how school is going and to offer a few words of encouragement.

I am thankful for new friends and classmates to lean on, commiserate with, and to help one another muddle through the papers, tests, quizzes, evaluations and examinations.

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

These are just a handful in a sea of blessings that I have been given,  but time slips away and I forget to be thankful for all of the little things.  Don't ever forget to give thanks for the good things.

Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend. Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow.
-- Melody Beattie

What are you thankful for today?

The Longest Week

Welcome to my cozy little nook, where I am currently sitting with a cup of tea,  

just taking a breather.

This is where I study, pay bills, and keep in touch with important people...but mostly study...as evidenced by the heavy heavy stack of books bowing the shelf above my head.  Last month, I was having a lot of back pain from sitting in one of our garage-sale dining room chairs to study here, in the nook.  My thoughtful and considerate boyfriend took me to Office Depot and let me pick out this super nice and comfortable chair to support my back during my long hours of studying.  And he plays video games in it when I am in class.

I thought this week would never end. 
The schedule of events:
Monday: Pick up patient assignment for Tuesday and start care plan and med cards
Tuesday:  Clinical 0630-1700
Wednesday:  Clinical 0630-1600
Thursday:  Simulation
Friday:  Med/Surg I lecture, final research critique turned in
Saturday:  Pharmacology exam and lecture

But finally, a moment to relax.
The only productive things I accomplished this afternoon were buying milk at the store, and putting up our new tiny Christmas tree.
It's too early, I know.

Tomorrow, I will be back in the groove, studying for the online Med/Surg I online exam that is to be completed sometime over the Thanksgiving "break".  Oh, and I also have two PICO questions due for my research class at the beginning of the week. Does anybody know what that means?

Just when I am starting to feel the stress and count down the days until winter break, some motivation for sucking it up and getting myself through this thing called nursing school:  On Tuesday, AOL compiled a list of the Top 10 Most Secure Jobs in 2011 from U.S. Department of Labor Statistics.  Nursing was number one.  Thanks to my friend Jennifer for sharing this with me, and thanks to my friend Jessami (who is a nurse) for summing it up by saying:

"Isn't it great to know that when you are finally done...someone will ALWAYS need you!"

Putting A Face To A...History of Presenting Illness

Today, like every day before a clinical rotation, I went to the hospital to pick up my patient assignment and fill in my blank care plan as completely as possible from the information in the paper and electronic medical records.  I find it inconvenient to have the information either split and/or duplicated in the paper chart and the EMR.  It takes me forever to find the information I seek.  But alas, this is the system we live with.

We are not allowed to meet or have contact with our patients until clinical day.  So as I was filling in the blanks as required (recent labs, demographic information, history of presenting illness, pathophysiology, current medications) I found myself, as I always do, wondering what my patient looks like.  And not only, what does my patient look like now and what will I encounter when I walk into the room tomorrow, but what did my patient look like before he/she was sick?  What kind of life did he/she have before becoming a patient in this hospital for weeks or months?  What kind of person must he/she have been before they were defined by laboratory values, diagnostic procedure reports and a "face sheet"?

I find it hard to relate to the history and physical as represented by a doctor's barely decipherable chicken scratch on a form in the chart (sorry docs...).  Without a face, a family, a story...there is no connection.  And it makes me resentful of the seemingly thousands of medication cards and numerous pages of care plans I have to fill out for this nameless faceless diagnosis.  

But I'm sorry!  I am not resentful toward you, my patient - I just haven't met you yet!!  And tomorrow, when I finally meet you, I will know your story; I will understand why you have all of those medications and tubes and machines, and radiological and surgical procedures.  And hopefully, I will understand what it means to you to be on all those medications and connected to all of those tubes and machines and to have all of those radiological and surgical procedures.  Then I will learn from you, and hopefully you will also learn from me.

Putting Theory Into Practice

Phew! Three weeks into Med/Surg I, our little group of six nursing students has completed three full days at the hospital in our first real clinical rotation.  Although much of these three days were taken up by computer and EMR training, tours, and an introduction to care plans, we did have some actual patient contact.  It's so exciting to be able to apply concepts we have learned to real life!

So far, the doctors, nurses, CNAs, and other health professionals on the floor have been very tolerant of us, and even incredibly helpful!  As much as we try not to interrupt their normal flow and function, I can only imagine how distracting we are with all our questions and curiosity as we follow our clinical instructor around in  our black student scrubs like baby ducks.  One of the other students joked about us being like an "atherosclerotic plaque" clogging up the hallways of the unit.  HA! Nursing school humor...

Though I feel terribly inept and spend most of my time trying just to stay out of the way, I am enjoying my clinical experience very much.  I was so excited to administer medications to a real patient!  I got to flush a PICC line, give two subcutaneous injections, hang IV meds and pass oral medications.  It was not nearly as scary as my medication CPE made it seem!  

I had the nicest patient both days this week, and was honored to hear from her and her husband that they would miss me after my clinical days were over for the week.  I appreciated very much hearing that they thought I was going to make a great nurse.  That is the sweetest compliment!  And the greatest motivation and encouragement to keep plugging along in this journey called nursing school.

An Empty House

This is my Papa Virgil.  Only he doesn't remember.

He doesn't remember taking me to the sale barn early in the mornings for breakfast.

He doesn't remember the little barn he built for all "My Little Ponies".

He doesn't remember being the subject of my World War II history project.

He doesn't remember how proud he was when I told him I wanted to be a nurse

-like his mother.

He doesn't even remember my name.

He doesn't remember his only granddaughter

His only grandson

His only daughter

His only Son-in law

His only wife.

This is my Papa Virgil.

An empty house

Abandoned by a good and careful tenant

Lights turned out

Familiar things strewn about

But not even a resemblance of the once lively, strong and proud.

***********

November is National Alzheimer's Disease Awareness Month and National Caregivers Month. Honor a caregiver by creating a tribute:  

http://ping.fm/SuqLy

To my Mom, Dad and Meme, the hardest working caregivers I know.  And to my Papa Virgil; may we find a cure for this cruel disease. 

Takin' It To The Streets

As I progress through my nursing program I learn more and more about the different roles of nurses and the wide spectrum of opportunities that will be available to me when I graduate from this program (and pass the NCLEX of course).  I came into this program wanting to be an oncology nurse (and I still do, more on this in later posts).  That's a pretty narrow focus, and almost daily I encounter possibilities that I had never considered.

In today's post from AJN's Off The Charts, the topic of discussion is outreach nursing.  Click to read "Harm Reduction or Stigmatization: What's Your Approach To Drug-Addicted Patients?"  These Canadian nurses go to their patients rather than waiting for them to be admitted to the hospital - oh, and their patients are illicit drug users and prostitutes.  Take a look at the video below for a segment of the documentary called "Bevel Up:  Drugs, Users and Outreach Nursing".

 

Not only was this topic striking to me because it wasn't something I had ever considered, but it's not a topic that I am very familiar with either.  I don't know that I would be able to do what those nurses do for their patients without judgment or criticism.  However, I know that even doing student nurse rotations in a city hospital, I am likely to encounter some of these folks.  It spurred my thinking and maybe will allow me to adjust my perceptions before I am in the situation.

"To handle yourself, use your head; to handle others, use your heart."
-Donald Laird

I would be interested to know about experiences you all have had, or perspectives on the topic if you are willing to share.

Med SURGE

Well we have jumped head first into the world of Med/Surg nursing. And I thought we were bombarded with information in Fundamentals! I AM loving the synthesis of all the information we have gathered so far though. This class is all about application of information to real life situation.

And just when I thought I was done with dosage calculation exams...I am not. We have a quiz on Friday, again requiring 100% in no more than three attempts. Welcome to week #1!

Tomorrow is my hospital orientation for clinical rotations. I am excited - my clinical instructor seems really nice, and I am SO ready to get into the hospital! I start my first shift on election day, and I'll be on the neuroscience floor again. I was really hoping for something different than I had already experienced, but I know that I will learn a lot on this unit, with a wide spectrum of disability and illness in the patients.

Before I start my rotation, I found a very appropriate blog post to help me prepare for the patient care experience on JParadisi RN's Blog called Let Me Tell You One More Thing You Already Know.  It's about therapeutic communication and patient-centered care which, as you know, are hot topics in the current nursing curriculum. After all, the patients are the reason that we are nurses, and student nurses, and CNAs, and healthcare professionals.  It's all about the patients. 

Please take a look at this blog post if you have time, and let me tell you one more thing you already know:  remember to listen to what your patients are saying.

Hot Wings and Nursing Research

What a fun weekend!  J. and I spent a lot of time with his family, including his funny and adorable niece and nephew.  We spent Saturday afternoon at the Denver Museum of Nature and Science...

Hello from the museum! What a pretty view!

 ...followed by dinner and games at Dave and Buster's.  Today, we had lunch with the fam at Dino's - a great little Italian restaurant on Colfax and Kipling with the best homemade spaghetti!  After lunch, we did some shopping at Colorado Mills outlet mall.  In the fitting room of Banana Republic (my favorite store) is where I determined that I really REALLY need to get back into the habit of working out (and cut down on eating out).  So I want to know if you all have any tips for squeezing a workout into a busy schedule.  And also, can someone teach me how to like running??  Because I can't seem to grasp this concept.

J. and I thought we should make a contest out of it - get a bathroom scale and have weekly weigh-ins to motivate us to get-movin'!  Has anyone else tried this "biggest loser" plan?  Though we both agreed that it was a good idea, it did not prevent us from making our first batch of homemade hot wings for Sunday night football (with a whole stick of butter - Paula Deen would be proud).  They turned out really good, and I had to eat a pear afterward to make myself feel better.

NOW, I am procrastinating this assignment for Nursing Research.  I think this is a very important class, especially in the context of evidence-based nursing practice.  I think it is important for nurses to be able to read, understand and critique research articles for their accuracy, validity and applications to practice.  I understand why we have to do this.  HOWEVER, I have a lot of experience with research.  Not necessarily nursing research, but research in general.  Between my liberal arts biology degree, my graduate certificate in clinical investigation, and my work experience in clinical research...I am really unmotivated to participate in this class. 

But I know I can always learn more, so I will try.  At least I chose a fairly interesting article to critique - about the effects of early mother-infant skin-to-skin contact on successful breastfeeding.  As it turns out, early skin-to-skin contact seems to have positive effects on successful breastfeeding habits as opposed to babies being taken for assessment and swaddling immediately post-birth and then being returned to their mothers.  Here is information for the article if you are interested in the details of the study:

Moore, E. R., & Anderson, G. C.  (2007).  Randomized controlled trial of very early mother-infant skin-to-skin contact and breastfeeding status.  Journal of Midwifery & Women's Health, 52, 116-125.

And now back to your regularly scheduled programming.

Fundamentals Covered

I have officially passed NURS 3002:  Fundamentals of Nursing.  Bright and early this morning I successfully completed incontinence care and a Hendrich II Fall Risk Assessment on my "patient".  Then I bought some new shoes to celebrate.

"When a man feels throbbing within him the power to do what he undertakes as well as it can possibly be done, this is happiness, this is success."
Orison Swett Marden

Salute to Tunes and Spoons

In my "spare time" I love to read blogs from other nurses and nursing students, but I also enjoy blogs from friends and family and about crafty things as well.  As I was taking a break from studying for my Interventional CPE I noticed a new blog post from Tunes and Spoons.  This post happens to include a giveaway that I would love to be a part of, but I am also motivated to celebrate and share with you all the love and creativity of the couple who created this fun site!

I know John from back home - his cousin is my very best friend, and his family (especially his Granny Marilyn,  Aunt Melanie and cousin Linsey) have been sort of a second family to me.  Although I have never met Rachel, I know that she is a lovely person, and I know that she and John are madly in love with each other. (See the most recent post for the romantic story of their engagement).  These two make such a fun couple and have so many entertaining stories and talents to share!  One of my favorite parts of Tunes and Spoons is the music of John and Rachel that is frequently featured.  Take, for example, the post where they dressed up and performed a cover of "I Wanna Grow Old With You" from The Wedding Singer.  So cute!

If you have some spare time or you're just trying to procrastinate, let yourself be romanced and entertained and informed by John and Rachel at Tunes and Spoons.  {See their blog button in the left margin.}

My Own Bigger Picture

If you have a chance, please read today's post of the AJN "Off the Charts" blog, No Explanation Required: A Preceptor's Tale .  It's about a preceptor and an intern in a critical care unit when they have to continue care for a patient who has died because the patient is an organ donor.  The post describes the difference in perspective between the preceptor, who enjoys the science of nursing in the process of organ harvesting and donation, and the intern, who prefers the art of nursing in caring for living patients with health problems.


"I prefer science; my intern does not. Or rather, she prefers more than science. She tells me she far prefers taking care of living patients and that, although she knows there’s a bigger picture out there, she’s just not feeling it and can’t explain why.
I think she’s finding her own bigger picture. No explanation required."

-Marcy Phipps, RN

But isn't that what we are all doing?  In our quest to prove that this life bears meaning and our existence affects the lives of others, aren't we all finding our own bigger pictures?  I think that is our charge.

On Monday, we start the second block of the semester - Med/Surg I for myself and half of my classmates.  Our very first assignment (as it has been for almost every class so far) is to complete a simple biosketch of ourselves and share it on an online discussion board.  The instructor asked us to respond to three prompts, one of which was to choose a song to represent us.  What a challenge!!!  The song I finally settled on is by John Mayer, called "The Heart of Life".  I believe that we will all face challenges and hard times, but the love of God, family and friends will see us through.  That is the heart of life, and it is good and deserves to be celebrated.  This is part of my bigger picture, and also part of why I chose nursing as a career.  Enjoy the song if you have time.

You Simply Have To Care

I hope everyone had a great weekend.  Just thought I would share this video, also shared by The Makings of A Nurse.  It's an encouraging message about the profession, the challenges presented, and the reason nurses stay nurses.  Enjoy!

http://www.youtube.com/watch?v=pPbGgIg0NIY&feature=player_embedded

monday monday

Another Monday down, only one more to go in this block of the semester.  A week from today I'll take my final exam in Fundamentals of Nursing.  We have covered so much content in this class.  It has gone pretty smoothly for me - a good deal of it has been over skills and material I learned as a CNA.  What I appreciated about this class is the focus on Evidence Based Practice and why nurses do what they do, when they do it, and how they do it.  We had at least three articles per week to read, linking current evidence to current practice in nursing. 

After the final written exam on Monday, I will have my "Interventional CPE".  This CPE will be performed in the simulation suite, on a dummy, with my instructors watching behind a one-way mirror.  If nothing else, the feeling of being watched increases the level of anxiety.  What are they saying behind that glass?!

We covered a lot of material in class today, including respiratory interventions.  Speaking of anxiety-inducing...one of my biggest worries about being a new nurse in a hospital is my first code blue.  Will I remember what things to do and what order to do them in, or will I just freak out?  We will see.  I hope I don't freak out.

After that lecture that seemed to last for days, I came home and J. and I curled up on the bed and took a nap together.  So nice!  If finally feels like fall in Denver, and I just want to cuddle up and drink tea and read a book.  Only a real book...not a textbook.  Oh well, maybe two years from now...

We were feeling too lazy to make dinner so...

I just finished a quiz for my online Nursing Research course.  Now I am half-heartedly looking over material for tomorrow's weekly pharmacology quiz while J. celebrates his favorite TV time with Colorado Avalanche vs. Philadephia Flyers Hockey, New York Jets vs. Minnesota Vikings Football, and Monday Night Raw WWE Wrestling.

BTW, have you had a chance to check out any of the nursing blogs I recently added?  Also, check out Tunes and Spoons this week for a really creative use of some old (but pretty) handkerchiefs.

Back to Nursing

I realized in reviewing some of my posts that I have gotten a little bit away from my original intentions for the project.  Although I want it to be personal so that people are able to relate, I also want to focus on the nursing aspect of this part of my life and how it is changing my "everyday" and my perspectives on life.  So I have added some links to your left to various blogs from student nurses, new nurses, and experienced nurses. They are all great sites and I encourage you to take a look when you have a chance. Once I get a grip on all the new material I may reference some of the posts in this blog. That's all for today; my brain is burned out from studying the drugs used to treat asthma. I am dragging J. to see "Life As We Know It" with me...I hope it's worth the arm-twisting!

By the way...

On a separate, but not totally unrelated note, I just found out that

I GOT 100% ON MY DOSAGE CALC EXAM!!!

...which means that I don't have to re-take it. And that makes me happy.

Thoughts on studying

A few days ago I received a magazine from the National Student Nurse's Association (of which I am a member).  I came across an article containing study and wellness tips from nursing school graduates.  I pored over the article, hoping to find something helpful to keep me organized and on-track with my studying.  Don't get me wrong, my current study practices are getting me some very good grades, but if there is an easier or more efficient way to go about it, I'm all for it.  Here are some of my reactions to the article:

1.  What is the deal with notecards/flashcards/drug cards??  It takes me a lot of time to prepare these cards, and I never look at them again!  They obviously work for some people, because they are commonly recommended - but I don't buy.  Until if is a mandatory requirement for my clinical rotations.

2.  Studying immediately after class - I like this idea.  However, most of the time when I leave a class I find it hard to focus on the same subject for any longer.  Four to five hours is a lot!  I may try to implement this strategy however, maybe later in the evening instead of immediately after class.

3.  Studying with friends/classmates seems like a good idea, but honestly I find it more of a distraction than anything.  I like to spend extra time on the things that I don't understand, and I know it will not always be the same information as another person.

4.  Recording lectures is not something I ever really considered until now because I have always been able to rely on my memory.  However, with the incredible amount of information I am being presented with, I think that maybe this is not a bad idea.  One person suggested listening to recorded lectures while crocheting, driving, or doing another activity - which is really appealing to me.  Does anyone know a way to get a recorded lecture onto my iPod?

5.  A lot of people recommend studying with an NCLEX review book.  Any thoughts on this?  It seems like I have so much to read already...

I welcome any thoughts you might have on this subject.  I have been getting by with an iPod or Pandora radio, green tea, frequent dog walks and lots of reading.  If I can stay on top of things and read the material before class, the results are alway better and less stressful!

Just waitin' around

Oh how I hate waiting.  Patience is a virtue that I am trying very hard to acquire.  My Dad and my Grandfather are/were two of the most patient people I have ever met.  I think I did not inherit that trait.  However, I feel that it might be beneficial to my nursing practice to try try try a little bit harder. 

It might be nice for my PATIENTS for me to have a little PATIENCE...

 

Today, I am waiting on two things: (1) my clinical placement e-mail for the second semester of this block and (2) the grade from my dosage calculation exam - both very important to me.  I know that I have been placed at the University of Colorado Hospital for my Med/Surg I clinical rotation (my first choice - yay!).  What I am waiting for are the dates and times/shifts that I will be assigned.  Also, I am quite confident that I did well on the dosage calc exam, HOWEVER, we must receive 100% on the exam (in no more than three tries) to pass the class.  Now as I said, I am certain I did well, but did I get through a 50 question exam without making one silly mistake?  Not sure.  But I really don't want to re-take it.

So I will just wait, and try to be patient.  And keep on studying.

  

Rest

“Take rest; a field that has rested gives a bountiful crop.” Ovid

For the last couple of days, I have been resting.  I am halfway through the first block of this semester, and feel like I have a pretty good handle on school things.  (That is not to say that I don't need to study!)  Fall is my very favorite time of year, especially here in Colorado, and I needed to take some time to enjoy it this year.  On Wednesday I headed up to the mountains where Josh had finished hunting (sadly, with no success).  We took a well-known scenic drive to see the colors that were left on the trees.  I have never seen or felt anything as beautiful as a Rocky Mountain fall.  Plus I hadn't seen Josh in nearly two weeks!  What a wonderful way to spend some time together.

We ate cinnamon rolls in our favorite coffee shop and took a stroll through our favorite antique store.  We enjoyed the still-warm weather and beautiful sunshine.

**Nursing Connection For The Day**

On Friday, we came back to Denver.  I had to watch a video about the Tuskegee Syphilis Study for my Nursing Research class.  If you don't know about this study, it was a major turning point in the United States for the regulation and protection of human research subjects.  This tragic story, like so many others deserves to be told and understood for sensitivity and understanding in our healthcare and research practices still today.  There are many good sites for information about this and other human research atrocities, but here is a link to the CDC website that I found helpful:  http://www.cdc.gov/tuskegee/timeline.htm

And then I gave Josh a haircut.  Now, one-length haircuts with electric clippers are do-able, but don't ask me to do any more than that.  There is a reason I am not a stylist.

On Friday night, we treated ourselves to a night out at the Grizzly Rose to hear the Josh Abbott Band.  Now, if you've never heard of this band, let me share.  This is a young band from Texas that plays a newer style of country music (are you familiar with "Texas country"?).  The music is good!

 

Why do I know about this band?  The fiddle player, Preston Wait, is from my own little southeast corner of Colorado.  Baca County is one of the largest counties in the state, with the smallest population.  Therefore, the smalltown adage that "everybody knows everybody here" applies to our whole county.  And he's a great musician!

So now, after a full two days of rest, I am ready to hit the books.  The intracacies of foley catheters, bed-baths and HIV medications will not escape me!

Nearly-Flying Colors

For crying out loud people, OCCLUDE THE TUBING when giving an IV push medication!!!

Today was my medication administration CPE.  Goodness - four weeks into the semester and we're already having one of our most major practical exams!  How many times did I go over the requirements of that CPE?  A lot!  I even highlighted the little things I was afraid to forget because I was so focused on the medications...

When giving an IV push medication into a primary tubing, you should always occlude the upsteam tubing so the medication goes directly into the vein instead of back up into the tubing.  That is why it is ordered IV push NOW instead of infusion over a certain time period.  This little bullet point was indeed one I had highlighted...and still forgot.  But I bet I don't forget it again!

Luckily, there were critical skills that, if missed, would result in complete failure of the CPE.  Occluding the tubing was not one of those critical elements (although it probably should be).  I still passed my exam - did everything else exactly right!  WHEW!

So relieved to be finished with that.  And I have officially been declared safe to administer medications to patients.

On a totally unrelated note, the season premiere of Grey's Anatomy is tonight!!!!  Therefore, I will be glued to the television for an hour with no thoughts of studying for any of my classes.

Yep, I'm an addict.

Role Models

There are many reasons I chose to go back to school and to pursue a career as a nurse.  Today, I would like to give a shout-out to a couple of people who have been very influential and encouraging to me on this journey.

I worked with these two nurses at the cancer center where I was employed prior to starting school.  To me, these two women epitomize nursing as a combination of art and science.  Not only are they incredibly smart, skilled and educated, but they are two of the most caring and approachable people I have ever met.  They are my role models - in patient care, in work ethic, in teamwork and collaboration (and on a side note, in future parenthood!).  These two women have been so kind and encouraging to me in the process of applying to school and pursuing my career. 

I only hope that someday I can be half the nurse they are!

These pictures were taken at my going away party!

I was very sad to be leaving this group of people...

There are many other people that have influenced me in my journey as a future nurse - the doctors, nurse practitioners, nurses, pharmacists and other professionals I have worked with - not to mention my wonderful friends and family!  Still, when I think of the examples that I would pattern my practice after, Susan and Leesa are those examples. 

Thank you I love you guys!

You are in charge of your feelings, beliefs, and actions. And you
teach others how to behave toward you.  While you cannot
change other people, you can influence them through your
own behaviors and actions.  By being a living role model of what
you want to receive from others, you create more of
what you want in your life.

Eric Allenbaugh

You've got to be careful whom you pattern yourself after
because you're likely to become just like them.

Rich Mayo

Time MISmanagement

As I have probably mentioned in earlier posts, I have very poor time-management skills.  It's not because I haven't been educated on the subject, it is simply because I am easily distracted and if there is something slightly more interesting than the task at hand, I WILL PROCRASTINATE!  There are a myriad of things that occupy my attention ahead of learning classes of antibiotics (e.g. the cooking channel, my various crafts and creative projects, my FACEBOOK addiction...)  Then there are two "things" that can occupy more time than any of these. One you have already met, and that is my Faithful Fluffy Friend, Lena, who insists on being outside every two hours while I am awake.  The other is this guy.

Luckily for me and my time management, he has been in the mountains hunting elk for the last week.  I had weekly exams in both Fundamentals and Pharmacology, then Thursday I have a pass/fail medication administration practical exam.  STRESSFUL!  It has been much easier to study with him out of the apartment for a few days, as he can be quite entertaining and therefore distracting when he is here.

I do miss him though.

Clinical Insights

Today was day number two of our two-day clinical placement for Fundamentals.  My group was placed at University of Colorado Hospital on the Neuroscience floor.  I LOVED IT!  Even though we were doing the work of a CNA (which I am quite familiar with) we got to see patient care, medication administration and procedures from the viewpoint of an RN.  We had a lovely and smart clinical instructor originally from Belarus who challenged us to be very involved and allowed us to work closely with our patients and the staff of the unit.  We were able to observe a tracheostomy tube being removed by a respiratory therapist, and we got to feel a man's brain through his scalp because a section of his skull had been removed to relieve pressure after a head trauma. 

I DID have to remove my nose piercing as per clinical policy, and I decided that maybe it was time to just get rid of the thing and move on instead of trying to put it back in.  It feels so strange after seven years!

I think that hole might be there a while!

**Also, I will never leave the house in my black CU scrubs without a lint roller to remove the white dog fluff that seems to surround me constantly.

We were each required to do a physical assessment of our patient, and since it was a neuroscience floor and all of our patients had varying degrees of neurological injuries, we had to include a neuro assessment.  I was nervous, since I hadn't practiced assessment since last semester, AND had never practiced on a real patient.  Now I was expected to do one of the longest and most complicated physical assessments off the top of my head?? 

Well it went fine.  I remembered all but one thing, and was even commended by my instructor for what a thorough job I did assessing and communicating with my patient.  She actually said that if she had had time to bring the rest of the class into our patient's room, she would have asked them to observe my assessment because it was exactly what she was looking for.  I don't mean to boast, but her kind words made me feel very good and boosted my confidence in my skills so far.  I know that I am a good communicator, and I am blessed with a good memory which is incredibly useful in certain situations, but it always feels good for that to be reinforced.

It also reinforces my feelings that I am exactly where I'm meant to be.  I love working with patients.  The theory and practice of nursing that we learn in class and in lab is very interesting to me, but it is the patient care that I love.  My patient was a very interesting man who allowed me to be a part of his life for just a little while - just long enough to know part of his story and for him to become part of my lifelong learning experience.  However, for that little slice of life I am grateful, because it is the patients and the human-ness of this profession that make me want to be a nurse!

P.S.  Being on that unit for two days in the midst of nurses, medical residents, pharmacists and pharmacy techs, attending physicians, nurses, CNAs, respiratory therapists, and a myriad of other healthcare professionals, I realized just how important the role of a nurse is in the treatment and daily care of patients.  Everyone relies on cooperation and input from the nurses, but perhaps none so much as the residents and physicians!

After two days in the hospital, I took a turn for the nurse.  ~W.C. Fields

Thoughtful Uncertainty

The pharmacology exam went well - very well, in fact.  I only missed one answer (who knew that cocaine has a medical use and is not a schedule 1 controlled substance??), and I got full credit for a five-point extra credit answer.  Yay!  Dr. Sampson assured us, however, that it was his "getting to know you" exam and that the next one would be much more challenging.  Yay. 

I can't wait until we have to start memorizing drugs (she said sarcastically complete with eye-roll).  Some of my classmates already have drug books that look like porcupines with colored tabs to mark important pages.  Over-achievers!  I don't even know what is important yet!  I have however begun a very meaningful relationship with this pretty little book that can be used as a reference during exams, complete with abbreviations, brand and generic names, and measurement conversions.

Ta-da!!!

Since I survived the Pharmacology exam, it's time to move on and prepare for tomorrow's Fundamentals lab.  It's a FIVE HOUR LAB starting at 7:00 AM and drilling us with the different skills we will need to torture...I mean, treat...our patients.  We are required to wear our black "nurse-of-death" scrubs (as described by one of my classmates) embroidered with the CU emblem and properly identifying us as STUDENT nurses.  We practice different clinical scenarios and stick needles into self-healing gel pads in hopes that it will be something like the real thing.

As simple as this sounds, there is quite a lot of required reading in preparation for class, and so far has demanded most of my study time, which has really become the equivalent hours of a full-time job.  My fluffly little friend, Lena, is less-than-enthusiastic about my class and study schedule, as she thinks we should be spending this time together running and playing outside.

Please go outside with me.

Are we going outside?

Bored.

Bored.

Only a year to go, my love!

I realize that I can get as much education out of my time in the nursing program as I choose to take from it.  I am trying to take advantage of that and really take my studying seriously, but as you know, I am really good at distracting myself and procrastinating.  I hope that by using this blog to reflect on my studies and to remind myself of my responsibility in this, that I will stay motivated and focused on the goal - to be an educated, professional nurse with the ability to think critically and provide the very best care for my patients.  I know I won't be an expert right away, but I know that I can arm myself with the tools I need to be successful in the future.

Education is man's going forward from cocksure ignorance to thoughtful uncertainty.

Kenneth G. Johnson (1922-2002) American educator, semanticist.

Pharmacoholic

“Nurses dispense comfort, compassion, and caring without even a prescription.”

– Val Saintsbury

Tomorrow brings my first Pharmacology exam/weekly quiz.  And despite the sentiments in the inspirational verse above, Dr. Sampson has assured us that we will need to know pharmacology and the prescription process very intimately before we enter the workforce as nurses.  Therefore, today is devoted to the study of Pharmacology.  I have a sneaking suspicion that much of this semster will be devoted to the same.

My newest friend.

Does anyone have tips for making drug cards?  It was recommended to us by our professors, but I wonder what information will be most useful to squeeze onto a 3x5 reference tool?

Procrastination Party!

I hate housework.  But it's amazing how many things that I find HAVE TO BE DONE before I can start my homework or studying.  I should have taken advantage of yesterday and today to review my notes from classes...but instead I did laundry and dishes and cleaned the kitchen and ironed some things and organized some things and watched a John Wayne movie that I've seen a thousand times.

I just started my second semester of five in a BSN program.  At the end of my first week back after summer break, the procrastination has already begun.  The weather has been GORGEOUS here in Denver for the last couple of days and I have just found things other than Pharmacology, Nursing Research and Fundamentals of Nursing to keep me occupied.  I don't think I will get away with it much longer.  My semester is about to get much more involved I think.

Only a week in, we've already plunged into the material!  After drilling us about patient safety, medication errors and recent Institute of Medicine reports on both, we've already learned the rules of medication administration and practiced (on inanimate objects) giving subcutaneous and intramuscular injections.  Fun!  However, I am really not a fan of needles myself, and it makes me really nervous to think about sticking one into someone else!  I want to be helping people, not hurting them!  I guess in the long-run, that is the outcome.  Besides, I'm sure the pain of a routine vaccination is nothing compared to starting an IV, which is the next skill we learn.  The IOM reports also make me worry about the frequency of medication errors, and I think it must be really easy to do - but I don't want to be one of those statistics!  So much to keep in mind...

Back To School

When I was little, I wanted to be a veterenarian.  I was always attracted to what it was about the practice of medicine (in animals or humans) that combined art with science - two of my favorite things!  As I grew in age, I also began to grow out of my shyness, which allowed me to enjoy meeting and working with members of the same species.  I realized that animals could not tell you what was wrong or what was hurting, and I could only imagine feeling frustrated and helpless in that career path.  So I decided to be a doctor - a MD - a human practitioner. 

After graduating with my first Baccalaureate degree in Biology, I decided that I really needed some experience before I could make that decision.  I worked in a small outpatient oncology clinic for over four years.  It was there that I found what I believe to be my calling.  I found a couple of nurses there who were terrific mentors to me and really opened up my eyes about patient advocacy, patient safetly, and quality patient care.  I realized that having that hands-on interaction with the patient is really what I desired, not just to be the one prescribing their medications.  Please don't get me wrong...that is not all I think about physicians (especially oncologists!) but I have oversimplified to make a point.

So here I am, five years after my first college degree, in school again for my second Baccalaureate - this time in nursing.  It took me a long time to get here, and each day that we learn a new skill I am not without doubts and reservations about whether I will good enough for my patients, but I finally feel like I am in the right place - like this is something I could do for the rest of my life.

Life is a succession of lessons which must be lived to be understood.

-Ralph Waldo Emerson

Be well.

First Blog Ever!

In the process of designing my new blog, I asked myself more than once why anyone would want to read whatever I write here.  The purpose of this blog is to be a record of my journey and the lessons gathered from my latest challenge - nursing school, as well as being a self-discovery tool as I am at the point in my life where some crucial decisions will have to be made.  I think that I am not alone in these processes and challenges, and therefore might have someone with which to share my experiences, or with at least to commiserate.

So anyway, here are my random ramblings.

So long, be well.