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.

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

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

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

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?

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.