Investing

Today I invested in a new stethoscope. The one I originally had through nursing school was a Littmann lightweight (which I know you are probably not sure what that is), which is pretty basic as far as Littmann stethoscopes go. I have a hard time hearing with them and thought since I will be working in the ER, it might be nice that I have a stethoscope that works really well.

So I invested in a nice stethoscope that cost about 3 times as much as my first one. But I'm ok with that. Also, I had a little help from Ray's mom and dad and sister, Katie and her husband Eddie as they gave me some money for Christmas to go towards it. So if any of you are reading this- THANK YOU SO MUCH!

I have a few odds and ends to still pick up to complete my collection of "tools" and I have to do some scrub shopping in order to be completely ready for next Wednesday. It is slowly approaching. And just as I have said a few times before and will probably say a few more times, I am excited and nervous and anxious and scared and ecstatic and other words that I can't just put into writing. I feel as if its still so surreal since I am not yet on the floor, but that soon will come to an end. Only 9 days left!

Until then........

Priceless

ACLS Course: $200
PALS Course: $220
TNCC Course: $300
Critical Care Course: $650
Stroke Certification: $0
Triage Course: $600
Getting all this education in preparation for my job as an ER Nurse: Priceless

Trauma Nurse Course

is complete! And I now have my trauma nurse card. I had a written exam as well as a practical skills test where I had to perform a complete trauma assessment.

And I passed!

So now I:
am ACLS certified (advanced cardiac life support)
am PALS certified (pediatric advanced life support)
am CPI certified (crisis prevention intervention)
am Stroke certified
am TNCC certified (trauma nurse core course)
have completed an EKG course
have completed a triage training course
have completed a critical care orientation course

I was due to begin my official ER journey next Monday, the 26th. However, the program director offered us, from corporate, a week or two off since we ended our course around the holidays. I opted in for this deal, even though it is without pay, so that I can spend time with the kiddos and family for the holidays. I did have Christmas Eve and Christmas Day both off, but now I will have off from this Saturday until the kids go back to school on the 4th. At that point, I will begin my days as a real ER nurse.

It still seems so surreal.

TNCC Day 1

Today was interesting but VERY long. I was at work, in a classroom, from 7:30am until 5:30pm. To spare you all the details of what I learned, I will say I learned how to do a trauma assessment, how to stabilize a patient's neck in case they have a cervical spine (c-spine) injury, how to remove a helmet from a patient who may have a c-spine injury and then put a c-collar (to keep their neck stabilized) on them and get them onto a backboard without compromising the possible injury. We learned a lot of different things about trauma. It was really interesting (yes I know I said this already). :)

Next Monday we have another TNCC class and we will be testing that day as well- a written exam as well as a skills demonstration.

Tomorrow I learn how to talk to aggressive people/patients and try to talk them into calmness. Yikes! I hope if I ever need to use this skill in real life that it will work!

Trauma Hawk Day

This week we visited the Trauma Hawk- (helicopter that transports very sick, very injured patients to the hospitals.) There we sat in a classroom and had a short lecture on mass cassualty triage (how to quickly assess a large number of injured patients). Then we had a tour of the facility and the helicopter. After lunch, we had a lecture on decon procedures (decontamination) which included practicing getting suited up (see the first pic below). It was a fun day and we still learned a lot.

This week I am working on my trauma nurse certification, stroke certification, crisis prevention intervention training and triage training. Next week we are finishing up the trauma certification and we may be doing pediatric trauma training but that part is up in the air. We should find out this week if that course is going to happen. Then I have my final test on the 23rd, and then classroom training portion of my program is over. Two weeks left!

Here are some more pics from our trauma hawk day:

Here is me and the other 3 people from my hospital in the training

programwith the Flight RN-Paramedic (middle). The guy on the left is in

our program, too, but another hospital. He just jumped in the pic

Me. In a flight helmet.

The 4 of us from my hospital with the helicopter

PALS

For the last two days, I've been taking my PALS certification course. PALS is Pediatric Advanced Life Support. Today I took my written test and my skills test and I am officially PALS certified!

Something REALLY cool that I have never learned how to do before, although I am certainly NOT remotely even comfortable doing since I have no practice-

Intraosseous (IO) access. What is that? Its like an IV, but instead of into a vein it is into the bone.

Pretty hardcore.

Not that I'd really want to have to do one, but I think being able to do them, and do them well, would be pretty awesome.

Anyway, tomorrow is a day at the Trauma Hawk. We're going to be taking a tour, getting to see the trauma helicopter, and also be doing some Hazmat stuff. We're doing almost everything we need to be certified in that, too, but since we are not doing one component, we can't get officially certified in it. At any rate, it will be really interesting to learn.

I'm still amazed at all the stuff I've learned so far. Amazed at all the stuff I didn't realize I didn't know. Amazed at how much nursing school DIDN'T teach me.

One of my most favorite things I've learned so far- which is kind of strange because it's one of the most terrible things to happen to someone?

Shock.

It just fascinates me. The whole body- the way it works, they way it compensates when it doesn't work, the way one little thing can throw it all out of whack- it's all just amazing. I wish I could put it into the proper words to really explain it, but I'm not that good at explaining.

Anyway......

I can't wait to get on the floor. I'm excited.

I'm also terrified.

2 1/2 weeks!

Tomorrow

I have one of my big tests for the Emergency Nurse Training Program. There are 2, and one is tomorrow. After that, for the next 3 weeks, I will be working on my certifications. I will be working on my PALS certification this week. PALS is Pediatric Advanced Life Support. After that, I will be working on TNCC (Trauma Nurse Core Course), Stroke, CPI (Crisis Prevention Intervention) and possibly ENPC (Emergency Nurse Pediatric Course- which is the pediatric version of TNCC).

Simulation is still going well. We learning tons. I am learning, besides the obvious stuff I should be learning, that I need to trust my gut instinct more, and that just because someone in my group has more healthcare experience than me that they don't always know everything, or they are not always correct. Granted, they probably do know more in some instances or situations. But not always. Example: I thought my simulation patient was in septic shock and my gut instinct was to give him 2000mL of fluids initially. As I started to say that I wanted to give the patient fluids, I was asked how much I wanted to give, and a couple of people on my team started suggesting amounts. I- afraid of being wrong- second guessed my self and I went for a lesser amount.

I need to stick to my gut. I have just as much of a chance of being wrong if I trust it then if I don't. Three more simulations left. I can't wait to learn more from them.

That also means my time until I am let loose on the floors of the ER are fast approaching. December 26th begins my first day as an ER Nurse.

I'm still in my own state of shock. I'm not sure 2000ml of fluids will help me on that though. Well maybe alcoholic fluids. Ok, ok, just kidding, not really that either. I might end up a patient myself with that much alcohol. But really. I'm being let loose soon. Crazy. And exciting.

Word of the Day

Penumbra.

Doesn't that just sound cool?

Is It Just Me

or is shock one of the most interesting subjects ever?

I Can't Even Begin To Tell You

how much I love Coldplay.

Just love them.

My favorite band.

I know it's not really related to nursing, but I am listening to them as I study, so they are indirectly related :) Just thought you should know.

Week 2

Well, I've reached the end of week 2. I have to say that while some parts of this week were long, drawn out, and boring, parts of this week were not.

Today, for example, was great. I had simulation this morning and this afternoon I had a lecture on sepsis. I swear, I've learned so much today alone. Six simulation scenarios, two mini-lectures and then the sepsis lecture. Chock full of knowledge. These instructors are geniuses. They know SO much. It's hard to imagine/see myself knowing even half of what they know.

I am still trying to wrap my head around the amazing information I learned today about sepsis. The body just amazes me. When you sit and really think about everything that happens, its just.....amazing. Well, not with sepsis, but in general. There's just so much detail, so many compensatory mechanisms, its really just awesome.

At anyrate, I won't bore you with my fascination with the human body any longer. The six simulations went well....er, mostly well. Two of the six simulations ended up with a dead patient, but that's what the simulations are for- for us to learn from our mistakes in a safe environment so that we don't make those mistakes in real life. The instructors were really impressed with the morning groups in simulation today (there are 4 groups of 4). They said that we all had great communication with our teams and that our level of anxiety was decreased from last week. They also said we looked how the groups usually look on week 4. I really enjoy the simulations. Especially when they end well. :)

That's all for now. Next simulation is Wednesday. I can't wait. I love it, and the best part is, I get paid for it! How great!

First Simulation Day

Today was simulation day. We were first split in half, and one half had lecture while the other half did simulation for the first half of the day. Then, after lunch, we switched. I had lecture in the morning and simulation this afternoon. Within our "half" of the class, we were separated into 4 groups of 4.

First we had a small orientation to the lab. Then we talked about doing good CPR. Then we were given a scenario and we had to take turns being a Team Leader (the person in charge), the nurse doing the assessment on the patient, the Scribe (the person who is writing down all of the info regarding the case) and the floater (the person who does whatever is needed). The first 2 scenarios were more for getting us acclimated and working on our assessments. The patients were "sick" but nothing potentially fatal. Then we watched the instructors run a code. After that, we broke into our groups and we were given another scenario.

This time I was the Team Leader. YIKES! (Yes I know its not real, but its nerve wracking all the same. Plus we're being video-taped and watched from every angle by all the instructors).

I ran my first (simulation) code. It was crazy. I have a loooonnnnggg way to go, and to be honest I felt like a train wreck most of the time. There were some things (ok, maybe a lot of things) at the beginning, small things, that I missed/forgot, but I did recognize what was happening early on, so I was glad for that. I also think that once the mannequin patient "coded" I knew what to do, I knew the patient's rhythm on the monitor, I knew that the patient's rhythm needed a defibrillator and CPR and meds. I knew what meds to give and how much to give and when to give. But like I said, I need some work. A lot of work.

He survived, my mannequin patient, in case you were wondering. :)

Tomorrow and Friday- more lectures. Next simulation is next week, Friday. Stay tuned....

So Far

These are the books I was given for my course.

(I took a picture next to a standard size coffee mug because its really hard to get the full effect of the size of the books in a picture)

The binder is a 3 1/2 inch binder, filled with double sided pages. I guess if they were single sided I would end up with a 7 inch binder. No thanks. It's already too big.

Over the next 4 weeks I will need to know that binder. All 1096 pages. I will have 11 tests in the next 4 weeks on that binder.

Fun, right?

Anyway, I'm not complaining, because I truly feel blessed with the amazing opportunity I am receiving. I still can't believe it. I will say, however, I do feel slightly overwhelmed at the moment. But I know that will pass and I just need to take things one step and one day at a time.

And I hope that all of that knowledge will stay in my brain.

Simulation Lab

Here is the web page for the simulation lab we're using during our training program. I am SO excited, I can't even tell you. It sounds so amazing. It looks amazing. Its amazing (yes, I've said that word a few times now) the kind of technology available to us today. It's just astonishing to me.

Anyway, click on the link and it will take you to the page. You can read that, and also check out the video if you have a few minutes (its on the menu on the left side labelled "See Us In Video.")

http://med.fau.edu/medicine/simulation_center/

Week 1

Well, folks, that concludes week 1 of my training. I did an EKG and an ACLS course and I am now certified in both.

Thank goodness.

ACLS was hard, but interesting and I will be doing it a LOT in the simulation lab that I will be going to at least once a week for the next 7 weeks. Even cooler? We will use a REAL defibrillator and deliver REAL shocks to the simulation patients. Like, in real life.

Seriously awesome.

Mainly though, I can't wait to not be so nervous anymore. In ACLS as part of our testing we have to go through a mock code as the leader. And boy, its so easy to know all the correct answers when it isn't your turn, but once it is, everything goes blank. I can't wait to NOT go blank anymore.

Until then, I'll just continue to learn and grow. Stay tuned.

EKGs

I can read them.

Ha! But really, taking an EKG course, as well as an ACLS course, were pre-requisites for the ER nurse training program I am in. Which, I'm not OFFICIALLY in until I pass both courses.

Today, I passed the EKG course.

Phew. I thought for a second I had failed, but I got a 91% (needed 80% to pass). Like I said, phew!

Now onto the next........Thursday and Friday is ACLS.

The Beginning

begins tomorrow.

Well, it will only be a taste, really. My director (sounds so.......real, important, weird) wanted me and one of the other new girls to come in tomorrow for 8 hours to follow around one of his nurses. I begin all of my didactic training OFFICIALLY on Monday, November 7, but I will be technically starting in the classroom next week.

I have an EKG certification course for the first 3 days, and then the rest of the week I will be in an ACLS course.

And then the fun begins. 7 weeks of intense Emergency Nurse training.

I am so excited to learn.

And scared.

And nervous.

At Long Last

I got a job! It's been a whirlwind of a week but it all started a week and a half ago, Wednesday the 14th. I just drove down to Miami to go to a couple of hospitals to see about finding a job. I'm leaving one hospital and heading to another when my phone rings. Its the hospital I had been trying to get a job at in the Emergency Department as an ER Tech for the last couple of months while I was waiting for their Emergency Nurse Training program to begin. The program was on hold indefinitely, with thoughts of the possibility it would begin sometime next year (the program is run by a hospital corporation at all of their local south Florida hospitals, so it is not up to the hospital itself, but corporate). I was told I was getting the ER tech job when all of a sudden it completely fell through, no real explanation why, except that they weren't hiring any more nurses as techs and the director reconsidered. After that, I pretty much wrote off the hospital, thinking I couldn't get any position in the hospital, that maybe something was wrong with me.

So they call me. It's the HR/Nurse Recruiter girl. She tells me that they've found out the program is set to begin this year and she wanted to know if I was still interested and still available. I told her yes to both questions and then she said she should know more by that Friday. The next day she called to tell me I had been scheduled for a phone interview with the CNO of the hospital for Monday, and that if I didn't hear from her by Tuesday, I could call her to follow up. Monday morning she called to reschedule my interview for Tuesday. Tuesday I had my interview, and Wednesday I followed up with her. She said everything was fine, not to worry, and it was just waiting for a final approval before she can offer the position. The next day, she called with an official offer.

So in a week, I went from no possibilities of a job to being hired for a job.

In the ER no less. And to top it all off, my friend that I studied with for every exam in nursing school will be going through the course with me.

Anyway, I begin orientation October 24th for the week. The following week I will be taking an EKG certification course and an ACLS course. Then the following week I begin the program. It's one day a week on the computer, 3 days a week in class, and 1 day a week in a simulation lab. Its about 5 or 6 weeks, with a test every week and then when that is done, I will begin on the floor with another nurse.

I'm beyond excited. Nervous. Scared.

Still.....

job hunting.

Hopefully in the next couple of weeks I will be able to get out and start walking into the hospital HR departments with my resume and my license and see what happens. Applying online isn't doing anything. I think I applied to about 70 jobs one night last week and no calls. Oh wait, I had one. It was to tell me that this particular hospital doesn't hire unless either A) you have 1 year experience, or B) you have a hospital scholarship.

If that doesn't work, my next step will be to take an EKG course and an Advanced Cardiac Life Support course so that I can add those certifications to my resume and make me seem like the more ideal candidate for the job.

We'll see how it goes.

Gabbi, RN

I passed my boards. Just found out today from the company that administers the examination that I did indeed pass. I'm still in disbelief, shock, or whatever you call it. I believed in myself, I knew it was possible, but I am a horrible test taker and while I was taking my test, I kept shaking my head at nearly every question given to me. All the answers seemed correct. What if I pick the 1 of the 3 incorrect answers for every question? I didn't get 75 questions like everyone but 1 of the other people from my class that took the test, I got 95. What does that mean? I didn't come out of the test confident at all, so I just didn't know.

It seems so surreal. I am finally here- at he destination I have wanted to reach for many years but for one reason or another could never seem to set forth on.

Here I am. I can't believe it.

Gabbi, RN

:)

Exam

My exam is done. You can get anywhere from 75 questions to 265 questions. I got somewhere around 95. The last question I remember having was 92 and I only had a couple of questions more and then it shut off. There is an unofficial trick you can do to see if you passed or not where you try to register to take another exam and you will get one of two pop-up screens. One will say you can't register - which is good, the other will ask you for credit card info- which is bad. I got the good pop up, so it looks like I have unoffically passed. It can take up to 2 business days for me to find out officially, which with the weekend and the 4th of July could take until Wednesday July 6th. Hopefully, it will not be that long but I'll just expect to see the results then and if they come sooner, great.

Hopefully the next time I blog I will blog with an RN at the end of my name. :)

Today

is the day!

It's finally here.

I can't believe it.

I'm so nervous.

I Can't Believe

that my boards are in 2 days.

that in 2 days, I could be Gabbi Kit, RN.

that all these years of hard work have (almost) paid off.

that I STILL feel so unprepared.

that people's lives may be in MY hands. Scary.

that I am so nervous. About the exam. About people's lives being in my hands. About going back to work after 9 years home.

that the end of the journey is almost here.

I can believe that none of this was possible without God. He gave me such a wonderful family/support system to make it here. I have no idea how else I would have gotten here.

2 days left, and counting.........

Studying Away

I am currently studying away, which is more like reviewing and doing practice exam questions, until the big day. That day is July 1st, for now, unless I feel like I am ready and reschedule it for something earlier. Check back soon for updates.

So, What Now?

Now, I take a little break.

But not for too long. I must begin studying for my boards, otherwise known as the NCLEX. The NCLEX is a national nursing exam, so even if I had graduated from a school in California, I'd be taking the same exam. One I pass, I can be licensed in any state. Initially, I will be licensed in Florida, since that is where I am applying. But if I ever move, all I have to do is submit paperwork to that state and I will receive a license in that state via an endorsement from Florida. I will not have to retake an exam to have a license in any other state. Just money and paperwork, and voila! I have a license.

So for now, I'm taking a few days to recoop. I will start determining my plan of attack, and then sometime in the near future I will begin studying. I would like to take my exam in the beginning of June sometime. Also, in the meantime, I will be applying for jobs, both locally and not, and I will hopefully be going on interviews or at least stepping foot into hospitals to talk to some HR reps or Nurse Recruiters, which could be helpful. Hopefully.

So for now, I'm going to go NOT study, and NOT go to school. Here's a pic from last night. More to come soon. (I'm in the third row, third person from the left)

*This message is courtesy of your favorite Graduate Nurse :)

Words

cannot fully express my feelings right now. I sit here, on the eve of my nursing school candlelighting ceremony, pondering how exactly I arrived here at this point.

How did I get here? It seems like just yesterday I was beginning this journey. It seems like just yesterday I would just look at the nursing building as I drove to my anatomy class with feelings of “not being able to wait” until I could set foot into that building. That same building would later become my second home; a home I found myself never wanting to step foot in again. Oh, the irony.It seems like just yesterday was August 24, 2009, my very first day of nursing school. Instead I find myself on May 2, 2011, my very last day.

Bittersweet.

But here I am- at the end of this particular road. And while this chapter is over- the book, however, is still far from complete.

I remember during my first week or two of nursing school I felt as if there was no way in the world I’d make it past that week, and let alone finish the program. I was reading 50 pages a day and trying to manage lecture class, clinical and clinical assignments, pharmacology class, and my family and it just seemed nearly impossible to humanly do all that was expected of me. I cried, and I told Ray I just didn’t believe it was possible.

But I made it. Not only did I make it, I never even once failed a class or got off track. Yeah I’ve failed an exam or two, but I passed all my classes on the first try. Others were not so lucky, unfortunately, so it just astounds my brain that I survived. I'm one of 20 out of the 130ish original students who started with me in August 2009. Those are some crazy odds to be stacked against- a 15% chance to graduate, or at least graduate on time in May 2011 as planned. I would never even think to bet with those kinds of odds. And somehow, I did it.

I am amazed at all that I accomplished these last 21 months. I am amazed at how much I’ve grown; At how much I’ve learned; At how much there is still left to learn.

I know that I could have never made it without God guiding me and giving me the strength and wisdom I needed to get through. He gave me a great, supportive family to help me stay strong and take care of things when I couldn't. He provided me with a study group to help me focus on the days before exams where I needed to study and may not have done so on my own. He somehow provided this otherwise well known procrastinator with proper time management skills, or at least the bare minimum skills needed, to conquer all the reading/re-reading/studying/assignments that were required to be completed for my courses. The more I think of it, the more I realize I could not have done it without Him at all.Best of all, He provided me with a husband who not only believed in me, but encouraged me every step of the way and went the extra mile in helping with household duties.Amazing that husband of mine. J

I remember the feeling of being overwhelmed at the start of each course throughout the program. I would look at all that needed to be accomplished and learned and it would just blow my mind. I could never imagine how I would ever know all the info I'd be learning in that course, or how I would complete all of the assignments for that course, and yet somehow, I would do just that. Even at the beginning of this last class, I looked at my journal that would have to be 100% completed by the end of the semester and I dreaded it. It seemed like so much. But it's complete. And as always, I managed. And now I'm done. No more courses to be overwhelmed with. No more assignments to complete. I'm finished.

Bittersweet.

One thing is for sure, however. While nursing school ends, I will always be a nursing student. There will always be something new to learn, a new class to take, a new job take on. Nursing is a dynamic profession. And I am a nurse.

Almost.

As I conclude the blog for today, I'll leave you with some quotes that I had hoped would one day prove true. That day is today.

If we all did the things we are capable of, we would literally astound ourselves. -Thomas Edison

What lies behind us and what lies before us are tiny matters compared to what lies within us- Ralph Waldo Emerson

Video

One of the group presentations that my fellow classmates did had used this video as part of their project. I just loved it, so I thought I would share it. Because of the dimensions of my blog, some of the screen is cut off. Just double click it (in the middle) or click the "Being a Nurse" title in the upper left hand corner so it will open it up so you can see it all. :)

Graduation Pictures

were today. Crazy. All of a sudden, everything seems like a whirlwind, and it just keeps getting faster. Eight days to go. Anyway, here are a couple of pics from today.

Two Weeks

from today is my Candlelighting Ceremony, or what I refer to as graduation. And it still baffles my mind. I can't believe how close it is.

I have no more assignments. No more clinicals. Nothing that is due, no studying, nothing that is expected of me except for just showing up to mandatory class days. I just have to show up Thursday and Friday this week (an NCLEX review both days), Monday and Tuesday next week (Monday is the last of the group presentations and Tuesday is clinical evaluations, state board info and pictures), and Monday and Tuesday (Monday we have an exit exam- not graded just an assessment tool- and Tuesday is Candlelighting rehearsal) the following week and I am done.

D

O

N

E

Still weird. Still weird I'm almost a nurse. Still weird I can have a life again. Still weird that my nights are not consumed with studying or paper writing or group project making. Still weird I can spend time with my kids again. Good, but weird.

The Next Time......

I step foot into a hospital, it will be one of the following reasons:

1) For a job interview.

2) To visit a sick friend/relative (hopefully NOT this option).

3) Because I am the patient (hopefully not this option either).

4) To start working.

One reason I definitely will NOT be stepping foot into a hospital:

For clinicals!!

I completed my final nursing school clinical today, and I must say, the Lord really looked over me today.

For one, my cell phone is my alarm. It has 3 alarm settings: weekday, on, or off. I have it set on weekday since it is rare I have to wake up on the weekends. Last night, Ray asked me if I wanted him to set his alarm as a backup for me. Boy am I glad he asked me that. My alarm was set on weekday, and I would not have woke up in time for my shift! That would have been bad, to say the least.

Another thing- I has a dream this morning that it was a terrible day on the floor. In the dream, we had like 7 or 8 patients and they were all very difficult patients and we had no help on the floor. Real life did not play out like that at all. We had 4 patients, and no admissions (which takes up a lot of time), and no discharges, which isn't a bad thing, but what happens when you have a discharge is that you get the next admission, and that takes up time, like I mentioned. The day went very smoothly. I really could not have asked for a better "last" day. I also ended on a great note. I had to "give report" on all of our patients today- give report is where I give the oncoming nurse a report of the patient; whats been going on, important things to know about, history, etc- and I had to give report on one of the patients to the charge nurse. After I was finished, she told me a did a good job because I gave her a very good report. That was nice to hear.

I had a patient that my nurse and I admitted yesterday again today. He and his wife were very nice people and I loved taking care of them. I had to put a foley catheter in him yesterday, and then today had to give him a suppository, so my poor patient jokingly referred to me as the bad guy. When he left for a test, his wife and I were talking, and she was really worried about him because in 65 years together, he'd always been healthy until just during the last 6 months. She started to get teared up, which in turn teared me up too because they're such nice people and we just connected. Before the wife left, she gave me a hug, just in case she couldn't say goodbye, and then blew me a kiss later when she walked out for the night. Before I left, I said goodbye to my patient, and he gave me a hug. And I felt good because I know I did a good job.

Now I'm a little sad because more than likely I will never see him again. I'll wonder how he's doing, if he's better, or if he's not. I'll wonder how his wife is doing. I'll wonder if the care he's getting will be good enough. And just as I had started on my first day of clinicals in nursing school with a patient I will never forget, I have ended on my last day of clinicals with a patient I will also never forget.

So there you have it. My clinical experience- as a student- has come to an end. I wish I had time to post more about my experiences, but it was hard with everything I had to do.

Don't worry though, there is still more to come. I'm not finished yet. I'm just getting started.

Finishing Up

This Monday I had a group presentation due. We decided to be the first of 12 groups because it would mean we would be completely done with everything while there were still 2 more weeks of presentations to sit through, which would mean 2 more weeks of having something due if we were one of the groups for those dates. We have a group paper due on Monday, but that is pretty much done. At this point, I have nothing else due. I had an exam, a portfolio, a resume and cover letter and a group presentation and paper. All but the paper have been done/turned in. I have 2 clinical days of nursing school left and will be completed by Saturday. Then, as of this weekend, I will be unofficially done with nursing school! After that, I have to come to 2 classes for group presentations, 1 day for clinical evaluations and state board information, 3 days for an exit exam review, and then 1 day for the actual exit exam. Seven actual school days left. Wow. Just wow. I'm still in shock.

Best news is that I completed everything in order to have the kids' spring break off with them, except for having to go into class on Monday. I'm so happy and even more so, I know the kids are so excited since I have been so scarce for the last 2 years.

After graduation, I will begin studying for boards which I plan to take in early June. I'm thinking about the future already and getting my Bachelor's degree, but I still don't have a real plan yet. I know that most hospitals are looking for this degree within 5 years or so of becoming employed there, but with taking one class a semester, it could very well take me that long. So we'll see what happens with that journey.

So there you have it. I've been slowly regaining my life back and it feels so good.

Busy Bee

On Monday, I have 6 weeks left. But really the next 3-4 weeks will be the meat and potatoes of it all. I have 7 articles in which I have to read, write an abstract on and then a 1 page paper on how I feel about the article. Seven of those. Then I have a group project- a group presentation and a group paper. I still have to do 8 clinical days- 96 hrs of time. No, it's not a lot, but I do have some writing to do for those clinical days as well in my clinical journal. I also have to attend and take part in one of the local hospital's disaster drills and I have to also sit through the State Board's discipline hearings with my class (so that we can see what occurs, etc).

I am not complaining. I'm just stating I'll be a little busy.

I met today with my preceptor at the hospital. She's really nice and I'm really excited. I start my clinical on Wednesday and then my second shift is Saturday. Basically I look at my preceptor's schedule and decide when I am going to come in, which is nice. I am hoping, if all goes as planned, I will be done with my last clinical day around the 7th of April. If not, I will have a day or two to do around the 13th. the best thing is that my article project is due the 11th, my presentation will be on the 11th, my paper is due on the 18th, all of my clinicals will be done by then as well, and my kids start spring Break on the 18ths, so I will be able to enjoy the entire week off with them with no work to worry about going back to the next week. I will be officially done with school by then- in one month I will be "done".

So cool.

But for now, I will be busy. I'll try to update after Wednesday and let you know how it went.

Wow!

I sit here in my living room catching up on American Idol (since I've gotten a little behind thanks to my Cardio class), thinking about tomorrow.

Tomorrow I begin my final course in this journey. I have 7 weeks left and it just blows my mind. Its amazing to me. 7 weeks. It's gonna fly by.

Until then, I must go slumber and face tomorrow.

Cardio is

Over.

Today was my final exam. Got a 79. Not totally proud of it, but it was enough to earn me a B in the class, so I am super excited about that. More importantly, I took my last real nursing exam today. I have one more class and one exam in that class, but the class grade is made up mostly of paperwork, and the exam is mostly common sense, as the teacher put it. That takes a lot of weight off my shoulders. I have 4 assignments, one of them being a paper, one being a group presentation, one being a resume and the other assignment is where I have to find an article on 7 different topics from a list, then I have to write an abstract on each article and a reaction paper about each article (the reaction paper is basically my opinions and feelings about the information in the article). This I may start over Spring Break because I like to get things off my plate as soon as possible.

For clinical I will no longer have a clinical group, or an instructor per se. I will have an instructor who oversees me, but for the most part, I meet with a preceptor (a nurse at the hospital I am assigned to) and I basically work with her. I find out what days she is working and it is up to me to decide when I want to come in. I have 7 shifts to complete and can do them as quickly or as slowly as I want, except that I have to have at least 4 completed by midterm. I will also be assigned one ER day, but I'm not sure when that will be exactly, however, I am super excited about that. I start back to school on March 14th and by April 18th, just over a month of school, I will be done with assignments and hopefully all of my clinical assignments as well. So after Spring Break, I have just about 1 month of school left. I will have to go into school for things, but nothing will be due, and that will be very nice.

I'm really excited about this next step. I have already requested to work with a particular preceptor, so hopefully that will work out. She is a new nurse, only been working 5 months, however she has a great attitude, is very organized, really knows a lot, is easy going, and I feel like I can really learn a lot from her. The nurses at this hospital seem to be.....lax in some, or most, regards. They don't seem to enjoy their jobs or are thorough enough and sometimes its just better to have a fresh perspective from someone new. My clinical instructor really likes her, too and agrees that she is a great nurse and one we can really learn from. I hope it works out that I have her. I think it would help give me a more solid foundation to build from when its time to venture out on my own.

So for now, I am on a 10 day Spring Break. Ah. No more crazy studying. Maybe some crazy paper writing, but thats it.

And best of all, exactly 2 months from today, I will have my candle-lighting ceremony. And I will be graduating.

Wow.

Exam 2 Update

On Monday I had my second cardio exam. I studied just like I always do, and I did practice questions just like I always do. I took the exam and felt no better or worse than the first exam. To my surprise, I got one of the best grades I have ever received on a nursing exam. I got an 87! I was so thrilled.

More so, I have pretty much solidified the fact that I will 99.9% pass this class. Unless I don't study at all, which will not happen, or somethings happens and my pencil magically erases answers on my test, I will pass. I need a 50 to pass. I need an 80 for a B, which is what I am going to study for. I really want this B. My GPA is hurting. But at the very least, I will be moving onto to my final nursing school course.

It is still so surreal to me. We received our calendar for "Trends" my last class that begins mid-March. My graduation date, well actually it's our Candle-lighting ceremony which is what everyone attends (the actual graduation is for everyone with every type of degree for the entire campus and can include hundreds of people, which I am not really all that interested in watching graduate)- is May 4th. Two months and two weeks away.

Surreal.

I remember starting my Anatomy and Physiology I class. It seemed like such a long and daunting road ahead of me, and now it's almost all behind me.

I will stop here. There is a lot I want to say, but for now I will say this. I'm graduating very soon!

ER Day and ICU Day Updates

I had my ER day at one of the local hospitals that has a busy ER and a Trauma unit. I went 2 weeks ago, Wednesday, and was hoping for a lot of action. Unfortunately for me (and fortunately for the patients) that was not the case. The only things that were close to traumas, which were not, but were called "high index" because they did or could be hurt pretty bad, was one person who fell off of a ladder and a bicyclist who got hit by a car. They were both non-life threatening injuries.

I still enjoyed my experience. And I started my first 2 IVs ever, AND I got them perfectly on the first try. Of course the first one was with some pretty good advice from the nurse with how I should go in the vein. Also, on the patients who I started IVs, I needed to draw blood on as well, which I just used the line from which I inserted the IV catheter, but I was able to experience how to fill the tubes with blood. I had to help a nurse hold a 5 year old who needed his IV started. I was pretty impressed that I didn't cry, but I didn't!

Last week I had my ICU day. I didn't get to start any IVs or anything fun, but I took care of 2 patients with the nurse I was assigned to. One was REALLY critical. Very bad, and very sad. He was young, 50's got sick at home with what they thought was the flu. Came in after a week of being sick, having a hard time breathing and was admitted with pneumonia. He was admitted right into the ICU and needed to be put on a ventilator. He was in such bad shape, and he was fighting the intubation, he had to be heavily sedated. After some tests, he was found to be positive for Influenza A, which apparently is pretty bad. He was in Acute Respiratory Distress Syndrome (ARDS) which is also really bad. Apparently, if a person gets to the point of ARDS, it's not a good prognosis. Obviously, I am just going off what I've been told, I don't know much about ARDS yet. But at any rate, this guy was in bad shape.

Let me try to explain how bad. The ventilator has settings. There's settings where the machine breathes completely for you. Theres settings where the machine breathes a little and allows you to breathe some on your own. The machine was breathing completely for him. There is a setting for the percentage of pure oxygen you can give the patient. The air we breathe normally is 21% oxygen and that is enough to give us a good oxygen saturation (normal is 93%-100%). He was on 100% (and 100% oxygen for too long can start to become toxic, so thats not good either). Anything less than that, he would have lower oxygen saturations and his blood gases (sorry, that one is too lengthy for me to explain in one blog, ha!) would start getting bad.

Another setting, which I haven't fully learned about but will be for my Cardio final exam, is PEEP (positive end expiratory pressure). It has to do with the airway pressure needed to be maintained in order to improve gas exchange within the lungs. Any way, most patients on a ventilator are usually in the neighborhood of a PEEP of 5. Maybe 10 if things are bad. This patient was on 14. Basically, his lungs were so full of pressure and he was on the highest amount of oxygen, the only place to go from here was to get better or crash. Nothing more respiratory could be done for him. He needed to have a central line put in (so they didn't have to have 3 IV sites going and just keep this one site). However, this meant bringing the patient down to radiology to have it put in (this hospitals protocol). This guy was so critical, they could not wheel him to the department, in his bed, for fear of collapsing his lungs. It was terrible to see someone so young with no past medical problems, so sick and there wasn't much else for anyone to do.

I got to talk with his daughter, a recent medical student graduate who hasn't yet started her residency. She and her brother basically camped out in the ICU waiting room, day and night. She was thinking of changing her career to nursing because she saw how little time the doctors spent with the patient and family and how much the nurses did. I thought that was, and unfortunately, true. I do think there are a lot of GREAT doctors that do take the time for the patients and families and kind of get the short end of the stick with being stereotyped with all the others. I encouraged her to keep going and make a difference in the field.

Yesterday, after lunch, my clinical group went into the ICU. Every week we do this and whoever was in the ICU that week presents a patient to the group. My patient was still there. But now he was awake. I saw the daughter in the waiting room and we stopped to say hello. She told me how well her father is doing and that he has improved SO much. It made me so happy to see that it seems he's going to be alright that I kind of teared up a little leaving the waiting room. It just made me so happy to see them full of hope. I asked my friend to get his vent settings. He is now on 35% oxygen and his PEEP is 5. Even if you don't understand the numbers, you can see that 35% down from 100% and 5 down from 15 is a big improvement.

So there's my ER and ICU updates.

Passed!

I passed my first cardio exam with an 82 (1 point away from a B). I was hoping for at least an 80 so I was really thrilled to get higher than that. I sometimes still feel like for the amount of time I put in studying, I should get a higher grade, but I am really thankful because I was starting to get a little worried while waiting for the grades to be posted.

Clinical is going ok. We only had one day so far and it was not a full day. This week I have clinical on Tuesday and then I have to be in the ER on Wednesday, so 2 back to back 12's will be interesting. But I am SUPER excited about being in the ER. Next week I go to the ICU, so that will also be exciting. As always, I'll keep you posted.

Stay tuned!

Tomorrow is

my first big Cardio exam. Yikes! Say a prayer for me! There is A LOT of info swirling around in my head. I have to know about Coronary Artery Disease, Acute Coronary syndrome (which encompasses unstable Angina and MIs aka heart attacks), Chronic Stable Angina, Heart Failure (right-sided and left-sided), cardiomyopathies (there are different types), shock (there are different types of this, too), critical care nursing, hemodynamic monitoring (oy vey- too much to explain), assessment of the cardiovascular system and I have to read EKG's and by read I mean interpret the rhythm, rate, determine the duration of the different intervals, figure out what's causing that particular rhythm and know how to treat it. Oh yeah, I have to know how to treat EVERYTHING I already mentioned above.

And this is all just for this first exam.

Phew. It's overwhelming just writing what I need to know for tomorrow. Well, I mean, I already have studied this and am supposed to "know" it already, but I still need to review because there's just so much I learned in the last 3 weeks.

I'll keep you posted tomorrow on how it went. For now, I must continue studying.

Realizing

I think I am realizing.............where I want to "specialize" in.

Going in, I had a good indication I would see myself in either Peds, L&D (Labor and Delivery) or ER. As I've gone through my rotations, I've kept my mind open to new things, just in case. I went through my OB rotation and felt a connection, just like I had thought. Lately, however, I have been feeling this pull towards critical care- mostly ER/Trauma.

Actually, more than a pull. I REALLY feel like this is me. When I think of the words "ER" and "Trauma" I just feel such a passionate need to be there. Thing is, I haven't even had my ER day yet.

So I suppose that I cannot yet be 100% certain that is where I see myself ending up, but it is a strong opinion that my heart has been right all along.

As I think back on L&D- it is still an awesome field and I really do love seeing babies! I'm just not really sure why I feel more of a pull to ER/Trauma than L&D.

I just know that wherever I am, I want to help others and make a difference.

And I like adrenaline, just a little bit. :)

Back to the Grind

I sit here the night before I begin my final semester of nursing school and a wave of emotions invade my mind. My final semester. Where exactly did the time go?

I'm excited. I've wanted this for such a long time, it's hard to believe I'm almost there.

I'm stressed. So much reading to do and I'm already behind. Time management has never been my forte.

I'm nervous. I know that I can do this, but there's always a small part of me that worries, "What if I don't pass?" (I have to say, though, after that last class I took, passing that helps me believe that I can just about do anything)

I'm relieved. The end is finally in sight.

I'm apprehensive. What if I don't do well as a nurse? What if I don't like it? I still feel as if I have barely scratched the surface with all there is to know, even though I know a lot more than I ever did before I started school. There's a lot of responsibility with the title....am I really ready?

I'm a little sad/scared mix. I have been a stay-at-home-mom for over 8 years now. Eight years of freedom to do what I want, when I want. When I graduate, I will have to go back to work for the first time in, by that time, 9 years. Nearly a decade. That's a BIG change. I will miss being able to jump at the drop of a hat to do whatever. I think this hit me hard realizing that this last Christmas could be my last Christmas off with family in a while. This is something that will take a while to get used to.

I'm enthusiastic. To finally have steady income and health insurance. Good health insurance.

I'm optimistic. I am hoping for the best job. One where I love to work, so that it's as if I am not working at all. I know for some, that seems like a dream, but in reality, I am just hoping I love what I do so much, more so than just having a "great job." I have hope that it will be everything I have looked forward to all these years.

I'm ready. I think.