Friday, April 26, 2013

From the Operating Room to Public Speaking


Well we are really getting down to the wire here. Only two more weeks of school left. Two more nights of clinical and then two exams and one group project.  Hard to believe we are almost at the end of the semester.  This will be the first year I am not taking a summer course since starting this journey three years ago.

So this week started with my OR (operating room) observation. I was hoping for some 'good' surgery to observe but unfortunately my 'day' I was assigned was 'joint' day at the hospital. I arrived just before our designated time (I am always early for school and clinical and was freaking out that I was going to be late) and found that another student was already there and shortly after I arrived the third student assigned to this same day arrived. We were met by an OR nurse who then took us to the locker rooms where we changed into hospital scrubs and 'geared' up for the OR. We were each in separate OR's watching 'similar' surgeries. I was with Speedy Gonzales. This surgeon was already on his second surgery at 8:30 am. I arrived in the room where surgery number three would take place. I watched as the scrub nurse prepared a LOT of equipment. I was going to see a left knee replacement. It was amazing all the tools needed. Soon they brought the patient in and I found out quickly that they are not put under general anesthesia for this but more of a spinal block and then a twilight or light sedation. Was a little creepy when the patient was coughing and gagging. (Too much TV surgeries where everyone is out cold, haha). So I watched as the cut into the knee and the sawed and pulled and hammered and I started to get 'hot'. I didn't feel sick but got worried I might have an issue so I was able to sit and watch and then I was fine. I certainly did NOT want to pass out and contaminate the entire sterile field (or hurt myself, haha). As soon as the surgeon was done with this patient, the Physicians Assistant stepped in to close the surgical site while the surgeon moved to the next surgery. After this patient was done we wheeled them off to the recovery area and it was back to the same operating room where it was already being prepared for the next surgery. It was amazing to see how much of a TEAM these group of medical professional are. The next surgery I was able to observe about 3/4 of it was a total hip replacement, but soon it was the OR nurse calling for us to prepare to leave.  Our 'shift' was over. It was truly an amazing experience and I hope to get to do it again (only a 'cooler' surgery would be good)!

After I finished at the hospital it was off to the school where I needed to finish up some mandatory lab hours. Shortly thereafter I get a call from one of my fellow students from my clinical group telling me that they were sent home from clinical this day due to a virus going through the nursing home. Wow, I certainly don't want to catch whatever is going around, so I am very happy that the school takes our health into consideration at times too.

On Tuesday since we were still unable to return to the nursing home, we had our clinical time in the lab at school. We had several simulations set up where we had to assess our patient or provide care for another patient, we practiced would care, diabetic testing and insulin shots and 'comfort' care for an elderly 'patient' who suffering from Alzheimer's. After I did this simulation, my instructor told me she felt my 'calling' was possibly for hospice or nursing home area. I told her I wasn't so sure, as I get 'attached' to my patients (in a matter of minutes)! We did get to work on SimMan again. It's crazy how 'life like' he can be. His eyes react to the light when you are checking PERRAL (pupils, equal, round, react to light and accommodation). He also had various lung sounds, pulse rates, blood pressure, you name he can probably do it.



We had a good afternoon of clinical and it was good to go over some things we learned much earlier in the semester. Always good to review.  

Well, today was a luncheon I had been invited too. It was in coordination with the scholarship I received a few weeks ago. The school likes to bring the donors and recipients together to see how the donors money is making a difference.  I was looking forward to this luncheon UNTIL I got a call earlier in the week asking if I would speak at the luncheon. I was told, just something short to give my 'story'; why I chose this school and how this scholarship will help me.  SURE, I said, no problem. And then I started to freak! I am not one who like to speak in front of people. I love to talk, but 'having' to talk is not the same thing. 

I had stressed about this 'speech'. I initially thought, I'll just 'read' my thank you letter that I wrote to the organization that awarded me my scholarship. Then a friend said 'don't read' just put bullets down and go from there so I tried that but found I was adding to much to my bullets. So today about an hour before leaving when a co-worker asked if I was 'ready or nervous' and thought oh no, I don't really have anything 'ready'. So I grabbed my note card and looked at my thank you letter and threw it all away. I put three one line notes on a 3x5 card.  

So I arrived about 10 minutes before the start time, got my name tag and was told what table I seated at. I then went into the conference center and found my 'place' at the table (there was a card with MY name on it!). I looked at the program that was laid at each place setting and FREAKED OUT!



My name was right there, I really was going to be speaking to this group (thankfully a smaller group of about 50 people). I got very nervous, my hands were shaking, my insides were shaking. Little by little everyone arrived and we started the luncheon. It was nice to just have 'normal' conversation while eating and getting to know the other people at my table. There were two other students at my table along with one donor and three faculty members.  We shared a little about who we were, what we were doing and enjoyed not thinking about that speech. So then it was time. The VP was up first. He recognized all the donors in attendance and the students. It was then time for the other student to get up and talk (thank goodness he was before me)!  He seemed all confident but was nervous too. He pretty much read his speech and told the audience he was doing that to make sure he didn't forget anything. Then it was my turn. Oh my gosh, deep breath, again, breathe!!!!

I walked up to the podium. I introduced myself and pretty much let it roll. I told them that I love to talk, but I don't love to 'have' to talk and that I was truly shaking! I explained how I worked in a small Christian school for many years and got to 'play nurse' since we didn't have one. I finally decided when I 'grew up' what I wanted to do. I explained that I chose this college due to the wonderful things I'd heard about the program I am involved in. I made people laugh when I mentioned how I attended an 'Nursing Information Session' roughly three years ago and thought NO WAY could I do that, it will take forever to get into the program. But I registered in May of 2010 for my very first college course. I tackled each one and just this past January I started the clinical portion of the program!

I went on to tell them that this scholarship meant so much to me. I actually cried when I received the call that I was awarded this scholarship. I teared up at this point and so did a few of the ladies there. I explained that my husband works two jobs and I work almost full time and we truly live paycheck to paycheck (like so many others). I told them how I had to take a student loan this semester. I hated the fact that I had to do that, but $1200 in book store charges alone this semester were far greater than the financial aid I had received. I told them that I hoped this scholarship would enable me to attend the fall semester without having to take another loan. I thanked the donors who have made so much possible for so many students and I think I looked down at my 3x5 card and said 'out loud' 'Well I guess I covered everything'!!  

I was told over and over by many in attendance that I should never underestimate myself, I am a wonderful public speaker. The Dean came over to congratulate me along with several other 'high up there' school officials, each saying how well I did, how my 'story' was touching.  The student who spoke before me asked 'Hey, I thought you couldn't talk in front of people, did you practice that?' to which I replied, NOPE!  I just let it roll. I was able to finish my lunch and then it was time to head back to work. I don't think I actually stopped shaking until I was back at my office!

I will have  just a few more updates before taking a little break for the summer. I pray that these last few weeks go smoothly and that all the information I am learning stays up in my brain where I need it!


Help me reach my goal for the Susan G. Komen Boston 3-Day

Thursday, April 18, 2013

Failing - Not An Option


I've been receiving information for that past two years from about Phi Theta Kappa Honor Society.  It's a Honor Society specifically for Community Colleges.  I finally bit the bullet and joined.  I've had a good GPA since starting this journey, but worry about the required GPA to continue as a member during these difficult two years of clinical.  This will hopefully encourage me to keep my grades up (and not just 'passing').  So, I am officially a member The Alpha Epsilon Zeta Chapter of the Phi Theta Kappa Honor Society.   Now I just have to keep my grades at the required GPA to continue in it.  I've not had a chance to attend a meeting but will get to one in a few weeks before classes are over for the semester.

At the very start of our shift we received notice of the bombing at the Boston Marathon.  It was scary, as the alerts came in via phones and tv's around the hospital.  So it was with a heavy heart that I started my last week of hospital clinicals.

So this was our last week doing clinical work at the hospital.  I was bummed as I really enjoyed this time.  And due to scheduling, I wasn't going to have a patient this week.  Monday was my turn as the Team Leader.  In that role, we shadowed our instructor, got reports on each patient that our students had and assisted where needed.  I didn't think I would enjoy this but I really did.  I liked being able to help others.  Last week we worked on parenteral meds so each of the students in my group would have to give an injection this week since we are no longer able to provide medications at the nursing home we will be doing our final two clinical weeks with.  So as Team Leader I accompanied the instructor and the student nurse to the patients room where the student nurse gave the injection.  Those that went before me all had to do insulin injections with the insulin pens.  So there isn't to much to mess up.  When it was my turn, I was shocked that I had to give a heparin shot (this is a blood thinner that helps prevent blood clots in patients who aren't able to ambulate).  So thankfully, my instructor, allowed me to review all the steps in giving this shot.  She tried to trick me up by handing me two different syringes.  I was smart enough to know that (after checking the patients medication administration record) my patient to receive 5000 units or 1 mL of heparin.  The one syringe my instructor gave me would only hold .5 mL so I knew right off that wouldn't work.  We were taught exactly what to do the previous week in lab, so I knew that I had to inject 1 mL of air into the vial of medication and then withdraw 1 mL of heparin.  I was to inject this in to the patients abdomen.  Since the patient had gotten their injection that morning in the lower right quadrant I was to inject in the patients lower right quadrant.  I was very nervous at first, but did as I was taught and BAM, it was over!  I did it and I the patient didn't flinch, so I guess I didn't hurt them.  I was on cloud nine that I had done something else that I'd been taught!

The next day, I was on IV observation.  Our hospital has their own team of IV nurses that go all over the hospital starting IV's, assessing those that had been started earlier (or elsewhere), changing the locations as a problem arose.  I'll tell you these nurses move.  We got called to the ER to only get there and find out the patient had been sent to radiology so we were off to another unit at the very opposite part of the hospital.  This went on the entire time so it's obvious these nurses move all shift long.  We got a short break for dinner and then I was able to follow another team of IV nurses that had to start a PICC line.  This IV is inserted through a vein in the arm and threaded up the arm, into the superior vena cava (near the heart).  This procedure took a lot longer than a 'normal' IV and is done under sterile asepsis.  I was so glad I had the opportunity to observe this and the other procedures this night.  It was a great last night at the hospital. 

I was sad as we left knowing we won't be back until the fall but we will get back there.

So today was my sixth exam of the semester, the third of this course and I failed my exam.  I've not failed anything since starting this journey and I was heart broken and ashamed.  I was not going to share this as I am embarrassed that I didn't' do well on this exam, but I have to say I have worked my bottom off for the past three years  next month and failure is NOT an option!  I will work this much harder so that hopefully this never happens again.  I'm very nervous as it has been rumored that 60% of all students FAIL the final exam in this one course!  I thought surely this can't be true but now I'm beginning to wonder.  I know several others who also failed this exam and they also have never gotten a grade this low.  I have to say my failure was a 70, passing is a 75.  I still have a B average for this course but I truly want to makes sure I don't drop any further.  The last two exams of this semester are both in less than three weeks.  Our exams are usually a week apart but not the final two, we have them both in the same week.  And the material in both of these courses is much more difficult.

So I end this week with lots of studying to do this coming weekend.  I have a motorcycle ride with Dale on Saturday and I'm going to spend some quality time with him as we don't see each other to often these days.  On Monday I will get my turn in the Operating Room for observation!  I've heard all kinds of reports from students who have already done this and the only complaint has been the 'smell' of burning flesh.  I'll see how that goes and will update you next week.




Friday, April 12, 2013

Learning Your Patient Isn't Going to Make It

Well, a week off from school flew by!  I had planned to spend a lot of time studying but the week was over before I knew it.  

The week started off with sad news.  Bridget had passed away the Thursday before. It broke my heart that this woman did not make it to her 30th birthday. This was her goal for so long.  So many, many sad tears were shed and again as I write this.  My heart still hurts.  29 year old women should NOT die from breast cancer. This is why I walk, this is why I fight, this is why my husband stands beside me in this fight (he crews for the walkers)!!

So back to the real reason I blog . . .

I was excited to get back to the hospital again Monday and Tuesday. We also had lab twice this week. On Wednesday, we learned about administering parenteral medications. These medications are given my injection. So when we go back to the hospital this coming week we will get to give injections!!  Nervous and exciting. Today we learned about nasogastric tube. How to insert them, remove them and irrigate them. Not a pleasant experience for the patient but some times the patient is not able to get nutrition through the mouth so it is sent down this tube directly into the stomach.

But onto the 'real' stuff. So Monday we were back in the hospital. For anyone who lives nearby, you know that Monday it was absolutely gorgeous out. Just a week ago, it was cold, rainy and even snowed one day. But summer hit Monday (and it's gone again). It was just beautiful walking into the hospital. So we get to our meeting spot and are handed our patient assignments and begin to review the information. At that point I realize, DARN, my glasses are in the car. I'm not sure if I mentioned this before, but the student parking area is about a 10 minute walk to the hospital lobby. The unit I'm assigned on is a little further away. Thankfully one of my classmates read my patient info for me to make sure there was nothing dire that I needed to know for when our instructor asks us questions before going to the assigned rooms. As soon as we were dismissed, I booked out to my car to get my glasses. Thankfully I've been trying to get my training runs in for the Broad Street Run, so my walk is much faster than it used to be. As soon as I got back to my assigned area the nurse going off duty was ready to give report to the nurse coming on.  My patient this evening had MS and had had a fall but had just been released to go to rehab. I only assisted with this patient for a little bit. Assisted the patient with getting dressed in street clothes (they did not want to go on the transfer in the hospital gown). Shortly after that the team arrived to transfer my patient to the new facility. After dinner I was able to assist other students as needed since I would not get a new patient for the short time after our dinner break.

On Tuesday I was given a new patient. The patient was just returning to the room from receiving some therapy. As soon as we started to transfer the patient back to bed it was apparent they needed to use the bedside commode. I jumped right in to assist my patient (funny how things that might of 'bothered me' before were not an issue at all now). Shortly after getting my patient back to bed, I began getting their vital signs and starting with the full body assessment. My patient was very tired so I left them to nap a bit while I documented my findings in my paperwork and the hospital computer system.  We get to document certain things in the electronic medical records here. I love when I have to sign my name to the paper chart and put "SN" after it for 'Student Nurse'! So while I was working on the computer another doctor went in to see my patient. A short time later the doctor came out asking where my patients nurse was. She was assisting another patient and I explained I was this patients student nurse for the day, could I help with anything with. At that point, this doctor told me that my patient was just told that there was not much time left. The disease this patient had was not responding to the aggressive treatment. Due to the other medical conditions this patient had, once they discontinued certain things the end would be imminent. I was heartbroken again. Granted I'd only just met my patient, but I would have the rest of the evening to assist them and wasn't sure how I would do. I initially went back to my patients room and 'acting' as if I knew nothing different.  I was able to assist my patient with their dinner tray and finished my assessment. It was our dinner break at that point, so I told my patient I'd be back in a little bit. After dinner when we returned to the floor my patients own doctor was in to discuss 'options' with them and to explain information over the phone to the family members. At that time, my instructor came by. She visits each of us throughout the day to check out some things on our patient.  She's one to just 'knock and enter'. As she was walking into the room, I grabbed her and told her to wait. Explained what was going on. That's when it really hit me. This person was going to die soon. Shortly after that the doctor came out asking the nurse to get something for the patient. This patient was trying desperately to not throw up while the doctor was talking to them. The nurse was explaining that it was too soon to give the next dose of what was administered earlier. At this point the doctor went into 'overdrive'. Her patient was suffering and she wanted something done NOW. So an order was provided for some fast acting meds. I n the meantime I went into the room and was hit with the thing I'd been dreading. I've dealt with all kinds of bodily fluids but I do not do well when someone vomits. When the kids were little, I would call Dale at work as I could not clean up the vomit when one of the kids threw up.  My patient had thrown up on them-self. I went right to work, got an emesis (vomit) basin and started to clean up my patient. The nurse then came in and administered the meds and soon my patient was started to feel better! As the evening wrapped up and I had gotten my patient all freshened up it would soon be time to leave. I spent some quiet time with my patient where we just talked. My patient was not scared of what was coming and told me that with my care and compassion that I will make a great nurse.

I was sad leaving the hospital. 

Yesterday was our third exam for the one course and this coming Thursday is the third for the other course.  I got a C.  I was bummed but accepted that I passed and that is what is most important.  We always get a chance to review our exams to see what we got wrong and what the correct answer was.  I had changed my response on FOUR questions!!!  Four questions would have given me a solid B in this course!  I will NOT second guess my answers on the rest of my exams!

Today I had my interim evaluation (from my time at the nursing home) and received a great review.  I am truly enjoying EVERYTHING I am learning!

Wednesday, April 3, 2013

From Ecstatic To Sorrow ~ All In A Few Hours

I received a phone call today from one of the nursing counselors at my school.  She proceeded to tell me that the scholarship (the first and only scholarship I ever applied for) had been awarded to ME!!!  To me, really???  This is a nursing scholarship from a local church in memory of their late reverend and his wife.  I applied only because it was sent to me in an email by the nursing office.  I never in my life thought I would get it but I did!  This will be a nice amount towards my fall semester!  Hoping with this I will not have to take out a student loan (which I had to do this semester).  I was so happy I actually cried!  I called Dale right away and then posted my great news to Facebook since that's the way to tell the world :)

Then, just a few hours later, I see a post on Facebook about one of the people who I told many about this past winter.  Her name is Bridget.  Bridget spoke at the 2010 3 Day for the Cure.  This link will take you to the YouTube video. It is less than 10 minutes.  If you have the time, go and listen.




Bridget was diagnosed at the age of 21!  YES 21!!!!  She had just graduated college. She discovered the lump six months prior but multiple medical personnel told her that it couldn't be cancer, she was too young, she had no family history, she would be ok.  Well, six months later she was told she had STAGE FOUR cancer!  At the age of 21, just when she was starting her life.  Well Bridget was determined to do what she could and make the most of her life.  She married her 'Big Guy' (what she always called her husband) and she fought and she fought and she fought.  On December 26th, Bridget wrote her last blog entry, saying 'goodbye' to her followers.  She had given up the fight and was going to spend what little time she had left with her husband.  

Today I learned that the end is very near.  Bridget's time on this earth is coming to an end.  My heart breaks for this woman who will not see her 30th birthday, who will never have her own family all the things that I've done since turning 30!  My heart breaks for this woman.  Please pray that Bridget's passing will be painless and swift as she has suffered far too long.

Bridget is just one of the reasons I fight!