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Wednesday, December 22, 2010

This class is done, and has been done since last Monday- thank goodness! I'm not sure how much longer I could tolerate the teacher.

Unfortunately, she is the worst professor (if I should even call her "professor") that I have ever encountered. She is rude, she would never admit she is wrong, she confuses herself during lecture, she doesn't know what she's teaching, she often contradicts the book during her lectures, her exams are just ridiculous and she is just overall mean, unless she likes you.

I am so glad to be out of her class. It was by far the most difficult and I am so thankful I did so well on the first exam and decent enough on the second exam to where I only needed to get 57 on the final to pass the class. I ended up getting a 72 on the final. That actually was a failing grade- C is 73-82. But it was enough to pass me and that's all that matters.

There was a lot of people who needed grades in the 70's on the final to pass. Some did it, some did not. A lot did not actually. If I had to guess, about 1/3 of the class failed. Even my clinical instructor said that if so many people are failing her class, semester after semester, doesn't that tell you it's not the students? I counted at least 25 students that took this class last semester that were retaking it now with me and I would say about that failed the course this time. Very sad. And makes me VERY grateful I was able to come out of this class alive and kicking. I can't even imagine having to sit through this lady's lectures and exams for another semester. Talk about torture.

My clinical instructor on the other hand was amazing. She really got us to think but in a non-intimidating environment. She was gentle and kind but didn't hold our hands- which is what we don't need. We need to be able to handle things on our own and think about things ourselves, but she never made us feel stupid or scared or imcompetent if we didn't know the answer.

I think all instructors need to take a course from her in how to handle students. Like I said, we don't need someone to hold our hands, we just need someone to believe in us. She did that, and it made a difference.

So next up- Cardio. This is a mixture of cardiology and respiratory problems, and a few endocrine issues. This is basically the last "stressful" course I will be taking, and once I am out of this course, the next one is just writing papers and doing projects and pretty much it is unheard of to fail that course. I will have 3 exams in the Cardio class and 1 exam in the last class, and then I am done.

Done.

Wow. Never thought I would reach that point. It seemed like such a far off goal, but now it's so close. I can finally see the light at the end of the tunnel.

Four months and 11ish days left. Wow.


Saturday, November 27, 2010

Exam 2, not as well as Exam 1. While I am happy that I passed, I was disappointed with my grade at first. I felt like the amount of hours I put into studying did not reflect in my grade at all. I got a 78 which is about a middle C. C is 73-82, so I was right smack dab in the middle. Not that low, middle or high C matter......a C is a C is a C no matter what.

I have 2.5 weeks left and then 3 weeks off. I cannot wait. I need that break after this class, let me tell you.

Everyone I talk to is in agreement, this is by far the most difficult course to date. The teacher makes things more difficult then they have to be, and it would probably be a decent course if there was a good teacher teaching it. But it is what it is and unfortunately, for some, it seems they will be repeating this course. I need a 57 on the final to pass, so I am fairly confident I will be moving on, but I am not going to take that for granted. I am going to study like the 87 I need to get a B will be what I need to pass, just so that I don't wind up getting a 56 somehow, which in this class is highly possible. I am, however, planning on moving on to Cardio in January. I am looking forward to that course. The heart has always fascinated me. I did spend 3 years working for 2 different cardiology doctor's offices. In A&P, it was really peaked my interest because I had learned more about it. I'm excited.

Clinical has been going well so far. Nothing super exciting, yet. We are allowed to start IV's this semester, however, there have not been any to start. This past week I had my ICU day, which was pretty interesting. My nurse's patients weren't that complicated and one even got discharged to a medical floor about halfway through my time there. I did get to do some things that I normally do with my instructor alone, so that was pretty exciting, and I almost got to start an IV but my nurse was unsure she was going to even do it herself because the patient was a hard stick. But I like the ICU, so that's up there in my interests. Three hospital days left and this clinical is over.

So that's all I have to say for now. Super busy. Exam in 2 weeks and 2 days. Lots of reading and studying to do until then.

Stay tuned........

Wednesday, November 17, 2010

Busy. Have had 2 clinical days so far. But I am just sooooooo busy with my lecture class it is crazy. I hope to blog more about it soon. I have a test on Monday that is composed of a ridiculous amount of information that I am not sure how it is humanly possible to even remember all this stuff, so I am pretty stressed out at the moment.

Until then.......

Monday, November 8, 2010

I passed. Whew. Actually, I even got a B. An 84 to be exact. I came out of the test feeling fairly confident, but once other students started coming out and voicing how hard and ridiculous they thought the test was, my confidence slowly started diminishing. Then two of the students who have consistently earned the highest grades in all the classes came out and said they weren't even sure they passed, I really started to worry. Person after person talked about how hard it was. Maybe I didn't do as well as I thought I did after all.

And then came the wait.

Usually my classes are in the morning, 9-12. On a test day, we'd be out by 11:30 and grades would be up by 12:30-1. This class is 1-4, and the teacher said the grades would be posted between 5-8pm. So we waited. And waited. And waited. And finally at 7:30pm there they were.

I didn't know right away. At first I got a phone call from a friend asking me how I did. I told her I didn't even know they were up and as I was checking my grade I asked her how she did.

She failed.

I felt so bad. I mean what do you say to someone when they tell you they got a 66 and you are looking at your 84? And she is a smart person, too. It's just sad to see these things happen to people, where they have to withdraw or they fail a class and have to retrack. It happens to so many, and could easily happen to me. I'm not out of the woods yet. I still have 2 more exams to go, but it always makes things much easier when you start off strong.

For now, I can breathe. Just a little bit.

Tuesday, November 2, 2010

I registered for my last semester of nursing school! At times, I can't even believe how fast this has flown by. It's been a crazy and amazing journey so far and it's certainly not over yet. But it's getting there........

Tuesday, October 26, 2010

Today was my first campus lab day for Ortho/Neuro. Cranial nerves, musculoskeletal issues, bursitis, arthritis, fractures, blah, blah, blah. While a very important aspect of our health, I tend to find some subject matter quite boring.

Anyway, my day didn't start off on the best foot. For this class, I have to be at my campus labs by 8am, which proves to be a little tricky when I have to take the kids to school and they can't arrive any earlier than 7:30am. I have to walk each one to class, say goodbye, get back to my car, drive to my school, park (and the parking lot is CRAZY), walk to class, and be in class by 8am. Well, my plan was to leave my house by 7am and no later in order to complete this task. At 7:15am, Grace walks into my room and tells me that it is 7:15am.

I immediately jump up out of bed. Then I put my head in my hands and say, "Oh my gosh, what am I going to do?" My awesomely helpful, and SMART, husband said he would take my car and take the kids to school for me so I can get dressed and get going. I don't know how long it would have taken me to think of that, but I'm so glad he did. So I was hoping this wasn't going to set the stage for the day to come.

Anyway, as normal on the first day of clinical/campus labs with every rotation, there is a math test. Ten questions. You have to score 90% or higher to pass, which means you can only miss 1 question. We get these practice questions for every course, with problems that are similar to how the test will be. Every step, they get a little trickier. I have to say, this was by far the worst math test ever. There were multiple steps to almost every problem. Each step needed some sort of rounding to be done. I dividing numbers like 0.133 by numbers like 0.167. Not that it's super difficult, but it's easy to make a mistake with so many numbers and decimals.

I was more nervous after this exam than any other I had been in the past. If you fail the first one, you can take a make-up exam next week, but really, who wants the pressure. I was so stressed over this exam, to have to make it up would honestly drive me beyond crazy. If you fail the make-up exam, then you have to withdraw from clinical and you have to wait until the next class, which wouldn't be until March.

Well, I passed. Deep breath. Sigh of relief. I was literally so stressed yesterday that I had a little breakdown and cried. It wasn't a long cry. It was just a put-my-head-in-my-hands-and-tear-up-a-little cry. However, it was pretty sad that Grace was trying to console me. She said that I was crying, and Nate said that I was not. Then Grace explained to him that I made a crying noise and my head was in my hands. Then Grace tried to console me by saying that it would be OK and that sometimes, when she has a test and she thinks she didn't do well, she gets 100%. She's so cute. The math exam is one exam where I don't care how well I do, I just want to pass. Unfortunately, passing means a normally "good" grade. But at any rate, it's over, it's done and I have 2 math exams left before I graduate.

Deep breath. Exhale.

Saturday, October 16, 2010

Yesterday was my OB final. Other than a few hours Tuesday afternoon and a study night Thursday, I hadn't really put forth much effort studying for this exam. One of the main reasons for my slacking is that this test was cumulative and I've heard that there was more content from the first two exams then there was stuff we learned after. Another reason is that I needed a 49 to pass and I was pretty certain I would at least get that much. But I wanted a B. I needed a 79 for a B. I thought I could at least do that much.

After class, a bunch of us went to Chili's to eat and celebrate the fact that we are now considered "upper classmen." Six classes down, three to go and only six and a half months left. Some people had phones with internet, so they would check periodically to see if the grades were posted. Around 12:30 the moment of fate had arrived. the phones were passed around the table for others to be able to check their grades, too. Then my turn came. I logged in, clicked the section that contained my grades and saw the unbelievable.

78

Really? I missed a B by 1 point? I didn't have anyone to blame but myself. I guess I am a really bad test taker, because the two girls I study with usually get similar grades and they usually always score higher than me (except the first exam, which I will count as a fluke, ha ha). One point. Very, very stinky.

So later on that day, I get home and I decide to check my grade again, which I always do, in hopes that it will somehow magically change into a higher grade. Never happens, but I still do it. I log in.

79

Had my eyes deceived me earlier? Are they deceiving me now? I got my B by the exact amount I needed. It's possible I misread it earlier on the small phone but 8 and 9 don't look that much alike, do they? At any rate, it doesn't matter that I misread it or if it changed, it's 79 now and I got a B. In the grand scheme of things, it doesn't matter what my GPA is, but I have this issue with myself,, I suppose which stems from how bad of a student I was in high school, that I have to prove to myself that I can get good grades. But really, when I am applying for a job, they're not going to ask me my GPA. The only way its going to matter is IF I apply to grad school, but even in that case, I can get good grades in my Bachelor classes to bring up my GPA enough.

Ok enough rambling. OB is over and I got a B. Ortho/Neuro begins in a week, which is scary and exciting at the same time. I will be learning how to start IVs this rotation. Not just hanging a new bag on a line but actually taking a needle and inserting it into a vein and the whole 9 yards. Very cool and very scary.

But until then, I will start my reading for lecture and I have to attend some sort of skills check off on Monday.

Saturday, October 9, 2010

Wednesday was my last OB clinical, which made me sad. I have never looked forward to clinicals as much as I have for this class. I loved all aspects of mother-baby care and am even considering Newborn and NICU in some of my top choices in nursing interests. This was a great experience and I wish I could have more, but unfortunately, that is not how nursing school works.

My last day I was in Labor and Delivery. It was much slower than the first day I was there, however, there was already one lady about to deliver and another coming soon. The nurse "asked" the first mom if we (the 2 students) could come in and watch, and of course she said no. You can't just ask a lady in the process of pushing if people can watch. Its all in how you ask, or not ask. I mean, you don't ask if the nurse can come in, do you? But really, there is a way to do it that works and just coming right out and saying, "Do you mind if the students come in and watch?" isn't it.

So the other student and I took it upon ourselves to start working with the next mom to get acquainted with the mom and her family so that we could just be a part of the delivery when the time came. There were 2 more moms who were progressing rather nicely as well and they happened to share the same nurse who was the most helpful to us, the students, that day. She was great- asked us questions about the whys of things, showed us things, asked us for help. Its always great to have a nurse who didn't forget he or she was a student once, too. Anyway, the mom ended up delivering at about 10:45am and it was so awesome! I just loved watching the proud grandma's face as she watched her firstborn grandchild enter life and it did make me all teary. I loved watching the dad as his son entered the world, so very cool. I ended up even holding one of the mom's legs up as she pushed her son out, with NO epidural mind you!!! She was awesome. It was awesome. I so wished I could have been part of more deliveries.

The other 2 moms was kind of a funny thing. They had the same nurse, had the same doctor, were exactly the same amount effaced, the same dilation, everything. They were progressing about the same rate. At 2:30 they were both at 9 cm and were nearing delivery, but we were supposed to meet our instructor for our post-conference meeting and clinical evaluations (usually we left the floor at 3:30pm) so we didn't get to be there for those deliveries. I was bummed, because I had been working with one of the moms all day, they were expecting their first born, a boy and I watched as the mom made the decision to just take the epidural after she had really wanted to try not to. I also watched as her baby had some decelerations of the fetal heart rate, what's called "late decelerations" and is not a good sign. The nurse I was with immediately ran into her room, while another nurse on the floor, who was watching the monitor, called in to see if she needed help, to which she replied a yes. The other nurse came in fast and immediately started running oxygen to give to the patient and they had the patient turn on her side, left to be exact. It was a little bit of a scare, but in the end, the nurse's were able to get the baby to get the oxygen he needed to maintain his heart rate. After all of this, I really wanted to be there to see them welcome their baby into the world. Alas, this was not the case for me.

But I did get to witness at least one vaginal delivery, and for that I am thankful.

I am off from clinical for the next 2 weeks, then I begin 2 weeks of campus lab days for Ortho/Neuro (2 days each week). Four weeks from now, well more like maybe 3.5 weeks, I will start in the hospital for Ortho/Neuro and I will have 6 weeks there.

Time really is flying fast now. My final is Friday. I have 3 classes/7 months left. It was 7 months ago I started the specialty rotations and now they are done. Wow. It is amazing to me how fast this journey is going. Once I remember thinking nursing school would never begin, and here it is nearly ending.

I won't have anything to update this week, so I will be studying until my final.

I will let you know how things went then. :)

Thursday, September 30, 2010

Yesterday was my day in the newborn nursery. Here's what I did yesterday:

  • I got to give a baby a Vitamin K shot. Vitamin K is synthesized by the bacteria in your gut, but babies' guts are sterile and therefore cannot synthesize the Vitamin K by themselves. The vitamin K is important because it plays an important role in blood clotting. To recap, babies do not have bacteria in their gut. Bacteria synthesizes Vitamin K, which the babies cannot do. Vitamin K is needed to clot blood. Without it, babies can be in big trouble. So they are given a Vitamin K shot. I gave a baby a vitamin K shot.
  • I got to put the Erythromycin Eye Ointment on the baby's eyes. the ointment is used prophylactically to prevent eye infections from bacteria the baby's eyes were exposed to during childbirth, even in c-section babies (at least at this particular hospital). You basically pull the lower eyelid down and apply the ointment to the very edge of the eyelid. Then you let the eye close as normal. I got to do this.
  • I gave a baby his first bath.
  • I did a newborn assessment and an exam to assess the baby's physical maturity, called Dubowitz/Ballard Exam for Gestational Age. This is done in order to correctly meet the baby's needs if the dates of pregnancy are uncertain, or if let's say the baby is smaller but happens to be more mature than thought. Babies will need different care depending on their maturational needs, so this will closely estimate their gestational age in order to ensure the receive the appropriate care. I did one, for my clinical grade, not officially for the baby/doctor/nurse or anything, but I did one.

Yesterday we had something a little interesting. One of the babies was going to be put up for adoption. The mom already had an agency she had been in contact with. I guess she wanted to see him one last time, so after his bath, we brought him over and while I stayed out of the room, the nurse said the mom was pretty emotional (which I could guess would be the case). Mom wasn't young- over the age of 30- has 4 kids already and is, from what I heard, a single mom. I guess she just wasn't able to care for another child on her own. I can't even imagine how hard this must have been for her- what a crazy difficult decision to make. I stared over her son for quite some time yesterday, he was so cute and oh how I wanted to just bring him home with me. But I know some wonderful family, some loving mom and dad, will take this boy into their home and love him. He already has more love in his first few hours of life than some people ever receive. His mom loved him enough to bring him into the world and make an unselfish decision to give him to someone else who can better take care of him than she can. *deep breath* I will keep her in my prayers during this tremendously difficult time. I can't even begin to imagine her pain, but what love she has for this boy.

The nurse we were working with in the nursery was a nurse who usually is in the NICU but was covering for someone yesterday. She was in NICU last week when I was in there and told me that the little baby I had mentioned in my last clinical post, the one with Trisomy 18, had passed the day before. Her parents made her a DNR (do not recussitate) and she was taken off life support. I overheard one of the students saying this, so I don't have the complete story as to where the parents were exactly or anything, but apparently one of the nurses held this baby for 45 minutes until she passed. How sweet, loving and courageous of this nurse! (sorry, need a tissue break)

I hope to be a nurse like that one day.

Anyway, I am really bummed next week is my last clinical. This has been, BY FAR, my favorite rotation. We'll see what happens next week as I will be in labor and delivery once again. It seems as if every week but the first had vaginal deliveries in addition to the c-sections. I am hoping next week is a crazy busy week, or rather a crazy busy Wednesday! I'll keep you posted.


Monday, September 27, 2010

Well, exam 2 didn't go over quite as well as exam 1.

I got an 81.

It seems as if everyone either did better on this exam or stayed the same, except for me and 2 other girls. Sigh. I know that my 81 is a good score, but it just feels horrible because I know that I can do better and I don't know what happened. Anyway, I'm giving myself a pity party today and then tomorrow I will snap out of it. I can still get my B for the class if I can get a 79 or higher on the final, and historically, I haven't had anything below an 81 on a final yet, and that was for psych, which was just different as far as her testing style. In a little over 2 weeks, I will have this class behind me and then I begin, 3.5 weeks from today, the class I have been dreading since I started nursing school- Ortho/Neuro. I guess I am a little scared of Neuro and since it's not my strong suit, I am slightly worried. But I think if I can make it this far, then perhaps maybe, just maybe I can get through the next 3 classes, including Ortho/Neuro, as well.

Ob final is on October 15. This week I am in the Newborn Nursery and then next week, my final clinical week, I have my beloved Labor and Delivery once again.

Thursday, September 23, 2010

So far, life has been pretty busy. I have been studying here and there, watching TV here and there (mostly here, lol) and I had to fill out 4 pages of paperwork on 2 different patients from last week in addition to doing 3 care plans and all of that was due this week. So now I must play catch up.

Last week at clinical I was assigned to the postpartum unit- one vaginal delivery patient and one c-section delivery patient. My vaginal delivery patient was a 17 year old and she was quite quiet. She didn't need much assistance, had a couple of visitors with her at all times, and for the most part, seemed very uninterested in my help. I think the most I had done with her was assist her to the restroom and teach her how to "cleanse" herself after each restroom use until her post-delivery bleeding stops, otherwise referred to as "peri-care."

My c-section patient was a lot more talkative and I feel like this was certainly a situation where I may have made a difference, even if ever so slightly. I felt like I was able to get in a good amount of patient teaching in, which is an important aspect of a nurse's job. She was a first time mom, about my age, hubby was there the whole time, other family came in, she was attempting breast feeding, etc. She had a lot she didn't know, some anxiety- I could sense- about breastfeeding, and I felt like she was very responsive to my assistance. I got her out of bed for the first time since her c-section, assisted her to the bathroom, taught her about peri-care, spoke to her about pain meds, gave her some reassurance about breastfeeding, got her to ambulate around the hallway once around, encouraged her- things like that. I really felt I did something that day. Unfortunately, the nurse to patient ratios are just insane in this unit. I believe the nurse I was working with had 7 or 8 patients. That's just ludacris. Honestly, if you are going to give good patient care in a situation like this, 4 or 5 is probably a lot. Giving meds isn't the hard part, but interacting and spending time with the patients, being their support, their teacher, their helper- it just needs more time then any of these nurses could really give. I mean, if all 8 patients were c-sections, who would have the time to assist them all to the restroom or ambulate them. This is what drives me nuts about hospitals. They cut costs at the expense of the patient and at the expense of the overworked nurse.

Ok this was a tangent I hadn't planned on. Let's move on.

This week I was in NICU. I knew that this would be a very light clinical day since we are not to do anything but observe. However, knowing myself and how I cry at anything baby related, I was really dreading this day a little. I wasn't sure how I would make it through without being a complete basket case all day. When we took the tour of the units, I had tried really hard to hold it together after seeing one baby with a picture of mom and dad in the bed. I was fighting hard. Somehow, someway, I made it. I didn't cry once. I did almost lose it at one point though. It took all I had in me to keep it together. Very sad story. This little baby, about I think around 32 weeks gestational age, (but for some reason I really can't remember exactly) was born. The mother had prenatal care, but apparently for some reason no one caught the cleft palate the baby had. The baby also had an extra finger on both hands and an extra toe on both feet. At the delivery, the parents were obviously surprised by this discovery, but were ready to take it on. Here they thought this would just be a simple (well not really so simple) cleft palate repair, but the doctor had sent the chromosomes out for karyotyping- which is where you basically examine the chromosomes- and the results come back that this poor baby has Trisomy 13. Basically, this baby was blessed to have even been born since most babies die in utero. And the prognosis is about as worse as you can have- more than 80% of children with trisomy 13 die in the first month.

This poor thing was on a ventilator- a machine which breathes for the patient. At one point, while the nurse was inserting a PICC line (peripherally inserted central catheter, used for meds and feedings), the baby's respirations went completely down to 0 (not she was on a med so that the PICC line could be inserted which was causing the decreased respirations). The other student and I looked at each other and would have been freaked out had it not been the fact that the machine was doing the breathing for this baby. Still, it was weird to see someone not registering respirations. Another baby was having chest retractions, which was scary to me and the other student, but apparently, it wasn't quite enough to warrant the attention of the NICU nurse. There are 3 levels of chest retractions, which the retractions are a usual sign of respiratory distress. I could never picture them in my head because no matter how hard I tried to breathe in, my chest did not retract. It just amazed my mind that our bodies were even capable of doing that, but boy, can those ribs sink in deep. Anyway, there are R1 retractions, which are pretty minor, R2 retractions, which are a little more serious, and R3 retractions, which are very serious. The baby had been retracting at R1 for most of the day, but later on, he started to work really hard to breathe, and his retractions got worse- up to R2.

The neonatologist ordered a chest xray to rule out pneumothorax-collapsed lung, and atelectasis (I love saying this word, its a fun word to say), which is a collapse of the alveoli, little sacs in the lungs that exchange the oxygen for carbon dioxide. The baby, almost immediately after the xray, started breathing better, and he ended up not having either of those things going on with him, which was good.

The NICU amazes me. The nurses are a real team. The doctor treats the nurses with respect. The nurses were all very informative, they answered a ton of questions and showed us so much, and even the doctor called us over to show us things on the xray. Everyone on the unit has this tremendous wealth of knowledge. I just can't wrap my brain around how much these nurses know- it is really mind blowing, well, for me at least. I feel where I am at now, I could never know that much information. But I know in reality, that I could know that much info after I have had as many years of experience as they have. It's just hard to see that end of the tunnel way over here at the beginning of the tunnel.

That's just the way it is in nursing. There always seems to be a tunnel to travel through. It's a never-ending journey somewhere, a never-ending learning experience. As I exit one tunnel, I will venture into another. In May, my journey in this tunnel is over and I still have yet to figure out where I will end up. Labor and Delivery is still high on my list. NICU is growing on me. ER might be a contender, but I'm not even sure I will experience an ER before I graduate.

We'll see how things go along the way. For now, I have an exam on Monday and I will be in the newborn nursery on Wednesday. I will post the results of my exam on Monday afternoon!

Friday, September 10, 2010

I got an 89 on my exam. My second highest grade in nursing school so far. This is a solid B, so solid in fact that I was only 3 pts shy of an A. So solid that I can essentially get an 80 on the next two exams and get a B in the class. And so solid that I can get a 65 on the next two exams to pass. I do need an average of a 94 on the next two exams for an A, which may be a little difficult, but hey, I'll still try.
Yay, I am so excited :)
OB Exam 1.

I think I am ready. But there is always so much I don't know that it's hard to tell.

Tune in later for the results.

I feel good so we'll see :)

Thursday, September 9, 2010

Labor and delivery. For as long as I can remember, this area has been number one in areas of nursing I am interested in. A close second is ER/Trauma and Peds as third. Maybe it's because I feel like I am making more of a difference in people's lives in these departments. Maybe it's because I find these areas so intriguing. Maybe it's neither of those things and something entirely different, but those areas have always remained on the forefront of my mind.

When I first started nursing school, I told myself I would keep an open mind, that I wouldn't close myself off to just L&D, or ER, or anything else. I would go through the rotations and see if maybe something else would surprise me. I went through three rotations on med surg floors so far. This is the area where everyone tells you to work a year or two in order to hone your skills as a nurse and then transfer to wherever you like after. My first two of the three med surg floors I was on I absolutely HATED. I'm not a big fan of adult poop or adult urine. I'm not a big fan of 1:6-8 patient ratios. I'm not a fan of doing nothing but passing meds all day. Or being yelled at by older patients. Or anything else really med surg-like. I don't feel like I am making a difference, I don't feel like I am helping anyone. The third of those three med surg floors I had a better experience, and ended up feeling a little more like what I was doing mattered. But still. It didn't feel like home.

Then came Peds. I felt more comfortable, but it wasn't how I envisioned it at all. I thought I would go in there and be super nurse, and make all these sick kids magically smile and feel better. I was naive, and my expectations caused me to be disappointed. My Peds rotation was just yet another med surg floor, this time the patients were smaller, and I had to deal with moms and dads on top of it, which can be intimidating. I know that there is a whole lot more to the Peds world than what I experienced and I did like it more than the other rotations, but it still just didn't feel quite.........right.

Then there was Psych. Definitely NOT for me. Charting non-stop all day in the nursing station, and passing out meds- not my cup of tea. I can be a secretary any day of the week if I want right now without a license. Nurses chart- sure, but not like this. This was just insane (no pun intended).

Then came OB.

The excitement of it alone almost overwhelms me.

I've only had one day on the floor and while I didn't experience much, something just feels......right. It's hard, because I am an emotional person, so I don't know how long it will take me to stop crying after every birth, after every loss. I fought back tears several times yesterday. Most happy ones, but there was a sad set of tears in there, too. In talking to the nurse I was working with, I was told it's OK to cry. We're human. If there's a loss, just be there for the patient, cry with them, and if I need to step out, then do it. I will be able to find a way to block things when I need to. I can do it. It might take some practice, but I think I can.

I really feel like this might be my home. And the realization of that kind of overwhelms me as well.

There are so many awesomely fascinating aspects of OB. It is really such a specialized area and I feel like while there is a lot that I know, and a lot that I am still learning, there is still SO much more to learn. There's also other aspects of OB, too- like postpartum nurses, baby nurses, NICU. I will be experiencing all of these during this rotation. Maybe I will like those, too.

There's just something about L&D.

So for my first day, I had a patient, who just so happened to be an RN herself. First time mom, didn't know the sex of the baby yet. I was so excited to be able to experience this time with her and her husband. Unfortunately, she didn't deliver before I left. In fact there was not one vaginal delivery then entire time were we there, yet the floor was crazy busy. By the time we left, all 12 beds were full and all 3 triage beds as well. There was about 4 c-sections earlier in the day, and I was able to see one of them. It was pretty cool to be able to see things from the other side of the table for once, and holy cow, the stitching involved is amazing! Way cool. So many layers......which I am sure I knew in the back of my head but just didn't realize until it was there in my face to see. Doctors and nurses all seemed very nice. My nurse even told me about the new grad program their L&D has about once a year.

I saw two epidurals given, I saw one spinal given (for the c-section I watched), I watched a foley cath being done, which I had asked to do myself because I know how to do them and can do, them, but my nurse thought it would be a better idea for me not to do it since my patient was a nurse. I saw the baby nurse and the pediatrician doing their thing with the newborn, suctioning out the mucous the c-section babies often have, doing the gestational age tests, APGAR scores, foot prints, etc. I saw everything BUT a vaginal delivery.

Right before we went home, a young lady came in who was 21 weeks pregnant with her water broken and in a lot of pain. The nurses were saying she was probably going to deliver soon. This was tough for me, because as I learned, with a baby that small, there is nothing that can be done. Nothing. Too small. Usually after 24 weeks there is a chance, and at 22 weeks they may evaluate to see if there is a shot but 21 is not enough. Sad, very sad. Apparently, the patient was a drug mom in a drug program at the hospital. Even sadder.

But not all the cases are like this. I can't express the coolness of witnessing the birth of a little life into the world. Watching them take their first breath and seeing the happy moms and dads, so proud. I got to take a picture of a dad cutting the cord off his little girl (was a c-section baby and they were doing it in the little newborn room, oh and the picture was for the dad with his camera, not mine!). So cool. So very, very cool.

There's just something about L&D.

Saturday, August 28, 2010

Being in OB with all the talk of pregnancy, labor, and babies, it has me thinking a lot about the times I was pregnant, and the time I had Grace especially. Although I had started getting contractions with Nate a whole THREE weeks early and before my scheduled C-section, I obviously didn't get to experience full labor with him. But since I have been thinking about my experience with Grace so much, and her 8th birthday coming up in just 2 weeks (oh my!), I thought I would share that experience here.

WARNING: This blog is extremely long. It is probably my longest blog, ever. Heck, it's probably anyone's longest blog, ever. It's that long. You are hereby warned.

Flashback to September 5th, 2002.

It's a hot Friday afternoon. Ray and I just closed on our condo, our first together since we got married. I was due on September 10th, a Tuesday ,and no signs of my little girl were showing yet. My next appointment was at 4pm on my due date and as of my last one, things didn't seem to be anywhere near getting started. I was scheduled for an induction on September 21st if needed (which I am glad I wasn't still pregnant that much longer than I was). There was a lot to do at the condo, and I remember we had to wait a little bit to get the keys to the place. There was some issue with the seller's realtor or something. My memory fails me as to what it was exactly but I just remember having to wait until evening before I could start cleaning. Over the weekend, we cleaned and moved and I probably didn't rest much at all. I wanted to get Grace's room as ready as I could for her and get things as ready as I could in the rest of the house for us before she came. So that weekend, I was a busy little bee. I think we got a lot accomplished.

It's Monday, September 9th. Ray goes to work, and I'm home. I go out to run some errands in the afternoon, and this is where I begin to remember feeling very uncomfortable. I was in the parking lot of Doris' Italian Market. I am there to pick up some thinly sliced steak of some sort to make steak sandwiches for dinner and as I walk through the parking lot, I remember having to stop because I had a moment of being extremely uncomfortable. I can't say it was a contract because it didn't feel like the contractions I had later on, but I kept having these uncomfortable moments every so often while walking.

I get home from my errands, and I feel as though I need to use the bathroom badly, urgently, all out of no where. I am almost literally running in the door of the bathroom when all of a sudden, my pants are soaked. "Did I really just pee my pants?" I think to myself. I can't even believe it. I am perplexed by how this could have happened and have a fleeting thought that maybe my water broke. So, I call Ray's mom and ask her if my water were to break, would I start my contractions. I don't know the exact wording of my question, but it was vague. Vague enough to where she answered, "Yes," and vague enough that I just continued to think I peed my pants. (Make note for later that this was probably in the neighborhood of 3pm)

I would later realize that this even was my water breaking. And I would later realized that I had several "stupid" moments where I should have done totally different things but did very air-headed things instead. This was one of them. I should have totally called the dr's office and told them what happened. They would have had me drive over and see what happened. They would have then admitted me into the hospital and by Tuesday I would have me a baby girl.

Instead, I just cleaned up and changed and made dinner and went to bed. This would be the last time I would be able to sleep before having Grace 2 days later.

It's 7am-ish Tuesday morning, September 10th. Ray wakes up for work, and I wake up, too. He leaves, and I am hanging out at the house, and I start to realize I am having these pains coming and going, so I start to keep track of them. I can't recall what they were now, but they were pretty far apart still, and they are coming and coming and coming. The pain is noticeable but completely bearable and I remember thinking to myself, "I wonder what all the fuss is about? These are NOT that bad at all. I can totally do this." My original plan was to have a baby without medicine. I had went through years of extremely horrid menstrual cramps. I would be in unbearable pain for hours on end and medicine would never help once they started. They would get so bad, I would literally vomit, which is something I don't ever do, except in that situation. Years I went through this. These contractions- nothing compared to that. I could totally go through with my "no meds" plan. Or so I thought.

It's Tuesday evening/bedtime. Ray goes to sleep. I toss and turn. The contractions had gotten stronger and a little closer together. Earlier that evening, I went to my friend's house who was also a neighbor at the time, to heat up my rice sock I got from childbirth class in their microwave because we didn't have one to give me a little relief. I couldn't sleep. Not a wink. Stronger and closer my contractions came, when finally at about 4am (it is now Wednesday, Sept 11th) I told Ray I think I needed to go to the hospital. We got ready, called his parents and my mom and headed down. Around 5am I get triaged and they are asking me a million questions and I remember I can't answer them because I am in pain. They exam me and tell me I am only 1-2cm dilated and that I should leave and go walk for 2 hours and come back. Two hours? That's like an eternity when you're in pain. Ray and I go downstairs and try to walk. I decide that it hurts too much to walk and that we should go try to eat instead (yeah, not the best idea when you are in labor, I realize now but that's what I did). We finish breakfast and I walk some more. At 7:30am we head up so I can get checked out again. Still 1-2cm. Dang it. It hurts bad enough, you'd think I was ready to push. I can't remember if they told me to go walk for another couple of hours or what, but I think they did. At some point they told me to go to the mall and walk. I told Ray to just take me home instead., and granted, the hospital was over 25 miles and 35 mins highway driving from my house. but I wanted to go there anyway (another non-smart decision). I was tired and I wanted to try to sleep, as I have already been awake for over 24 hours now, and have been in labor for the same amount of time.

At home, I couldn't sleep, the pain was just too much. Finally we decided to go to Sawgrass, since it was about half way between our house and the hospital. We walked around Target, and I was trying my best to put on my poker face and try not to look like a pregnant lady in labor because I didn't want people freaking out and calling me an ambulance or something. I had an appt with my doctor at 4pm and I contemplated either keeping my appt or going back to the hospital (the office was in the bldg right next to the hospital, so I would essentially park in the same spot for either place). For some reason, I decided to go to the hospital instead and when I got checked again, I was told I am finally at 3 cm and they would admit me. After I am admitted, I am told to go walking around the halls. So I try to walk but it's really hard with the pain. I ask for pain meds, but was told that I had to be in a labor room for an epidural where I could be monitored and there were no rooms. It was so busy that day, they had beds in the hallway with partitions around them so patients had some sort of privacy. I was lucky to be sharing a small closet like room with 1 or 2 other patients so at least I wasn't in the hall.

Around 6pm or so, my doctor comes to see me after she finished up with her office patients. She tells me they are going to break my water and that she wasn't on call that night, instead the Nurse Midwife from the office was and she would tend to my delivery. There was another OB doc who was on call if I were to need a C-section.

A little while later, Midwife lady comes in to break my water and when she goes to do it, she asks me, "When did your water break? Why didn't you tell us?" I tell her that I have no idea when it broke and if I knew, I would have told them that. I don't think she believes me....something in her attitude and tone. Something blocks my brain and doesn't allow me to recall my peeing my pants 2 days prior (Yes it is now over 48 hours from when that happened, which is not good because anything over 24 hrs increases the risk of infection and we are now at double that). I am in the neighborhood of 5cm at this point. I REALLY REALLY want an epidural but I am told the same reason as earlier that I cannot have one. I don't remember at what point they gave me an IV med called Nubain (boy does that stuff make you loopy!!!!), but I think it was earlier because I remember it wearing off and I had asked for more and got some. I had about 30 second cat naps in between my excruciating contractions that I must say, were about a zillion times worse than my horrible menstrual cramps. Bad. Very bad. So bad in fact, that I think I might enjoy getting shot or something more than having contractions. Apparently, I was told that I was doing extremely well because there were people screaming all over the place, and I was not yelling or screaming or anything. Maybe moaning, but I was quiet. I was certainly screaming and yelling enough in my head. I do remember moving and squirming around in my bed and grabbing the bed rail as hard as I could squeeze it during my contractions.

During this time, I am extremely cold. Too cold, like something isn't right cold. I am shivering. I feel my forehead and it feels warm. I ask others to feel it and they agree. I tell the nurse that I have a fever. She leaves and comes back and takes my temp, and yes, I have a fever. My water has been broken for 2 days. Fever + 2 day broken water= possible infection. The nurse leaves and comes back with some IV antibiotics and I think some blankets.

At 11:30 pm, I am checked again and I am told that I am now at 8cm. All of a sudden, for the first time, I am in full blown freak out mode. I remembered in child birth class they talked about the transitional phase. This is where you go from 8-10 cm in a relatively quick time. Usually too fast to get an epidural at that point. I tell the midwife that I am very sorry, but if she doesn't find me a room and get me an epidural right then and there, that I would not push and have my baby. She needed to do something if she wanted me to do anything for her. Not 5 minutes later, she tells me that a room (magically) opened up and I would be going there right now. A few minutes after that, the anesthesiologist comes in. I am in the middle of a contraction when he wants me to sit on the edge of the bed and lean forward so he can get this epidural party started. I ask for a minute, and to my recollection, he tells me kind of rudely that if I don't do it now, I won't get one because he has other patients waiting for him. Now maybe he was sweet as pie, but for some reason I am remembering him to be not so nice and needing a little course in Bedside Manner 101.

They say that the epidural can take 15-20 mins before you start to feel it, but I swear to you as soon as he was done injecting my epidural space with the medicine, I no longer felt one single iota of pain from then on out. Immediately I went to sleep. I know I said earlier that Monday night was my last sleep until I had Grace. I won't really count this sleeping because I had to constantly be checked and it only lasted a little less than 3 hours, but I was out cold every time I had the chance to be in between all the poking and prodding they were doing.

At 2:30 am, the midwife comes in and tells me that I am no longer progressing. My cervix, which was at one point 100% effaced, is now swelling. I am still at 8cm and have no moved one bit (when I went from 3-8 in about 6 hrs time earlier and now I am not progressing at all). She says what I thought was that she "thinks" I should have a C-section. Because I thought she said "thinks" I try to convince her that I should try a little longer. Just give me another half an hour to see what happens. She tells me that I'm really not going to change anymore. I'm swelling, and that's not good for delivering a baby. It's best if we just proceed with a C-section.

I say Ok. I am calm. I just want to be done with this. It has now been 43 hours since my contractions have started and 43 hours since I have been able to have a solid rest. Let's go have a baby! Ray, I think, was a little concerned that I was about to have major surgery. Me, I was still loopy from all my meds. I am wheeled immediately into the OR and surgery is begun at almost the speed of light. I've never seen people move so quickly. Within like 20 mins of being told I need to have a C-section I was wheeled in, prepped, cut open, and Grace was born, which is now 2:49am. I think within 25 mins getting into the OR, I was totally stitched up and heading back to my room to recover.

Now here is where I look back and question things.
  1. From what I was told from my mom and Ray's mom, while I was in the room, sleeping, not feeling my contractions, they were waiting and watching my monitor. From what they could tell, each time I had a contraction, Grace's heart rate when down. I was never advised of any sort of problems with my labor. If she was having this decelerations in her heart rate, why wasn't I told?
  2. From what they thought, Ray's mom and my mom said there was another lady who had already been wheeled into the OR and apparently they got her out and brought me in so that I could be done first. Why not just do her and have me wait another 45 mins? I've been waiting 43 hours, what's another really? This just reinforces the fact to me that maybe there was an issue (see #1).
  3. I can't recall now, but I vaguely remember something being not so good with Grace's APGAR scores.
  4. I remember the nurse telling me they would take Grace for a bit bring her in about a half an hour to my room. After I got in my room, I fell asleep and didn't wake up for nearly 3 hours. When i woke up, I realized they never brought Grace in, so I had Ray go get the nurse (don't know why I didn't just use the call button) and they finally brought Grace in.
  5. Apparently, while I was sleeping, Ray's mom and my mom could see them, a small team of docs and nurses, maybe 4ish or so, working with Grace. Slapping the bottom of her foot, a long wire going into her nose (which I am thinking it was this suctioning type thing and not an intubation type thing, by the sound of it). This went on for a good 20 mins or so. So what was going? And why didn't they tell me?
For all I know, maybe everything was fine. It just seems a little strange.

At any rate, that is the story of Grace Elisabeth and her grand entrance to Earth (and I how I managed 40 out of 43 hours of labor with no epidural.)



Thursday, August 26, 2010

A few things to talk about.

  1. I have orientation in the hospital next week. Its a new hospital that I haven't been to yet. In my Peds class, this hospital was one of the options to go to, however, I ended up getting the one that was closer to my house. It works out well because I can pick the kids up on my way home and I won't have to go out of the way at all.
  2. I am finding this class extremely interesting and I really just can't wait for clinicals to start. I am still nervous about them, but I'm more excited.
  3. My teacher has said that on numerous occasions students have been the only person in the room with a patient and have had to basically deliver the baby- because we are NOT allowed to leave the patient to go get help- all we can do is call for help and they don't always get there in time. This is so awesome. Ok, so I am not really expecting this to actually happen to me or anyone I know, but man if it did...................
  4. I found out yesterday I won a scholarship I applied for. They will pay all of my tuition, give me extra money for books, supplies, and other costs, and I will also get a monthly stipend. All they ask is that I work for 2 years in a hospital, clinic, etc. that has a critical shortage of nurses. It can be anywhere in the U.S. and just about every place is critically short of nurses. Unofficial word is that there were 6400 applicants and 500 scholarships. Whoa! I'll keep you posted if I get more of an official word on those numbers. I'm so excited!
That's it for now. It's been a very busy, intense week of nothing but lectures (she wants to get as much info in about normal pregnancy, normal labor and delivery and normal newborn stuff before we start in the hospitals next week). I'm so glad I will have my 2 days off each week again starting next week.

Sunday, August 22, 2010

Tomorrow, Monday, begins the first day of OB. I can't tell you how excited I am for this rotation because this has been the area I have felt was of most interest to me. I have envisioned working on the floor for a while, getting my Bachelor's degree and then eventually making my way into a Master's level Certified Nurse Midwife (CNM) program with a dual degree as a Women's Health Nurse Practitioner (WHNP). Of course, this was all subject to change, and I could be a trauma nurse in the ER for the rest of my life. But if I had to guess, this is where I would end up. Now, I could love floor nursing and be there forever and never have to go another day of school again after graduation. I could possibly be forced to get my Bachelor's later on because of hospital politics and never see the light of day in a Master's program. Who knows. But tomorrow begins my journey of finding out whether this particular road is one I still want to possibly venture down in the future.

We'll see.

I am scared, nervous, and excited all rolled into one. This semester I will be doing tons of new things. The instructors will expect more of me. I will be starting IVs later this semester. I have to start thinking like a nurse and proving I can do so. This is my second to last semester. The game is officially stepping up.

It's funny. I get all nervous and afraid of clinicals sometimes, until I am actually IN clinical. Then, somehow, I have this barrier that shuts out the nervousness and I just do my thing. Like the time I had to do my first and only foley. I was sooooo scared. I was literally freaking out inside my head. Then it was time and I had to go and I just pretended like I knew what I was doing, (Ok so I knew what I was supposed to do, but actually doing it was a different story) and I just played it cool. Don't know how, but I did. And I hope to continue that throughout the rest of the program.

Anyway, off to finish some reading for tomorrow and get to bed.

Finally the class I have been looking forward to since I decided to start this journey. Can't wait!

Tuesday, July 6, 2010

After my psych final, I left nearly right away to go on vacation. I just got back Saturday so I figured I would give a little update on things.

I was hoping for an 85, but I ended up with an 81 instead. It didn't earn me the B that I thought would be no problem to earn, but I passed. I passed another nursing course. I have passed five so far. Five more than I thought I would pass when I first started the program nearly a year ago. Four courses left. I am amazed, to say the least.

But now, the hard part begins. Well, first is the part I have waited for since the beginning. I had always had an interest, a main interest, in Labor and Delivery. My next rotation is OB. I am BEYOND excited. It is my last specialty course, my sixth nursing course, the beginning of my fourth semester. I am excited and I am nervous. There is a lot of information (although that can be said for any of the courses, really). I am always overwhelmed by the amount of information I need to know at the beginning. It's overwhelming to look at, but as I progress through the course, I learn, my confidence grows, and I get through it. At any rate, I more excited than anything else.

August 23rd begins the beginning of the end. The homeward stretch. A little over eight months until graduation. Wow. It seemed like just yesterday I was still taking my pre-reqs and had two years to go, at least. I'm getting closer, and that's really strange.

So after OB, which will be from August-October, it's Ortho/Neuro which is October-December. After my three week winter break, I will begin my final semester taking Cardio. I will have Spring Break for one-two weeks and then I will have my final course we call Trends (it's basically my preceptorship).

So now, I am on summer break. I am taking a non-nursing class that I need to graduate online. I am hoping to get everything done soon so that I can focus on spending all my time with the kids. I have some things I need to do around the house and I also would like to start reading ahead for OB.

So that's all for now. I won't be posting anything until after August 23rd since there really isn't anything to post about with school on break. See you soon!

Monday, June 7, 2010

I got an 82.

I don't know how I did it, but I did it. There definitely had to be some Divine intervention because when I walked out of that exam, I really felt like it didn't go well. AT ALL. I felt way better about the first exam, and ended up with an 82, so I was convinced that this didn't bode well. I thought that there was no way I had gotten anything higher than a 78 at the very most. But I got an 82. I was stunned.

From what I have heard so far, 83 seems to be the highest exam grade, and that was from a guy who got a 92 on the first exam. Other people who did really well on the first exam saw significant drops in their grades on this exam, and even people who didn't do well on the first exam saw them as well. I stayed the same. I just can't even believe it. This was a hard exam.

It's amazing how an 82 can seem mediocre one minute and make you feel like you're intelligent the next. That's just how I roll, I guess.

I had my first clinical last Thursday, and I have to say, it was very interesting. All we're supposed to do is walk around and talk to patients all day and attend group therapy meetings with them. We have learned a little bit about"how" we are supposed to talk to the patients, but to actually talk that way is another story. It's pretty hard trying to think ahead in your brain, figuring out what you should be saying next while you are trying to listen at the same time and not seem distracted. It's also hard to talk to people about "difficult" topics, such as suicide, which is what I had to talk with one of my patients about. I was on the more difficult unit. There are two. One with patients who are less aggressive and with mood disorders such as depression. The other unit is patients with psychosis (break with reality), which consists of mostly schizophrenic patients. We did have a bipolar person and a couple of depressed patients because the calmer unit was full. But I have to say the experience was very interesting, and very sad.

Its hard for me to deal with schizophrenia. After learning about the disease, I've learned that the onset of this disease is usually late adolescence to early adulthood; most commonly, college-aged students. Because this disease has NO cure, and a lot of the patients are not responsive to treatments, I find it hard to see these young people, with their whole lives ahead of them, succumb to a disease where they live their life outside of reality, engaging in constant, daily battles with their hallucinations and delusions......to live like that for the rest of your life......it's just hard for me. It makes me very sad.

But, the disease is very interesting, and I actually have a neighbor who lives in my building who has some type of schizophrenia. I like learning about it. I just don't like seeing it in real life.

Whoa. That got deep for a minute.

Anyway, Psych is going well so far. I am learning a lot and its very interesting, but I don't think this is the type of nursing I see myself doing. It seemed like all the nurses did all day was chart. While as my past rotations have shown me that a nurse is constantly charting, it seems like there was a lot more interaction with the patients. Now it's not like they don't ever interact with the patients, and it's not like there isn't anyone talking to the patients all day. There are techs walking around constantly talking to the patients and whatnot, but it just seems like the nurses do nothing but charting.

Well, that's all for today. Stay tuned. Clinical #2 coming up this Thursday. 2 weeks of school left and then it's summer break!! Woo hoo.

Friday, May 21, 2010

Two weeks into my six week Nursing Psych class and there isn't a whole lot to report. My hospital clinical time doesn't begin until June, and I have only 3 hospital clinical days, so there hasn't been anything to report about there. My first exam was today, so until now, there just hasn't been much to talk about.

I had thought that I studied pretty well for this test, so I was a little taken aback to see that I got an 82. An 82 is considered a C (83-91 is a B, 92-100 is an A). While this is still a decent grade, I am nervous because the second test is supposed to be more difficult than the first, and in order to get a B in the class I will need to get an 83 and 84 on the next two exams or some combination of
167 points within the next 2 exams. The good news is that I need a minimum of 68 on the next two exams to pass, which I think I could pull off.

Clinical begins June 3rd and my next exam is June 7th. So look for more updates then. Only a little over 4 more weeks until summer break. Can't wait!!

Friday, May 7, 2010

begins.

Today I sent out my scholarship package to the U.S. Department of Health and Human Services for the Health Resources and Services Administration's Nursing Scholarship Program. According to their website, the program is competitive and there are usually a lot of applicants:
EXPECTED NUMBER OF AWARDS
The NSP for the 2010-2011 school year is expected to be very competitive. The Program anticipates more applicants for scholarship awards than there are funds available. It is expected that 500 awards will be made for the 2010 – 2011 school year.


PAST AWARDS
In FY 2009, NSP received 425 eligible applications and made 189 initial awards and 15 continuation awards.
In FY 2008, NSP received 340 eligible applications and made 169 initial awards and 5 continuation awards.

If selected, I would find out by July 31. If not, I should hear something concrete by September 30. I suppose that is in case those who are selected either turn down the scholarship or do not provide their additional documentation in time.

Today I also completed my online application for the Tylenol Scholarship Program. If selected, I should hear something by July 15th.

It looks like the month of July will be a test to my patience, well at least the last 2 weeks of July anyway.

And so the waiting game begins.

Monday, May 3, 2010

now officially over! It was fun while it lasted, but it is over none-the-less.

Today was the final. I studied hard and at times I probably hardly studied. I made some big mistakes during my second test that ended up costing me my B for the class. But I am proud to say that I got an 86 on my final, which is a B and is very good, especially since the grades I've been hearing coming back have been a 90, an 88, another 86, an 85, an 84, an 82, an 80 and a 78. So overall I did very well. And while I didn't actually get a B, I can know that I have "B" knowledge in my brain. I just have to remember how to use it sometimes.

I have a week off and then psych begins. It's summer term now, which means the class is a little shorter; only 6 weeks. But then....oh my.....after this next 6 weeks I will begin my long awaited 2 month long summer break. TWO MONTHS OFF! Only 7 weeks and counting.........

Saturday, April 24, 2010

My Peds clinical days ended abruptly on Wednesday during post-conference when my instructor advised us that it would be our last day in the hospital. You see, next Wednesday was supposed to be our last day in the hospital, but apparently JCAHO, the Joint Commission on Accreditation of Healthcare Organizations, will be in the hospital checking things out. And apparently, the hospitals don't want students around (for good reasons, and its not just this hospital.....some of the other Peds clinical groups at another hospital had the same issue). So instead I have to meet at school and watch a few videos. While I am happy to be out next Wednesday by 1pm instead of 6pm, I feel a bit jipped that that could have been my very last pediatric experience ever, and I didn't even know it until it was over. I was actually looking forward to another hospital day, and while watching movies is great and all, you just don't get the same learning experience as you would in real life. Everything is always different in real life.

And so there it is. My Peds clinical days are over. I'm still not sure of the role Peds may have in my future, but it still is a contender. I still have a year of rotations to figure it out. But for now, my Peds final is in 9 days, in 16 days Psych begins, and in just over 8 weeks I will begin my long awaited and definitely needed 2 month summer vacation. I'm almost half-way there!

Saturday, April 17, 2010

It's not something I like to include as part of my vocabulary. It's something I had hoped to completely elude during my nursing school journey. I had seen so many people fail exams, and subsequently fail the classes and I did not ever want to be a part of that group. Unfortunately, I am a part of the group.

I have officially failed my first nursing exam. 11 exams down, 16 more to go. 10 passed, 1 failed. Sigh.

Passing is 73 or higher and I scored a measly 70. Wow. I'm not sure I even have words.

Now, the upside to all of this is that I am still passing my class. In fact, I only need a 65 on the final to pass and apparently, according to the teacher, the next test is supposed to be easier. She has said that the first and last exams people tend to do well on while the second test is supposed to be the zinger. A zinger it was.

Just about everyone had a drop in their grades; some more than others. I can count on two hands the number of people I talk to regularly that failed. I haven't even talked to everyone yet, either. Its going to be an interesting Monday.

I will admit that I am being hard on myself. I know that it's not the end of the world and that best of all, I am still passing. It could be worse. It could be a lot worse. But I know that I can do better and that is why I am so upset. I should have done better. I can think of 6 or 7 or 8 mistakes at least, that should have been correct answers. I don't like to make excuses, but I can't help but think that maybe this had something to do with not getting much sleep the night before. I had went to bed at almost 2am, then woke up at 5am because my poor Nate had a bad dream and then after getting back to sleep at 5:20am, I got out of bed at around 6:15am after hitting the snooze every 5 minutes since 5:45am. So essentially, I had about 3 hours of sleep. Not a good night's sleep the night before an exam. Heck, not a good night's sleep for anything. But like I said, I don't want to to try to make excuses. I made some stupid mistakes and I hope that I have learned enough from them to not repeat them again.

So here I am, dusting myself off and moving forward. I'm admittedly not the best student in the world, but it's gotten me this far. I am going to try my hardest to study as much as I can over the next 2 weeks. I am studying for a 95 on my final. That would earn me a B for the class. Is it possible to get a 95? Yes. Is it probable? No. But if I don't try for a 95, then I certainly won't get a 95. And at the very least, I will pass Peds.

Thursday, April 1, 2010

My clinical yesterday was pretty uneventful. I had 2 patients: a 2 year old boy with asthma and pneumonia (in both lungs) and an 11 year old girl with stomach issues. (sadly, the 11 year old is probably 4 inches taller than me) While I was at lunch, my 11 year old got discharged and was on her way home. Ironically, it seemed that I had more down time with 2 patients then the previous week with 1. at any rate, I find it funny that right before clinicals, I find myself dreading going. I'm not sure why, but I do. I don't know if its the fact that I can't just stay home and hang out, or if its a fear of what the day may bring. But I find once I walk through the hospital doors, I am fine. There really wasn't much going on with my patients except that my 2 year old had to be on constant oxygen via a mask otherwise his oxygen saturation levels would drop below normal levels. They were watching him and repeating tests to decide whether or not to move him into PICU (pediatric intensive care unit). As of when I left the floor last night, he was not going to be moved to PICU.

In other news, I found out from some friends who have my lecture teacher as their clinical instructor that the highest grade in the class was a 90, which is also a B. And after talking to others, it seems that mostly people scored in the high 70's, low 80's. I know someone who got an 89, 2 people that got an 86, one person who got an 85 and then two other people who got an 84 like me. We have about 55 people in our class, so I suppose this means the test was hard if the scores are as they were??? Not sure. But I am still proud, and relieved, that I got a B. Now I am just working on trying (since I haven't started yet) to study ahead of time for my next test. I really slacked off with the first one and I didn't really look over any of my notes until the last few days. I heard the second test is more difficult than the first, and I certainly don't want to lose my B.

Monday, March 29, 2010

So I took my first Peds exam today, and boy, did the day not start out right. We had one of the worst storms this morning, and while I love thunderstorms, I do not love having to go out in them. I woke up at 6:30am to go over some of my notes and it was already going. Pouring like crazy. Thundering like crazy. Lightning like crazy. Roads flooded. Just insane. Good thing was the kids spent the night at Grandma and Grandpa's. Grace is on Spring break and it would not have been a fun morning trying to get them Grandma and Grandpa's dry. Luckily, by rolling up my pants, carrying my flip flops, bringing a towel and having an umbrella, I didn't get too wet. It wasn't such a pretty sight at school for some others, though. One girl was in the bathroom, socks and shoes off, wringing out her socks. People were soaked left and right, mostly because the parking lot was flooded like I've never seen before. Just crazy. And there was a tornado close by this morning, too, on top of it all.

So, we're sitting in class waiting for the teacher to come in with the exams. There's a lady who comes in on Mondays who is doing her preceptorship to become a Nurse Practitioner. She came in with the exams along with the teacher who teaches Cardio (that class I will take as my second to last class) and advised us that our teacher would not be in today because she is sick. She said she would grade the tests and bring them to our teacher later tonight. Ok, so we have to wait longer than expected. We took the test, met in the hallway after as we so commonly do to compare answers and then headed home. I wasn't sure how I felt about the test exactly. It certainly wasn't easy but it didn't seem super hard either. Well about 7pm I decided to check my grade and there it was. An 84. A "B". I was so excited. I am beyond thrilled. I sooooo want a B in this class. I just have to get at least an 82 one one and an 83 on the other to get my B.

So there you have it. My first B in peds. Now I have 2 projects to work on, 2 exams left, and 4 more clinical days to complete. Next up: clinical on Wednesday.

Thursday, March 25, 2010

Yesterday was my first Peds clinical in the hospital. We had 2 campus lab days already, but yesterday was the first actual day in the hospital. We started off at pre-conference, where we meet, talk about the day ahead and anything else that needs addressing and then get our assignments. Our instructor had us go around the room and say our name and if we had any children of or own or any experience with children. We actually don't know more than half of our class because in specialty classes, we are mixed with different graduating classes. This is my class's first specialty. The class that started the semester before us is on their third specialty. When I start my third specialty in the fall, we will be with the class that started the semester after us. (Then for the last three courses, I will be back with my graduating class again.) After that, she talked a little bit about some things she expected of us. Then she handed out our assignments. I was assigned a 7 month old boy who was having fevers, gastro issues, and of all things, gallstones. Yes, he did in fact have gallstones, confirmed by u/s. How that happened, I have no idea. Anyway, he was a pretty easing going child. We are allowed to do axillary temps (under the arm) in kids under 4 unless you get a reading over 99. At 8am, his temp was fine, but at 12 his temp was taken and it went up to 101.8 axillary. Now I had to take it rectally. But I have never done it rectally. So, I had to enlist the help of the PCA to assist me (the instructor told us that if we have never done it before, have someone help). Yes, after two kids I have never taken a rectal temp. I prefer the mom method of chin to forehead temp checking. I know thats not a reliable method.....I have always done that to see if they felt warm, and then used the ear thermometer (although at first with Grace I did the axillary route for a while). I used the same brand my pediatricians office uses- so I assumed it was fine to check that way, and would always confirm the fever. Eventually, I upgraded to a temporal scanner thermometer, and that was more accurate than my ear thermometer, until it was dropped on the floor by one of the kids and has never worked right since. Now they are old enough to do oral temps, so thats what we do. I have always found that even though the ear was inaccurate, it was always on the lower side and not the higher side. And the only time I've ever dealt with an extremely high temperature was when Grace had strep throat. But she didn't have any symptoms of being sick, was not acting sick at all, and the only way I even knew to take her temp was because we were changing to go to swim class and she was the hottest I had ever felt a person to be. Her ear temp was 104. I didn't even call the pediatrician, I just hopped in the car and took her straight there. Sure enough, the doctor looked in her throat and was amazed that it didn't hurt her because he said it was a mess.

Wow that was a tangent if I ever saw one.

So anyway. I assisted the PCA with the first rectal temp. And man, are babies who are getting rectal temps squirmy. Now I know why I never opted for this route. Once the kids run a fever and get meds for the fever, we have to recheck the temp in about an hour. Which meant I needed to recheck the temp. Rectally. Sigh. I tried my best to hold down the little squirmy baby, but I don't think I did the best job. He squirmed quite a bit, but I could tell he was cooler and the thermometer didn't get nearly as high as it did earlier. Actually earlier, it almost immediately went to 102 within a few seconds, and now it was barely reaching 101 the entire time I was trying. An hour or so later, it was time for 4 pm vital signs and his axillary temp was way down.

It was a pretty uneventful day otherwise. There was one thing though that really bothered me. Actually, it bothered just about all of us, and especially us with kids. There was a 6 month old little girl who was in for an infection in her toe. She was alone. I tried as hard as I could in my head to give the benefit of the doubt, but at the end of the day, I just got mad. And sad. One of my classmates was taking care of her, and fed her around 11:45am and then the parents showed up. Then at 4 or 4:30 they left. They didn't bring her clothes. Or toys. And they didn't feed her the entire time they were there, saying that she was sleeping when other students had seen her awake in their lap in the chair. And then they said they wouldn't be back until tomorrow. Sigh. Seriously? I get that people have jobs or extenuating circumstances or whatever. But you can at least sleep at the hospital, right? And then the mom comes in all done up....her hair, her makeup, her clothes. She obviously had time to take care of that. I will stop there. I can't say more without getting angry. Poor baby. We left the floor at 5 and the unit secretary had the student nurse put the baby in the stroller to keep with her at the nurse's station because otherwise the baby would be alone. The nurse's have about 4 patients each to take care of, so its nearly impossible for someone to just sit with her in her room. The best that could have been done was to check on her often. At least the baby was able to be at the nurse's station for a bit. I couldn't help but think of her today.

So that was my first Peds day. The jury is still out on whether or not Peds is for me. There's still 4 more clinical days to try to figure it out. Stay tuned......first exam is Monday. Oh boy, I am so unprepared........

Wednesday, March 3, 2010

So Wednesday was my last clinical for GIGU. It was a light day, starting at 8am for pre-conference and 8:30am on the floor and then leaving the floor at about 1pm for post-conference and our final evaluations. I was given two patients. One was older, having gastrointestinal issues and getting ready to have some tests done. My other patient was younger, nearly 60, in with an infection in her leg. About sometime late morning, I stopped in the latter patient's room to check on her. After talking to her for several minutes, she started to cry. She was tired of being sick- this was the seventh surgery and she's kept getting recurrent infections in her leg. She was just worn down from it all because its affected her physically and understandably so. I spoke to her with comforting words, or what I thought might be comforting because I really didn't know what to say exactly. Whatever I said worked, and she pulled herself together and I was glad because I felt like for the first time I could see the fruits of my labor. I could see that what I am doing IS helping and IS somehow making a difference, even if only for a few minutes.

I didn't realize that last part until one of my instructors brought up something else I did that day in our post conference. Another patient, not mine but another classmate's, was getting a chest tube put in (more about that in a minute). Both the doctor and the patient allowed us to watch, and so next the bedside we stood. As the doctor was finally putting the chest tube in, I started rubbing the patient's arm to give him some sort of comfort. It wasn't much, but as my instructor put it, it shows the patient that we are there, and that we are giving them support and are comforting them.

When we were getting off the floor, I spoke with my nurse and then went and told the patients I was leaving. My second patient stood up and gave me a hug and thanked me for being there when she needed someone to talk to. It was the first real time that I was with a patient and started to tear up. It felt good to know she felt better. It was definitely a good day.

Now about the chest tube- there was a patient on the floor who had a lot of fluid accumulating in his chest, so the doctor decided to put in a chest tube. I cannot even begin to tell you how excited I was to watch one of these for the first time in real life. Aside from that, I actually got to hold the tube for the doctor, open it for him and give it to him. I know its not much, but it was something, and a lot of doctors aren't nice enough to even do that. But man, was it cool.

So now its Spring Break and Peds begins in a week. I am really excited and can't wait for it to begin. Until then.........

Tuesday, March 2, 2010

So, after leaving my exam, I felt pretty good about it. I actually felt like I knew a good amount of the info and I felt like I at least did better than my last 2 exams. I needed a 92 on the final to get a B for my class and I only needed 63 to pass. I did really well, but not well enough to get a B. I got 85 and while I didn't get a B, I am very proud of my final grade. I changed up a little of my studying, and while I did slack a bit at the start of the content for this last exam, I did work hard at the end. Also, I think it helped a little that this class had some very interesting topics, such as Diabetes and Endocrine disorders, both of which I really like.

At any rate, I am thankful to have passed and move on to my next course- Peds.

On another note, I have applied for a hospital scholarship, which essentially means that if I get it, they will give me money for school and I agree to work for them for 2 years after I graduate. There were 3 different hospital scholarships- each from a different hospital organization. There was one organization that I REALLY want to work for, so I applied for only that one and not the others. You can increase your chances of getting a hospital scholarship by applying to all 3. This is because we have 3 campuses, all with roughly an average of 50 people at each campus. There are only 10 spots for each hospital scholarship total, not per campus, so it is fairly competitive. Anyway, I really didn't want to get stuck getting a scholarship for a hospital organization that I really didn't want to work for, so I applied for the one and am hoping for the best. I think we may start getting calls for interviews pretty soon, so I will keep you posted as soon as I hear anything. I think we might even know by April sometime if we are recipient of a scholarship.

Speaking of scholarships, I will be applying for one in April that is REALLY cool. Its a government based one, I believe, that pays for school and gives you a monthly stipend on top of it. The only thing they want is for you to work in a hospital that has a shortage for 2 years, and that can be anywhere in the country. However, this one is EXTREMELY competitive. There was around 180 people selected and about 5,000 people applied, so that tells you just about how competitive this scholarship is. 3.6% of the applicatants received a scholarship. Can you say, "Slim Chance?"

Tomorrow is my last clinical and my final evaluation. We have a short hospital day and then we will be meeting to complete the evaluations, and then Spring Break will officially begin!

Monday, March 1, 2010

Today is my final for GI/GU and man, I am soooooo very glad its over. My professor, while a PhD, is not the greatest teacher in the world. The content was interesting, though, since we learned a lot about the kidneys and the endocrine system, both of which I really like a lot. But up next is Peds, and I am EXTREMELY excited about this. Two out of our three specialty rotations are areas I have had great interest in and am very excited to see if I am still interested in them once class begins. So from March until the beginning of May its Peds time. Then from May to Mid-June I will be taking Psych, something I am not so interested in. In the fall I start OB, and out of everything, I am most excited about that rotation.

Even more exciting? Once I finish Psych, I am over half-way done! Can you believe that? Its really flying by. Well I am off to bed, because its actually 1am and my final is in 12 hrs. G' night!

Sunday, February 21, 2010

Sometimes it sounds like a long way away still. But when I look back at where I was a year ago, I can't believe how fast it went. A year from now, I will be getting ready for Spring Break and getting ready to take my last nursing course of this program. It seems so far away, yet so close. The feeling sometimes overwhelms me. I have waited so long to begin this journey, and sometimes I wonder, when listening to my instructors rattle off their knowledge, will I ever know that much information? Will I ever be able to really think like a nurse. It seems like an unreachable feat, but I also know it comes with the territory.

I remember starting Anatomy and Physiology class. I skimmed my book to see what I would be learning by the end of the class and was so overwhelmed at the fact that I was supposed to know ALL the bones and muscles in the body. How would I ever know all that? It didn't seem possible at the time, but by the end of that class, I aced my lab and had the highest grade in my lab class. I knew those bones and muscles backwards and forwards. I know I still have tons more to learn and that's only to complete THIS program. My instructors have years of nursing experience plus they have Master's degrees in nursing. Of course I don't know as much as them and I shouldn't be discouraged by their knowledge either. Sometimes, though, it just seems like a never-ending journey. But, you know what? It really is. A nurse is always learning, always a student. And just when you start to feel comfortable, its time for a change. Good thing I still have a lot to learn. And in a year from now, I will have a whole new set of things to learn.

Thursday, February 18, 2010

Well, exam #2 came and went. I once again did not do as well as I had hoped, but I am very pleased that I did the same as my first exam because it seems that everyone else's grades went down from their first exam grade. I got a 78. Same exact grade exam 1. Stayed the same. And I passed. I now only need a 63 to pass, which takes a lot of pressure off of me for the final. If I want a B in the class, however, I will need a 93 and I believe that may be nearly impossible. I am slowly coming to terms that I will be getting C's in nursing school. Sigh.

Clinicals are going well. The last two weeks I have been getting 2 patients to take care of. I did my first IV push medicine the other day- a medicine that is injected into the IV line of a patient through a syringe. For the most part, I have just been doing things I have already done. I'm liking the rotation more now, mostly because I have been working with great nurses on the floor and we seem to have a pretty good group of students in my clinical group. I also like my instructors. The head instructor (I'll call her this because its her group and she is training the other instructor who is new to the school) is VERY smart and really knows her stuff. She asks a lot of GREAT questions to get you thinking. However, with some of the students, I think she can be short and snippy with, and I think a lot of the others are intimidated by the fact that she asks tough questions. I think she means well and that she isn't trying to be intimidating, and I try not to take it personally, but I think some of the others do. I like the fact that she gets me thinking and I hope to be able to be as knowledgeable as she is one day. Right now, I have no idea how I will ever know half of what she does.

As of now, I have two lectures left, two clinical days left and one day for my final exam. This course is winding down and I am glad to have made it through my third nursing course. In a week and a half, I will be one third of the way done with my program. 33% complete. I can't believe it. By summer, I will be over half way done. Its going by fast.

Wednesday, February 3, 2010

I've been completely busy with studying, clinicals, and assignments that have been due. I have a week until my second exam, and I am coming close to being done with all of my assignments, but I will continue to stay busy for the next few weeks until this course comes to an end.

Clinicals have been going well. Right now we have been taken care of one patient, but starting next week we will have 2. By the end, I will be taking care of 3-4 patients, so we gradually work our way up. Yesterday, I got to insert my very first foley catheter on a patient. It didn't go as smoothly as I had rehearsed in my head a hundred times before, and when my instructor asked me how I thought it went afterward, I said I would give myself about a 6 out of 10. My instructor disagreed. She said I had a very difficult patient, it was my first time, I knew all the steps I needed to do, I did NOT contaminate my sterile field (this is a VERY sterile procedure, by the way), and I looked confident and stayed calm despite the circumstances, including the patient saying we needed to hurry up because she was getting nauseous again. She said that should would have given me an 8 or 9 out of 10 and that I did a really great job. She also said out of the 16 students my instructors have between their 2 clinical groups, I will probably be the only one with the chance to insert one since they're pretty hard to come by up on the floors. Usually these are more commonly done in the ER.

Today, which is not a normal clinical day for me, I had to come in special for observation in the Endoscopy suite. Endoscopy is a scope that is inserted down the throat and can go to the lungs (bronchoscopy), stomach (gastroscopy), etc and has a camera at the end to see whats going on. I observed two cases and a fellow student observed two. The first one I observed was a bronchoscopy with fluoroscopy (an imaging technique that uses an xray and a fluorescent screen) and a biopsy of the lung. The second case I observed was a gastroscopy. Both patients were under general anesthesia. The first case, the patient was also intubated. On the second case, it was a nurse anesthetist, and she was really nice and really encouraging towards the field of nurse anesthesia. This is something I had an interest in before, but found myself gravitating away from, mostly because I have felt like I would never be able to achieve this goal. At this point, it really is too early to consider it as an option, but its also too early to disregard it as well. We will see what the future holds in that regard, but it was nice to see someone encouraging rather than discouraging, and friendly none-the-less. The doctor on the second case was especially friendly and extremely helpful in the fact that as he did the whole procedure, he explained everything that we saw from the moment the procedure started until it ended. He also joked with the staff and it was a breath of fresh air to see that not all doctors are uptight and egotistical (no offense, John. You're not uptight or egotistical either!!). It renewed my sense that there are caring doctors out there, which really seem to be few and far between nowadays. All the staff in the endo suite were really helpful and I really enjoyed my time there.

After I observed those two cases, I had to switch with my classmate so she could observe some cases before the suite closed up. So we switched places and I got to go to same day surgery recovery. I saw a few discharges and also checked the vitals on a patient receiving an outpatient blood transfusion. The staff there was very helpful and friendly as well.

We have 4 more clinical days left of this rotation. I really like my clinical instructors and the 7 people in my group. I've been very lucky to have a great group of people each rotation so far. We'll see what the next 4 days bring.

Wednesday, January 27, 2010

I got a 78. Not my proudest moment ever, but I passed. I can't help but feel completely unintelligent when I do not do well on exams. One down, two more to go.

Monday, January 25, 2010

*****It was brought to my attention by my husband that my post sounded more harsh than I had intended, so I thought I would clear the air. I was not a racist person, I just had SOME prejudices regarding a specific group of people. I did not hate anyone, I did not ignore people, I was not rude to anyone. I just had some general ideas about who they were. My ideas have since changed.

It has been 12 days since the 7.0 magnitude earthquake that hit and devastated Haiti and the story still rocks me. I still cannot begin to comprehend or even wrap my head around what the situation is there in the country of Haiti, nor what the people there are going through right now. It brings me to tears every time I think about it.

Living in south Florida, we have a very large Haitian population here. I have to admit, in the past, I hadn't been so happy with that fact. I will also admit that I had been very closed-minded and stereotypical towards those from Haiti, but since starting nursing school I have grown more and more empathetic and less judgmental.

One of those contributing factors was talking to a guy I will call E. E was a man of very small and thin stature. He worked full time in addition to attending nursing school. We were talking after our very first exam, of which he had failed, and he was trying to make sense of it. Here he was, studying while working, jeopardizing his job to pass a test, and yet, he did not do so. What was he going to do now? This conversation really opened up my eyes and I felt so much for this man. He was a hard worker and he wanted to make a better life for himself and that dream was being pushed further and further away from reality. I had seen it happen with others, too, who were just as hard of workers missing their dreams. I looked at these people with a different outlook, and for the first time in a long time, I was letting go of my prejudices.

Now, here we are 12 days past this horrific event and I just can't help wanting to help. There are a good deal of Haitian people in my nursing school. Everyone that I have talked to knows someone who is missing or dead and everyone they know does as well. This is something that is effecting so many people and I feel so helpless.

I wish there was something I could. I wish I can go there to help. This is a time when being a nurse already would have been really helpful.

Whenever there was an event where people were needed to help, I have always wanted to, but I've never been qualified to. So I have always sat and watched from the side. As I get closer to becoming a trained professional, I find myself really wishing I was already a nurse so I can jet off to Haiti to help. The question is, if I was a nurse already, would I? If I was single, yes, without a doubt. But I am not. I have a husband and 2 young kids and a wonderful family. Maybe I wouldn't go, because that would not be best for our family. That's obviously a bridge that hasn't been crossed yet and won't be crossed for a while still.

The feeling, however, almost overwhelms me.

This is exactly why I wanted to become a nurse. I want to help others. I want to make a difference.
 
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