SICU Crew

Yesterday was the last day of clinicals. I was placed in the Surgical Intensive Care Unit this semester.

The purpose of lab and clincials this semester was to become proficient at the physical exam. The first part of the semester we practiced conducting physical exams on our lab partners until it became a habit. The second part of the semester we conducted actual physical examsd on real patients. It was much harder to do physical exams on my patients than my lab partner. My lab partner (third from the left) was responsive, agreeable, helpful, and not sick. Most of my patients this semster have been intubated, had numerous IV lines and EKG leads to maneuver around, had restraints on, and were sedated. The few I had that weren't sedated had ICU induced psychosis and were absolutely crazy. Every exam had to be modified and I learned a lot.

I enjoyed my time there. I learned so much everyday and I left wishing we could stay longer. I look forward to the day when I can.

Thoughts

I suppose I feel like I have been burning the candle at both ends for quite some time now. Prior to Thanksgiving break, I had adapted so that I could function at a very high level of stress. Then I had the week off at Thanksgiving, which has thrown me completely off. I'm having trouble regaining my momentum and even though the end is in sight, I feel I will never make it to next Thursday. I have always been amazed by people who would work so hard and then quit right before they accomplished their goal, but I think I can understand now. It would make perfect sense to me if someone were to drop out on July 31st, despite pending graduation on August 2nd. Sometimes you just don't have it in you anymore.

My break will start next Thursday and will last until the 5th of January. I look forward to the time off from school, but overall I'm not excited by the events which the break will bring. I'll be moving, my parents will be moving, much of life, as I have grown accustomed to it, will change dramatically. I'm not one for changes.

Growth is often a product of change and I hope that that is what the upcoming changes will yield for me. Fear is often a byproduct of change and I know that that resides within me; however that which I fear is not well defined and is somewhat obscure. Change often presents new opportunities, new beginnings, and new challenges - each of these can offer both positive and negative aspects to one's life.

I wonder a lot about my future job - where I will work, and what exactly I will be doing. I wonder about my future place of residency - where on this great big Earth I will live. I wonder about so many things and that wonder at times leaves me feeling so unsettled and lost. I wonder where my place is and what my purpose is. I know that I am in the process of doing what I am supposed to be doing, I feel that as I have never felt that, but there are so many contingent factors associated with that that I do not know. I do not know what is best for me or for my future or for my family. I suppose something that saddens me a great deal, is that I do not have a home. I've lived a nomadic life. I had begun to think I did, but in coming days that is passing away. It is difficult to step outside of one's self and establish yourself and allow yourself to become, especially when you must do it alone.

I've never in my life been under the level of stress that I have been under the last few months for a prolonged period of time. I've learned what it means to take it one day at a time. I've been unable to look more than two weeks in advance without becoming disabling overwhelmed. Yet, I am surviving. I look back over the last few months and I see my growth and I am able to identify my progress. But there is so much I do not know. There is so much I will never know. I try to learn and to grasp it all, but it is not possible, there is simply too much.

There have been so many events that have occurred over the past few months and their stories reside within me desiring to be let out and told. I do not know that they will make it out, but I do hope they do. If for no other reason than I do not want time to elapse and awake one morning to find those events have left me. Birthday Curse #2, Male Surrogate exams, Female Surrogate exams, Lost Dogs, Liver/Kidney Transplant, the cursed 20 page paper........

Second Year

Second year started with me sitting in a large auditorium for orientation. As I sat there I couldn't believe that I was where I was and that that day had finally come. All of my life I have been anticipating and seeking a challenge. Desperately wanting to be put to the test so that I can have the opportunity to prove myself, to prove me to myself. As I sat there in that auditorium that challenge I have always desired was staring me in the face. It was a very surreal feeling.

In the eight weeks that have passed since that orientation day, I have encountered and met my challenge on nearly an hourly basis. It has been hard. I have sat in countless lectures and thought many times that I can't do this. Most days I have left class and questioned if I really have it in me. I've studies these past eight weeks as I have never studied before. I've found that no matter how hard I study there is still so much I don't even begin to comprehend. And as much as I study my test grades usually fall just below my goal. This has been incredibly disheartening at times. Studying so hard and yet feeling as though I still didn't do enough, that I didn't quite make it. The concepts are daunting and yet when I look back to the first weeks of lecture I feel as though I understand them and have integrated them into my knowledge base.

This week marked the middle of the semester. I left school last Friday and thought to myself, for the first time, maybe I can do this. Then I laughed at myself. Tara, I said, you are doing it.

The weeks and months to come continue to promise of the challenge I have so desperately desired. The opportunities, adventures, and events of the near future are daunting and yet so exciting. I'm living the dream I've dreamed a thousand times, but have always been to afraid to embrace. In the past fear of failure and fear of living has stopped me short, shot me in another direction, or humbled me to nonexistence. Today I am acknowledging, accepting, and embarking.

It is hard, horribly hard. I can't wait for August the 2nd - I think about it every day. But I know when August the 2nd does arrive a part of me will mourn the end of this unparalleled experience.

Boobs in a Box

So today we had our 3rd week of lab. Lab has been focusing on the head to toe assessment. We had to learn to do the head to toe assessment last year, but we did that as nursing students. This year we are learning to do the head to toe assessment as nurse practitioner students and let me tell you, there is a difference.

Nurses can assess, but they can't diagnose. Nurse practitioners, like medical doctors, can diagnose, write orders for further tests, and/or write orders for drugs. So you have to learn to do the assessment on an elevated level.

There are lots of things between the head and toes: cranial nerves, heart sounds, lymph chains, muscles, reflexes, boobs. Yes, boobs.

Everyone has a lab partner. This is good because you need a real body to feel real aspects of the human anatomy. It's nice to use your partner as your constant "body", however, your partner gets to use your body too.
So, today we go to lab and our professor is set up in the middle of the lab with a box. She opens it and there are the boobs. She props the dummy boobs up and begins to explain about the breast exam. It was awful. The whole class was anxiously nervous. To make matters worse, she kept moving the boobs so the whole class could see them, and just like real boobs, they jiggled. Every time the boobs jiggled a nervous laughter filled the room. The professor was unaware the boobs were jiggling and kept telling us there was no reason for us to be nervous and we all needed to relax and take charge of the situation. Then she'd move the boobs again and they would jiggle and we would laugh. So she showed us how to make deep circles around the boobs starting distally and then moving proximally to the nipple. The exam ends with a tweak of the nipple, that is the incorrect way to say compress between the forefinger and thumb.

Then it was time to break off in pairs and reveal our pairs. It was somewhat embarrassing. But we just owned the situation and did it. I'm so ticklish though and was practically laughing the whole time. I just stared at the ceiling and endured it. When I had to do my partner it wasn't nearly that bad and she didn't respond as I had which made it easier for me.

It was a crazy experience, but it could definitely be worse. Other specialties (midwifery, women's health) have to use their partners too and as they say, "they know each other inside and out". I'll have to learn how to do pelvics and testicular exams too, but luckily for that we get surrogates. People the school pays for us to use - I have both a male and female day scheduled for that. Like I said, it could be worse.

The NCLEX

The NCLEX has been looming over me the entire summer. As I have previously mentioned it is a test I have to take and pass in order to continue on in school. If I should take it and not pass, then my 2nd and final year of school would turn into 2 years.

The NCLEX is what is known as a CAT, a computerized adaptive test. So it’s a smart test. If you do good it gives you harder questions. If you miss questions it gives you more of the kind you missed. Although this seems mean, really it’s to help you pass. The NCLEX is trying to see if you are competent or not. As a health consumer I think this is incredibly important – I want competent people taking care of me. As an individual who has never been a good test taker I think this somewhat stinks.

The test is also very variable. It can be as short as 75 questions or as long as 265 questions. You don’t know how many questions you are going to get until the computer just shuts off. Yes, it just shuts off. Then you have to wait for 2 days to find out if you passed or not, and to make matters worse you have to pay $7.95 since to even find out if you passed or not.

Not only is the test nerve racking, but taking it is too. I have to drive downtown Nashville to this testing site. Once I get there I have to provide identification. They then give me a key to a locker that has a 12 inch long key chain that I am supposed to keep on my person. They then proceed to give me forms to fill out. They then call me back up to the desk where they ask me for my identification again. Then they make sure I have nothing on my person (except the 12 inch long key chain). Then they finger print me. Then they escort me 10 feet down the hall where they fingerprint me again – three times. They then escort me into the testing room where I am assigned a computer. The computer has a video camera perched above it and it is recording me the entire time with audio. Also there is a woman behind a window in a box staring at me the entire time. If I should need to use the facilities then I must be escorted and have my finger prints taken again before entering (this is so I won’t change my fingers while I’m using the facilities). When I am done and the computer shuts off they then walk over to me and escort me out of the room (I’m still carrying around my 12 inch long key chain). Out of the room I must be fingerprinted again. They then instruct me to get my things out of the locker return the 12 inch long key chain, and have a nice day. A nice day? How can I have a nice day when I don’t know if I passed this monumental test or not?

I will have to say that this was one of the hardest tests I have ever taken . About 10 questions in I felt like I wasn’t even qualified to be taking this test. It was hard, very hard. But 2 agonizing days later I paid my $7.95 and found out that I had indeed passed.

I am now officially a registered nurse and licensed to work in the state of Tennessee.

Yeah me!

The Wedding

There have been few times in my life when the actions, the story, the choices of another have brought true joy to my heart. I am usually caught off guard and taken aback by the briskness the situation has at infiltrating my heart. However, with this most recent of rare occurrences, I was not caught off guard, but, much like the situation, the truest joy slowly flooded my heart.

There are some love stories that people are not privy to observe. The blooming relationship of one's parents is one, one's grandparents is another. Time and circumstance forfeit opportunity and we are left observing that which has maturated. There are times, however, when life circumvents itself and we are able to observe a love story out of time - but in its place.

I have not known the man to be without, to be alone, for most of my life. Yet the past few years that is how he has been. Unpartnered, unmarried, unwed. He had not finished his maturation process with her and yet he had. And there he was. He hurt. It was evident in the worry wrinkles around his eyes. He had lost a spark.

Then he had a friend.

A friend who he could eat with, watch movies with, talk with, share with, cry with. A friend who in time he learned to love. A friend who in time he learned to need. A friend who in time he didn't want to be without.

As I sat there amid the congregational singing on his wedding day my heart was finally full. I felt that last drop of joy spill in that caused my heart to overflow. My eyes began to water and the tears began to fall. What a homecoming! What a gift! I had been gone too long - chased away by grief and sadness, by the knowledge that things would never be the same. And as I sat there I observed life going on, new people smiling, old people smiling. Life is not so different after all.
When things change it can be shocking. It can be paralyzing. But the courageous ones gather themselves up.

And when I left I saw that thing that filled my heart with joy the most - he had his spark back. That twinkle in his eye.

Mr. and Mrs. Richard Dodgen

August 16, 2008

The Stress Response

Yesterday I learned that there are over 1400 physiological processes that occur in response to stress. That is quite an amazing fact I think. Those 1400 physiological processes effect nearly every aspect of our bodies: eyes, hands, lungs, urination, heart, brain, GI tract, cognition, etc.

We often allow ourselves to do things, to think things, and to fear various things and we truly have no idea how those "things" affect us. Not all stress is bad, this is eustress. Not all stress is good, this is distress.

Stress in truth is the bodies responsed to discomfort. Fortunately, our bodies compensate to most types of discomfort. However people who live in a chronic state of compenstated comfort (or people who are chronicly stressed) are living in a state of allostatis. Unfortunately, our society is trending toward allostasis as normal life due to our complicated and busy lifestyles. A recent book has been written that I wish I had time (and the understanding) to read; it's entitled "Allostasis, Homeostasis, and the Cost of Physiological Adaptation". Really that is just a fancy title to say how we are physically running down by living a life in a constant state of stress.

Chronic stress can cause serious physiological consequences of :

• Mental dysfunction (Depression, Panic anxiety, Obsessive-compulsive behavior, Poor memory, Anorexia nervosa/ malnutrition)
• Active alcoholism
• Aggrevated PMS
• Asthma
• Inflammatory bowel disease
• Common cold/mononucleosis
• Opportunistic infections (e.g., herpes - this is the shingles type)
• Dermatological manifestations (or acne)
• Burnout (Feeling overwhelmed, fatigue, Angry outbursts, Forgetfulness or disorganization, Guilt or self sacrifice, Disillusionment, Passivity, Distancing (that is pushing others away), Letting your self go, Substance abuse, Physical illness, etc.)

It's funny how those little things that keep us up at night, that we carry around in our hearts and minds throughout the day, that nag us as we drive to and fro, those little things that stare us in the face when we take the time to look - it's funny how those little things can have such a powerful effect on our bodies. All those little worries, all those little fears, all those little thoughts.

Crossing the Bridge

As of 30 minutes ago I have completely finished all of my requirements for the 1st year. In the next hour I will participate in the Crossing the Bridge ceremony. I cannot explain the relief I feel.

The HESI

In truth, I'm not even sure what HESI means. I know that it's an acronym for something, but I don't know what. I do know however, that is has been a thorn in my side and a fear of great magnitude.

So what is the HESI? The Evolve book company (which is the publisher for all of our textbooks) generates a test based on the concepts and ideals we have learned over the past semester. So at the end of the past 3 semesters we have had to schedule a time to take the HESI in the computer lab. A score of 850 is passing for the HESI, but luckily these semester tests have not counted. This is good because in the fall I scored a 790, in the spring I scored an 846, and in the summer I scored an 846. So all three semesters I haven't passed with a score of 850.

This hasn't been a big deal until the past few weeks. The test at the end of each semester - doesn't count, but then we take one big HESI test at the end of the year - that does count. In fact, it counts as 40% of my boot camp grade. A HESI score of 850-949 (which is passing) is only worth an 85/B; you must score over 950 to get a 95/A (did I mention that I hadn't even gotten an 850 yet?) To make matters even worse, you have to keep taking the test until you pass with a score of 850. But you can't take the test a 2nd time until you have completed extensive remediation (just to make the whole thing even more embarrassing and stressful).

So I studied and just worried to death about the dumb thing. I just knew I wasn't going to pass and wondered how in the world I was going to have time to do my "remediation" during boot camp. It's truly amazing how much anxiety an individual can generate over inconsequential things. So I went up to school (on my day off) to take the HESI. I parked my car in the garage and walked the 4 blocks to school. The whole walk I talked to myself and I built myself up. If what I said had been out loud, people would have surely laughed, but I was so pumped up by the time I got there I could have run the marathon I have always promised myself I would (one day).

So I took that 160 question test over a 2 hour period and when I finished out popped my score. I couldn't believe my eyes and yet there it was - 989. I not only passed, but I got my A. Let me just tell you that if people would have laughed at my mental verbal broadcast on the way to school, they would have surely fallen out of hysterical exhaustion by that broadcast that blared on my walk back.

Boot Camp

Heading out at 5:50 a.m.

The past few weeks have been a bit of a blur. They have been filled with tests, lectures, and long 12 hour days of "boot camp".

I'm enjoying boot camp. It's giving me the opportunity to practice what I've learned. I've preformed some great sticks (started IV's, drawn blood, and given some SQ shots). I've DC'd some catheters (both urinary and IV). I've administered meds (multivitamins, hypertensive agents, antibiotics, narcotics, etc.). I shaved a man's face. I've given some bed baths. I learned what it means to have non-reactive, non-consensual pupil reactions.

All the time though, I learn how much I don't know. At times I wonder if I will ever know enough to be effective. I've learned so much everyday these past couple of weeks and wonder with anticipation what more I will learn in the next week or so. There are so many things I wish to share, mostly visions and experiences of the last few weeks. I look forward to sharing.

Almost home at 8:05 p.m.

Group Work

This past Monday I had a group presentation, and this presentation marked the end of a long run. Since January I have spent a significant part of each week with this group. Together we experienced our pediatric rotation, psyche rotation, medical-surgical rotation, and obstetrics. We have had a patient die, watched new patients be born, spoken with poor souls who are truly crazy, watched children recover, cleaned up a lot of poop, started IV's on each other, given each others shots, taught each other, learned from each other, and grown as future nurses together.

Next week I will start boot camp. I will be placed on 6 North at Vanderbilt Medical Center. This is a neuro unit - so there will be patients who have had CVA's (strokes), seizures, head trauma, etc. I'm looking forward to the whole experience and am getting excited about starting year 2. Boot camp will provide me with a new group of partners. There will be six of us this time; 4 of us worked together in the fall semester, so there is some familiarity there.

Yesterday concluded all of my classes. I still have some tests to take and 4 weeks of clinical to experience, but for the most part - year 1 is almost complete. It's amazing how fast this year has gone, it's amazing how much has happened, it's amazing how much I've learned. But the journey is only half way over and really just beginning.

Knight in Shining Armor or Desperado

So Monday I went to school and stepped into the student lounge to put my lunch in the refrigerator. I realize as I walk in that there is a commotion going on. Check you mailbox a friends says to me. So I walk over to the mailboxes and find the letter that has been placed in every nursing students mailbox - this is more than 300 people. It read as follows:

"My name is Tray and I need your help with something. I met a really awesome girl at a swing dance which was held at Otter Creek church in Brentwood on June 16. I've been hoping to run into her again but she hasn't been dancing there since. Unfortunately I didn't get her name or contact infor. I know I know . . . the dance ends at 11 and at 10:30 I was like "I should get her contact info". . . and she had left a little bit prior to that. While we were dancing she told me a lot about herself. . . except her name. She is a 2nd year Nurse Practitioner student. She works part time at Vanderbilt medcial center. She also lives in an apartment off campus with several roommates. I realize at this point I am describing about half of the nursing students. She is blond, about 23/24, nice eyes, works out, nice skin . . . nice everything. If you're the one I'm looking for, send me a message. It would be great to talk to you again. If you think you know her . . . help me out!!"

So the guy brought these letters in some time last week. Funny thing is he hadn't known there were mailboxes, so he left and had copies made. Some individuals saw them and alerted security and then another individual went behind him and pulled most of the letters out of everyone's mailboxes (I keep some papers in my mailbox and so she missed the letter). Also, the 2nd year students aren't even on campus any more and are pretty much done from what we understand - so "the girl" isn't even on campus. The girl he described truly is half of the 300 people in the program.

So some people found the whole thing to be incredbily sweet and endearing. Other people found the whole thing to be creepy and stalker like - maybe she didn't give you her name for a reason. So everyone went and checked out his myspace page (which I have still yet to do) and made further observations.

The whole thing has been kind of funny.

Summer School and Boot Camp

Tomorrow starts our 7th week of summer school. We finished clinicals one week ago and so we are completely in the class room for the next three weeks. Since we aren't in clinicals right now, we are focusing on Community Health and learning about the various roles a nurse plays within the community. We are also going to do a disaster training seminar, which I'm really excited about, because at the end of the seminar we will be certified with the American Red Cross. So if a disaster strikes, we will be able to help (not that we can go with school and all).

At the end of nine weeks, we get two days off and then starts the infamous Boot Camp. Boot Camp will last for three weeks. During boot camp we are expected to act in the role of a nurse. We will have multiple patients and perform in the clinical setting as any nurse would. By this time we are supposed to be nearly completely almost trained - we'll see how it goes. I'm excited for boot camp and nervous too. As with anything though, you really aren't proficient at something until you do it all the time. I look forward to that in the next few weeks.

Then when boot camp is over - I cross the bridge!

Bittersweet

There are consequences to every action. People often tend to think of consequences as something negative, but there are positive consequences too. Consequences are just the result of a decision we make or an action we commit. We can't always see the consequences that occur because of a choice we make and we don't always understand or even know how they impact other peoples lives. Consequences can often be life altering. We are often found to be victims of consequence and change. But those are the circumstances that make up life.

The past 18 months have produced a significant amount of changes in my life. I suppose I have fallen victim to consequence and circumstance. Ironically, the majority of the changes I have encountered which have so dramatically altered my life, were generated by those that surround me and not be me at all. It's amazing how other people can so significantly affect us.

Life altering events cause us to question - this is only natural. We question what the real meaning of life is. What's the purpose of it all? What is God's plan for me? Does God have a plan for me? Am I doing what I'm supposed to be doing? Am I being who I am supposed to be?

In the past 18 months I have gained and I have lost. I have been blessed and I have grieved. I have felt full and I have felt significant lonliness. I feel I have found my purpose and yet I feel more lost than I ever have before.

It's funny to every think that one is in control of their own life.

This past weekend I traveled to Birmingham and watched one of my greatest friends get married. She was absolutely beautiful and I am so happy for her. She will stay in Birmingham and I will dearly miss her.

A couple of weeks ago I recieved a beautiful gift and I look forward to the joy she will bring.
A few weeks ago my little friend Haydn had her preschool graduation (she's still in preschool though).
A few weeks ago my twin moved to another state and took a part of me with her.

A month ago I learned of a friend's struggle that has left me confused and grieved.

Seven months ago I observed a most beautiful event. It is amazing to watch him grow.
Seven and a half months ago I participated in a close friends wedding. It was a true dream. She moved to Ohio and I dearly miss her. Eleven months ago I quit my job and started on a two year journey.

A year ago I recieved my second little friend and she has brought a smile to my heart.
15 months ago I learned I had been accepted to school and was excited and scared.

18 months ago I was on top of the world.
And there has been so much more. There is still so much more to come.

L&D

This week I was assigned to L&D, that is Labor and Delivery. I participated in helping with two births on Wednesday. The first came very fast when it came, the second not so much. They were both spanish speaking pt's which made for somewhat of a barrier. Mi espanol is muy picito y muy mal. (I speak very little spanish and it is bad.)

The first pt was having her fourth child. They had given her pitocin and she went from a 4 at 70% to a 10 at 100% very quickly. We went in the room and tell her not to push and she doesn't, but she kind of sighs and the baby falls out. It was one of the oddest things I have ever witnessed. Sigh, then baby. It was a beautiful baby and the mother and father was so excited. The fathers aunt had died roughly an hour or so before and so they named the babe after her.

The second pt was having her first baby. The had her on pitocin for a long time and she was progressing very slowly. She stayed at 8 and 90% for a long time and then 9 and 90% for a long time. She presented full at 10:50 am and we helped her push for four hours. She was working so hard and trying so hard. She was truly exhausted. The baby's head was not going to come through it was presenting at a bad angle and positioned such that it was not coming through. The next thing I now I was in the L&D OR prepping the pt for a c-section. Once it got going I stood at the foot of her bed and observed the birth of her baby. The pt had been pushing so long that the baby was in the vaginal canal, so at the appropriate time, the circulating nurse had to crawl under the operating table open a trapped door, reach in with a sterile glove and manually push the baby out of the vaginal canal. So the pt had two hands in her at one time - weird. Moments later a beautiful baby girl (with an oddly shaped head) was born. She responded slowly to the world due to the drugs she had received, but eventually she came around.

Life is truly amazing. This morning my little friend Haydn is staying with us and Christa and Dewayne are off to Baptist to have my newest little friend Ava. I'm excited to meet her today. Funny how it's different when it is one of your own as opposed to one you just help with. May God bless them.

Yesterday and Today

I suppose I should say a little more about why I don't like pediatric medicine. It is not that I don't like children. In fact it is quite the opposite. The truth is that I have always loved children; their innocence, their purity.

Seeing people with illness, disease, and other difficult situations is hard but, unfortunately, it's just a part of life. Seeing children with illness, disease, and other difficult situations is hard but that is in no way a part of life. People live their lives, get older, get sick and die. When that happens to children it is devastating because they are cheated - they haven't gotten to live their lives yet. I've spent the last 3 years working with a population who often die. I've learned to understand it, to accept it, and at times appreciate it. I don't want to spend my life watching the pediatric population suffer. That's not to say that all health care situations end in death, because they don't, but I wasn't build to watch children suffer.

But, there is one beautiful aspect of pediatric medicine, maybe the most beautiful aspect of all medicine - that would have to be birth. That moment when one begins their journey.

I spent yesterday in the newborn nursery. My task was simple - hold whichever baby was crying, comfort it, wash my hands, and then pick up the next. It was truly a moving task. I held one baby and looked over at the name card on their crib and realized they weren't even 12 hours old yet. I acknowledged at that moment the sovereignty of life. What an honor to spend the first few moments of life with this child. As I held the different blessings in my arms I wanted and wished so much for them. I said small prayers to God for them. What an amazing gift it was. I then realized as I hoped so much for them how insignificant I am. As I stood there holding them and wanting so much for them I realized how truly powerless I was. As much as I wanted, there was truly nothing I could do to enhance or encourage these little people and their lives. All I can do is pray for them.

Today a lot of things occurred. I shall only focus on the afternoon though. This afternoon I gave a presentation, ironically on pediatric nutrition. Today I got to be a Registered Dietitian and give an hour long lecture to my peers and faculty. This was not an assignment, it was a request from a previous instructor I had. I had the most fun - something I have greatly needed for many weeks. I cracked jokes, fielded questions, and I was just overall awesome. One day, in some capacity, at some university, when the time is right, I will teach. I will be an amazing teacher and I will love it.

I've become one of those people

So yesterday was my first day of OB and it was incredibly uneventful. I pretty much stood around all day. Oh no, I did forget one exciting thing - I got to look at 2 postpartum rectums to see if the pt's had hemorrhoids. 1 did, 1 didn't. Very exciting!!

It also happened to be my plan of care week. We have to do plans of care for a grade at least once every rotation. A plan of care consists of a nursing diagnosis and two interventions for 7 systems (neuro, skin, cardiac, respiratory, GI, genital-urinary, and musculoskeletal), signs and symptoms for each nursing diagnosis, and a lenghty analysis statement for each nursing diagnosis. Usually a plan of care takes me anywhere from 4-8 hours depending on the pt and depending on how much I can copy from a previous plan of care I've done. This week however I had to do one for the mother and the baby, so that's 2. This rotation we go all day on Wednesday and then half the day on Thursday or we get lucky and get the whole day off on Thursday. Luckily I got the whole day off today. So, I started working on my double plan of care at approxiamately 9:30 this morning and finished it about 5:00 this afternoon, this is 7 1/2 hours. On one hand I'm glad I'm done, on the other I wish I could have done something fun on my day off, on the other hand I have the whole night free to watch my two shows (survivor and Lost), on the other hand I won't have to do it this weekend (which is good because I have an excessive amount of other homework). So I have four hands.

As I have indicated in previous blog posts I am also working to prepare for next year. One requirement of next year is that we have a PDA. The PDA will pretty much have to be on our person at all times so that we can consult all the multimedia we get to buy as well as document on pt's and send reports in to faculty when we are at the hospitals and various clinical sites. It may initially sound very exciting but really it is just a ploy to give us more work. So anyway, my contract came up with Verizon in March. I've been with Verizon for 6 years and have greatly appreciated their business and professionalism. I wasn't sure what I wanted to do, which PDA to buy, etc. I did a lot of research (this is an understatement coming from a person who spent 6 months researching before buying my 1st real car). I spoke with my advisor and got the basic requirements for the PDA. Looked at phones. Went to 5 different stores and spoke at length with tech people and got all the positives and negatives, the good the bad, the prices, the specs, the perks, the quirks. In the end I finally made a decision (yes, it is shocking). I got a Blackberry. I really do like it. I have become one of those people. I've had it about 5 weeks and I'm really enjoying it. I've downloaded some applications that have come in quite handy - the Bible (I can read at lunch), epocrates (a complete drug reference guide), and my personal favorite - disco bowling (I'm awesome).

Unfortunately, two weeks after I got my Blackberry, we had a specialty year meeting. At which they told us not to buy a PDA yet because they were working some kinks out of some programs and we may only be able to use a certain PDA. I'm fearful that brand will most likely not be Blackberry.

Summer School

So summer school started last Monday. It's amazing that so much time has already passed. It's hard to believe that I am already 1/3 of the way done with school. When they presented the syllabus in class last Monday, they said this semester was going to fly by and that if we turned around twice it would be over (I tried this and it didn't work).

So, tomorrow I start my OB rotation at Nashville General Hospital. I'm excited and looking forward to this new experience. Hopefully it will be uplifting in comparison to other rotations I've had since having a baby is usually a positive thing. At this point though, I'm not exactly sure how to get to Nashville General, but I'm sure I'll figure all this out before 6:45 in the morning. Nashville General Hospital serves much of the lower income population of Nashville and a lot of the Hispanic population are served there. My Spanish is incredibly rusty, but then again, it is really bad anyway. Anyway, I'm assigned to the postpartum unit tomorrow, so no live births for me - that'll have to be another week. I'm looking forward to this rotation though and have been all year.

This week through different lectures and a growing familiarity with my new classes has enabled me to begin to see the light. You know, the one at the end of the tunnel. I'm begining to realize the end, of this year anyway, is in sight. The days are numbered and I'm happy for that. That's not to say that this tunnel doesn't still have a lot of hurdles.

Amazing

Isn't it amazing. . . . .

that the sun rises and sets every single day.

that the stars come out each night.

that the seasons come in the same order year after year.

that the force of gravity is constantly present.

that the waves never cease to rise and fall.

that the heart continues to beat.

that the lungs continue to breathe.

that birds are born knowing how to fly.

that water evaporates to the sky and condenses back to replenish the earth.

that there is a sense of smell.

that mustard seeds grow into trees.

that the earth is close enough to the sun to have adequate heat but far enough not to burn up.

that spiders spin webs.

that the element sodium burns the skin and the element chloride is a poisonous gas, but

together they form a compound, sodium chloride, that the human cannot live without.

that the kidneys filter 180 L of fluid every day.

that when fires are caused by natural means, such as lightning, then they are easier to control

and don't cause as much damage as man made fires.

that the earth continues to spin on its axis.

that every spring the flowers bloom and the trees blossom.

that human fingerprints are formed based on their movements while in the womb.

that trees grow toward the sun.

that no two snow flakes are alike.

that a grain of sand can form a pearl.

that humans have a soul.

that caterpillars can turn into butterflies.

that rainbows form after rain falls.

There is so much much more. And yet tomorrow, the sun will rise, the wind will pass, the rain may fall and another day with be. It is all the simple basic constant things that make life so truly amazing.

It is all those things that acknowledge the existance of God.

One more test to take. . .

I have one more test to take and then I will have 4 days off. I'm so excited. I take my final exam on Monday and then I'm free for the rest of the week. I will be flying out on Tuesday to visit a good friend who moved away in October. I'm sure that we will have a good time.

So much has happened the last few weeks.

I had to do a presentation on my change project. I had three goals for my change project:
1. By the end of the personal improvement project, the student nurse will exhibit a weekly average stress score of 25 based on the Psychological Stress Measurement Tool.
2. By the end of the personal improvement project, the student nurse will have exercised three times per week for each week of the project to reduce stress.
3. By the end of the personal improvement project, the student nurse will decrease her stress as evidenced by a decrease in the number of times she walks in her sleep to 1 time every two weeks or less.
Unfortunately, I did not meet any of my goals. The end results were as follows:
1. Student nurse did not meet goal of decreasing stress from a measure of 40 on the Psychological Stress Measure Tool to an average of 25.
2. Student nurse did not meet goal of exercise 3 times per week for eight weeks to decrease stress. Student nurse exercised 3 times per week the first four weeks but only 2 times per week the second four weeks.
3. Student nurse did not meet goal of decreasing the number of times walked in sleep to 1 time every two weeks or less. Student nurse walked in sleep 9 times in 8 weeks.
Fortunately, I did make some progress on each goal. So overall, I was pleased with that.

Clinicals have been good. I was able to do more new things and become more competent in other things. Last week I ended up with three different patients, each with their own unique set of problems. I learned something from each of them and was blessed to be a part of each of their care.

A few weeks ago I went to Freed-Hardeman for the weekend for Makin' Music. While there I spent some time hanging out with my little friend Louise. We had such a good time!

I've also been blessed to hang out with my favorite 4 year old friend Haydn and that is always such a constant joy in my life.

I spent last Friday at the Williamson County Health Department. I had to spend the day there as part of my community health class. There were lots of people in and out very fast. It was an interesting day and I enjoyed it somewhat.

This past Wednesday we had a simulation lab experience. We read over the simulated pt/manequin's chart the night before and became familiar with his case. We then had 30 minutes to treat Mr. Rodgriquez. There were multiple things wrong with his medications, his vital signs, etc. that we had to use our critical thinking skills to correct and manage. Our patient was in a very small "hospital" room that had a large mirror. On the other side of the mirror were 4 faculty members monitoring our behavior. It was a little nerve wracking, but I felt I did fairly well. I look forward to doing more simulations in the future.

For now, I've got to spend this rare day off going to work and learning more about those I encounter.

Getting Experienced

Last week was full of many new experiences during my clinical days. We were back at St. Thomas hospital on the cardiac rehab floor, where we care for pt's who are 1-6 days post-op open heart surgery. This rotation has been more exciting for me than many of the others I have had. I am getting to do and see things that I came back to school for. At times it seems that life has been so full of all the things I need to learn, that I lose sight of the big picture and forget my end goal. The small things in the meantime are foundational cornerstones to major principles in the future, but at times they feel more like annoying stones in my shoes. So, this St. Thomas rotation has been incredibly encouraging. I had the exciting new opportunity last week of giving someone a suppository. It is quite odd to find yourself 4 inches into someone's rectum, but that is just part of it. Unfortunately, the suppository didn't work. This led me to the new opportunity of giving someone an enema, actually before it was all over with I gave two to the same poor soul. At times however, an individual may be so impacted that even an enema won't work. This leads to one final option - the digits. My digit to be exact. 10 minutes later the pt was feeling much better and I was able to give her the 2nd enema, which she still needed. On a brighter and more exciting note, I started an IV line on my first attempt, luckily the pt had very good veins and I got a good stick. The pt even said they didn't feel a thing. This was good, especially since the pt kept shaking a fist at me and smiling. I also got to take out a sutured in centrally inserted IV line. The only difficulty associated with this was the extreme amount of tape I had to peal off the pt in order to even get to the surgical site. Overall the two days last week were fun, tiring, educating, and interesting. I appreciated my time there greatly.

This week, we will unfortunately only be able to spend one day in clinical. Our other day of clinical will be spent at the state Capital for TNA day. This is the Tennessee Nurses Association day on the hill. We will spend time with the governor, network with nursing school all over the state, listen to new legislation, and talk with congressmen and lobbyists.

Overall it should be a good learning experience, but I'd rather be in clinical. Fortunately, it only affected our short day of clinical and not our long 12 hour day.

Overall things are going well with school. This semester ends in three weeks and then I will have 4 days off before summer semester starts.

my week in review

So Monday was St. Patrick's day and the 10:00 lecturer, being Irish, asked the professor who had previously preformed the "Irish Jig" to come back and dance for us again. Thankfully she did not dance on the table this time, but on the floor. She also brought her 12 yo daughter to dance too, since she was on spring break. They did three different dances and even included some clogging. It was interesting. Had absolutely nothing to do with the lecture for the day at all. Everyone at school was excited to go out and drink green beer that night.

So on Tuesday, we were provided with a free pizza lunch at the cost of listening to a man speak during our hour lunch break from a company called Kaplan. Kaplan is a testing center which helps people to focus on their test taking skills. In August, we all have to take the NCLEX exam in ordered to be registered nurses (this is what some people call their "boards"). In fact, if we do not pass this exam, then we will have to go part time in our second year, making our second year turn into 2 years. So, it is very important that we pass this test. The Kaplan guy explained to us how the test works, how the test is administered, tips to passing, etc. He, of course, also encouraged us to take the Kaplan class on how to pass the NCLEX exam. I probably will, as it is in my best interest.

On Wednesday I started a new rotation at St. Thomas hospital in Nashville. It has already been very eventful in the 2 short days that I have been there. In many ways I suppose I felt like I was on a medical hiatus while at the psyche hospital because we merely focused on therapeutic communication and did not do any physical assessments, medication administrations, etc. I'm looking forward to the next few weeks while I'm there and hope to take advantage of all the opportunities that are presented.

Things worked out in such a way that I did not have a pt this week, I was a floater. Even still I was able to hang IV (intravenous) iron, administer an IM (intramuscular) injection, check numerous blood sugars, empty catheter bags, change a man's diaper, see a scrotum the size of a football (this is in no way an exaggeration), and follow an acute care nurse practitioner for the day. I enjoyed following the nurse practitioner. She gave me a great deal of advice about her professionalism and the way that she conducts herself. It was appreciated. It helped in some ways to reaffirm my choice of acute care as opposed to another specialty, though I wish I had had more time with her in order to have a better understanding of what she does in a typical day.

Friday is my community health day. We spent the morning at the Nashville Humane Association (yes dogs and cats), and then spent the rest of the morning at the Nashville Red Cross discussing a project that we will be working on until July. The project will focus on volunteers and everything that encompasses that. It should be intersting. I have always wanted to work with the red cross and so it's kind of nice that things worked out the way they did.

For now, it's Saturday and I am so so so so happy. Yesterday, we all went to the park (we means everyone except Dewayne). It was fun! We played outside and put the babies in the swing. Haydn and I ran all over the ginormous playground. We took a walk. It was a truly beautiful day. Last night everyone (including Dewayne) was at the house and we dyed easter eggs and just enjoyed being together. Chara and Josh will go back to Oklahoma today and Laura and John will go home. Life is made up of such beautiful brief moments.

Come take a walk with me

I have enjoyed spring break this past week and tried to focus only on relaxing. While on this academic hiatus, I thought that I would share a little bit of school with you. As I have often mentioned my daily walk to class, I thought that I would invite you to take a walk with me to the nursing school.

Next week is my last week of psyche and then it's back to the hospital. Hopefully that will lead to more adventures in nursing and more interesting blog posts.

Monster Truck Rally

So, here is my picture from the monster truck rally.

Not so monstrous are they?

So, as you can tell, I didn't quite make it to the Monster Truck Rally this year. I was disappointed, beleive it or not, because as crazy as it sounds, I really did have a lot of fun last year.

So why didn't I go? Well, last week I spent time with a pedaphile, a paranoid schizophrenic, and a lady with a diagnosis of incubus - all have incredibly interesting and at time humorous stories, none of which I will be relaying. I also worked roughly 15 hours and I needed a break. So, Friday, Chara and I packed up my car, and her baby, and headed out of town. We spent some much needed time with family and friends. I did no homework, watched 2 movies, went to a softball game, ate out a lot and just rested.

As a result, my homework schedule is incredibly hectic and I'm a little behind, but I'm rested and it was well worth the trip.

Psych-Mental Health and Chest Pain

Last week I started my Psych-Mental Health rotation at Middle Tennessee Mental Health Institute. It was very interesting. My pt was an older gentleman with schizophrenia. He never expereinced any acute delusions or hallucinations while I was with him; though his chart indicated he has had many in the past. There were quite a few interesting characters there and quite a few interesting stories to go with them. There are 9 different units at MTMHI and I will get to experience most of them before the conclusion of my time there.

We also had our first test last week. I studied all weekend and did fairly well on it. Would have liked to have done a little better, but overall I was pleased. I debated a great deal over one particular question and did not go with my gut feeling - I missed it, my gut was right. Unfortunately, that one point would have made a big difference. Oh well!

Tomorrow I have to give a ~2 hour long lecture with two other students focusing on chest pain, indigestion, and nausea. The presentation is mainly focusing on the case study of a woman who is experiencing a heart attack and the treatment plan for her involving delegation, action, drugs, vital signs, etc. We have incorporated a lot of onlin videos into the presentation, so hopefully they won't be too bored and it'll work out well. We also have an activity planned where we are tying strips of fabric around their chests and then encouraging deep breathing. The restricting fabric prevents a full inhalation, thus leading to chest pain and mimicking the feeling of a heart attack. Of course I intend on having the students do jumping jacks after they take their deep breaths (I mean the shallow ones). The jumping jacks will further deplete their oxygen stores and increase the chest pain. I'm sure it will work out very well. (No, I'm not pregnant in the picture - the point is to pull the strip of fabric tight. And yes I know my clothes do not even remotely match - this is my "study" attire.)

I've worked A LOT the last two weeks and will this week also. Things at work have been busy and frustrating. I enjoy being there though and I find myself missing the people - the pts and the employees. I feel a lot like I have a place at work, that I can be busy and make a difference. I don't feel like that at school. Sometimes it is difficult to remember that this is all for the greater good. It was a good time to refocus. Sometimes I get so tied up into going to school that I forget the goal, the reason.

Well, I wont be too busy this week not to make time for a little fun. I will be headed off this Friday night to join a friend and coworker at our second venture out to the MONSTER TRUCK RALLY. Don't worry, I'll take pictures!!!

Irish Jigs and IV catheters

Classes have been different this semester. We have one main class where we get a great deal of information, the content's very intriguing, and we learn a great deal. Another class is comprised of our clinical hours and we are challenged, pushed, and forced to grow as nurses. But the other 3 classes have been somewhat uneventful, disenchanting, and laborious. That is not to say that all the lectures have been bad in those classes (though some have induced suicidal ideations), that is not to say that all the lectures have been a waste of time in those classes (though some have made me wish I had a DVD for my laptop), or that they are not important (though I really didn't need a lecture on how to be spiritual in an open minded, unbiased, all inclusive, everybody should be happy world). I can feel pretty confident in saying that my classmates and I are underwhelmed this semester. That is not to indicate however, that I have not already had a lot of homework in these four weeks, that I have not learned anything, or that I have not been challenged; it is merely to indicate that classes have been different this semester.

I did however have somewhat of an eventful week despite my aforementioned bemoaning. This week we had a lecture on the importance of nurse wellness and we discussed many of the factors that play into our own personal wellness, such as lifestyle, activity, diet, creativity, spiritual, and emotional. In order to relay the importance of personal activity, our lecturer for the day came prepared to do the Irish Jig (I didn't know there was such a thing either). She stood/danced on two tables at the front of the room that had been pushed together to form a dais. She then preceeded to dance, with very high kicks, on these two wobbly tables at the front of the class for approximately 90 seconds. No, she did not fall, though the potential was great. I thought, how ironic, we are talking about nurse wellness and in an attempt to illustrate activity, she potentially placed herself in a situation that could very easily lead to nurse unwellness. She was a very fine dancer and did an excellent job (not that I can truly judge someone on the proficciency of the Irish Jig). That particular class day was not uneventful.

Clinically, I had a somewhat exciting week as well. Thursday was my last day of my pediatric rotation and while I am somewhat happy about this, I am somewhat sad as well. My clinical instructor this time has been very encouraging and I have greatly enjoyed working with her. I felt that she did an excellent job as a clinical instructor and I greatly appreciated her time and support with us. As I said, Thursday was our last day of pediatric clinicals and our time at the hospital was cut short as we had to do some work in the simulation lab. Afterward we met for our weekly clinical conference. This is when we discuss our pt's, what we learned, what we should have done better/different, etc. This week I also gave a brief presentation regarding pediatric nutrition focusing on kcal needs, behaviors, addition of solid foods, etc. I felt that it went really well, but I really do enjoy giving presentations. Afterwards, the real fun began. We had an additional conference educating us on the technique of IV catheter insertion. We watched, we saw, we did. I gathered my supplies and was quite eager for my first attempt (I'm sure my recepient - the aformentioned appreciated instructor, was not quite as eager). I went for a hand vein. The truth is they are harder to stick, but it better to learn there as that should be the first site of IV insertion. Once you insert an IV in an arm you can't use a vein below the one you used, so it is best to go as low as possible to save more veins for later use (so if you use the hand, you can still use the cephalic, or the antecubital - but if you go straight to the antecubital, you can't go back down). So I attempted my first IV stick and I was doing well, that is until I blew out her vein. She was very gracious about the whole thing. Then, she let me do it again. The second time I attempted, connected, and got a beautiful blood return in the IV line I started.

I suppose it's going to take me 2 tries with all the catheters I try out for the first time. Lets just hope my 2nd attemps only take 1 try.

Pediatric Clinicals

I HATE pediatric medicine.

Personal Change Project

In December I learned that we would have a personal change project for the Spring Semester. I thought a lot about it. I thought about finishing my pilot's license (a goal I fear that I will never accomplish), but then I found out that it had to be health related - so that was out. I thought about a lot of things that I could change or do differently to improve my overall health, and believe me, the list is long. So I thought about the thing I think about most often - exercise, after all, my B.S. degree is in Physical Education. My exercise habits have had incredible peaks and troughs. My senior year in college I ran cross country and ran anywhere from 3 to 10 miles a day. I was in the best shape of my life. I then went on a 2 year stint in which I exercised rarely if at all. I then found myself in training for a leg of a triathlon and got back to running around 4 miles a day; I was in fairly good shape at the time. Then I went on another 2 year stint in which I have exercised rarely if at all.

So I have to have a personal change project that positively impacts my health. So I focused on running. I've been reading books to improve motivation and running techniques. I've thought about other habits that discourage my desire to exercise and rearranged my schedule or pattern of routines in order to align myself with a more positive outcome and decrease the prevalence of my barriers.

I had to submit my proposal this week for my change project. The change project has to be measurable, so then I have to think what health factor do I want to measure - heart rate, blood pressure, weight? So I decided on stress. I found a great rubric to measure my stress and I am going to cross reference it with my exercise habits and evaluate the effectiveness of exercise on my stress level.

Looking at things from the perspective of stress has rearranged my thinking a lot about the whole project. I had initially been solely thinking about exercise and all that encompasses, but focusing on stress makes so much more sense now. I am doing other things in conjunction with the project to evaluate my stress level. It has truly been interesting and I look forward to the end results.I've been running for three weeks now. It is getting some easier, but I'm still really out of shape. It hasn't helped that the temp's been in the 30's or that it was spitting sleet while I was running today. But I do feel better, my rubric is already indicating the positive effect that exericse is having on my stress level.

Learning to control my stress will become an incredibly important tool in the following months. I had a meeting with my advisor yesterday and we talked about a great deal of stuff. I have a lot of concerns regarding the 2nd year of the program and I needed some perspective. There are ~15 different specialties. I have chose acute care, which, incidently, is the most intense program. I asked about the course of the 2nd year and all that it involves. I asked how the intensity of the 2nd year compared to the intensity of the current 1st year and she replied that there was no comparison. She said that the fall semester will require dedicated studying at least 6 out of 7 nights a week and that I should basically plan on not having any type of social life (which fortunately will not upset my current state of affairs). As ironic as it may sound, my discussion with my advisor provided me with some clarity and decreased the extreame amount of worry and fear I have over next year (not that I don't still have an extreme amount of worry and fear).

Tomorrow begins my 3rd week of pediatric clinicals.

Another way to hold your breath til your blue in the face.

So, the first day of class we talked about the physiological changes that an infant experiences right after birth. On the second day of class we talked about suicide. So we start with birth and go directly to suicide, how's that for consistency? Yesterday we talked about schizophrenia and psychosis. And today we talked about conception and fetal development. The funny thing is this is all the same class. We are going for one extreme to another.

The lectures have all been very interesting, but I have especially enjoyed the fetal development/birth lectures. A lot of stories were relayed and I thought that I would share a funny one.

The story was told of a pregnant woman who was placed on bed rest. It seems that at 20 weeks gestation, the baby (a.k.a. the fetus), begins to make purposeful movements. This includes sucking the thumb, holding hands, or even playing with the umbilical cord. One such infant found that he really enjoyed playing with his umbilical cord, he in fact, loved to squeeze it. So, he would grasp hold of the thing and squeeze and squeeze. Now for those who don't know, the umbilical cord is the blood and oxygen supply to the baby and, consequently, when your blood and oxygen supply is cut off, one usually passes out, much like holding your breath. So this baby enjoyed playing with and squeezing his umbilical cord to the point that he would pass out. Luckily, when he passed out, he would let go and the blood and oxygen supply would rush back to his little body. They knew that this was occurring because they would watch it happen on the ultrasound - over and over again. So, the mother was forced into bed rest in order to protect her baby when he continuously passed out. At birth, the baby was found to have no difficulties, abnormalities, or mental deficits. There was however, a long line of health care professionals waiting their turn to spank the baby, the mother, of course, was first in line.

VP Shunts and Sunsets

Today did not go as I had expected. Today was my first day of pediatric clinicals. Yesterday I was in orientation all day and then spent the evening researching my pt for today. After all that research I only got to spend about 3 minutes with my pt - maybe. I suppose it wasn't all that great of a loss though, since my pt only had a UTI.

I didn't get to spend any time with my pt today because I got put on another pts case right after I got on the floor and ended up in surgery all day. I observed the placement of a VP shunt - so essentially I was in brain surgery all morning. It was really incredible. I think the reality of the situation really hit home when I saw the pt's skull shavings fall to the ground like saw dust as the surgeon drilled a hole in the pt's skull. It was quite amazing. The story is so much more than skull shavings though. I was with the pt 1.5 hours before, the 1.5 hours of, and the 1.5 hours after the surgery.

It's amazing the things we are able to do and the people we are able to help. It's amazing to see the underside of someones skull. It's amazing to think how amazing and beautiful God is. We often go in search of beauty - chasing sunsets, visiting museums, planting flowers, etc. But the truth is, there is so much beauty inside of us. Watching the skull shavings fall to the floor today, I couldn't help but think about bones - their strength, their ability to grow and constantly regenerate (bones are an organ and though they are hard they are constantly changing); I was in awe of the physical manifestation of calcium - the end result of milk. I watched the pts blood and thought about the different cells that comprise it and the power that lies within them - the white blood cells and their fighting power, the red blood cells and their life giving ability, the platelets and their life maintaining function. I watched the hair fall to the ground as it was shaved from the pts head and was amazed at the tiny detail that God designed to keep us clean and enhance our bodies. I watched the lungs fight for breath as they tried to overtake the intubation tube and the power they forced on the pts heaving chest. I followed the pt to the recovery room and listened to the monitor beep incessantly, mimicking the ever beating heart and acknowledged the power that resides within each of us.

I suppose much of life is about perspective, though. The amazingly beautiful and powerful human body would have been before me whether I had stayed with the pt with the UTI or followed the pt to surgery, but it took me seeing a pts brain to acknowledge it.

Maybe we are all guilty of chasing sunsets......but then again, they are amazingly beautiful too.

Back to School

Well, today I was back at school. The break flew by, but that was mostly because I worked so much. I would have liked one more week off, but if I'd had another week off I would have worked, so I suppose in all reality it doesn't matter.

I had three classes today. We actually got to change classrooms, so I don't have to sit in the same seat all day, although I can't really figure out why they made all 129 (minus those who have dropped out) of us move to the room next door, but it was nice to have a change of scenery. My first class today was part 2 of a class that started last semester. It meets on both Monday and Tuesday mornings. It's interesting, very fast pace and exhaustive, but I enjoy it. The second class was okay, not sure what it's all about yet. My third class is all about change and ironically I am very excited by this. I first learned about it at the end of last semester and, in truth, I have thought a lot about it over break. The class focuses on how to encourage our patients to make a change in their life. Of course the best way to learn is to do, so we have to make a change in our lives this semester and then discuss it an the end of the semester. Essentially they want you to focus on something that will make you healthier - physically, emotionally, spiritually, socially, etc. Like I said, I have thought a lot about this and I have already come up with ~4 ideas (I'm sure there are hundreds of things that I can do to improve my overall health/self). I still have some more thinking on this before I decide what I want to do for sure.

Wednesday I start clinicals at Vanderbilt's Children's Hospital. I have never worked with children in a clinical setting before. On one hand I'm really excited about it, on the other I'm not so much. I hope my ped this week is just in with a broken leg or something simple like that. It's kind of funny, students in the medical field always want their pts to be really sick because they learn so much from them. I love having people with horrible problems (as horrible as that sounds). But I don't feel that way this time. It should be a very interesting 4 weeks. I hate that this it going to end up being my shortest rotation.

2008

Can you believe that it is 2008? I can't. Life often feels surreal and feels like it is happening to me rather than something that I am experiencing.

I went on a road trip to Ohio for the New Year. A friend and I went to visit another friend of ours who recently got married. We had a lot of fun just hanging out and talking, watching a stupid movie (Flicka), shopping, going to church, and watching a lot of football. It was good to spend time with good friends and bring in the New Year.

I also got to see an incredible exhibit that I have wanted to see for a couple of years. It is called "Bodies" and it is an artistic display of actual human bodies that are cut and preserved in order to show the amazing organization of our bodies. I enjoyed it immensely. There was everything you could want or imagine to see except for a cross section of the liver, the eye ball, and the heart. But I've dissected a heart and an eye ball, so all I really wanted to see was the liver. It may sound incredibly disgusting to a lot of people, but it was truly amazing and awesome (awesome in the true meaning of the word and not in the ninja turtle meaning of the word). I felt so blessed to have been able to view such an interesting exhibition.

As 2007 has come to an end, I can't help but reflect on the events of the past year. Where I was January 2007 and where I am January 2008 are totally different places. I have been blessed with a new niece and nephew - two truly amazing human beings who provide so much hope and excitement for my future. I find myself practically unemployed and back in school, something that deep down I knew I would do, but am still surprised by. I also realized that 2007 is the first year, of my entire life, that I did not, at least one day, sojourn to Oklahoma - and now my life has a recorded year without my being there. I had 2 very close friends move away. I went to 2 new and very exciting places. So many other things have come to pass that will forever define 2007 for me. This leads me to thoughts of the New Year and the opportunity for new beginnings. This causes me to ponder my goals and plans for 2008.

The future holds so much hope and excitement. We found out we are having another girl today. This will give me 4 babies. I am so blessed.