My journey through life, as a Christian, a daughter, a sister, an Acute Care Nurse Practitioner, a teacher.
Thursday, December 11, 2008
SICU Crew
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.
Tuesday, December 9, 2008
Thoughts
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........
Thursday, October 23, 2008
Second Year
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.
Wednesday, September 24, 2008
Boobs in a Box
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 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!
Tuesday, September 9, 2008
The Wedding
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.
The Stress Response
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.)
Thursday, July 24, 2008
Crossing the Bridge
Tuesday, July 15, 2008
The HESI
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
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.
Wednesday, June 25, 2008
Group Work
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
Sunday, June 8, 2008
Summer School and Boot Camp
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
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.
Friday, May 23, 2008
L&D
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.
Thursday, May 15, 2008
Yesterday and Today
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.
Thursday, May 8, 2008
I've become one of those people
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.
Tuesday, May 6, 2008
Summer School
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.
Friday, April 25, 2008
Amazing
Friday, April 18, 2008
One more test to take. . .
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.
Tuesday, April 1, 2008
Getting Experienced
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.
Saturday, March 22, 2008
my week in review
Saturday, March 8, 2008
Come take a walk with me
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.
Tuesday, February 19, 2008
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.
Monday, February 11, 2008
Psych-Mental Health and Chest Pain
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!!!
Friday, February 1, 2008
Irish Jigs and IV catheters
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.
Thursday, January 24, 2008
Tuesday, January 22, 2008
Personal Change Project
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.
Tuesday, January 15, 2008
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.
Thursday, January 10, 2008
VP Shunts and Sunsets
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.
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.
Monday, January 7, 2008
Back to School
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.
Thursday, January 3, 2008
2008
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.