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.