it's been a gas

Friday, December 18th, 2009
How unbelievable it is that the time has flown by like it has since I last posted.

This has the potential to be a very long post.

I can't blame the time entirely for my lack of posting. It seems this semester nearly got the best of me, that and I've had a bit of a blogger's block. There's been a time or two that I've signed on intending to post, but have been left with nothing to say. That's partly due to the fact that those few times when I had a slight opportunity, I ended up riddled with guilt...shouldn't I be studying??

The semester ended officially for me yesterday when I went and took my last final exam. Our finals were scheduled for Monday, Tuesday and Wednesday. I will get to why I didn't take my Wednesday final until Thursday a bit later. For now I'll go over some highlights of the past few months.

Our semester was split up into four week rotations for each clinical experience. The first week we had orientation, and the second week my group was split up and added to other groups since there was a lack of instructors/clinical opportunities for that week. The first day we weren't able to do anything because we didn't have access codes. This left us coming in late the second day, as they weren't going to have the codes until after 8 a.m. I was so very nervous that day, knowing we would start patient care. It intimidated me to no end.

The next two weeks my group were "orphaned" as it had come to be known when a certain group was not on a regular rotation, but would instead be placed into one day spurts of observation in a variety of different clinical areas. This happened because the opportunity at the other community hospital we were all supposed to go to fell through.

My group did get to go. The first day we spent at the long term care facility. We toured it and then ended up in the Alzheimer's unit playing balloon volleyball with some of the residents. We actually left around 10:30 a.m. because there was nothing left for us to do. It wasn't intended that we would do any patient care that day. The second day we actually went to the hospital side. I spent the morning in the ER, which I loved tremendously. I saw some really interesting cases.

The following week I went to a local surgery center, which I loved, and then for my second clinical day that week I went to the local wound care center...not much love was felt for that place. (Some of this is repetitive from previous posts, but I figure I'll just bring everything up-to-date, adding in more details with the more recent experiences.)

Next we went to one of our first regular rotations, a medical floor that has patients with cardiac, respiratory and other conditions warranting telemetry. Once again I was nervous those first couple of days. By the fourth week I was a little more comfortable. I'd taken care of patients with COPD, CHF, DM with exacerbations of other problems mainly related to neuropathies. The instructor was an incredible teacher. By the end of that rotation we all wanted a pocket version of her to carry on with us in our future endeavors. She offered encouragement, constructive criticism, and just an overall rewarding experience.

Our next rotation was spent on the medical/surgical floor. My first patient on that floor had a vertebral compression fracture, after a fall in her kitchen. I took care of her both days that week.


Monday, December 21st, 2009
And there you have it. I lost the oomph to post any longer in mid-paragraph.

Let's see if I can finish this up and then maybe I'll be able to post in the future without any problems.

All in all I had some good basic experiences during my two middle rotations. Our last rotation was the one I was most excited about. After working OBGYN back in my Air Force days I feel a ceratin draw to women's health.

My whole group was elated upon the start of our family birthing center rotation. Our first day I spoke up and told our instructor that I had been in on c-sections before so she assigned my four classmates to the two cases that were scheduled that morning. I went in on an induction. It was an easy, breezy day. The nurse I shadowed was awesome to work with. She taught well, and I was able to assist her with a couple of procedures. During one procedure I helped her with a newborn blood draw on a little guy that was having slight problems. The second day I spent with a younger nurse, who actually let me dive in and do some admission charting on our induction for that day.

I loved the mom from that day. She was terrified, and I found that to be a nice change from the mom who is all excited about giving birth and her new baby. This woman was in tears and I felt so bad for her. She wasn't incredibly young, and was not only absolutely terrified of needles, but of the whole experience. It was interesting to be a part of that dynamic. Because the hospital was having special visiting hours, due to H1N1 procedures, when normally there are no visiting hours, she had to receive special permission to have both her baby's daddy and her mom in with her. It was the first time I saw an epidural insertion, and I inserted her Foley. She startled with everything that was done to her. One could barely touch her without her panicking.

The following week was Thanksgiving week, so we didn't have clinicals.

The week after I saw my first (and only) vaginal delivery. I didn't only see it, I got to be right there in the thick of it. I helped mom breathe and I held back her right leg. I absolutely loved being in there. This mom was giving birth to her 6th baby and she came in as an induction with a history of precipitous deliveries. This one didn't go that quickly, but it went quickly enough for one of my classmates and I to be in on it. We were with her the next day as well as with another induction, of which we thought we just might see the delivery, but it didn't happen before we left. She was a primigravida, was progressing nicely, but just not nice enough for us to see it happen. The following Wednesday we missed because of "inclement" weather. That Thursday there was nothing going on so we left early and went to IHOP for brunch with our instructor. By this point none of us minded too terribly since finals were lurking in the near distance. One of the nurses who has taken on the role as one of the bereavement nurses did give us a little impromptu inservice on their bereavement procedures before we left. Although it's a depressing subject, I coudn't help but find it incredibly interesting.

As this semester came to an end I found myself wishing I'd had more experiences to learn from, but being in a small community hospital I was left with a decent amount considering.

This past week was finals week. A couple of my classmates and I got together a few times to study and prepare for what we thought would surely be our demise. We were extremely nervous for our exams, since the volume of material was horrendoues and we didn't have much to go on as far as focus. Monday was the OB/peds final and I got a B, and ended up with a B in the class. Tuesday was the health assessment final, on which I got a B and ended up with an A in the class. Yay me! So far the finals were good exams, surprisingly. They were fair and not as monstrous as we thought they'd be.

Then came Wednesday. Oh, the exam that day wasn't all that bad...from what I hear. I didn't end up getting to take it that day. Instead I took a trip to our local ER!

Prepare for some TMI...

I awakened at 2 a.m. to urinate, and then went back to bed. At this point I started passing gas, and decided to get up for what must be nature's need to expel waste. Nothing major, just your run-of-the-mill regular ole BM. Surprisingly, I am able go back to sleep. At 6 a.m. the alarm goes off and I start my morning routine. Each morning the girls are fed and then let out for their morning consitutionals. After that I make myself a cup of coffee and/or some sort of breakfast. I sit down at my computer where I check emails, Facebook, banking, etc. As I'm sitting there...here...I start getting this 10/10 type pain in my right side...forget quadrants...it's the whole right side pretty much. I decide maybe nature is calling again and sure enough I have diarrhea. I go back to sit down and am unable to sit. I've had this pain before and usually I just go lie down on my left side, on the couch for a few minutes and it goes away. The pain may return once during the same spell, but usually no more. By this point it's around 7 a.m., and the boys have left for school while I'm lying there on the couch.

I knew I had to get up and get going because I had my final at 9 a.m. for gosh sakes! I head upstairs, and only make it up to go lie down on my bed, once again on my left side. After a bit I'm better so I take a shower. I've tried calling my neighbor who lives across the street, to no avail, so I press on with readying myself for the end of my semester. Nope, no can do. Too much pain.

For me, my worst pain has been my attacks of cholecystitis, and giving birth naturally both times. These are my 10/10s. As the pain I am experiencing is right up there with those other pain experiences, and it won't go away, I know I am not going to be able to drive myself to school. It was all I could do to get my panties, sweatpants, and shirt on. I knew I had to clothe myself as I didn't want to be naked for anyone who was going to have to come help me. That's what it was coming down to. I had to get help.

We don't have a normal keylock on our front door. We have a keypad where you punch in a code that unlocks the deadbolt. So I know that I have to go downstairs and unlock it, and just be down there for my rescuer(s).

I hobble my way downstairs, unlock the door, and commence to lying on the couch. By now my neighbor has called me back and I ask if she can take me to the ER. I call Big B and tell him what's going on, amidst tears, and email him my neighbor's cell phone number on my BlackBerry. It seemed like a lifetime before my neighbor came over to get me, but by this point a friend of hers had shown up and they were going to take me in her car. This was a saving grace, because otherwise I would have had to sit up in my neighbor's Corvette. Instead I was able to lie on my left side in the back of my neighbor's friend's car as they sped me to the local hospital.

They get me signed in and have contacted Big B, who is on his way. I thank the neighbor and her friend and send them on their way. The nurse who took care of me started an IV line, drew labs, and gave me an IV push of Toradol. Of course by this point I am no longer having the 10/10 pain. It's more like 3/10. I'm more worried about my final exam that I'm about to miss and the fact that my semester is going to have to be prolonged. They take me back to radiology where two films of my abdomen are taken, and then they wheel me back to my room to wait.

One of my classmates, who has become a great friend, has taken her exam and called me by now and she comes for a visit. She stayed with me until Big B shows up, and then the fun really began. He has low tolerance for hospitals. Thank heavens for the diversion a TV can create.

I lie there awaiting any word from the doctor, and Big B finds People's Court to keep him busy. Finally the doctor comes in and informs me that my labs came back perfectly normal, but he did see a huge amount of gas in my large intestine. He said spasms from the gas caused the pains. By this point the nurse had come in and given me Senokot and Maaalox, so I knew it was going to have something to do with my digestive system. Surely a small bowel obstruction would be what was keeping me from the sheer feeling of joy and accomplishment that comes with the end of a college semester.

No, I had gas. I didn't take my final final exam regularly scheduled with my classmates because I had gas.

Some girls have all the luck!

As it turned out I was able to go Thursday morning, and complete my exam...and put an end to what was a very challenging semester. I really couldn't even tell you what I got on the exam, because by the time I checked that evening all I cared about was my final grade for the class...a B.

There you have it. My third semester of nursing school will always be remembered as ending with extreme pain caused by gas, as if it hadn't been a big enough pain in the butt already!

where have all the babies gone???

Two days at the family birthing center and I don't get to see any birthing! harumph! Ok, so there's five of us in my clinical group and since I was the one who admitted to having seen a c-section before the other four were split up and went in on two different c-sections. I went in on an induction. Of course the baby couldn't make an appearance on my time. I did get to hang antibiotics, and assisted the nurse I was working with on a blood draw on one of the other newborns. At least I got to touch a baby! He was a trooper about being stuck. From one of the c-sections came a macrosomic infant who was incredibly cute. Normally the babies are kept with the moms, but this one was having some neuro deficits. We were able to go into the nursery and watch the nurse care for her. She was later transported to another facility. That was all Wednesday.

Yesterday, still nada. I came close to seeing a delivery, but it was time to go (1 p.m.) and I hadn't eaten since 6 a.m. so I chose to go, although I could have stayed. She probably delivered within the hour after I left. This was the patient I worked with along with the nurse I was assigned to, so I was able to push her Stadol and Phenergan, as well as insert her Foley.

Next week we only have classes on Monday, including a test in OB/peds. We don't have our Tuesday class or clinicals. I hope the last two weeks of clinicals will be extremely eventful and that I get to see at least 1 c-section and a couple of vaginal deliveries. It's a small community hospital, so I can't expect hoards of laboring women.

As soon as I finish posting I'll be heading upstairs to study for a bit. This afternoon Big B and I are picking AW and his GF up from school and heading out on a double-date to see New Moon. The rest of the weekend will be spent studying, as usual!

Three weeks until finals!

wham bam thank ya ma'am!

I have some great news concerning my nursing program. It appears that our discussion with our instructor paid off and they will be making changes! The changes will be taking place next semester even! They're working it out so that one of the primary RNs on the floor will make the patient assignments, and we'll be given 2 patients. It is gong to be based on readiness, so they're taking that into account, which I think is great. It's awesome when you take part in effecting change that is for the positive.

In other news we finished our med/surg rotation. Our care plans were due Wednesday and the instructor grades them the night they're due. (We still haven't received our graded care plans from the previous rotation--in fact no one has, even from the beginning of the semester. That's really the only downside to that particular instructor. It's easy to swallow though considering what you gain from her. You don't mind waiting for your care plan, at least not so much.) I did swimmingly well on both my care plan and my evaluation, with 99s on both. I would have gotten a 100 % on my care plan except I left out past surgical history. I really can't remember there being any and in going over the paperwork I had didn't find any, but I didn't state that either. Oh well, one point isn't going to send me into respiratory alkalosis or anything.

Four weeks until finals!!

It's so unbelievable how it feels to be able to say that and to know that unless I really F things up between now and then I'll survive what is our hardest semester!

Next week we start our OB/newborn rotation. My whole group is incredibly excited to get our hands on those babies. We know it's not always fun though. One of our classmates witnessed a fetal demise the other day, and sadly he knew the family. I've been waiting all semester for this, because it is one area I've felt a draw toward. So, I am full of anticipation for experience as a whole.

suppozin' I should mention...

Thanks to all who have chimed in on clinicals. It was very enlightening.

I should have mentioned what we do do during our fourth semester, so that we don't look as unfortunate as I might have made us out to look like. We do an advanced med/surg rotation, which includes leadership building, as well as a 3 week preceptorship. We'll have clinicals all the way through up until our preceptorship at which time we will become a RNs right hand woman or man. I look forward to this as I think it will be the most valuable experience of all, up to that point.

I'm off to health assessment class this morning. Tuesdays are usually our fun days. Another student and I, whom I've become close friends with, may as well be called Lucy and Ethel. We have a blast.



Last week we got a great laugh when she went to carry one of the mannequins off the bed we needed to use for practicing respiratory assessments on each other. Up she pulls Sheman and plop!! right out onto the bed falls Sheman's unmentionables. It was just so unexpected we found it pretty comical.

Oh well, if you can't keep your sense of humor through nursing school you may as well throw in the proverbial white towel!

brainstorming to battle hindrances

Yesterday we spent some down time during clinicals talking to our clinical instructor about other possible clinical opportunities. Our program is very limited in the opportunities we have. First semester we do nothing clinically speaking, other than lab learning. Second semester we spend 6 weeks (maybe it's 8 weeks, dont quite remember), at a long-term care facility. Third semester we do med/surg/ortho/tele, OB/newborn, and we're supposed to do an observation-only Peds rotation at a local practice. Because of H1N1, those of us that are supposed to be going during the latter part of this semester have been prohibited from going. There is also a time period during this semester where each group has been "orphaned". We do not have enough clinical instructors in our local, small community hospital, and there are no contracts out for any of the larger hospitals or medical centers in the region. (Let's not forget I live in the DC/Northern VA region where there is a plethora of all that is medical.)

The other two community college's programs go to vast medical centers for their clinical experiences, and oh, you might have heard me mention in the past one of those programs is also sharing our local, small community hospital. It's not an extremely large group invading our territory; however, their instructor has asked one of our two instructors if they can take the one floor that one of our groups was supposed to have! From what I heard our instructor (our group wasn't with her at this point in time) conceded!!!!

I digress; so when we're orphaned, we go to other clinical experiences, which are usually observation-only or very limited hands-on experiences. They've been overall wonderful opportunities. Most everyone's enjoyed going to interventional radiology, the infusion center, wound care center, a local same day surgery center, staff development, ICU, (no, we don't get that as a regular rotation), etc. It's usually only been one day here or there.

In our bigger rotations (med/surg/ortho/tele, OB/newborn) we are only given one patient at a time. For instance, my patient yesterday was admitted with a GI bleed with anemia. He was completely independent, so all I did was vital signs, get his cup of ice chips (he was NPO as they were waiting on GI to get in to consult, and send him down for a procedure--didn't happen on my time), straighten up his bed (he'd been admitted the night before), and do his assessment, I&O and flow chart.

We're talking lots of down time. We bent our instructor's ear something fierce, because we want better opportunities next semester, and for future students. The program is being overhauled and this is a major need. Our instructor had spent some time earlier in the morning talking with the other program's instructor (OPI). The OPI informed our instructor of all the things they do clinically and that by their third semester they're taking on at least 2 patients.

Our mental health rotation is incorporated in as part of our LTC rotation because we work with patient's with dementia. We do have a mental health facility within 40 minutes--which in this area 40 minutes is nothing. All 5+1 (we had an orphan for the day) of us sitting there voiced that we would be willing to drive to other locations, at a distance, to be given better learning opportunities.

Bottom line is we want to feel somewhat comfortable when we're interviewing for our first nursing jobs that we we'll be a little more comfortable taking on our responsibilities. We know that we'll be oriented to the facility. We know that you really don't have your true nursing groove until you've been at it for at least 6 months. We just want the same opportunities as others.

I'm wondering: what clinical opportunities were you or are you being given as a student nurse?

5 down, 11 to go

Yep, there's only eleven more weeks in this semester. I have to say it's moving along quite nicely. I barely have time for anything other than reading, reading, and more reading.

We started our clinicals back up at the hospital this week, and that went very well. I went in there so nervous yesterday morning, but that eased up as the morning went on. I passed meds, observed PT changing the dressing of my patient's stage 4 pressure ulcer of the heel, charted, and other fun things.

We were then excused to go to a medical ethics meeting. The initial subject was preparation for H1N1 and patient surge. Ethics comes into this say, when you have two patients needing a ventilator--in the instance that things get that bad--and one has a 50/50 chance of survival, is mid-forties and has a family, the other patient is 75/25 with no one and just so happens to be 75 years old. Who gets the last available ventilator?

Then the other issue raised came from a recent case where a woman at 24 weeks came in wanting a therapeutic abortion because of fetal anomalies, where the fetus would be non-viable upon birth. This hospital is a small community hospital, that receives private funding. The population of the local area is pretty conservative. Every OB doc who was available became a part of this issue when it happened. Some were for it, some weren't. The ethics committee was called upon to make a decision. In the end the woman was transferred to a university hospital. The issue doesn't end there as it may happen again. Yeah, big...huge...can of worm there!

Today was pretty low key. The excitement came when we were notified that the above mentioned pressure ulcer is infected with VRE. Fun times to be had in the hospital!

Thursday afternoons are one of my current favorite times of the week. There are no classes and no clinicals on Fridays, and only the weekend to look forward to...even if it's spent reading and studying for Monday's exam.

like kids in a candy store!

my classmate, LP, and I

Seriously, when the clinical coordinator took us back to the locker room and told us to change so we could go observe some of the morning's cases you would have thought we were two kids in a candy store. We were so excited to be putting on surgical scrubs and getting to at least observe surgeries. Today was one of my most fun clinical days by far. Not to mention I dig the whole scheme of the surgery center...and the work hours aren't so bad either! That's some food for thought for later...

I observed three cases total. The first two were Ts&As, or tubes and adenoidectomies. The CRNA, MD and RNs were awesome as far as letting me get in right over their shoulders and seeing every little thing they were doing. My last case was a GYN--hysteroscopic D&C of polyps, and what was supposed to be an operative laparoscopy. The polyps turned out to be the size of large peanut M&Ms and the lap ended up being only exploratory as the surgeon didn't find anything problematic. He was as great as the CRNA and MD from before, and so was the CRNA from the GYN case. The GYN surgeon let me get right in their over his shoulder and get a bird's eye view of the whole procedure.

Everyone we encountered today was awesome to be around. It was sort of a utopia of medical facilities! So after an exhilarating morning LP and I left as high as if we'd sucked down some gummy worms, sour patch kids, and pixie sticks!

Tomorrow (I'm going out to lunch with a friend, getting my hair trimmed and a pedicure), which would normally be a clinical day is instead a day off, since LP and I are going to a local wound care center on Friday. That's as exciting to me as all the other things I've been doing. Next week we head up to the hospital and start our regular rotations where we'll be doing med/surg, telemetry, ortho, etc. We'll have a total of about 8 weeks doing that, which should also include trips to the ED, OR, IR, and other such places if we're lucky. Then our last four weeks, which include Turkey Day break, will be spent in OB/peds. I just have to make it through the in between stuff and suck up as much good experience from it as I can. I just do not see me doing med/surg for any great length of time once I graduate. Who knows I may love it. I can't wait for the OB/peds rotation though!

open says me

My eyes can barely stay open and they're just watering like crazy. If this post makes no sense whatsoever chalk it up to pure exhaustion.

Monday we had off (yay!) Tuesday was a bit of a waste of time. We practiced taking health histories. We partnered up and asked each other a bunch of questions off of a health history form, that was pretty redundant in a lot of places. Then we were dismissed. Yesterday for clinicals we went to a neighboring county's health care campus and toured the long term care facility, which includes an Alzheimer's unit, sub-acute care unit, rehab unit and a couple of other units. After our tour we played balloon volleyball with about 8-10 of the female residents on the Alzheimer's unit. Then we were dismissed. The five of us that had to participate this week in my clinical group (I LOVE my clinical group!) went to lunch. Today we had to be at the same campus, but this time at the small community hospital, and we had to be there at 0630.

Did I mention this was about an hour away? I've been up since 0415.

When the instructor arrived she informed us that one would go to the ED, one would go to OR, and the other 3 would go with her up to her med/surg unit. I lucked out and got the ED!!

I saw some really cool cases including a person that was HIV positive who had had seizures; a person who was having mysterious neurological deficits (mysterious because all the tests were coming back negative/normal); and a few other minor cases. It was awkward because I knew that me being there only one dday, and a half day at that, that not much would be invested in my learning experience. The nurse I was assigned to observe was actually great to work with though, so overall it was a pretty good experience. I would elaborate a bit more but I am spent and will now be taking my tired eyes...and body to go relax...after making dinner. Thankfully spaghetti is too easy.

sangria y mis amigos

One thing's for sure, I can no longer drink red wine, even if it's just Sangria. Red wine gives me headaches. It's like suffering from a hangover the same night you've been drinking. I had three. They weren't large glasses either. Still I ended up with a same-night hangover by about 8:45 p.m. Guess it'll just be white wine or the hard stuff if I want to enjoy an alcoholic beverage from now on.

There only ended up being 10 of us who showed up. MB brought his wife. We all had a great time rehashing some of the things that irritated us. It's pretty much a consensus, we have one classmate and one instructor that we all find troublesome. As I've taken up saying lately, they're all speed bumps to RN! In the top picture you might notice there are only 8 of us. MB's wife was gracious enough to play photographer, and one of our classmates left before we started the photo shoot. I really wish we'd have started before as I love the classmate who left to death! She was my "roommate". In other words she took care of the resident with whom my resident roomed with at the LTC facility. All in all it ended up being an enjoyable evening and I look forward to getting together over the summer.

for pete's sake

Could this week have been anymore stressful...or weird...or just plain tiring???

First off, just now I was checking our bank account and sometimes it's no fun being the family miser. I see an entry for proflowers.com and immediately searched my brain for something I'd sent recently. Nope, nada. I called Big B and asked him and got this response, "oh geez...yeah, maybe". oops. The light bulb clicked on instantaneously. Duh!!! How sweet is that!? He's sending me flowers!! I am so gushy mushy right now! I love getting flowers. I don't care that they wilt and don't last. It's more than that. It's romantic.

This past Sunday we had something happen in our family, soon after Big B left for a business trip (being a military wife I'm accustomed to the military version of Murphy's Law--when the hubby leaves, things will go wrong!). I alluded to it in a previous post. Sorry, I can't share. Just know it was something that would freak out any parent...even the most strong, solid, level-headed. The point is it happened, and started off this wacky week.

As far as Monday goes I'm drawing a blank. Tuesday we had Drama in the Dugout. To update, CB did call the AD on Wednesday. He couldn't do much for her as of the phone call, as I'm sure he had to confer with other administrators. He was supposed to have gotten back to her later that afternoon. As of last night he still hadn't done so. I tried reassuring her, telling her that it will probably take some time. Yes, it would be nice for him to just give a courtesy call to tell her it's being handled, or whatever.

Wednesday and Thursday were the last days of clinical at the LTC facility, for this semester. Wednesday went pretty smoothly, if I remember correctly. (I feel like I'm in the first stage of dementia.) Yesterday, ahem...I had to go and get a little oversensitive. Let me preface this by reminding all that my class only has 19 people in it. So we're sitting in the lobby waiting to get started with our day, and I'm sitting on the couch with two other classmates. One of them asks me to take a picture of her and the other one we are sharing the couch with. OK, no problem. They're long-time friends. Then classmate #1 proceeds to take pictures of everyone else, it seems, but me. Not that I want to be in any photos, but it's nice to be included. Speaking of inclusion. I go and talk to one of the classmates with whom I've become close and she informs me that Classmate #1 is having some sort of jewelry party this weekend, but did not invite her as she had everyone else, by way of snail mail. My friend had been handed an invite in person, as kind of an after-thought. Apparently several other classmates have been invited, and one of the nurses we worked with at the nursing home. Everyone, but me. I really did get very upset by this yesterday. I suppose it is the fact that I am sensitive, and it was sort of an emotional day anyway since it was our last, first clinical, and we had to say good-byes. Whatever. I don't expect to be best friends with everyone, but in my eyes if you're going to invite a good portion of a small class, why not be nice and invite everyone. Not everyone is going to go. I know this because several have plans for the weekend. I wouldn't even be attending, as we do have finals Monday and Tuesday and quite frankly that's what I'll be doing this weekend, besides throwing more mulch, weather permitting. It was so sad saying good-bye to my resident yesterday. She really made an impression on me. We did have a bit of a party/activities session for our residents, and a few of the other residents who wanted to join in. We did some sittercizing, balloon volleyball, one of our classmates plays piano and guitar and put on a small show, and we ended with the bunch of us students doing the Hokey Pokey. It was a blast!

We have the "swine" flu that is rampaging it's way across the globe. Evidently it's even hit Virginia, as of just yesterday. One of my friends knows of a Mexican family who just came back from a trip home, and one of their family members attends the local schools. It's kind of scarey to think of this child, this family, being carriers, or maybe they're infected. I've instructed both of my boys on how important it is to wash their hands, which usually isn't a big problem for LB, but AW isn't the best at it. I've also told them, knowing kids share lots of things, to not share anything...like sodas, etc.

Big B returned home safely yesterday with more of the Rocky Mountain Chocolate Factory apples. This time he brought back two caramel/chopped nut, one Oreo, and one with mini white & milk chocolate chips, one white chocolate coating. The boys are home from school today. Our county is celebrating its 250th anniversary. I will be heading out here in a few hours to take my Fundamentals and Mental Health ATI tests. I'm a bit nervous, but everyone has been passing, if not doing very well. Those who actually studied have been pulling the higher scores, and those who didn't, well they're happy to have passed. Go figure. For now I'll go finish up studying for it. Tonight we're supposed to have one of LB's baseball games, but it's also supposed to rain. We've had several games rained out, and so next week we're looking forward to a week full of baseball.

Tuesday, after I've taken my last final of the semester, we'll have a double-header, and it's Big B's 40th birthday. He's doing his annual May trip to Richmond for the Nascar race, this weekend. It's how he usually spends his birthday. We'll probably take him out to dinner some other night. I feel bad because I would have liked to have planned a party for him, but can you imagine? I'd truly have lost my last marble!

otto giorni

eight days

That's all that's left until I become a second year nursing student. Of course that's all bearing on my passing my classes, which at this point isn't much of an issue.

Looking back, sometimes it seemed as if time was standing still. Other times it seemed to be rushing past like a marathon runner.

I still have a considerable amount of things to do to tie up this semester. I have to continue studying for my ATI tests. Then I take them this Friday. So far everyone is passing. Some are even getting really good scores back. Sixty-five is all that's needed to pass, and right now I'll be happy with just that. It would be nice to come away with a high score, but I'm not striving for it. That may sound bad, but it's more about the reality I am living right now. I don't have the time, haven't had the time, to study as much as would be necessary to score highly. Life happens, and let's face it I live with teen and pre-teen boys. If it's not baseball or some other activity, it's some new challenge we're facing with the need for wings to be outstretched and boundaries to be tested. I won't go into details of the latest trials and tribulations. Let's just say my skin should be as thick as an elephants by the time both my boys leave home!

I also need to finish up my careplan, and study for finals.

That mountain of mulch is still sitting on my driveway, even though I put a dent into it yesterday morning. I wont get to it this week as Big B is out of town, and I am therefore playing mom and dad. We have two home baseball games to go to, but as usual they'll be used as study relief. I also have to be the resident taxi driver from baseball practice/lacrosse games tonight.

I've been taking my antibiotics, so my sinus infection is resolved. The Prilosec isn't doing much for the suspected GERD/lump in throat feeling I have when I swallow. The referral for a barium swallow is still sitting on my desk, so I suppose I can always reschedule. I do go back for a follow-up to my PCP on the 6th, and will address the issue with her.

Our last two clinical days are this week. When I've gone to dress my resident I've always had trouble finding socks for her. Today I had to pick up a few things and bought a bunch of cute, and colorful pairs for her to keep. I meant to do her nails last week as they're pretty jagged and in desperate need of filing, so I also bought a 7-in-1 file that files, buffs, and does all sorts of good things. One of my nursing diagnoses has been social isolation r/t diminished mental capacity AEB limited social interactions, so I've been changing her brief, dressing her and assisting her into her geri-chair and then we head out into the halls. We visit others who happen to wonder by, and go and look outside or sit by the aviary and watch the birds. This week I'll do nail care, and then we'll venture out for some socialization. Thursday we'll be having a little get-together with the staff and residents to say good-bye. It'll be bittersweet since so many of us are so done with the semester, but at the same time we've grown somewhat attached to our residents.

back to work...

brotherly wonders

As I was taking a brief moment of relaxation (very much needed after the mood I came home in from clinicals today) I happened to look out the back windows, from which we can see a good portion of our backyard and the common area beyond, and I caught a glimpse of something near miraculous. My two sons, who are two completely different human beings, were outside playing football together, with some other boys. I had to catch it on film, and even though the photos aren't of the greatest quality I wanted to share them anyway. I've also included two photos I took yesterday with my Blackberry. With all the rain we've had lately the clouds have been nothing short of amazing. I think one of the things I'd like to do with my free time once this semester is over, is to go out and spend some time just taking pictures of some of my favorite things

dose of humble pie

As is the recent standard we have no sunshine in the skies above Virginia. You look out your window and all you see is gloomy gray ranging from slate to dove. It suits my mood right now. Today was hard, hardest yet. I had to witness an occurence report that I brought on to myself with shear stupidity.

In clinicals we're trading each others' residents to gain experience in skills we otherwise wouldn't get, at least in the near future. My one classmate, LW, and I swapped so she could administer meds via PEG tube, and I took care of her resident. Boy did I ever take care of her! It was horrible. I dressed, we'll call her Mrs. Doe in her gown (a pretty new thing she got for Easter--not one of those icky hospital types), and then proceeded to transfer her from her bed to her wheelchair. Lesson learned: do not forget to lock the wheelchair and make sure you have a second person to assist. If you don't follow these simple rules you may end up on the floor, as I did with Mrs. Doe. I actually couldn't tell you if her buttocks even touched the floor because I already had her under her armpits, with my arms to support her. One thing I remember from my days as a medic in the Air Force is how to go down to the floor with a patient. Recall from the depths of your memory can certainly come in handy!

One of my classmates was taking care of her resident in the next bed over and I immediately called for her assistance. She was there in a flash! We managed to lift Mrs. Doe into the chair. Schew! After getting Mrs. Doe settled in activities I promptly went to let my instructor know what happened.

She told me to tell the nurse, and so I did. The look that came across Nurse C's face made me get queasy, but she just said we'd have to fill out an occurence report. Along with the report itself she also filled out the physician notification and then I saw the spot on the report where it asks if family has been notified. Gulp. Nurse C called the family and that's when I lost it. All I could think about was if it were me on the receiving end of that call and how I'd feel.

After a few minutes in the restroom I gained my composure and went back out to the nurses's station and got the "everyone makes mistakes, and we learn from them" schpiel, along with reassurance that it was all going to be ok. The family member was at first horror stricken because evidently Mrs. Doe has had an actual fall that left her with broken bones. Fortunately there was no injury sustained today. I'm sure she may be a little sore under her arms. I know I supported her with all my might and adrenaline as I guided her downward.

If you do ever go through this horrid situation I hope you have someone react the way that Mrs. Doe did. Can we say "angel"? I, of course, apologized profusely, to which she gave me the "we all learn somehow" schpiel. The events of the morning along with the necessity to obtain vitals signs and blood glucose per the occurence report protocol, not to mention everything else the woman endures, left her very tired. When I went to go I told her how much I appreciated her patience with me, and she said, "That's alright honey". She was too kind, too, too kind.

Well if that isn't all enough to wear a woman down I just received the call from hospital #1 and got the "we decided to go with other candidates...there were so many great, experienced people....please apply next year as a new grad..."

Lovely.

no rest for the weary

Yesterday we took our 3rd exam for Nur108, Nursing Concepts and Principles. Many of us were left feeling broken and abused. Evidently there were about 5 questions that ended up being, well...questionable because I went from an 80 to a 90. That would be one point away from failing to a high B. I'll take it. From the sounds of it I had one of the highest grades. That sounds pretty crazy to me, even now, because as soon as I'd finished the test and turned it in I thought for sure I was going to see a lot more wrong answers than I did. Even crazier is the fact that I didn't study as much as I should have! Remember, last week....little motivation...

Today we took our 3rd mental health nursing exam and it was a more pleasant experience than yesterday's. I'm extremely happy with my grade, which is also a 90. If nothing else I'm consistent. Once again I didn't put as much effort into studying the material as I should have. I'm not going to complain though, just do better time management and learn from my complacency.

My complacency, lack of motivation, whatever, caused me to have a near anxiety attack on Sunday. It dawned on me that we only have 6 weeks left in the semester until finals week! If final exams aren't bad enough we have two ATI tests to look forward to, one for fundamentals, and the other for mental health. I'm not a big fan of the ATI modules so I've actually ordered a couple of other books to help me prepare. I'm going to have to focus on the end prize. Short-term we're talking the end of the second semester of nursing school, and long-term would be becoming a nurse and living out a dream.

Tomorrow we start our clinical rotation at the nursing home. My classmates and I are somewhat disgruntled because not a one of us feels like we're prepared to walk into our perspective LTC facility tomorrow. I have angst over not knowing if I'm supposed to look forward to the first couple days being spent as basically a shadow or are we supposed to jump right in and take over. If that's the case, well um...hello???

Oh, geez...can we say nervous?



I also have to condition the boys into getting up a tad-bit earlier than usual so I can get out the door and not have to worry about someone oversleeping and missing school. There isn't a lot of parking at the place we'll be working at, and so we've been advised to carpool. A classmate has offered to meet us at the local grocery store parking lot so we can pile in and head over. Well, depending on how the boys do will be the deciding factor in my being a participant in said carpool, at least in the beginning. By skippy the boys will learn after this week what's expected of them on Wednesday and Thursday mornings!

Friday I have an interview at one of the local hospitals for a summer position as a nurse extern. I ended up only applying at two hospitals, the two closer ones to be exact. This summer I also have to take A&P II, since the school only awarded me credit for A&P I from my prior A&P class. When I took it it was a one semester, 5 credit class, whereas now it's a two semester, 8 credit class, so I have to make up the 3 missing credits. I also have to take nutrition and development. My school isn't offering A&P II at all, at either campus. One of the other local community colleges is offering what is probably my best option, considering I am planning to extern, and that is an online A&P course! It may sound somewhat daunting, but after taking the plethora of online courses I have, I know I will manage. One of my instructors also informed me she's going to be offering an online section for the N&D class.

The only problem is with the two classes I need to take I am left taking a total of 5 credits this summer. To keep my student loans from my BS degree in deferred status I have to maintain half-time status. Normally that would mean 6 credits. I do need to clarify that it's the same for summer classes. If it is than I need to come up with one more credit. Other CCs are offering other nutrition classes, for more credits, so I may take that route. I also still need Developmental Psych, (yes, even with a degree in psych, I've never take Dev Psych)! I plan to CLEP out of it.

I'm so tired I am bailing on the family baseball player for the second night in a row. Last night I bailed to stay home and study, that and the fact that the game was quite far away. Tonight's game is even further and it is still so cold out that I've decided to play the part of the errant parent. I still have drug cards to write up too. I feel horrible though. Last night I misssed two awesome plays made by LB, and will probably miss more tonight. I don't usually do this, but I guess this would be one of the mom-is-a-nursing-student-sacrfices I knew I would be faced with on this journey. Still doesn't make it feel any better.

LB has ended up playing on the JV team, much to his pleasure. I think he got kind of irritated with the Varsity team because they weren't as cohesive a team as the JV group. He'll see way more playing time on JV anyway. Selfishly speaking I prefer the JV team since I know more of the parents, and a couple of them are some of my closest friends. One mom and I met and have become friends because our boys have been on the same teams together for a few years now. She's bailing too, because of the cold. Heck, it's nearly 6:30 p.m. and 48 degrees out! Don't get me wrong, if it were a home game I'd be there!


It's time to take my weary behind and go write up the rest of my drug cards!

indications for retail therapy

I should really be studying for Wednesday's pharm final, but it's been a few days since I've posted so here I sit typing away to my heart's desire. This past weekend was spent studying and it was fruitful to say the least.

Let me back up for a bit though. Last year I had to take basically a full year of math. First it was Introductory Algebra, since I placed that low on the university (where I recently graduated with my B.S. in psyc) placement exam. It wasn't good enough that I had taken remedial-get-your-high-school-equivalency-credit when I first returned to college in 1999. Nope, not for this brain--too much time had passed. Then after Intro I had to take Intermediate Algebra. I actually went back to the U after finishing Intro and attempted the placement exam again in hopes of placing into College Algebra. WRONG! I had yet another grueling semester of algebra to look forward to, fortunately I had one of the best professors ever. Mary D was one of the most positive and inspiring people I've ever learned from...ever. Mind you, since we've been back to the states, up until I started my nursing classes, so from 2005 until 2008 (in finishing my psych degree) all my classes were online and a deadbeat Prof can make or break a class! Finally last spring I was able to take College Algebra, which I finished with an A, and in the summer I took Statistics for Psych (that Prof left a lot to be desired in a prof), but I believe I came away with an A or a B in that class so what the heck, who gives.

Anyway. What's with all the mathematical babble? I obviously somewhere in all those semesters of algebra learned about ratio and proportion. For the life of me I could not figure it out the other day when one of my classmates tried showing me how to do it in relation to a heparin drip problem. I basically (iffy, to say the least) got it. I sat down with my textbook, which was no help. It just further confused me. I have the book, Math for Nurses and found my lightbulb moment contained within. Seriously. It's as if the lights all over the country went out...and came back on all at once. Originally our professor had shown us a different formula for heparin drips, that was just little bit more labor intensive, and well once my classmate had pointed out the ole ratio:prop method, I had to give it, and him, well...props! Now that I am hip to the whole scheme of things, I'm cool!

Friday, we didn't do anything over-the-top for LB's birthday, even if it was his 16th. All he wanted to do was go skating. This was much to my displeasure even if it was the much less expensive option in comparison to what we (I) had originally planned, which was taking him and some of his friends out to dinner, restaurant of his choice, of course. Whatever. I will give him tons of credit for what did happen in the later part of the night. He and his one friend made an extremely wise choice. He intended on having three friends stay over, only two ended up staying through the whole night. To make a long story short, and what's turning out to be a novel, even shorter, two of the boys decided to sneak out with a fifth boy who had come to pick them up, unlicensed, in his own parents' car. They were out past curfew and got busted. One of the two who snuck out, and also lives across the street ended up at home, the other ended up back in our house. Kudos to my son and the other kid who chose to stay behind. Good on them!

Saturday was the first varsity "game", in all actuality it was a scrimmage. Our team lost. LB played the last two innings. He's the only sophomore, so it's what we expected. We hope for him to play more as the season goes on. One of his previous coaches gave him a glowing compliment on how he has improved over the time this coach has known him. Tomorrow I will take a short break from the studying as we have "Meet the Coaches" night for all the spring sports at the high school. We'll get to meet all the coaches that are working with LB. We've only really met one of them. We'll also do all the parenty (yes, I meant "parenty") kind of stuff like assign meals and such, whatever that means.

It's also a big day tomorrow because it's our orientation for our clinical placement at the long term care facility. I'll be ironing my uniform tonight (sorry, you can take the girl out of the military, but not the military out of the girl-besides it's that stiff-ass white scrub material crap). I have my notebook, 4x6 cards to write up my drug cards, because we have to write them-grr- and all my other little supplies, not that we really need anything tomorrow other than our notebook and pen, oh and our badge. I'm the nerd who's had her's in her purse since, oh, about day 15, first semester.

Wednesday's the big Pharm test...might've mentioned that a time or a hundred...and ten.

Thursday I am partaking in some much needed retail therapy. I want some new shoes of the sandal variety, and some new tops, and maybe some new capris also. Oh, and maybe a new purse too! Besides school I've been putting up with a lot as far as dealing with living in a house full of b-o-y-s-es, and I deserve some mommy/girl time!!!

this time next week

Next Tuesday we orient to our first clinical site. Yikes!!! I am both nervous and excited, all rolled up into a boundless, near mindless frenzy of energy! This semester we'll be spending six weeks in long term care, working one-on-one with one patient (I'm not too sure I like being limited to one patient, but think there will be opportunities to help where help is needed). The following week we have spring break, and the week after we actually start patient care. I am soooo nervous because aside from the free clinic I volunteered at for two hours this past semester I have not interacted with patients in oh, about ten years!

One thing I am not looking forward to is the insanely ugly uniform we have to wear...pictures sure to follow. After leaving class today I dropped it off at the cleaners to have the patches sewn on. I'd try myself, but decided to go for the straight option. Little did I know it was also the rip off option, at $30 a pop!!! That's the total for three rockers, three rectangulars on two shirts and one lab coat!

This all hinges on passing the dreaded pharmacology final/class. Back to the books...