I think I can, I think I can....

I swear I'm still alive

2009-03-07T19:40:00.000-08:00

As it turns out, my free time (and, thus, blog-writing time) has taken a hit these past two months due to the following combination of factors: working full-time, going to school full-time, getting married in less than two months, and going house-hunting.

I still love work. I've become more independent these past two months. Lately, my major goals have been to do as many labor checks and triage assignments possible, since that's the majority of cases we see on night shift. It looks like I'll make the switch from days to night shift sometime around the 28th of this month. Then I'll have a couple of weeks to orient on the mother-baby unit, and then they're releasing me on my own.

How scary is that?!?

A huge compliment

2009-02-23T18:47:00.001-08:00

One of my patients asked me what my married name will be so that she can request me to be her labor and delivery nurse when she has her future babies.

It makes me feel like I'm doing something right. I absolutely love my job.

So. Tired.

2009-02-15T20:16:00.000-08:00

My poor little blog has been quite neglected for the past month.

Between school, my RN residency, orienting to my unit, wedding planning, and trying find time for the rest of my life... I'm exhausted!

It's one step forward

2009-01-17T15:47:00.000-08:00

One and a half steps back. At least in terms of my technical skills. Take, for example, cervical checks. For every elusive cervix I find, there's one check that I'm not sure about. And those gosh-darn IV starts. Let's just say after having four days off, I've been a bit off my IV game.

Things are still going well, though. I find myself spending much more time with my patients in their rooms. It seems like many of the more experienced nurses think it's because my patients are needy, but I get such joy from answering my patient's questions and helping them try different labor positions.

I've had a couple of kind of scary delivery moments that made me very thankful that I am still orienting to the unit. Each day, though, I strive to be more independent than the day before. My preceptor says I'm doing a great work. I'm just trying to keep it up!

I have officially been baptized

2009-01-07T21:20:00.000-08:00

in amniotic fluid.

I consider this a labor and delivery rite of passage.

In other news, I am much more confident in my ability to find the elusive cervix in the early stages of dilation. Effacement (thickness) and station (how high -- or low -- the baby's head is in the mom's pelvis) are coming along nicely, too.

Now if I could just master the consistent IV start and the best way to communicate with physicians, I'll be set!

I can't believe I get paid to do this

2008-12-26T18:11:00.000-08:00

Seriously, it boggles the mind.

I love it. Love love love love it. In fact, I will probably be so sad when I transfer to the mother-baby unit. Or, maybe I'll appreciate the break from the excitement of L & D. Either way, it sounds like I'll have plenty of opportunity to float between the two units.

Everything is different from the hospital I was at this summer, but the nurses are supportive and seem to genuinely operate as a team. My preceptor is wonderful, with many years of labor and delivery experience and a wicked sense of humor.

I'm happy that much of what I learned this summer is starting to come back to me. I have to brush up and practice my skills, but I have all the confidence in the world that those will improve over time.

And, I just got paid today and found out that even though I am working day shifts during my training, I still get paid my night shift differential. How sweet it is!

An Orientation Wrap Up

2008-12-20T16:21:00.000-08:00

My orientation was cut a day short, thanks to this freak winter storm weather we've been having. I haven't had much trouble commuting to work, although I have to drive much more slowly thanks to the ice and snow.

Our little orientation session with the hospital's legal counsel scared the bejeebers out of me in terms of what types of documents can and can't be used in a court of law. (Diaries and, I'm assuming, personal blogs can.) I haven't shared shared any personal patient details from my clinical experiences so far, but I am going to be doubly sure to be careful now.

As for the rest of my orientation wrap-up, I have continued to enjoy being the sole RN in the group. I also got my work schedule for the next couple of weeks and had another little tour of the unit from the manager. I met my preceptor, whom my manager described as being "A tough girl. Good teacher" which kind of has me shaking my shiny new nursing boots.

It's unclear whether or not I'll be starting in labor and delivery or on the mother-baby unit. I guess I'll find that out Monday morning, weather permitting -- which I sincerely hope it does, because after only two days of this I already have cabin fever!

Day 1 of Orientation

2008-12-15T20:53:00.000-08:00

And all I can say is, I think love this place. If I feel half as welcomed on the unit as I do by everyone that's running the orientation, I will be very happy here.

I was talking to one of my nursing school buddies about how I think being new to the organization and new to the unit is scary. She pointed out that this basically means I have the chance to 'reinvent' (or in this case, invent) myself as a nurse. I've decided that I will be Robin-the Assertive Nurse. So far I'm the only nurse in our very small orientation group, which makes asking questions a lot easier because I'm not as worried about sounding stupid or inexperienced.

Tomorrow I get to learn a bit about their IV pump system, which I think is one I've actually used before... but I am so excited to get a chance to practice everything!

And maybe, just maybe, I'll find the gumption to call my manager and find out my work schedule next week.

This seems kind of cruel

2008-12-12T16:55:00.000-08:00

One of the managers from the unit I precepted at this summer left me a voice mail today. They're considering my application for a night shift position in labor and delivery.

I was so surprised to get the voice mail -- and angry, and frustrated -- that I cried. At school. Again.

Funny thing is, I was told by two different HR representatives on two different occasions over the past week that there no positions available for new graduates in this unit -- nor would there be in the forseeable future. I, in fact, even told this HR department this week (very nicely, might I add) that I had taken a position with a different facility.

Part of me wanted to shout hallelujah and agree to the interview. I mean, even though I signed all those contracts, I didn't start hospital orientation until Monday morning, right? I could call the new hospital, explain the situation, and see where things went from there!

A bigger part of me (my egg nog latte-gut, perhaps) thought otherwise. I was raised to honor my word, and the fact remains that I was ecstatic about the possibility of working at this new hospital after my interview.

After some soul searching and talking with my advisor, I decided to buck up and call the manager back. I wasn't exactly sure what I was going to say. Like I said, part of me wanted to be effusive and thankful and take the interview. Part of me wanted to give them a piece of my mind. And the other part of me just wanted to tell the sad truth about how thankful I am for the offer of an interview, but the timing and series of miscommunications make it impossible right now.

I guess I have more time to think about it, though, because I had to leave your standard "Tag, you're it!" message. Hopefully I'll hear back from them on Monday.

Human pincushion Part II

2008-12-09T07:34:00.000-08:00

To all my friends with children, PLEASE BELIEVE THEM when they say their arms hurt after a tetanus shot! I did my arm workouts and everything yesterday, and my left arm is still very stiff.

Anyhoo, my appointment at the hospital was more than just for the free vaccines and blood draws. I got to sign my contracts! Yes, there are more than one.

One contract for the position of an RN in the Mother-Baby Unit.

One contract for my position in the new graduate residency class starting in February.

One hours-agreement contract for my position in the Mother Baby Unit for the time period between December 15, 2008 and February 2, 2009. I think I'll probably be working 12-hr day shifts.

One hours-agreement contract for my position as a Resident RN for the time period between February 2, 2009 and April 27, 2009. I'll be working either 12-hour or 8-hour shifts during the residency.

One hours-agreement contract for my position as an RN in the Mother-Baby Unit following the successful completion of my residency program, starting April 27, 2009. That's when I'll start working my 32-hr a week, 8-hr night shifts.

There were a bunch of other documents, too. The HR representative reviewing my new-hire paperwork with me took one look at it all and said, "My God, you have a lot to sign!" No kidding.

I also got to take my ID badge picture, which looks like a mug shot because I took my glasses off and the curmudgeonly security guard (whom everyone else was calling Sarge) didn't tell me he was taking my picture. But that's okay, because it has a nice big sticker on it that identifies me as an OB nurse -- which makes me so happy! It's kind of hard not to feel like I'm in some sort of elite nursing club.

OB nurses, unite!

Photographic evidence

2008-12-08T19:10:00.000-08:00

Of just how excited I am to work at this hospital. I had not one, not two, but THREE pokes today. One for the flu vaccine, one for the DTaP vaccine, and one for a blood draw:

I'd like to take this time to apologize to the injection room nurses I terrorized as a kid whenever it was booster shot season. At the ripe old age of 27, I am finally able to get poked with a needle without flinching.

I'm hired!!!

2008-12-05T12:00:00.000-08:00

I just got the call from the HR representative, and they chose ME!!!!

I don't remember all of the details, but I know I have to make some quick decisions about benefits and take a drug test -- which I'm dreading because I absolutely hate peeing on demand -- but I am so unbelievably happy. I didn't even think twice about accepting the offer.

I start with hospital orientation on the 15th, and then will have six weeks of working on the mother-baby unit before I start the official residency program on February 2, 2009. Like I said, the rest of the details are a bit fuzzy right now but I'll be sure to share them once I can think straight.

Oh happy day!

Meeting with a Midwife

2008-12-04T17:41:00.000-08:00

I had the opportunity to meet with a midwife who is on staff here at school. She's practiced midwifery for over 30 years, and shared some wonderful stories and advice about trying to get started in the profession. She also has connections at the hospital where I precepted this past summer.

It was so easy to talk to her. I felt comfortable asking questions about her practice, how I might be more likely to find a labor and delivery position, and what it was like balancing a young family with her midwifery education and eventual practice. Oh how I would love for her (or someone much like her) to be my mentor some day!

At the end of the conversation, she offered to call the manager from my preceptorship hospital to see if she can get an answer about their hiring plans for L & D residencies. She also mentioned that the hospital that I just interviewed at isn't the "greatest" in terms of its environment and what it has to offer labor and delivery nurses. They also don't use midwives. But -- as this midwife also said -- that doesn't mean I couldn't be the person that starts to change things!

Glimmer of hope?

2008-12-04T12:23:00.000-08:00

I caved in and called the recruiter this morning. Of course, I obsessed over the message to leave her just in case she didn't pick up the phone. I wrote a script, practiced it 20 times, and then called Andy at work and recited it for him. Twice. (The man is a saint, I tell you.) Thank God it went to voice mail. I would have freaked if she answered the phone!

The good news is, the recruiter called me back. Naturally, I was driving on the freeway when she called so I had to let it go to voice mail. (Safety first.) Here's the scoop:

They just finished interviewing for the position.
The manager gave the OK to check my references.
The recruiter is working on that today.
The recruiter hopes that she'll be able to call me in "the very near future" with "good news."

I actually cried when I heard her message. The job isn't guaranteed -- but it looks like I'm in the running! And I could start work as early as December 15th. At least we know I'll know by then.

P.S. I got another email rejection this afternoon. This one from UW.

Two rejection emails in two days

2008-12-03T15:03:00.000-08:00

From two different hospitals! Rejection still stings, even though I'm getting kind of used to it.

Still no word on the position I interviewed for.

*sigh*

I wonder how long I should wait before I call the recruiter? Interviewing right before Thanksgiving has made the timing of this whole situation quite tricky.

I'm feeling much less optimistic than I was yesterday.

No word yet

2008-12-02T12:32:00.000-08:00

Haven't heard back about the job yet, but I'm trying to stay positive. The way I see it, the longer it takes for me to hear back from them, the longer they're considering me for the position. That's the hope, at least.

If there has been any silver lining to my unemployment this semester, it has to be the "extra" time I've had to work on homework. Which, in retrospect, there hasn't been much of because it seems like I've been working full-time looking for a job. Hmm.

As for the paper that's due on Monday, I'm almost finished with a rough draft. It's not going to be a masterpiece, but it'll get done. Which is good, because I have two more papers due next Friday that I need to get started on.

I will be oh-so-happy when this semester is complete!

Am I losing my mind?

2008-12-01T07:15:00.000-08:00

I must be more stressed out about finding a job than I previously thought, because two bizarre school-related things happened to me lately.

One: I lost a textbook. Never happened to me before. Very unlike me. Also, very expensive mistake to make.

Two: I misjudged an important deadline. I have a seemingly impossible-to-write 10-12 page paper due on December 8th. Up until yesterday, I thought it was due on December 15th.

Oh well -- at least it wasn't due December 1st!

Crossing my fingers

2008-11-25T14:47:00.000-08:00

The good news is, I think the interview went well. I felt a connection with the manager and the nurses on the unit -- which is absolutely beautiful, by the way. And, the more the manager described her leadership philosophy and the details of the position, the more I thought about what a wonderful fit it would be for me!

The bad news is, they may not need another new nurse on the unit. As a new RN, I would require more training than a nurse with even just a year's worth of acute care experience. It technically isn't a resident nurse position, so it would also take some extra effort to schedule my necessary certifications and residency classes. If any of the other candidates they've interviewed have more experience, I may be out of luck.

Still, I'm crossing my fingers and hoping for the best. I might find out as early as Tuesday (!!!) or sometime soon after the Thanksgiving holiday. Wouldn't a new job be something to be thankful for?

Update: Just got a reply to my thank you email from the recruiter that A) they thoroughly enjoyed meeting me and B) the manager probably won't make her decision until after the holiday. I'm still thinking happy thoughts!

Finally, an interview!

2008-11-19T15:24:00.000-08:00

I'm working on an unbelievably crummy and long paper that's due on Friday -- but not even that can get me down because I FINALLY got a job interview!

I've never been to this particular hospital before, but a classmate precepted there this summer and liked it. The position is a night-shift (11:00 PM to 7:00 AM, I think; 4 nights a week) in a mother-baby unit. I would be cross-trained in labor and delivery, but the majority of my shifts would be in mother-baby.

I am so happy the the manager wants to interview me! When I originally applied, the recruiter told me she couldn't promise me they would consider hiring a new nurse for this particular position. And even though they still might not hire me, I am so happy to even be considered. It was starting to feel like all of those applications and cover letters were just floating off in cyber space -- now I know that someone actually read one!

Phew! I'm feeling rejuvenated and inspired to call more recruiters tomorrow afternoon. But first... it's back to paper-writing for me.

Back to more of the same

2008-11-11T07:38:00.000-08:00

Hunting for jobs and doing homework. It's what I do.

I think the hardest part is the waiting. I've started casting a much wider net, in terms of my job applications for positions in hospital birth centers. For example: I've applied for three jobs up in Seattle, one in Bremerton, one in Auburn, one at an Army hospital, I-don't-know-how-many in Tacoma and Federal Way. Next up is Puyallup. And maybe Olympia.

I often wonder why I'm not getting interviews. Being the last of my nursing school study buddies to find work is depressing and, frankly, kind of embarrassing. It also doesn't help that most of my classes this semester are pretty uninspiring. I hate to admit it, but I'm starting to second-guess myself and my performance in my preceptorship this summer. I know that I've chosen a competitive area of nursing, but I also know that I'm a strong candidate. I hope that choosing this particular nursing school program wasn't a huge mistake for me. Right now it seems possible that my dream of being a labor and delivery nurse (and eventually a midwife) might not work out as I'd planned.

I realize that doesn't necessarily mean it won't work out eventually, but I know that I will be so much happier if I start my nursing career in a specialty that I feel passionate about. Also, it'll make working those night shifts (which I am sure to be scheduled for as a new nurse) that much more enjoyable.

And now for something completely different

2008-10-26T20:41:00.000-07:00

Studying for the NCLEX almost robbed me of the majority of one of my favorite months of the year. Fortunately, I strategically scheduled my test around one of my favorite October celebrations: Pumpkin Day.

This past Saturday marked the 5th Annual Pumpkin Day Celebration. What started as a small group of friends meeting for a homemade brunch and trip to the pumpkin patch has evolved into what may best be described as an organized festival of fun.

Our most recent pumpkin day celebration started with a 5K run, followed by an afternoon trip to the patch and ending with an evening pumpkin food potluck and pumpkin carving party.

If there's anything I've learned over these past five years of Pumpkin Day, it's that (in terms of pumpkin carving) my eyes are often bigger than my stomach. Andy documented my "catch and release" of the first pumpkin I picked out from the patch.

Ready to hit the patch and find the perfect pumpkin.

Um, it's really heavy.

I mean REALLY HEAVY.

Seriously, I can't even get it in the wheelbarrow.

I guess it just wasn't meant to be.

We took a moment to say our goodbyes.

Oh well. Maybe next year!

We ended up with three beautiful, albeit significantly smaller pumpkins. Now we just have to carve them and roast the seeds. I love this time of year!

Unofficial results are in...

2008-10-22T10:26:00.000-07:00

and I PASSED!

Unofficially.

Now I just have to wait for the state to give me my license, and I will be an official registered nurse! This also means that I will hopefully have a job sometime in the near future.

I'm too excited to write anything more substantive.

I'm a nurse! I'm a nurse! I'm a nurse!

Update:

Holy cow, my license has already been activated by the state! Now I really AM a nurse.

Initial NCLEX update

2008-10-20T18:57:00.000-07:00

It was awful and I feel like I failed. Unfortunately, I also feel like the girl who cried wolf -- my dear sweet Andy can vouch for my perpetual lack of confidence in my test-taking abilities. Please trust me, though, that I am not being melodramatic when I say this:

I have never felt more terrible about a test-taking experience for so many different reasons.

I'm trying to take comfort in the fact that everyone said I would feel awful when it was finished. Still, I have a really bad feeling about this. It seems cruel that we don't know our results right away. The wait isn't nearly as long as some other professional exams, but the time between now and Wednesday feels like an eternity.

I predict I will have no fingernails by then. I may also have eaten twice my weight in fried potato products.

Deep breaths... deep breaths...

2008-10-19T21:54:00.000-07:00

Yesterday I took a glorious two hour nap in the afternoon, went for a lovely run, and crammed in one more practice test.

While the nap seemed like a good idea at the time (not so much when I tried to go to bed later that night) the run was undeniably perfect. The sun shone through the brilliant autumn leaves and the air was crisp without being cold. Also, I saw a bulldog. And he barked at me. My heart soared with the eagles! I almost forgot about my big test tomorrow.

Yes, I love October! It's usually my favorite month of the year. This year, though, it could either be the best (I pass the NCLEX) or the worst month ever (I don't pass). I'm kind of starting to wish I hadn't told everyone I was taking it tomorrow.

It's mere hours away...

At this time next week...

2008-10-15T19:21:00.000-07:00

I'll probably be doing one of two things:

A) celebrating my new R.N.-hood with a ticker tape parade and appropriate libations
B) drowning my sorrows over my NCLEX failure

The Big Test is in T minus 5 days... and you can bet your sweet bippy that I'm paying the extra $8 so that I'll have my results by Wednesday afternoon!

P.S. I'm hoping for option A.

What's new, honeydew?

2008-10-10T08:49:00.000-07:00

My little blog is horribly out of date. Seriously, though, you should thank me for it. My days are pretty boring. In fact, I had just started to write out a schedule for my typical day to share with you but it was too depressing. I had to delete it.

I still haven't heard anything back about the jobs I'd applied for in labor and delivery. At this point, with my test date only a week and a half away, I figure I might as well just wait until I have my license. That way it'll be more like taking off a Band-Aid if they reject me -- and less like I'm being strung along, which is how I feel right now.

I'll be honest, it has been more than a bit of a bummer.

I have a test date

2008-09-16T10:40:00.001-07:00

It's officially scheduled.

I'm taking my NCLEX-RN on Monday, October 20, 2008 at 0800.

Wish me luck!

And now I can't believe it's already mid-September

2008-09-13T09:58:00.000-07:00

I can't believe I had a whole month off from school. At first, things went a little bit like this:

Day One: House cleaned, dishes done, called labor and delivery nurse recruiters at two local hospitals, baked a batch of cookies, and redid the dishes -- all by twelve noon. And then I got bored.

Several friends advised that I should, in fact, appreciate the boredom. Fast forward a couple of weeks, and I finally started to. I also stopped being so disciplined about doing the dishes and keeping the house cleaned. Some things never change!

I went to a Tacoma Rainier's game, started running regularly again, got lots of wedding planning done, went to at least one concert -- and, I think I even finished reading a non-nursing related book. I also applied for several jobs (only to be told that it was too early for me to apply because of the bizarre-o program I'm in), and started thinking about studying for the NCLEX.

Now that school has started, though, it's time for me to actually start studying!

I can't believe it's already over.

2008-08-14T09:39:00.000-07:00

I successfully completed my 337-hour preceptorship in labor and delivery. I couldn't be happier with my experience; I feel lucky that I had such a great preceptor and that my unit is so supportive of student nurses. And, I'm proud of myself and everything I learned this summer. The experience was exactly what I needed to confirm that labor and delivery is where I'd like to work as a nurse.

My last day was kind of crazy. First, Ashley and I took care of a c-section patient. Then, my secondary preceptor snagged me patient planning a natural delivery, rich with opportunities for labor support. It was exactly what I wanted on my last day -- because everything is all about me and my needs, right?

Oh contraire.

We ended up having a slightly emergent cesarean section. (Another learning opportunity!) The silver lining for me -- other than the delivery of a healthy and happy baby, of course -- was that I was able to be a helpful part of the team as we prepared for the surgery. If we'd had this situation earlier in my preceptorship I would have just gotten in the way and wouldn't have known what to do.

I promised to keep Ashley updated on the hiring process and my plans for the NCLEX-RN exam in October.

Maybe she could be my residency preceptor!

Blood, sweat, and even a few tears

2008-08-09T12:22:00.000-07:00

All for this monstrosity:

If you find a typo, dear God, please don' t tell me because I had to take it to the printer's yesterday.

I swear, the dang thing is almost as big as I am!

Only one day left

2008-08-08T09:22:00.000-07:00

Tuesday is the last day of my preceptorship in labor and delivery. I'll have completed 337 clinical hours -- and I think I might actually cry at the end of the day. I'm looking forward to having a vacation from my classes, but I'm genuinely going to miss my clinicals. I love labor and delivery, and I love the culture of this particular unit.

I did have the opportunity to introduce myself and talk with the unit's clinical supervisor about employment opportunities. They have a lot of new hires right now, so she said I would likely start as a supplemental employee and probably work nights. It's not a guarantee that I'll get hired, but I know the staff likes me and it seems like they'd like me to work there. Hopefully that'll be enough to help me get my foot in the door.

And now I'm off to finish my research poster, study for Monday's final exam, and think of appropriate thank you gifts for my preceptor and the unit.

Almost a babycatcher...

2008-07-21T20:13:00.000-07:00

For the second time in a week, I came thisclose to delivering a baby.

The first time was with a first-time mom. I'd been providing labor support while she pushed for almost 3 hours. My preceptor took over so I could go to lunch (it was almost 2 PM) -- and when I came back, SHE was delivering the baby!

My second almost-opportunity came with a mom having her fifth baby. She didn't make any cervical change for hours, had her labor augmented, and then *foom!* it was baby time. It went a little something like this:

I check on the patient. Contractions are a little bit stronger, but the patient still feels like she has a ways to go.

(Ten minutes later)

Family member runs to the nurses station looking for me. "She needs you! She says the baby's coming!"

I help the patient to bed and check her cervix. She's dilated to 7 cm, so I calmly instruct the patient not to push, and make sure my preceptor has paged the doctor. I stay with the patient to help her try to breathe through each contraction -- which have definitely turned into strong, get-that-baby-out-of-here kind of contractions.

(Five minutes later)

"The baby's coming! I have to push!"

That's right about when a spare midwife rushed in and took over. The patient was complete and she delivered in about 2 pushes.

Just goes to show that when those babies decide it's time to make their grand entrance -- they really make an entrance!

A cervical epiphany

2008-07-19T22:29:00.000-07:00

I finally found the cervix.

I've been doing semi-successful cervical checks for the past few weeks now -- where I was pretty sure I'd found it, but I always a little uncertain. Unless, that is, the baby was half-way to crowning and the mom suddenly felt like pushing. I'd gotten pretty good at those checks.

I don't know exactly what or how it happened today, but it was a like a light came down from heaven when I checked my patient for the first time today. There was no doubt in my mind that I had found that cervix, it was dilated to 3 cm, and that there was still a bulgy bag of waters.

The most satisfying part was when the doctor agreed with one of my cervical assessments later in the day. I still need practice -- especially for determining effacement and fetal station -- but I'm really starting to get the hang of it.

For the first time, I felt like the idea of me being a labor and delivery nurse (or even a midwife!) wasn't just some crazy dream. Someday, I could actually do it!

I've turned the corner...

2008-07-06T09:57:00.000-07:00

I'm not yet to the halfway point in my summer preceptorship, but I feel like I've had my "a-ha!" moment this week.

I had my first day with my secondary preceptor, and I LOVED working with her. She has tons of labor and delivery experience, teaches a class for childbirth educators, and worked as a doula for 11 years. We have very similar philosophies about the role of a labor and delivery nurse. And, she's incredibly supportive of students. I think, for the first time, I didn't feel like I was a burden to the unit.

I also had the chance to do my first independent delivery with Ashley, my primary preceptor. She took on the role of the baby nurse, and I helped the mom with the delivery. I couldn't believe it -- early on, I was helping the mom push and I was the only health care provider in the room! Not only that... it was all in Spanish. It went a little something like this:

"Uno, dose, tres...fuerte fuerte fuerte! Bien! Bien! Mas!"

I still have so much to learn, but I really feel like I'm starting to put all of the little pieces together and thinking of the "big picture" rather than the tasks that surround nursing care.

I love it. I love it, I love it, I love it.

Where has the time gone?

2008-07-01T20:39:00.000-07:00

Suddenly, it's the first of July. I officially have 120 hours (of my required 336) logged in labor and delivery. It feels like so much has happened, it's like I don't really know where to begin!

I'm 1 for 3 for IV starts on patients. I did, however, manage to start an IV successfully on another nursing student who's working at the hospital as a tech for the summer. I was proud of myself today because I managed to get a mom all cleaned up, gown changed, underwear in place on my own -- even though she was still a little bit numb from her epidural. I've finally gotten used to the 12.5-hr days. Don't get me wrong -- I'm still tired when I get home, but now I can at least stay up after 2100 after getting home from my shift. I'm very comfortable with my preceptor, to the extent that I'm more nervous when I'm in a patient's room by myself than I am when she simply stands in a corner and watches me.

I've had good days and bad. Today was a good day. I had my first delivery where I didn't even feel a bit like shaking while coaching the mom through her pushes (in Spanish!) and I've finally overcome my habit of getting lightheaded in the OR.

I guess what's most important is that I still love it and am so happy to be here. I'm slowly becoming more independent, and each day I'm a little more confident.

I hope, I hope, I HOPE I get a job in an L & D unit when I get my license!

What do I think about L & D?

2008-06-12T10:44:00.000-07:00

My past few shifts have been crazy, but I love it. I have been, literally, up to my elbow in babies.

I've been able to practice lots of my skills, and slowly delve into the world of labor support. I was going to take pictures of my war wounds from being labor support during a precipitous birth (the baby came too fast for an epidural), but our camera was out of batteries.

One thing I hadn't anticipated was all of the paperwork and charting involved in labor and delivery care -- I think I have as much to learn about THAT as I do about how to be a great nurse at the bedside.

I'm learning so much from my preceptor, though. She does a great job of labor support, which I felt was really missing from my previous clinical experience in OB. And, she's supportive of me and my comfort level.

I still have to condition myself to the twelve-hour shifts. All in all, though, it's incredibly challenging, an adrenaline rush (I think I've finally got the shaking under control), and extremely rewarding when things go well. I cannot wait to see how much more I have to learn during this experience!

Day 1 is tomorrow!

2008-06-05T15:44:00.000-07:00

I met my preceptor for coffee today, and I'm even more excited than I already was about my summer clinical in labor and delivery. I really liked her. She seems super nice, and excited to teach.

She's even going to let me practice starting an IV on her, so she could also be a saint. Or maybe a martyr, because she'll be suffering so that my future patients don't have to.

Oh, and I start TOMORROW.

I've never been so excited to work weekends!

Summer Update

2008-06-01T14:39:00.001-07:00

Hawaii was wonderful. I went paddling in the Pacific Ocean in an outrigger canoe, helped plant some pineapples, spent every day at the beach, went snorkeling, got a ridiculously funny-looking tan line, and had papaya for breakfast almost every morning.

I also found out more information about my preceptorship!

I'll definitely be in labor and delivery. (Yay!)

The rest is still kind of up in the air -- but I should tentatively be on 12 hour day shifts at St. Joseph's hospital. Our first day of summer classes is tomorrow, so hopefully I'll find out more then.

I did it!

2008-05-23T09:40:00.001-07:00

I finished my first full year of nursing school! And I didn't just survive it... I actually did a pretty good job. I can't believe how much I've learned and grown over the past year.

Last night, I was inducted into the International Honors Society of Nursing, Sigma Theta Tau -- or what I've been casually calling the nursing hall of fame.

I do have class this summer, starting on June 2. We're completing our preceptorships, which I believe is something like 350 hours of working with a nurse in one of the local hospitals. I don't yet know:

A) which hospital I'll be at

B) what kind of unit I'll be on

Or,

C) my shift.

We got to request all of these things, but I believe I wrote on my card: "I will work at any hospital for any shift if it means I can precept in a labor and delivery unit." Who knows where I'll end up? My only hope is that it's not the night shift.

Between now and then, though, I'm going to Hawaii with a friend from school.

Alooooooooooooooooha!

Last day of spring semester!

2008-05-16T05:49:00.000-07:00

True, I still have finals Monday through Wednesday -- but this is the last day of my spring semester.

And do you know what that means?

I've survived my first year of nursing school!

Now Andy and I just have to make it through the first stage of our Great Big Move to Tacoma this weekend.

Right now, though, I'm pretty sure I could survive just about anything.

Yay! Yay! Yay!

Friday: A simultaneous awesome and bummer of a day

2008-05-09T17:20:00.000-07:00

Awesome because our OB class was taught by the "real" instructor. She's been on sabbatical for the past year (catching up on midwifery work and research) but she agreed to teach the lecture about contraception. It was, by far, one of the best lectures I've had yet at PLU.

Sad because it makes me think about what our OB class could have been like, had she been our teacher the whole semester.

*sigh*

Oh well.

Woo hoo!

2008-05-07T00:46:00.000-07:00

I did it! I was responsible for the care of three patients tonight. Up until now, the most I've cared for is two patients at a time.

I'm pretty satisfied with how my night went. It felt a bit hectic at times, but that wasn't unexpected. (I think 2.5 patients would be juuuuust right for me.) In fact, I think I'll actually be able to sleep well tonight, rather than staying up to obsess about things I could have done differently.

This clinical experience has given me so much practice with medication administration, getting comfortable with IV lines, and managing my time. I've actually really enjoyed it.

I feel all nurse-like and stuff!

Nothing too exciting happening...

2008-05-01T23:37:00.000-07:00

But I recently got to watch a doctor sew up a patient's abdomen at the bedside. Turns out when you have a ruptured appendix, they leave the incision from the original surgery (to remove said problem-appendix) open for a few days to reduce the number of germs that get stuck inside.

Needless to say (no pun intended) it was pretty cool.

Blech.

2008-04-18T18:59:00.000-07:00

I can't believe it, but I missed my first class today. I wonder how many hundreds of dollars that cost me?

I probably could have stuck it out if I didn't have four hours in between my morning and afternoon classes.

Looks like I've finally got that icky cold that has been making its way around the Puget Sound area. My throat is sore, my nose is runny, I've been making stupid mistakes all day, and am having the occasional chills.

A two hour nap and some hot tea made me feel much better but that doesn't change the fact that I hate being sick -- and I missed OB!

Evening clinicals are a tricky thing

2008-04-17T06:07:00.000-07:00

I've discovered I really enjoy the evening shift. It has a different flow than the day shift. As long as I save my caffeine fix for the afternoon, I'm pretty alert and thinking clearly from beginning to end.

Turns out I like Adult Med/Surg nursing, too. We have more responsibility now as "Senior I" students, which is both exciting and downright scary. We have access codes to the medication administration system and can give certain medications independently. The medications we take out of the system are double-checked by the RN we're working with, but I'm proud to report that I've now given three subcutaneous injections all by myself. It's exciting, because I feel like I'm finally getting to practice my skills.

I continue to be impressed by the breadth of knowledge the nurses on my floor have to have to do their job well. I'm also impressed with their speed and efficiency -- having a student to mentor can really slow them down. On Monday, though, I was responsible for the primary care of two patients. I've never cared for more than one patient at a time, so it was exciting to take on more responsibility. By the end of this clinical experience, I will hopefully be caring for up to 3 patients per shift.

That whole being alert at night thing is a real problem though. I'm alert for my drive home, and I'm alert when I should be sleeping. I've turned into an insomniac! For some reason, I didn't have any trouble taking naps and sleeping soundly when I got home from my morning clinicals. It makes me miss them.

And now for something completely different

2008-04-03T11:21:00.000-07:00

I've switched to evening shift clinicals. That means I start work on my adult medical-surgical unit at 3 PM and work until 11 PM. It makes for a TOTALLY different clinical experience... and it means I don't get home from the hospital until after midnight.

This is the first time I've been on a true medical-surgical floor. Admittedly, I'm more than a little bit concerned. Why, do you ask?

A: Parking at the hospital stinks in the afternoon. I park my car at a friend's house, which is just about a 20 minute walk away. It's great in the afternoon, but not quite as much fun after 11 o'clock at night -- especially when you have to pass through parts of a neighborhood that has a reputation for being slightly unsavory.

B: The unit has one of the worst reputations as a clinical site among nursing students, due to tension among the staff.

C: It utilizes a "team nursing" approach, which means one nurse can be responsible for up to 6 patients at a time. The care for those six patients gets shared between different staff members: CNAs take vital signs and perform primary care, like give baths and help with ambulation; phlebotomists take patient blood sugars before and after meals; nurses pass meds and do charting... and so on down the line.

It's very fast, and seems very task-oriented. I'm trying not to have any sort of expectations -- so I guess we'll just see how it goes!

Riddle me this

2008-03-26T06:32:00.001-07:00

Why is it that after two blissfully lazy spring break mornings of sleeping-in, I woke up at 4:45 this morning -- and still haven't been able to fall back asleep?

Day 5 of OB: Labor and Delivery Part Deux

2008-03-12T10:39:00.000-07:00

Soooo... apparently there have been lots of OB days that I haven't blogged about.

I've had the opportunity to spend one day in antepartum (AP), caring for women who may or may not be in labor, and two days in labor and delivery (LD). They've all been wonderful in their own separate ways.

My day in AP taught me an important lesson, and that is this: it's not the babies I love about labor and delivery. (Although, I admit, they're super sweet.) It's the moms-to-be! I had the chance to care for all sorts of different moms-to-be and all sorts of different pregnancies.

My days in LD reinforced that lesson. I saw my first vaginal birth on day 1 in LD, and then spent the rest of the day helping admit a new laboring mother to the unit. She was young and scared -- and I think I'm the first person who told her that it's normal to be nervous or scared about having your first baby. She was so relieved! I spent lots of time talking to her and her mother, holding her hand during contractions and when they started an IV.

On my second day in LD, I saw a cesarean section and spent the rest of my day (plus some additional hours) helping a woman through the labor of her 5th baby.

I never did get to see that baby born. I did, however, get to put a catheter in for the first time. (It took a couple of tries.) And, I had my first experience with adult poop. For the sake of those with weaker stomachs, I'll just leave it at that.

One thing I've noticed about my experience in L&D and AP is that, by and large, these nurses love to teach. I have learned so much from my few days with them!

It makes me want to cry when I think about Black Tuesday -- i.e., my last day in OB nursing.

It's almost overwhelming

2008-03-03T21:30:00.000-08:00

just how much I love working with moms and babies.

I can't believe people get paid to do this. It should be a crime to find such joy in a clinical experience!

More on my second day in labor and delivery later. It's bedtime for Robin.

Two things

2008-02-25T20:29:00.000-08:00

#1. Labor and delivery rocks.

#2. Do not hold your breath with the new mom while she's pushing. First of all, for baby's sake, she shouldn't be holding her breath for too long with each push. Second of all, it makes you (the observer) lightheaded and then you (the observer) have to leave the room to take a walk and get a glass of water.

Don't worry, though, I made it back in plenty of time for more good, hard pushing and the birth.

A birth! I finally saw a birth!

Day Two of OB: NICU

2008-02-23T11:36:00.000-08:00

I spent today caring for three of the tiniest little babies I have ever met.

All of our patients were in relatively stable condition. None were on oxygen, and two were almost ready to go home. The third baby was the youngest -- only a couple days old, born prematurely, and weighing in at right around 3 lbs. Little ones like that stay in one of those isolated, heat-controlled cribs like you see on TV.

My sister's cat, Gus, weighs more than 5 times more than this baby. Now, I admit Gus is one big kitty, but it kind of puts thing in perspective.

My nurse just kind of threw me into the thick of things, which was great. It didn't give me a chance to get nervous about taking care of such little babies. I took all of their temperatures, listened to their heart rates and respirations, and helped with the rest of their assessments throughout the day.

Two of my greatest challenges were changing their little preemie diapers and coaxing the two babies who were bottle-feeding to eat. Diaper changes were difficult because they have such small little bottoms. Feeding was especially tricky because the babies kept falling asleep. When I was with the lactation consultant, we did what we could to keep a sleepy baby awake -- take their hats off and rub their heads, tickle their feet, or take an extra layer of blanket off just during their feedings so they could be awake enough to eat.

Preemies, though, have even greater trouble regulating their body temperatures than a baby born at term. The most I could comfortably do was take off the baby's hat and rub his or her head to wake them up a bit, or burp them. And, some preemies need help supporting their chins to get a good seal around the nipple of the bottle.

Despite all the tricks I learned, I had trouble getting my two little patients to eat their minimum amount. I had better luck later with each feeding, but each time my nurse had to take over and try her best to coax more food into them. She usually had more luck than I did -- but she always let me try first.

So far, I've loved everything about OB. On Monday, though, it's on to labor and delivery -- or, as I like to call it, the Big Dance.

Oh, how I hope hope hope there are midwives in the building and lots of babies being born that day. Wish me luck!

Day One of OB: Lactation!

2008-02-13T11:38:00.000-08:00

The good news is, my clinical instructor was very understanding about the whole alarm clock fiasco. The even better news is that the lactation consultant doesn't start making patient rounds until about 0745 or 0800, so technically I wasn't late to my scheduled clinical activity.

I really enjoyed my day making lactation consultations -- which is great, because I had many fears and misconceptions about breastfeeding. By the end of the day, I even got to do some patient teaching of my own! I was so happy to be able to answer a new parent's questions. It felt very natural and satisfying.

If anything, my experience demonstrated the fact that a) pregnant mothers, by and large, are not sick or ill and b) breastfeeding is a learned skill for both mother and baby. It seemed that a lot of new moms struggled with that, because they felt like they should just naturally be good at it. Turns out breastfeeding takes practice. Who knew?

There were lots of questions about whether or not baby was getting enough food. Imagine the surprise of new parents (and this student!) when they learned that their newborn baby doesn't usually eat more than a few teaspoons at each feeding. During their first week of life, newborn stomachs aren't much bigger than the size of a walnut.

It is so hard for me to believe that my stomach was once that small.

Just my luck

2008-02-12T17:30:00.000-08:00

My first real day of OB clinicals -- a day that, quite honestly, I've been looking forward to since THE FIRST SEMESTER OF MY SENIOR YEAR IN COLLEGE -- and my alarm clock doesn't go off.

Seriously, the dang thing is still set for 5 AM. I don't think I'll ever know what happened.

Luckily, Andy's alarm clock went off at 0700. (Tuesday's his day to sleep in.) Mind you, I was supposed to be at the hospital at 0645.

Say it with me now... awk-ward!

Not exactly the lasting first impression I wanted to make on my clinical instructor.

An orientation to labor and delivery

2008-02-11T16:50:00.000-08:00

I know I loved pediatrics, but this really could be the clinical experience of my dreams. I don't know what it is about childbirth or labor and delivery that I find so intriguing, but it really is like a Robin magnet.

Like other clinical experiences, we'll have the opportunity to rotate through different units and shadow different nurses. We're spending most of our time in the mother-baby unit of the hospital. We also get two days in labor and delivery, one day in the NICU/special nursery, one day in antepartum, a day at a community WIC office, and a day to follow a lactation consultant -- which is what I get to do on Tuesday.

I can't wait to get started!

A Pediatric Recap

2008-02-03T13:20:00.001-08:00

It's odd. Pediatrics was by far my best clinical experience but I wrote very little about it.

Due to a Monday snow delay, I only spent two days on the hospital floor. I did, however, get to spend a day in the pediatric hematology/oncology outpatient clinic, which provided me the chance to do lots of observing, ask questions, and entertain younger siblings while an older child got their chemotherapy treatment. It also provided what was perhaps one of my most profound pediatric experiences, when a four year old boy rattled off the names of each of his chemotherapy treatments to me -- this was shortly after he and I talked about the joys of a peanut butter, jelly, and banana sandwiches. I felt like someone punched me in the stomach.

My days on the floor were wonderful. I shadowed great nurses (some of them PLU graduates!), and performed lots of assessments on a wide variety of patients. My first day we had an adolescent under observation during her recovery from a suicide attempt, a toddler recovering from a sickle cell crisis, and an infant recovering from several complications from surgery to repair a congenital heart defect.

I spent most of my time with the baby even though I couldn't hold her. I helped the occupational therapist during her assessment, and watched the baby's PICC line get removed. I also had the chance to take out the toddler's IV prior to his discharge. That kiddo had a pretty mean right hook. :)

My second day on the floor was a little slower. I took on the care of a school-aged child with asthma. I performed his assessments, and gave his medications. I also had the chance to help another nurse on the floor with a difficult patient. He was a fussy infant experiencing withdrawal symptoms while being weaned from narcotics. It took me and a nurse tech to calm him down, and then I held him for an hour. The unit secretary came in the room to tell me how sweet it was to see him calm and letting someone hold him. He'd been inconsolable the day before.

And there were so many more wonderful experiences! If there's anything I've learned in pediatrics, it's that I don't like seeing sick kids -- but I do love taking care of them.

Labor and delivery has some serious competition.

I was just thinking....

2008-01-25T05:38:00.000-08:00

If you would have told me at this time last year that in just 12 months time I'd be waking up voluntarily at 5 AM... I'd probably still be laughing at you.

But here I sit, at 5:30 AM, sipping on a cup of decaf coffee -- and it's not even a clinical day!

An even MORE Important Announcement?

2008-01-13T20:13:00.000-08:00

Andy and I are getting married!

Let the planning begin! We've been engaged for a little over a week now -- and I don't think a day has gone by where one of us hasn't brought up an idea for our wedding. We have a tentative date set in late spring 2009.

Right now looking at wedding stuff is a reward for good study habits. For example, after reading another [terribly written] chapter out of my textbook, I get to look at wedding gowns for 15 minutes.

An Important Announcement

2008-01-08T20:31:00.000-08:00

I have never felt this way about a clinical experience before.

I spent my first day in pediatric clinicals in the observation unit -- an interim place for kids who are too sick to be sent home, but may or may not have to be admitted to the hospital. The census varied from teenagers to infants.

I started out mainly as an observer. Eventually, I performed an assessment on a wiggly toddler (my first!) and helped out with patients and around the unit as much as I could. I held and fed a five-week old baby that is failing to thrive, having gained just shy of one ounce of weight since birth. He has some serious reflux, so it was a major achievement that he didn't spit up half of his feedings.

I also watched the "real" nurse change the dressing around a gastrostomy tube (a tube going through the abdominal wall and into the stomach for feedings) on an infant, and use suction on that same infant's nose and mouth.

I put "therapeutic hugging" into practice while the nurse got a blood draw on one very unhappy toddler. No amount of soothing could help calm the kiddo during that particular experience -- but my heart positively soared later that afternoon when that same toddler smiled at me and let me listen to his heart sounds with my stethoscope.

Some of the kiddos have special precautions because the source of their illness is unknown, which means health care staff has to gown up, don gloves and masks. I wish those masks were see-through, especially with the younger patients so they could see when we were smiling at them and trying to calm them. Every time I put one on today it made me think of how Tyra Banks is aways telling her aspiring next top models to "smile with their eyes."

*sigh*

Let me just say that I think I at least have a major crush on pediatric nursing. I don't want to jump to any conclusions, but...

This could be the start of a very serious and wonderful relationship!

Happy New Year's Resolutions!

2008-01-04T06:30:00.000-08:00

I'm always conflicted about the first of the year. It's sad to see the Christmas holidays go, but I love the excitement and anticipation of a new year. Like so many other people, Andy and I have a tradition of writing down our new year's resolutions. I'd like to share some of my school-related resolutions with you.

ROBIN'S NEW YEAR'S RESOLUTIONS
1. Ask more questions in clinical settings and in class.
2. Stop fearing having the wrong answer.
3. Eliminate the nervous hand tremors.
4. Pass the NCLEX exam on the first try.
5. Decide which track to pursue for my graduate program (nurse practitioner or clinical nurse specialist) -- and be happy with that choice.
6. Get hired as an RN!

I may add more as I think of them.

One of my other resolutions was to update this blog more frequently, but even just four days into the new year that seems to be off to a rather poor start.

Oh well.

This is a few days late...

2007-12-27T11:53:00.000-08:00

but better late than never, right?

Happy Holidays, everyone!

Glorious news!

2007-12-16T12:01:00.000-08:00

I'm done!

Finals kind of stink, stank, stunk -- but that's obsolete now. I already have my textbooks for my January-term class (pediatric nursing) but I'm not even going to crack open the shrink wrap until after Christmas unless I get reeeaaaally bored. So far, that hasn't happened.

It feels SO NICE not to have homework. In fact, Andy and I have already had the following conversation several times:

ROBIN: Hey, Andy, guess what?

ANDY: What?

ROBIN: I totally DON'T have any homework tonight.

(And then we high-five.)

It's kind of like my very own knock-knock joke. And it's so versatile! I've also used the "I totally DON'T have a test to study for" or "I totally DON'T have any reading to do" variation of the punchline.

It was kind of sad, really

2007-12-06T17:51:00.000-08:00

Today was my last day of clinicals for the semester. On the one hand, it's a relief to have a break. On the other hand, it was kind of sad -- but I know I'll have many many many more hours of clinical experience in the hospital in the very near future.

I actually didn't give any patient care today. (And that wasn't just because I forgot my stethoscope at home.) Since it was our last day, we had the opportunity to spend the day observing nurses in different settings. One student went to the OR, two students spent time in the cath lab, another went to PACU, one to ICU, and I spent morning shadowing the palliative care nurse.

Palliative care is focused on caring for the patient and their family during the disease process. They're concerned with symptom management (like pain), comfort measures, spiritual and emotional needs -- it's all about a person's quality of life. At this particular hospital the palliative care team can get involved as soon as someone is diagnosed with a chronic illness, so it's not limited to patients who are close to death. It just so happened, though, that the families we met with were facing the imminent death of a loved one. That could be another reason why my day was kind of sad.

I loved watching this nurse at work. She had such balance and poise, but was still genuine and empathetic. She obviously cared for her patients and their families -- but even more importantly, the families seemed to really value her support. In the course of the morning, we did rounds on her patients in the hospital. I think that was the first time I've seen someone who is close to death.

We also spent a long time talking with a family whose loved one was dying. All I did was listen, but they still thanked me for being there when the conversation ended. In reality, I was the one who should have been saying thank you to them for letting me be there.

Now THAT's a relief

2007-11-30T17:42:00.000-08:00

I do like nursing after all!

I'll be honest, I was a little apprehensive about returning to clinicals after our much needed 2 week break. I had SO MANY concerns. I think they were a lot of the same concerns that I had at the beginning of this clinical experience. Like...

What if I couldn’t remember how to give a subcutaneous injection?
What if my hands started to shake again during my patient assessments and medication administration?
What if the nurses groaned when they saw more students enter the report room?
And, oh God, what if after my restful and relaxing hiatus, I discovered that I didn’t like nursing after all?

I was relieved when I got to the unit on Thursday. If the nurses groaned at the sight of our PLU uniforms, it was only on the inside. Despite all my worrying, I was actually HAPPY to be back on the unit. It even felt kind of normal to be there. I gave two subcutaneous injections, had the opportunity to hang IV antibiotics, and learned more about the importance of timing of certain medications. It was all very nursey and exciting.

This week was special, too, because I spent the majority of my time giving patient care. I realize that as a ‘real’ nurse I won’t have the luxury of focusing all of my attention and energy on one patient. And, I'll be honest, I was a little bit disappointed when I didn’t take on two patients on Friday – but, ultimately, I valued that extra time I was able to spend with my patient.

My patient was a sweet, dear woman. It was obvious that the time she'd spent in the hospital was starting to take a toll on her emotionally, so we spent a lot of time talking. There was also lots of time for patient teaching. It was during those moments that I was reminded how I do indeed love nursing.

I've also learned that patients who have endearing accents can make talking about anything (including poop and emesis) that much more enjoyable.

You Tube + Medicine = fun fun fun!

2007-11-22T12:52:00.000-08:00

Sadly, I can by no means take credit for this brilliant adaptation of Justin Timberlake's "SexyBack."

Instead, I give you the University of Alberta Medical School's adaptation: Diagnosis Wenckebach.

And, since I cannot figure out how to embed the video into my blog, here's the link to the YouTube video:

http://www.youtube.com/watch?v=GVxJJ2DBPiQ

(You have to cut and paste it because it I am extremely technologically challenged today. I blame the tryptophan.)

Enjoy!

The holy rhombus of nursing?

2007-11-19T06:50:00.000-08:00

Another milestone in my nursing career: encountering vomit for the first time.

I think this means I've encountered all four elements found in the holy rhombus of nursing: blood, urine, poop, and puke.

And, as a onetime sympathetic puker, I'm happy to report that I kept my cool -- even when a little bit landed on my arm.

CABG and PTCA

2007-11-17T16:28:00.000-08:00

I'm sure I'm not the first person to think it's odd that the abbreviations for these two cardiac interventions (CABG = coronary artery bypass graft; PTCA = percutaneous transluminal coronary angioplasty) sound like delicious foods.

It does, however, make them easier to remember for a test.

In this past week, I've seen both procedures done live and in person!

Nursing school is SO COOL.

Sgt. Pepper's OPEN HEART's Club Band?

2007-11-16T16:10:00.000-08:00

Soooo, I saw an open heart surgery today. Maybe it was more like an open chest surgery because the heart wasn't technically open. It was a coronary artery bypass graft. Which means, in very crude terms, that a blood vessel is harvested from somewhere else in the person's body and then the surgeon hooks it up to divert blood flow around the clogged part of one (or more) of the coronary arteries.

Either way, the point is that I saw a human's insides today. Not only that, I saw a HUMAN HEART. And it just kept on beat-beat-beating away all the way through the surgery.

I was, not surprisingly, dumbfounded. Awestruck. Speechless. But to the doctors and nurses on the cardiothoracic team, that's just another day at the office. I guess that's how it should be.

I had a fantastic view of the whole thing, right at the head of the table with the anesthesiologist. Everyone on the team was wonderful. The surgeon really took the time to explain things (and I'm standing there thinking, OH MY GOD he's holding a heart in his hands), asking me questions, quizzing me about anatomy, and that sort of thing.

And then I got lightheaded and had to sit on the floor. Twice.

After my second dizzy spell, I took a little break in the staff lounge. (BTW, it looks nothing like any of the staff lounges on "Grey's Anatomy." Neither did the OR for that matter.) I ate a little snack, had a cup of coffee, and took some deep breaths before heading back into the OR for round two.

The bummer? I missed the exciting part when they had to shock the heart back into a regular rhythm.

The good news? They were so proud of me for not fainting that they said I could come back anytime.

Go Robin!

Another important lesson

2007-11-03T10:37:00.000-07:00

Once you sing a few karaoke songs that you don't really know the words to (and you don't get booed off the stage), suddenly singing in public doesn't seem quite so scary.

It's just one more important life lesson I've learned at Bob's Java Jive.

Week 2 in Med-Surg Nursing

2007-11-02T16:00:00.000-07:00

This past week in clinicals further convinced me that going to nursing school was the right decision.

I cared for the same patient (a very sweet and lovely elderly woman) for two days. My official responsibilities were to administer scheduled oral medications, and to perform the morning and afternoon nursing assessments. Other responsibilities include trying to jump in and help out or observe just about anything cool or interesting that happened on the unit.

Medication administration went pretty well. Janet (my instructor) has been sharing tips for how to deal with my shakey hands. The more meds I administer, the less my hands shake; looks like it's just going to take lots of practice.

I liked explaining the therapeutic effects of the different medications in patient-friendly terms -- i.e., sans medical jargon. I know it's important for me to understand the pathology of a disease or a drug's mechanisms of action and side effects on a smaller level, but I found that being able to put things in a "big picture" perspective was both helpful and satisfying.

My assessment skills are getting better, too, but I still can't wait until the end of the semester when I finally have a good, systematic rhythm.

I also got to see chest tubes get removed, measured input and output, emptied a foley catheter by myself, cleaned a bedpan for the first time, gowned up to help care for a patient in contact isolation, tried to act as an advocate for my patient and helped her ambulate in the hallway.

The most important thing I learned, though was how much the caring things a nurse can do (like offer a patient a warm washcloth to wash their hands and face before breakfast) can make a positive impact on a patient's hospital experience.

When we said goodbye on Friday, my patient insisted on giving me a hug and thanked me for taking good care of her. As she said, "Even just a little TLC makes all the difference when you're sick."

Same bat time... totally different bat place

2007-11-01T05:30:00.000-07:00

It's Day 2 of my medical-surgical rotation!

I'm on a cardiac unit, which kind of scares the bejeebers out of me, but I should learn a lot. The nurses have a reputation for encouraging their students to be critical thinkers, and for letting us observe some pretty cool procedures as they come up. I'll also have the chance to spend some time in the OR, but I don't know yet when that'll happen.

Last Friday was spent observing a nurse while she did her morning routine and assessments. (So cool.) I got to perform the second assessment of her shift, which was super exciting. It was the first time I've heard a heart murmur in person (!) and I've discovered that my stethoscope is kind of craptastic. Either that, or I just have a really hard time hearing lung sounds.

Today I'm assigned one patient to care for -- and I have three goals! They are:

1. Perform both the morning and afternoon assessments
2. Administer scheduled oral medications
3. Chart, chart, chart!

Because charting is a nurse's best friend?

Operations GMI and BMS

2007-10-24T10:27:00.001-07:00

This semester I've undertaken two separate, albeit closely related, operations. They are Operation Be More Social (BMS) and Operation Get More Involved (GMI).

Operation GMI:
I've been trying to be more involved on PLU's campus and in the Lakewood community. So, I joined the Pierce County YMCA and Delta Iota Chi, the School of Nursing's service club.

Even though I haven't really been "giving back" with my YMCA membership, I know I've gotten a lot out it. I love love LOVE my spinning class, taught by possibly the world's nicest drill sergeant. (Seriously, he showed up to class in fatigues one day.) And, the little 70-year-old women shaking their thangs in the cardio salsa dance class are truly inspiring.

Delta Iota Chi has been a nice way to explore the link between community service and the practice of nursing. So far, I've volunteered at a blood drive and am helping co-organize the ELMSN class's contributions to the annual Thanksgiving basket drive. We'll have to wait and see how that goes.

Operation BMS:
With all of this extra time on my hands this semester, I quickly realized that I'd like to leave nursing school with my education AND a new circle of friends. I also wanted to avoid spending my spare time annoying Andy and pining away for my Seattle peeps.

So, I played on my first ever IM soccer team (Team MRSA). Andy and I hosted a pumpkin pancake breakfast, and then attended our first ever PLU football game. I've also had more dinner/lunch/coffee dates with girls from school, in addition to our requisite study sessions.

Perhaps best of all have been karaoke nights at Bob's Java Jive. There's nothing quite like singing a duet with a big bald man named Vinnie Bob.

Never a Dull Moment

2007-10-18T16:52:00.000-07:00

I just finished up my clinical rotation at the inpatient psychiatric unit. The final day was pretty uneventful, with the exception of the impending windstorm on everyone's minds. There were lots of new admits, although some patients that had been previously discharged were back. It was sad to see them in that state, but having a few familiar faces in the mix was oddly comforting.

After thinking about it, I realized that I learned quite a bit during my rotation. I became more comfortable talking with patients, and even came to appreciate having a nursing experience that is not so task-oriented. Hopefully I'll be able to maintain that focus as my move into my next clinical rotation this Thursday in the main hospital.

I also had the chance to wear this little number to class on Tuesday:

And it wasn't even Halloween! I played the role of a visual hallucination (specifically a talking cow) in a friend's skit about the signs and symptoms brief psychotic disorder. It was pure educational gold -- everyone learned something, and was wildly entertained! Fabulous.

And the "Most Likely to Make Mistakes" Award goes to...

2007-10-07T14:10:00.000-07:00

Robin!

So.... perhaps I exaggerate. Let's just say, though, that medication administration was much more nerve-wracking than I had expected. Seriously, my hands were shaking. And I didn't do everything right. Sometimes I absolutely hate not being perfect.

The good news is, I was only responsible for the medication administration of 4 patients on the unit. I cannot imagine what kind of knowledge I would need or what kind of madness would have ensued had I been responsible for preparing the meds for all 15 patients.

The even better (and most important) news is, I learned a lot from the experience. As my instructor so kindly said, I couldn't have experienced more teachable moments in one day even if I'd paid for it. And I did a decent job of rolling with the punches and trying to think on my feet. I'm still trying to learn have the cajones to trust my instincts, though. If I had, it would have saved me a lot of trouble on Thursday!

By the end of that day, things improved. My hands stopped shaking once my instructor gave me some space, and I wasn't as conscious of being watched. I did a kick-ass job of giving an insulin shot. And, when I administered afternoon meds, the routine of asking each patient important questions about side effects and how certain medicines made them feel felt much more natural.

I know I'll never be perfect. But, perhaps my shaky hands and initial cautiousness will pay off in the long run.

This may be the week

2007-10-02T15:23:00.000-07:00

That kicks my butt. Or it could be the week that kicks my butt out of nursing school.

Like I've mentioned before, I have lectures Monday through Wednesday, with clinicals on Thursday and Friday.

This week has been unusually hellish. I've had:
-two exams
-two quizzes
-a paper due
-a teaching plan due

And I have four papers due next week!

Thursday I'm responsible for medication administration (which I'm actually pretty excited about) for some patients on the unit, and on Friday I'm leading an hour long "Life Skills" group. We're talking about stress management. Maybe I'll learn something?

I remember a time when October used to be my favorite month of the year....

*sigh*

Those were the good old days.

Ch-ch-changes

2007-09-28T22:21:00.001-07:00

At this point in the semester last summer (about 4 weeks of class) I was almost halfway through our curriculum and positively overwhelmed by the amount of information being thrown my way.

Fast forward to today -- almost 4 weeks into class and it seems like we haven't learned much of anything. Not from books or most of our lectures, anyway. Many of the concepts we learned this summer are being reinforced, but it feels like most classes are still stuck in first gear.

I can't decide which situation is worse: being overwhelmed or underwhelmed. I wish I could find a balance. I may have already said this, but I think the majority of my learning will come from my clinical experiences.

I'm learning a ton in mental health. My week in the chemical dependency unit taught me that addiction is indeed very much a disease. And this week back in the inpatient psychiatric unit has helped me practice my listening and communication skillz. It still isn't easy, and they need some work -- but I am having a much easier time initiating conversation with different patients in the unit.

I even got to contribute some insights and observations during a treatment team meeting with the psychiatrists and social workers. It felt pretty good after one of the docs told us that students were only half as important as everyone else in the room. (Zing!)

I think he was joking, though.

You know it's a Monday when

2007-09-25T15:48:00.001-07:00

You drop your phone in the toilet, right before a big test.

And then you remember that it's actually Tuesday and life's just funny like that.

Fall Semester: Week 2!

2007-09-14T18:03:00.000-07:00

I just had a fabulous day in the ER. Sounds kind of strange, doesn't it?

Thursday marked my first real day of my mental health clinical rotation. My instructor has arranged for us to do something a little different each week. My schedule looks a little something like this:

-two days in the chemical dependency unit
-one day in the emergency room crisis center
-one day shadowing the charge nurse for the inpatient unit
-one day shadowing the group nurse for the inpatient unit
-one day administering medicine to patients in the inpatient unit
-one day assisting the mental health technician
-one day with the social worker on the inpatient unit
-one day leading an occupational therapy group
-one day in the outpatient program
-one day doing home health visits with a mental health nurse practitioner.

I spent my first day in the voluntary inpatient psychiatric unit. My main task was to shadow the social worker, observe his support group, and observe the treatment team meetings. Treatment team meetings are a time for the whole team of care providers (psychiatrist, nurses, occupational therapists, social worker) to discuss a patient's history, treatment plans or options, their progress and plans for discharge. It was truly fascinating!

The first half of my day was quite uncomfortable, though. Since the social worker didn't get to the unit until 0900, I spent the first couple of hours floating around the unit. I helped take vital signs before breakfast, spent some time looking over charts, and participated in the morning exercise group, but my main task was to observe and try to talk with the patients.

Who knew just sitting back and watching could be so difficult? Having 10 new people on the unit caused anxiety for many of the patients -- and I think most of the students (myself included) felt a bit of anxiety of their own. Things improved as we all became more comfortable around each other; by the afternoon most students were able to approach patients and strike up a conversation.

On Friday, I spent the first part of my morning shadowing an ER nurse. I got to help clean rooms, observe wound care (although I left before seeing the doctor actually staple the laceration shut), help move a patient up in bed, and talk with the nurses. The rest of my day was spent in the crisis center, which was positively overflowing with people in crisis.

The crisis services center has three patient rooms, a small office, and a quiet room. When I got there, all three of the patient rooms were occupied, the quiet room had been turned into a makeshift patient room, and three additional beds in the ER were filled by crisis patients. Much of my time was spent talking with the crisis center nurse, and observing as the crisis counselor struggled to get patients placed with appropriate resources. Some major shuffling had to go down when a homicidal patient showed up in the ER lobby.

I can't decide what was the best part about my time in the crisis center -- talking with the crisis services team, interacting with patients when possible, or how I was able to advocate for myself so I didn't just sit around. Perhaps that was the best part of all!

I'll take two, please!

2007-09-13T17:28:00.000-07:00

This may be the greatest gas station sign EVER.

I just LOVE propane-filled ice cream, don't you?

Fall semester has begun!

2007-09-10T17:57:00.000-07:00

I've entered my first full week of classes this semester. It's a full classload, but I am quite excited for what we'll be learning!

I'm studying:

Pharmacology and the Nursing Process
Professional Foundations in Nursing
Mental Health I
Adult Health I

Not only do I have all new classes -- I have a whole new schedule! Lectures meet on Monday, Tuesday, and Wednesday. Class usually runs from 8 AM to the early afternoon, except for Wednesdays when we just have class from 1100 to 1300. Clinicals are Thursday and Friday from 0630 to 1530.

I'll be honest, last week I had some trouble adjusting to this newfound afternoon freedom. I'd like to think the three naps I took helped me catch up on my sleep for this week, but I think I was probably just being lazy.

Lazy sure felt good, though! Oops.

Vacay: A Photographic Essay

2007-09-03T19:35:00.000-07:00

OMG, road trip!

Andy just loved Whitman.

Outside the scary batcave.

Paradise was a real adventure.

We even saw wild animals!

Glorious vacation!

2007-09-03T19:30:00.000-07:00

My two weeks of glorious, blissful vacation ends today. Some highlights:

Slumber party, sushi, and shopping with my big sister
Dinner with girlfriends
Trip to Chelan with the fam
Trip to Walla Walla with Andy
Braving our way through the batcave in Chinook Pass
Finishing Harry Potter
Hiking at Mt. Rainier with Andy
Karaoke night in Tacoma
Bocce ball
An afternoon with Abbey and Josh

The lowlights:

Not seeing all of my Seattle friends
Embarking on a 10-mile run in the middle of a sunny Seattle day. By myself. With no music. And no water. (Dumb-da-dumb dumb...)

Am I forgetting something?

"The best part of waking up"

2007-08-24T12:08:00.000-07:00

Inquiring minds want to know exactly how much coffee one nursing student might drink during her 8 week session of summer school. The answer is this much:

I drank this whole thing of coffee almost singlehandedly in a 7 week period. And there were many more cups of coffee consumed at various coffee shops and espresso stands during many of our marathon study sessions.

It's kind of embarrassing.

Drum roll please...

2007-08-17T11:44:00.000-07:00

I'm done!

I wish I'd studied a bit more for my last final, but I won't know how bad it really went until grades get posted next week.

Time to do a happy dance. :)

Long Term Care Part II

2007-08-16T17:33:00.000-07:00

Today was the last day of my long term care clinical experience.

I was assigned to do rounds with the team of restorative aides, so I didn't get to do morning care for my resident. We assisted with range of motion exercises and helped several residents walk the distance from their rooms to the main dining hall.

I felt guilty, because we told our resident on Tuesday that we'd have one more full morning together. She seemed quiet and kind of down that day, but we thought it was because she hadn't slept well. I was surprised when she stopped her morning meal to tell me that she wished we weren't leaving. She then refused to let me help her finish eating; my partner had to take over. It felt like she was mad at us.

Luckily, I got to visit with her over breakfast this morning. She smiled, said hello, and even made an effort to talk. I was pleased that she was happy to see me. (Or maybe it was the waffles on her plate? I'll never really know.)

Saying goodbye was strange, though. I didn't think she remembered our conversation on Tuesday about leaving, but she did seem to understand today that we weren't coming back.

I told her how much I had enjoyed spending time with her, and thanked her for letting us help her with her morning routine these past few weeks. She took my hand and squeezed it, and just nodded her head. Perhaps it shouldn't surprise me, but it was very difficult to just turn around and leave.

Now that we're done with this experience, I am so happy that it was my introduction to nursing. I know that my future clinical experiences will focus on critical thinking, nursing diagnoses and more advanced skills. However, long term care gave us the chance to really focus on the human side of nursing -- the holistic focus, therapeutic communication, and importance of establishing trust and therapeutic rapport.

I sincerely hope I never lose that perspective.

Latex Gloves

2007-08-14T21:01:00.001-07:00

One very important lesson I learned early on in this adventure: with enough latex gloves, I can do anything. It's true!

(Come to think of it, I have yet to encounter poop in person. I've been wearing my lucky bulldog socks, and I think it's working.)

Seriously, my right hip is about 4 inches wider than my left when I'm at my clinical site. It's stuffed to the brim with my extra pairs of size small non-latex gloves. That's my clean pocket -- my dirty pocket, with the hand sanitizer, is on the left. I'm a righty, what can I say?

Long Term Care Part I

2007-08-09T18:35:00.000-07:00

We just finished up the fourth day of our long term care rotation. I've come to terms with the fact that this clinical rotation will be a simultaneously rewarding and challenging experiences.

My client is an elderly woman with advanced Alzheimer's. Her speech is often incoherent, which makes it difficult for her to verbally communicate her needs. She's totally dependent on others, meaning she cannot toilet, feed, or dress herself. We have to use what's called a Marissa lift to get her out of bed and into her wheelchair -- her feet virtually never touch the floor. I don't think I have ever seen anyone who is so vulnerable.

I was absolutely terrified on my first day as her co-caregiver. (Fortunately, I have a partner!) I'm sure that was nothing, however, compared to what it must have been like for her to be woken up at 0630 by two shy strangers who were both awkward and eager to help her start her morning. It was touch and go, but we eventually got her to the dining room.... an hour late.

By now, things have fallen into place. We've been trying to promote a sense of autonomy by offering her simple choices. It didn't seem to make much difference on the first day, but by now it's clear that she likes us and likes having options. Every once in awhile, when her speech is clear and lucid, we get a glimpse of her personality. And for some reason, I really make her laugh.

It's a good feeling! (Although sometimes I think she's laughing at me, rather than with me.)

Cool New Skillz

2007-08-05T13:49:00.001-07:00

I managed to add four new and exciting skillz to my nursing repertoire this past week. They include:

1. Giving subcutaneous injections (on a real person!)
2. Giving intramuscular injections (also on a real person!)
3. Starting an IV (not on a real person)
4. Inserting a urinary catheter (also not on a real person)

I also received two injections this week. For those of you that know of my long and sordid history with the Virginia Mason injection room, you will be proud to know that I:

A) did not cry
B) did not run away, and
C) did not have to be held down during the injection process.

The whole class cheered. Go Robin!

Cool New Duds

2007-08-04T13:44:00.000-07:00

Here I am, looking all official in my student nurse uniform:

Actually, I probably look even more official now that Andy's mom hemmed my pants. Even the petite pants were about 5 inches too long. Awk-ward!

All that's missing is my snazzy white lab coat. (It's on backorder.)

Another reality check

2007-07-29T11:34:00.000-07:00

Now that we've finished one class and started the clinical portion of another, it feels like my classload has considerably lightened.

It's time for me to snap myself back into reality. Here's what I have to accomplish sometime within the next three weeks. This time Nursing Competencies I is in purple, Nursing Competencies II is in green, and Pathophysiology is in yellow:

Complete Lab Modules for 7/30
ATI testing 7/31
Dosage Calculation Exam 8/1
Exam I 8/1
Complete Lab Modules for 8/1
Quiz 8/1
Complete Lab Modules for 8/3
Quiz 8/3
Worksheet Due 8/3
Clinical Problem Set Due 8/3

Complete Lab Modules for 8/6
Complete Lab Modules for 8/8
FINAL EXAM 8/8
Exam II 8/10
Clinical Problem Set Due 8/10
Work Sheet Due 8/10
Neurological Disorders Presentation 8/10

Complete Lab Modules for 8/13
Putting It All Together Day 8/15
Final Exam 8/16
Final Exam 8/17

Functional Assessment Due 8/17
Environmental Assessment Due 8/17
Pain Assessment Due 8/17
Therapeutic Conversation Assignment Due 8/17
Life Review Paper Due 8/17

I think I need to start using that little engine that could mantra again.

Week Six down

2007-07-28T10:35:00.000-07:00

And now there's only three more to go.

This past week was FULL of exciting firsts!

On Thursday, we had our first orientation at the long-term care facility. We had a short tour of the building, and reviewed our instructor's expectations of us as student nurses. We also got to wear our lab coats and ID badges for the first time. Super exciting!

Considering all of the negative preconceived notions I had regarding long-term care facilities, I was pleasantly surprised. The facility has two wings: one for short-term care, and another for long-term care. Short-term care had much more energy, more obvious interaction between patients and staff, and a much brighter ambiance. Long-term care seemed much... slower. And routine. And kind of sad.

On Friday, we gave our first injections. I already LOVE this new class. We have yet to actually stick a real person -- that's on Monday -- but that was fine by me. I had enough trouble drawing saline into the syringe from an ampule or a vial.

I still haven't quite grown that nurse's "third arm," but my instructor swears she can see a little bud growing.

I can already tell, this is going to take a LOT of practice.

The good news is...

2007-07-24T17:40:00.000-07:00

I passed my practical lab today, bed pan, bed bath and all!

The scary news is, I have to be able to do all of those things (and more) for a real patient NEXT WEEK. A week from today, in fact.

I'm just going to keep telling myself that with enough latex gloves, I can do anything. And to remember that my nursing instinct will take over, just like it did in lab today.

Now if only that same nursing instinct would kick in when dealing with my landlords...

Transition time!

2007-07-23T07:36:00.000-07:00

Everything starts changing this week!

And by everything, I mean my class schedule. Which, right now, is pretty much everything to me.

"Health Assessment and Promotion" wraps up this week. We have the practical lab exam today, and our final exam and final paper due on Wednesday.

I'm also finishing the lecture and practical lab portion of "Nursing Competencies I." The practical lab exam for that is early Tuesday morning. I've been having nightmares about bedpans and bed baths, so we'll just have to wait and see how it goes.

Friday marks the beginning of "Nursing Competencies II." This is the class that previous cohorts claimed made them feel like "real" nurses. It's when we learn how to give injections, draw blood, administer IV medicines, and stick nasogastric tubes down the mannequins.

I have yet to tell my classmates that it once took 5 nurses to hold me down for a routine booster shot. Here's to hoping I don't have a repeat performance!

Over the hump

2007-07-21T11:14:00.000-07:00

Last Wednesday, July 18th, marked the halfway point for my summer program -- making it the the ultimate hump day.

It really wasn't that exciting. It was a long day on campus, just like every other Wednesday.

Luckily, I wasn't expecting a ticker tape parade or anything like that.

Assessment in action

2007-07-16T14:55:00.001-07:00

Here I am, causing trouble in the lab as I palpate prosthetic breasts for lumps:

Notice how my partner, Kara, smiles sweetly and I look like I'm up to no good.

Coincidence? You decide!

I survived!

2007-07-14T12:00:00.000-07:00

I'm not gonna lie, that patho exam was a doozie.

There were questions that I knew, and there were those that I didn't. I don't feel great about it, but I don't feel terrible either. In fact I feel kind of.... numb? relieved? satisfied? exhausted? I just can't make up my mind.

It's almost as though that test serves as a rite of passage for ELMSN students. (Seriously, I half-expected the professor to pass out merit badges when each person turned in their exam.) It made the celebratory margarita taste that much sweeter.

The most important thing is we survived -- and we're totally going to kick ass on the next one!

So much to learn by Friday....

2007-07-08T18:55:00.000-07:00

We get 20 minutes of open-book time during the exam. As you can see, my book is all marked up and ready to go:

Yellow post-its are things we have to know "cold." Pink and orange ones are the figures and tables we have to be familiar with.

If you really squint, you can see my handwriting on each and every little tab.

The hope is that most of the yellow tabs will be gone by Friday morning because I'll know the stuff.

If not, I guess there's always that 20 minutes!

Week Three

2007-07-07T11:57:00.000-07:00

It's hard to believe that I'm almost halfway through my summer!

This last week was special because we had a mini-break on Wednesday. I may have taken more of a mega-break, though, and neglected to study sufficiently for my patho quiz on Friday. The break was necessary, but it shouldn't have carried over into Thursday evening.

Awk-ward! That's a mistake I won't make twice.

Next week will be a doozie, mainly because we have our first exam in pathophysiology on Friday the 13th.

To put things in perspective, I have been dreading this particular exam more than bowel elimination day. It covers the first 23 chapters of our textbook and is worth 25% of our grade.

My game plan is to finish all of my work for my other classes today, so that I can devote my spare time on Sunday through Thursday to studying for patho. Hopefully I will also have time for other things like sleeping, eating, showering, and peeing.

It's going to be a loooooong week. But when it's over, I will officially be 1/2 way through my summer of nursing boot camp! (And possibly delirious or in need of a hug.)

A breakthrough?

2007-07-03T19:33:00.000-07:00

We've reached that point in our Nursing Competencies class where we learn how to perform some of the most intimate procedures known to man, more commonly identified as personal hygiene.

I'll admit, I approached this part of my education with trepidation. I was concerned with my potential reaction to mouth care, bed baths, and body fluids in general.

So far, talking about potential "situations" and looking at slides of things like stage 4 decubitus ulcers and scabes was much harder for me than, say, performing perineal care on the mannequin. I'm just hoping that I'm able to keep my cool once I actually encounter my first incidence of fecal incontinence live and in person.

A day of rest

2007-07-03T07:34:00.001-07:00

Never have I been more excited to welcome that holiest of holy days, the fourth of July.

We get the day off from school!

This is almost better than Christmas.

Phew!

2007-06-28T18:27:00.000-07:00

Let preface this post by saying: this week I've been under a little bit of, um, stress. And very, very tired.

We had our first written exam in Nursing Competencies 1 on Tuesday, and our first graded assessments in lab today. In order to pass the class (with a C) we have to pass all of our clinical/lab assessments, as well as get an average of 71% on each of our quizzes and written exams. Oddly enough, we have to maintain a 3.0 average just to keep our spot in the ELMSN program.

Oh, the pressure!

All of our written exams are in a multiple choice NCLEX format where you have to pick the "best" answer. This will be great practice when we're actually sitting for the licensing exam, but on Tuesday things just seemed downright tricky. It was easy to narrow the answers down to two good ones. The hard part was choosing the best one.

Let me tell you, I have never been so happy to get an 86% on an exam before in my life.

The lab skills test was taking vital signs (temperature, pulse, respiration rate, blood pressure) and handwashing. I aced them all, with the exception of bumping the sink when I washed my hands (-1 point) and being a bit too eager to hear the systolic pressure reading on the first try (-1 point). Keep in mind these are skills that I have to opportunity to practice every day -- so I know they'll improve over time.

The good news is, I'm feeling much better about school today than I was at this time last week. I actually feel like I'm gonna make it.

At least for now.