Stress Relief

*I started this post last Friday; I'll pick up where I left off!
I am trying to come down from the extreme anxiety pharmacology and those exams cause me.  Last night, after I took the exam, I came home, made a quick dinner for Erin and I, and we watched a show.  I was winding down, realizing my grade probably won't be posted for a few days.  Then, my good friend from school starts messaging me about all the questions she wasn't sure about and how she was looking them up and thinking she had more wrong than she originally thought.  This sent my stress and anxiety level right through the roof!  She is my go to person for questions, aka a smarty pants!  I know I get a few wrong, but it is impossible to remember all the questions and what I answered.  Needless to say, my stress level shot right back up!

So now I sit, this cold and rainy Wednesday morning.  Typically I am in clinical on Wednesdays, about two hours into my shift by this time (8:30am) but today, I am in my pjs, next to my snoozin' pup googling recipes!  I wish I could say my stress level was at a 0, but no such luck.  We have yet to receive our grades for pharm exam #2.  My stomach has been a mess these last few days.  I am 99% sure it is all stress related.  I am trying to take deep breaths and relax.  I SHOULD workout as this is usually helpful, but lack all motivation at this point.  I am more interested in baking Thanksgiving goodies!!  I also have a few projects due for school next week.  A short paper I should have done weeks ago, but I put it off, per usual.  It's a two page paper on cultural care and should be interesting.  I also have a huge care plan to do for clinical.  That I am dreading just because it will be long and tedious.  Deep breaths.

We had some more sad news in my family.  My beloved great aunt, Sister (she was a nun) passed away.  She was 89 years young and we now picture her surrounded by her family, surely playing a mean game of poker.  I have such wonderful memories of my aunt (who we all called Sister or "the nun").  The college I attended was connected to where Sister lived.  I was a frequent visitor to the nuns dining hall as they had way better food.  Sister always sent me home with as much food/snacks as I could carry.  She was also always encouraging me to bring friends to dinner with us.  Sister was wonderful.  She was a spitfire and one of the most loving and generous people I have ever known.  I often joke with my mom that Sister was a preview of her in 30 years.  They have very similar dispositions, demeanor and are all around wonderful people.  My poor mom is very sad, but glad that Sister isn't suffering.  Sister was one of nine children.  Times like this make me sad that I live so far away from my family.  I briefly looked into flights home, but being the busiest travel weekend of the year, the prices were unreal.  With a lab day this coming Monday, it is impossible for me to go home to attend her funeral.  I believe my brother is going, which I am glad, for my mom's sake.  I know I have someone else looking out for me now.

I am sure my unsettled stomach is due to stress and sadness.  This too shall pass.

I am off to pick my favorite recipes for pumpkin cheesecake, apple spice cookies, spiced nuts, pumpkin bread and maybe a few new ones for our family Thanksgiving tomorrow!  We will be spending this holiday with my wonderful wife's family.  My sister is staying local and joining us (and making her AMAZING mac and cheese).  She will be heading over this evening so she can get up early to bake. 

Happy Thanksgiving!  Remember to stay home and out of stores on Thanksgiving Day!  Shop on Friday and support Small Business Saturday!!!  I will be thinking of my mom and all the other poor employees that are stuck leaving their family to go in to work.  It is out of control!!

6 Months

Today, as I wrote the date at the top of my clinical notebook at 6:45am ready to get report on my patient for the day; I realized I have been in nursing school for six months.  Wow.  It's also a little ironic that today may have been my longest day so far.  I left my house at 5:45am (up at 4:45am) and had a full day at the hospital, just shy of our typical 12 hours.  I then drove with my car pool buddy to school to work on a group project and attend a required lecture at 7:30pm.  The lecture, though very interesting and educational, ended at 9:00pm and the last 15 minutes of it I was suffering from ADHD!  Couldn't sit still for anything.  I finally got home at about 9:30pm.  Looooooong day to say the least.  Erin and I had about 10 minutes of being in the same room, just giving snip-its of our respective days to each other.  Erin had a full day of work followed by a long evening of driving to her parents house, having a quick dinner and then a couple hours at the hair salon.  She is beyond exhausted, with a fresh hair do, and I am exhausted smelling of a hospital.  I believe today, in a weird way is a summary of the last six months.

I cannot believe how much I have done, seen, learn, read, sat though, stood, cried, stressed, screamed, wanted to give up, pure excitement, pure exhaustion, and never doubted my desire to be a nurse than I have in the past six months.  184 days into an accelerated nursing program.  I know a HUGE part of me was so doubtful that I would ever make it this far.  Another part of me is still very doubt full I will finish.  A small part of me cannot believe I am in nursing school!!  What a wild ride this has been.  I have been blown away at the amount of knowledge I have been able to fit in my brain (and hopefully have retained a small fraction of it!).  I am not sure how I will fit in more.

Before heading to bed tonight, I am forcing myself to read through more pharmacology slides.  We have our second exam tomorrow.  I am already feeling the extreme test anxiety.  I didn't do great on our first exam, somehow got a 100% on our second quiz and I am hoping with every ounce in me I score better on this second exam.  I do not aim for a 100% on the exam, but an A sure would be amazing!!  I must stay positive, take deep breaths, and relax as I go into the exam tomorrow.  My saving grace is that we are allowed to use our drug guide book.  You better believe I already have that book in my bag ready to go!  Our professor is a nurse practitioner and he believes there is no way to memorize every drug with it's dosage, side effects, etc., and as a nurse we will continue to look up medications we are unfamiliar with.  I have agreed with his philosophy from day one!

I could ramble on and on, but my pharm slides are yelling at me.  184 days down, only 250 more to go!!

Lets hope this is not me tomorrow!

ICU

Yesterday in the hospital, I had my observation day in the surgical intensive care unit.  I was excited simply because the pressure of having my own patient on the step down unit was gone.  Now, I would just be a shadow and see how an ICU nurse handles a patient and watch what they do.  Little did I know, that was only a small portion of what my day had in store for me.

I was brought down to the SICU by my instructor and paired up with a nurse.  My initial reaction was, she really doesn't want a student following her all day.  Luckily, that couldn't have been further than the truth! We started our day getting report from the night nurse.  We only had one patient for the day. (Typically the ICU nurses have 1-2 patients because of how critical they are)  The night nurse was great.  He was so thorough and clearly values his job and really cares about his patients.  He set up the next nurse to be able to walk into her shift, prepared and the patient stable, clean and properly cared for.  After report, we went into the room to check on the patient.  We checked his IV sites and settings, his ventilator to make sure it was set to the right settings, and the overall status of the patient.  Once that was settled, we went to the computer to see what morning medications we wold give.  This was great to see and to experience.  The nurse I was following questioned medications that didn't make sense to her.  She then followed through with these questions and went to the team of doctors (which is convenient because the doctors are on the unit majority of the time). The medication orders were cleared up and we went to administer the medications.  I was the observer for morning meds.  We then had to turn the patient and assess his skin integrity and do a full head to toe assessment.  The nurse stressed to me the importance of seeing every inch of ICU patients skin.  Most of them have numerous tubes and wires and are in bed, lying flat most of the day.  If a patient is laying on a wire or tube, this can cause skin breakdown which leads to a pressure ulcer (bed sore).  This is quite the job for a nurse with a patient who is not fully alert and oriented.  We spent a good while turning the patient, moving his gown and checking in every crevice to make sure there were no signs of skin breakdown.  If there is a spot on a patient, it has to be documented and interventions are taken to prevent it from progressing.  I was very impressed with this patient's care.  This patient, although very sick and bed and chair bound, was very clean, very little skin breakdown; clearly well taken care of.  It was very nice to see.  Throughout the day, the nurse I shadowed, allowed me to partake in patient care.  I was able to administer a few subcutaneous injections, draw up medications, suction a trach tube, and change dressings.  It was great to have the opportunities to help with patient care.  I also was pulled into a couple other rooms with other nurses to observe different procedures.  It was a great learning experience and I felt very welcomed by the staff and nurses.  My day flew by, which was nice because it was a 12 hour day!

During this advanced med surge clinical, I have decided that critical care is probably not for me.  With that being said, after a day in the ICU, I wouldn't completely rule it out.  I also realize I had a very exciting day with a lot of support, so maybe that had something to do with it.  It's on the back burner, along with about 2040359 other things at the moment ;)

This week was also my first med surge exam.  I was beyond nervous!  I studied most of the weekend.  I actually didn't leave the house from Saturday evening until I left for class on Tuesday afternoon.  Sunday and Monday, I literally spent the day at the table, in my sweats, studying. I discovered on our course website, we have the ability to not only listen to the lectures (which I have done previously) but they also videotape the lectures, so I can re-watch lectures, see the power point AND see myself front row center (yeah, I sit in the front row, always).  It was really weird at first, but overall very helpful and beneficial.  I am pretty sure I spent a good 8+ hours were listening to these lectures.  My brain hurts again.

Today, is our pup's 7th birthday!  I am currently making him some homemade pumpkin biscuits.  The house smells wonderful!  Jackson is passed out in his bed snoring away.  Such a life. 

Our sweet pup!

Service With A Smile

Service, a term I am familiar with.  As I sit here tonight, I have a few things going on that I can relate to that word.  Service, what I will provide (hopefully) to my patient tomorrow.  What I will provide to my future patients as a nursing student and as a future RN.  I give a service to my wonderful, supportive, stressed out wife.  Tonight we are sitting at our dining room table, which rarely happens!!  She is typing away prepping for one of many meetings she has coming up.  I do believe her service plays a vital role in many children, parents and other teachers daily lives. Her service may not always come with a smile ;)

Tomorrow I have my second 12 hour shift at the hospital.  I am even more nervous than I was last week.  Although, in the moment it always seems worse.  I now know what I am walking into tomorrow morning at 6:45.  I will catch a 6:05am train to be on the unit by 6:45.  I have a vivid recollection of what last Wednesday was...it's like the first day on a new job.  It's overwhelming, scary, nerve racking, thrilling, and educational.  I really like the patient interaction; conversing and learning about an individual.  I do not like the feelings of inadequacy, nervousness, anxiety, worry and the constant feeling of being in the way and out of place.  A few classmates and I were walking out of school tonight, all sharing these same feelings (at least I am not alone!).  It is as if I am starting a new job every six weeks.  Not a fan!!  We all joked how Tuesday nights are filled with nerves and as we leave the hospital tomorrow, we will be all smiles and totally relieved that we made it through another clinical day.  I have my uniform all prepped, bag of supplies ready to go now just  need to pack my lunch and I will be as ready as I can be!  I might be giving medications tomorrow, which is always so exciting and, you guessed it, nerve racking!  There is a common theme here!  I may also have the chance to observe in the ICU.  No clue when that will be, so I will be ready whenever.

Another service in my upcoming months is the service trip!!  I get to go on the service spring break trip in March!!  It is going to be freezing cold and snow covered, but I don't care.  There are only five students, including myself, heading to a small school where we will be put to work.  We will be helping to give well-child health screenings, health promotion teaching, and possibly observing in a medical facility.  In the evenings, there is talk of cultural immersion and lectures we will listen to.  I have a meeting with the professor who is taking the trip with us and the five students.  I am sure to have a lot more information about this trip.  We have five guys in our class of 75 and three of those guys will be on this trip.  Only two girls, of course we are both named Katie, because there are 23 forms of Katie, Kaitlyn, Catherine in our group of 75!! Crazy!  In the next few months I am in search of a warm winter coat and maybe a new pair of warm snow boots!

Service with a smile; I must keep this in mind tomorrow.  Even if I am terrified, I need to stay positive and know that I will get through this. 

Empathy

We watched this in class a little while back and wanted to share.

Cleveland Clinic Empathy Video


I can't wait to be a nurse!

Back To The Grind

I am now finishing out my second week back from break.  This is my second week of advanced Med Surge.  Advanced it is!  Our professor for the first two weeks was intense, but maybe one of my favorites so far.  She is high energy, keeps my attention and explains things so well that I actually understand what she means.  Her focus was all cardiology; so I feel like I know so much more about the heart.  Now to study a lot to retain this information!  Along with this new course comes my third clinical placement.  Today was my first 12 hour shift.  It went as well as can be expected.  I was really tired and ready to go home.  I felt overwhelmed, inadequate, not prepared and over half the time I was clueless as to what I was doing.  Ahhh the familiar feeling has come rushing back to me!!  Hopefully these next few weeks go by quickly.  Not that I want to wish away my experiences, but I know I do not want to do critical care and I simply cannot wait for the spring where I will be doing pediatrics and OB!!  I cannot wait!!  Critical care is a bit more involved (I say this now as I have completed one day..one day! Who do I think I am?!)  The nurses have at most four patients.  At my previous med surge clinical, the nurses had up to eight patients.  Big difference.  The patients on this floor are definitely more critical.  I am not in an ICU, but a step down ICU floor.  Most patients have had surgery and are not so critical they need the ICU, but they need closer monitoring then they would get on a typical floor.  I need to brush up on my basic nursing skills.  After so many weeks in psych (we didn't touch patients or do vitals or head to toe assessments!) I was thrown right back into the trenches today.  Next week we will be giving medications and I am sure held to higher expectations.  I was able to have a new first today; I checked my patient's blood glucose!  We were not allowed to do that at the previous rotation.  It was a small thrill.  I hope to challenge myself and my comfort level in this rotation.  I know I will be pushed by my instructor, which scares me but will also keep me on my toes.  I have a good clinical group and we seem to all get along really well.

I turned in my application for the service trip over spring break.  The instructor who is in charge of this trip has been sending out desperate emails due to a lack of interest in the trip.  I am really hoping she doesn't decide to cancel the trip!  I am still holding out hope I will be chosen.  Today, in her latest email attempt to get students to apply, was to do a last call to our group.  If she doesn't get any more applications, she will open the trip up to other groups of nursing students.  I will keep you posted on what happens!!  

Tomorrow is Halloween; I will be spending my evening in Pharm class.  I was thinking recently, I am pretty positive I have yet to have the chance to pass out candy with Erin since I met her.  I have always had an evening class on Halloween.  This should be the last year!! Sadly, next year I could be working on EVERY HOLIDAY!! I must enjoy the perks of being a student while I still am one :)

Speaking of Erin, she has convinced me to do this 90 day workout.  It is kicking my butt!!  The last two days I have struggled to walk due to my insanely tight calves.  It is ridiculous how out of shape I am.  She is further ahead of me and has become a rock star at these workouts.  We can do them in the comfort of our own home.  Some nights it's only 10-15 minutes.  So far I hate it, but I have an accountability partner and Erin cheering me on! 

Off to try and convince my calves it will feel good to do another workout!

Last Moments of Fall Break

Sunday night has reared it's ugly head...but thankfully this next half of the semester I only have class and clinical on Tuesdays, Wednesdays and Thursdays!  That's right, four day weekends!  Before I get too excited, I have to remind myself that those extra days will be spent with my nose in a book.  But at least I can sleep in a tad (who am I kidding, I wake up at 6:30 everyday!) and wear my sweats all day if I want!

I am finishing up my application essay to turn in this week and hopefully get chosen for the service trip over spring break.  It is geared to pediatrics, so I not only feel I have to go for the experience; I HAVE to go because I will love it!  Going into a school to help educate children about the importance of healthy choices and to provide well-child health screenings.  It would be such a wonderful experience.  Fingers crossed they want me!!  It sounds like the second installment of our payment, if selected, is due in November or December.  Hopefully that means not too much of a wait time to know if I get to go.

In other news, I was thankfully excused from jury duty the night before I was scheduled to report.  What a relief!!  Not only did I not want to have to go sit for hours on end, I was also nervous if I was selected my letter and my situation wouldn't be enough to be dismissed.  Thankfully, all that worry was gone as I heard the automated service say "you're excused and do not have to report."  Woo Hoo!!

The past couple days I have finally gotten more serious about school work.  I went through my orientation information and took the required three quizzes for the hospital I am placed for my next rotation.  I will be in a step down surgical intensive care unit.  Definitely more critical patients.  I am nervous, per usual.  It will be nice to actually touch patients and take vital signs and other new skills I have yet to learn.  In psych, you never touch the patients; really it was lucky if you were able to sit and have a conversation with someone.  Before my first day, this coming Wednesday, I have a whole lot of work to complete and read in preparation for our simulation lab day.  I believe our focus will be patients with tracheotomies.  This will be brand new for me, so I have a lot of work to get through.

Ok, off to make my Erin and me some dinner and then back to the grind.