Check Your Vitals

Jan. 21, 2012

2012-01-25T14:02:00.001-06:00

I finally got my chance to be in labor and delivery today! And it was the most amazing, beautiful, unreal experience!! I cried--and that is something I didn't see coming!

The father was so supportive of his girlfriend, cheering her on, holding her hand, and getting her water as she needed it. And, I was able to take some pictures and video for them, so that was great.

I felt kind of useless, but I know that just being there for them, silencing alarms, and helping hold the mother's leg when the nurse was busy was definitely a big help. And the nurse was AWESOME!! You'd have to be a really special person to work in labor and delivery and love it every day! There are good days and there would definitely be bad days. But she said this was a really good delivery to see--it could have gone so much worse, but considering all the risk factors, it actually went really well.

That experience took up most of the day, and I had very little time to gather my information for the labor and delivery assignment, so I stayed a little late today. That's fine--because tomorrow will be the first day in what feels like forever that I won't have to be up at 0500!!

I talked to my instructor, and she said I had too many nursing diagnoses, and that some of them I didn't have enough evidence or support for. So that simplifies my assignment quite a bit. I will be completing that and studying for the upcoming week! We have a new class that starts on Monday--Research! It's mostly a hybrid class, where we do a lot of work outside of class on the computer, and meet only a few times. This will be nice, since it's that same professor I am really struggling to like.

Jan. 20, 2012

2012-01-25T13:53:00.004-06:00

As expected, there was probably 5 or 6 inches of snow overnight, so driving this morning was definitely interesting. I'm really glad my car has front-wheel drive and snow tires. Neither one is a saving grace, but they definitely help! I did, however, get stuck a little bit when pulling into the coffee shop we met up at. Not for very long, but it was still a little bit nerve wracking and annoying. My partner, however, was late--she got REALLY stuck on a side street. So, when it came time to drive over to the home visit, she rode with me.

The visit went really well. They seemed really settled into their roles as parents and seem really comfortable with their new baby! They had very few questions and were grateful for the information we brought them, as there were some things they hadn't heard of or thought of. When we discussed toy safety, they even had us look over their toys for them so they could make sure they had safe toys for their son. We were there for about an hour, gathering the information we needed for our assignment and providing education, and then we were able to leave.

Then, I immediately set to work on my postpartum assignment and concept map. I had some questions about it, because I wasn't really sure how extensive it needed to be or how many nursing diagnoses I needed to come up with. And, looking at the rubric and assignment guidelines was not particularly helpful, because it wasn't really specific. Being that this assignment is only worth 15 points, too, makes me think I don't have to come up with so many diagnoses. Even with the five I came up (two of which were kind of stretching it), it felt like the most pathetic concept map I had ever come up with. So, I intend to ask my instructor about it tomorrow.

Jan. 19, 2012

2012-01-25T13:47:00.004-06:00

Clinical day number three! And, since I didn't get a second clinical day with a partner because of last week, I got to be with my partner again today. It was nice, although I felt the nurse spent a lot more time talking to her friends than actually spending time with patients. What was great, though, was that we got to follow her around to most of her rooms. I selected a patient to do my postpartum assignment and concept map on, so I look forward to getting that one done and off my plate. Then, all I would have left would be my labor and delivery. Unfortunately, there was not a delivery for me to see today--although the other two who needed to see one got to go. So, I am on the priority list for seeing one next time.

Overall, it was a pretty good day. We got to help with discharge education, as well as admitting a new patient to the floor.

When I got back to my apartment, I had to do some prep work for our home visit assignment tomorrow morning!! They want us to come over at 9, and my partner and I are planning on getting together at 8 to review what we have. And, looking at what the weather is planning on being like overnight, I know I have to get up extra early to get ready and leave with plenty of time to accomodate for the snowy conditions!

Jan. 18, 2012

2012-01-25T13:36:00.002-06:00

Since we had a holiday on Monday, we had to have class today (Wednesday) my normal day off. Which means that the other clinical groups only have one clinical day this week, while we still have two. Worry you not, though--it will be balanced out in two weeks!

Today we had a quiz. And wouldn't you know it--the professor had quesitons on it that were not from the chapters we had to read. It was only after we protested this that she said she would consider altering our grades because it was unfair to have had questions that we weren't told to study for. The e-mail she sent out later, added insult to injury, as she said she was being generous to do so. This coming from the professor who claimed she hadn't looked at or revised the quiz questions on the medication quiz in five years. This threw some of us off--because one of the questions in particular had a correct answer that was no longer in practice!

In any case, we had simulation today. And let me tell you, I felt completely shattered afterwards. Confidence? Broken. I don't believe I was ever cocky or overly confident--but I felt I was at least competent in being a nurse, and I didn't feel that way after this simulation at all. But, the professors said we all did a good job.

The scenario was a woman coming in to the hospital because she hadn't felt her baby kicking as much. SHe was found to have hypertension, so she had to be admitted. She had to have a Foley placed, as well as an IV. Then, the lab work returned that she had HELLP syndrome (hemolysis [breaking down of blood cells], elevated liver enzymes [from the blood being broken down], and low platelets [not able to clot as well]). When it got to my group of five, she had a hemorrhage, and I was the medication nurse. Everyone said I did so well with the calculations and medication administration, but I was shaking and honestly felt like I wasn't doing good at all.

Oh well--it's time to shake it off and get ready for clinicals tomorrow!

Jan. 17, 2012

2012-01-25T13:06:00.003-06:00

Happy Anniversary to my parents!! 31 years, I do believe!!

Now, you may be asking why I'm writing on Tuesday. We didn't have class yesterday!! So I had some extra time to work on my newborn paperwork, prepare for simulation this week, study for the examination and medication quiz today. I feel the examination went well, and as I was leaving the medication quiz, the instructor gave me a thumbs up, so I know I passed it this time. We had a little bit of a short day today, though, since there are some check-offs this afternoon. This is fine by me, because I was pretty brain-dead after the exam and quiz today. And, I can spend a little more time working on the simulation prep work, making sure I know what I am going to have to do for tomorrow.

Jan. 14, 2012

2012-01-25T13:02:00.001-06:00

A few more people had the opportunity to go to labor and delivery--which left me partner-less! So where did the instructor put me? In the nursery!

And yes, I was terrified. But, I got to do a lot of firsts today! I changed my first diaper--and yes, I mean ever! I got to watch a circumcision, which, as barbaric as it looks, was not too terrible. The physician talked me through the whole procedure and had a lot of insights and knowledge to share. As much as the nurses thought I would pass out--I didn't! I have a much better stomach than most, I think--at least better than the medical staff I work with gives me credit for!

I also got to give a shot--the Hepatitis B vaccine--and help with assessments and hearing tests. It was, between all of these things, a fairly slow day in the nursery, since most infants are with their moms for most of the day!

In post conference this afternoon, we learned about fetal heart monitoring and did some practice with analyzing them. By the end of the day, there were only three of us who hadn't gone to labor and delivery. So, assuming there are enough women having children next Thursday, all three of us will go--but I am last on the list, so I may not go until Saturday.

Time to set to work on the newborn assignment paperwork!

Jan. 12, 2012

2012-01-25T12:55:00.003-06:00

Today is my first official clinical day! I was up at 0500 to make sure I could get there at 0630! And what, you may ask, was the weather like? It was a baseline 3 degrees out, snowing with 17 mph winds for a windchill temperature of -17. I FINALLY got to wear my new down jacket that my mom gave me for Christmas!! It was a great day in clinicals, too! I had a great family to care for. The instructor paired us up with primipars (first-time moms) so we could have a good family to offer a home-visit to. It was very tough to get a chance to ask if they would be willing to allow us to come over, though, since there were so many people visiting! Which is fantastic for them--having a great support system is so important.

But, we got them to agree to allow us to come over and teach them some things, and basically just make sure they are doing well. And by we, I mean myself and my partner, since we are paired up for the first two clinical days and for the home visit.

And, wouldn't you know it--half of our group already got to go to labor and delivery to watch a delivery!! How amazing is that!! The instructor said that's almost unheard of!!

Since I was feeling somewhat ambitious, I headed to open lab after clinicals. I was able to sign up for my check-off on January 24, as well as the other check-off we have in February. I tried to practice a Foley Catheter insertion, and I think I did alright, I was just too tired to actually feel like I was getting anything out of it. I don't think the procedure itself is particularly difficult--it's just going to be the whole sterile field deal (whihc apparently is very easy to break) that will be difficult.

Now, off to studying and sleeping!

Jan. 10, 2012

2012-01-25T12:48:00.004-06:00

So, of the 20 questions on that medication quiz, I missed 5. This means I have to retake it. Me and 14 other people. The things that killed me was the routes of medications. The rubella vaccine is given subcutaneously--NOT intramuscular. Methergine is given intramuscular--NOT intravenously. Oh, and the best thing to give with iron is orange juice--not a meal.

And, I'm not sure I could honestly tell you what we lectured on--because I couldn't really focus on anything else after doing miserably on that exam. Thankfully, though, we got out at 1200. Groups 1, 2, and 3, though, had to stick around and do the first simulation experience from this term.

So, I will be working on relaxing and studying more for the re-take of the medication quiz I will have to do next week. No clinicals tomorrow!

Jan. 9, 2012

2012-01-25T12:44:00.002-06:00

Happy Birthday to MEEE!!!!!!!!!!! I'm 25 years old now! That is a quarter of a century, and as my fiance likes to remind me--I am very old now!

I did a lot of baking yesterday, as it seems to be the tradition for the birthday person to bring the class treats. And these cookies went over amazingly well--they were mostly gone by the end of the day!

They had a dual purpose, too--not only in celebration, but to lift our spirits after the first examination.

I think I did pretty well, but good grief--the study guide AND the reading guides were not helpful at all! Luckily, we had the other professor teaching us today, so it was a much better day in lecture than it otherwise would have been.

Class until 3:30, although we got out earlier, which was nice! And, one of the girls in class asked if I wanted to go out to lunch or something in celebration. I hadn't even thought of doing something like that, so it was nice that someone was so kind! So, I had Olive Garden for lunch--YUMMMM!!!!!!!!!!

Afterwards, though, I had to go study for the medication quiz in the morning. The best part about this? I have to get an 80% on it to not have to retake it. And, should I have to retake it and not do well, my parents will get sent a midterm deficiency notice. Yeah. Interestingly, we never had a medication quiz in the previous two terms that had such weight. So it makes me wonder why these medications are so much more important than, say, cardiac medications that most of us will be administering more often. Oh, and did I say the study guide for this quiz is 30+ pages? Bring it on!

Jan. 7, 2012

2012-01-25T12:36:00.002-06:00

We had to meet at the hospital at 0730, at which point we took a tour of the hospital. Our instructor showed us the best door to come in at, the best place to park, as well as the locker rooms we were to use. Then, she took us up to the triage area, where women are monitored to see if they are in labor. If they are, they are transferred to an actual labor room on that same floor. And, if they are discovered to need a C-section, they are taken straight to the operating room on that same floor--right down the hall, actually.

We got to see one of the labor rooms. What an amazing thing! It looks very comfortable, but if you move some of the paintings and open some of the cupboards, they reveal the suctioning and oxygen equipment, as well as some other medical equipment to use when the baby comes!

After a few hours in the labor area, mothers are then moved up to their family suite in the postpartum unit on a different floor. We got to tour this area next, as this is where we would be spending most of our clinical time. This floor is incredibly secure, with only one door in or out for family and guests. All other doors require a staff badge to open. The nursery is the central hub. Infants have a two hospital bands, and one third band that has a security tag, which I would equate to those tags on the expensive clothing at department stores. Except it doesn't explode ink on the baby when it gets near the door; it sets off the alarm system on the floor, and the entire floor shuts down. So, basically, it's an infant security system. Also, the mother of the infant will have a matching tag sort of thing that, when mother and baby unite, it sings a little lullaby--another way to ensure the right mom is with the right baby.

Then, we had to do a scavenger hunt on the floor, and then do our check-offs. I did pretty well, considering I was really nervous about doing it--seeing as how we just learned the information this week! But, I am authorized to begin my clinicals on the floor next week!

Jan. 5, 2012

2012-01-25T12:16:00.001-06:00

Last day of classes this week!! Huzzah!! I don't think I mentioned it, but classes have started at 0800 and haven't gotten out until 1700. THAT is a long day.

We finished up our team-based learning, then had some lab quizzes on IV meds and Foley Catheters. Then, I opted not to go to open lab, since it had already been a long enough day.

I did well on both quizzes, which is awesome!

Oh, and the weather is CRAZY!! It's 60 degrees here!! Which is odd, since it's winter. And it really should be much colder than that. Even crazier? The Weather Channel is calling this "Severe Weather". I'm sorry, but 60 degrees is not severe--although a record high temperature in the Summer would be severe weather!

But the best news of the day? I get to sleep in tomorrow!! All four other clinical groups have their orientations tomorrow, but I have mine on Saturday.

Jan. 4, 2012

2012-01-25T12:03:00.000-06:00

Lecture again at 0800, during which time we had lecture. Well, at least that's what I'd like to say. Instead, we have "team-based learning". And, we don't even get to choose our teams! I can appreciate the wisdom in randomly selecting our teams--we are going to have to learn how to work with all sorts of people, even people we may not get along with or associate with. However, I feel I would learn better if I was in a group of people I am friends with or associate more frequently with--or just am more comfortable around. Not to mention that we are basically being asked to learn the material ourselves and then present case studies. So, read your textbook and then teach the class.

I can see this being useful in some settings. But when we are learning how to care for human beings, I don't think having inexperienced nursing STUDENTS read dry textbooks and then present the information is the best way to go about it. The professors are supposed to be TEACHING us, using their experiences and the textbook as a guide that has the most up-to-date evidence-based practices.

Not to mention that if you get a bunch of students in groups, how many of them are actually going to do the group work? Only one or two, and the others will just chit-chat.

I am frustrated by this method of "learning"--if you can even say that we are learning anything. I know I am learning a few things, but I don't feel I am getting as much out of it as I could be getting if it were a more traditional, lecture-style class.

In any case, I will hope that the other professor who teaches this class will have a lot less team-based activities, and a lot more lecturing.

And now that I am done ranting about this ridiculous experiment in learning, I will go on to say that we had lab this afternoon. We got to meet our clinical instructors, and then we had the opportunity to watch the instructors demonstrate the postpartum and newborn assessments. The catch? We have to check off on these during our hospital orientations this week. If we don't pass, we don't get to participate in clinicals--they have to make sure we are competent enough to handle doing these assessments on real patients.

Upon getting home--I feel like sleeping, but I have many more videos to watch and readings to get done before class. At 0800 in the morning. Again.

Jan. 3, 2012

2012-01-25T11:49:00.002-06:00

0800 is way to early to have a class. Especially after two weeks off. We had orientation this morning for a few hours, followed by lecture. And, after a very confusing break, trying to figure out which clinical group I am actually in, it turns out that I am not in the clinical group in which I thought I was. So, instead of having Thursdays, Saturdays, and Sundays off, I get Wednesdays, Fridays, and Sundays off. At least for the Maternity/Newborn set of clinicals. It will change when we get to Med/Surg and Pediatrics.

We were supposed to have taken a quiz right after orientation, but our professor decided to give us time to let the information slip from our minds, having to sit through some class-time before the quiz.

Oh, and I should mention that the professor for moms and babes is one who I am not thrilled about learning from for reasons that I will come to explain. I am trying to give her the benefit of the doubt and make an effort to pay attention--she just makes it very difficult.

UPDATE: I meant to take a power nap after school today, because it was such a long day. And I didn't wake up until about 0130 on January 4. So, I spent some time watching videos and writing the summary I had to write, and then went back to sleep for a few more hours.

Jan. 1, 2012

2012-01-25T11:39:00.000-06:00

So first, let me say Happy New Year!! It's 2012!! And we will, at the end of this year, be finding out if the Mayans were on to something!

And next, let me say, I am so sorry for being so ridiculously behind on my blog. It has been a crazy busy semester so far, and I've finally a moment where I have the time and the courage to tackle the arduous task of catching up! So, here we go:

It was a nice relaxing evening on New Years Eve. We had planned on going to the First Night festivities, but we decided instead to spend our last evening together for this visit at home. Then, I packed up everything in the morning, spent some time with my sweetheart, and then went to the airport for my flight back.

I freely admit that I was sobbing. I knew it was going to be difficult, but knowing it doesn't really make it any easier to cope with that feeling of separation.

The flights back were good, though. Nothing terribly interesting to report in terms of that. Although I will say that the weather, upon my return, was FREEZING!! I checked the weather after getting back to my apartment, and it was amazingly cold, with the wind chill reaching into sub-zero temperatures. I was amazed that my car even started after two weeks!

School starts back on Tuesday. I suppose I had better begin studying!!

Dec. 25, 2011

2012-01-05T13:49:00.001-06:00

Okay, so about that next year thing? JUST KIDDING!!!

MERRY CHRISTMAS!! HAPPY HOLIDAYS!!!

And for us? CONGRATULATIONS!!!

I got a fiance for Christmas!!

It was the most perfect morning! We opened all of our presents, and he said, "Hey, you missed a present in the tree". So I went searching for this present I had apparently missed, grabbed it up from the tree, and sat back on the couch with my sweetie. I took off the THREE layers of wrapping paper and got to a box. My heart was racing, but I was so sure he wasn't going to propose until after I was done with school....

So I opened this small box.... and saw this:

But worry not!! The disappointment and confusion didn't have long to set in, because he pulled out another box, opened it in front of me, and said, "I was hoping that you would want to be my wife".

I cried immediately!! SOOO HAPPY AND SURPRISED!!!!!! After only a few seconds, the only thing I could say was, "Of course!!". And I took off my promise ring, and he slipped on the most BEAUTIFUL engagement ring EVER!!

I am very happy!!! I have such an amazing man in my life--I feel so honored and lucky!

And apparently, everyone and their dog knew for FOUR MONTHS!!! Except, of course, for me!

Dec. 18, 2011

2012-01-05T13:29:00.002-06:00

Last night was AWFUL!!

I took a couple of benadryl to help me sleep (I was too excited to sleep!!) at around 9:00pm or so, and I was woken up by the herd of elephants upstairs stomping around at 10:30. And I could not go back to sleep. I tried, I really did. I played soft music, I played some ambient sounds. I played some games on my iPod to try to tire me out. Nope. WIDE AWAKE.

I finally gave up around 3:30am and decided to get up and get ready. Good thing I did, too. My one checked bag was pretty heavy, so I took stuff out and put it into a second. When I got to the airport, it was a really good thing I did that, because my big checked bag was just shy of 50 point at which they charge you more money for having an extra-heavy bag.

Besides that, the flights were fine, although the three-hour layover in Denver was unpleasant.

I got to the airport a little earlier than anticipated, and my boyfriend wasn't there just yet. He got stuck in traffic. So, I grabbed up my bags from baggage claim, and stepped outside--and there he was!! I cannot express how GOOD it was to see him!!

Then, we went out to lunch and went HOME! He decorated the place so well! All our little figures (our Chinese dragon, our Indian statue, etc.) had Santa hats, and the tree looked AMAZING!!!

I am so lucky!! It's gonna be an awesome break! So long until next year!!

This is our GORGEOUS tree!!

This is one of our special ornaments for the year; we are adding two special ornaments each year, in hopes that one day we will have Christmas trees with just unique ornaments!

Here are our other special ornaments; we actually got three this year.

Here's the North Pole Village we are collecting. We actually have many more than these three, but these are the three oldest in the collection!

Our pair of teddy bears in their Santa & Mrs. Claus outfits!

Nightmare Before Christmas scene!! I love this!!

Here's our Indian statue with a Santa Hat!

Like I said--everything had a hat....

Dec. 15-17, 2011

2012-01-05T13:07:00.001-06:00

December 15th:
My apartment is already nearly cleaned, with just the bathroom left to clean. Yeah, I know I should be focusing on studying, but in all honesty, the class with the remaining final is so common-sense that it would be a waste of my time to study. Not to mention that the study guides provided for previous exams didn't help AT ALL for examinations. So, I feel good having spent my time cleaning... although I'm not really sure what I will do after the final.....

December 16th:
The final went just as expected: exceptionally common-sense, and the review I did of the study guide didn't help. Regardless, first one done again, and the professor looked up, pointed, and mouthed "I knew you'd be the first one done!"

I was able to finish up all my cleaning, with only some more packing, dishes, and laundry to be done. YAY!!!! I fly home on Sunday!!!

December 17th:
All packed! You know, except for the few small things like my toothbrush and other minor things that are packed last-minute.

I will be getting up at 4:00am, to leave by around 4:30am, then get to the airport by around 5:00am, board a plane around 5:40am. Said plane will then take off at 6:10, and arrives at HOME at 12:23pm!!

I'LL BE HOME FOR CHRISTMAS!!!

Dec. 13, 2011

2012-01-05T12:50:00.001-06:00

Blah, I dislike how I feel after Pharm exams. No matter how much I study and prepare, I never like how I feel coming out of it. At this point, the only way I can get an A is if I get 100% on the exam AND get a full 10 points on the extra credit paper. Pretty sure I will come out of this with a B, which is FINE with me!

Hopefully the professor gets these grades out quickly, although knowing her, it will take a while.

Now to set to work on the extra-credit paper.... after a nap...

Dec. 12, 2011

2012-01-05T12:46:00.004-06:00

Only a quick update: I got a 97% on that med/surg final!! THAT is how you start your finals week!!

Dec. 11, 2011

2012-01-05T12:45:00.002-06:00

First exam is done. And who was totally prepared? Oh yeah, this kid here. I ROCKED that exam, and was the first one done. In fact, it was 120 questions, and I was done in 45 minutes.

Now I will spend some time working on studying for Pharmacology. Oh, I also handed in my long-term care paperwork, since it's actually due tomorrow and I don't feel like going out if I don't have to. It ended up being close to 40 pages I think? Maybe more than that.... It's off my plate, so I am not really worrying about it!

Dec. 10-11, 2011

2012-01-05T12:42:00.001-06:00

While I should be studying this weekend, I freely admit that I have spent more time wrapping presents and preparing for packing. And sleeping. I love that I get to sleep in. I did, however, manage to read every single page of notes from my med/surg class -- which my professor stated to be impossible! Bwahaha!!

Yeah, I hope it helps, though. If not, that would have been an enormous waste of time. First exam in the morning, and then I can focus my energies on Pharm.

Dec. 9, 2011

2011-12-17T17:43:00.001-06:00

(I am so sorry for being so behind... I have a lot of catching up to do!!)

Last day of clinical for the term, and I had a rather mild patient. This client was one of those who, despite looking "awful" on paper, was really not so bad in person. Just a lot of stuff going on with her, a large medical history, but the actual process of the day was great.

So, it was just a very low-key, relaxing almost sort of a day.

I had my evaluation with my instructor today, who had a lot of good things to say. She liked how organized I was with my nursing process, making sure all my Ts are crossed and Is are dotted. She also liked how clean I was... I think she meant she liked how I have such a focus on staying clean and organized....

It was good to hear those things, as well as have her offer to be a good reference for me someday when I am applying for a job.

Besides that, and a particularly lengthy post-conference, not much else to report. (That... and I sort of don't remember much else....)

Dec. 8, 2011

2011-12-17T17:42:00.001-06:00

0800 is too early for an exam.... Seriously.... that time of the morning comes about way to early anymore. But, being that it was a Community Health exam, it really wasn't so bad. Once again, I studied from the study guide, and it didn't really help. At all. Well, a few things helped. But overall, basically a common-sense, don't be dumb kind of a test.

Theory was so intense this afternoon, though. It was med/surg, and we had a TON of catching up to do, since we were cut short last week because the professor wasn't feeling well, and cut short today because of the exam being moved into lecture time. And even more because the professor needed to end early to make another doctor's appointment. So, it was the world-record of lecture with a ton of material in a very short amount of time. I think we had 40 pages of notes to go through--and that was just the outline.

But, we did, and it was good. LAST LECTURE OF THIS TERM!! Of this year, even!! HOOORAAYYYYY!!!!!!!!!!

Clinical in the morning. I don't think I mentioned it, but I turned in that database/concept map/care plan/teaching plan last Saturday, along with my surgical experience write-up. I am really hoping she has it done, so I can know where I'm at!!

Dec. 7, 2011

2011-12-17T17:38:00.003-06:00

Pearl Harbor Day. A date which will live in infamy. But apparently not as much as we think--not really much on the news or anything about it being Pearl Harbor Day... Have we already forgotten?

So, there was that Pharm exam and quiz today. I feel I did pretty well, although there were a few questions I was really kicking myself over afterwards. I hate feeling like that. Luckily, the professor pushed the quiz until the end of class-which gave all of us more time to study for it. I feel bad saying that, but it's true--I mean, I was sort of half-way, kind-of paying attention through most of the lecture. But I did read through the notes relevant for the quiz a few times, too.

In any case, I am VERY happy that the exam scheduled for this afternoon was postponed until tomorrow morning. I would not have been able to function very well if it was actually on for this afternoon.

But, what we did do this afternoon was make up points on that completely botched med/surg exam from last week. I am grateful our professor is letting us do this. As it turns out, I got a 75%, which, by this program's standards, is failing. (76% is the lowest you can get and still pass). So, I was able to make back half of the points I missed, which bumped me up to an 88%. Very nice--my grade isn't so damaged now!!

Dec. 6, 2011

2011-12-17T17:34:00.001-06:00

So yes, I did have a different patient today. My patient from last week got sent home a few days ago. Today I was assigned a fairly old little lady, who had some interesting cares. She had a pacemaker placed recently, as well as an ostomy bag. Didn't know about the ostomy until I got into her room. Wow. I was really unprepared for that. I did wound and dressing checks on those, administered meds (using a Pyxis for the first time!!), and then spent the rest of my day answering call lights and typing up some more for my paper. Not much else I could work on, though.

I was happy to be done with this experience; I feel a bit robbed, though, because it wasn't actually long-term care. Oh well--I imagine it's fairly similar, just the clientelle move through rehab faster.

Pharm quiz AND exam tomorrow. Yuck. Study, study, and study some more. It's all memorization, but still--it's tough material. And, it's being taught from the perspective of a medical doctor / PhD, not from a nursing perspective. Basically--it's being taught at a level much higher than what we need to know. Still good to know, but I don't feel I'm getting all the nursing implications.

Dec. 5, 2011

2011-12-17T17:29:00.001-06:00

A day of quizzes and tests. I am really looking forward to finishing up this term.

Today we had our last quiz in Community health. It's such a shame that I spend time studying for this class, when the study guides and the notes aren't all that useful. The test questions themselves are really mostly common-sense type stuff applied to the nursing field. Oh well....

And this afternoon, we had our on-campus lab final. I really studied hard for this last night, not really knowing what to study, since there really was a lot of reading/videos to go along with the material. Turns out, the questions were more general, procedural things, and nothing very specific. This is nice, because with the professor we have, I would have anticipated it being much more nit-picky and precise. So, 100% on that one!!

I spent the rest of the evening trying to finish up what I could from Long-Term Care, since I have that again in the morning. I just know my patient got sent home, and that I will end up having a new patient tomorrow. I'm bummed out by this, because I really, really wanted to finish up what I could from the information packet. And, after having gone through what I could, I was able to highlight in the packet what still needed to be done---and it isn't as much as I thought I was missing.

Early morning tomorrow!

Dec. 3, 2011

2011-12-17T17:24:00.003-06:00

So I am shamefully behind... like, really very badly behind.... I am attempting to catch up now...

After an amazing surgery experience yesterday, I am still blown away. And I could not have had a better patient for the day than the one I had today. He was so sweet and so talkative and fun to work with. He was very into his geneology, and shared with me many stories that he had to tell about his Scottish heritage. And, I was able to share some of my heritage, since I go back to the Royal Stewarts myself, so it was fun.

Something that made the day even more fun was how BUSY he was! It was truly one thing after another, with everyone wanting a piece of him--blood draws, echocardiogram, Doppler studies of the legs, cardiac cath lab, and the doctors and nurses who needed to do assessments.... and then there was little, ol' me who needed to give him as many of his usual meds and the newly ordered meds before the cath lab came to get him. I ended up having to have them wait while I pushed this one med into his IV, which had to be pushed over three minutes. It was a crazy busy morning!

When we got to the cath lab, I went to the observation room, and my patient waved at me. He had said that he used to be in the military, jumping out of planes, but the thought of the cardiac catheterization scared him very much. So, I think it was nice for him to have a familiar face there for moral support. Then, they strapped down his arm, in case they would use it for the access to his heart, and as he tried to wave at me again with that arm, the nurses in the room yelled at him. I felt kind of bad that he was getting in trouble, haha!

His procedure went fine, and his heart vasculature was very healthy--always a plus. By that time, though, one of my group-mates showed up to see the procedure--that was already finished. Luckily for us, though, the cardiologist talked us through the entire procedure, showing us what he saw and what he didn't see on the videos that were taken. Very cool, and I am very grateful that he took the time to do that for us.

After that, I spent the rest of my day finishing my assessment and helping out where I could. A busy morning made the day go by pretty quickly, and truly, my patient was so pleasant, that certainly helped, too.

It was snowing as I left the building, with a thin layer sticking. Winter is on it's way!!

Dec. 2, 2011

2011-12-02T17:28:00.001-06:00

Is it just me, or has this week gone by incredibly fast? It feels like it has...

Anyways, so I was up at 0200. WIDE AWAKE. I hate getting sick, I really do. Luckily, I was able to go back to sleep until 0500 when my alarm went off. Surgery this morning, and I have to be there at 0630! The instructors have told us to have a good meal, so I made myself egg burritoes this morning. Not only is it perfectly delicious, but it is also very filling and sticks with me for most of the day. So that is great.

I met my friend outside the building so we could walk in together, and it was about, oh, 10 degrees out. Yup, cold. And I don't like it!!

Anyways, we found our way in and made our way up to the surgical waiting room and put in a call to the coordinator. She walked in a few minutes later and took us to the locker room, where we had to change into the hospital's scrubs (yay for no student uniforms!). We then met her in the lounge area, where she told us a bit about our patients and what the order of the day was going to be. Then, she escorted us downstairs to the preoperative area, asking us about our interests and our previous majors. I told her I was a sociology major with an interest in hearts and expressed my hope that I would get to see a heart. By then, we had arrived at the holding area, and she introduced us to the nurses who we would be with for the day.

We each then sat down and started taking notes on the stuff we needed to have prepared for the assignment (i.e. labs, client history, etc.) and spoke with our nurses a bit. My friend's patient arrived, and I just continued asking questions about the preoperative process, and my nurse was very friendly and willing to answer any questions I had. 20 minutes after the expected arrival time, my patient still wasn't there, and she wasn't answering her cell phone or her home phone. Then we heard she called in the day before and seemed apprehensive about the surgery--the feeling was that she might cancel.

So, I called the coordinator to see what she thought, and she said she would look for plan B and then come find me. A few minutes later, she arrived and said her plan B was to have me go see an aortic valve replacement--A HEART!! The only downside was that I would miss out on the pre-op and post-op care, because the pre-op was already done and the post-op was done in the ICU setting (not a PACU, like our assignment tells us). At that point, I really didn't care--I was going to see a heart!!!

Just as we were leaving, my original patient arrived, so we made a modification to plan B -- I go see the heart, and the coordinator would pull me out when my original patient was done, so I could do the PACU care. Sounded good to me!

Off we went to a completely different area. The cardiovascular surgery area is separate; it has three operating rooms dedicated to just these patients, and an ICU attached, so if a patient needs to be taken to surgery, there will be an OR available and close to the room. What a great idea, huh?

I got in the operating room, and met the circulating nurses and the scrub techs, who were hard at work in their sterile field, setting up a LOT of instruments. The cardiopulmonary perfusionist was there also, setting up the heart-lung bypass machine. There was also an anesthesiologist and CRNA, monitoring the patient. The anesthesiologist was also looking at the trans-esophageal echocardiogram (TEE) and taking images that would be useful for the surgery. I was told ahead of time that the surgeon doesn't like people talking during the case, so any questions I had should be asked now.

The coordinator came in with me and showed me around, literally holding my hand to guide me through so I wouldn't enter the sterile field around the patient. We made our way over to the anesthesiologist, who was kind enough to show us some of the images he had taken and tell us what we were looking at. Very cool--and I was able to see the difference on the post-procedure TEE.

Right about that time, the surgeon came in, and I was able to meet him and his first assist, as well as thank him for letting me come in on such short notice. While he and his first assist were putting on the sterile gown and gloves, there was a time-out procedure to make sure everything was ready to go, with the right patient, and to verify the procedure.

Then, everybody got in place to begin. I took my place on the right side of the patient, kind of behind the surgeon to his left, several feet back from the table. Yeah, I didn't explain that very well, but you can figure it out. I had a pretty good view of what was going on, so I saw the incisions through the skin, subcutaenous layers, right down to the bone. Electrocautery was used to cauterize the little blood vessels to reduce the amount of blood lost as well as reduce the amount of blood in the surgical field. And yes, it does smell funny. Not funny "haha" but funny "weird". But burning hair still smells worse.

Anyways, then the surgeon got out the bone saw. It was like a little power tool, hand-held deal--not nearly as big as I'd imagined (obviously based on movies, right?). What I thought was interesting was that they deflated the lungs before cutting the bone, so they had less of a chance of cutting one. Kind of a good idea, although you just know that somebody learned it the hard way.... Yeah....

I'm not sure this is exactly it, but it looks pretty close..

So, the process of cutting through the bone was actually a lot faster than I expected. As in, less than 30 seconds. Then, they put a sterile towel over the site, put in the retractor to hold open the sternum, and cut a hole in the towel. This was cool, because the towel could soak up blood while also acting as padding between the metal retractor and the patient's tissues (which would probably get more sore without the padding).

This is the sternal retractor, and you can kind of see the little cylindrical things on the top where sutures could kind of be hooked? Yeah, that comes next in your reading...

Then, a lot of time was spent putting sutures in the fascial layer (the muscle layer that lays over the ribcage). This actually helped keep all the subcutaneous fatty tissue back up away from the surgical area. The ends of the sutures were actually kind of clipped onto little ridges or something on the retractor, so the tissue was absolutely stable. These sutures would then be later used to close up that particular layer of tissue.

So, more tissue, more electrocautery, and I'm still back behind the surgeon. And then I saw it. The heart, beating within the open chest cavity. There are not words enough to describe how amazing that truly was for me. There's the thing that pumps blood through our bodies, that is essentially the engine that keeps us going. No bigger than your fist, and yet it is so important. I had the perfect view of it, coming from the patient's right side.

Alright, so enough marveling, for now anyways. The surgeon then moved more in front of me, blocking my view, to insert the cannulae for bypass. Although I did see a lot of squirting blood. Yup, splashed quite a bit, although I guess that's to be expected from a muscle designed to pump blood throughout the body! Then, they put in these cannulae, and the one was at least an inch in diameter... huge... and at this point the nurse was holding the tubing with the open end upward (obviously) until it was connected to the pump, but as the heart was beating, you could see the blood moving up in the tube. It actually looked kind of funny, but it was still pretty neat at the same time.

Okay, so when bypass was initiated, the lungs were deflated again and the anesthesiologist left. I then moved to where he had been standing, and the nurse put out a step-stool for me to stand on. I was standing basically at the patient's head, looking down into the chest. And it was awesome. The heart was still beating in the cavity with these huge tubes coming out of the chest, and you could see the blood moving through them. Then, they put ice around to heart to cool it down and keep it cool.

Once the heart was stopped, the surgeon began cutting into the aorta. He cut it about.... hmm... maybe a half inch or so away from the heart, not too close but not too far from the aortic valve. Then, he looked around with a little dental-type mirror to see what he was up against, and then started cutting away the valve. Now, when I saw it on echocardiogram, the anesthesiologist said it was bicuspid (which means there are two leaflets; the aortic valve is suppose to have three leaflets) and that there was a lot of calcification on it. It wasn't able to open as well as it should, is basically why they were replacing it.

The normal aortic valve has three leaflets, but the bicuspid aortic valve has only two--almost like there should have been three but it didn't cleave or something... I have it on good authority that people can live symptom-free for many, many years with a bicuspid aortic valve, although they usually tend to notice it in their 30s or 40s

So, after cutting away what he could with scissors, the surgeon then gripped the remaining tissue with a huge pair of tweezers and took a scalpel to cut away the rest. Then, lots of rinsing with what I assume was normal saline delivered in what looked like turkey basters. The surgeon then tried out some valve sizes. The companies that provide valves send out little models that are the size of a particular valve. One company had a test thing that had how big the valve actually is on one end and then on the other end how it would seat, with the attachment material on it also. So, the surgeon played around with 19-mm and 21-mm valves from both companies, and decided which was best.

The next part was probably the most tedious part--putting the sutures in place. The sutures are pledgeted, meaning they have little pledgets on them, which are used to absorb some blood but also to protect the wound. The surgeon used 14 sutures in a 21-mm or so area. It was very meticulous work to put them all in just right so the pledget is in place and you have both ends of the suture coming up (don't worry, I have a picture to show what I'm talking about). What was good, though, was there was a suture keeper device to keep them all separated and in order--because the ordering of it is very important.

See the white thingies? Those are pledgets.

If you look kind of around the hole, you can see where the pledgets are. Look also how the sutures have both ends coming off. That's important for later.

And here's the suture organizer. For one suture, each end goes on each side of the blue. This helps number them , keep them in order, and keeps the ends from tangling.

Right, so once all those were in place, the surgeon then started attaching the valve to the ends of the sutures already attached to the heart. In order--remember how I said that was important? If they get out of order, things aren't going to line up right. So, that was a little less meticulous, but still meticulous work for the surgeon.

So here you see all those sutures sewn through that valve, and now they will just slide it down into place.

When all the sutures were through the valve, it was put into place, the sutures pulled tied, and then the knotting began! Lots and lots of knotting. At least 30 minutes' worth. But, it's very important to make sure the valve is in the right place and is secure. Especially considering the high volumes and pressures the aortic valve has to endure.

And here's the valve in place, "pulled down" the sutures. From here, the surgeon will begin knotting everything up to tie it in place. Very cool stuff.

Once that was done, and having checked meticulously throughout for any problems or errors in suturing, he began closing the aorta. Again, more sewing. But that is one artery you do NOT want leaking. Once the aorta was just about closed, I was asked to move, as the anesthesiologist was back to prepare for weaning off bypass. It was over before I knew it, actually, and closure began shortly thereafter. I actually missed the retractor coming off for how many things were happening so quickly.

The first layer to close is obviously the sternum. I have never seen a bigger suture-needle in my life. That thing was a friggin' beast! I mean, of course it has to be to thread wire through bone... but still... you know... it was intimidating....

It took two people--the surgeon and the first assist--to tighten up the wires simultaneously to the point where it was a good closure. Then, the wires were twisted and then cut with a large pair of wire cutters.

Then, the fascia was closed, using the sutures already in place, followed by the subcutaneous layer of tissue (which is mostly fatty tissues). The surgeon didn't really finish doing this layer, and left the OR. He let the first assist finish the subcutaneous sutures, and finish up on the subcuticular stitch (sewn under the skin to close the skin). The surgeon came back in a few minutes after he left to do his dictation. And, just as everything was wrapping up around 1030, the coordinator came back in to get me, because my original patient was done with surgery. Perfect timing.

As we were leaving, the first assist began joking around, saying that she was surprised I didn't faint--because they like getting students in who get woozy and pass out. She said she tried to make it gory for me so I would. Not so!! I am too tough for that!! But, I am happy I didn't pass out--I was sort of in that I-have-a-headcold-and-feel-foggy state, so I was swaying a bit (sure felt like I was, anyways).

Seriously, today was meant to be. I had been so wanting to see a heart, and circumstances lined up so perfectly for me to see one today--from start to finish even. I am so grateful for the way this worked out! And, I was just so excited to share that I had to get caught up on my blog to be able to write this ridiculously long entry about an AMAZING day!!

I should probably tell about the rest of my day... so PACU was interesting. My patient was a fairly old lady (pushing 100!), still working part-time, and just a vibrant little thing!! Basically, I just helped get vital signs per the orders and watched the nurse go about her routine. It's one-on-one care, which makes sense, and while we were waiting for orders to come down for admission, it was pretty much just a waiting game. So, I was able to get a lot of my write-up done then and just waiting to be dismissed.

Then, I came home, and set to work on homework, but got side-tracked by my desire to update my blog. So, I will resume homework directly.

All in all, it was an amazing day, and I feel very blessed and happy to have seen what I saw. : )

DISCLAIMER: I do not own any of the images provided in this entry; I used Google to find them and added them here. I give full credit to their rightful owners and thank them in advance for letting me borrow them!

Dec. 1, 2011

2011-12-02T16:19:00.001-06:00

Neuromusclar disease = not my friend. Well, the exam anyways. Good grief. I'm not sure if it's because I'm a bit sleep deprived or I didn't study as hard as I usually do or some unknown reason... but Myasthenia Gravis, Multiple Sclerosis, and Amyotrophic Lateral Sclerosis all started running together.... And none of the questions throughout the test "helped" to determine any answers for any other questions. I think what's hard is how similar some of the presentations are and then the abbreviations, at least for MS and MG, are similar enough to help throw people off.

It seems like the whole class didn't do as well as we wanted to--and the professor could tell that we had two Pharmacology quizzes the day before. I'm not sure when grades are going to be posted, but I'm almost afraid to see what it looks like...

It was another early day. The professor had to leave earlier than her already-scheduled early day to get to some more medical tests, so we did the evaluations for our clinical instructors and then were able to leave. I came home and rested up in anticipation for the surgical experience I would be having the next day.

And, of course, I start having cold/flu symptoms. I'm not sure what the cause is, but whenever I get sick, my pupils dilate. Noticeably. My brother gets chatty, and I look like I'm on drugs; mom always could tell when we were sick. I took some DayQuil to get me through the rest of the day. Because I didn't know what procedure I would be seeing until my instructor contacted me, I opted to work some on the long-term care paperwork, and got through most of the medication information stuff. That stuff is hard to get through, because there is so much pertinent information for all the drugs.

At around 1900, I decided it was getting late enough to hear from the instructor. So I called her to find out what I would be seeing tomorrow so I could do adequate preparation for it. No answer. She called back around 2000, and said she didn't receive the call from the coordinator, so she didn't know what we were doing. Then, she called back at 2100 or so to say she checked her e-mail, and found out there was a laparoscopic cholecystectomy and a lap-band placement, and that I would have my choice.

My initial thought was to take the lap band, since that might be more interesting and it would be something nobody else in our clinical group had seen. But, I remembered my friend (who was also going to surgery in with me) said something about kind of not wanting to see a lap-chole because everybody else had seen one. So, I opted to take that so she could have something different and perhaps more interesting. That being said, I finished up the medication sheet for the long-term care paperwork, took some NyQuil, and went to sleep. Early morning tomorrow!!

Nov. 30, 2011

2011-12-02T16:15:00.001-06:00

So, I stayed up way later than I should have last night, worrying about how much of that long-term care packet I got done. I started working on it to see how MUCH I was missing, and by the time I was finishing up, it was midnight. And I still hadn't started studying for the two pharmacology quizzes for today. So, I picked up the Pharm book and started in reading and going over drugs. Thankfully, I am already familiar with most of them, but it was good to get a little deeper into what they do, how they interact, etc.

By the time my alarm went off, I think I got about 3-4 hours of sleep, and had to be up to finish studying. I got to school and took the quizzes, and thought I would head home. But, I felt it would be disrespectful to the professor to leave in the middle of class, so I opted to stay through lecture, but leave to go sleep and miss the afternoon class. I know, I am awful. It would be the only class I have missed so far.

Luckily for me, though, the professor cancelled class this afternoon due to illness, so I was able to go home and nap, guilt-free! And then try to study for the last exam in the week. Blech. Too much happening, haha! So much to do.

But, the light is at the end of the tunnel!! Only a few more weeks and I will be home enjoying time with my loved ones :)

Nov. 29, 2011

2011-12-02T16:09:00.001-06:00

So, long-term care was not long-term care at all. It was a rehab unit in a facility that also houses long-term care residents... Oh well....

I showed up and was wearing my uniform, as the instructions from the instructor said. Only problem was--I was wearing my community uniform (black pants and the school polo shirt), when I think they meant scrubs. Oops. At least I wasn't the only one--two others were wearing their community uniforms.

In any case, we began the day with helping the nursing staff take vitals and sitting with the patients during breakfast. Then, we met and went over the expectations. Yes, another 12-page assingment. How many pages do you think I can turn this one into? Yeah... Awesome....

I got to meet with my patient finally, and from the start, I knew it was going to be tough to get through a bazilliion pages of questions. The standard program gets three days for this--we get two. Two days to work with elderly patients who are tired and have a tiring schedule already--and then we add this crazy-long questionnaire.

Thankfully, the gentleman I was working with was very pleasant and was very willing to share so much with me. I felt like I got a lot of information, but looking back at the packet, it really doesn't feel like that much. And, he felt he was going to be discharged later this week, so I may or may not see him next week to finish with all the questions.

Oh well--it was an interesting day. Definitely not what I would have thought of as long-term care nursing, but very cool to hear the stories some of these folks have to tell.

Nov. 28, 2011

2011-12-02T15:36:00.001-06:00

Today was a short day all the way around. We had another IRAT/GRAT in Community. If I haven't said wat these are, they are individual readiness assessment tests and group readiness assessment tests, or something along those lines. We take a 5-point, 20-question quiz individually, and then as a group and get scored on both. Today, for the first time, I got a 5/5! The questions are tough, and even though I studied from the study guide, I feel it didn't help very much.

Class ended early, which was nice. I was able to go home and rest and then practice some on my sterile glove technique, which I had to get checked-off on this afternoon. Not for points, but it was something I had to pass.

I plan on spending the rest of the afternoon not doing much of anything! Well, I suppose I will prepare for long-term care clinical tomorrow, but that's about it.

Nov. 26-27, 2011

2011-12-02T15:30:00.001-06:00

Well, I put in way too much time on that Database / Concept Map / Care Plan / Teaching Plan, but luckily for me, it's almost done. Just a few more things to finish up, which is wonderful. I spent all day Saturday on it (taking frequent breaks, of course), and it looks like the final page count on the database, care plan, and teaching plan will be 23 pages, and the concept map will probably be another page on top of that. Good grief, I doubled the page count from the original assignment. The sad thing is--I don't think I did MORE than what was expected of us.

Sunday, I spent most of the day doing a whole lot of nothing, with a little bit of studying at the end of the day. It was a nice, relaxing way to spend the last of my Thanksgiving vacation. As much as I am not liking the idea of going back to school in the morning, I will be happy to have a routine back again.

Nov. 25, 2011

2011-12-02T15:25:00.001-06:00

Black Friday shopping was a success!! And I survived, obviously... you know, since I'm writing this...

Anyways, I got to Best Buy last night at around 2230, and there was probably already at least 500 people in line. Crazy, right? So, I hung out for an hour and a half and was surprised to find the thing I came in for was still there!! Hooray, so I picked it up and was out of there by 0030. Then, I proceeded to Kohl's and didn't get what I originally came for but got something at a better deal than from the other place I had planned to go--WIN! But, the sad part was I didn't have a cart carrying these particularly heavy items, so two hours later, when I finally got through the line, my arms were jelly and sore. Then, off to Toys R' Us to buy a gift for my niece, and after that to the car dealer for a $15 oil change. I finished off the evening with a few more stops and waiting for stores to open, and got home, unpacked the car, showered, and was in bed by 0700.

But, my body didn't want me to sleep that much, because I was up about 5 hours later ready to get going on some homework. And boy am I glad I got started on that beast. It started out as a 12-page assignment, basically a template to fill a bunch of information into. Yeah, with all the information I gathered, I added many more pages, and I'm STILL not done. But anyways, It was a good day (morning?), and now my schedule is a bit off.

Oh well, hooray for good deals and getting to sleep in tomorrow!!

Nov. 24, 2011

2011-11-27T19:40:00.001-06:00

HAPPY THANKSGIVING!!!! HAPPY TURKEY DAY!!!!

My stomach could not have picked a better day to feel better, because I had a Thanksgiving FEAST thanks to the Cracker Barrel! I just didn't feel like cooking for just myself, so I had someone else do it... it was really nice.

And, at the same time, very lonely. I was really sad not to be able to go home for Thanksgiving, but thankfully my boyfriend is a sweetheart and called me frequently today to make sure I was doing okay and so I wouldn't have to feel quite so lonely.

I have shared so many things that I am thankful for--material things, things about myself, and the most important people in my life. So today, I will bring it all full circle and say that I am very grateful for the life I have, with everyone and everything in it. It has not always been easy, but there is so much to be happy about and grateful for, that I cannot help but feel happiness in my life, and look forward to a lifetime of such happiness and fulfillment!

Happy Turkey Day, everyone! Here are the fun turkey lights my mom sent me! Hooray!!

And tonight, I am off to do some crazy Black Friday shopping. Can you believe there are places opening up at 2100 tonight? I am against this--imagine the people who have to work, and what about those crazy folks who probably skipped Thanksgiving meals with their families to camp out in front of those stores. Quite sad that, although here I am participating in it also. I will be heading out to Best Buy around 2230 or so for their 0001 opening (that's one minute after midnight!). Wish me luck!! I hope I survive!!

Nov. 23, 2011

2011-11-27T19:18:00.001-06:00

AHHHHHHHHHHHHH to sleep in!!! I really needed it.

I had some stomach pains yesterday that I kind of figured was food poisoning from maybe Chinese food or carrots, but when I had eggs this morning, I still had pain. So, maybe a stomach bug? Most of the day was spent just relaxing and trying to rest and recover.

I finally caught up on some of the shows I have been watching, which was nice, and I am definitely looking forward to the holiday!!

Today, I am grateful for my boyfriend. I feel very blessed and lucky to have him in my life. He is incredibly supportive and is always just a phone call away. I love that he takes care of me and lets me take care of him. We are a great team together, and I feel such peace and joy within our relationship. I love him very much, more than I am able to express in words. I am sad that I cannot be spending this holiday with him, but look forward to the many holidays in the future that we will be able to spend together.

Happy Almost Thanksgiving, everyone! I hope you are all able to be with the ones you love the most at this special time of year!

Nov. 22, 2011

2011-11-27T19:01:00.001-06:00

Last day of school stuffs before break!! And--last community health clinical ever!!

Realistically, though, it was just a day of presentations. And, since our instructor is pretty cool, it was super laid back. Each of us brought in something to contribute for breakfast, and then we did our presentations. There were four group presentations on community resources, and then we each did our 5-minute presentation on current events, which turned into an introduction by the presenter, and then a 15-20 minute group discussion. It was a great way to end before the break.

I spent the rest of my afternoon wrapping Christmas presents (yes, I know it's early; but it's actually fairly late for me...). No Christmas music, though. Not allowed until AFTER Thanksgiving. One holiday at a time. Yeah, I'm crazy, I know.

Today, I am thankful for my Dad. My dad is an amazing man, and I am so grateful for the good relationship we have. It wasn't always so, but I am so happy that our relationship has developed to where I can call my dad anytime to talk about anything. He is always there for me and has such great wisdom and advice that he is willing to share. I am truly grateful to have such a great friend who also happens to be my dad.

Nov. 21, 2011

2011-11-27T18:49:00.001-06:00

Exam day in Community Health. I went into it feeling pretty good, felt semi-good afterwards, and felt awful by the time we got through the group exam. The wording of the questions were kind of awkward, and the answers were worded kind of awkward, too, so that made it kind of difficult to pick the best answer. Oh that, and there was a bank of 45 questions, but the test was only 40, so when we did the group exam, each of us had different questions. Then, when we had some disagreements among us and we asked our instructor to advise us on how to think about each question, all she would say was, "Well, we talked about that in class". Not so, actually. There was a lot of information she skipped over and said we could read on our own. As awful as it sounds, I am losing faith in her as an instructor.

Overall, though, the scores came back pretty decent, which was surprising. The instructor didn't really seem thrilled about some suggestions to read the questions from the test bank BEFORE putting the test together, to make sure they make sense and aren't difficult to understand. Oh well.

I spent my lunch watching the wound care videos and reading the transcripts on how to do each wound care activity, and then took a quiz after lunch. Not too difficult--for the most part pretty straight forward. Then, we really didn't have much to do for lab--practice removing sutures and staples, and get fitted for sterile gloves. So, it was nice to get out of there early.

I spent the rest of the afternoon finishing up my current event presentation note card and relaxing, which was very nice.

We're winding down on time before Thanksgiving, so I am shifting gears into the people in my life I care most about. Truly, I am thankful for these people everyday, but today I would like to share my gratitude for my siblings. We don't get to talk very often, but when we do talk, we talk for a long time and just sort of pick up where we left off--as if not very much time has passed. It's so interesting to have a relationship like that. But, I am grateful I have that with my brother and my sister, both of whom are amazing people that I can always count on no matter what.

Nov. 20, 2011

2011-11-20T22:27:00.001-06:00

Yeah, yeah, I've been horrible about keeping caught up. Not that I haven't had the time--I've just kind of let it build up, once again, and then get too lazy to get caught up. But, for now, I am all caught up with my life here up until now, so this is very good. Hopefully I can actually get my backside in gear to STAY caught up.

So today marked the four-week, exactly 28-day mark for when I will be on a plane on my way home for Christmas!! Needless to say, I am VERY excited about this!

I spent most of my day on chores--doing laundry and dishes. I had some more pie filling that needed to get baked, so I made up two pies for the girl in my class whose parent's house burned down last week. I was actually going to spend Thanksgiving with her, but seeing as how family will absolutely take precedence, I will still send her with some pies for her family to enjoy.

And, as if I wasn't having enough fun with pumpkin pies, I had 9 cups of pureed pumpkin left that didn't have all the other ingredients added, so I went ahead and prepared all of that today also. It turns out I have the fixings for four pies, so all of that is divvied up into four separate Tupperware containers and is in the freezer. I plan to make a pumpkin pie for Christmas, and then leave the other three things of filling with my boyfriend so he can make a pie whenever he wants to if I'm not there. Probably we will have at least one left over for next year, though, so I will have to learn another type of pie for next year.... Hmmm...

Aside from that, I worked some on my current event, talked to my loved ones, and am now catching up on my blog before going to bed. I like days like this--very laid back, with very little pressure to get things done. Although, I have been feeling the need to get caught up on my blog, especially since I wanted to get my clinical stuff caught up before I forgot all the amazing things I got to do!

Today, I am grateful for windows. Yes, windows. It's strange to say, but hear me out. This morning, and the past couple of mornings, I have woken up feeling like I was having a fever for how ridiculously warm my room gets. So, when I say I woke up this morning, partly because of this apparent hot flash and also because I went to bed so early, I mean I woke up at 0430. I did get back to sleep, but only because of my window. I was happy to be able to crack it to let in some cool air to counteract the heat, which helped me sleep comfortably and not wake up feeling ill. Huzzah!

Nov. 19, 2011

2011-11-20T22:12:00.001-06:00

So the whole gang was here today, and I had a partner down my wing. Weekends are always low key, and with my particularly low-key patient, it was even slower than yesterday. It probably didn't help that I am Speedy Gonzalez when it comes to assessing my patient--probably because she was so easy to work with, and had her meds, I&Os, and assessment all taken care of before 10. I even got her up for a walk shortly thereafter.

I felt like I spent most of the day just twiddling my thumbs. Until my instructor told me she was going to have me pull a central line! How exciting!! A central line is a catheter of sorts that is usually placed in your right subclavian vein and fed to your superior vena cava--right above your heart. It is used for medication administration (which hits the body really fast since it's right there at your heart) and quick blood draws. I was disappointed, though, when it was time to pull it--because she promised it to another student AFTER she had promised it to me and my partner. Bummer. And, the other group she promised it to were kind of snotty about getting to do it, so I just let it be. I was grateful, though, that the patient was cool enough to let me come in and watch. I think she had five of us in there, haha. She was a retired nurse, though, and understood the importance of us all being in there to watch.

Almost as if to make up for the central line thing--my instructor had me pull an IV and put in a new one! I am just recently checked-off for this skill, and will be the first in our group to put in an IV! YAY!!

I was pretty nervous, because it is different doing it on an elderly lady instead of a plastic mannequin arm. And I had two of my group-mates come in to watch, but that didn't actually make me that nervous. I was more worried about doing it wrong. But the nurse came in to watch and assist, and she said I did really good, and the patient said it didn't hurt at all!! It will still take some getting used to, for sure, but I am excited to have the first one out of the way. Oh, and I learned later that she was a pretty difficult "stick" (if you'll pardon the medical jargon) because she is on prednisone, which apparently makes veins more difficult to access. Even more pride being felt on my part here!

This very exciting experience actually pretty much ended my day. I took my patient out for a walk after this, right before post-conference, which was nice. Post conference was nice--I got to hear about everyone else's experiences for the weekend, the surgical experiences, and we each talked about a different medication, which I like because I get to hear it from my classmates!

I went home to relax and have a nice dinner, only to fall asleep quite early around 1930. I didn't call my boyfriend because I knew he would be calling me and I wanted to catch a few Z's before he did. Bad idea. Apparently, I psycho-babble when I'm really tired and get woken up. My poor boyfriend had to deal with a barely coherent, barely cogent, babbling girlfriend. There are parts of that conversation that I don't even remember. Apparently, after the parts I do remember, I kind of fell into that half-asleep state and went into nurse mode, asked him if there was anything else I could do for him before I took off. Wow. I am thoroughly embarrassed by this. Yes, I surely am. The good thing I can pull from this is that the nurse in me is apparently becoming second-nature, since it comes out when I am half-asleep.

Today, I am thankful for my friends. I seem to have made quite a few friends within this class, and I am so thankful to have them. I have received a few invitations to spend the holiday with them and their families, and even though I think I will turn them down (for the sake of staying in town to relax, do homework, and catch some Black Friday sales), it warms my heart to have been the recipient of such kindness.

Nov. 18, 2011

2011-11-20T21:49:00.001-06:00

Wow, it was definitely strange being back to the hospital for clinicals. I was all by myself down one of the wings--the girl who was supposed to be down that wing with me didn't show up today. I am absolutely fine with being by myself, though. Forces me to learn more quickly and doesn't give me an excuse to NOT be busy. I was disappointed, though, that my instructor gave me an easy patient--she said I had a rough week the last time and she thought I could use an easier time. Honestly, I would have preferred someone more difficult--or two patients, even, just so I could stay busy and not be bored.

Fortunate for me, though, my patient was a doll--such a pleasure to work with. She and I laughed so much today, just telling stories and learning from each other. It was really refreshing. My nurse, on the other hand, seemed like she was none too happy to have a student. I understand, I really do--we can be such a burden, because we can't really do anything without someone else being in the room, it seems. Or at least the bigger things--like giving meds. I know she was really busy, and the last thing she probably wanted was a student who needed to have her observe medication administration.

I was able to go with her, though, to do a bladder scan, which was interesting. What was most interesting, though, was being able to see the distention from the bladder being very full. It amazes me that some disease processes take that feeling of fullness away from you--so you don't know you need to go and therefore don't go and end up building up a ridiculous amount of urine!

I then had the opportunity to accompany my patient to occupational therapy, which was different than I thought it was. It was great to get to see, though. For those who don't know what it is--it is the therapy that helps you get back to normal daily activities. I saw the therapists working with other patients on how to dress themselves, and what they did with my patient was encourage her to stand while doing a puzzle to simulate standing in front of the stove or bathroom sink--helping her build up tolerance to standing for longer periods of time.

After I got back down to the floor, I was called in to do a staple removal. Coolest thing ever!! The little pair of scissors for removing staples have one prong on the top leg and two prongs on the bottom leg that crimp together to crimp the staple and bend it out of the wound (the staples are in the skin, wrapped under very much like a staple is in paper). I will put in a picture, so hopefully it makes more sense (kind of hard to describe without hand gestures, haha).

So, the one girl in our clinical group was an athletic trainer and had lots of experience with staple removal and steri-strip application, so she was a great teacher for me. I think I pulled out something like 12 staples, and put on a lot of steri-strips. Yay!! Oh--and the patient had hiccups, so I am even more of an expert, because I was working with moving targets, hahaha!

So these are the scissors... you can't really see but there are two prongs on the bottom leg....

This shows a little better how the crimping action works to pull out the staples -- really cool

And this kind of shows the scissors and the staples. This is not my patient -- this is from google images!

Right, so that was pretty much my entire day. I gave a lot of meds, figured out how to put on a gait belt (harder than it looks, apparently--probably just me), walked with my patient a few times, and learned how to use the IV pump. OH!!! I also helped a physical therapist apply lymphedema bandages to my patient. Not that she has lymphedema, but the principles that help with lymphedema also help with general edema. Of which my patient had quite a bit in her legs. It was interesting to hear the therapist talk about the cotton bandages she uses versus Ace wraps. Ace wraps have elastic in them, which allow it to stretch up to 200%--which isn't very helpful with edema. But, just plain cotton bandages don't allow that great of a give, and so are much better for helping with edema. Also, she made a point to say that we don't have to wrap the patients up tight--the multiple layers actually create a tightness in themselves, making tight wrappings unnecessary.

So, today, I am thankful for laughter. It really is the best medicine, and it really can bring people together. I felt I really connected with my patient today, and mostly because she and I were both able to laugh and did laugh at every occasion we had. And it just feels good to laugh--you're smiling, happy, and filled with nothing but good feelings. Huzzah!!

Nov. 17, 2011

2011-11-20T21:36:00.001-06:00

It seems like we just had an exam in med/surg theory, but we had another today. It went even better than last week, I think. I am feeling more confident in my critical thinking skills in terms of nursing, although I've still a bit of work to go.

After the exam, we usually do a group exam to work through some questions with our peers and logic it out with each other. There were two that I had the right answer, but nobody believed me. I was quite proud to have gotten those right, because my one friend usually is right--so I'm glad I remembered correctly, although I wish I would have fought more to put my answers down on the group test.

The one I am exceptionally proud of is the antidote of Coumadin. She and I even talked about it before the test--she just took the notes wrong. I had protamine sulfate down as the antidote for heparin and low-molecular weight heparin (although it's not as strong of an antidote for the low-molecular weight stuff), and vitamin K down as the antidote for Coumadin. She had the not as strong bit for coumadin, instead of the low-molecular weight stuff. So, when we came to the question about what you should have on-hand on the unit for the Coumadin antidote, she argued for protamine sulfate, but I absolutely didn't budge on the Vitamin K. Bwahahaha!! I am obviously a gracious winner, hahaha!

Lecture today was on neuromuscular disease, which, as interesting as it is, I couldn't entirely focus on. I can't really explain why I am so tired lately--although it probably does have something to do with sleep deprivation and stress, or some combination of those. In any case, we finished up lecture about 2 hours earlier than anticipated--our professor is awesome in this way--and I got to go home for a nap.

Well, at least I intended to have a nap. I told myself that I would nap until I got a call from my boyfriend, which, on a normal day, would have given me maybe an hour or so. Well, I ended up working on other things, getting ready for clinicals the next morning. I started to get worried when I hadn't heard from him, and like any rational-minded girlfriend, called him a bunch. I then monitored the news to see if a car accident had been reported, and wondered if I should call the ER or police. In my head, I knew this was irrational--that he was likely just at work. But I hate when I don't hear from him. I finally did get a phone call at 2130, and he had just gotten in, having left his cell at home. He had an emergency case added to the case he was already working on that day, so it was a long, rough day for him. Probably didn't help to have a concerned, upset girlfriend on the phone at the end of the day.... Ooops....

Oh well -- Clinicals in the morning. It will be strange going back after a weekend off. I hope I remember everything....

Today, I am thankful for my cell phone, and in particular, the communication abilities it provides me. Without it, I would have no immediate way to get in touch with the people I love (I am without a landline, and my loved ones aren't ALWAYS at their computers).

Nov. 16, 2011

2011-11-20T21:22:00.001-06:00

Pharm quiz!! I feel really good about it, although there were a few I wasn't 100% sure on. And, of course, looking into one of the ones I could remember later, I got it wrong. Darn those drug classes confusing me!!

Oh well. Overall, though, I feel I did pretty well.

Lecture was fun, with lots of professorisms. Some of the best from today include:

Dice-Rhythm-Mirrors = dysrhythmias
Die-Gocks-In = Digoxin (said dih-jocks-in)
Excise Tolerance = Exercise Tolerance
Excursional angina = Exertional angina (although I think I like the sound of excursional angina more!)
Nitro-Gly-Side = Nitroglycerin
Ween = Vein
Vig-Rah = Viagra
Shortness of Breast = Shortness of Breath

I love this class, and I really like our professor. I am not trying to be unkind or rude or make fun in any way--just trying to share some of the interesting pronunciations I have been trying to translate at the same time as learning the material.

Over lunch, we had our potluck, which was awesome, although I think it would be better to have half the class bring stuff rather than all 40 of us. Yeah, there was a LOT of food. And I only got rid of a pie and a half. So the other half went home with someone who said she doesn't like it so doesn't make it for her boyfriend who LIVES for pumpkin pie. I'm happy it went to a good home! I also got rid of another full pie to a girl who said she was thinking about buying one at Wal-Mart, and I talked her into taking one of mine instead. Huzzah--only three more pies....

After lunch, we had presentations. Ours went well, I think, although it didn't have pictures. I didn't think to look for any for the subject of HIV/AIDS & Hep C in Prisons.... Yeah.. probably best to go without. One of the other groups was also presenting on HIV/AIDS, but in a much more general sense. They did a good job, but the jerk in their group (who has been losing all my respect in the last few months) got up and said, "Well, we're also presenting on AIDS, but our presentation will be shorter and hopefully a lot more fun". I don't know if he realizes how much of a jerk he is.

So, for today, I am thankful for self-control. And kindness. I am happy that I, for the most part, am able to think before I speak, and most especially to re-think before saying something unkind. I am happy that I didn't shout out to call him an ass. Nobody needs to point that out--he does a good enough job of it for himself.

In any case, it was frustrating, but overall a good day. Now, if only I could figure a way to get rid of these pies....

Nov. 15, 2011

2011-11-20T21:05:00.001-06:00

Today was nice. It was another day I had the opportunity to sleep in, which was especially nice. This afternoon, my clinical group had our last actual community health clinical experience at an adult day-care. It was so much fun! We got to participate in chair Zumba, listen to healing music, and spent some time sitting and chatting with the participants. We also had to take some vital signs and weights, as well as administer a geriatric depression test and mini-mental status exam. Since there were only three mini-mentals/depression tests to give, we broke into three groups. Our group had the sweetest, most upbeat little lady ever. It was hard to keep her on task, though, because for nearly every question, she would say, "Well that's an interesting question," or "Well, that's tough to answer," and then go off on a long tangent, often unrelated to the question.

I will say, though, that she had a very tough life, of which she shared so much with us. I was left speechless from her stories and I nearly cried to hear how much this woman endured. It was difficult to let her tell her story while try to keep her on task with the questions. None of us wanted to interject or cut her off while she was talking, because she probably doesn't often get to tell her story, but at the same time, we didn't have all day to talk to her and get this information. It was a difficult balancing act.

In the end, she gave us all hugs and went on her merry way.

Today, I actually have two things I am grateful for. First, I am grateful for how relatively easy my life has been. I have had difficult times, as everyone does; but after hearing this remarkable lady's story, I feel so grateful for how good I have had it.

And, one of the people responsible for how good I've had it--I am grateful for my MOM! I was actually planning to say my thanks for her later on in this gratitude thing, closer to Thanksgiving, but seeing as how it is the day of her birth, I will give my thanks for her now! She is such an amazing woman, and I look up to her very much. She is a shining example to me of what a woman, a mother can be--strong, smart, kind, wise, and the list could go on forever. She has always been there for me, even at times when, looking back, I probably didn't deserve her kindness and love. I miss being able to spend time with her, although I am glad I get to talk to her as often as I do. I love you, mom, and today and every day, I am grateful to have such an awesome woman to call "mom".

Nov. 14, 2011

2011-11-20T20:26:00.001-06:00

Today's Community lecture was about culture. It was absolutely a repeat of the culture lecture from last term in Communication. From the same professor. Awesome. The only difference was we added on something about rural health. It's interesting to think about what is considered rural health and to think about an area like ours, that is very much an agricultural area, where most of the state is considered rural and how few health clinics must be serving large rural areas. The catch phrase of the day was, "when you're it, you're it". I think the professor said this at least 10 times, trying to illustrate just how important decision-making and critical thinking skills are to rural health nurses, who will usually be by themselves no matter what comes through the door.

Then, we had a crazy speaker. No joke, I think this woman was on something, which is perhaps not nice to say, but you'll see what I mean as I explain. The speaker started out by asking our majors, as each student already has a bachelor's degree in something. I shouted out "sociology," and she looked up, nodded, and replied, "Oh, sociology. Good." I have grown rather fond of my previous major, so I was a bit disheartened by her lack of enthusiasm, but figured perhaps she didn't know what it was. The next major shouted out was horticulture. Yes, we have two horticulture majors in our class. I kid you not--the speaker went off for ten minutes, at least, about how important horticulture is to nursing, and how you can especially apply it in women's health to help women understand the ebb and flow, the cycles of their life just like the cycles of a plant. Seriously?! Because horticulture has a much better application to nursing than sociology.

At this point, I was already tired of listening to her. But, I continued on anyways. I never really got what her point was, or what it is that she actually DOES for a living. Something about working in a women's clinic and being very opposed to having male patients come in.

The last bit of her presentation had something to do with quantum physics. This sort of came out of left field, but I sort of got her point. She had us watch a snippet of a movie called, "What the Bleep do we Know Anyway?!" or something to that effect. We watched the part about Masaru Emoto's apparently famous study about water crystals and the effect of words on them. Mean words, like "Adolf Hitler" and "I hate you" taped to a bottle of this water made the crystals look ugly, where kind words taped to the bottle of water or a Buddhist monk prayer make the water crystallize into perfect-looking crystals. Then, she told us that if it could do that to water, imagine what happy energy and positive thoughts could do to people--because we are mostly water anyways.

Sooo.... if I think happy thoughts and say kind words to my patient, all the water in his or her body is going to crystallize into snowflakes? Sounds painful, if you ask me.

But then I had to wonder--was she serious? Because quantum physics and this water crap had so much more science and reality and application to nursing than sociology, right? Sorry, still a bit sore about that.

To close, let me just say I believe in positivity and having a good attitude and that it can work wonders when working with people. If you're happy and upbeat, your patient will be a lot easier to work with, I think, than if you have a bad attitude. So yes, happy energy has power--but not enough power to make the water "pretty". Also, let me say that Masaru Emoto's study was proven false--he was never able to reproduce the same effects in a controlled environment.

Water Exposed to a prayer from a Buddhist monk

So, all in all, today I am thankful for short class days, especially after a lecture and presentation like that. Wow. I am glad I have extra time for all that to sink in, as well as more time to devote to mixing and baking my pies for Wednesday, AND to study for pharmacology quiz on Wednesday. Wahooo!!!

Nov. 13, 2011

2011-11-20T20:20:00.001-06:00

My partner and I were finally able to meet to put together our presentation and she was able to look over our paper and brochure to see what else needed to be done. Overall, we are pretty much ready for the presnetation now, with just a few tweaks here and there, and our paper will be ready to turn in in a few days, which is well before the 11/21 deadline. Awesome.

After we sat and got that all put together, I invited her out to lunch, and we went to Cracker Barrel. I LOVE that place. Not only is the food amazing for super cheap, but their little store is so adorable. If ever I had a financial downfall, it would be there. I did, however, buy our second special ornament for this year. My boyfriend and I are collecting two special ornaments each year until further notice, so one day we can have a Christmas tree with JUST the special ones. We got the first when we went on a train, and it actually looks like a train lamp, which is awesome. The one I just got is a sock monkey with a Santa hat. I really like sock monkeys, so this was just perfect!

Today, I am thankful for my background in Sociology. I think I have done more reading and ripping articles apart in that major than ever before in any setting. Over this weekend, I have been ripping apart articles, pulling out important information, and applying it to my projects. Also, I am grateful for a particular Sociology professor, who I first met in Classical Sociological Theory; this remarkable woman's particular style of teaching and testing forced me to think critically, which has been an invaluable asset in nursing. Thank you!

Nov. 12, 2011

2011-11-20T20:12:00.001-06:00

Not much to report for today. Did some more homework -- I started working on my patient database, but didn't get very far on that. I spent most of the day relaxing and reviewing what I had put together already on my homework. Again, neither of us felt particularly well, so we will just meet up tomorrow.

Today, though, I am grateful for my laptop. Sounds silly, I know, but I am grateful for this incredible piece of machinery that I do my homework on, I can communicate with my family with, and I can get my entertainment on in the form of movies and TV shows online. Love it. I am so thankful that I get so much all wrapped up in one thing!!

Nov. 11, 2011

2011-11-20T20:04:00.001-06:00

It was such a lovely day to sleep in. After this week, I really need to catch up on sleep. It has been a very stressful, very sleep-deprived kind of week, so sleeping in on this great holiday was fantastic. Even though I woke up not feeling very well. Stress cold, methinks.

Luckily for me, my partner also woke up feeling ill, so I had more time to work on our presentation and our paper and brochure, which looks amazing now, by the way. Since my partner had some issues with finding information about TB in prison populations in the US (lots of info for Russia; our presentation is on Communicable Disease in Correctional Facilities), we switched gears to HIV/AIDS for me and Hepatitis C for my partner. So, I began right away, and it took me the better part of the day to gather information, read the articles, and put it all together into slides. Then, I decided I would try to work on my part of the emphysema info paper, and ended up writing all of it, excepting the part about epidemiology (mostly because I wasn't really sure what to include on that) and the conclusion. Hey--I had to leave something for my partner to do! And, I finished up the night with putting all that info into a brochure, as if I was going to give it to a patient. It looks awesome, if I do say so myself.

So, not much to report for the day besides doing homework and relaxing a bit.

Gratitude for today is fairly obvious, but I am thankful for veterans. I am grateful for their service to our country, so we can have the freedoms we do have. I am grateful these men and women have the courage to stand up for America.

Nov. 10, 2011

2011-11-20T18:19:00.001-06:00

This morning began with a med/surg theory examination. These tests are kind of hard, because they are the NCLEX-style questions that have more than one right answer and you have to choose the BEST right answer. And, I still feel like I don't like any of the answers sometimes. It's kind of a weird place to be in, because sometimes, too, there are three answers that I like bits and pieces of OR that I would do all at the same time (i.e. assess a patient's respiratory status AND level of consciousness).

In any case, I feel like this examination went far better than the first. In fact, I thought it was pretty easy. Although my classmates seem to disagree... Most were saying this test was too hard. Perhaps at the end of a very long, trying week, it should have seemed harder to me, also.

Oh well. Lecture was fun today, although for the most part, it still feels like a review of pathophysiology, with a bit more added on in terms of how to care for a person with specific issues.

Hmm.. something I forgot to mention about yesterday -- I had my check-offs for placing an IV. Serves me right for not staying right on top of my blogging every day!

Overall, the check-off went really well. I had the crazy professor that I am just sort of starting to like. Again. She's kind of growing on me, although I couldn't really tell you why. She said I did really well, and I only missed half a point for not filling the drip chamber BEFORE I primed the line. And, instead of just getting one critical thinking question, I ended up getting four. How fun for me. I suppose she just asks me so many questions because she knows I know stuff. Maybe. Who knows.

Overall, though, it has been a great week. I will be spending my weekend working on homework--I've got a presentation next week that I am not really looking forward to, and since my partner and I will be working on that, we will also spend some time working on our professional paper. I am hoping to work some on my database/concept map/care plan/teaching plan (yes, that's all one assignment) and my current event presentation. But, we shall see. I think maybe I will bake pies for my class on Monday now, seeing as how we have a pot luck on Wednesday. That is a much better opportunity to take in my home-made pumpkin pies!!

And, in keeping with my gratitude thingie, today I am thankful that my IV check-off is, in fact, finished and I don't have that hanging over me until Monday afternoon. Huzzah!!

Nov. 9, 2011 -- PART II

2011-11-13T11:58:00.001-06:00

So today was interesting. Pharmacology exam in the morning, which I thought went pretty well. I only spent forever studying for it! Seems like some of my classmates didn't feel as good about it as I did, though.

After the exam, we had some lecturing. As always, somewhat difficult to understand at times. I think my favorite professorism of the day... well, actually I have two. The first was about diuretics, the most common of course being "hydrochloro-cyanide" (supposed to be hydrochlorothiazide). That is one way, I suppose, to solve edema. Although, I am sure there are better options... The other was in speaking about the adverse effects of diuretics. One of these, apparently, makes you have goat (supposed to be gout). I feel bad, because as much as I'm trying to stay serious, it's really hard NOT to laugh sometimes.

Interestingly, one of our nursing professors sat in for the first hour of lecture, and then took off. We found out after lunch that she was getting first-hand experience, because there have been some concerns raised to her about the difficulty of understanding our professor in Pharmacology. Also, after lunch, this professor had the program coordinator come in to listen to some of the concerns we had.

It was very professional and nothing was said directly about any one person, just situational things. i'm not sure I ever said what happened with that girl calling me the other day. She and five others were failed on the IV check-off because they grabbed the wrong type of fluid. Now, she and I understand why she had to be failed--medication errors are very serious. However, I also understand where she's coming from--I was in the same group that was taught by a different lab instructor, and we never went over where the bags of fluid were OR that there were different types. Now, from my transcription experience, I did know about different fluids. But, unless you are taught, you probably don't know that 0.9% sodium chloride is Normal Saline.

The program coordinator insisted that if we had a concern, we present a solution. So, along with presenting this concern, my classmate suggested that there be a unified presentation given by the main lab instructor with all the other instructors there, so that everyone can be on the same page and everyone is getting the same instruction. I threw in that something else to consider is not assuming we know things; many of us come into the program without any medical experience, so assuming we know something and NOT teaching it to us can be detrimental.

Emotions were running high during this open forum. Several people were crying. I think the stress is catching up with everyone, and the difficulties of inconsistency in teaching and a professor who is hard to understand is no doubt complicating the issue.

After the program coordinator left, our professor took some time to talk to us more candidly and to kind of ease us back into lecture-mode. There were still a lot of emotion, and one girl took it upon herself to tell everyone to suck it up and quit complaining--we are the elite of the elite, since we are in the accelerated program, we were told this term was going to be tough, and we should all just deal with it. And, if we are so concerned about pharmacology, just do what she does--read all the chapters, do all the review questions, and pay attention in lecture--because she is doing "fine" in that class. Now, I get where she was coming from, but the way she would about saying it was all wrong. In fact, one classmate turned around to her and said, "You know, I am doing all those same things as you, and I am NOT doing fine. So what you just said is a personal attack to me". And he nearly started crying as he was saying it.

After this, nobody was able to focus and the professor only lectured for maybe an hour. I was glad of that, because the animosity in that room was making me feel sick and like I needed to cry. Which I did as I was driving home. I know that I am stressed, but I don't really feel stressed or act on it. I just buckle down and do what I need to do. The worst part for me is knowing and feeling the tension and bad feelings between my classmates. I feel like we are a family--some are the cousins we don't see or talk to all that often, and others are the brothers and sisters we hang out with all the time. But, no matter if we talk much or not, we are all family and when there is tension and hurt feelings, I feel that.

All things considered, I feel better knowing that we were listened to today by someone who can bring about change.

So, I am thankful for a professor who initiated the process, who has sympathetic ears, and is sensitive and understanding to the needs of her students.

Nov. 9, 2011 -- PART I

2011-11-09T01:04:00.001-06:00

So, I know it's really late for me here, and I have been up studying and will be going to bed shortly. But I have been seeing a lot of folks doing a Thank-A-Thon or something like that. Anyways, each day, a person is meant to post on their respective social media something they are thankful for. I'm more than a week behind in starting, so I will hopefully be able to make up for that here, using my experiences from each day to hopefully formulate something relevant to be thankful for (so it is something that I would have said on that particular day) and then continue right on through Thanksgiving.

Nov. 1 -- I am thankful for how my parents raised me. I am grateful I understand accountability for my actions and respect for others, among many other valuable lessons. On this day, I taught health promotion to K-5-aged children, and some of them were just plain rude. I am happy my parents taught me NOT to be that way, but to instead show regard for those around me and especially those in authority positions. I probably didn't make it easy on them, but I am so happy my parents were able to teach me these things.

Nov. 2 -- I am thankful for education. Not just the education I have already received, but my future education as well. I am grateful that I have the opportunity and access to education to be able to further my knowledge and experiences.

Nov. 3 -- I am thankful for a working vehicle. I know I sometimes complain about my car--although probably mostly to the car itself. But, I am truly glad I have a car and especially a reliable car that runs very well. It has been about 7 years now that I have had this vehicle, which is more than half of its 13 years. And it is amazing and runs very well with very few problems. It is able to transport me from point A to point B, with probably a few stops in-between sometimes. And, while I appreciate the importance of public transportation, I am grateful that it is not something I am required to take advantage of.

Nov. 4 -- I am grateful for my background in medical transcription. I feel it has been advantageous for me in so many ways--even though many people have written it off because it is not clinical experience. I cannot tell you how many things I seem to know (from having picked it up during transcription and while looking up weird terms I didn't know) that some of my instructors and nurses don't know. Okay, I guess it's really not an exorbitant amount, but still--it shocks me that I have knowledge that they seem not to have, and my knowledge comes from "worthless" non-clinical experience. So yes, I am grateful for what my background has done for me and will continue to do for me.

Nov. 5 -- I am grateful for being confident enough to speak up. Today I had the opportunity to advocate for a patient who otherwise would have missed out on a dressing change because of a nurse being either lazy or ignorant. Perhaps it didn't make a huge difference--perhaps that dressing would have been changed the next day. But, not changing it would have risked further infection and breakdown, especially if it was given another three days to wait. In any case, even if it didn't make a huge difference, I feel more confident for having spoken up and advocating, and I feel empowered to continue being a patient advocate--because who else will advocate for them if they can't do it for themselves? That is the calling of a nurse.

Nov. 6 -- I am thankful for sleep. It is so rejuvenating and refreshing and I love it. And on this day, we got an extra hour--or so it seems with the "fall back". It is a simple thing to be grateful for, but I find myself glad that it is something that gives me a break from school AND makes me feel better AND allows time for the learning to sink in and process. Yeah--amazing.

Nov. 7 -- Blankets. I am grateful for blankets. And sweatpants. There is just something about, at the end of the day, taking a shower and getting bundled up in sweatpants and a blanket (and other articles of clothing, obviously) that is very comforting. Perhaps it is the warmth of it, or just being able to be comfortable in pajama-type clothes. I guess I don't really care -- it just feels very good, and I am grateful that I get to do this routine after my obligations of the day.

Nov. 8 -- I am thankful for music, and in conjunction with this, for the ability to hear it and feel it. Music is such a big part of my life, although I'm not sure I could tell you why. I hear the beauty of it and feel the emotions it conveys, and I am so grateful for this. I'm also glad music makes such a good backdrop for studying and how certain types of music can help me focus and retain information.

Yes, so that brings us up to today. I know I have put some minor things up here, but I feel it is the minor things that sometimes get overlooked--as the things we take for granted. Now, for my loved ones -- not to worry, you will be mentioned as we get closer to the actual day of thanks. You have not been forgotten!!

TO BE CONTINUED.....

Nov. 8, 2011

2011-11-09T00:20:00.005-06:00

The health screens went so well! What amazing kids! I loved them all!!

We just did vision screens, which went fine until the last kid I screened... he was doing so poorly and I struggled to know which line he was reading off of, because what he was indicating was so drastically different from what the answers actually were. I wondered why he was doing so poorly and thought that surely he would have been caught in screens before.... and then I realized I forgot to remove the blurry thingy... Yeah, apparently I'm kind of an idiot.

After this and helping the school nurse clean up a bit, I took off to go study some more for pharmacology before heading back to school for the guest speakers from a refugee placement association. It was pretty interesting to hear the extent of this program and how many refugees are taken into the US each year (which is apparently only 1% of the number of refugees worldwide). Then, a woman spoke, who is an employment advocate (she helps find jobs for refugees and makes sure they are trained adequately), and she told her story as a refugee from Sudan and her journey through the system to where she is now. Amazing. This might sound insensitive or just not the most appropriate thing to say--but hearing her story with all the hardships she faced really put things into perspective for me that my life, no matter how hard I might perceive it to be, has really been very easy.

She was 7 when her village was attacked, and in one night, 6 of her siblings were murdered. She was separated from her family, and ended up with a distant relative who took her along to a refugee camp in Kenya. She didn't know it until many years later, but her parents, 2 sisters, and 1 brother lived and went to a refugee camp in Uganda. Her family assumed she was also murdered. She spent ten years in the refugee camp in Kenya before she was able to come to the United States. She was unable to find work because she was not yet 18; after she turned 18, she applied and immediately got a job, but realized it was not something she wanted to do forever. She pursued education, and at the age of 21, graduated from high school. She then attended college and graduated in 5 years. Oh--and before attending high school here, she had never learned to read or write; so she was learning the ABCs when she was 18. She is able to read and write in English, but cannot in her native language.

After she was here in the US for about 10 years or so, she found out about her parents being alive and took a trip to see her family. It had been 20 years since her mother had seen her, and each had thought the other was dead. I cannot imagine how awkward (perhaps) and disconnected things might feel after that assumption and length of time.

So yes--I have had a very privileged and easy life, especially when compared with the hardships that this remarkable woman--and many millions like her--endured.

Just amazing.

Nov. 7, 2011

2011-11-09T00:06:00.001-06:00

Exam this morninig, which was fun and interesting. I came out of it with an 87%, which isn't too bad, considering how dreadful the quizzes seemed to go, haha. Community Health lecture after that, which was really boring. I have a hard time connecting to the material, because it honestly doesn't feel applicable with where I'm at and where I see myself in the future. And, it's hard to sit and be lectured by someone who has no experience in public / community health nursing--I just can't see her as an expert. Now, I know she's just teaching us the concepts, but still.

Ahh well. After class got out a smidge early, I connected with my presentation partner for a bit to review a few things, and then I left early, which was a nice change of pace. There was no lab that day--just open lab and check-offs for IV placement. More time to devote to studying pharmacology!!

I spent most of the rest of the day making up notecards like a mad woman to get ready for the exam on Wednesday.

I then got a strange phone-call from a number in the area. I figured it had to be either an instructor or a class-mate, so I answered. Sure enough, it was someone in my clinical group who wanted to know if I was re-doing my check-off on Wednesday and if I had failed for the same reason she did. Instant panic attack--did I accidentally sign up for a lab check-off time today in addition to my open lab and check-off time on Wednesday? Is that why she called--because she saw my name up there for check-offs twice?! ZOMG!!!!

Couldn't really focus after that. I told her that it was my initial check-off, but that I was sorry to hear it didn't go well for her. She said she would explain more in class on Tuesday.

So, for this evening, I did some studying and some panicking, and not really much else. Some prep for school health screens tomorrow, which I'm not sure if I'm excited about or not. Should be interesting, if nothing else. I don't really remember much about the screening when I was in elementary school. Perhaps this will bring back some memories!

Nov. 5, 2011

2011-11-06T17:35:00.000-06:00

Clinical weekend 2, day 2.

This morning, my instructor assigned me two patients. I was told to keep the same patient I had from yesterday and to follow up on my patient from last week, who was still in the hospital. She said I was only required to do one assessment on a patient of my choosing.

So, I looked at what was going on with my patient who had the ICD placement, and he was due to be discharged but didn't need his medications until 0900. So, I checked in with my nurse and then went to the other wing to check in with my patient from last week. The nurse was different, which was somewhat disappointing; I was hoping to have the RN who graduated from our program a few years ago.

In any case, I was able to assist with wound dressing changes and medication administration for this patient, as well as do my assessment on her. It was interesting to me that the RN I was with didn't know how to do a dressing change on her; at least, that's what he said. So, I showed him what was shown to me last week for changing the silver-nitrate infused foam with the spray wound cleanser. I felt glad that I was able to advocate for the patient in this way; otherwise, I'm afraid the dressing would have stayed on for another few days, which would have made her more prone to infection.

After this, I checked back in with my "actual" patient for the day. I gave him his medications, pulled one of his IV sites, disconnected him from the bag that was hanging and saline locked that IV site, and then went back to assist with my other patient. During this time, I had to ask her a few more questions, and my "actual" assigned nurse for the day hunted me down to find out why I hadn't done an assessment on her patient. I told her my instructor said I only had to do one assessment, then asked if she wanted me to go do an assessment. She replied with, "Well, it depends on how much you want to learn." Wow, gee thanks for that. I was really learning a lot from doing an assessment on a patient who was about to be discharged and didn't have much in the way of abnormal assessment findings.

At this point in the day, though, it was nearly lunch time, so I finished up what I was working on with my patient from last week, and as I was just about to leave the room, she began sobbing. So, I stayed to sit with her for some time until she had calmed down, and then informed the nurse that she was upset and asked if there was anything we could do for her. There really wasn't much, but it was noted. I then went to lunch.

After lunch, I followed up with my "actual" patient and did a brief assessment on him, took out his other IV site, changed the dressing on his ICD incision site, took the dressing off his groin access site, put a band-aid on his radial access site, and helped him dress for going home. After this, I charted the assessment and then assisted with discharge teaching and saw him to the elevator.

With my last 15 minutes or so before post-clinical conference, I did my journaling, and the nurse who had hunted me down looked over my assessment and added a few things to my notes. NOW I get why she was so desperate for me to do that assessment--she wasn't doing her OWN assessment and was relying strictly on mine. I didn't take vitals on my patient this morning, and neither had she, but thankfully I'm awesome and took his BP and HR before giving him his blood pressure medications, so she had that to chart. It was kind of upsetting, but I am grateful that I was able to see what half of a patient load is like. Right now, it's kind of tough because I'm still not really sure what to do sometimes, and some patients require more time. But, I'm happy to say that I still love what I am doing and look forward to when I will do more of it!

Nov. 4, 2011

2011-11-06T15:36:00.000-06:00

Weekend 2 of clinicals and it was an amazing day!

When I arrived this morning, the instructor had a list of patient assignments to hand out, but hadn't made any specific assignments to us. The first thing she read off was for a patient who would be getting an EP study and possibly an ICD placement that morning. I took this patient, and then went to the right nurse's station. I introduced myself to the nurse I was going to be working with that day, and then learned my patient was already gone. They took him really early at 0530, so I was rushed down to the cath lab, so I could maybe catch the tail-end of the procedure.

Unfortunately, I missed out on the EP study, which is too bad. But, I was in time to catch the ICD placement. It was really interesting to see everything on the monitors (for most of the case, my view was blocked by the surgical tech). I think the most unnerving part wasn't when they did the ICD testing (they induce an irregular rhythm and check that the ICD picks it up and delivers a shock to get the patient back to normal sinus rhythm), but was in fact after the shock was delivered and the monitor wasn't reflecting a return of heart beat. It turns out the monitor was just slow, but still. I had about 15 seconds of near-anxiety wondering what was going to happen if the ICD wasn't working properly.

After the procedure, I helped transport the patient back to his room, and then took over the post-anesthesia monitoring (vital signs every 15 minutes x4, then every 30 minutes x2, and then every 4 hours x6). At this time, I was also able to do an assessment on him, and spent the rest of my day working on giving cares for him, speaking with his family, and then taking notes on another patient for my care plan/concept map.

After the EP study, it was a pretty quiet day, which was kind of nice. Nap time shortly after getting home, having lunch, and taking a shower! Hooray for afternoon naps!!

Nov. 3, 2011

2011-11-06T14:44:00.000-06:00

Today was an all-day lecture about the respiratory system. I didn't think we could lecture that long about it. Three hours in the morning, and hour for lunch, and then another two hours. We finished up early, which was nice. What made it much better was that we got to bump up open lab time, although later we found out that we really shouldn't have. Our regular lab instructor wasn't going to be down to monitor for until 1600, but we started anyways at 1400. However, the lab manager was kind enough to allow us to go. And, even better, she gave us an unscheduled, unplanned teaching session on how to use the extension sets (on the IV, the part that connects from the catheter in the arm to the IV tubing to the back). There are four different kinds available to us, and nobody really showed us how to use each kind. She spent about 5 minutes of her time showing us each type, which connections we need for each, and explainning some of the common uses for each. It really would have been nice to have had that teaching session when we first started doing IVs.

In any case, my partner and I were practicing the full check-off from start to finish, which was really beneficial. I still feel like I am forgetting a few things here and there, but I think just getting to practice more and using the skill more will be beneficial to getting rid of that, "I'm forgetting something here" feeling.

After lab, which I got done really early, it was off to home to get rested up for clinicals. Woo!!

Nov. 2, 2011

2011-11-06T14:15:00.002-06:00

Let me just say that I am grateful for only having Pharmacology today. Exam was interesting, although I think I focused on studying the wrong things and then put some really dumb answers. Blach, I hate days like that.

It will be a few days before we can see what our scores were. Oh, and she pulled a quiz on us that had drugs we didn't know we were to study. What we were told to study were the prototype drugs, ones that represent the particular drug class. What was on the quiz were none of the prototype drugs.

Oh well. It was good day to relax afterwards and focus on catching up on sleep to get ready for clinicals. Clinicals in a two days! Woo, I am excited!!

Nov. 1, 2011

2011-11-06T14:09:00.001-06:00

FIRST DAY OF NOVEMBER!!!!!!!!!!!!!

I really love Autumn.... Have I mentioned this before? Probably.

Anyways, today was school teaching. I'm so glad because I got to sleep in and take my time getting ready through the day. We actually taught in an afterschool program to about 100 K-5 kids. The older group was actually more receptive to us and paid better attention. Perhaps because they were the smaller group? The K-3-graders were really rowdy and didn't really pay attention.

Anyways, our topic for presentation was handwashing. We used some Glo-Gel, which is a special lotion that shows up under UV light. The older kids thought it was pretty awesome, and we could really see where they needed more practice washing their hands.

The younger kids, though, thought we were showing them real germs and panicked a bit to know if they had any more germs on them and wanted me to check their food, too. It was kind of a tough concept to explain that they were "pretend" germs we were showing them, and that what they were seeing came from the lotion. The point, I said, was that just because we can't see germs doesn't mean they aren't there. The kids were then upset that we had "tricked" them, haha. It was really a no-win situation at that point. Although I am glad that i didn't create seriously anal-retentive, germophobic children!

Pharm exam tomorrow. Not really sure what to expect, to be honest. I am worried that it will be intense and scary, haha.

Oct. 31, 2011

2011-11-06T13:58:00.003-06:00

Happy Halloween!!!! Perhaps one of my favorite holidays! I just love the fall-type decorations and the mix of spooky halloween decor that goes along with it. Not to mention how adorable children are in their costumes and how excited they all get about dressing up and going trick-or-treating!

I am sad to say, though, that I didn't dress up. I was too busy being in school and I figured it wasn't entirely appropriate. I think I've passed the cut-off age for dressing up for Halloween to school and/or work. But, lucky for me, I have teddy bears that I CAN dress up. I just dressed them up not too long ago, and they look adorable in matching Kimonos!

In terms of school, it was a yucky, 0800 morning for Community Health theory lecture... which finished up at 1100 including the time spent with a guest-speaker. I am still unclear as to why we start this class so stinking early and ALWAYS get done early.

After this, it was on-campus lab time for med/surg. It's strange, though, because we had to sign up for what time we wanted class, instead of the professor having to do some organizing to make sure everybody got through. I spent most of my time working on hanging the IV bags. I am feeling pretty confident about putting in the IV, but I haven't had much in the way of practice on hanging the bag and connecting all the tubing. After this, I went right on home and looked over some Community Health clinical paperwork. I finished up my research for Bhutan, the country I had to prepare a clinical packet of paperwork for, and finalized the community resource presentation we have to give in a few weeks. I am grateful for having these things done this early, because I know this term will only get more difficult.

School teaching tomorrow.... I've already heard horror stories from the other groups. Unfortunately, they are having us teach the same group of kids the same information. Yeah, they are really going to pay attention for us. Oh well -- we have a cool presentation, so hopefully it works well for us!

So here are Pookie and Baby in their costumes! Happy Halloween!!!!

Oct. 29, 2011

2011-11-06T13:27:00.000-06:00

Med/Surg clinical day 2. I was assigned a different patient, seeing as how my patient from yesterday got discharged. My instructor gave me a somewhat complicated patient, with several things going on. The nurse I was assigned with actually graduated from the same program I'm in two years ago, so she was a great resource to have to ask questions. She also had another student with her who is in the standard, 2.5-year program, and she is set to graduate this December. She also was a great resource. The nurse encouraged me to follow her through the day and really pushed me to get involved and do things. She had me pull IVs, give a flu shot, give some insulin and other medications (oral route only), and do assessment workups. It was really cool to get to follow them around to see what a normal day in the life of a nurse would be like. I still wish there was more I could do with the patients besides do an assessment, chart I&O, and give parenteral and non-parenteral meds. But, I know that we are building up to it all, and I will be able to do more before I know it!

I think the most interesting part of my day was getting to do a wound dressing change. VEnous stasis ulcers are nasty looking things. The one I assisted with was 5 x 14 cms, which is pretty good-sized. I have never seen the foam pads that have silver-nitrate in them, which helps promote healing. Pretty cool, and you can see the healing process better because you don't have to add creams or anything that can block visualization.

Oh, another amazing thing I got to see was an echocardiogram, transthoracic. The ultrasound technician was really cool and had so much information to give to us. She showed us how difficult it can be to get good images, because the images are taken between ribs, and then if the patient takes a deep breath, the view can be obscured that way, too. She described how vegetation and calcifications would appear on the ultrasound. She also told us about her course of schooling and how it's a lot of physics. Getting to see the valves was pretty neat. They moved differently than I imagined they would.

It was a pretty great experience today, so I am excited for next week and what other great opportunities will be opened to me.

Oct. 28, 2011

2011-11-06T10:01:00.000-06:00

So, this was clinical day 1 in the med/surg setting. I was very excited, because I'm at a different hospital than last time, and as if that wasn't exciting enough, I am on the telemetry floor! That means, I am in the right place to be able to see an open heart surgery (although I realize the likelihood of this is very slim).

By the end of the day, I was exhausted. I hate that feeling, because it really isn't that I'm doing anything that is extremely physical or anything.

Most of the day today was spent listening to our instructor tell us everything we needed to know and more. We spent 2 hours in an empty patient room reviewing how to move the bed, how to set a bed alarm, what is in the medication drawers in the patient rooms, and lots of other things. If I'm being honest, it felt like it was clinical day 1 in term 1... or at least how it should have felt. Lots of hand-holding by this particular instructor.

It probably would have been nice to have had someone walk us through everything at the very first clinical of the year, but at this point in the game, I'm pretty sure I know most of the equipment in the med drawer (i.e. needles, cups, gauze, etc.). Also, I think I did pretty well last term with just being thrown into it and being forced to learn, so perhaps because it was what I was used to, it was what I was expecting.

Oh, and I should mention that she made us watch some of the patient education videos that are available in the rooms for the patients. Wow.

In any case, after the two hours we spent in a rapidly warming patient room, we took a tour of this particularly huge hospital, with our instructor telling us about areas that are, for now, irrelevant to us. We eventually made our way to the learning center. And sat for another 2 hours or so discussing her expectations for the term from us and telling us about herself and the hospital network. We were then excused for lunch for an hour, and then reconvened to received patient assignments for the last hour and a half of the day.

The instructor then advised us to log on at our respective nurse's stations to make sure we could get into the computer systems. With the last hour, the instructor accompanied me and one other student for doing patient assessments. I had to go first, because the patient I was assigned was getting discharged that afternoon.

And then I went home and took a nap.

Oct. 27, 2011

2011-10-28T00:08:00.002-05:00

CAUGHT UP!!!!!!!!!!!!!!!!! My boyfriend has been harassing me about not being caught up on my blog, and has given me reminders of how far behind I am. Of course, he was behind on READING for about a month, but just caught up the other night. So, since he got caught up, I figured I should get caught up, too. Plus, I wanted to be caught up before clinicals, so I could spend a fair amount of time working on writing about my experiences!

Tomorrow (well, I guess later today) is my first actual clinical, so I'm very excited about that. I get to be on a telemetry floor again, with mostly cardiac patients and some pulmonary patients, which will be exciting. I am in the right place for the surgical rotation to possibly see an open heart (how amazing would that be?!?), but if that falls through, I will at least get to see a cardiac catheterization and help place IVs.

So, enough about what is to come -- let's get down to today.

The exam was intense. I studied, but I felt so unprepared when I was reading the question. It was NCLEX-style questions, which have like 3 right answers but you have to choose the best right answer. In some cases, though, I felt that all the answers were wrong, so I was choosing the best, least-wrong wrong answer.... if that makes sense. It was tough and definitely made me think a LOT about where I would put my priorities and how much more I need to think about the question before choosing an answer. And, not to read into it too deeply, because I think that screwed me up a lot today.

Then, we had 4 hours of lecture on the endocrine system. Wow. I didn't think we could have spent any more time on it than we did last term in TWO classes. Add four more to it, and wooo-- you've got a LOT to know about it! However, I do see the reasoning behind it, because diabetes is such a huge issue and one that is fairly common.

And, since we were lucky and class got out early, I was able to spend some time with my partner for community health so we could put together our teaching plan for next week (we have to teach school-age children about handwashing), as well as cover some of the presentations we need to put together. Good stuff. I feel a lot better after having met.

I have an idea about teaching handwashing to kids, and I want to see it work. I saw this teaching plan that talked about having Glitterbug Potion that has stuff that shows up under a black light. I would LOVE to do something like that but not have to spend $20.00 for the "potion". I could make something like that by myself, right? Uhmm, no, not so much. Not yet, anyways. But my boyfriend gave me a few new ideas to try, so I will give those a go tomorrow after clinicals.

And now that I am caught up, I am going to bed. Wish me luck, tomorrow!!

Oct. 25-26, 2011

2011-10-27T23:59:00.004-05:00

Tuesday was nice, with nothing to do except relax, study at my leisure, and work some more on finding articles for my community assignments. Each one requires at least one journal article. And believe me, trying to find an article that speaks to religion and medicine and how they interact in Bhutanese culture is not that easy.

Besides studying, I spent the day chilling and catching up on sleep. Well, mostly that was the morning, because I slept in.

Wednesday was the first day of Pharmacology with our actual professor. She is from China and has an obvious accent, although her English is better than I think most of the class was expecting. It took a few minutes to get into her rhythm and get used to her idiosyncrasies, but overall lecture wasn't too bad.

I think I was one of few who thought so, though, because a lot of people were complaining afterward about how difficult the class is going to be. Now, I don't think they have the right idea. I think it's going to be difficult because the professor originally had 6 hours per week to teach us, then it was cut to 4, and now it's down to 3. So, with how much the lecture is limited, we have even more to do on our own at home. Yeah, the hybrid idea for this class was not a good idea. I would rather see the community lecture be a hybrid class, because for the most part, what we do feels pointless to spend 6 hours a week on. There is so much downtime, we could donate time from that class towards Pharmacology and still be in good shape.

And, speaking of community health lecture, we had that right after Pharmacology, with another quiz, group quiz, and group activity that took up a lot more time than was necessary. The class concluded a little early (like, 1630) thanks to the guest speaker from the Public Health Department. I felt bad, because I was so far gone by that point that I just could not give her the attention I wanted to give. Interesting presentation, although I don't think public health is for me.

I ran home to take a quick shower before open lab, to try to wake myself up and freshen up for the last hour and half I would be spending at school. I grabbed a small bite to eat and headed right on back. Open lab wasn't too bad. I am getting better and more confident about starting a saline lock (insert the catheter to the vein, attach the pigtail line that is filled with saline, which can then be connected to the IV line). Now, I need to work on hanging the bags.

I did the IV simulator thing, too. The point of the assignment is to take a clinical situation, assess what tools we need, and then practice the entire procedure with a combination of the computer program and the attached fake insertion site with a fake needle insertion thing that detects angle, speed, advancing the catheter part, etc. I sat near my friend, who failed a few times before getting frustrated and letting me sit. I tried and passed on the first go, but I still had to do two more attempts. I let my friend try again, and she took a few more tries before she passed, but she had her minimum of three attempts with one passing. I then did two more attempts and missed the 100% by a hair!

So, all is well with that. We had until Thanksgiving break for that, but I'm glad it's done early!

The night concluded with some studying for the exam in the morning. Blech, very long day. Oh well -- onward and upward!!

Oct. 24, 2011

2011-10-27T23:08:00.001-05:00

Sooo, today was interesting. I was supposed to wake up at 0600 or so for class at 0800. Oh no. My alarm didn't go off at 0600, and I didn't wake up until 0815. Yeah, that made for an interesting morning. Did I mention there was a quiz? Yeah. I e-mailed my professor to ask about how I would make up the quiz and that I would be there in about 20 minutes. I threw on clothes and rushed in to class. And, lucky for me, they did a bit of review before the quiz, so I made it in time! Come to find out, I set my alarm to go off at 1800. Yeah, I never do that on days that aren't important. Only on days with a quiz or presentation or something. Because I'm special like that, haha.

After being exceptionally grateful for not missing the community health quiz, which was challenging, we had to do a group quiz and then activity with our clinical groups. We had to do a presentation on the National Health Objectives. I have nothing against presentations, but this is just one of about 10 that it seems we have to do for this class. And this was just an impromptu 10-minute one. Good grief.

I spent my lunch hour reviewing the IV administration videos, because that was the quiz for med/surg lab. The quiz was much easier than before, mostly because of less content to cover. Then, we began practicing starting an IV. Scaaarrrryyyy!!!!!!!!!! Not really, but still a little nerve-wracking.

Once again, I am not fast enough to get in for open lab, but I am signed up for 10-26 and 11-03. Plus, I got my IV simulator time on 10-26. Apparently, this is a computer program that we have to navigate to simulate putting in an IV, which should be interesting. But, Wednesday is going to be a very long day. I will be at school until 2000.

Oct. 22-23, 2011

2011-10-27T22:58:00.000-05:00

Weekend, glorious weekend. I spent most of it relaxing and cooking up pumpkins. That's right, pumpkins! I have a recipe for making pumpkin pie from scratch (except the crust, although I'm sure I could learn this, too). Since a lot of people in class have brought in treats, I felt it was my duty to make pumpkin pies, because it is the one baked good I know I can do really well and is totally unique. Did you know that the so-called pumpkin in cans is not actually pumpkin? I KNOW! It's butternut squash, which has a similar taste and texture to pumpkin. Fascinating!

So, the weekend was spent cutting and scooping and baking the pumpkin, scooping out the cooked meat, pureeing it and then putting it away in the freezer!! Wooo!! The hardest part is done, though, which is awesome. All that remains is adding the spices and yummy stuff and putting it in a crust to bake. Yum!

I did spend some time relaxing along with cooking up the pumpkin, and a little bit of time looking over some of the assignments I have for community/public health. There are quite a few presentations and such to work on. So, I will get going on those, even though I don't have to have them ready until the middle of November. But, better to get it done now than have it all pile up at the last minute!

Oh, and in case anyone was wondering about the party bus, it was interesting. I never really got into the whole drinking and partying thing, so it was a bit uncomfortable. Dinner was nice and I made some new friends, which was cool. Then, the drinking commenced on the bus (I took a few sips, but that was all for me for the night). And oh my goodness, I would have thought people would have gotten through the drinking/partying phase the first time around in college. I guess not, because I saw things I cannot un-see, haha. I imagine they were hurting pretty bad the next morning.

Oh, oh, oh! And on Saturday morning, I went to get a massage, because I figure I will need some calm before the storm of this term. Then, I went to this adorable country orchard, which is where I got the pumpkins. Cute place!! It halfway makes me want to have an orchard someday!!

Ahh, but one note of disappointment. We were supposed to do flu vaccines on Tuesday, but it fell through. Sad day! But, hopefully they will be able to reschedule that clinic for us.

In any case, a nice restful weekend. Bring on the week!!!

Oct. 21, 2011

2011-10-27T22:40:00.001-05:00

Check-offs went well today. Of course, I had the professor. Yeah, that one. But, she wasn't so bad. I had to give my patient (a mannequin) one oral medication and one parenteral medication, which turned out to be Demerol (when I was expecting insulin because of the more complex procedure for drawing up two types of insulins in one syringe). Then, I had to go over the side effects of the medication, explain what it would do, and then chart that I administered the med.

Overall, not too bad. I got marked down 0.5 points for not cleaning the injection site. I'd rather mess that up here in check-offs than actually out in the field.

And now, off to go get ready for the party bus tonight! It should be interesting. One of the guys in class organized dinner and the bus for anybody in the class who wants to come. A great opportunity to see and interact with everyone outside of class.

Oct. 20, 2011

2011-10-27T21:45:00.001-05:00

Class began at 8 today. Toooooo earrrrrllllly, haha. There just don't seem to be enough hours in the day, and it's only week one. Theory lecture again for med/surg, although much less somber. Today was about pain and the perioperative period. So, we learned all about what the nurse's role is prior to surgery and after surgery, and the various roles nurse can have in the operating room. As surgery is something that interests me (among a few other things), I found this pretty good information, although if I were to choose a role, I would choose anything BUT the circulating nurse. They don't actually get to scrub in it seems, but they just run and grab whatever the surgeon needs, scratches his nose if he needs it, etc. An important job, I'm sure, but not something that I would find challenging and interesting every day.

That is the beauty of nursing, though -- if you don't like what you are doing, you can move into another field.

More dimensional analysis today, too. More complicated than the last time, though. It was more about IV fluids and figuring milligrams per kilogram and how many milliliters that equates to. It's good information, although I'm not sure we really need to devote 4 hours to it; most of what the instructor teaches is right out of the book. They could perhaps just assign readings and homework assignments to turn in, since the biggest part of what we do on dimensional analysis days is practice problems.

Medication check-off tomorrow at noon!! I think I'm mostly ready!

Oct. 19, 2011

2011-10-27T21:36:00.001-05:00

Pharm, Pharm, Pharm. Today we had a substitute teacher instead of our regular professor, because she is apparently out of the country doing a conference in China. And I probably didn't mention this before, but I am nonetheless intimidated by the fact that she is an MD, PhD. Yeah, wow. I regard her already as a very educated woman who will know her stuff and will be an excellent resource.

But, the lecture today was great by our stand-in professor. She was really knowledgeable and pinpointed the most important pieces of information to cover. It's a lot of information, though. And, the best part is, pharmacology is a hybrid class, meaning half of it we are supposed to do outside of class on our own. So yes, it is somewhat intimidating and overwhelming at this point. But, it is doable. If classes before have been able to do it, so, too, can I.

And after lunch, more med/surg lab was in order. Because we didn't have enough fun the first time around! So, more practice on parenteral medication administration. So, three IM sites, three subcutaneous sites, and usually one intradermal site. Practice, practice, practice. I'm not really worried about the intradermal, which is like giving the tuberculin test (testing for TB). Come to think of it, I can't really think of any other uses for intradermal injections....

Oh well, so a few different techniques for each and special considerations for finding each appropriate site. The only part I'm worried about is selecting the size and gauge of the needle. I'm still a little fuzzy of how that works, although it's coming together bit by bit. And, open lab was helpful for practicing the actual procedure for how check-off was going to work, which was really nice.

Oct. 18, 2011

2011-10-27T21:16:00.001-05:00

Busy day today. Kind of a depressing beginning to the day. It was med/surg theory, which is actually the lecture. In any case, it was on elder care and end-of-life care. It was made all the more somber by the fact that our professor just lost her husband about 19 months ago, and it was a very sensitive topic for her. But, she did really well with the information and, as unfortunate an experience as it was, she was able to provide some very good, first-hand experience from the perspective of a family member receiving care.

After lecture, the Dean of the School of Nursing brought in ice cream (apparently our school has a major that requires the students to make ice cream and cheese and stuff! Cool!!) and presented very briefly on the history of school. It was interesting to see how the school was founded and how it developed and how the nursing program emerged.

Then, I had lunch and went to one of the local hospital offices to do my training for their electronic medical record system. Thankfully, I was able to get a lot of training and preparation done for that the night before and didn't have to stay for the full four hours, but was done in two. Already, I feel exceptionally overwhelmed with so many things to do that I just don't even know where to begin!!

Oct. 17, 2011

2011-10-27T21:09:00.001-05:00

Happy First Day of Term 2 Day!! Or something like that....

Anyways, the day began with orientation to our clinical instructors and discussing how clinicals were going to be and what was expected of us and going over all the paperwork associated with clinicals. Except, it was only our Tuesday clinical, which is community / public health. Our instructor seems nice and laid back. She said she wouldn't make the term any more difficult for us than it already is, so that is nice to hear.

Remember that professor I may have mentioned before who doesn't teach very well? Yeah, she is our professor for med/surg lab. Yay. She actually seems better now than for the IPR teaching she did before. I think perhaps she just hasn't been a professor in a while and needs to get reorganized and reoriented to it. But still, it makes learning difficult when I just can't get a straight answer.

Oh yeah, and we had a quiz today. It wasn't too bad, but there were a LOT of videos to watch to prepare for this one. In any case, I missed out on open lab sign-ups, but I did get signed up for Wednesday to practice more of giving shots and administering oral medications. After all, we have to check off on it on Friday. Yeah, I don't feel unprepared at all!!

Oct. 14-16

2011-10-18T23:36:00.002-05:00

So, Yellowstone was amazing and gorgeous! It was chilly, though! I realize I should not be surprised by the cooler weather in that region in the middle of October...

In any case, it was an amazing visit with my boyfriend, and we had such a good time together (as always). We got to do lots of walking around and hiking, so I at least am quite sore. Did I mention it was absolutely gorgeous this time of year? Yeah, it was. The coloring was beautiful, although it would be interesting to go back at another time to compare the water levels (it looked a bit dry?).

Here are some of the highlights:

Beautiful Bull Elk

I think I figured he was about 6 points; him and one of his girls

Waterfall

Barely visible!!

I just love the water!! Look how clear it is!!

This was called "Red Spouter"; very appropriate name....

The steam was just blowing at us; it was amazing, like a sauna!

It's like a mummified or petrified dragonfly..... Not really sure what it's called when it is preserved in hot water...?

I am still amazed by how crystal clear the water is...

Such an amazing big splash...

...followed by an adorable little splash....

The tail-end of Old Faithful

Water, water, water

BUBBLES!!!!!!!!!!!!!!!!!!

I just love the colors.....

Look at that baby's face!! So cute!!

This is Dragon's Mouth Spring... it really does look like there's a dragon living there.....

And it was a gorgeous sunset in this valley!!

It's a little fairy land!! That's what we both thought, anyways. It's this little green happy place in the middle of all the brown surrounding it (of which there was a lot!)

So... the sulfuric acid must have corroded this grate..... Hmm.....

Grand Canyon of the Yellowstone; I think the water looks kinda fake because it was getting dark.... digital cameras don't do well with poor lighting, apparently....

Just a pretty shot of the valley and the mountains beyond

I love the water action shots and the variation in color surrounding the geyser!

And yet another gorgeous waterfall; this one we almost would have missed if we didn't stop and look back!

The road surrounded by those funky rocks looked cool....

The Terraces at Mammoth.... such interesting formations, no?

Here's some more of the terraces...

I have a fascination with clouds.... GORGEOUS!

It just amazes me how different the landscape is in certain areas, and how normal it looks all around it!

So much constrast and juxtaposition here... light, dark, normal, abnormal. Lovely!!

So, those are some of the best of 200+ pictures I took. Yes, I go a bit shutter crazy, but I just want to get the best possible pictures. Aaaanyways, so I am home safe as of 1730 my time! I am happy I got to see my sweetheart, but sad at the same time for having to do the whole goodbye for now thing all over again.

AMENDMENT:

I was home safe. There was something in my window well this evening. I heard some movement as I was unpacking and after I took my shower, but I was too scared to open the blind, for fear it was something creepy. Like a peeping Tom. Or something...

I finally got up enough courage to pull up the blinds, and I shone my flashlight out the window to better visualize what was out there. Not a thing... No movement, no person, no animal. Nothing.

So, I went back to studying for the quiz I had (yes, homework before the term even started.... awesome). I heard more rustling, but wrote it off as the wind. I then cracked open my window and heard patterned scampers and saw movement. So, I grabbed up my flashlight yet again and shined it right onto a rodent!! It must have been hiding right along the wall below the window, so I wouldn't have seen it.

I went upstairs and asked my landlord how he is with rodents. He thought I meant there was one in my room, but I told him there was, in fact, a mole-like creature in my window well. He grabbed his son, and we all went out to investigate. When we got to the window well and shone our flashlights in.... nothing. Elusive little beast, if I do say so myself!!

Then, I saw the little drain pipe to drain off water from the window well. I asked if it could have gone down there, and my landlord said that it probably did and that he should have taken care of the covers for it before. His son jumped down and looked into the drain and sure enough saw the rodent. He spent a good 15 minutes or so trying to decide if it was a bunny, a mole, or a rat. If it was a bunny, he wouldn't have been willing to kill it. So, he finally figured that it couldn't be a bunny and was probably a mole or a rat.

He shot it and then it took him and his father another 15 minutes to pull the creature out of the hole. In the end, it was win-win for us humans, as I didn't have the rustling rodent in my window well anymore and my landlord would have one less mole destroying his lawn.

I have now had enough fun for one weekend and am going to bed.

So, here's the little beast in the drain pipe....

And here is the post-mortem shot.... see the hands? Yep, mole.

Oct. 13, 2011

2011-10-18T22:27:00.002-05:00

The Communication final was easy, as predicted. The little studying I did do was unhelpful; most of the test questions aren't really things that are in the notes. It's more, as I said, common sense. Don't be an idiot when you communicate with your patients. Although, I admit for me, sometimes this is difficult; there are times when I get so dang nervous and I experience the word vomit phenomenon. Words just come out without any conscious thought. I am working on improving the connection between my brain and my mouth, haha!

Anyways, I went home after the final, made myself beautiful, finished up the last minute packing, and relaxed a bit before picking up a friend (who was flying to the same place I was flying to!) and off to the airport we went!!

We made our first connect just fine, but the second connection was delayed for like an hour. So my poor boyfriend had to wait even LONGER than he did before. But, it was definitely worth the wait for me to get a chance to see him. :D

Now, we are off to Yellowstone for a mini-getaway! Yay!!

Oct. 12, 2011

2011-10-18T22:23:00.002-05:00

The patho final was rough, but definitely doable. I only had a few questions that I was unsure of and had to go back to. It's probably the best test strategy I have: answer the questions I know, mark the ones I don't and come back to them later. Then, try to reason why each answer is wrong, and if I can't reason an answer as wrong, it is more of a possibility that it is the correct answer.

In any case, it was such a relief to have that exam done. It was the big one I was the most worried about, although I had a lot of leeway in terms of how many points I could miss and still maintain a good grade.

After the exam, I went home for lunch and then came back at 1300 for the presentations in Professional Nursing. And, of course, we were next to last. I would have had us go first, if I had a choice, just to be done with it. The other presentations were really interesting, though. One was about animal-assisted therapy, and another was about violence against nurses in the workplace. Our presentation was about perceptions of nurses, both public perceptions (to include stereotypes) and perceptions by other health-care workers. I feel we did really well, but I am happy to say that it's done.

Now, I would love to say that I came home and studied, but in all honesty, I came home and packed for my short trip to see my sweetheart :) I did do a bit of studying, though, but for the final tomorrow in Communication, there really is only common-sense preparations to be made.

So, packed and ready to go, except for a few minor things that can be packed in the morning. Wahooo!!

Oct. 11, 2011

2011-10-18T22:18:00.000-05:00

First final down!! It was Health Assessment, which was a fairly easy final. I still hate being one of the first two people done (it's always me and this other girl), because it makes me second-guess myself and wonder if I actually knew the material as well as I thought I did.

So, I hung out after the test to wait for my clinical group for our short meeting before the presentation tomorrow. Once we all finished and got together, we sat down and reviewed what we had for the presentation up to that point. Everyone seemed satisfied, and there were only a few minor things that needed to be changed.

I went home and made the few adjustments, added a few pictures, and voila! A presentation was finished and sent out to the group for final approval.

Then, I spent the rest of the afternoon reviewing my notes for pathophysiology, taking time to handwrite the most important pieces of information from each section. It takes time, but it really helps me in a few ways. First, I am reviewing all the notes but only pulling out the most important points and writing it in my own words, essentially explaining it to myself in my own terminology. Second, handwriting stuff always helps me remember it better.

So, one final down (94%, by the way!) and two more to go.

Oct. 9-10, 2011

2011-10-18T20:17:00.002-05:00

Long, restful weekend. Sort of. I am glad there was a holiday, but at the same time, the long weekends really throw me for a loop.

In any case, it has been a weekend filled with much studying for finals! Hooray for finals week! I can't believe the term is already almost over. It really doesn't seem like it has been two months already, but I suppose time flies when you're having fun. Or at least when you are busy!

I did some studying this weekend at one of the college libraries in town, and it was so quiet, I could have heard a pin drop. Imagine that, a library that is quiet on a Sunday morning. Who would have thought?

I spent time studying and preparing the presentation for this week, as well as putting together my professional portfolio. It looks awesome, although I really wonder if we ever have use of these? I've never been in an interview where a professional portfolio has been used, although perhaps a nursing career is different. I'm not really sure, but I look forward to adding more to it throughout the year.

So, that's that. Time for finals week!! Bring it on!!

Oct. 8, 2011

2011-10-18T20:13:00.002-05:00

Last clinical day!!! And let me say, it was amazing.

I was the 6th of 8 people to arrive for clinicals, and because we didn't have assignments given to us, we apparently got to choose the patient we wanted. First come first serve. I looked over the remaining three patients, and opted not to choose my patient from last week, figuring I'd try someone new. I chose a patient who was in for rule out MI and was just transferred out of the ICU.

And it was a good choice. Although, I admit, I wasn't really sure what to do with such a nice, quiet patient who wanted nothing more than to be nice and polite to me. Goodness, I was wondering why he wasn't yelling at me!

Then, later on in the course of the morning, we had our evaluations with our instructors. They both told me they wanted to take a copy of the concept map and care plan I had done, because it was the most perfect one they had seen. They only took off one-quarter of a point!!

I was very excited and humbled, though, when they told me that I have been a pleasure to have in clinicals. They told me that I respond well to their advice and apply it immediately to the clinical setting (as opposed to arguing and grumbling about it), as well has maintained a very positive attitude even with very challenging patients and duties to perform. They then told me they had two options on the evaluation form, Satisfactory and Unsatisfactory. But, they felt it would not do to lump me in with the rest of my classmates by selecting satisfactory, so they put "highly" next to it and created a new category.

HAPPY!!!!

Don't worry -- I'm not letting it go to my head; I'm incredibly humbled and grateful that I did as well as that. I knew that I couldn't have done poorly, but I honestly did not think that I did THAT well.

In any case, it was an amazing, fulfilling clinical experience this term, and I look forward to more next term!!

Oct. 7, 2011

2011-10-07T22:44:00.001-05:00

So, there has been a wild wind happening for the past few days, which is pretty exciting. I didn't sleep as soundly as I would have liked last night, but I am feeling much more human today.

I have finished up my professional portfolio!! Yay!!! All I need to do is revise the tabs I have in there.... they are hidden by the plastic sheets I have all my papers in... Oh well. I also have been piecing together the powerpoint presentation for my group presentation next week. So far, I have received pieces from two classmates, and I have my portion mostly complete. So, just waiting for 5 more pieces, which I should have by Monday morning, and then we will be good to go for presenting next week!!

Aaaand, we don't know what we're in for in clinical tomorrow. Apparently there aren't very many patients, but there should be more coming in from the ICU in the morning, so we all have mystery patients right now!! I am a bit nervous to see who I will have tomorrow, because I did tell my instructors to keep giving me the difficult patients.... I'm sure I was going for having more opportunities to learn... but really, what was I thinking?

Oh well; tomorrow should be great. It will be the last day of clinicals for this term, and I will get my evaluation tomorrow (I hope). Then, it will be time to study, study, study for finals next week! Wahooo!!!

Good night everyone!!

Oct. 6, 2011

2011-10-07T12:59:00.000-05:00

Braaaaiiinnnnnsssss........ BRRRAAAAIIIINNNNSSS..............

That's about how I felt this morning. I slept horribly last night, and I halfway wonder if it was the crazy wind going on all night. Possibly....

In any case, Communication class started at 0800, and to nobody's surprise, finished at 1100. I don't know why we start so early to have a two-hour lunch. It just kind of throws off my rhythm. Oh well....

Today we lectured on anxiety, grief and loss, and conflict. Very quick day, followed by evaluations. Not too bad, although the content was a little straight-forward and kind of common-sense.

The "lab" for this class followed lunch at about 1300, and we did a few activities and skits and watched a movie about conflict and anxiety and how to be assertive when faced with conflict. We then took a few quizzes about our experiences with death, so we know where we stand when it comes time for us to handle it in our working environment.

The day ended with a 1.5-hour lecture from a Thanatologist, or someone who studies death and specifically grief associated with death. It was an interesting enough lecture, although I started feeling like a zombie again.

Some of the highlights:

Bereave originates from the old English word, berafian, which means "to rob". So, to be in a state of bereavement means to be in a state of having been robbed. An interesting way to think of loss.
Handling grief or difficulty in the animal kingdom:

During a storm, a turtle will hole up in his shell and wait until it passes. Often, humans do this, too, figuratively speaking; we withdraw into ourselves and wait for the hurting to pass.
During a storm, a bald eagle will fly high above the storm and just hang out until it passes. Humans who don't withdraw often do this; instead of working 40 hours, we work 60+ hours to keep ourselves busy enough to not handle the grief.
During a storm, a tatonka (yes, this is the actual term the thanatologist used; a buffalo) will turn into the storm and walk into it. This is how we SHOULD handle grief -- just deal with it head on and get it over with sooner rather than later.

Interesting day, although a bit of a downer at the end of the day and end of the term (for lecture, anyways).

After class, I went home and gave in to my zombified feelings and took a nap. You thought I was going to say that I ate brains, didn't you? Ha! No, just took a nap to recover some sleep.

Then, I watched some TV and will very soon be heading to bed for hopefully a full night's sleep! No more zombie me!

Oct. 5, 2011

2011-10-07T12:44:00.001-05:00

Last Lecture in Patho.... EVER... I think I'm actually sad about this, although I am excited to move forward with my learning. We did Reproductive system disorders today, and it was a very short, 1-hour lecture. Then, we filled out the professor evaluations and had an early lunch.

After lunch, we had our last lecture in Professional Nursing, too. This class is just too much fun, and I really wish we would have met more often. This is only the third time this class meets, and the last time we meet next week will be for giving presentations and doing professor evaluations. We took a group examination today, then worked on defining the scope of practice for different levels of nursing. This ties in with education for nursing, and we learned that many hospitals are no longer hiring RNs without a BSN. It's becoming the preferred education, and when I did a job search just recently, I noticed that every job listed for an RN says BSN preferred, required after 2018.

After class, I hunkered down at home and watched Inception. I really, really like that movie. I studied a bit for the quiz in Communication and then off to dreamland. Only one more day of actual class, and then it's over and done with for this term! Amazing!!

Oct. 4, 2011

2011-10-05T09:09:00.001-05:00

I ended up staying up until about 0200 last night (this morning?) to finish up the concept map and care plan I needed to finish up. It took me FOREVER to find an article from a nursing journal about GI bleeds. But, I finally did, and was able to finish up that assignment and turn it in around 0145. I try not to do late nights like that, but I figured since class wasn't until 1300, I could afford to stay up a bit later and sleep in a little bit.

And yes, it was Tuesday so Patho Exam day. Today was Examination 3, and was the last exam before the final!! I didn't do as well as I usually do; the sensory system always gives me trouble. I didn't do terribly (82%), but that's much lower than I have been getting (96%). I will just have to get at least an 84% to maintain the A letter grade I have in there.

Anyways, enough about grades. Lecture was pretty interesting. We were supposed to just do a lecture about blood diseases (anemia, leukemia), but the professor decided to add in bleeding disorders. So, we stayed the full time of class, and get to start class an hour later tomorrow.

After class, I came home and relaxed. I have turned in just about everything I need to turn in for this term, and all that's left is examinations and a group presentation, which we will probably work on this upcoming long weekend.

So, let me just say, Thor is such a great movie. I think it could possibly be my favorite of all the Marvel films so far, although Captain America is a close second. Perhaps it is my love of mythology that influences how much I like Thor? Maybe... Oh well. Did anyone notice Odin's horse? 8 legs--straight out of mythology! It was such a small detail, but so cool. Anyways, that's all for now!

Oct. 3, 2011

2011-10-03T20:56:00.002-05:00

CAUGHT UP!!!! So, let me apologize for being a bum about keeping up with my blogging. However, I just churned out two weeks of content within a few hours, so I'm feeling pretty good about that!

Anyways, I should be covered from Sept. 19 up to now.

I spent most of yesterday (Sunday) doing homework. I finished my Denver write-up (I found a question that I hadn't answered), read an assigned article for discussion and posted my thoughts, and finished up the IPR analysis. I tried to work on my concept map, but I have been having a hard time finding an article that speaks to the main medical diagnosis my patient had. Not too eventful of a day until I was just about to go to bed.

I noticed something dark on the floor as I was walking through my semi-lit living room back to my bedroom. I turned on the light and saw the biggest, scariest spider I have ever seen in my life (except the ones at the zoo that have glass between us). Now, I have this terribly irrational fear of spiders, and I rely on my boyfriend to dispose of any spider, no matter how big or small. Unfortunately for me (but probably fortunately for him) he isnt' here to take care of my spider issues. So, I had to handle this one on my own. But first, I did what any rational human does and took a few pictures of it. And yes, I threw down a quarter next to it for size reference. Something I didn't think through very well, because I realized afterwards that I may never see that quarter again....

See? Killer spider.....

Anyways, I grabbed some of the indoor bug poison I had and gave it a direct spray. It didn't like it very much and took off down the hallway towards my room. I sprayed it again and once more for good measure. Then it just kind of stopped moving. I figured I had won, but then gave it some thought.... Should I leave it there until morning? What happens if it's not actually dead but just pretending to be dead so it can come into my room and eat me while I'm sleeping? (I know, irrational....)

So, I opted instead to grab a few pieces of paper to pick it up and put it in the toilet. I made sure to keep the maximum amount of paper between me and this killer spider, and when I tried to pick it up, it was still about 40% alive. So it moved.... a lot..... At this point, my NyQuil was kicking in, so I was trying to be as clear headed as possible, but I'm sure I made the process of picking up this spider much more difficult than it actually needed to be.

I finally got it on the paper and the dropped it into the toilet. It sunk, which was weird to see. Then, I flushed it away, thinking about what I would need to do in the morning, which would include a thorough inspection of the area around the toilet, in case it somehow came back up the pipes to attack me when I was most vulnerable. I realize this is irrational, but I can't help but be afraid of the vengeance of killer spiders.

So, after that fiasco, I went to sleep. I spent the night in a NyQuil-induced coma. Awesome. I had a good day in lecture. It was about sleep and then the reproductive system and how to assess for both. We were supposed to stay until 2, but we finished up at 12, so that was great. I got to come home and take care of some laundry. I then proceeded to pass out for a 3-hour nap. I awoke with such energy that I cleaned my place and organized a bunch of stuff and then decided to get going on catching up on my blog!

So, that's where we are now. I am excited to be done with this term. I just got the calendar for next term today and it's BUSY! Bring it on!!

And, a few days ago, I got a care package from my mommy, and today I got a care package from my boyfriend. I have such an amazing family! They send me such fun and interesting things!! I love them all very much!

Here's the Halloween lanterns my mom sent me! I think Halloween is my favorite holiday.....

Oct. 1, 2011

2011-10-03T20:14:00.000-05:00

Happy first day of October!! I actually just forewent all my catching up so that I could accurately capture the mood of today. Not that when I miss a day or two (or a week or two) of writing I forget how I felt on a particular day. It just takes some thinking, and right now, in this moment that I'm writing, today is still pretty fresh.

So, clinical day today. Wow. It started with a bang... Actually it started with nothing at all. Yeah, no alarm that is. I looked up at my clock, wondering what time it was, and it was 6:35. After a few seconds of stunned silence, I shot out of bed like a rocket, thinking, "I needed to leave five minutes ago!!!" There were also a few expletives in there, but I will let you use your imagination on where those appropriately go. I will say that I briefly investigated the reason for the faulty alarm, and I found nothing wrong with the volume (which I checked the night before), and I did not push the snooze button while half-asleep. Radio broadcasting issue is all I can think of.

In any case, I was grateful that I had set out my stuff the night before, because all I had time to do was throw on my scrubs, grab my bag (which has my wallet, textbook, stethoscope, ID badge, clipboard, etc.) and my lunch. I left my house at around 6:44, and arrived at the hospital at around 6:56. I had just enough time to RUN to the elevator to get up to the floor in time for 7:00 morning report. Yes, I probably could and should have booked up the four flights of stairs (yes, four; the bottom floor is considered Ground, the next floor up is Floor 1), but I figured I wanted to be able to breathe when I got upstairs.

Lucky for me, morning report was a bit late, so I had a few moments to compose myself and tell my bladder to quit harassing me for just a few moments. So, morning report was successful, and then I learned how to do a measurement for a patient with a PICC. Then, off we went to go gather vitals.

My patient today was a rather large fellow, although was pleasant enough for most of the shift. I was happy that he was as cooperative as he was, because everything else was very, very tough with him. Because he had a fistula (for dialysis) in one arm and a PICC in the other, blood pressures had to be taken in a leg, which was a new experience for me. I barely was able to take his vitals and chart them before I needed to get back into the room for bed bath and changing dressings. Oh, and the room was contact precautions--so gown and glove up!!

I required some help with bathing the patient, as he had lots of tissue to move to get to fungal infections and because he had a hard time rolling to one side for us to scrub his back. Thankfully, I had a classmate who was willing to help, and I truly don't think I could have managed alone. It was a great day for the "TEAM" in "health care team". After spending most of the morning changing a dressing, doing his bath, helping him move up in bed a few times, and doing a brief assessment on him, I finally got a moment to sit down at around 10:45. At this point, my bladder had given up hope that I would respond, so I took an opportunity to take care of that little hiccup. Then, I had some water--I was parched from a lack of breakfast! No sooner did I enjoy some water and sit down for a few moments to begin writing down my assessment findings then my instructor walked in to tell me I needed to do a blood glucose on my patient. He was about ready to have lunch and needed the glucose taken beforehand, so we would have enough time to feed him before taking him down to dialysis.

As I was preparing to enter the room to do the glucose test, he called for a bedpan. I snagged a classmate to help me, and once again, I was incredibly grateful that she was willing to help. When he was finished, I went back in to do the glucose test, get him off the pan and clean him up, do a hemoccult test on the stool, clean the bedpan, and then assist 3 other nurses to put the patient in his dialysis chair. After we got him comfy there, he had his lunch, and then I took another set of vitals and wheeled him down to dialysis. Once there, it took 4 of us to move him up in his chair so he was comfortable (he tended to slide down a lot). At this point, it was around 12:00 or so, and I got to put in the second set of vitals and start eating my lunch.

Lunch was interrupted twice for me so I could respond to the care my patient needed (move up in the chair, scratch his back). Today was the day that I truly began to understand what our professors have been talking about when they say that nurses don't really eat meals, they sort of graze throughout the day.

So, that pretty much concluded the care of my patient for the day, because dialysis was a 3-hour process and that about finished my day! He actually just got rolled back into his room when I was leaving for the day.

I spent some time doing my charting and finishing my lunch, and then we had some post conference meetings and a quiz. We reviewed our concept maps and care plans individually with the instructors. My instructors said that I did very well on my homework, taking first place in the "least red ink" contest. They also made a point to tell me that I am doing very, very well on the floor and that I'm a huge help. This made me feel pretty good, because I haven't really felt like I've been doing much. It seems like we are so limited on what we can do because we haven't learned it all yet, so I tend to feel useless or like I'm just sitting around doing nothing.

The one instructor also said that the patient they gave me today is a patient they never give to students unless they are very short on patients. So, apparently they think I am capable enough to handle a rough patient. This also made me feel good, and I told them to keep the tough ones coming, because I am loving the opportunities to learn.

After clinicals today, I had to rush home, shower, and change, because I had a Denver II test to administer to a 3-year-old. It was fairly simple to do, especially considering that I hadn't really looked too intensely into what I was going to be doing with her. But, she did really well and was exactly where she needed to be developmentally. She got a little shy when I was asking her questions, so there were things that I couldn't pass her on; I just simply stated that she didn't do them, which isn't to say that she can't.

Afterwards, my friend who set this up and I sat around talking for a good hour or so, and then she invited me to stick around to study with her. I didn't have anything to study with, so I offered to go home and gather what I needed, as well as pick up some dinner for us, and then we could have dinner and study together. She appreciated the company, as her husband and children were out of town, and I was happy to have someone to hang out with and study with (otherwise there may not have been any studying happening).

So, we completed the Denver II write-up and got a good way into the IPR write-up. I didn't get done everything I wanted to get done, but I feel like today was a good, productive day.

And, my thought for the day, after a wild crazy day, is: It is better to conquer yourself than to win a thousand battles. Then the victory is yours. It cannot be taken from you, not by angels or by demons, heaven or hell. ~Buddha

Sept. 30, 2011

2011-10-03T20:13:00.001-05:00

My partner and I agreed to meet about an hour before the examination so we could take a real set of vitals to put on the paperwork (instead of making something up) and do a verbal walk through of what we plan to do. Since we were there a bit early and were prepared, we got to start a bit early, which was really nice. My partner examined me first, and did a really good job and was like 27 minutes. She only forgot like one or two things.

Then, it was my turn. I did the best I could to try to remember everything, and I only forgot to check her sinuses for pressure or pain! Yay!! I did go over by like 30 seconds, but because the professor didn't know when the timer she was using reset, she let it slide. After we both did our assessments, we had to sit down and chart our findings. That took all of 30 minutes to make sure it was thorough and that I had everything I needed on there, both positive and negative findings.

Interestingly, the night before the assessment, my partner noticed the back of my throat was really red, and this morning, she noticed the same thing, and that my tonsils were enlarged. I cannot get sick, but I have been coughing all day. I cannot be sick tomorrow!! I don't want to share with my patient!!

I spent the rest of the day working on my assignments and my portfolio for Professional Nursing. Early night to sleep tonight -- I'm going to need as much rest as I can give myself to get well!

Sept. 29, 2011

2011-10-03T20:06:00.002-05:00

So hooray for the IPRs today. I got to sleep in a smidge, as I had already done preschool. Lecture began at 1200 today, and it was on culture and how to communicate in a culturally competent way. It's going to be difficult to get rid of some preconceived notions I have; not that I consider myself a particularly racist or prejudiced person. However, we did a brief exercise before beginning lecture, and it made me realize that I need to keep a more open mind and take some time to learn about other cultures so I can consider more than one reason.

One of the situations was a young woman coming in with welts and circular burn-looking marks on her back. My immediate reaction was that she was abused, but the actual situation was that she was of a culture that believed in cupping. I have never heard of this practice, but apparently a cup is heated up and placed on the ill person's skin to draw out evil spirits.

Another situation was a women not wanting to see her baby right after he was born. My first thought was an undesired pregnancy, perhaps a rape. But, the situation was again a cultural belief that there must not be any bonding with the child until it has reached a certain age, because it may be susceptible to learning evil ways.

So, point of the story is that I would like to spend some time learning about other cultures and religious practices so I can be more culturally competent and have a more open mind to not just jump to conclusions.

After lecture, we had the IPR experience. I had a strange situation. The scenario was set in a busy walk-in clinic that was understaffed. I had to go in to see the patient to find out what brought her in and to tell her that it was going to be at least an hour before the doctor could see her. The client was avoidant and made eye contact maybe once. I basically just took care of what the objectives were on the scenario sheet, and then went to write down every word that was exchanged to analyze later. It was really nerve-wracking and I don't think I did anything correctly. I felt like there wasn't much opportunity to be therapeutic.

In any case, I am glad it's over. That was one stressor I am happy to have behind me.

My lab partner came over one more time tonight so we could practice for our exam tomorrow. We were both under 25 minutes and only forgot a few things. Overall, though, I think we are super prepared and are going to do really well.

Sept. 28, 2011

2011-10-03T19:56:00.002-05:00

Sensory system continued! There is soooo much information on the sensory system!! It's almost more information than there was on the heart! It's kind of overwhelming and there is going to be so much to remember!! But, after today, there are only two more lectures. I'm actually kind of sad, because I love this class so much. It is so interesting, I wish there was like a refresher course or something later on. Maybe there is something like that for continuing education when I actually get done and get a job.... Hmm.... Must look into that....

I think what I find most interesting in Patho isn't really in class. I am enjoying seeing in clinicals what I am learning in class. There are so many more interactions that we can possibly learn about in class, but I am just fascinated to think about how everything pieces together and how it sums up into a patient's presentation.

Anyways, back to class. After lunch was the second time we meet for Professional Nursing. What a fun class this is! We did this activity where we had to write our answers to a "Would You Rather _____ or ______?" quiz. It was kind of fun and kind of serious, and made me really think. It revealed so much about us, as we were standing up for each answer and giving explanations about why we chose that answer.

The point was that each of us is unique and it is that uniqueness that will make each of us a good nurse. We can be the smartest people in the world, but it is our personalities that make us great nurses. And, we must embrace our individuality and never forget that each patient is an individual also. It was a very thought-provoking and amazing day in class.

And, once again, class got out early and we were able to bump up our open lab times. My partner and I were able to get into an exam room to practice with the otoscope and ophthalmoscope and adjust the bed a bit, so we were satisfied. We opted not to do a practice exam on each other, deferring it until the next day.

If anyone is interested in that "Would you Rather ____ or ______?" quiz, I will post it here. It's kind of interesting to think about why you choose each answer, and even more interesting is that you will think more about the question and how you would justify your answer as you go along. By the end, you may want more information about each question. Enjoy!!

1. Would you rather go to the doctor or to the dentist?

2. Would you rather eat carrots or broccoli?

3. Would you rather listen to music or watch TV?

4. Would you rather own a lizard or a snake?

5. Would you rather go on a beach holiday or a mountain holiday?

6. Would you rather BE a banana or an apple?

7. Would you rather have the ability to read minds or be invsible?

8. Would you rather be hairy all over or be completely bald?

9. Would you rather be the smartest person or the most popular?

10. Would you rather be in a newspaper headline for saving a life or for winning the Nobel prize?

11. Would you rather go the rest of your life without having fast food or without having TV?

12. Would you rather have permanent constipation or permanent diarrhea?

13. Would you rather be very handsome or beautiful and very dumb, or ugly and very smart?

14. Would you rather be always hot or always cold?

15. Would you rather not be able to hear or not be able to see?

16. Would you rather eliminate hunger and disease worldwide, or create long-lasting world peace?

17. Would you rather be stranded on an island alone or with someone you don't like?

18. Would you rather see the future or be able to change the past?

19. Would you rather be three inches taller or three inches shorter?

20. Would you rather fight a lion or a shark?

Some interesting facts, in case you might be interested:

If you chose carrots over broccoli, you have a higher likelihood of having a sweet tooth.
Invisible vs. Reading minds -- there is a gender disparity and not really what you would think (or at least not the way our class seemed to think). Men typically want to read minds, where women typically want to be invisible.
The extreme stereotypes of ugly and smart vs. beautiful and dumb brings to light trust. One's appearance is directly related to how professionalism is perceived. If you walk into a patient's room well-groomed, good hygiene, the patient will see a professional and will trust you.
The choice between not seeing and not hearing is often the choice that has the most disclaimers and explanations.

Sept. 27, 2011

2011-10-03T19:34:00.000-05:00

Tuesday means what?! Yep, you guessed it, Patho Quiz/Exam day! Today was a quiz, the last quiz of the term!! And guess what? I just couldn't focus while studying. I really hate it when I have a million other things on my mind and no matter how hard I try, I just can't stay interested and study.

So, needless to say, I felt really crappy about the quiz. There were about 8 questions that I had to come back to. Which was about 1/3 of the test. I was able to reason through most of them. I find that if I look at each answer and write out why I think it's wrong, it is a better way of doing the process of elimination, because I'm actually recalling information. Blech, I just felt so bad about it though.

I couldn't even bring myself to look at the key the professor posts on the wall. BUT -- I only missed one!! Hooray for my reasoning skills and for my dumb luck for guessing!!

Lecture was on the sensory system, but once again, I struggled with staying focused. Usually I can shift gears pretty easily, but I was fixated on how unprepared I felt for the test. There is a lot to know about the sensory system, though, and it's all very intense. It just blows me away how something so small can cause so many problems downstream. I guess this shouldn't still amaze me, but it does.

This evening, I had my lab partner over so we could practice for our Physical Assessment exam. We did pretty good. She's really fast. We have a 30-minute time limit to get a full head to toe assessment done. She was consistently under 25 minutes, and I'm about 27 or 28 minutes. We each did two run-throughs and will practice again on Thursday evening. I'm not really nervous about doing the exam; I'm just worried I'm going to forget something big, like listening to the heart or something!

Sept. 26, 2011

2011-10-03T19:23:00.000-05:00

After spending most of the day yesterday working on the concept map and care plans that I have to do for my clinical experiences, I realized I had some missing information from my patient for the first one, so I woke up extra early to go to the hospital to gather that last bit of information to put in and complete the first one. Lucky for me, I didn't need as much time as I allotted, so I got a good parking spot at school and got to class plenty early, which is always nice! And, today the lecture was really easy, just a few hours with a video. It was the last really important lecture for health assessment, because it pulled together all the body systems into how to do a full head to toe assessment. And yeah, there is a physical assessment examination that my partner and I are going to do this week on Friday.

Class was done at 1200, and they bumped up the open lab times. We had originally signed up for 1600, but because they moved up the times, we got to go in at 1300. My partner and I got there early and nobody else was waiting outside, and as people started to gather, we mentioned to some people that we would like an examination room to get the general layout and practice with a few things because we were the very first group to go in and do our exams. A few people rolled their eyes, and there were a few groups who bolted right past us to the examination rooms.

I am frustrated about how rude people can be. This was a competitive program to get into, but now that we are all in, I don't think we need to be competing with each other anymore. It's not like we are graded on a curve. But, the way I see it, what goes around comes around, and those people who were so inconsiderate will get their own.

My partner and I then were forced to going behind the curtains, which is a bit awkward, and after our hour was up in lab, the two groups in the examination rooms still hadn't come out. I at least wanted an opportunity to adjust the exam table and to look at the wall-mounted ophthalmoscope and otoscope... Oh well; we blocked out some open lab time on Wednesday, too, so hopefully we can get in for just 10 minutes or so then.

Sept. 24, 2011

2011-10-03T19:13:00.004-05:00

Today I made an extra special effort to leave the house early so I could get to the hospital early enough to find out if there were patients admitted to the floor overnight, or if I was going to the ICU, and in that case have enough time to find the ICU and be early enough to get report.

I found my instructor, and she was surprised I was so early, but she told me she told me they had gotten two patients overnight and that she had a really nice patient for me. I was a bit disappointed that I didn't get to go to the ICU, but I was glad that I would be able to stay on the floor to be able to ask for help if I needed it.

Well, I am happy to report that when my instructor said she had a nice patient for me, she was being sarcastic. I had the most cranky patient EVER. Now, my clinical career is all of two days at this point, but I don't think I've encountered anybody in my life that cranky. But, I am happy to say that I was able to provide him with the highest quality care possible (he was not very verbal, even though I was pretty sure he could hear me) and I was kind to him through the entire shift. I know he wasn't mad at me; he was frustrated that he had to be in the hospital and that people were bugging him. And really, that's how you have to think when you have a patient who is non-cooperative and verbally combative. Overall, he wasn't too terrible to work with, although I did get a bit nervous about the possibility of him running me over when we got him onto his scooter....

After clinicals, I came home, showered, and crashed. I slept for a long time, was up for a few hours, and then fell right back asleep. I wasn't really short on sleep, but I think it was just a little bit of a rough day and there was a sense of relief at the end of the day that just required more sleep to take care of it.

Sept. 23, 2011

2011-10-03T19:03:00.003-05:00

This morning was the preschool activity. And, naturally, I got lost on my way there. It was pretty confusing and hard to find, but I got there!! It was huge! We met with the professor who was coordinating the day, and she just sent us off to our assigned rooms. Without telling us what we were supposed to do. I had no idea if I was supposed to be playing with the children or just observing them. I was in a room with two children and one adult (not really sure of her title....), so I just kind of watched the little ones play for a bit, and then joined in.

I never really had the babysitting experiences when I was growing up, and I had no younger siblings to look after, so I admit I'm a little uncomfortable around children mostly because I don't really know what to do. But, these two were so sweet and non-scary, that I couldn't help but to have fun! We played blocks and then cleaned up so they could have breakfast. Then, I read them a story, and they both wanted my lap to sit in. And, because there were only two, we moved to another room across the hall that had 7 children, so then there were 9 total. And once again, my lap was very desirable here too.

It was amazing to see how the children interacted with each other and how different the genders were. Gender roles at that age (I think my group was all 3 year olds) are already distinguished. Although I will say that one of the little girls, who had 3 older brothers, behaved much differently than another little girl who just recently became a big sister.

I spent the rest of the day working on homework for my professional nursing class. I love how this class makes me think about all aspects of nursing that perhaps I didn't think about before.

Do you know how the pinning ceremony for nurses came about? Florence Nightingale received the medal of Red Cross for her service during the Crimean War. Following the war, she wanted to extend this honor to the most outstanding students at her school for nurses, and thus the pinning ceremony was born! That's a fun factoid for the day!!

Oh, and I got my clinical assignment for tomorrow. I panicked at first because I didn't see my name... until I read at the top that said they were going to send me to the ICU unless they got admissions overnight. So, I went to sleep worried about what would happen tomorrow, not knowing what kind of patient I was going to have, if I was going to be in the ICU or not.... Kind of looking forward to going to the ICU!

Sept. 22, 2011

2011-10-03T18:51:00.001-05:00

So, this morning, I had a bit of a late start, and I had to be at the school for the standardized patient activity at 0800. I got there with a few minutes to spare, and as soon as I got sat down, the professor pulled my name out of the hat to go first. Funny how that works...

The activity was cool, though. There were three of us that went together, one as the nurse just getting off shift (me), one as the nurse just coming on shift, and one as the tech. The scenario was receiving a patient in transfer from the ICU and we had to give report to the patient's mom about what had been going on and what we were planning to do. Apparently, we three did an awesome job because we took care of everything we needed to take care, took note of important issues, and were able to meet the mom's needs and give her some reassurance. The one mistake I made was missing the NPO (nothing by mouth) order, but the other "nurse" caught it and made up for my slip-up pretty well. And, in return, I made up for his slip up saying that the NPO order was for a procedure; this made the patient's mom panic, so I stepped up and said that it's usually accompanied by a procedure, but because there was some issue with the patient's blood sugar and chemistry, we didn't want to feed him anything that could cause more imbalance.

Oh, I should say this was not a real situation. The patient was one of the mannequins, and the "mom" was an actress. But, it was fun and not as scary as I thought it was going to be. And, we finished up really quickly and the professors watching said we did really good. So, I went home to rest and study up some more before the examination at 1300.

This examination was not very much fun, but I did well enough. For the most part, I like my communication class, except that it's an all day event with the same professor all day long. It makes it hard to stay focused. And, after the exam, I was told I could just leave. But, I found out later that I wasn't supposed to. Oops. Apparently, one of the professors had another little blurb to say about the IPR that we had to do the next week (a similar thing to the standardized patient we had done today, just individual, and we have to write down the entire conversation, all the body language, then analyze and interpret it all). I didn't miss much, apparently; I just had to get from a classmate when my time was.

Tomorrow is preschool!!

Sept. 21, 2011

2011-10-03T18:42:00.002-05:00

It was pretty funny that after the respiratory lecture yesterday, there were people in class who were saying, "Wow that was so intense; I feel like I need to go have a few drinks!" and other similar statements. And today, we lectured on GI and the liver. Nobody wanted to go for drinks after today, which I thought was pretty ironic. I'm convinced they structured the lectures like that to discourage drinking after the intense respiratory system lecture!

But overall, it was a good day. I didn't have an exam, which was a nice change. I took the opportunity to relax a bit and prepare for the other examinations. And catch up on sleep, haha! I seem to be short on that lately. Oh well.

Sept. 20, 2011

2011-10-03T18:38:00.002-05:00

Tuesday, Tuesday Patho Quiz/Exam Day!

But before that, we had dimensional analysis, which was fun! We lectured first briefly on mental status examination and cranial nerves, and then did some practice problems on medication calculation. It's kind of confusing, because there are three systems to convert between: metric, apothecary, and household. So, that can be kind of confusing, but I think with more practice and usage, it will become easier.

After lunch was examination number two, which was awesome. I love this class, and I actually did much better on the exam than I thought I did. I hate that feeling. I am usually the first or second person done with the test in that class, and then I always second-guess myself and wonder if I actually knew the material or if I really didn't know it that well. I don't know why I get that anxiety, because I usually do really well when I feel that way.

And then we finished lecturing on the respiratory system, which was pretty intense. I was pleased, though, that the professor told me I ask good questions. I am sometimes nervous about asking questions, because I don't want to be that person in class who asks so many questions and who the rest of the class really doesn't like.

Two tests down and only two more to go!

Sept. 19, 2011

2011-10-03T18:33:00.002-05:00

Okay, time to do some serious catching up. It is almost midnight on a Saturday night, and I know I have been LAZY about doing my blogging. I have been busy, no doubt, but this is going to be a big job to catch up! And what are big jobs? Little jobs that you didn't do when you should have!

Right, so September 19.

Nothing too big to report from this day, excepting the fact that I got surprised with having to do my Vitals and Oxygen check-off; apparently it was the last day and I was the last one to know! Overall, I did okay. My professor pointed out not to count respirations when taking an apical pulse; he thought I was basing it off of lung sounds, but I let him know that I usually do it when I'm taking the radial pulse and just did it differently that day. I thought it would be good to do respirations while taking the apical pulse, because I could see the chest rising and falling, to which he said to be careful about that because not everybody's chest rises and falls (some people are abdomen breathers).

Oh, and I had the first of four exams of the week. Thankfully, it wasn't too terrible and I did pretty well, so it was a great way to start the week.

And, that's all I've got to say about that.

Sept. 17, 2011

2011-09-20T23:49:00.001-05:00

CLINICAL!!!!!!!!!!!!!!!!!

Early day to start, but thankfully I got lots of sleep the night before... yeah... right... I survived on coffee!! You know those stress dreams you get right before a big day (usually the first day of school for me....). Yeah, I had some of those.

Anyways, I got to the hospital right on time (0650) to allow enough time to get up to the floor for morning report. We got reports and our patient assignments (6 of my group mates were paired up because of low census; I was by myself--scary!!). I had a patient who had severe COPD. We were supposed to spend some time talking to our patient to gather their social history and past medical history. Unfortunately, my patient (who was set to go home) had some severe deterioration and progressed to where he could only say one syllable at a time. I did what I was assigned to do (took two sets of vitals, monitored Is & Os, did a quick head to toe assessment, and charted), as well as a few additional things (got him coffee, made sure RT was called for breathing treatments, and got him a change of pajamas). Overall, I was pretty happy with the day, although there was one or two things I messed up on. I promise you that I will never mess up on those again, though!!

At the end of shift, I had to report to my patient's nurse. I was glad she paid attention to my well-delivered report... yeah... because one can pay attention while doing a crossword puzzle and not making eye contact..... Nurse's eat their young.

After clinicals, I came home and crashed for about 5 hours.... I didn't really do anything to make me tired; I think it was just because of such a buildup of stress and anticipation for the clinicals and then to have it over with really took a load off my shoulders!!

Anyways, nothing else planned for the weekend, except to study, study, study. Four exams next week!!!

Sept. 16, 2011

2011-09-20T23:39:00.000-05:00

Alas, today was supposed to be a day off... but it wasn't. With the whole mess-up of the VA stuff, I had to go in for computer training from 0800 to 1100. It was okay, kind of boring, but we got our passwords and learned how to use the EMR system, which was good. Also, we got to finish the badge process (although they weren't done by the end of the day) and meet our clinical instructor. We got a tour of the floor we are going to be working on, too, which was nice!

And, I didn't get to do my check-offs today, but that was okay by me. I came home and relaxed and got everything ready for my FIRST clinical!! I also had to finish writing a few essays for my professional nursing class, so that was good.

Not much else to report for the end of the week. Overall, not a terribly busy week, but certainly a lot of buildup for CLINICALS!!!!

Sept. 15, 2011

2011-09-20T23:31:00.004-05:00

Communcation.... Blarg. This is not my favorite class, I am sorry to say. It starts at 8 (instead of the usual 9:00 for the rest of the classes) and runs until 5 (instead of the usual 4:00). I know I shouldn't complain...

Anyways, we lectured on teaching -- different learning styles and how best to present information to each style, as well as developmental considerations (i.e. older adults require more time to process information; children do better with teaching through play).

Also, we learned about special needs--how to assess if someone has special needs and how best to teach someone with those needs.

Unfortunately, I missed a big chunk of this lecture, because I had to go to the VA hospital to begin the process of getting my badge. I spent an hour away from class total in order to spend 10 minutes with the person processing information. Needless to say, I was slightly frustrated about that. But, flexibility in nursing is what they teach us! So, flexibility I must have!

Following lunch, we changed gears a bit, talking about the standardized patient activity we're going to do. We have to record a conversation with a patient and determine our therapeutic techniques as well as our blocks, and what nonverbal communication was exchanged. Scary, because sometimes I can't remember what I talked about five minutes prior to when I'm thinking.... I can usually trace back but I am worried about having to remember every detail.

Then, we spent about 45 minutes focusing on how to interpret the nurse's thoughts and the nurse's feelings. The professor (who hasn't been teaching for many years) fixated on the word "THAT". After we do this conversation with a standardized patient, we are supposed to write down what was said, what techniques were used, and then interpret our feelings as well as the patient's. Her concern is that we distinguish feelings and thoughts.

Where she got flustered was trying to explain that if we say "I felt THAT", the "that" is an indication that it's not a feeling, it's a thought. If that doesn't make sense, don't worry--it really doesn't. What she was TRYING to get at is if someone says "I felt" followed by the word "that", it's probably a thought, versus saying "I felt" followed by an emotion (i.e. happy, sad, exasperated, etc.), which would be a feeling. She spent a good long time confusing the class about this; actually, if I'm honest, most people tuned her out after about 5 or 10 minutes (myself included).

So, her first lecture after not teaching for many years didn't go so well. I halfway wish my appointment time for the VA stuff would have been later in the day....

The last part of the day, though, was awesome. We got to simulate special needs and then do discharge teaching. So, I wore cataract goggles and earplugs to simulate visual and auditory deficits. I then had to repeat back how much medication I was to take, when my next appointment was, what my activity and diet restrictions are, and sign the discharge plan with those deficits. Wow... cataracts suck... I was dizzy after a few minutes of wearing those.

Then, I had to walk my partner through the same discharge plan and teaching while she was wearing hearing plugs and glaucoma goggles. Hehe, she could see more clearly than I could, but she had no peripheral vision. It was pretty fun and enlightening!

Sept. 14, 2011

2011-09-20T23:00:00.000-05:00

Patho lecture is the order of the day! Today was renal and urologic disorders. This is another pretty fascinating area of study. The kidney system is amazing. It filters so much through our bodies and has a great capacity for this, but some disease processes cause a minor decrease in function and can then overwhelm them very easily. Once again, this can throw off the entire body system: respiratory, cardiac, neurologic, etc.

Then, because we finished somewhat early, our professor started us on the respiratory system (because there is a LOT on respiratory disorders).

That was it for the day, which was a nice change of pace, although there was homework and studying to follow the lecture. It's good to have the afternoon off, though, to get it all done!

AND -- we are almost at midterm already!! That means I've completed nearly half of an entire semester (something like 7.5 weeks) in about 4. Wow.... That's almost insane.

Sept. 13, 2011

2011-09-20T22:53:00.000-05:00

This day was a looooooooooooooong day. Health Assessment class started an hour earlier, which was... painful.... It's hard to get into a rhythm and then have something break that rhythm. Today was special considerations for assessing a hospitalized patient, and then we switched gears to the Denver II lecture. We have to do a Denver II assessment on a child under the age of 4 to see their developmental age.

Then, Patho was an interesting day. We took a quiz on endocrine and circulation disorders & cardiac failure. It wasn't terrible. Endocrine is a really hard "system" to study, because there are so many hormones involved, and you have to know what happens when there's an EXCESS or a DEFICIENCY in circulation of each hormone. For the most part, if you can learn what happens with just the excess, the exact opposite happens with a deficiency. But still.... it's complicated... I did poorly with endocrine when I took A&P. I am happy to report, though, that I think I'm doing much better with it at this point!

Then, we lectured on issues with conduction and structure of the heart. Love, love, love the heart. Have I mentioned that? So interesting how something small that is wrong, like a small hole between the atria, can throw off the entire body!

Sept. 12, 2011

2011-09-20T22:43:00.002-05:00

I'm late, and I know it. I've been kind of lazy about blogging lately, but I'm determined to get caught up tonight! We'll see how well that goes. In other news, I'm giving up on stating what day number it is, and instead converting to what date I'm writing about.

So, Monday the 12th. This day brought an abbreviation quiz (the last one!) which went pretty well, although I disagree with the one question I got wrong. The test was structured as doctor's orders and we had to answer questions about it, centered around what the abbreviations were. The one I got wrong was regarding a cardiac patient who was put on BR (bed rest). The question was: can this patient get up and go to the bathroom? I said yes, because I figured it wouldn't be too much stress for the patient to get up and go to the bathroom, but apparently this is not the case.

Following this, we lectured on the cardiac and peripheral vascular system assessments. The hardest part about the cardiac assessment is listening to the chest, especially with a female. They don't really teach you how to work around modesty for a female patient and especially with large-chested women. Other than that, it's just a matter of remembering where you hear each valve best.

The professors let us out a bit early today, which was nice because we had the White Coat Ceremony! They said they were "cloaking" us, but really, they just helped us into our white jackets and then we all said the nurse's oath and we got to take a picture with the Dean of the School of Nursing. This is a more modern version of a hat ceremony; I guess before major concerns with organism contamination, student nurses were given the traditional nurse's white hat as a welcome into the nursing profession.

Families were given the opportunity to write on a card for their student, which was then placed in the pockets of that student's white jacket. My mom gave me two cards, each with some wisdom and motivational stuff. She also included the Nurse's Prayer:

Dear Lord,

grant me the serenity to accept the things I cannot change,

the courage to change the things I can, and the

wisdom to hide the bodies of those Doctors I had to kill because they pushed me too far....

This made for some good laughs and certainly made my evening! :)

Following the ceremony, I had to attend a support group for an assignment. I went to a support group for stroke survivors. It wasn't really what I thought of as a support group, where everyone sits around and speaks about their experiences. This was more of an educational session, and the topic of the evening was living in the moment (not fretting about the past or the future). It was very informative and was a great group of people! There was a lot of positive interaction before and after the lecture, which was good to see.

So, that was about it for the day. A good evening, overall :)

End of Week 3, Beginning Week 4

2011-09-11T19:02:00.001-05:00

I just looked at the calendar earlier today, and wrote up on my whiteboard all of my assignments and just got organized for the upcoming week, and insodoing noticed that in one month, I will be just about done with this term! It's flying right on by!! I'm grateful for this, although the weekends seem to drag on. I know I shouldn't complain, because once I start clinicals, there just won't be ENOUGH weekend. But, I feel like I get up some good, time-killing momentum during the week allowing time to fly right on by, and then it fizzles in the weekend.

Oh well. This past week, I got a care package from my parents and a care package from my boyfriend. My parents sent me some good stuff--some healthy snacks, a shirt, some party lights, and a puzzle (I LOVE puzzles). I've already reviewed some of the contents of the care package from my boyfriend (I'm still baffled about the "edible" crickets....), but I've decided to share one item with everyone. The ridiculously huge, baseball-sized jawbreaker. I figure it will be interesting to take weekly pictures of it to determine how long it takes to demolish such a huge piece of candy (unless someone is grossed out by it... please let me know, and i am happy to make arrangements so the picture isn't readily available for everyone to see).

Also, I wanted to share my cacti. My boyfriend thought it would be good for me to have something to take care of while I was away. Although, it escapes me why we thought sharp, pokey plants were a good idea for someone as accident-prone and klutzy as me. It will be another challenge--to see if I can, in fact, keep them alive for one year!

And speaking of time, We are down UNDER 100 days until I fly home for Christmas! If you didn't notice, I'm pretty excited about it ^_^

So this is the monster jawbreaker....

See? Baseball sized, roughly.....

This is one of my cacti; I love it, because it is multiple colors and just looks odd but cool

This is my three-for-one cacti pot; I love the way this is arranged!

And finally, my mini-saguaro (although I am sure that they are not actually in any way related to saguaro cacti...)

Back to classes tomorrow, although this week will be pretty light, since lab was frontloaded and is actually mostly done!

And, a quote to go:

A woman is like a tea bag - you can't tell how strong she is until you put her in hot water. ~Eleanor Roosevelt