puking blood

This is a good news bad news story, and I'm shaking as I write this. In the grand scheme of things, this isn't horrible bad, but it just looks bad more than anything.

Here's a very abbreviated glimpse of what happened. I interviewed at a small community hospital over a month ago. They never called back. They did however, ask me if I wanted to do my preceptor (kind of like an internship) there.

I told the hospital that I already submitted my letter but I would see if it could be changed. The school told me that it might not be possible to change.

Over lunch one day during class, we (my classmates + clinical instructor) were talking about preceptorships and one of the classmates asked if I knew anything about my placement (she knew about my asking to possibly switch preceptorships). I mentioned how it probably wouldn't change because yadayadayada. My current instructor, the one eating lunch with us said, "I'll see what I can do."

During all this time, the small hospital was quite pushy about changing my preceptor assignment, going as far as to call the school, me, etc. The hospital sent me multiple emails. I kept saying, "Thank you, but I'll see what I can do." I really didn't to make waves or force changes....it was no big deal to me where I did my preceptorship.

I eventually found out my preceptorship would be at the small hospital. Still no job offer.

My current clinical instructor and I had our end of clinical evaluations and she ended up questioning me as to why I wanted that position. She made some comments that were totally true and it got me to thinking about that area of medicine.

Still no job offer.

Then, about 2 1/2 weeks ago the small hospital called to say they were offering me a position in a department that I thought I wanted...the one with the preceptorship. I freaked out...asked if it was ok to let them know in 2 weeks. They sounded surprised but were OK with it (they wanted to know right then and there).

Fast forward to two weeks later (which was last week). I had an interview at the big hospital. 2 days following the interview, I called the nurse recruiter. we played a game of serious phone tag.

My friend got a spot for the same position I interviewed.

Next day I still couldn't get in contact with the recruiter from the big hospital. I hastily call small hospital and leave voicemail saying I'll take the job.

4 hours later I get offer from big hospital. Better pay. Better benefits. In state (read: one state income tax, not two).

I play phone tag with nurse recruiter from small hospital. Finally get in touch with her today. Tell her I'm very sorry for not being about to get in touch sooner. Tell her I'm sorry about the offer. I know I verbally accepted over the voicemail, but I am no longer going to be able to work in their state. Repeat I'm sorry. She was silent and then said thank you for letting them know. Then that was all.

I didn't know what to do and I feel sick to my stomach. I'm worried about the preceptorship assignement and am hoping that the school doesn't hate me after this. I honestly don't care if I still do my preceptorship there. I never told my instroctors that I was even offered a job there, because honestly, I just found out a couple of weeks ago, before the preceptor garbage went through.

Seriously. Want to be an ostrich right now and stick my head in the sand. I'm confident that iI'm making the right decision in employment, and I hope that everyone else can come to this realization. I just hate that I made that hasty phone call.

Anxious

So I might have some big news about that thing you're supposed to start after graduation. It's big. It's so big that I'm hoping my cards are played right and that I'm making the right choice after screwing up eariler today. this is cryptic and vague, I know. Let's just say I can't manage to keep my foot out of my mouth and I have the inability to make a decision and I might have to change a decision that I made on a whim. The decision on a whim was made today and within 4 hours, the mind was changed. But as I haven't signed anything, I think it's ok. Bad, but not as bad as it could be. And because the more I type the more cryptic this message becomes, I think I'll write about something else.

Like parties!

There's an holiday party tomorrow night....one of the traditional students at my school invited me to her holiday party, which is complete with turkey and ham (!), so I'll need to figure out something nice to wear.

Shiny leggings might not be appropriate.

but they might be good for Saturday's Tacky Xmas party (you know, where you wear one of those awful sweaters/sweatshirts that are Xmas themed). I feel bad for all the older ladies out there who spend that much money on those sweaters!

Here's what I have so far to wear:
reindeer headband? Check
Red/Green sequined headband? Check
Rudolph blinking nose? Check
cream colored mock turtleneck with tiny snowman motif? check
Red sweatshirt with white lace collar, complete with design of xmas teddy bear wearing an xmas bow? Check
Xmas themed pins? Check and Check
leggings? check

I think I'm going to have to go with the stirrup leggings. As you may have seen from a previous post, the shiny leggings with a shirt above the butt aint' so cute (sorry, had to use the aint').

leg warmers? Check...although I might take those off...I think they were made for a 10 year old. no wonder they were only $4.

Keep your fingers and toes crossed that the right choice is being made and nobody gets upset... And that the xmas parties are fun :)

Weekend in Review

Too much to say, too little time (need some sleep!)

• Friday night Trivia: we rocked it with 2nd place! Followed by a very cold & brisk walk to other local bar for karaoke, followed by brisk and colder walk to friends home for some shut eye.
• Saturday: gourmet breakfast at friend's house, grocery shop, class project, Gator Game (um, YAY!!!!!!!!!!), Scrabble
• Sunday: NY Times @ local coffee shop, Costco (we bought a vacuum), lunch, try vacuum. In disbelief at amount of hair/dirt sucked up by vacuum. Empty canister. Repeat vacuum in same spots. Begin to wonder if the vacuum comes with dust bunnies that are to be released into canister or if vacuum is sucking so hard that the carpet will disappear before our very eyes. Finally, more lazy reading, purchase Xmas tree (complete with ice chips!), decorate, cook, eat, etc.
• Monday: Xmas tree is on floor, in horizontal position. cats are wisely hiding out and no where to be seen.

I Say It's Great...

To Be...a FLORIDA GATOR!!!!!!!!!!!!

(now why couldn't the Gator's do this when I was there??)

Product of the 80s

Proof:

I just bought a pair of pseudo-stirrup leggings. What is that..the 3rd pair of leggings I've purchased recently?? About a year and a half/two years ago, while living in SC, I bought a pair of black leggings. Then I bought a few fun colorful pairs: green, yellow, and white. I only wore the green pair once and that was for St. Patty's day....(I realized that I'm too old for the other colors)

Then a few months ago I bought those shiny latexy leggings. They were a hit and I honestly can't wait to wear them again somewhere.

And finally today I couldn't pass up the pseudo-stirrup leggings from Macy's. They were ON SALE. On Sale PLUS a 20% off discount.

I love how the new stirrups are more like extra long leggings with a whole cut out for the ankle. Remember when they looked like true stirrups (pants with a a piece of elastic hanging off the bottom)?

What's next...sliders/biker shorts underneath skirts? slap bracelets? goony bracelets? hypercolor tshirts???

Bullets

Today's blog is in bullet form (because I'm just too lazy to write coherent sentences)

• It snowed here a couple of times this past week. That's two times too many.


• I ran 3 miles today with hubby and I'm so happy he helped me get back out there (of course it doesn't hurt that the winds were only at 6mph instead of the 18 mph we tend to have...)


• I had a GREAT med/surg 2 rotation. My instructor was witty, sarcastic, and sassy without coming across mean or vicious. That said, this med/surg rotation left me thinking a lot about health care in America. One of these days I will organize my thoughts and explain...


• We spent part of the weekend at the King of Prussia mall. I finally broke down and am getting a North Face jacket for the holidays. Black, waterproof, ending just above the knee with a zipper and belted waist, it's sporty and feminine. And better keep me warm (especially for the price, although the jacket was an unheard of 40% off at Nordstrom)! I'm beginning to wonder if I hate winter because I don't have appropriate clothing. PS....King of Prussia mall has the best Nordstrom with the best sales. It's the second year in a row that I've gotten something sweet, luxurious, classic, yet trendy for a reasonable price.


• The Lucky Store. I've never purchased anything from the actual Lucky store (too pricey), but a few years ago I purchased a pair of peace earrings from Belk (the earrings are Lucky brand). Using a Belk coupon with a sale, I got the earrings for yet another ridiculously low price. For some reason this past weekend, I wanted to go into the Lucky store. Bad idea. I found a purse that I can't forget about.

I have thought of this bag every day hour since I saw it (yesterday). Here's the deal with me and bags: I rarely buy them. I'm using a used bag right now because my brown bag (which was a holiday present 2 years ago) broke. The bag before that was again, 2 or 3 years old and cost less than $100. I'm not the type to buy a new bag every couple of months or for every season. So part of me says that the bag is a definite buy. Scratch that. I KNOW the bag is a definite buy. It's just that it's $268 ($267 on Zappos) and I don't have a job yet (oh, please won't someone offer me a job??). I tried explaining to the hubs that that if I used this bag every day (which is reasonable when you think that I've used the same bag for 2 years straight), the cost per wear is less than a dollar a day! A serious bargain!!

• final bullet: I need to study for tomorrow's exam. please please please send well wishes that I get this bag do well on my exam. I really need the good vibes!

Red Carpet Moment

I had a red carpet moment today, complete with paparazzi.

Ok, so maybe that's a slight exaggeration.

There was an induction ceremony for the totally nerdy, study all the time, book smart extra-smarty pants student nurses. (Note that I didn't say we were any good in the clinical setting...) I'm usually running around like a complete ditz.

But anyways, we were all lined up, in alphabetical order, walking into the auditorium, which happened to have red carpeting. All these parents were turned in their seats taking pictures of us, aka their kids. It was pretty quaint, but it totally felt like my pre-school graduation (which shockingly, I can remember).

there you have it...my red carpet moment :)

Second Thoughts

Today was the first day in the clinical setting where I actually thought, "Why am I doing this?" and "Is this (nursing) the right move?"

Nobody yelled at me or anything (my instructor actually said, "What the hell is wrong them?" in reference to the students who made this week's patient assignments), but that didn't stop me from feeling incredibly incompetent today.

Hopefully tomorrow is better.

Today...

was the first day I had to wipe ass.

No seriously. I was flirting with the idea (to myself of course) that I might actually get through nursing school without wiping adult poop.

But for this med/surg rotation, I'm on a medical floor (previously I was on a surgery floor). A floor that has a history of lots of poop.

Ick.

Halloween

For reasons that should be left unsaid-and for reasons that you can only imagine, I'm banning myself from ever playing Flip Cup*.

But the party was so much fun! and the outfit was great. I loved it so much that I was planning on wearing it out again tonight, but I ended up sleeping in my clothes. I'm still wearing the outfit. I swear, it's that comfy. Stylish and comfy....TLC's What Not to Wear would be proud!

*how new is Flip Cup? I never heard of it until we came to Delaware. Seriously. Did this game exist at Florida???

Much Better....

Shiny Leggings

I have shiny latex looking leggings (black) that I found at Target for $12.99. I was PSYCHED to find these, because the ones at Expressess were around 30-40 dollars.

Tonight is halloween. the party I'm going to is a halloween party, but nobody is dressing up (what the hell is up with that??) AND it's BYOP...bring your own pumpkin to carve. huh? why are we carving pumpkins on halloween??? In my humble opinion, the BYOP party should have been last weekend and the halloween party WITH COSTUMES should have been tonight. (although I am super excited about tonight anyways!)

so I am insisting on wearing something that's different, but not a costume. I think I'm going ot wear my shiny leggings, my skull & crossbone "diamond" studs, and possibly a black wig (only if I can get my makeup to look good...dark dark eyes, possibly with fake eyelashes).

The problem is the shirt. What to wear with leggings? One classmate wears leggings all the time with cute shorter tops (tops that end at her hip bone/above her butt). she looks adorable in them. I feel if I wear a shorter top, people will be looking at me.

Although let's face it...that's kind of what I'm going for (isn't that why we get dressed and wear what we do? we can wear jeans and t-shirt and blend in, or have fun with sylish and edgy outfits and express ourselves (cue Madonna). I'm always much more energetic when I'm wearing something fun that I love)...back to problem:

I don't want to people to think I look slutty (When I first showed the husband the leggings (the express pair), he said that if I wore those people would think I worked on the corner). I'm going to run to Kohls now to see if I can find some sort of knit long shirt that ends below my butt. My dresss are all dark and I want something lighter color to offset the leggings. tell me what you think...I love it and would wear it in a heartbeat, but the whole working on a corner comment....please please please give an honest opinion....

She's Alive!

It seems like the past 10 days have flown!

I was sick at one point (still on antibiotics) and haven't gone to the gym or jogged in just over a week. The lingering cough is nearly gone, so I should hit the road soon...because.....

I have this crazy idea of trying to run a full marathon this next time next year. I realize that might be kind of crazy, so it might not be for another two years. The goal: a marathon by 30.
This past weekend was the Mairne Copr Marathon -don't want search engines to pick up, sorry-and we went to see our friends from charleston run. My friend's husband ran this marathon last year...this was her first time running a marathon and she did a terrific job. She's quite the motivator right now.

Finally, the last day of psych has arrived! As much as I initially hated this rotation, I really am going to miss the patients on my unit. My partner and I puroposely put ourselves on the geriatic floor because we figured while they might be able to spit on us, yell at us, and smack us, they wouldn't be able to out run us.

And naturally, nobody spit on us, yelled at us (um, scratch that..some did yell), but nobody smacked or chased after us. My heart goes out to some of those patients who are in the state facility because the have no family, or the family essentially abandoned the patient.

Unrelated to psych, (or not as I keep replaying the events in my mind), the first job interview has come and gone. It was like speed dating in slow motion...I went from nurse recruiter to the nurse manager of one department to the nurse manager of another department. At two hours, it was probably my longest interview, and I'm not really sure how it all went. I had woken up early that morning with a splitting headache that reappeared about an hour and a half into the interview. Hopefully I hear something, but it won't be for a couple of more weeks. I'm still keeping my eye out for some of the larger teaching hospitals in the area.

and tonight is halloween! More on that later. What are you all doing for the Halloween??

Stressing

NCLEX is stressing me out! It's a test that we take in order to become licensed as a registered nurse. The test is taken at a testing center on a computer. You answer one question, and if you get it right, the next question is slightly more difficult. If you answer it wrong, the next question is slightly easier. If your computer shuts down during the test, it can mean one of three things:

(1): you answered enough questions correctly to show that you are competent.
(2): you answered enough questions incorrectly to show that you are not competent.
(3): someone pulled the plug and the electricity is out. Just kidding. Hopefully this doesn't happen.

Your computer can shut off at 75 questions...meaning, "Congrats! you passed!" or "Ain't no way in hell you're going to pass." The maximum number of questions to answer is 265. I'm not sure if there's a percentage that you have to make in order to pass. If this information is available, I can't seem to find it.

For an optional assignment in one of my classes, I've been spending one hour each week answering NCLEX questions in the computer lab on campus. As my professor said, "It's ass time in the chair."

I've also been answering questions at home, about 10 a day.

And about once or twice a week, I try to complete two chapters in this gigantic NCLEX review book. These chapters are outlines that feature major points about more than you ever wanted to know about a given topic.

The problem is that I'm not seeing any sort of improvement. In the computer lab, my scores have ranged from 61% to 74%. Today I answered 180 questions from a CD rom and got a 66%.
My 10 a day questions have gotten better, but I think that's because the questions are easy (a few scores have been as low as 40%, but I have quite a few that are in the 70-80-90% and a handful at 100%).

Some questions I answer because I didn't carefully read the questions (which usually results in some serious ass kicking). Some questions I just don't know. A lot of those have to do with orthopedics (different types of tractions). I vaguely remember learning about those in med-surg, but there are only two things I remember:

1. there's something out there called Bucks Traction. I don't know anything beyond that.
2. the weights must remain off the floor

So obviously I know thati have to review some ortho. I'm kind of ok with pharm....there's definitely some reviewing that I need to complete. I haven't even tried to look at cardiac issues.

Anyways....I realize this post is more cathartic for me than juicy gossip for you. so here's something: I scored a job interview for an ED position at the small community hospital! Interview is next week. I better be feeling your good vibes!

Homework

For my psych rotation, we have to complete a weekly verbatim. Basically, write out the conversation you had with a patient and document the therapeutic responses with a rational.

It's done from memory....we aren't supposed to write things down when talking with the patients, and we don't use a recorder. If you don't get things word for word, that's ok.

Last week I had no problem with this.

This week, with the full moon and the changing weather (darn winter fall), the patients were a bit agitated. Somewhat off. The conversations were so bizarre, and I'm not sure how they got from Point A to Point B in the conversation so I'm having trouble making this verbatim comprehensive or coherent (although the conversations were anything but).

One patient told me yesterday, "I'm going to move over there. Everyone's a bit nutty today."

Omens and Cynicism

I just can't watch the debates anymore. I feel like we've been watching debates for over a year now.

News:
the open house last night. Apparently a success. I sent thank you emails to three key people associated with the hospital.

The nursing director replied to my email and said that I should receive a call for an interview from a nurse manager! YAY!

THEN...

I saw that our phone voicemail light was blinking. Apparently my name was 'picked' in the raffle drawing for a GPS thing-a-ma-jig! I don't think I've ever won any sort of raffle...a positive omen? or something else?

I'm torn between possibly working for a large teaching hospital (although I haven't submitted my application yet) or working for a small community hospital in a different state (possibly meaning more taxes). What do you all think? Unfortunately, the large teaching hospital requires a two year commitment after a 16 week internship (which starts at the end of Feb). All you military bloggers understand my weariness...

Jobs Baby Jobs!

With graduation rapidly approaching, it’s time to start looking for jobs. This I can’t believe. Was it really just a year that I started my Pathophysiology and research classes? Did I really start-and survive-that hellish spring semester? Are there really no more labs?!

And even harder to believe: I only need to take three more classes to graduate! We’re going to take them over a “5 week session” that will really last about 8 weeks since we actually begin the classes between fall semester and winter session.

THREE more classes?? Wait. That means…GRADUATION?!

But oh no…if graduation is around the corner….that means NCLEX is pretty darn close. And oh yeah…how about a job?!

So, the million dollar question is: What kind of nurse do I want to be?

There is always med/surg nursing. A LOT of people (all of our guest speakers) believes, “You MUST do a year of med/surg before moving on to a specialty. This is where you gain your confidence and basic skills.” Med/surg wouldn’t be the end all-be all, but it’s certainly not a dream. There are three aspects of nursing that have captured my interest: pediatrics, hematology/oncology, and emergency.

There is no particular order of which I like best, and I would love to combine peds with hematology/oncology or emergency.

Unfortunately, the local children’s hospital hired two new graduate nurses last year. I think someone needs to die in order for a spot to open. Not that it’s going to stop me from trying to get a job there.

The local cancer center wants experience and oncology certification.

The emergency departments want experience and certifications. BUT…there is something called an internship program, where, “…Yes, we can take YOU and CAN become an ED nurse in ONLY 6 months!”

The program has a 6 month orientation program and following the orientation, you are required to commit 20 or 24 months to the hospital’s ED. I think I’m going to try and apply for the program. Downside: I have NO hospital experience outside of clinical. Our program is so fast paced and compact that there really isn’t time for externships or working.
The worst that they can say is, “HA! Who does she think she is? Let’s throw the application in the NO WAY pile!”

Tonight I’m attending a job fair/open house at a small, private community hospital in a rural area out of state (it’s only 25 minutes away). I definitely would rather work at a larger teaching hospital, but if this is where the jobs are at, I’ll take it!

Where’s that crystal ball when you need it?

3.0

YAY! Ran 3.0 miles today.

Ok, I know this isn't some sort of great accomplishment. I've ran my share of 5ks. But I always end up jumping off the band wagon (I think the last 5k was back in July...).

And with a friend of mine prepping to run in the ma_rine C=orp marathon, I'm motivated. Again...

Before moving, I used to track all my runs on a cool runnings website, but the website was bought out by active trainer and I didn't care for the new site. I found it cluttered, difficult to navigate, AND they wanted me to pay for certain things that were free on the cool running site.

Recently I discovered Running Ahead, which you can see in the right hand column of this page (twitter had to go). Everything about the site reminds me of cool running. It's bare bones, easy to use, and allows you to enter tons of data. For instance, if you click on 'more stats' (again, in the right hand column), you'll get to a chart of my runs. Then, by clicking on "workouts" you can see each run listed, and by clicking on the glasses icon, you can see a more detailed account of my run, such as weather, intervals, etc.

Today's run was pretty slow...my 5K times tend to be faster (nothing like wearing a number, seeing real runners, and being pushed to run by a the sound of a start gun!), but I decided that I would pace myself, and boy did I ever!

My first mile was done in 11:38 (granted, it was pretty windy at this point of the run), second mile was 10:28 and the third mile was 9:09.

The husband said I started too slow. I don't know....I felt pretty good at the end of the run and not too exhausted. Here's hoping that one of these day I can run a 10k :)

19 Firsts...

The four week maternal-child nursing clinical is nearly over (today is the last day).


As I did at the end of my Med-Surg I clinical, here is a list of firsts/things I've learned:


1. Diapers have numbers on them. The number needs to be on the front. Why they never told us this important fact in lab or in class I will never know.
2. Changed a diaper.
3. How to get a spec grav (specific gravity) for a child in diapers.
4. Neuro exam.
5. Fetal Heart Rates...accels vs decels. I think I finally understand :)
6. pushing!
7. Witnessed first C-section!
8. First newborn assessment....wow babies breathe fast!
9. Gave baby's first shot...first eye drops...
10. Baby's foot prints!
11. vaginal delivery...oh boy.
12. baby's not breathing....start resuscitation.
13. Witnessed first epidural.
14. Inserted first foley.
15. Removed first foley.
16. Yet another day in the NICU...not yet sure how I'm feeling about it....
17. Bottle fed a baby!
18. Bathed a baby!
19. Taught dad how to feed a baby. huh?! ME?! I had just fed a baby for my first time 4 hours earlier....


A little background: my maternity lecture class was the last class of the day on Tuesdays. Tuesday usually began at 9am or 10 am with labs. Then we had a 2 1/2 hour med surg class....an hour break, usually taken up with another scheduled lab, followed by a long pharm class....followed by a 35 minute break and then 3 hours of maternity (class started at 5pm). (This was after a long monday.)

In other words, by the time we got to maternity we were brain drained and exhausted. Patience was low, and the teacher-an amazing very holistic oriented midwife with a PhD-didn't have classroom experience. She was great in small, conversation type groups. In class, we had the giggles. I have no idea how I ended up with the grades I did and was extremely worried that I wouldn't know what to do in clinical. For better or worse, we had a clinical instructor who really held our hand-something I greatly appreciated as babies scared me (they still do, by not nearly as much...).

Now I have to decide what sect of nursing I want to go into. More on that later :)

L&D Week in Review

In three days I “helped” deliver 2 babies. The first delivery was a C-section after over an hour of pushing. The second delivery was a vaginal delivery. I don’t normally get queasy, but I almost didn’t make it through the vaginal delivery. Newborn assessments went smoothly, but this experience confirmed that L&D isn’t for me. One of the nicest things (extreme positive) I saw during my L&D rotation is the love among the mother, the father, and the present family members.

Of the 5 nurses I worked with, two were pretty great. They didn’t mind when I asked questions, they invited me to try new-to-me procedures (my first real foley-yay!). I don’t want to go into negatives here, but when I become a nurse, if I ever have a student assigned to me, I will answer questions, show and explain procedures, and talk to them. I hope I won’t read Cosmo, ignore the student, or roll my eyes at the student or instructor whenever they ask a question. I hope to take advantage of teaching opportunities and, in a sense, pay it forward.

And about those teaching opportunities, here’s one where an MD got a chance to show a nursing student (me) how little she knew (not that I ever pretended to know much about nursing, much less epidurals). Be forewarned, it’s a lengthy post…

On Friday, the last day of the L&D rotation, a patient who was just admitted was getting set to receive an epidural and I was invited to observe the anesthesiologist administer the epidural (my first time).

I put on a mask and hair cover and the MD asked me why the woman was in pain.
SHIT. I wanted to say that the patient was in pain because she was in labor. So as I’m trying to not to pee my pants, I’m going on about “…well, uh, so, she’s um, in the first stage of labor….in the active stage…”

MD: Yes, but why is she in pain. What tissue is the cause of her pain?

Me: What tissue is causing her pain? Her uterus…uterine tissue? (Seriously, it felt like 2 minutes passed before I could answer that)

MD: Yes! You’re exactly right! Good. And what’s causing her pain?

(Another long pause)
Me: She’s having contractions…the baby…the fetus…the contractions…blood vessels are constricting…???(shhiiiiittt…I have no clue what this woman wants me to say. I don’t know! I feel like a certain woman from alaska!)

MD: yes, but what is causing the pain?

Me: I’m sorry….I don’t know.

MD: Ischemia. Decreased blood flow to the tissue. Ischemia is the cause of her pain.

At this point I feel like an ass. Of course ischemia is causing pain...that plus the build up of lactic acid....But it gets better.

MD: So, why is it important that I monitor the patient’s blood pressure after this procedure?
Me: The epidural is going to lower her blood pressure and we don’t want it to fall too low.
MD: yes, but why is it going to lower?
Me: (long silence). Her blood vessels are going to dilate….
MD: Ok. But before that. What is going to cause her blood pressure to lower?

I am nearly trembling. My knees are locked.

MD: We’re going to get her relaxed. That’s going to help lower her blood pressure. But what else is going to lower her blood pressure. Before (or did she say after??) we get her relaxed. Why (or what?) is going to lower her blood pressure.
Me: Numbing…we’re numbing? the numbing....I'm sorry, I’m not sure….

At this point the doctor says something about numbing the smooth muscle fibers (I think that’s what she said). Seriously, I was so low, beaten, dumb founded that I wanted to fall to the floor and faint just to get out of the interrogation.

And it doesn’t end there. The nurse I was assigned to had to leave the room and the doctor apologizes to the patient, “I’m sorry that you have to hear about this lesson while I yell at my student.”

Ally McBeal moment here: I envision taking this woman out with a karate move. But I continue standing there with my hands behind my back. I don’t even roll my eyes like the nurses on the floor.

And then just when you think it couldn’t have gotten any worse, the interrogation continues (seriously, if I was the doctor I think I would have kicked the student (me) out of the room for her lack of knowledge).

MD: Why did I use these two syringes?
MD: What happens if we get the medication in the blood stream?
MD: What will the patient feel if the medication is her blood stream?

And finally, the end occurs. The MD approaches me and tells me I should really review and become familiar with this medication, as I will be using it nearly all the time, on any nursing floor. I thanked her and she said, “No thank you! We really enjoy working with students…blahblahblah”

So that was my scary Friday. I honestly couldn’t sleep that night. True, I probably should know more about epidurals. Unfortunately, my maternity professor never went into detail about epidurals except to say that 60-70% of laboring women receive them, they are inserted between L3-L4, a side effect is hypotension, and THAT’S IT. My maternity lab instructor often voiced her opinion that too many women receive epidurals. None of our lab scenarios involved women receiving epidurals.

The questioning will strengthen my back bone (even if recounting the scenario as I just did makes me anxious). Clinical is about getting asked a gazillion questions in which you are not supposed to know the answers. However, it’s never happened to me so unexpectedly. Plus when questioned by our instructors, they help guide us and eventually, we end up recalling the processes studied in class. In my med surg clinical, if I couldn’t answer a question off the top of my head about a medication, I would tell my instructor, “I don’t remember off the top of my head, but I know that it’s in my folder on my drug sheet.”

A professor this past summer gave us some advice as we were starting our first clinical experience (med-surg). She said something to the effect of: “Don’t be that person who sits at home at night memorizing drug information and disease processes. Study the information. Take notes. Bring a clipboard containing your notes into clinical with you. Your instructor wants you to do your homework and care for the patient, not memorize facts and figures. It’s more important that you are able to find the information you need than to memorize. Over time, you will get your facts and figures down.”

Post partum rotation is next week, then psych. More soon-

Whoa Baby!

I'm starting my L&D rotation tomorrow night!

disclaimer: the exclammation point is more dread than excitement. classmates are taking bets that I'll become a maternity convert.

drink please

worst clinical day ever.

Time to crawl under a rock.

Toss-n-Turn Post

Can't sleep.

So I decided to quite literally empty the mind.

Here is what's in it now:

Job Fair tomorrow morning. Don't want to wear the typical black pants and blouse. Plus for some reason, I think my body fat is getting re-distributed. Pant crotches are nearly down to my knee (slight exaggeration). Found a great grey pencil skirt in my closet that was thrifted, but can't seem to find the matching grey jacket (I KNOW it 'came' with a jacket). Might be able to get away with wearing a blouse with pencil skirt, but the blouse didn't fit as perfectly as I'd like. Might have to wear the skirt with suit jacket combo, which will make me feel like a recruiter or a politician. Either way I think it'll make me look matronly. Granted the job fair is just for practice. Not even sure if my resume is up to par.

Pediatric clinical starts wednesday. Pray for me.

Peace. I wore my peace earrings today. I've had them for about 3 years and only one person has ever noticed them so much as to actually say something.

My professor (I believe she will be an awesome professor and can possibly be a nurse idol) mentions my earrings twice. Once before class when I ask about the guest speaker (from the career center). the teacher tells me about how the guest speaker will tell dos and dont's of interviews (no sandals, shorts, watch the type of earrings to wear...). (as if I would actually wear big earrings to an interview??)

Then during attendance, I hear my first name and immediately go "here" (I have a seriously long name). She says, "Ok. Are you married?"

I say, "yes"

"newlywed?"

"no...5 years now"

"Ah, ok. " (and then she says to the class) "Her last name has a hyphen. It wasn't like I just knew she was married because she is wearing peace earrings."

HUH?

She either hates me (because of the earrings) or is secretly excited about having me in her class (because of the earrings). I hope not to disappoint. Next week I'll go back to wearing studs, but wait until she sees what I ordered online this past weekend....

I ordered the brown on the bottom left, but now I'm wondering if I should have gone with dusty or tan...

And don't worry....I have enough sense not to wear the shoes with the peace earrings!

Double Standards?

Take it for what it is. If someone can find a video of democratic commentators/strategists doing the same (double standards, etc), I'd love to see it :)

Again...is it really sexism? Shouldn't she just "...work harder. Prove yourself to an even greater degree..."

Is it Really Sexism?

note: I'm in the middle of a 2 day sneezing fit, so hopefully this is coherent....

I've been reading a lot online and watching a bit too much tv, but it might be safe to say that a lot of people feel that the VP pick is not being treated fairly. People are asking questions that aren't asked of men.

And they are right...questions ARE being asked that aren't normally asked of men in the same position.

When we are exposed to something that we've never experienced, no matter what, we have questions. 20 odd months ago, questions were asked about a certain candidate regarding his religion, his education, and the time he spent as a child overseas. As voters, we had a right to wonder and ask these questions.

And now, once again, we have someone new on the stage. We have new questions, just as we did 20 odd months ago. Some may find this sexist, but I don't. As a women who will one day have children, I want to know how she does it.

Not because I think having kids makes the job of VP impossible (it doesn't), but because I want to have kids. I want to go back to school to earn a masters. I want to work in public health, out in the community. I want to work with the NIH or CDC in conducting research. Like my communities in nursing professor, I want to be a state representative. I want my kids to have music lessons, be on the swim team, play soccer and little league baseball. I want to see their recitals, their swim meets, and their tournaments. I want to have dinner with my family at the table.

Will I need a nanny? Will my husband have to end or change his career? Will our parents have to live nearby to help raise our children? There is nothing wrong with any of these options-I just want to know if that's what it will take.

So when I ask, how does she do it? How is she going to do it? I'm asking because, like my friends who are parents and millions of other women in this country, I haven't figured out how to make it work.

Blogcation Redux Part 3: Massachusetts

Finally! The rest of the vacay:

So after our breakfast in Portland, we drove through all parts of Maine...and decided that after seeing roughly 4 small coastal towns in Maine, they all begin to look alike...

On our way to Boston, we ended up driving back through NH and stopped for lunch in Portsmouth, which reminded me of Portland, which reminded me a bit like Charleston. The downtown area had lots of privately owned trendy businesses. My favorite was Second Run Books, a used bookstore that had their walls covered with "things found in books," ranging from train tickets to Penn Station in NY to photos, love letters, newspaper clippings, and shopping lists. It's where I bought this book.

And what is apparently a common thread of New England, we found another public garden.

After eating a slice of delicious cake with coffee, we began to head down to Boston. Honestly.

We actually stayed in Cambridge, just across the river from Boston. I liked this because it was between MIT and Harvard. We were surrounded by brains.

How to describe Boston? It's like a clean Philadelphia (which I'm not sure says much as I believe any city is cleaner the Philadelphia (aka Philth-adelphia). We walked parts of the Freedom Trail, lots of American History, historic graveyards, more seafood, and great Italian food. We were pretty disappointed in the hyped up Faneuil Hall-this was a glorified tourist trap....I imagined something more along the lines of the market at Grand Central Station in NY, not a high priced fast food hall with chain stores like the Gap.

We did take a swan boat tour....

The bookstores in Cambridge though...oh. my. goodness. My new fantasy? to be locked in the The Harvard Coop or the The Harvard Bookstore. Guess I'll have to look into grad school sooner than later ;)

BlubberMouth

ARG! Does anyone else blubber into the phone when talking to an answering machine? For the past year I was the 'welcome' contact for our squadron and have probably left my fair share of funny messages on the voice mails and answering machines of spouses new to the group. What I always meant to say was this:

"Hi! This message is for NEW SPOUSE. My name is Rachel _ and I'm calling from the _squadron spouse group to welcome you to the new area. I wanted to let you know about the spouse webpage and spouse coffees, information about the base and area, etc. My phone number is__. Please call me when you get a chance so I can tell you about everything, or answer any of your questions."

Except usually the messages came out:

"Uh, HI! This message is for NEW SPOUSE and I'm calling from the Dover Welcome Spouse Group-I mean the _spouse squadron group, er, the _squadron spouse group. My phone number is __. I wanted to let you know about the squadron and spouse group, how to sign up for emails, get on the webpage, spouse groups, and just to see if you had any questions about the area. So, again, this is Rachel and I'm calling....."

You get the idea. That's just one of the reasons I passed on the torch of "welcome person."

Today I got the nerve to call one of my professors. I'm not sure why, but I tend to get nervous talking to professors over the phone. Naturally this isn't an every day occurrence, which may explain blubber mouth. Two weeks ago, I called one professor who is also my academic advisor. I stuttered my way through, and my sentences made no sense (but she still agreed to complete the endorsement form-score!).

Anyways, back to today: I need a second professor to complete an Endorsement Form on my behalf...she never returned my email, which I thought was odd, but then figured she might just be out of the office. Classes don't start until next week, I figured she might be back at her office, but no such luck. I left a message on her voicemail and already, I'm cringing. She's probably thinking that English isn't a first language...(more on that later). Fingers crossed she gets back to me!

Blogcation Redux Part 2: Maine

Ah, so Maine, land of lobster and lighthouses!

The first half of the day, Maine was cold & damp. If it wasn't damp, it was all out raining. But we still found it enjoyable, despite the weather.

We first stopped at Pemaquid Point. One word: wet.

Then, off to Portland, but not without stopping for a most delicious lobster roll (very light on the mayo-yay!) in Wiscassett ,the prettiest little town (no really, it is pretty). If it wasn't so wet (we ate standing), I would have taken a picture of our lobster rolls, plus the stand where we ordered it.

We went into a few antique stores, but everything was, oh, $500-$5000 out of my price range. Personally, I find it more enjoyable to hunt for treasures at second hand shops.

On our way to Portland the sun FINALLY came out and we went to another light house (the Head Light). It was here that we quickly realized that Maine (and New England in general) has done amazing things with redevelopment and public parks. The park was free to enter, free to park, and very, very pretty.

Can you believe this photo was taken on the say day as that above video was taken??

That night we headed to Portland's downtown, which looks like Charleston, but with wide streets and a salty breeze (no horses). The vibe was very much of what you feel/see in Asheville, NC. They had a great independent bookstore, with many many other great stores. One memorable store was named "Condom Sense" and had a poster that I think should be in the halls of every high school and/or college in addition to every hospital, subway stop, bus stop, etc. I've tried to find a copy of the poster online, but it went something like this:

"See Dick with an erection" (two stick figures in bed, presumbly dick and friend, was illustrated)
"See Dick with no protection" (naked stick figure..don't worry, no parts!)
"See Dick with an infection" (stick figure Dick is in hospital bed with IVs hanging)
"Don't be a Dick"

Back to Maine...

For dinner, Ryan had his first lobster, where the older lady at the next table went all out to teach him how to eat different portions of the lobster (as in her hands were on his fish...but she really was a kind, sweet, older lady so Ryan found it excusable). Breakfast was delicious the following morning before we left and headed for Boston...

Breakfast at the Porthole

Blogcation Redux Part 1: NH

With an unheard of five straight weeks off from classes, I told Ryan, "I am NOT sitting at home in Delaware."

So we planned our own New England mini-road trip. The plan? 3 nights at a B&B in NH, 1 night in Maine, 2 nights in Boston, and 1 night in CT.

We ended up starting the vacay a day earlier and spent the night on post at West Point, possibly the one thing the military has done right (ie, the only military institution that I've ever been on where there are trees, green grass, landscaping, and buildings that did not have the brown/beige color combination...some were grey-haha). The town of Highland Springs (outside the post) was quaint, but in all honesty, the area is absolutely beautiful. Mountains, valleys, and water, plus Manhattan was about an hour away...what more can you ask for? These people get nature AND the city...

Then off to NH where we stayed at a bed and breakfast (our first) that was just outside of a tourist trap of a town (read: Maggie Valley NC or Gatlinburg TN). Waterfall, a hike, a moose, and the best damn beer I've ever tasted.

On Sunday, we decided to hike Tuckerman Ravine, inside the White Mountain. We had no plans to hike up Mt. Washington (read more here and here). The first video clip shows us just past Tuckermans Ravine, on our way up to Mt. Washington. The second clip was taken pretty close to the top of the summit. Notice how rocky it is? The pyramid rock formation that you see at the end of the clip was a way of following that portion of the treeless trail (instead of the yellow painted strips you normally see on trees). Once at the top, our hair was wet as we were in a cloud (no joke). In the 7 1/2 hours it took to complete the hike (up and down), I went from wearing a tank top in sunny weather, to wearing an additional two layers of long sleeve clothing,

to back to sunny weather. We went from mid80s at the bottom to low 50s at the top. After buying a patch that says, "I climbed Mt. Washington", we left the park and headed 'home' to the B&B to wash up, pop some motrin, and head out for a much deserved beer. Cheap asses that we are, we COULD have taken a van DOWN the summit (saving us 3 hours, 15 minutes), but at $26 a ticket, we thought "rip off!" After 2 hours of climbing down, we were kicking ourselves.

Monday we woke up and I could not sit, stand, squat, or move either leg without a reminder of the humbling hell we put our bodies through (we still loved it though!). We headed to Diana's Bath, which anyone who has spent summers in the western mountains of NC knows how refreshingly cold the water is, and we relished every moment our legs were in the water. It was a true ice bath that actually soothed our legs. More waterfalls, more ice baths, until finally we found a place for Ryan to jump off a giant rock into the water.

(l to r: Diana's Bath, Diana's Bath, Ripley Falls, Ryan jumping off Upper AmmonoosucFalls)

Remember those friends in swimming lessons who wouldn't jump off the diving board, no matter how much you encouraged them? I don't ever remember having that fear, but on this day, I was that child. It took me 15 minutes to jump, from one of the lower (although not the lowest) boulder.

(sideways view...anyone know how I can switch it to right side up?)

She finally jumps! (this is actually jump number 2...picture of jump one shows me peering over the edge...PS...I screamed the entire way down on the first jump. Chicken.)

It was AMAZING, and a great way to end our trip in NH.

The Recent Source of Much Giggling & Squirming...

Vacation stories coming soon, but first more on the vaginocavernosus reflex...

Blogcation

we'll be back in a few!

The Return of the Gym Rat

Growing up, I was always obsessed with exercising and aerobics. I remember being in elementary school and for the holidays someone in my family gave a "Get in Shape, Girl!" set that came with cassette tape, poster, jump rope, wrist bands, etc.

You go girl! -the modern-day set- They now even have Get In Shape, Girl Yoga!

In late elementary school and middle school, I was obsessed with my mother's Jane Fonda tapes.

Leg Lifts!

In high school, I would occasionally jog or ride a bike. I especially enjoyed rollerblading 4miles nearly every day of the week. It was in high school when my parents joined a gym, getting a family membership. I was a bonafide gym rat.

In college, I discovered that I could eat a box of oreos and no would stop me. I could eat soft ice cream on the way to class, and get another cone after classes, walking back to the dorms. I could eat chocolate chip muffins for breakfast at the student union. All the time in the gym wouldn't prevent the inevitable. In those four years, the idea of going to the gym sort of died.

Living in Charleston wasn't so bad...I would go the gym occasionally and try to run or jog outdoors. Anything to not become a sloth. Then we moved to Delaware, where the winters are, for me, bitterly cold with a strong wind to boot. I turned into a sloth. And by sloth I mean, being short of breath after climbing two flights of stairs.

On Monday night, after a summer spent eating (and huffing & puffing), I broke down and finally joined a local gym. I feel sort of guilty doing this, especially since I have access to not one but TWO free gyms.

The gym on base is free, and in Charleston it was decent. By decent, I mean that it was usable. If it wasn't for the treadmills and other exercise equipment, I would think the gym was actually a bomb shelter (no windows), but considering it was only 3 miles from our place, I couldn't complain.

Here, the on base gym is about 30 minutes away, plus a $1.00 toll each way. A storm from a few months back damaged the roof and and there is tarp covering 'the roof'...a la south Florida after Hurricane Wilma. The air conditioner doesn't really work, which makes for some pretty noxious smells.

My school gym, is again, 30 minutes away (in the opposite direction), with a $1.00 toll each way. For Summer it would probably work, but in the fall and spring, it is apparently so crowded that unless your goal is to exercise your right to find a date, it's best to run outdoors.

So as a present to myself I decided to join a local gym (I found out that I'm receiving scholarship money that will cover this past summer term, upcoming fall, and part of winter session). The gym is only 2 or 3 miles from my place, and it's dirt cheap. So cheap that I'm hoping they don't go out of business any time soon.

After lifting some weights yesterday, I am unable to move my arms without that "oh, ow, I'm sore" feeling.

I LOVE that feeling!

Does anyone know of an online exercise log that is user friendly & free? I used to have an online running log, but a new company took over the running log, and redesigned the layout losing some old information. I might end up making an excel speadsheet.

In the meantime, here are the digs on this weeks workout:
Monday: ran outside...not sure how long or how far...over 1.5 mi, definitely within 25 minutes but I wasn't wearing a watch...
Tuesday: gym: weight machines (all parts), Elliptical, and later at home, after sitting around the house, bored, I biked outside for about 20 minutes.

Let's hope I can get a little something done each day of the week :) The gym rat is back!

Eyes Wide Open

can't see well...eyes are dilated and words are blurry. Someone should have told me that I wouldn't be able to read! New clinical assignments are up and I can't really read them very well!

ARG!

MMmmm....oh, Mmmm....

This is SO GOOD! (ok, let me explain now that I'm a very verbal eater. if I think it's that good, the people sitting at the next table in the restaurant will know)

Dinner last night...was. so. freaking. delicious.

The last couple of Barefoot Contessa episodes were Paris based which got me inspired to have a night of French cooking.

So yesterday afternoon, I pulled out my cookbooks, made my list, headed to the grocery store, and for the first time in my life, I bought a whole roasting chicken (uncooked...trust me, we've done the cooked versions many times).

Let's first get something out on the table: I am not a cook. I try. There are many memories and stories about me in the kitchen, fighting with my uncooked food. I am the queen of pouring batter into the trash because I don't think it tastes right. I once baked salmon for 45 minutes. Flan has ended up with whole cinnamon sticks because the three recipes failed to mention to remove the cinnamon and the flan has ended up as a sticky mess, running down the cabinets onto the floor during the breath defying 'flip.'

You get the idea....but I've gotten a little bit braver, gained some more self confidence, and if I see how it's made on TV and then read, and reread the recipe about 4 times, I might be able to make something half way decent.

So yesterday I made Barefoot's lemon chicken with croutons and french string beans. The hardest part of the recipe was cleaning out the chicken (I think my chicken had two livers-ew) and then tying the chicken legs together and tucking the wings under. I kept the chicken in the oven for just under 85 minutes.

While that was cooking, I prepped the bread for the croutons and prepped the veggies for the side dish. In the cookbook, Barefoot makes a point of saying to use french string beans, NOT regular string beans. It's pricier, but so delicious. And who doesn't love a little gourmet every once in a while? When the chicken came out of the oven to rest, I put the veggies in the oven and started cooking the croutons. I don't think my oil was hot enough for the croutons, and I probably added too much olive oil, but it all came together nicely.

Ryan was cutting up the chicken while I was sauteing/warming up the string beans before finally mixing it all together with the peppers and onion. (I had already blanced the green beans.)

The dinner was delicious. the chicken was incredibly moist. I was surprised to have not tasted any lemon flavor at all....in fact, it tasted just like chicken, but I didn't find it bland...maybe because it was so moist and I used so much olive oil with the croutons. For next time, I would use an entire red and yellow pepper, not just half for the vegetable side dish-because I liked the sweetness it added. I would have allowed the olive oil to heat up more prior to sauteing the bread for the croutons.

It's an incredibly simple dish that probably took me longer than it should since I felt I had to babysit the meal. It would be a great dinner for guests. I'm curious to see if anyone else has made this (or is willing to try)-let me know what you think!

What's Your Personality?

From Mike & Erica

Jung/Myers-Briggs Pesonality Test

I'm an ESTJ:
Extrovert 44%
Sensing 31%
Thinking 25%
Judging 39%

Guardian™ Portrait of the Superviser (ESTJ):

Supervisors are highly social and community-minded, with many rising to positions of responsibility in their school, church, industry, or civic groups. Supervisors are generous with their time and energy, and very often belong to a variety of service clubs, lodges, and associations, supporting them through steady attendance, but also taking an outspoken leadership role. Supervisors like to take charge of groups and are comfortable issuing orders. They are cooperative with their own superiors, and they would like cooperation from the people working under them. Rank, they believe, has its obligations, but it also has its privileges.

Comprising at least ten percent of the population, Supervisors enjoy and are good at making schedules, agendas, inventories, and so on, and they much prefer tried and true ways of doing things over speculation and experimentation. Supervisors keep their feet firmly on the ground and would like those under their supervision to do the same, whether employee, subordinate, spouse, or offspring. Supervisors have no problem evaluating others and tend to judge how a person is doing in terms of his or her compliance with, and respect for, schedules and procedures.

Supervisors are unbelievably hard-working. Even as children they are industrious, and they usually respect their parents as authority figures. In school Supervisors are often model students, dutifully following directions, doing all their homework, doing it thoroughly, and on time. Above all else, they wish to do what they are supposed to do, and they rarely question the teacher's assignments, method of instruction, standards, or authority. And their industry and perseverance only become more important to them as they grow into adulthood and take on the responsibilities of job and family.

Supervisors approach human relations along traditional lines. Marriage and parenthood are sacred to them, and they tend to have a large circle of friends, with many friendships faithfully maintained over the years. Social gatherings and ceremonies have great meaning for them, and they look forward to holiday parties, club dances, weddings, class reunions, awards banquets, and the like. In social situations, Supervisors are friendly and talk easily with others. Though they can seem a bit formal in their manners, Supervisors are pretty easy to get to know. At ease in polite company, they tend not to confuse people by sending double messages or putting on airs-what they seem to be, they are.

Jack Webb, Judge Judy, Dr. Laura Schlessinger, George Washington, Sandra Day O' Connor, Mike Wallace, and Vince Lombardi are examples of a Supervisor Guardians.

Case of the Nasties...

There's a certain Cable/Internet/Phone company in the area that I despise dealing with.

I had to call them last week because the one TV that gets basic basic cable, was only showing a picture that said to call the company in reference to some sort of box we needed.

No big deal, but it would have been nice to have been notified about this newly needed box BEFORE we had guests.

I spent about 30-40 minutes between transfers, being put on hold, and talking to a human, and while I still dont' have the box, I'm going to hope that it gets here by Monday and that I won't have to deal with their supposed "customer service."

Today we received a letter, addressed to us personally (not dear customer), and the letter stated that our previous bills were in fact too low and that, while we wouldn't have to make up the difference, our next statement will reflect the correct billing amount.

-blood pressure increases-

The letter didn't tell us anything more, except to call for questions. So I called, inquiring about the billing error in addition to asking about the new correct charges.

Between being bored for most of the day and watching House reruns (a new favorite by the way), I picked up a case of the nasties...that or House mannerisms and just didn't care about other people's feelings.

3rd Employee I spoke with (don't ask)....after being on hold: "Ma'm, you're bill won't be changing at all. That letter was sent to all customers, but you won't be affected."

Me: Even though my name is on this letter? This is a generic letter with my name on it telling me about a billing change, but I won't be affected? And my name is on it?

Employee: Yes, that's right...

Me: Geez. Dealing with Verizon is like dealing with people from Mars.

This was 6 hours ago and I STILL cringe when I think of it. No more House for me...

12 hours later.....

I had lunch today at 2:00.

A salad.

That came with tomatoes.

A voice in the back of my head said, "hm, maybe you shouldn't get that."

but then the 'rational' voice said back, "Get real. What are you going to do? Stop eating because of some bad batches? And they haven't pulled it off the market yet, so it can't be that bad..."

And not that you want a history of my bowel movements, but....

and now. at 2:22 am, about 12 hours after eating my salad (which obviously had tomatoes), my stomach is crampy.

I'm hoping this stomach thing is the fact that I've been eating crappy lately and that I'm in a downer of a mood. Stupid Delaware.

The Art of Being...

I'm taking an online Holistic Nursing course right now.

This is how I feel:


more cat pictures

Biddle-De-Bop!

That phrase has been in my head all yesterday afternoon!

Yesterday was the last day of my med-surg clinical!

YAY!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

The experience wasn't all bad...in fact, with the exception of my first patient, I don't believe I had any difficult patients. And I definitely did not have any difficult family members or visitors. some things I've learned in the past five weeks:

1. How to mix and run Nexium. Would you believe that the last 4 or 5 patients I had was on Nexium IV? I've yet to see that purple pill...

2. How to get blood from what looked like a central line (but wasn't a central line...don't ask). flush both lines. Draw waste. draw blood. flush both lines.

3. How to flush a percutaneous tube.

4. How to drain a percutaneous tube.

5. How to flush a NG tube.

6. How to hang a Mag rider. This one is incredibly simple, but was particular difficult for me to understand. I saw how the old Mag rider was hanging. I then spoke to my instructor. I finally figured out that the person who last put up the mag rider did it incorrectly. The poor patient had straight mag running into his line. Ouch.

7. How to change a chest tube dressing.

8. How to look for an air leak ("cough for me please")

9. How to make sure the right IV med is running. And to make sure it is running into the patient, not onto the floor (funny story....)

10. How to separate an IV tube from an IVR (another funny story...)

11. How to use a needle-less syringe (heh...take off the cap)

12. Using a tuberculin syringe to withdraw a certain med.

13. Using a carpujack (sp) holder (hate those). (pain meds)

14. How to take an accucheck....and how to get enough blood on to the strip.

15. How to give insulin with an insulin pen.

16. How to draw insulin up in a syringe.

17. How to give lovenox.

18. How to give heparin.

19. How to give meds via IV push.

20. How to check IV compatibility.

21. How to give lopressor (monitor monitor monitor!)

22. Incentive spirometers

23. Pneumatic Compression Boots

24. Missing Doses

25. Labs

26. BP 80 something over 50 something? page doc. fluid bolus.

27. increase bands count + rhonci = possible infection

28. Diabetic gastroparesis

29. small bowel obstruction

30. NPO (nothing by mouth)

31. Diluting drugs

32. Slicing pills

33. Carry lots of red caps!

34. Ditto for Alcohol pads

35. Flush. Flush. Flush.

36. Get the patient up and out of bed!

37. Cough and deep breathe!

38. MRSA. Hypochondriac that I am, I'm convinced the car, house and I are contaminated.

39. I&Os

40. Always ask why. why why why.

41. Nurses are busy. I will have to learn that the I can start an IV when a doc is talking to a patient. Not that I would want to do this if the doc is telling the patient something awful, like they if they have cancer...My instructor said today: "Get in there from behind the patient and start the IV. You are just as important as that doctor." She probably wanted to see how I would react to a doctor yelling at me for interrupting. Fortunately neither one of us got that chance...the doc was finished by the time I walked up to the patient.

I wish I got to see or do more. A lot of my patients seem to have had the same thing wrong with them (abdominal pain). Only one or two post-ops. No major dressing changes. There was one patient with a wound which required dressing changes, but my instructor wouldn't allow me to change the dressing (the first patient, who my instructor didn't like).

My evaluation went well enough. My instructor thinks I need to go on to grad school and research. I believe that's code for: you can't do any of the practical stuff.

Last night I celebrated with a glass or two of red wine and the Woody Allen flick Manhattan. Something about red wine, Woody Allen, and Gershwin makes for a nice quiet evening. Now if I can only find the motivation to study for exam 2 or write that paper that's due Monday....

Gotta Get Through This...

clinical today left me flustered.

My last two patients haven't had many issues (ok-one had issues). What I really mean is that my last two patients weren't heavy with tubes or meds.

this poor person had 3 or 4 meds this morning. Which I know is not a lot. but for me, I struggled. I couldn't answer questions today (a DO was asking me, why are we giving NaCL bolus? what does the stomach produce?....swear to you, I couldn't say what the stomach produced. I kept thinking, "cholr...cholr...cholrid....?? damn HCl Acid). The entire day I was 'off.'

It started with blowing a vial of nexium...honestly. the needle popped off the syrine and the vial poured out onto the counter.

Even my instructor said to me, "Relax. take a deep breath. I'm not mad. Do I look mad? I'm not mad. Now, tomorrow if you don't know this, then I'll be mad."

Great.

Here's a list of things I learned today in clinical (out of order):

1. how to send orders to the pharmacy for missing doses. Or for wasting a vial of nexium.
2. dilaudid. inject over 2mg over 2-3 minutes. so if patient gets 1 mg, push over one minute.
3. how to give lovenox.
4. how to give meds IV push (although still not 100% on this, even though I know it's ridiculously easy)
5. those needless syringe systems? there is an extra cap on there that I didn't know about and I spent quite a few minutes trying to screw the syringe into the IV port before instructor told me that the cap was still on.
6. draining and measuring NG tube suction stuff. not sure what exactly that is called (output), but it reeked. oh my goodness did it reek.
7. the nurse actually flushed the NG tube for me. Hopefully I will do it tomorrow.
8. fetanyl patches
9. that I'm not sure what I'm doing there.
10. and I learned that I'm 1/2 way done with this semester's clinical. 5 more days!

Steady...Steady....

clinical patient tomorrow has nasogastric tube.

Not sure if I should be giddy with excitement or dreading the day...

stories to come :)

4 Down, 6 to Go..

but not that I'm really counting how many more days are left in clinical. :)

I've survived the first two weeks, but I know it will get worse.

why? Because my first two patients were tube free. no chest tubes, no nasogastric tubes, etc. (all of my classmates in my clinical group have had tubes...somehow I've had none of it).

First day of clinical included orientation and I came home and wept. The teacher, who I've dealt with before, completely stressed me out. She's quick and pretty tough, but not all that organized, which naturally made me nervous. there was so much that i didn't know, and up to a point, I was so confused and stressed that I knew I had questions, but I didn't know what to ask.

At the end of the our orientation at the hospital, we received our assignments and I copied down everything I could. That night I reviewed dressing changes, meds, vitals, assessments, etc.

I didn't sleep well that night.

and on Tuesday, I found my patient (pt) had been moved to a new room due to an infection. Lovely.

I wish I could tell you what the pt's deal was, but I also don't want to post information that shouldn't be posted. Let's just say that my instructor wouldn't allow me to change my pt's wound dressings because of the pt's general behavior. and my instructor replaced that pt with another for the clinical group that meets later in the week. I did get to inject insulin though-twice!

This week was interesting: when I went to pick up my pt info on monday afternoon, I found out that the pt went to surgery and "may or may not return to the floor" and that I wouldn't know until 6:00ish that night. That doesn't leave a lot of time to prepare for the next morning (we begin at 6:30am). Long story, but I was reassigned to a pt who didn't have any tubes or dressing or anything! But there were IVs, and the pt was incredibly patient and kind. The past two days were somewhat uneventful due to the fact that it was all IVs and not much else. The night nurse even changed the sheets while he showered that morning, just before I came on shift!

I have made some silly mistakes though: I would forget to do parts of an assessment...or leave the the roller clamp of the IV down (which meant the IV wasn't running, even if the pump/computer said it was)...I can go on and on...

But I can guarantee that next week will be a killer for me. My teacher is either going to give me two patients and/or give me one (or 2) 'heavy' patients, meaning lots of tubes, dressing changes, etc.

Keep your fingers crossed....hopefully it goes well!

butterflies

I start clinical tomorrow.

Nervous doesn't even begin to explain how I feel right now.

send some good vibes my way please...

Survived...

the wicked spring semester of nursing school! Final breakdown:

Pharm: A
Med Surg 1: A-
Med Surg 2: B+
Psych: A-
Maternity: A-
Communities: A-

When looking at those grades in black and white, I think, "wow. how did that happen?" That NEVER happened with my first degree. How much of it actually stuck?

Taking some of those finals made me realize I still have a lot more to learn. Midway through the final for Med Surg 2, I thought, "what am I doing here?" Each test question had answer choices of:
a) Inadequate
b) You are inadequate
c) Still inadequate...
d) Can you not take the hint? You're all inadequate!

And yet, despit the horrible experience, I ended up with a half way decent grade on the final. Just don't ask me to set up chest tubes or administer meds to a person in v fib without a 10 minute refresher.

Monday I start my summer classes and....CLINICAL.

Clinical scare me. There will be no plastic patients or robots/simulators. These people will be breathing. I will have to touch and help care for real people.

Our clinical instructor has helped us out a bit and provided a heads up list of things we need to be prepared to do for the next five weeks....and I hate to say this, but I think I'll be working with poop for the next 5 weeks.

ick.

It's all motivation for me to keep running, biking, walking, and increasing my fiber intake. Wish me luck!

Aye, Que Rico!

Thanks to gorgeous gal pal Traci & my brother for making this past weekend so enjoyable! After a rough week of finals, I flew home to south Florida.

My brother & his girlfriend picked me up in Ft. Lauderdale and he didn't flinch once when I asked him to drive along Ft. Lauderdale Beach.

So he flinched a little bit. Camera shy maybe?

We didn't get out to go anywhere in Ft. Lauderdale. something to do with my brother's wardrobe. Don't ask. Just be warned...if you're picking me up at the airport, be dressed to GO OUT!

17th St Causeway & A1A. I miss palm trees. and neon.

After the mini-road trip that night was a stop at Pollo Tropical for a Tropi Chop (or chop chop). Essentially black beans and rice (white) with chopped grilled chicken. You're supposed to eat them with plantains, which you order on the side, but mix with the rice, beans, and chicken. Except Pollo was out of plantains....which is like McDonald's being out of fries. Very disappointing, but the rice, beans and chicken were delicious.

Saturday morning I got my brother out of his place by 8:45am...unheard of for him. First stop? A nearby cuban restaurant for a cortadito...1/2 cuban coffee, 1/2 steamed milk. then a bagel (hehe, I hit both of my cultures). Then a trip to my old house and neighborhood plus a visit with my childhood friend Liz and her beautiful daughter Ella.

Afterwards my brother and I shopped for his place...then I met up with Traci!

That night was filled with good food, shopping, and Sex & the City. We started off at a favorite restaurant, where I had bistec empanizado (breaded steak) with moro (black beans and rice that are mixed in while cooking). Followed by dessert.

The best flan ever. I will have to try making this again...without spilling it on the floor...

Then it was off to Lincoln Rd on Miami Beach to see Sex & the City. Snapshots of the city...notice the pink sidewalks of Miami Beach. I was thinking of these pink sidewalks during my final exam on Friday afternoon....

The movie was hilarious. We laughed so much in those 2 1/2 hours! After the movie we walked Lincoln Rd which was just as I remembered it: young, old, gay, straight, English, Spanish, South American, all with their dogs.

Sunday we had breakfast at the News Cafe & walked along either Washington of Collins Ave...I forget which one. Then a trip to Merrick Park where we gawked at the art inside Neiman Marcus. I found a couple of Dolce & Gabbana dresses that I had to have. Then Dadeland...where I am still mad at myself for not getting the shoes I saw marked down to 80something.

More Miami Beach....I spy tourists, even if I played (and dressed) like one...

Finally, we met my brother & his girlfriend for dinner at a Miami staple. Versailles. No, not french food, but more cuban food. You've all seen this place on the news...the minute something happens in Cuba, the newscasters head to Versailles to interview the cubans who are sipping their coffee. This is a restaurant where you will see people dining in baseball caps and tee shirts next to people in tuxs & gowns, dressed to the nines.

I had arroz con pollo (chicken and rice...even though I make that a lot). and for dessert, Tres Leches. !que rico! then it was time for the cafecito at the window.

Un cafecito & dos cortaditos, por favor...

Then it was time for a photo shoot!