4.Whoa!

In the midst of the experience of a lifetime, living out my dream, I felt overwhelmed. There were times (quite a few, in fact) that I just wanted to give up. It would be so much easier to just work and not have to worry about papers, the 5:45am alarm clock, studying for next week's quiz and/or test, oh and trying to make sure that I didn't get too behind at the office. I would have all of the time in the world to spend with my friends, my boyfriend, maybe even take a trip up to visit my parents once a month, like I was used to doing.

But, any time that I felt like giving up, I always had a voice saying that I could do it, whether it was in the form of Post-It from Amy on my desk, or a flat out, "You cannot quit" from Justin or my mom. I even had Akbar, via Skype, telling me that he knew I could do it, I just had to believe in myself. In spite of it all, I somehow found the inner strength to take one more deep breath & to keep going.

I knew that the first semester wouldn't be easy, that it would take a lot of hard work and sacrifices, but I also knew that in the end, I would be proud of myself. In the past four months, I have gained more confidence than I have in the past 26 years. I have not only impressed myself, but apparently, I have impressed nurses (instructors, charge nurses & floor nurses) as well.

Honestly, I have not felt any greater joy than opening up that e-mail on Friday afternoon. I not only survived my first semester, but I did it with straight A's. No matter what happens, that is something that will never be taken away from me.

I have always been my worst critic. The tears that streamed down my face on Friday afternoon were from years of hard work & heartbreak. But, I did it. And I did it with a 4.0.

1 semester down, 3 to go.

Mental Health Rotation

I started my mental health rotation this week.

Let's just say that my first day was extremely different from the acute care setting.

Because of the sensitive nature of this rotation, I won't be blogging about the experience for the next 6 weeks.

Sick & Tired

Well, Friday was pretty much the worst day ever.

To make a very long story short - I ended up crying to my instructor in the hospital supply room. I was able to pull myself together long enough for post-conference and the drive home.

As soon as I saw Justin, I just started crying all over again. It's nice to have someone who doesn't mind that he's dating a crier!!

Today - we spent all day at a senior housing development. We participated in an aerobics class and chair exercise class. Let's just say that it kicked my butt!!

I wasn't feel well to begin with today & by this afternoon, I found myself at an urgent care getting diagnosed with a sinus infection that is apparently so bad that I don't need just one antibiotic - I need three. Figures.

And now I'm off to catch up on some TiVo & head to bed.

In the meantime, I sure hope that my head doesn't explode with all of this sinus pressure. Yuck.

Teeth!

I wish that I had a video camera today:

My patient doesn't speak any English - so it really put my very minimal Spanish skills to task.

"Dolor?" I find myself asking. Boy, I wish that my Wisconsin accent wasn't so obvious sometimes!

I am about to feed him breakfast, when he keeps repeating something. I have no idea what he is trying to say, until he gestures towards his bedside table.

I look at the table - to see if I can figure out what he is trying to say.

My blood turns cold as I realize that he is pointing towards a blue cup: a blue denture cup.

I don't deal well with feet or teeth - that was one thing that I knew long before I started this adventure.

As I gingerly pick up his top dentures, I try not to make a face.

I ask him if he needs his Fixodent. He shakes his head no.

He opens his mouth, I put his dentures in.

He says something, with his teeth in his mouth, I still have no idea what he saying.

Finally! I figure it out - they're his bottom dentures.

Nice job - only I would try to put someone's bottom teeth!

I put the other half in without a problem.

Maybe I'm glad that there isn't a Student Nurse reality show after all...

Exhausted & Overwhelmed

Do you ever have one of those days where you just don't know where to begin?

I have a 30+ page gerontology paper to do by Wednesday morning, a quiz to study for & my careplan due from last week's patients.

Well, I need to get to work on figuring out where to begin - and something tells me that it should be my gero paper...

As my 82 year old patient told me, "Don't get old - it's terrible, just terrible."

Hospital Week #6

Wednesday afternoon, as I walk into the hospital I feel completely overwhelmed. We have to pick two patients this week! I haven't even started to begin feeling comfortable taking care of one patient and now I have to take care of two!?! The thought of it alone was making my palms sweaty.

Once I get onto the floor, I happen to see the nurse that I worked with last week. I run up to her! "Hey! How are you?" She actually looks a little excited to see me. I rattle off questions to her immediately. "Do you have any patients that will be staying until Friday? I need two of them!" She tells me that all three of hers will either be leaving Wednesday night or Thursday. I just hope for the best and pick two out of her three patients.

I can't believe how old one of my patients is. I didn't think that people lived to be that old anymore. As it turns out, he is one of the sweetest people that I will ever have the pleasure of meeting. I will always remember his thick accent: "Have you ever been to the Phillipines? It's beautiful - just like California."

Thursday was also my first day cleaning up poop. I have been pretty lucky - everyone else in my clinical group has cleaned up poop multiple times. I am proud of myself for the simple fact that I don't gag. My patient spends the whole time saying "I'm so very, very sorry." I tell the patient, "It's okay, don't even worry about it - it's my job."

I shudder a little bit when I say that. What did I get myself into?

I also give my first intramuscular injections on Thursday - a flu vaccine & pneumonia vaccine. The patient only speaks Spanish - she tells the nurse that it didn't hurt at all. As I walk away, she grabs my hand and looks me directly in the eye & I wish at that very moment that I could speak Spanish. But, at that moment, our language barrier didn't seem to matter. Truthfully, she seemed so happy that I took the time to open her blinds so that she could see outside. Hey, I remember a few things from my days at Paraclete. Ventana = window...right?

Friday morning, my back is starting to throb. For the first time, I've had patients who are pretty immobile, which means a lot of lifting. Yes, I know, you're supposed to protect yourself at all costs. At the same time, even if I have 4 people helping me move a patient up in bed, my back is still going to hurt, lifting 180 pounds.

I spend the morning following one patient to an abdominal MRI & then I follow my other patient to watch a vascular access procedure. I meet several scrub techs and a radiologist. They are all really nice, until they realize that we don't have the proper forms signed in order to perform the procedure.

This was an eye-opening week. I've learned that if for some reason, a friend or family member is in the hospital, I don't want anyone to know that I'm a student nurse (or nurse when the time comes.) I want to be a helpful family member, but I don't want to be the annoying one. I don't want to be the patient's daughter who tells me, "Maybe you should go see if you can help your nurse with something so that she can come here now." Wow - I didn't realize that the School of Nursing patch on my scrub tops means that I'm your servant.

At the end of an extremely long week, my nurse gives me her phone number and tells me to call her with any & all questions that I might have. I will always be so grateful for her taking me under her wing over the past two weeks.

She tells me that I'm going to be a great nurse & week after week, I am really starting to believe that myself.

Hospital - Week #4

Just as I thought that I was getting comfortable with this whole hospital thing – BAM! I have to rotate to a new floor, which means new nurses & new security codes to get into the supply & laundry rooms. The security codes don’t seem like that big of a deal – until you have an incontinent patient and you have to change her bed at least 3 times yourself. (I don’t know how many times the CNA ended up changing the bed…)

Wednesday afternoon, I picked out my “elderly” patient – since I have to write a paper & went home to bundle up for Justin’s water polo game. I know, I know, I should have stayed home & worked on my patient’s careplan instead, but I just couldn’t help myself. I refused to listen to my mom (which generally, isn’t a good idea…) & I went to the game. As I’m driving into Santa Ana, I realized that my Google Maps application isn’t working on my Blackberry. Great, just great. The game is about to start in 5 minutes, so it’s not like I can call Justin and ask him what street the school is on. After ending up near Mater Dei – I realized that I was totally lost – turned around and turned left onto some random street with a familiar name. I made it! Now, I just have to figure out what is going on. I’m getting better at understanding the game – but I still have a long way to go.

After freezing in a long-sleeved shirt, hooded sweatshirt & jacket, and watching the varsity boys win – it’s time to head home to do my careplan….and get ready for a busy two days.

So, the 2 alarm clock idea has worked well – and I wasn’t late at all this week. For the first time, I have a nurse who completely takes me under her wing all day – even to the point where she invites me to take breaks with her. I help her pour Stroke Lady’s crushed up meds into her G-tube. (She has problems swallowing – so all of her meds get crushed up and are inserted directly into her stomach through a tube.) Later, she allows me to “spike” the bag for the tube feeding, which is basically like spiking an IV bag. My classmates are excited and a few of them admit to being jealous when I tell them what I got to do. One hasn’t really gotten to give that many injections, I tell her that my patient has 3 – so maybe she will be able to do some tomorrow.

Thursday was also our midterm evaluations. I always get nervous when it comes to performance evaluations – I don’t know why. It doesn’t matter if it’s at Advanced Wellness or at Ken Clark or sitting in a conference room at Western Medical Center. It’s like I’m afraid that something bad is going to happen & I haven’t been able to prepare myself for it.

Well, nothing bad happens. As a matter of fact, my professor gives me what you could say – glowing – remarks. She tells me that she can see that I was meant to be a nurse – that I have the drive & the compassion to be a great nurse. I almost cry. She also tells me that I need to go on and get my Master’s degree so that I can teach. I almost cry again.

The nurse that I worked with today tells me that she could see me working in the ER or ICU – not on “a boring floor.” She says that she can see that I have great potential. As I say goodbye to my patient – she pulls me closer to her – so that I can hear her. She tells me that I am going to be a great nurse because I really care. I almost cry again!

I have worked so hard to get myself where I am today – I have been to the bottom and crawled my way back up to the top. Many of you were there to support me through it & I am so grateful for that. I spent the majority of the summer completely freaking out about this terrific opportunity that I’ve been presented with. I was afraid that I would fail and disappoint not only myself, but all of you.

During the past eight weeks, I have learned more about myself than I ever have before. It hasn’t been perfect, there have been a lot of tears and “freak outs.” But whenever I thought that I might not be able to do this, I have always had at least one person to tell me that I can. Whether it’s reminding me that there are hundreds, if not thousands, of other people wanting to be in my position as a nursing student at Saddleback (thanks, Justin) or asking me if I really want to be a secretary for the rest of my life (thanks, Mom) or just telling me that they have faith in me & I just need to have faith in myself (thank you to everyone!) - I have been able to find the drive deep down inside of me to keep pushing through.

I found the similar drive on Sunday morning. At Mile 10, Amy & I start cramping up & feel practically every fiber in our muscles stretching and pulling. We never really thought about giving up - I knew that we could do it. As we actually jogged/ran that last ½ mile towards the finish line – we accomplished something that a lot of people didn’t think that we could (myself included.) We finished our first half marathon. As we cross the finish line – holding hands & jumping in the air – I almost cry again.

Hospital Day #5

The alarm clock reads 6:30…I slowly roll over to my face my current companion in bed and I find myself staring into a pair of deep brown eyes – 6:30!?!? Zoe looks a little frightened. I check my ‘crackberry.’ Yep – 6:30. Oh my gosh, I was supposed to be awake an hour ago – I’m supposed to be at the hospital right now. What happened!?! Adrenaline, mixed with frustration, surges through me. I set my alarm clock last night, but apparently, just forgot to turn it on.

Two scenarios run through my mind as I thumb through zillions of papers in my notebook, “Where is Barbara’s number? What am I going to say to her? Should I just tell her I’m sick and take the whole day off?” Whew. I find her number. Before I know it, my clinical instructor answers her phone. “Barbara, it’s Amanda…” The tears start creeping up into the corners of my eyes and my voice starts to break – “I just woke up…I don’t know what happened…What do you want me to do?” Barbara calmly, almost comically asks, “How fast can you get here without breaking any speeding limits?” “It will take me 30 minutes to get there…I can be there in 45 minutes.” She sweetly says, “Calm down and stop your tears…be here by 8:00.”

A huge sigh of relief escapes as I get ready to face my day. I realize that I only would have been hurting myself if I would have lied about being sick. After all, I stayed up (and Skyped with Hillary) and did my homework, including an extensive patient workup. I didn’t do all of that work for nothing!

I put my white scrubs on and then start the process of ‘putting on my face.’ I giggle to myself as I remember Akbar telling me, “Amanda, it’s makeup – not magic.” Well, it’s definitely magic this morning! It doesn’t help with the bad hair day, but whatever.

I walk into the nurse’s station at 7:35. My nurse doesn’t even seem to notice that I’m there an hour late. Awesome! She goes with me so that we can introduce ourselves to my patient. Before I know it, the lunch trays are here. I’ve already given my patient approximately 5 medications PO (which means “by mouth”) J along with three injections. I’m starting to feel a little comfortable with a needle in my hand…watch out!

The charge nurse is talking with my patient’s “roommate.” The post-motorcycle accident guy will be going home later today. Diabetic guy will be around until at least Monday. “Excuse me, Mark” I find myself saying to the charge nurse. I scoot past him and the door – Diabetic guy’s lunch tray in hand. BAM! Coffee and chocolate pudding are on the floor and have splashed up all over my white scrubs. I can feel my face turning as red as the sharps container hanging on the wall. Mark, the charge nurse, doesn’t laugh at all. “This happens all of the time!! I’ve ripped tons of scrubs with that stupid thing.” I’m playing everything back in my head. My sleeve got caught on the door handle, when I moved, everything else moved, but me. Mark goes and grabs some towels to clean up my mess. As he walks back into the room, BAM! His sleeve gets stuck too. I’m still wondering if he did that for my benefit. I giggle to myself wondering what Justin is going to say when he hears this!

I clean everything up and replace Diabetic guy’s cup of coffee. I run off to join my classmates at lunch and feel the need to instruct them about watching out for those trick door handles! They all say that they can barely notice the coffee, which has now dried onto my scrubs. It’s true – you only see it if it’s pointed out. But, I know it’s there and feel like everyone’s watching me!

After about 90 more minutes with Diabetic guy, I tell him that I’ll see him in the morning. He responds, “I’ll see you tomorrow, God willing.”

He instantly reminds me of my best friend, Akbar, who always says, “Insah Allah (if God wills it).

As soon as I get home, I ask Gabe if he has any Spray & Wash and declare that I’m going to need a lot of it.

He looks at my scrubs and laughs as I give him the rundown of what happened.

As I walk to the laundry room, a little boy and his parents are walking to the pool. He stops on the sidewalk and says, “Hey girl! Are you coming to the pool too?” “No – I have to do some laundry because I have to get up really early tomorrow.” “Girl, what’s your name?” “Amanda. What’s yours’?” “Joseph.”

I look at Joseph and his sweet little smile helps me remember why I chose to be a nurse – a pediatric nurse. Insah Allah.

Hospital Day #1

You take a deep breath and you walk through the doors
It's the morning of your very first day
And you say hi to your friends you ain't seen in a while
Try and stay out of everybody's way

Who would have thought that the opening lines of Taylor Swift’s song, “Fifteen” would actually be an almost perfect fit for my first day at the hospital as a student nurse. I did see my fellow student nurses in class yesterday, and you need to add ten years to fifteen…but you get the picture.

As I drive down the freeway, Justin’s directions run through my head – I take a few deep breaths, followed by “I can do this…I can really do this! This is what I’ve wanted for so long and I’ve actually made it!” I still end up in the parking lot of a gym, but I am running early for once in my life, so I’m not bothered by the fact that I was burning a few minutes.

As I’m turning left in the hospital parking lot, I realize that I am following one of my classmates. What a huge relief to see another fellow marshmallow! (At least that’s what I feel like in my all white scrubs!) We somehow make it to the cafeteria – where we were early for our first meeting. After a few hours of paperwork and discussing why we actually want to be nurses, including how we felt about our first day, we go on the tour of the hospital. We all giggle as a patient made cattle noises when we walked by. Seriously, we were a herd of student nurses in white scrubs.

My group is the last group to get “dropped off” at our floor. Our instructor shares a laugh with an RN and then assigns me to her. She doesn’t seem too opposed to be taking a student under her wing for the day (or so I like to think.) We are introduced to two other RNs who will be supervising two of my classmates on the floor. We meet the charge nurse, who is surprisingly very helpful and welcoming. As soon as introductions are made, we shyly smile and rush off to do our scavenger hunt. We start the morning having absolutely no idea where anything is.

“Where is the supply room?” “I don’t know – I haven’t seen it.” Within thirty minutes, we have the codes to the supply rooms, as well as to the medication room, and have an RN who is helping us “cheat.” We have already asked questions that stumped at least one RN and the charge nurse. He seems proud when he tells us that the water main shut off is done by the engineer and that the valves are in the ceiling. (He didn’t know this information previously and we were a little shocked that he followed up on his promise to find out for us.)

We rush to finish the “treasure hunt” before lunch and before we can no longer ignore our grumbling bellies. Lunch is amazing – for $5 I get a HUGE serving of beef stir fry and a Diet Coke. I announce how it’s enough food to bring leftovers home for dinner & then promptly scarf it all down.

As we head back up to the floor to pick our patients for tomorrow’s assessments – I am giddy with excitement. I think to myself, “I wonder who my nurse is going to pick for me.” She says that she’s going to give me an “easy” patient for my first day. While some of my friends get multi-trauma accident victims, patients with MRSA – my patient has her gallbladder removed. I breathe a sigh of relief! Then, I find out that my patient is sleeping, so I need to follow my nurse to another patient’s room. She rattles off a bunch of diagnoses – I nod my head and utter “uh huh.” In reality, I have no idea what she’s talking about – I can pick up a few words here and there, but still have no idea what was wrong with the guy. I follow her to give a blood transfusion. “Awesome! I get to see something cool.” To my complete embarrassment, she tells me to take his vital signs. “Oh my gosh – I thought that I was just watching…I’m so not ready for this!” I say, “Okay” and rush off to find the vital sign machine. I ask where the patient’s disposable blood pressure cuff is. “Right there…next time, look around and you will probably find what you are looking for.” She’s not being rude, just straightforward. I feel my face turning bright red and my palms start to get a little sweaty. I go to put the cuff on his arm and his arm doesn’t move. “C’mon guy, help me out a little bit here…I’ve got 3 people watching me!” I struggle a little to put the cuff on his arm and turn the machine on. I can hear the Velcro starting to separate. “Please stay on, please stay on” I pray silently. “We need his temperature too, before we can start transfusing.” Shoot, I knew that I was forgetting something! “Oh, okay, sir, please lift your tongue – I’m going to take your temperature.” I vaguely remember her introducing me to him and explaining what I’m doing. Another thing that I forget to do. She reads the blood pressure and temperature off the machine. I’m standing there holding the thermometer thinking “What do I do now?” I turn off the machine, before the nurse gets his pulse. “Good job, Amanda! Way to screw up again.” She turns the machine back on – I’m still holding the thermometer. She takes it from my hand and tries to put it back in the appropriate holder. It won’t fit. She realizes that I didn’t dispose of the cover and has to pull the cover out of the machine with her forceps. She throws the used cover into the little trash bag attached the machine. “Oh! That’s what that’s for.” The nurse takes the patient’s pulse. I look for a sign of encouragement from my friend, standing there, observing. She smiles at me like it could have happened to anyone. Later, she confides that she didn’t realize that the makeshift trash bag was attached to the machine either.

I must have looked like I was going to cry. As we walk out of the patient’s room, my nurse tells me that we will be taking the patient’s vitals again in fifteen minutes. She squeezes my shoulder, “Good job in there. Just keep practicing!” I announce that next time I will be taking the patient’s temperature simultaneously with the blood pressure. She smiles, like she remembers exactly how it felt to be in my shoes 40 years ago. “Go ahead and leave that machine in there, since we’ll be taking his vitals again in a few minutes.” I walk back into the patient’s room and leave the machine. My instructor/professor is walking down the hall at that exact moment. “Wow! It’s good to see smiles on everyone’s faces.” Obviously, she was mistaking my look of terror for a smile. I follow my nurse back to the nurses’ station – everything at that moment is a complete blur. She is going over lab results with me. “That’s odd – his hemoglobin isn’t low enough to require a transfusion usually.” I look at the lab values intently. I look at the patient’s name. It’s unfamiliar. “Are these labs the right ones for this patient?” She looks over them. “Wow, you’re right.” She tosses the labs to the nurse behind her. “These are your labs, they were in my patient’s chart.” “How did you find them?” “The student found them!” I smile proudly, I might not have been 100% on my vital signs, but I found what could have been a very costly error.

We go back to the patient’s room – “I thought that I told you to leave the machine in here…” (More of a question as opposed to a statement.) “I did – I don’t know where it went!” So, the hunt ensues, after only asking one time where it could be – I find not only one, but two machines. It’s a miracle! I proudly wheel the machine back into the patient’s room. I slap on the blood pressure cuff – I’m a pro now! I put the thermometer under his tongue. I turn on the machine. Nothing. Great, just great. “You need to turn on the machine before giving the thermometer to the patient.” Okay, I can still do this…no big deal. I obtain the patient’s vital signs. She charts them and has me get him the grape juice that he requested. And the Shredded Wheat cereal. And the whole milk. And the high protein shake. “He wants another grape juice – is that okay?” ! “Yep, we want him to take in as many calories as possible. You’re doing a great job getting him to eat.” “Oh, okay, thanks.” I haven’t done this much serving since I worked at Chili’s!

It’s 2:40, I’m supposed to have taken a break at 2:30, to be back in post-conference at 2:45. Shoot. I quickly thank her for all of her advice and help. I silently thank God that she didn’t yell, “What do you mean, you don’t know how to do this?”

I take the time to realize that I’m really here, I’ve really done it – I’m a student nurse.