Attitude of Gratitude

 

Source: honeybearlane.com via How Does on Pinterest

You know those "25 days of I'm thankful for _____" status updates that started today on Facebook?  Well I think those are great.  Though I will spare you the day-by-day, I will share with you my day #1 and encourage you to take a moment to recognize and be grateful for the blessings in your life.

 

Today, I am grateful for the opportunity to further my education and achieve a degree that I believe will lead to a challenging and fulfilling career.

Even though I am really tired of boring textbooks and online discussion postings and research papers...I am grateful!

Options

Ok let's talk about options.

First, new-grad nurse residency programs vs. preceptorship (assuming that I could actually get a spot in a new-grad program and get hired at a hospital without one, and would have the option to choose).  I know that there are statistics that show that new grads who go through the residency program make less mistakes and are generally more satisfied with the transition from student to RN.  However, I feel like the length of some of the programs might be overkill, and I wonder if I would appreciate the increased autonomy of a shortened preceptorship instead.  I would have to start applying to new-grad programs now for a March start.  Thoughts?  Experiences?

Second, what about joining a professional organization (e.g. ANA, ONS, etc.)?  I know if I join now as a student, I get a discounted membership.  Are there real benefits besides receiving a journal in the mail?

Third, how about NCLEX prep courses?  I could pay a whole bunch of money for a Kaplan course that guarantees that I will pass on the first try...or I can take my chances with my NCLEX review books.  Has anyone taken the Kaplan course?  Any other ideas?

So Close Now

Well hello again, old friends.  I realize it's been a while since we've caught up.  I hope you've had a lovely fall.  

So I completed my Senior Integrated Practicum.  I was a little less than excited about my placement.  However, I had a great experience.  My preceptor was a lovely woman who has been an oncology certified nurse for almost 30 years.  What a wealth of knowledge!  I also enjoyed the culture of the hospital, and the other nurses and administrators were extremely supportive.  

(They even encouraged me to come back and apply for a job once I pass the NCLEX!)  

I completed an educational project about Graft-Versus-Host Disease after stem cell transplant for the unit, and really enjoyed both the subject matter and the research.  The night shift was difficult, but I learned to manage.  It's not so bad as long as you are prepared and manage your time accordingly.  It does require a lot of planning ahead for meals and homework (and I'm sure childcare and transportation for many).

The actual didactic portion of the class was less than fun, but important I'm sure - to cover the roles of leadership, management and quality in nursing.  What I am learning in this semester is that I am really not a huge fan of online classes.  I miss the connection with classmates and teachers, and sometimes it is hard to know if you really grasp a concept if you don't have someone explain it to you.  Sometimes, books and articles just don't cut it.  But then, you don't know that you haven't really grasped it until you do poorly on the exam.

After SIP ended, I decided to feed my creative soul for a bit.  I did no homework for a week.  Instead, I got a haircut (see above photo), I finished the thrift store dresser I had been trying to refinish since August, and I started crocheting again.  It feels good to relax and put my effort into something I really enjoy.  

I recommend a creative and/or active outlet for anyone going through nursing school.

Public Health is my last course, and it started a week ago.  My clinical placement is in rural Colorado, near where I grew up.  Although public health is not something I want to jump into after graduation, I do have an interest - especially in rural public health.  I know that it is very hard to recruit and retain qualified health professionals in rural areas, and that access to care is limited in many areas.  I think that once I have some acute care experience under my belt, I will probably be interested in doing some rural public health work.   Perhaps I will even enroll in a Masters or Doctorate program in the future.  But let me not get ahead of myself!   

By the way, did you notice the countdown to graduation in the sidebar?

Attitude Adjustment

Well.  It seems like a lot has happened since my last post.  I finished up Mental Health with a good grade.  I finished my 26-page paper one hour before it was due at 0700.  I took my final a day early because  

my Papa Virgil went to heaven.  

We said goodbye to his body, and gave thanks that his soul could finally rest, with a little memorial service with family and friends.  I spent some time at home with my family, praying for rain, enjoying the animals, losing all my pennies to the senior citizens at bingo, and savoring every delicious bite of my momma's cooking.  Now I am back in D-town, preparing for my last semester of nursing school - yipee!  My diploma application has been submitted, my financial aid is verified, I am enrolled in classes and ready for the challenge.

This week I finally got my clinical placement information for my Senior Integrated Practicum.  I was so hopeful that I would get placed at one of my top three choices, because they all have Bone Marrow Transplant programs.  Well, I did not.  At least I got placed on an oncology unit, but my 144 clinical hours will all be achieved on the night shift.  That's right, my old friend the night shift.  

Sheepishly I will admit that I was incredibly disappointed when I received my placement information.  It's not because the hospital isn't wonderful; in fact, I have heard great things about it.  I just wanted to be at my first choice so much, and felt that I would have a much better chance of getting hired there later if I could complete this rotation there now.  And, of course, I am not a huge fan of night shift as you might remember from my pediatric rotation.

When I was little (and naughty), my mom used to tell me that I was in need of an attitude adjustment.  Well, she's right.  I know that I should be grateful to be placed on my unit of choice in a great hospital with a preceptor who is clearly organized and experienced.  I know that I will get out of this experience what I put into it, so it's up to me how much I will learn from it to become a better nurse for my patients.   

Thanks Mom, 

I think an attitude adjustment is exactly what I needed.

Mental Fatigue

Today, I am tired.

Day three of 12 into my mental health rotation, and I am mentally exhausted.  Although not nearly as physically demanding as previous rotations, this one just seems to drain all of my brain power - not to mention the anxiety created by being locked-in (we even have to ask the nurses to let us into the locked bathrooms!).  I can only imagine what it is like for the poor patients who have to re-tell their story to every group of students, and who have to deal with energy and stigma of mental illness every day, locked in a medicated cage.  

I have learned that mental illness is much more prevalent than I had previously thought, and that with treatment, many patients can be pleasant, functioning members of society.  I have also glimpsed the darkness that can swallow people whole, with delusions that are as real to a patient as anything you or I might see or hear.  It's a hard thing to wrap my head around.  I'm still working on it.

Also, I'm pretty sure that writing care-plans could be used as a torture technique.

I've been told that sometimes nurses develop a dark sense of humor to deal with stress, and here is my attempt with a video.  My official diagnosis of Jack Johnson here: paranoia and ideas of reference.  

Besides I just love J.J. and I think this video is funny.

Mental

Hello again, friends.  Once again I would like to apologize for the extended silence.  It seems that I have come down with a bad case of what can only be described as...SENIORITIS.  It happened at the termination of the Spring semester, when I realized that I had been back in school full time for an entire year, and that I only had six months left until I am awarded a Bachelor of Nursing degree.  Wow am I ready to be finished and get out there!  Besides, summer has always been my favorite season, and I would much prefer to be soaking it up instead of constructing mental health care plans.

Speaking of mental health, I tomorrow will start my fourth week in (out of eight).  I have a lot of respect for psychiatric nurses and I know that what they do is vitally important, but it didn't take me too long to figure out that it is not my top area of interest.  We aren't even allowed to pass medications or follow nurse preceptors...we observe and have discussions with our patients.  Talk about being out of my comfort zone.  That being said, I know there are a great deal of mental health issues surrounding physical illnesses and disabilities that I will surely encounter in any specialty, and I am doing my best to stay actively engaged in the learning process despite my shortened attention span.

A couple of weeks ago, we had to submit our placement requests for Senior Integrated Practicum (SIP), which for me, is coming up in Fall semester, block one (which mean the first eight weeks of a sixteen week semester).  I had some anxiety over my placement choices, as I know that I am competing for spots not only with my classmates, but with all nursing students of the same level across the Denver Metro area.  In addition, I know that new grad programs at the top hospitals are highly competitive and "may or may not" give preference to students who completed a SIP rotation on one of their units.  I am lucky to have the advice of some of the physicians I had worked with in the past about how to rank my placement choices.  I am just hoping I get a spot!

As I contemplate applying for a job (and hopefully a new grad program) I get so excited about being a nurse in the changing times.  With the latest Robert Wood Johnson Foundation Initiative for the Future of Nursing, I believe that nurses are starting to be recognized for their professionalism and leadership in the healthcare profession.  I also believe that it is up to us (the future nurses) to put this change into motion and set an example for future generations of nurses.  In the latest issue of "Imprint" - a quarterly publication by the National Student Nurses' Association, professionalism is the topic of discussion.  Several articles talk about how nursing has long been one of the most trusted professions.  They also mention that often to a patient, one nurse can represent all nurses - either positively or negatively.  The bottom line is that it is up to us to ensure that we portray those characteristics of a professional, so that we remain among the most trusted professions and we maintain quality patient care and advancement in the profession with integrity.  I know that I and my colleagues often grumble about the strict dress and conduct codes that take a whole class period to discuss each semester, but I know we all realize the importance of professionalism to our patients, our professors and our peers.

Sorry for the Neglect!

Dear Friends,

Sorry for the long period of silence.  I just got back from vacation in between semesters, and just this week started Mental Health Nursing.  I plan to do some posting this weekend with thoughts on Mental Health rotation, upcoming Senior Integrated Practicum, and the latest issue of "Imprint".  Thanks for your patience!

This Week

This week...

I finished my Med/Surg II rotation on the transplant floor, and turned in 27 pages worth of care plans and probably three times that many pages in drug cards.

I visited the Bone Marrow Transplant floor for a "specialty" day, and remembered why I LOVE working in oncology.

I successfully completed my Med/Surg II Simulation, and managed not to kill my post-MI dummy in the pretend cardiac step-down unit.

I reflected on some of the great and not-so-great experiences I have had in nursing school so far.  I related to Jennifer-Clare Williams in her guest post on the AJN blog "Off The Charts".

This is a MUST-READ for current and aspiring nursing students!

I especially liked how she described feeling more awkward and uncertain than ever before in her life, while realizing that she was learning and surviving in the process.  I feel like Jennifer's words came straight from my brain.

And it's only Wednesday!

 

On a lighter note...

My thoughts have been a little heavy the past couple of weeks, as you might notice from my previous post.  So to lighten the mood a little, I wanted to share this video that I first saw posted by a fellow nursing student on Twitter.  

If you are not a nurse, or nursing student, the humor may escape you.  I have included the video for my new favorite song by the Local Natives below, just for you!  It seems kind of appropriate in regards to the uncertainty I feel as Senior Integrated Practicum (Fall) and Graduation (December) fast approaches.  Hope you enjoy!

Reflections

There are many times during nursing school that I have felt so totally incompetent, that I believed I truly would never know enough to be a nurse.  But there are also those times when I think, "Hey, it's okay.  I've got this!"  And so it goes, the roller coaster of self doubt and self confidence.  I imagine it will be that way well into my career.  I can't imagine a day going by without learning something new.

I've been on the transplant floor for my Med/Surg II clinical rotation.  I find it extremely challenging, and at the same time, reaffirming my decision to pursue this career.  Although transplant was not my first choice, I have enjoyed it very much and I learn so much every day.  I have seen a lot of liver and kidney transplant patients, and I feel like the complications of their illnesses give me a good systems perspective on the "big picture" of disease and how the deficiency of one organ can affect everything else in the body and the person.  

I have found that there is a unique aspect of psych nursing to transplants that I am not always prepared for.  It's an interesting dynamic - the life of one person depending on the death (or at least major surgery) of another. And what about the person who is in need of a transplant because of their own actions (e.g. alcoholic liver cirrhosis)?  Man I thought OB was full of ethical dilemmas...

But the most devastating situation I've encountered is a patient in need of a transplant through no fault of their own, who became too sick to accept the organ even if one were to become available.  I was almost sick hearing the attending physician explain to the family that the patient probably would not live long enough to recover and receive the long-awaited organ.  I wondered again as I have often wondered,  
why do such bad things happen to such good people?  
I will always remember that patient  - how they held my hand and thanked me for my help even at the end of life.  And though I felt totally helpless, and my heart was breaking for this family, I was glad to have known them.

But as I consider working in rural medicine, I wonder - would I be able to provide the same care for people that I know and love?  Would I have been able to hold it together if that had been a friend of mine?  I remember my Mom telling me once that she hated being an EMT in the county that we're from, because she knew everybody that she was called to help.  A good friend who is a Nurse Practitioner in the same county told me, "You just do it.  You do what you know how to do, then you break down later."

I would be glad to hear your thoughts on that topic if anyone has experience and is willing to share.  Just leave a comment at the bottom of this post or e-mail me at ntbnotes@gmail.com.

A Letter to My Stomach

Dear Stomach,

I was really upset with you this weekend, as you clearly were with me as well.  I don't know what kind of bug got into you, but it got us both down for a while.  Thanks to you, this is what I looked like in class this morning as we learned about the brain in our neurology lecture.  Thank you for rebounding and allowing me to have half a turkey sandwich for lunch.  If you could just chew on that for a while so I can get some studying done, I would appreciate it.  I promise to feed you yummier things than ginger ale and saltines if you are good.

Love, Me

*Picture retrieved from Google Images

Wishful Thinking

So...remember yesterday when I was all "springy spring spring" but I mad the caveat that I live in Colorado and rarely do we escape April without more spring snow?  Well this is what it looks like at my window today.

First it clouded up and the temperature must have dropped about 20 degrees.  Then the wind came.  Then it rained, and now it is snowing.  And Lena and I are both looking out the window wishing for spring to come back soon so we can go out and play.

Oh well, here is my unwanted excuse to sit down and do some studying.

Speaking of wishing...
It seems like every day, in every job, in every situation, there is always somebody wishing that "this day would just be over already!".  We all do it.  We're always in a hurry to get to the next "important" event.

*BUT*

If you knew it would be the last day you would see your friend, the last day you would talk to your mom or dad on the phone, the time you would kiss your kids on their way to school or the last "good morning" you would say to your sweetheart, would you still wish it away?

With recent tragic events in Japan and worldwide and events that may even hit closer to home, I think it is important to remember how precious life is, so hold your loved ones close.  

Don't wish away your days!  Once that time is gone, you cannot get it back.  Time is for love and for making memories - these things live on forever after.

Feeling Springy

Hello again, friends!

I realize I've been MIA for the last couple of weeks, taking some much needed vacation time to see family, and diving head first into the dynamic world of Adults With Complex Disease Processes (aka Med/Surg II).  I am so excited about this class for a few reasons:

1.  Our instructors are incredibly knowledgeable and helpful

2.  I feel like we are getting beyond the basics to the guts of nursing

and

3.  We get to have some input into the floor on which we will be doing our clinical rotation

(Oncology please with all of my fingers crossed!!)

Also, the weather is actually starting to look like Spring!

(Just a little late for Spring Break...)

I have lived in Colorado long enough to know that there is still a very good chance of having snow again before summer is here, but the trees are starting to bud and the afternoons are warm so I am hopeful.  Even enough so to have painted my toenails in anticipation of wearing flip-flops!

Also, I am "on" again in reference to my on-again/off-again workout program, and that puts a little extra spring in my step.  As an added incentive, my ten year high school reunion is this summer, so I try to keep that in mind as I am burning up the treadmill.

(What would I rather be doing...studying??)

Good music gets me through the workouts with a smile, with Grace Potter and the Nocturnals being my latest iPod addition.

(Grace and the gang also make great study buddies.)

***

What do you like to listen to when you study or work out?  Any suggestions for awesome new tunes?    

Halfway There!

Today is a day to celebrate!

I am officially finished with both Peds and OB (successfully complete!), and that means that I am halfway through my BSN program.

Hooray!

Notice the new countdown widget in the right margin :)

It also means that I am on Spring Break.

Hooray!

Although Spring only describes the time of year and not necessarily the weather in Colorado in March.

Plus, we are in the throes of March Madness, which is always exciting!

(And J. is only beating me by one point in our bracket challenge.)

AND

My very best friend Linsey celebrated the birth of her second child today.

Happy Birthday Trace Asher Bishop!

Hooray!

For spring break we are going home for some family time.  First to the mountains to be with J.'s family, then south to the plains to be with my most favorite family ever and ever!  In honor of going home, enjoy a little ditty by Edward Sharpe and the Magnetic Zeros called...HOME!

I Like My Life!

I saw this web video featured on TV and loved it so much I just thought I would share.  Wouldn't it be nice if we could all be this positive, and start out our days like this every day?

Happy Monday everybody!

Welcome to 28

So yesterday was my birthday.  My mom and dad were able to come up for a visit and took me out to dinner for my birthday.  My mom also brought my favorite banana birthday cake! I was overwhelmed with awesome birthday blessings from friends and family - I am so lucky!

If you asked me if this is where I expected to be at 28 years old, I would have said no.  Now I know that 28 is not old, by any means, but up until now I always imagined having accomplished more by this point.  Like, being a doctor.  Or a wife.  Or a mom.  And attending my ten year high school reunion (this summer) with my husband and kids and career in tow.  Funny how things work out.

Now, if you ask me if what I imagined is where I would want to be right now, of course not.  I realize that things don't always happen according to plan.  I also know that I am exactly where I am meant to be.  So here I am, still in school, having fun in my tiny apartment in the city with the best "roomies" ever!

I do know that I am not a big fan of the night shift.  It's not the actual hours that I mind so much, but all of the kids are sleeping for the largest part of my shift.  Not only do I miss the patient interaction, but I hate sneaking into a dark room every four hours and trying my hardest not to wake someone up to get vitals and an assessment.

FYI, sick nine month olds are generally not too happy about being woken up with a thermometer in the armpit.

Since pediatric nursing is not something I was too sure about, I am a little disappointed to not be able to have that clinical experience during the day, for some more patient interaction.

I did, however, quickly rule out the possibility of enjoying a job in the pediatric intensive care unit after a trip through there one night.  Those kiddos are so sick and hooked up to so many machines - I could feel my heart breaking as I watched them sleep.

At least we only have two more weeks of this block (and two more weeks until spring break!).  In two weeks, I will be officially halfway through nursing school.  

Then the countdown to December 16th begins.

And with a little luck, I will have a BSN and an RN license in my hand before I turn 29.

OBjectivity

"The purpose of education is to replace an empty mind with an open one."

-Malcolm Forbes

I'm halfway through Spring block 1, waist-deep in the foreign world of Obstetrics and Labor and Delivery nursing.  I'm enjoying it more than I though I would, although there are some things about the culture of the environment that make me uneasy.

Clearly, there are ethical and moral dilemmas and questions in every field of medicine/nursing.  However, I find the lines of right and wrong and safe and just to be a little...mushy...in OB.  A large focus of our curriculum is to adjust delivery of care to patient preference including cultural and religious diversity.  But no other area of study has caused me to question my own values and feelings so much in order to provide patient care, because there are two patients instead of one. Decisions made by the mother and her family will affect the unborn child as well.

Some examples of the issues I am referring to are:  home birth, "lay" midwives, elective abortion, elective cesarean section, no prenatal care, prenatal genetic testing, illicit drug use and/or cigarette and alcohol use during pregnancy, homelessness during and after pregnancy...just to name a few. 

I have strong feelings about most of these things - as I'm sure you all do.  But what do you do with that?  How do you provide the necessary education to a patient without passing judgment on their decisions?  How do you care for a mother when all you want to do is shake her and say, "Are you crazy!?  Don't you know what you are doing to your child?"

Clearly, I have much to learn about objectivity.  Maybe OB nursing is not the field for me.

Happy Valentine's Day!

I must be the luckiest girl.  I have the best family, friends, boyfriend and dog a girl could ask for.  And even though it doesn't have to be Valentine's Day for me to know that, it is a nice reminder of how loved I am and how many things I have to be thankful for.

And I will keep reminding myself of this as I am resting from today's clinical rotation to prepare for tomorrow's.

I know that Valentine's Day can be a "greeting card holiday".  I know that it can be fun and romantic for some, and lonely for others.  But never forget to count your blessings and be thankful for love - from wherever it comes.

And share it! 

Where there is love there is life.
-Gandhi

Super {Bowl} Sunday

I'm sure most of you know that last weekend was the Super Bowl.

 

I love the Super Bowl, even when my beloved Broncos are not participating.  Most of all, I love the Super Bowl parties!  This year, J, Lena and I had our own little party on a budget, and celebrated the win of the Green Bay Packers in our own little apartment.

And no homework was accomplished.

 

 

We snuggled on the couch and hid from the snowy Denver Day.

No hot wings and nachos for us - a Super Bowl Salad instead.  I got a little creative and crafted this yummy chef salad for our snacking pleasure. 

J did his best to explain the strategy of the game to me.

 

Notice the tribute to the fallen Denver Broncos.  Here's to next season!

Coming Up For Air

Whew!  What a long week!

In my accelerated nursing program, our clinical courses are structured with "frontloading."  For the first two weeks of the course we have class on Tuesday, Wednesday and Friday.  For the remaining six weeks, we have clinical shifts one or two days a week with classes on Friday.  

This semester is the only semester (thank goodness) in which I have dual clinical courses.  So for the last two weeks I have had class from 0800-1700 on Tuesday, Wednesday and Friday.  This week, in addition, I had orientation for my Peds clinical rotation on Monday from 0900-1500, and my first OB rotation from 0630-1900, and my first OB exam in class on Friday morning.  

Yikes!

At least I had paid enough attention in class to do well on my exam without much study time...

As scared as I was about my first twelve hour shift on a labor and delivery floor, I had a really great experience.  I got to meet the most lovely couple who were having their second child.  I wasn't sure the baby would come before my shift ended, but he did decide to make his appearance at the last minute, and I got to help his Mom and Dad celebrate his very first birthday.  It was incredible.

So now, here I am taking full advantage of my Saturday, sleeping in and lounging around while I take a minute to breathe.

While catching up on my reading list, I found a couple of things I would like to share with you, and I think I might try to make it a weekly Saturday thing to share some interesting bits with you.  Any ideas for naming such a weekly segment?

First this week is a few "Survival Tips for Every Nurse" from Nursing Link.  I think it is very applicable to nursing students, like myself, as well as new nurses and experienced nurses.  I especially like the section called, "When You Want To Run - Stop and Stand Still" because I think it will come in handy for me with these two rotations!

 

Second, this is the most adorable video of a puppy bath, set to the music of Ingrid Michaelson (who, as you know, is one of my faves).  It's good for a smile and a laugh.  Five points for cuteness.

Speaking of dogs, here is some interesting and compelling news from NPR Health about dogs and their ability to "sniff out" cancer.  Intriguing, although I'm not sure what the real-life implications of this could be...yet.

Last but not least, the National Database of Nursing Quality Indicators (NDNQI) has recently recognized five hospitals that exhibit extraordinary nursing quality.  I would like to point out proudly that three of the five hospitals are in Colorado!  This article describes four key traits exhibited by all five hospitals that help to make their nursing care extraordinary.  Food for thought in your current or future nursing careers.

Thanks for tuning in.  I hope you all had a great week and are taking advantage of the winter weekend!

All About the Tiny Humans

After two full days of classes, I feel like this semester is already flying by!  With a dual clinical scheduled in Obstetrics and Pediatrics, this semester is all about the tiny humans <3.

This is a reference to <Grey's Anatomy>, by the way!

I have very little experience with the little ones.  While my besties are having their babies, I am fumbling my way through nursing school.  But I love love love babies and kiddos, and I think they are possibly the closest we get to experiencing pure joy.  So I am both terrified and ecstatic for this round of rotations.

While on the topic, I would like to give a shout-out to all the mommies and daddies out there.  Even in two classes, learning all about the pregnancy, birth, and illness experiences with children makes me appreciate the heck out of you guys!
And makes me a little terrified to be a parent.

I successfully passed my third medication dosage calculation exam yesterday (for Peds) with 100% (required).  I will be taking yet another dosage calc exam on Friday for OB.  Gosh! I realize that this is an effort to reduce medication errors in patient care, but I am over these anxiety-inducing math tests!  Ugh, I hate math.
Sorry, Mr. Denning. 

In addition to eye-openers about the secret lives of tiny humans, this semester will also be an introduction to the night life for me.  Twelve hour night shifts during March for Peds...ahh!  You might as well suit me up and ask me to play in the NFL.

Here I go.  And as I learn, hopefully I will come up with some interesting topics to discuss.  I do love your comments and suggestions, so hit me up if you have something to say!
 

 

So far...so good!

Well I'm two workouts into my New Year's resolutions and already thinking about procrastinating the reading for the first classes next week.  

Bad idea, I know.  

While pondering my options and taking full advantage of my vacation, I started to reflect on my nursing school journey thus far.  I thought it would be appropriate to post a list of things I have learned in my first two semesters of nursing school.  Not a list of skills and facts I have memorized, but things I wish I had known before starting last summer.

********** 

So here's what I've come up with (not necessarily in order of importance):

1.  There is A LOT of reading.  It's hard to keep up with.  But class will be so much harder if you don't.

2.  Find good shoes.  I mean really good shoes.  I know that the best shoes are often the most expensive, but it will be worth the investment after two days in a row of 10 or 12 hour shifts.

3.  Nursing requires a good deal of physical strength and stamina. Who needs to exercise?  Oh yeah, I do.

(By the way, I haven't tried that 5 hour energy drink, but I think I might.)

4.  If you have a question, don't be afraid to ask.  Chances are there is someone else with the same question.

5.  If you have the opportunity to practice a skill with a real patient, and they are willing, DO IT!  Dummies are nothing like the real thing and you may not get another opportunity until you are a real nurse.

6.  Eat and hydrate when you can during shifts.

7.  Be open to constructive criticism.  No person is perfect, and your instructors and peers can help you improve if you will listen.

8.  Use caution buying used textbooks online.  Although hundreds of dollars can be saved, you may not get what you ordered.

9.  Be thankful and be kind to your patients, instructors, peers and other healthcare professionals you encounter.  You may need some support or a letter of recommendation someday, or an opportunity to start an IV for the first time ever.

10.  Get a laptop.  Take it to class.  Take notes directly onto the power point presentation and save.  STOP PRINTING! Save as much money on paper and ink as possible - trust me - it adds up more quickly than you think.

10.  Balance.  You work hard, and you study hard, but take care of yourself and don't forget your family and friends!  Sometimes it is totally worth it to have a glass of wine and watch Grey's Anatomy with your honey instead of poring over pharmacology notes a third time.

(BTW, have you noticed the hot hot male NURSE that is flirting with Dr. Bailey?  Love it!)

**********

So here I go into a dual clinical semester armed with this knowledge and eager to add to the list.  This semester will bring an added challenge/learning opportunity as I have been assigned to the night shift for my pediatric rotation.  I have no idea how this will go...I am usually asleep by 10 pm.

Cost Crazy

At the beginning of every semester I get a little nervous waiting for the tuition bill and the syllabi that tell me what $$$ books I have to buy for this round of classes.  And for good reason, I think.  Today, I got a cheerful e-mail telling me that I have a new bill from the University ($$$$) and purchased three textbooks from the University bookstore ($$$) that must weigh 15 pounds each.  One is paperback, so maybe it is only ten pounds.  Even the cashier commented on how heavy the books were as she was straining with her little arms to put them into a bag.

For as badly as nurses are needed, shouldn't nursing school be a little easier to afford?

The anthem of the poor college student.
Grace Potter & The Nocturnals "Money"

And tuition!  I wonder if anyone else has ever experienced this:  I applied and was granted two federal student loans (one subsidized, one unsubsidized).  However, the amount of the loans is not enough to cover my tuition and fees, not to mention my cost of living.  As I am a full time student in an accelerated nursing program, I am currently unemployed (translate: incoming cash = 0$).  How can this happen?  The lovely man at the financial aid office was glad to tell me how this can happen when I called him in a panic, on the verge of tears at the beginning of last semester.  This is my second bachelor's degree.  I am not a true undergraduate student, nor am I a graduate student.  I am in this weird doughnut hole where I do not qualify for loans awarded to the above mentioned students, but can only receive up to a certain amount each year...yadayada, etc., etc.  Has this happened to you?  Were you able to get a private student loan with no income?

I was also curious as to what has been your experience with ordering used textbooks online.  I know that hundreds of dollars can be saved by ordering from sellers on sites like Amazon.  However, twice now I have ordered books that I never received, and I end up buying them at the campus bookstore anyway because I don't have time to re-order.  Do you have any favorite sites to order books from?  Do you have any horror stories?

Well this has been my rant for the day.  I would love to hear your stories and/or suggestions.  We now return you to your regularly scheduled programming.

Like An Open Book

At the end of last semester, each Med/Surg student had a perioperative/ER day that I may or may not have previously mentioned.  We were at the hospital from 0600 to 1830 splitting our day between the operating room and the emergency room.  

So I wanted to tell you about  

the day I decided that I don't want to be an ER nurse.

My day started in the pre-operative area, where I was assigned to a patient undergoing a robotic assisted bilateral salpingo oophorectomy (translate:  robotic ovary removal).  The patient and her husband were lovely and I enjoyed meeting them very much.  I was able to experience the whole interdisciplinary "well-oiled machine" that is the perioperative system from pre-op to PACU.  It was fairly cool.  The actual procedure was super cool.  Not my first choice as an RN, especially the long sterile surgery in the OR, but I think I could do pre-op or PACU if my options were limited.  I miss the continuity of care though as patients are stamped and processed through the machine from one nurse to another, to another.

Then I went to the ER.  The Emergency Room.  Where the waiting room was packed full of sick, tired, uncomfortable and unhappy patients.  Twice while I was there, a doctor or nurse had to go into the waiting room and apologize to the angry patients and explain that all of the beds in the ER were full, as well as all of the beds on the floors upstairs in the rest of the hospital.  Ugh!  I found the experience so chaotic and uncomfortable.  

Even two successful first-stick IV starts weren't enough to convert me.

I find the human body fascinating.  That being said, the human brain is something different altogether.  I have absolutely zero experience with psych patients, or even persons diagnosed with mental illness.  To treat physical symptoms is something I am learning well, but what do you do for someone who is so sad that they have tried to end their own life?  How do you fix that?  There were several psych patients in the ER that night, and I'm sure I had something similar to a "deer in the headlights" look on my face through the entire shift.  I'm not really looking forward to my mental health rotation, but I'm sure I will learn a lot. 

Yeah, I'm not very good at hiding my emotions...or even my thoughts.  My face is like an open book.

Anyway, I now have the utmost respect for the ER nurses who do intake assessments and triage patients and mitigate repeated complaints and manage the filled beds in the rooms and lining the halls and face the ambulance bay prepared for anything.  You guys do great work in a chaotic, stressful environment and my hat's off to you, but you probably won't see me in the ER if I have another option.

I am so thankful for the whole experience.  I had great experiences with all of the nurses, doctors and paramedics I worked with and I was able to see a lot of things that I will learn from, and never forget.  I find that I learn the most from hands-on experience, and I am looking forward to my dual clinical rotation this semester for more lessons!

New Year

Be always at war with your vices, at peace with your neighbors, and let each new year find you a better man.  ~Benjamin Franklin

Well I realize that I am a few days late but here's wishing you all the best in 2011.  Welcome to the year of the rabbit.

Now let me wrap up 2010.  I ended the semester by procrastinating all assignments to the very last moment possible...but ended up with stellar grades in all of my classes - even better than I expected!  I ended up writing my evidence-based proposal about implementing a routine sexual health nursing assessment for adult oncology patients in a rural outpatient oncology clinic.  My professor commented that it was a unique and important idea, but I have experience and my last job to thank rather than my scattered brain.

When all the assignments were finally completed and turned in, J. and I headed to the mountains to visit his family for a few days before Christmas.  Then we dropped about 6,000 feet in elevation to spend some time with my family for Christmas and New Year. 

There was lots of rest and relaxation to be had by all (even the dogs),

there were many games of cards and dominoes to be played,

snow on New Year's Eve,



and the break found me surrendering to the curls that I have battled off and on for so long.

Oh! And more food than you can imagine.  Did I mention that my mother is the best cook in the entire world?  I think my New Year's resolutions will have to go into effect somewhere else...

Speaking of resolutions, I have been trying to think of something new this year.  Of course I always have the same resolutions to exercise more, eat less, study harder, etc., etc., but what could I do that would make a real change in my life and the lives of others?  I know that I can only control myself, and my actions and reactions, so I decided to focus on that - to be a change agent and do everything with love as suggested by my two favorite quotes from two great people:

"You must be the change you want to see in the world."
-Mahatma Ghandi

"We cannot do great things on this Earth, only small things with great love.”
-Mother Theresa

So I will try to make these changes in myself so that I can better achieve my goals and be a better student for my professors, a better nurse for my patients, and a better person for my friends and family.

So I've had a wonderful break, an opportunity to recharge, and hopefully I will still be able to catch up with some good old friends before I return to the world of nursing school.  I noticed this morning that the syllabi have been posted for my two classes this semester, and there is quite a long list of reading for the first class...so my break might not be quite as long as I expected.  I am looking forward to having two clinical courses and no online class though.  OB and Peds here I come!