Monday, December 24, 2007

A Sanders Family Christmas

The past six years have brought a tremendous amount of change in my family. The root of the changes primarily started with my sisters getting married. My sisters' marriages have altered my family, my life, my time, my thinking, and many other aspects of my life. Their marriages altered the afore mentioned for them as well, but it also altered their priorities. A change in one's priorities can potentially change a great deal of things. A change in my sisters' priorities led to the cessation of Christmas as I had always known it. Admittedly it was hard at first, irritating even. Why should my life change because of the choices of others? But life isn't fair. And as time would have it, the Christmas' of the past, due to even more changes, are now gone forever.

So as time has passed I have pondered Christmas and family and tradition and the meaning and purpose and goal and function of it all. This led to many discussions between my mother and I. It seemed that Christmas often led itself to our family spending days on end in the same house, but not necessarily together. One would find their self in a book, another watching television, another on the computer, another sleeping for an inhumane amount of hours. And it seemed unfathomable that as the days passed with so many people in the same house, that they never really talked or experienced each other. Amazing and sad, pathetic even. So for many months my mother and I conversed. What should we do? How do we change it? Will we push to hard, to far? But the main question was, What do we do?

So, this past week the Sanders Family Christmas itenerary was born. It read as follows:

Saturday (12/22)
5:00 Dinner at the Watson's
Sunday (12/23)
9:00 Church
11:30 Family Lunch at Home – Pizza! Pizza!
1:15 Family Picture
1:45 Cookie Creations
6:00 Church
8:00 Sanders Family Talent Show (all must participate)
Monday (12/24)
9:30 Suduko Challenge (Boys vs. Girls)
10:00 Family Breakfast
10:45 Time for Christmas Presents
1:30 Family Lunch
2:30 Mystery Gift
4:00 National Treasure: Book of Secrets (Thoroughbred Theatre)
6:30 Family Dinner
7:15 Apples to Apples

Truth be told we did not follow the itenerary as perscribed. I was not schocked. Fortunately, I had prepared my OCD mind for this possibility so I was able to successfully go with the flow.

The talent show ended up on Monday instead of Sunday, all did participate, and it was a lot of fun. Even little Haydn had a part.

We weren't able to do the Sudoko challenge on Monday morning as one particular family was very late.

The family picture had to be redone on Monday. The one from Sunday turned out to dark, which was too bad because it was a great picture. But it was okay because my hair looked better on Monday.

The cookie creations were so much fun and we had to take family pictures of those too. Of course Mom's (a.k.a. Martha Stewart) turned out the best.

Dad and Mom

Christa, Haydn, Dewayne /Josh, Jonah, Chara

Me /John, Louise, Laura

Everyone had fun this year. Was it everything I hoped Christmas could be this year? Yes. And no. Life brings about change and change it hard to accept at times. I still find myself in the warmest (in the spiritual sense, not the temperature sense) of houses, hearing the sounds of joy and laughter, smelling the scent of savory foods, and residing in the shadow of two patriarchal figures; but the house is not the same, those that gather are not the same, the two partriarchal figures are not the same, the grandchildren are not the same, and the location is not the same. I suppose one will always long for that which began their fondest of memories. I wore a sweater today that the original matriarch gave me on a previous Christmas - that was my small way of having that far away, long ago place reside with me.

This Christmas did bring with it the vision of the future and there is so much hope, promise, and treasure that lies ahead.

Merry Christmas to all, and to all a good nite!

Thursday, December 13, 2007

Winter Break

Winter Break has officially started and I have a semester's worth of credit from Vanderbilt University. 1 down and 5 more to go or 1 year and 7 months left. It's amazing in some ways how fast this semester passed, especially since at some times I thought it would never end. I spent from this past Friday night to Wednesday morning studying for final exams. I had one on Monday, one on Tuesday, and a final one on Wednesday. I've been so mentally tired that I've been doing some crazy things like trying to step into my shirt when getting ready for bed the other night believing they were shorts, opening my car window when meaning to put my turn signal on, and a few other things that were truly humorous. I don't know all of my final grades yet, but I'm okay with them. I didn't make all A's, but I did my best, so it's okay. I learned a lot of things that I can do different/better for next semester.

Next semester starts on January 7th and we take off running from day 1. The spring semester is only 14 weeks long, but we have 15 weeks of clinical to squeeze in, so the first 4 weeks we are doing 5 weeks worth of work. Crazy times!! So, I'm already looking forward to February. Truthfully though, I am enjoying the challenge of school. I find that getting up early, in my scrubs, with my stethoscope toggled around my neck, making my 2.5 block trek to the hospital amid the other nurses and health professionals makes me feel strong and important, useful. I am enjoying learning and growing. I constantly have to fight with myself to believe that I can do this and that I am capable and that I've made the right choice.

I suppose I feel a little embarrassed at times for going back to school. People will laugh and say I'm a life long student or joke that I need to make up my mind. Younger classmates think it's funny that I already have a Master's degree and yet here I am (although, most of the older students (27+) have Master's degrees). I guess I've always desired to have direction in my life, to present myself as a professional, determined individual, to live as someone who knows where they're going. I've always wanted to be that person that people want to emulate. I feel that my "wishy-washyness" in regard to my "career" degrades my credibility and takes away from those characteristics I desire and pursue to present. I suppose my decision to go back to school causes me to question my loyalty to my new found profession.

On the other hand I'm very proud of myself and in someways feel that for the first time in my life (in regard to "career") I am finally following my heart and pursing my goals. I've always, since as far back as I can remember, had a fear of failure. When I was in elementary school I wouldn't read books because I was afraid I couldn't finish them - I eventually conquered this fear. But sometimes facing the fear is more rewarding that not failing.

Tomorrow I'm taking my niece to the movies. I have no homework to worry with. For now, I am blessed.

Wednesday, November 28, 2007


April 22, 1993 - November 28, 2007

Today, Mom and I went to the vet and put Belle down. It was hard. It was sad. It was time. She really had no quality of life anymore. She couldn't see, couldn't hear. She whined a lot from pain. She shook at times from pain. She constantly had dermatological infections. She couldn't play anymore. She couldn't run anymore. She slept most of the day. Scratched all the time. Cried a lot.

It's different to think about death and dying in regard to a dog. But the loss of an attachment hurts no matter what form the attachment was in. I was blessed to have her in my life. She was a fun dog. A good dog.

Tuesday, November 27, 2007

Should I blog or not?

Today in school, we talked, in 2 different classes, about the importance of privacy and respecting HIPAA. HIPPA is a warranted, yet quite annoying act. If you haven't heard of it, you will. I have personally taken great pride over the past 4+ years of my personal practice of HIPAA. I do my best to not reveal, disclose, or transmit any information about any pt that I come in contact with. At times my personal observation of HIPAA has even offended those I know when I won't discuss the current health status of a joint friend. Not following HIPAA guidelines can have serious consequences as outlined in section 1177:


"SEC. 1177. (a) OFFENSE.--A person who knowingly and in violation of this part--

"(1) uses or causes to be used a unique health identifier;

"(2) obtains individually identifiable health information relating to an individual; or

"(3) discloses individually identifiable health information to another person,

shall be punished as provided in subsection (b).

"(b) PENALTIES.--A person described in subsection (a) shall--

"(1) be fined not more than $50,000, imprisoned not more than 1 year, or both;

"(2) if the offense is committed under false pretenses, be fined not more than $100,000, imprisoned not more than 5 years, or both; and

"(3) if the offense is committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm, be fined not more than $250,000, imprisoned not more than 10 years, or both.

The class discussions today, brought of different aspects of HIPAA which have caused me to feel quite perplexed. I fear that many of my blogs may in fact be in violation of the law. I question at this time what I can and can not share. I question whether I should blog at all about my experience. I pondered today shutting down my blog altogether, but I have really enjoyed it. So I ponder if I should or should not blog. Without the mention of pt cases it is not very interesting. However, I wouldn't want to go to jail for 5 years or pay $100,000 in fines. I will have to ponder this more.

Thursday, November 22, 2007

Feeling Thankful

I worked yesterday. It was good to see friends and feel the building excitement of Thanksgiving and the approaching holidays.

Working also helped me to reflect on what I have to be thankful for.

Yesterday, I saw the worst wounds I've ever seen. This woman was literally coming out of her skin. The wounds were huge and the skin was decaying all around. She had been at home literally rotting away and admitted the night before for treatment. I am not sure if we can treat her. She was in so much pain; it hurt her to sit, to stand, to lay on her back, on her stomach, on her side.

Last Thursday I had a 26 year old pt at the hospital. She had been shopping in a store that was being robbed. The robber came up behind her and slashed her throat three times and then stabbed her in the face twice. She only spoke Spanish. My Spanish is muy picito y mal. We laboriously conversed all morning and I discovered that she has been in the country for 3 years and has a ten year old daughter. At the end of the day she discharged home. She was petrified though. She came to a new land to have a better life and got assaulted.

Last Friday I had a 53 year old pt who was in the hospital for a gastric bypass sx that went bad. Her husband left her, one of her sons died, she can't eat, she has no energy, she has chronic abdominal pain, and her hair is falling out.

At times working with so many sad situations can be depressing and can cause one to feel somewhat hopeless regarding the fate of this world we live in. But at times, working with so many sad situations can reaffirm how completely and totally blessed I am.

I have great friends. Friends who encourage me and lift me up. Friends who know me and understand me. Friends who laugh at my jokes (or suttle sarcasm). Friends who tell it to me straight even when they know it's not what I want to hear. Friends who listen. Friends who truly care about me and I about them.

I have a beautiful family. One that is quickly multiplying. A family who encourages me, lifts me up. A family that makes me feel appreciated, wanted, needed, and loved. I have two parents who have always guided me and been there to cheer me on or pick me up. I have three sisters who have always been and will always be my friends. I have three pretty great brother in laws who respect me. I have three little friends who make my heart smile.

I have a strong healthy body. My extremities work. I can breathe. My heart pumps. My skin's intact. I have no difficulty with my bowels or bladder. My senses are all working allowing me to feel, taste, hear, see, and smell. My mind works well. I have good energy. I can communicate with my friends and family. I can play with my little friends. I can learn. My liver and pancreas function well. My hormones are balanced.

I've been able to travel and go places. Four countries, hundreds of cities, a multitude of states. On my travels I've been able to eat some excellent food, see some great shows, see God's magnificent creations, experience new cultures. Grow.


Las Vegas


I was allowed the opportunity to quit my full time job and go back to school to push myself farther, reach higher, and pursue.

I have so many many more blessings than those I've listed. I am truly truly blessed. I have a lot to be thankful for.

Tuesday, November 13, 2007


My second week of clinicals was a little less exciting than the first week. I had a 72 yo African American male. He was fun and I had a good time hanging out wit him. Most the time when people are in the hospital it is not a joyous occasion. Births are the only real joyous hospitalizations. Well, my guy had HCC or hepatocellular carcinoma or liver cancer. So he was admitted to the hospital to have a right hepatic lobectomy. They went in and took out 3/4 of his liver. The tumor they removed was ~20cm which is a little more than 7 inches. The medical student who came in on Thursday jokingly said he actually delivered a small baby. The pt got a kick out of that. This type of cancer is not generally followed up with chemo or radiation, so pretty much the treatment for his HCC is complete. The doctors said they got it all, so I suppose this was actually a joyous occasion. The pt said he could tell a big difference. He said that before he could feel his liver protruding from his belly. It was actually pushing on his kidneys and causing him to have trouble urinating also. He said over and over how good he felt.

I did get to remove his catheter, his IV's, and do his discharge education. We talked a lot about his alcohol and tobacco habits and how they would negatively impact his healing and length of life. He said he had no need for any of that anymore, but who knows. Overall, he was a fun guy to talk with. He had been a concrete worker before he retired and laid many of the bridges on I-24. He also has 11 children with his wife. He was a fun guy to take care of last week.

Last week was the most hectic week. We had 3 tests and 4 major projects due in one weeks time. To make things even more difficult, we had all of our tests outside of class time and two of them were on my days off. This made it really hard to get my projects done. The week was so hectic that some people even dropped out last week and some are still thinking about it this week. I'll admit it's tough, but not unconquerable.

Next week is Thanksgiving and I get the whole week off!!

Friday, November 9, 2007

Laptop Girl 2

So what happens when you sit for 6 hours a day and look at celebrity blogs on your laptop instead of listening to important lectures reguarding treatment you are going to give to sick patients in hospitals???

Answer: Your drop out of school when you make bad grades.

Sunday, November 4, 2007

Urine and Shoo Shoo

Last week was full of excitement. Thursday and Friday we went to the hospital. It was really funny being there as part of a different team. It is truly amazing how much nutrition and nursing interact. It's funny to be on the other side. While I was at the hospital on Friday there was a dietitian on the floor with 2 interns. This time last year I had 2 interns following me around. And now I'm less than an intern. Hadn't really thought about that before hand; funny how things turn around.

Thursday was fun. I had a middle aged female who was 1 day post op gastric bypass surgery (nutrition stuff again). She was super nice and let us poke and prod and look and inspect. She was very gracious to my partner and I. She was a true pleasure. She had a 10" incision in her abdomen - it was very pretty. There were 28 staples. Good times. Although she was a perfect pt, she was a little boring to take care of since she was so independent. But then some excitement came about. Another pt down the hall needed a catheter. Her catheter had been dc'd the day before and she had not urinated since, so she needed an in and out cath. An in and out cath goes in, gets all the urine out, then comes out. So they told my partner and I that we could put it in. I was extremely excited. Put a catheter in a real pt and not just a mannequin with a huge pee hole!!! So I was nonchalant with my nurse partner for the day.

"you can do it if you want" I said thinking she doesn't want to.

"are you sure?" she said, "don't you want to do it?"

"yeah" I said, "I'll flip you for it. do you have a coin?"

"no" she said, "lets rock, paper, scissor it."

"okay" I say - I have to win this!!

1-2-3 both scissors. do over

1-2-3 she's scissors. I'm rock. I win. I get to do the catheter!!!

The pt is a young woman who was in a car accident and broke her pelvis. We go to her room and find her walking to the bathroom trying to urinate so we won't have to cath her, but she got nothing. so in we go. Now when you cath a woman you prefer for her legs to be as far apart as possible so that you can clearly see the urethra (also known as the pee hole). Unfortunately, when your pelvis is broken it is difficult to spread your legs. So I got about a 3" spread (this is very small). So her legs are very large and she is African American and I can't see anything. My partner is holding the flashlight and I'm looking and thinking maybe I should have chosen paper. Oh yeah, and the pt keep screaming in shear pain due to having her legs slightly spread with a broken pelvis. So I go in, only it was the wrong hole. I tried to cath her vagina. Just so you know I didn't get any urine. So I pulled out resterilized my field and went in again. I still saw nothing. It was like a wall and then all of a sudden this little window came open and a hole appeared. I threaded the catheter in. Poof, we made contact. A flood of urine field my bag. I got 400 mL. It was very dark. I pulled the catheter out. We covered her back up, she screamed some more. We were gone. I charted. Task completed. Urine retrieved.

Friday wasn't nearly as exciting. We started our morning evaluating our patients and taking vital signs. We had some down time and one group had a job to do, so the rest of us joined them. So all 6 of us went in to take care of an older man. He has 2 broken arms and a broken leg(that's what happens when you are walking down the street drunk). Oh yeah, and he's delirious. So as he said he had a shoo shoo. So we all go in to bathe him and change his sheets and he's laughing and doesn't have a clue that 6 girls are in there who don't have a clue what there doing and we're laughing and he's laughing and the whole thing was really funny. The rest of that day was super boring. I mean when the highlight of the day is cleaning up a delirious man's shoo shoo....well, you get the idea.

This week I have three tests, a paper due, and two more exciting days at the hospital. Can't wait.

Tuesday, October 30, 2007

It was so foggy this morning as I drove to school. It was really pretty and peaceful, which was somewhat calming as I drove the 20+ miles of parking lot (i.e. Interstate 65) into Nashville. I found myself feeling somewhat reflective. I thought about the past 10 years. Ten years ago today, October 30, 1997 I was a senior in high school. I also attended a friends funeral. He was 15 and died after a year long battle with cancer. It's amazing to realize how much time and life has passed since that day and yet how the lessons learned from that time still reside so closely to me. I learned so much about family and friends and the importance of communication with those around you and with you. I learned about the importance of hope, the power of prayer, the feeling of loss. I learned over time that life goes on and yet as the days grow more and more since that person was on the earth, you always carry a part of them, a part of your time and experience with them. I can't say that he and I were very close. We had really just become friends when he was diagnosed. The truth is I learned more about him after he died than I had when he lived.

That was my first real experience with loss, with the finality of death. Since that time I have become more aware of it. Recent years have taken the lives of those I was close to, of those who I now carry in my heart. That has allowed me to develop a deeper understanding for true loss. At times I wonder if I have become indifferent to death. I remember a period of three work weeks in which 19 patienst died, some of which I was quite close to. Death can change you.

But those changes aren't always bad. Especially when you are a person of faith and the finality of death is not so ugly or infinite or empty. Knowing that there is hope is a blessing. But it does change you.

I suppose that when your work is centered on life it must encompass death as death is a part of life.

I have always had a desire to be involved in health care. To study the truly amazing human body that God has granted each of us. To help bear and share in the burden of injury and illness. It's a funny calling I suppose.

The fog was quite beautiful this morning.

Monday, October 29, 2007

The past few weeks have been very eventful and restful all at the same time. I have had very full days and very restful ones. I had fall break last week and in the process I have somewhat slacked off of school. That, however, does not mean that school has slacked off of me. I have had papers due, projects, five tests, and the ever present reading. Overall I've done okay.

Last week we had our final lab test in which I had to perform various skills in order to validate my professional safety in the hospital. I had to place a foley catheter in the mannequin as well as a nasogastric tube. I hate practical tests, they make me nervous and I don't do well. I think I would actually do better if the person was real and I wasn't getting graded. The good thing is that I passed and so I am allowed to begin clinicals this week.

Begining clinicals means that my schedule will change. Since school started I have had every Friday off and went half a day on Wednesday while going all day Monday, Wednesday and Thursday. Now I will go all day Monday, Tuesday, Thursday, Friday with Wednesday off to do work that is due on Thursday.

My clinicals will be at Vanderbilt University MC on 9 South. It is a gastrointerological post operative unit. So we will have a lot of pt just out of stomach surgeries. I'm excited about this. Ready to get my feet wet. I'm sure that it will be an evenful 5 weeks with a lot of new experiences.

I suppose this week I am having some trouble feeling motivated. Not sure why that is. I'm sure it will turn around soon.

Saturday, October 20, 2007

on the other side of life

There are some opportunities in life that cannot be refused. Chances that cannot be dismissed. Experiences that cannot be repeated. Today was one such day.

I'm not sure what I was expecting or what I had pictured in my mind. Even now I have trouble acknowledging the reality of the events that occurred earlier. I feel joyously numb, emotionally drained, and at a total loss for words.

It was beautiful. It was amazing. It was all very simple and natural. Yet it's an everyday occurrence, a routine, a regular practice.

I've been waiting for the call. She told me way back that she wanted me there. I can't describe the honor that gave me. Yet I wondered what in the world was I going to do? I know a lot about a lot of things, but one thing I really don't know very much about is birth. So I've been anxiously waiting. I've feared for weeks that he would come on a day that I had big tests or mandatory class lectures or during the wedding I was in recently. But none of that happened. Today was a beautiful day. We spent the afternoon celebrating Haydn's 4th birthday and playing outside. It was a great time of communion and fellowship. All the while her body was pulsating with joyous eruptions announcing the arrival of her son. I waited with anxious anticipation as I made balloon animals for Haydn and her little friends. They left the party and I soon followed them home.

When I arrived she was quietly acknowledging her contractions. Calls were made to the midwife and she found solace in a warm bath. She resided there for an hour or more meeting each contraction with courage and fear, knowing their intensity would grow and bring forth her son. I helped when needed, but mostly I stayed out of the way and occupied myself by watching portions of a movie. He stayed right by her, encouraging her, monitoring her progress, taking notes of times and changes. A final call to the midwife and we left for the hospital.

I drove, He sat in the back holding her body and supporting her all the way there, cheering her on. She held on to him tightly, cringing, feeling the pain. We finally got to the hospital. I believe I hit every pot hole and dip in the road (she later told me she didn't even notice). They went in the ER, a mistake, and I parked the car. I got up to delivery with the rest of the stuff he couldn't carry and waited and waited and waited. The anxiety within me was mounting. Where were they? After an irritating ordeal in the ER they finally made it up and off we all went.

We got to the room and the team came in. It all happened so fast. I can see it in my mind - the events, but there are too many words to tell and yet not enough to truly express. We flanked her, he and I. We each held a hand and a leg and gave words and looks and held our breath. The team was nice and respectful and couldn't have been any better. I had the best view in the room. I stroked her hair and held her hand and watched. When it happened I found myself with tears running down my face. I don't even remember feeling them come. But there he was. Her hand was gone from mine and wrapped around his little wet squirmy body. He did not cry out but bayed soft blissful whimpers that were truly mesmerizing.

Other things happened and the midwife, knowing I was a nursing student, explained everything to me in detail simply for the joy of it. And it was. The time came for him to cut the cord and he didn't really want to. So they offered. And of course I accepted. So I cut the cord. That was my small part.

It's funny being a twin. I suppose that since I had shared in one birth with her that I might as well share in another.

So, may I announce the birth of Josh and Chara Watson's first born son, Jonah Andrew Watson. Born at Vanderbilt University Medical Center on October 20th at 4:19 pm weighing 6# and 15 oz and 20" long. Mother did great. Baby is healthy. All are truly truly blessed.

Thursday, October 18, 2007

Head to Toe

Today I had my physical assessment test. I had 30 minutes to review 9 body systems on my lab partner: mental, HEENT, respiratory, cardiac, gastrointestinal, genitourinary, musculoskeletal, neurological, and integumentary. It was pass/fail. I was very nervous. I had planned on reviewing for about thirty minutes before we started, but ran into some nursing students who wanted to chat. Needless to say I didn't look over anything. I am a pretty confident person in regard to most things. I don't usually get too nervous. But, of course, right before it started I got nervous. I was so nervous I was shaking, which is unfortunate when you are trying to monitor someones pulse rate (luckily, I wasn't giving a shot). I then got going on my assessment and got really out of order. But I finally settled down and recovered quite well. I only ended up forgetting about 2 things. Needless to say I passed.

Then I had to do the written aspect of the physical assessment. Unfortunately it was not pass/fail but graded. I had two hours to write up an exhaustive note on my findings from the physical assessment. I didn't think I would need two hours, but it ended up that I did. It came to 5 pages. In reality, I'll probably never write up a 5 page physical assessment as a nurse. But I'm glad to know how to do it and how to do it right.

One component of our physical assessment skills test was professionalism. So, we had to wear our Vandy scrubs today, complete with a Vandy patch on the left shoulder. It was fun, made me feel like the real thing.

Oh yeah, I cut my hair this week.

Wednesday, October 17, 2007

things we value

My Foundations of Nursing class is very unpredictable. We are never sure who will be speaking about what. We talk about a plethra of things in there ranging from the nursing shortage to communication to philospophy to E.R. and Grey's Anatomy. It is sometimes a fun class and other times, well not as fun. Last week, one of my favorite Vanderbilt professor's, Dr. Krau spoke about Evidenced Based Practice. His discussion was very interesting and I appreciated what he had to say a great deal. During the course of his lecture we talked about perception and values.

He posed a question: of the following, which three would you give up forever?

career, family, love, money, self-esteem, peace, friends, spirituality, happiness, freedom, health

It was an interesting question. A hard question. I chose my three. This of course led to a discussion. He posed many questions about our values. He asked how many people chose family? One guy in the back of the room raised his hand. The class laughed at him and he defensively said, hey, you don't know my family. He asked how many people chose money? Probably 30% of the room raised their hand. The he said, okay now how many people really meant it? and probably 1/2 the hands went down. We all laughed. Then he asked how many people chose spirituality? About 25% of the class raised their hands. This really disturbed me. How can 25% of the class not value spirituality and yet want to take care of the sick?

I have thought about this a great deal. I had a long and very interesting discussion with Dr. Krau after class. I greatly appreciated his thoughts and comments. He brought a great deal of insight to the subject. Still makes you think.

So what would you choose to let go of for the rest of your life?

Thursday, October 11, 2007

What A Week

Wow, this has been one intense week. Papers and group projects due. The reading. Being awake enough to be attentive in lectures. A very intense test on Wednesday that lasted almost 2 hours long. I have no idea how I did. Half way through my eyes were truly crossed and I had trouble concentrating. It was one of the hardest tests I have ever taken, and I still have 5 more semesters to go.

And if that wasn't enough, I had to give myself a shot today. In truth it was the tiniest possible needle and it really didn't hurt. Needles don't bother me too much, but it is somewhat difficult to stab yourself, no matter how small the weapon. I would have to say that I did a pretty good job overall, though there was some minor bleeding. I didn't really even think about it till later on when I was running and noticed my abdominal muscles were somewhat sore on my right side.

So even though Thursday starts my weekends I have done nothing all evening but work on a paper that is due on Monday that I don't feel good about at all (sometimes you just can't get it out) and I turned in two homework assignments via e-mail that are due tomorrow and Monday.

Crazy how it never stops. I find myself looking forward to Christmas break. Not so much because it is Christmas, but because I won't have anything due or looming above me that needs to be done. I am only 7 weeks in and already I can't quite remember what it was like to be completely free of external obligations. They said during orientation that week 6-8 would be when we really feel overwhelmed and would begin to question ourselves. Not me, I thought. Yes me, I say.

I have to work tomorrow at my former full time and now extremely part time job. I'm glad for this. On one hand I would love, beyond true description, to sleep in tomorrow and relax. But on the other hand, working helps me refocus, redirect, and remember why I'm doing all this. Seeing coworkers who are still in the trenches everyday, seeing patients who are fighting for their quality of life everyday, and seeing the sights, smelling the smells, all this grounds me - wakes me up. This is a positive thing.

Wednesday, October 10, 2007

Laptop Girl

It is absolutely amazing to me that someone would pay an extreme amount of money to sit in a classroom all day long and read about celebrities on her laptop.

The girl in front of me is driving me crazy. We pondered throwing water on her but haven't. Nearly everyone has moved away from her so they don't have to know what Perez Hilton or Pop Sugar says for the day. It truly is a sad situation. It is also incredibly annoying. I guess that's what happens when your dad is a rich doctor.

But hey, if anyone wants to know anything about Brittney Spears I'm your girl.

Thursday, October 4, 2007

this weeks lab....

Last week in lab we learned how to give an enema, so it was only fitting that we learned about catheter's this week. Fortunately we did this skill on our mannequin's. Urine is sterile and the whole procedure must be completed in a sterile fashion so as to prevent UTI's (urinary tract infections), so we had to preform this skill very carefully so as not to cross contaminate. It really wasn't as hard as I was expecting it to be, but then again the mannequin never reacted to me in any way - I suppose that is one of their downfalls.

We also learned all about restraints this week. When it is appropriate to use them, the different kinds there are, and how to apply them. This is something that I was already familiar with from working. We have often had to use the mittens for patients who wouldn't stop picking at things or eating certain things - but I won't go into that.

I also got to use my hammer this week to check for DTR's (deep tendon reflexes). There are five that you check for. My lab partner this week has had a lot of knee surgeries and her lower extremities are practically non-responsive. I did her first and got nothing. Then she did me and I was highly responsive. The whole thing was quite humorous.

Amazingly, today was our last official lab day. We will be tested on a complete head to toe assessment in two weeks. Little nervous about that, but I'm sure it will be fine.

Tuesday, October 2, 2007

It started in high school. They called me T, not for Tara, for Texaco. They called me that because they said I was a gas station.

In college I lived in a community dorm and they said that I would clear the bathroom when I went in. At least that's what my roommate said. Surely it wasn't that bad, was it?

So last night I got in from school and was making myself some dinner. I, for whatever reason, had a big craving for beans. My dietitian self said hey it'll be fine. If you eat them now you'll digest them in ~12 hours and that'll be around 6 am in the morning and you won't bother anyone. So I ate beans. I ate a whole can of beans.

So when I when I got up this morning I thought hey I haven't really gotten to those beans yet? When I was driving to school at 7:30 I got to those beans.

When I was working having gas wasn't a big deal. You just keep moving from one senile patient to the next one and no one is the wiser. Or you go find a patient with Clostridium Difficile and stand outside their room and no one even notices.

Unfortunately in school I sit in the same chair in the same room for 6 hours. There are no senile patients to blame, no Clostiridum Difficile to hide behind, no air currents to walk through. This was not something I had thought about when making my carreer move.

I pondered my delimma as I made my way to my chair. I decided on going with the truth. So I turned to the girl in the seat next to me and said hey, uh, sorry but I ate a lot of beans last night. No problem she laughed. A feeling of relief washed over me.

Later she said she didn't feel good and missed the 2nd 2 hour session.

Texaco strikes again.

Friday, September 28, 2007

Enemas, NG tubes and Tests

This was probably the hardest week so far. We had two tests this week. One was in my clinical applications class and the other one was in pharmacology. They weren't too bad, but it made it impossible to do any other homework or reading since I was studying for the tests. They don't like to waste class time for us to take our tests, so we have our tests at an additional time. That means we still have class for that week in addition to studying for our test.

For this weeks lab class we learned about the "ins" and "outs" of health care. The "ins" would be tube feeding and fluids. We learned how to insert NG tubes for the purpose of suctioning and feeding. An NG tube is a nasogastric tube. It goes in the nose and down to the stomach. It was funny to be on a different side of tube feeding. I've written hundreds of tube feeding orders, but I've never carried them out or actually administered them.

And the "outs" would be enemas and constipation. Not necessarily the most fun things to do but still an important part of the job. So if anybody is feeling a little constipated, I can help you out.

Wednesday, September 26, 2007

Birthday Curse

It all started September 1999. It was my 20th birthday and I was a sophomore in college. I was driving home to see Chara for our birthday and I got pulled over. I was going 81 in a 70 on the interstate. I was awarded a speeding ticket on my birthday. The sad thing was the cop had to write my birth date down once and the date down twice, you would have thought he would have figured it out.

The second occurrence was September 2000. It was my 21st birthday and I was a junior in college. I was driving to a friends house (who wasn't even home) and I got pulled over. I was going too fast. I was awarded a warranted speeding ticket, on my birthday. Again the cop had to write my birth date down once and the date twice, you would have thought he would have figured it out too.

The next year I only drove 2 miles on my birthday and was quite careful. It was my senior year in college and Chara and I went to a Mexican restaurant for our birthday. She didn't have a car.

On my 23 birthday I drove over 75 miles on my birthday and nothing happened. I wouldn't say I was careful, just lucky.

Then in September of 2003, my 24th birthday I drove from Missouri to Franklin and was in a car accident. The guy in front of me slammed on his brakes on the interstate. I slammed on mine and then into him. Luckily we had the same 1988 Toyota Camry with the same rubber bumpers. The cars literally bounced off each other with no damage. The guy was a foreigner. He yelled at me and then drove away rather quickly. Luckily I did not get a ticket.

I thought the curse was over. After all, it has been 4 years with relatively no curse activity. Until last Wednesday. It wasn't my actual birthday, but when it is within 7 days it's close enough.

I developed a horrible habit in Missouri. The subdivision I lived in had yield signs instead of stop signs, so I got in the habit of rolling through intersections. Over the past few weeks I have told myself on numerous occasions to stop at the stop sign at the intersection of 25th and Children's Way, but I often rolled through.

On Wednesday morning I got to the the intersection and looked to my left and saw two cops sitting on motorcycles. The one on the right reached into his pouch and put a wad of tobacco in his mouth. This really irritated me. I thought about rolling down my window and telling him what I thought about it. I thought about pulling my car over to them and telling him what I thought about it. But I didn't, I rolled on. Yes, I rolled on through the stop sign. So I look in my rear view and Mr. Chewing Tobacco pulled me over. I thought, should I say something? He came over told me I rolled through the stop sign and wanted all my paperwork and license. So as I sat there I stared at Mr. Chewing Tobacco and was really irritated. So he came back finally and hands me a "citation". He starts to walk off, and that's when it happened.

"You know", I said, "I think it's really inappropriate for you to be chewing tobacco when you working".

"Mam", he said, "it's not tobacco. It's mint leaves."

"What are mint leaves." I said with somewhat of an attitude.

"Mam, it's what people chew when they are trying to quit." he said.

"Oh, well, that is partly why I rolled through the stop sign"

"because you thought I was chewing tobacco?"

"Yes, I really feel like it is unprofessional. But I think it's great you are trying to quit." I said

He was annoyed, embarrassed, irritated, "Have a nice day, Mam." and he waled off.

Did I deserve the ticket, most assuredly. Did I regret saying something to the cop. No. Weather it was mint leaves or not, I perceived he was chewing tobacco.

So I guess the curse is not over. I wouldn't say that I was a bad driver at all, just overly aggressive at times and occasionally non-compliant. All my tickets have been warranted. I just hate that it is always around my birthday. But, such is life.

Friday, September 21, 2007

This week's lab

This week in lab we learned to do a lot of "nursing" activities.

We learned to give bed bath's, which was very exciting. Luckily we just bathed the maniquins and not our lab partner (which is good since I am somebodies lab partner).

We also learned how to take blood pressure this week. I have been taught how to take blood pressure at least 5 times previous to being taught this past week. However we learned how to do it on a much deeper level. I've always thought that you just listen for 2 sounds, but you actually listen for five. I also learned that you don't have to pump it up as high as it goes before you let the air out and that there is a very simple way to take blood pressure so that the patient has relatively little discomfort. I'm sure that my mother will be glad for that.

We learned how to do a proper cardiac exam also and how to find the five main spots on the body to listen to cardiac sounds with our stethescope. That was interesting. I've always listened to my heart with various stethescopes that I have owned, but now when I listen to heart sounds it means so much more than it every did before.

Last but not least, we also learned how to change bed sheets with a person still in the bed. I already knew how to do this and have actually done it before at various times at work, but I learned how to do it more efficiently and more effectively.

I'm starting to feel very "nursey".

Wednesday, September 19, 2007

First Test

Today I had my first big test. It was 100 multiple choice questions. We were told that every test we take this year will be multiple choice in order to prepare us for the NCLEX (the registered nurse licensing exam). These multiple choice questions though are presented with multiple correct answers and you just have to pick the BEST answer. For an individual who is overly analytical this is truly torture. I have, in times past, known the right answer and analyzed my way right out of it. Let's hope that I did not do that today.

Tuesday, September 11, 2007

Citizen's Arrest

Some people may be surprised to know that my mother has a mean streak. Today as I was walking through the kitchen, minding my own business, my mother decided to turn on the sink and spray me with the hose. And for no apparent reason.

Monday, September 10, 2007


As I may have stated in an earlier post, I have a lot of reading. Tonight I read over 7 different chapters. Some of the books are interesting, some of the books are not interesting at all, but I don't mind too much. Usually I will listen to classical music when I read/study as it prevents my mind from wondering and helps me to maintain my focus (not that I don't have to redirect myself at times.)

I have thought a lot about the reading though. This is a two year program and obviously I am a first year student, there are 125 of us. I don't know how many second year students there are, but many of the first year students have asked the second year students if it is truly important to do all the reading. After all, it is somewhat excessive. And nearly all of the second year students have told all the first year students that the reading is not important, just look over your notes, go to class, pay attention and you'll be fine.

This doesn't do much for my motivation department. Why should I spend all evening reading after I have spent all day at school? The second year students say it doesn't matter anyway.

Why would an individual train for a marathon and then walk the whole race? I spent an entire year going to night classes after working all day, spent a month interviewing for my replacement and then an additional five weeks training her, went from full-time to very part-time and all so I could begin a journey. A journey that for all intense purposes has hardly started. It is much too early in this race to walk. Do I have other things I could be doing? of course. Do I have other things I'd rather be doing? yes! But I made big sacrafices to pursue a dream and I owe it to myself to do my best.

I suppose that after two weeks of hearing the first year students quote the second year students that the reading wasn't that important I just needed to rant and rave and justify that I wasn't wasting every free evening I had. Sorry for the soapbox.

Friday, September 7, 2007


I've always thought they were cute little creatures; scurrying around trying to gather nuts with their brown furry tails following behind, and their whiskers enhancing their playfullness. They are everywhere at Vanderbilt, there are literally thousands of them. Initially I was very excited by this. I would walk the four blocks from the parking garage to the nursing building and pass hundreds of scurrying squirrels every morning and afternoon. I temporarily imagined I was at Walden pond and feelings of great peace overwhelmed me.

But as the morning walks became more routine (translation: less Walden like) I noticed that the squirrels weren't so cute. In fact, squirrels are really just like rats only with cuter tails; they are very much like rodents. They scurry everywhere. You can here them rustling in the grass and scraping their teeth on nuts. They run past people to get to their favorite spots or to the lastest fallen nut. They seem wild and almost rabid.

I was following aproximately 20 feet behind a fellow nursing student one morning who kept reacting fearfully to the squirrels. I laughed inside myself thinking, "who should be afraid of a squirrel?" ha ha ha. Moments later as I continued on my walk a scurrying squirrel lunged at me. It lept off the ground into the air straight in my direction.

I screamed. Yes, I, Tara Sanders screamed in fear of a tiny "playful" squirrel. Luckily their was a tree between myself and the squirrel which intercepted it's lunge at me and the squirrel stood still on the side of the tree as though I wouldn't notice it.

The girl who I had just silently laughed at of course turned around with big eyes and witnessed the whole thing. She then slowly turned around and was silently laughing at me.

Now when I walk to class I watch the squirrels, fearing an oncoming lunge. I hear them rustling in the grass but I now know that they are really stalking me, waiting for the right moment. I wonder if there was any hunting at Walden...

Thursday, September 6, 2007

Lab #2 - some fundamentals

Today we had our second lab and we reviewed the fundamentals of nursing. We began by learning proper hand washing techniques. It was very exciting!! To be properly clean you must wash your hand for 30 seconds, so you can sing happy birthday or yankee doodle twice or twinkle twinkle little star once. Cleanliness is not about antibacterial soap, but about time and friction.

After practicing our hand washing skills, we worked on various tasks in the lab. Our instructor then wanted us to check out the cleanliness of our hands, so she gave us some special lotion to rub on, the lights were turned out and the black light was turned on. Wow - the germs were amazing. Even though we had just washed our hands, they were already covered in germs.
FYI: there are always more cells on your body that aren't you than those that are.

We then learned how to check body temperture. We actually used the mecury thermometer. We were told that no one uses them anymore, but we still needed to know how. We also "learned" how to use the digital thermometer. Luckily, we were only instructed on how to correctly check rectal temperatures.

Fundamentals are important, but learning to wash your hands and take tempertures seems somewhat silly. Knowing how to perform these simple tasks is the foundation for being a great nurse. I wouldn't call what we are learning right now exciting, but you have to learn to walk before you can run.

Thursday, August 30, 2007

Clinical Simulations

Today I got to meet the simmulated manequins in our clinical lab. There are nine of them and believe it or not they each have their very own name, personality, and voice. They can do just about anything - vomit, breath, cough, urinate, deficate. They have a pulse, can yell at you, can receive injections and IV's. They are absolutely amazing.

Today I actually learned how to use the stethecope that I was given. We performed respiration assessments and listened to different breath sounds. They were very exciting. Our manequin was able to exhibit different respiratory abnormalities, so we were able to listen to pneumonia, wheezing, rattles, a patient with decreased inspiratory volume, etc. It was interesting. Some of the sounds resembled the log ride at the local amusement park - I know weird analogy.
We also learned how to suction patients today using the Yankhauer suction. It was okay, but I can honestly say that I was very happy the manequins didn't actually have any mucus.

This first week of actual classes has been good. On Monday and Tuesday I sit in the same room for six hours and listen attentively along with 125 other students. It's not too bad since we get frequent breaks. Our classroom has been recently remodeled and it is great (for a classroom). It's wireless, has power acess at every seat, and has very comfortable seating. The whole room is state of the art.

Overall, it's been pretty good. I've felt somewhat overwhelmed at times this week. The amount of reading we have to acomplish for every class day is excessive. At times we have to read 3-9 chapters a night. One text book is a great read, the rest are mediocre. Early on this week I thought, what have I gotten myself into??? But as the week has gone on I have settled back down and feel good about everything. We'll see how I feel after the first test.
So for now, I'm reading and focusing on sims.