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.