Sunday, June 13, 2010

March 2010

March 07

Long day...

You know you are in for a long day when the patient you are on the phone with says, "I'm going to put you on hold while I get my bowel movement diary."

August 2009

August 08

Advice for Nursing Students

Starting nursing school soon? Scared out of your mind? Don't worry, so is everyone else in your class. One of the most popular searches that leads to my blog this time of year is: "scared to start nursing school." So you are definitely not alone!

My advice for soon-to-be nursing students:
1. Never forget that every other person in that classroom is just as scared as you are. If they always look confident, it is just an act. So don't let them stress you out.

2. Be prepared to work hard. You will have to do a lot of reading, and it will be very confusing at times. Do the best you can to get through it, and highlight anything that might sound important.
3. Find a few classmates you get along with, and stick with them through the whole program. At times when no one else in your life fully understands what you are going through, they will. I can't emphasize enough how important this mutual understanding is, and I guarantee that these people will talk sense into you every time you are 100% sure you are going to quit.

4. Be prepared to feel lost. My first time doing everything (including putting a patient's sock on her foot), I was so scared I was shaking. It is normal to completely forget how to do everything (even the most simple tasks) when you are nervous. So don't let this make you feel stupid or inferior- it is NORMAL!!

5. Ask tons of questions. If you are told by a nurse to do something on a patient and you are not familiar with it or are uncomfortable, ask for help. Don't let it bother you that she rolls her eyes at you, you have the right to learn, and your patients have the right to receive safe care.

6. Be prepared to laugh at yourself. If you fail to do this, you will be more stressed out than necessary. When you do something stupid, laugh. Don't be embarrassed, we all do dumb things. Also, allow your patients to laugh at you. One patient told me that watching me frantically search for my clipboard (the clipboard I was holding in my hand) and then laughing with me when I realized my mistake, was the highlight of her week.

7. Even though you are extremely busy, take one night off. This means do not do any school work whatsoever one night every week. Thursday night is my night off. I watch TV, catch up with friends, just do whatever I want. On Monday, when I really want to watch something on TV or feel unmotivated to work, I keep telling myself that I only have a few more days until Thursday.
8. Find an outlet for your frustrations. This site has been wonderful for me- I just write about what I feel, and even though I usually don't end up posting those things for the world to see, just writing about them makes me feel a lot better. Although this takes away from my study time, it is well worth it. I don't think I could keep going all those hours if I didn't have some way to release some steam.
9. Know that you are not alone!! If you need someone to vent to or share your wonderful experiences with, leave me a comment and I will get back with you (just don't forget to leave your email address).
Good luck!!


Click here to see advice from other student nurses:



January 2009

January 20

May I have your attention....

Christmas dinner was held at my sister-in-law's house this year. She did an amazing job with the decorations and the food, and everything seemed perfect. She has two adorable sons, and the younger one just finished potty-training. As we were sitting at the table eating, the older son Joey got up to go the the restroom. Soon after he closed the door, it flew back open and Joey stood there with a huge grin across his face. No one said anything to him and we kept talking and eating. After standing in the doorway unnoticed for a few seconds, Joey shouted, "May I have your attention please! There is poop on the bathroom floor!" Unsure of the socially correct thing to do, everyone continued talking and ignored Joey. Not satisfied with the response, Joey repeated his announcement. Still nothing. In a high-pitched whiny voice, Joey added, "It's real live poop, I promise."
Christmas memories......

December 2008

December 08

Garage sale treasures

I should have braced myself for something awful the second Mike said the words, "You are not going to believe what I got for FREE at a garage sale down the street!" I knew the excitement was probably over some random piece of junk, but wasn't prepared for what Mike had sitting in our living room:




"We got a free step-stool!" he said, sitting down on his amazing find. I would have immediately informed him that an elderly person was probably recently sitting on his "step-stool" completely naked and possibly even going to the bathroom, but I was laughing so hard that all I could say was, "Great!"
Husbands. Gotta love them, right?

July 2008

July 07

Respect

Some people earn instant respect by the credentials after their name. Others earn it by the school they went to, the awards they have won, or the position they hold at their job. In pediatric nursing, these achievements mean absolutely nothing. A few weeks ago I had a fifth grade boy as a patient. He had a wound on his leg that I needed to examine, but he was terrified that I was going to hurt him. When I would come near him he would move to the other side of the bed. I needed to earn his trust or I was going to get nowhere. “How far can you get in Guitar Hero?” I challenged him. “I can almost beat it on medium,” he bragged. “That’s cool, I can beat everything but Jordan,” I casually said. His eyes got large and his mouth dropped open as he froze and looked over at me. “You can almost beat Guitar Hero on medium!?” he asked. I smiled and replied, “No. I CAN beat it on medium. I just can’t beat Jordan on expert.” As we continued to discuss Guitar Hero, I assessed his wound and changed the dressing without even an “ouch”.



June 2008

June 24

Jump!

Photo by Adept Studios, Ft. Lauderdale Florida
June 12

The Wedding

Click on the link on the right to see our wedding pictures!

May 2008

May 30

The power of gas

After certain abdominal surgeries, passing gas can help relieve pain. I learned yesterday that farting is such a powerful healing tool that even fake farts can make someone feel better. My patient was a grade-school aged boy recovering from a painful operation to his leg. He paged me to his room for pain medicine and as soon as I began examining his IV, he let out an extremely large fart. I looked at his face and could tell he was trying not to laugh, so I smiled and said, "Feel better now?" Both he and his sister burst out laughing. This laughter led to several more drawn-out farts, and it did not take me long to realize that there was a fart machine involved. "Where is it?" I asked with a smile. He pulled out from under his sheet a little remote-operated machine. Wow, the whoopee cushion has gone high tech! His doctor had ordered that he get up and out of bed several times each shift, but he had not been willing to walk around yet. Applying my hard-learned critical thinking skills from that awful experience I call nursing school, I said, "Want to have some fun with that?" His whole face lit up and he shouted, "Sure!" I grabbed his crutches and handed them to him. I gave his sister the fart machine and I took the remote. "Let's go for a walk by the nursing station," I casually said. His mom laughed and his dad hid his face in his hands. Peter* slowly climbed out of bed and our journey began. At first he was slowly navigating down the hall. When he passed the extremely busy nursing station, I pushed the button on my remote. A loud but quick farting noise was immediately heard, and Peter hunched over forward and put his hand on his stomach. A few nurses and doctors paused and looked up, but no one said anything. As he stood there, I pushed the button again. This time the machine picked a long, diarrhea-sounding noise. Peter took off on his crutches moving down the hall. The nurses all looked around at each other, and my coworker Donna said to him, "Are you ok?!" He replied, "Yea, I *INSERT LOUD FARTING NOISE*, uh..." His sister was laughing so hard she was almost crying. Donna was obviously trying to stay composed, but after another push of the button, she could not control herself. As she started laughing, so did Peter, followed by most people at the nursing station. "I think I should go back to my room," Peter said, and as he began going back down the hallway, I accompanied him with the appropriate sound effects. When he finally returned to his room and was filling his parents in on his performance, he could not stop smiling. "How's your leg feeling," I asked, expecting it to be pretty sore after walking around. "Oh, it's great!" he answered, surprised. Two hours (and numerous times retelling his story) later, he still was not having any pain.

March 2008

March 11

My Prince Charming

We were on our way home from a nice dinner and I started having a mini "I'm getting married soon" freak-out. To calm myself down, I began thinking about how perfect Mike is. He's sweet, loving, cute, and an overall great guy. By the time we pulled into the driveway and got out of the car, I was excited again about getting married. I smiled at Mike as we walked towards the house. But before we made it to the porch, I felt an awful sensation: a spider web stuck to my face. As I frantically began to rip the web off, I noticed a large spider on my stomach. Now, I have a strict no-kill policy when it comes to bugs, and I consider myself to be a tomboy, which is why I cannot explain or account for the sounds that I started making or the actions of my body. I let out a high-pitched scream as my arms, without my brain telling them to, began to hit at my stomach. "Get it off me!" I desperately screamed to Mike. I kept hitting myself and kicking my legs (I'm not sure how that was supposed to help get the spider off) when I noticed that Mike was not coming to my aid. I managed to temporarily regain control of my limbs and ran towards him. That's when he did the unimaginable... he ran away from me. With one well-placed swat I finally managed to get the spider off myself, and I sprinted into the house. "Why didn't you help me?!" I screamed at my soon-to-be husband. "Because it was dark out and I didn't want to get the spider on myself," he replied. Well, at least he's cute.

June 2007

June 01

Triage notes

Before entering my new patient’s room, I read his triage notes. “Diarrhea at 0300. Mucous membranes moist, patient playful, drinking Gatorade at triage. No fevers, no signs of distress.” I looked at my watch and noted that he had only had diarrhea for a few hours. This should be an easy patient, which was exactly what I needed at the end of this long shift. I walked into the room and introduced myself to the family. The boy was around two years old and was sitting on the examination table. He looked calm, but was working hard to breathe. This was not consistent with diarrhea for a few hours. The parents were Spanish-speaking only, so maybe there was a miscommunication at triage? I began examining the boy. Everything seemed fine- his breath sounds were clear, no fever, and he appeared well-hydrated. I bent down close to him to lift up his shirt to see if he was retracting (using extra muscles to breathe). That’s when it happened. “GRRRRRRRRRRRRR!!!!!!” he screamed, raising his hands up in a claw-like fashion while making a scary face. Startled, I jumped back, now fully awake. “GRRRRRRR!!” I growled back, tickling him. The triage nurse forgot to note that my patient was a little dinosaur. After he stopped giggling and doing his dinosaur breathing, he looked like a healthy little boy. Not wanting to spoil the doctor’s fun, I forgot to mention the patient’s reptile-status when she asked about him before entering the room. A few minutes later I heard another “GRRRRRRRRR!” followed by the doctor’s laughter and, “Would you please grab this dragon a popsicle?”

March 2007

March 07

Is he or is he not...

The day began like a normal morning in our busy ER. I had Ben, a student nurse, working with me, and we were taking care of two patients having difficulty breathing. While we were examining one of our patients, I noticed I was getting an ambulance patient in my open room. I debated whether we should finish the exam or go right away, and decided to go check out the new kid then return to finish our exam. “Adolescent male, postictal after his fifth seizure today,” the EMS woman told me. I watched as they transferred the boy from the stretcher to the bed. He didn’t react at all. Most kids at least appear startled during the transfer. Ben and I walked over to the patient. His skin was pink but he wasn’t reacting to us or responding to painful stimuli. We placed him on monitors and they immediately started alarming. His oxygen saturation was 81%. “Is he breathing!?” I shouted. EMS quickly answered, “Don’t worry, he’s just postictal.” Ben and I stood there examining him, and Ben was the first to speak. “I really don’t think he’s breathing.” I agreed, and had the tech overhead page for help while we started grabbing the airway equipment. Within seconds we had a respiratory therapist, pharmacist, and two attending doctors at the bedside. They started shouting out what felt like hundreds of orders while the respiratory therapist was bagging the patient. Within minutes we had the patient in the critical care room for intubation. As I was giving report to the critical care nurse, I saw Ben peeking in from the hallway. I motioned for him to come stand with me. I was expecting him to be reluctant to enter the room- it’s an intimidating place with all the doctors and machines, but Ben was at my side immediately. An ER nurse is born, I thought to myself. We went back to our assignment and began deciphering my notes so we could chart on the insanity that had just occurred. While we were standing there, Ben said, “That was so cool! I definitely want to be an ER nurse!” I was still shaking slightly and had been fighting the urge to vomit. I think I prefer my patients when they are breathing!

Feb 2007

February 08

Deep breath and.....

Ok. Blood culture, urine culture, lytes, CBC, rapid RSV for room 3. Has the baby in 2 peed yet? I still need to do his urine dip, and why won't his line flush? He still needs his Rocephin, has it been thirty minutes yet? I'll call the pharmacist again after I take care of 3. The doctor is in room 1, so hopefully I have a few minutes before I have orders. But that baby is really retracting and her oxygen sats are 94%, so I should take care of her before I worry about the baby in 2. Crap. Why is the mother for 3 standing in the hall waving me over? Ok, blood culture, urine culture, lytes, blanket, Gatorade, CBC, rapid RSV for 3. I'll get my supplies together, what size IV should I use? 24 gage will probably work. Is the doctor writing orders on 1 now? Deep suctioning, rapid RSV for 1. But I still haven't even started the workup on 3. Whose alarm is beeping? 1's sats are now 92%, I'm not comfortable with that. Why aren't there any neonatal nasal cannulas in this room? I'll get the bag and mask ready just in case. Are her lips blue? No, just my panicked imagination. 86%, is this machine reading right? I’ll wake her up and see if that helps. I wish I could find a tech to help with the workup in 3, I should be done with that by now. Is there something in my shoe? I keep feeling a sharp stabbing pain in my foot. But I can’t sit down yet. I have to take care of this baby now. It’s been fifty minutes since 2’s vital signs. I’ll be with 1 and 3 for at least twenty minutes, so I have to get 2’s vitals first, but he’s stable, should I just wait for his Rocephin and be late on his vitals? Oh yeah, I still have to call the pharmacist.....

This is what my brain goes through in just a few minutes at work. Winter in a pediatric ER is like this nonstop. By the time I get home, I don’t want to think about patients or hospitals or anything work-related. Unfortunately, as soon as I fall asleep, I am suddenly overwhelmed with patients again. I wake up panicked because I’m late on vitals and giving meds. I remind myself that I am not at work for another four hours, then close my eyes and return to my demanding patients yet again. When my alarm goes off around 5, my brain feels ready for a break, not to begin another twelve hour shift. Am I overwhelmed? All the time. Am I on the verge of a breakdown? That’s a possibility. Do I love what I do? Absolutely.

January 2007

January 09

ER life

I am no longer an ER intern. I am now an ER nurse. Saying these words is exciting, yet terrifying at the same time. My first day on my own started off nicely, with most of my patients only having minor problems. I began building up my confidence- I can handle this whole nursing thing! Then a patient with DKA (diabetic ketoacidosis) was brought to my room. I dread DKA patients more than I dread any other type of patient. They require a large amount of work and monitoring from the moment they enter the room until they finally can go up to the floor. I am not sure why the charge nurse gave me this child my first day on my own, but it probably was not the wisest decision. The girl’s blood glucose was above 700 (should be around 100) and her blood pH was 7.14 (her blood was acidic). She was slurring her words, which is never a good sign. DKA puts patients at risk for cerebral edema (brain swelling), which can cause death. I took a deep breath and started working. I had a little cheat sheet I made for myself on how to handle DKA patients- what labs to draw, how to calculate the fluids, etc. I knew I needed two large IV’s, so I overhead paged my tech. No response. I overhead paged any available tech. No one was available. Crap. I tried twice to get an IV on her, but was unsuccessful. Not off to a good start! I finally got a small IV in and was able to get her blood sent to the lab. By the time I got everything organized, it was time to draw more labs. The IV would not draw back blood, a new resident had picked up her chart and was standing there reading through the protocol to see what to do next, and the mother kept demanding that we give her a meal ticket for the cafeteria. Didn't she realize how sick her daughter was? I felt like the room was spinning and that I was going to hyperventilate. I still had two other patients! Right when I was about to lose it, the resident figured out what needed to be done, my tech arrived and was able to start an IV, and the pharmacist helped me hang all the necessary fluids and insulin. Another nurse agreed to check in on my other two patients, and even helped me get that first IV to work again. As I was charting everything going on in the room, it hit me. I am nowhere near being alone! The night nurse arrived and although it took half an hour to give report and try to explain everything that had gone on, I couldn’t help but smile as I walked back to my car. I had made it through my first day “on my own.”

December 2006

December 19

Gifts in the ER

Some days the ER gets hit with the "breathers"- the kids having asthma attacks. While the rest of Dallas is enjoying the sudden change from cold to beautiful weather, we are suffering from all of the asthma attacks it caused. Last week, we had so many breathers that they started changing regular rooms into asthma rooms- several "breathers" in a room where you normally only have one patient. My room was given this "honor" and I got hit hard- a two month old breathing 90 breaths a minute (try to breathe that fast for just one minute) and a toddler having an asthma attack. Just keeping up with the back-to-back albuterol treatments and epi treatments was keeping me busy. Then I saw the dreaded EMS guy strolling down my hallway. "Don't go in my room. Don't go in my room. Crap. He just went in my room." I peeked in the room and saw a cute little girl, smiling and calm. Probably an appendicitis transfer from another hospital, I thought. I told the EMS guy I had a sick kid to take care of and I'd be back as soon as I could. His expression let me know he didn't like that, but I really didn't have a choice. A few minutes later I went back to see what was going on with my new transfer. I walked in the room and the EMS guy handed me a small cup with blue water in it. Uh oh. Is this a urine sample? Is this an ingestion case? Why is her urine blue? I held the cup up and was examining it when part of a finger floated by. It caught me off guard and I got that all-too-familiar-now feeling in my stomach. After winning the battle with the contents of my stomach, I handed the cup back to the guy and said, "Door hinge?" The mother replied with a surprised, "yes" and I quickly resumed my job of taking care of my patient.
Lesson of the day: Never accept a "gift" in the ER from an EMS you made wait.
December 10

I'll be ok.... maybe

"Possible seizure at school," the EMS said to me as he wheeled his patient into my room. The patient had never been diagnosed with seizures, but this was his fifth similar episode. At school, the boy suddenly became quiet and sat there, staring straight ahead. He would not speak to anyone or move, even when directed to do so. An altered level of consciousness like this could signal many scary situations- seizures, brain tumor, blood sugar problems, drug toxicity, etc. What was wrong with my patient? The resident ordered all of the appropriate and expensive tests, and the neurologist was at the patient's bedside quickly. She was not sure what the problem was, but planned on admitting the patient after the MRI was complete. The boy's mother was begging him to respond to her, but he sat there quietly. When I was in the room doing an assessment and checking his pupils, I noticed that he had tears in his eyes and that his lower lip was quivering. I asked his mother if I could speak with her son for a minute, and brought her to a chair outside the room. I sat down next to him and said, "When I was in school, the kids made fun of me because I was so short. I came home in tears all of the time. I hated going to school." This made him start to sob. "The kids all say my mom is crazy," he replied to me. "That must really hurt," I said. This made him cry harder, which made me want to cry. "You can't tell your mom why you are upset, because this would hurt her feelings too," I asked him. He nodded his head. I asked him what he did when the kids upset him but he couldn't tell his mom. "This," he replied. I talked with him for a few more minutes, and then went to tell the resident that he was able to speak. She quickly went into the room and came out a few minutes later. He wouldn't say a word to her. I went in with the doctor and explained to the boy that I knew it was difficult, but that the doctor really needed to hear him talk. I asked him what his favorite subject was. "Math," he answered. I left the room to take care of my other patients and when I checked back a bit later, he was no longer being admitted. They performed a CT scan just to make sure things were ok, and arranged for him to follow up with a psychologist. When he was leaving with his mom, he walked up to me and gave me a huge hug. Finally, I felt like I could handle this ER job. I was making a difference. What have I been stressing about? As I stood there filling out the rest of his paperwork, smiling to myself, the housekeeper rushed in to clean the room. I looked behind me and saw another EMS guy coming towards me with a young boy. Can't I get a minute to recuperate!?! He started giving me report before the room was even clean- dog bite to the lower leg. No big deal, probably just a few stitches, I thought. They brought him in the room and as they passed me, I noticed the word "Flight" on the back of their jackets. "He was flown in?!" I asked, panicked. "Yes, it was a pit bull," the man responded. Thankfully, an attending doctor walked by as the EMS said this, and the attending followed me into the room. He took the bandage off the leg and immediately instructed me to find the other attending and bring him STAT. I looked up and immediately regretted it. There was barely anything left of his calf, and I could clearly see his exposed muscles. I found the other attending and overhead paged my preceptor immediately. Before she was there, both doctors were giving me orders - Morphine, IV fluid, sterile saline, portable x-ray, antibiotics, etc. I froze. Morphine and what else? What am I doing here? Did I really just see that boy’s calf muscle?! Was that his bone? I want to be a receptionist again.....

December 06

Lessons from the ER

Here are a few of the things I have learned from my patients over the last few months:
~ Slamming your finger in the doorknob side of the door hurts. Slamming it in the hinge side of the door will take your fingertip right off.
~ Texas football fans are insane. Our ER is dead during any big football game, college or professional. An hour after the game, we get slammed with the kids who should have been brought in several hours earlier.
~ An untreated ear infection can lead to brain surgery.
~ An untreated cavity can lead to an ICU admission.
~ Some parents will choose buying cigarettes over buying their child's asthma medications. The result? The cigarettes can trigger an asthma attack, and there will not be any rescue medication available..
~ When making up lies for how their child was injured, parents usually forget to take into consideration their child's developmental age. A one-month old is not going to roll off of the bed and break her femur.
~ ER rooms can somehow become cursed for the day. On my last shift, every patient who was sent to room #6 ended up being sent to the ICU. Ashley, another intern, had two patients in room #1 get intubated. Some days every patient in a certain room will have the same condition- seizures, vomiting, etc.
~ Partially or completely amputated fingertips do not bother me. But cuts on the fingers slightly deeper than paper cuts? They make my stomach drop.
~ I desperately need to learn Spanish.
~ Popsicles have more healing power than Bandaids.
~ Ariel is the most popular Disney character.
~ When siblings are present, it is important to let them know that their brother/sister is going to be ok. If you fail to do this, you will quickly have two screaming children to take care of.
~ The most important thing you can say to a child when you first enter the room carrying something is, "This is not a shot."
~ Unless you are actually carrying a shot.
~ When you find out that one of your patients has died, such as my little cardiac baby from a few months ago, you have to make yourself move on. This is much easier said than done.
~ The best cure for an infant with constipation? Taking a rectal temperature. It seems to unintentionally work way too often.
December 03

Triage according to Katie

Every patient who comes to the ER is triaged when they first arrive. When triaging a patient, a complicated formula is used to determine what "level" to make that patient. Here is my own version of our levels:
Level 5 - should have gone to a pediatrician's office- send down hall to First Care
Level 4 - same as level 5, but higher priority than level 5
Level 3 - stable for now, keep close eye on
Level 2 - kind of stable, requires a lot of work, could go downhill any minute, send to Katie's room
Level 1 - trauma, life or death situation

I don't know why, but for my last few shifts, all of my patient's have been level 2's. The first few days I handled things without too much difficulty, but on Wednesday, I was put in the Asthma room. The Asthma Room is a little taste of Hell. It is a small room with seven reclining chairs lined up against the wall. There is one nurse responsible for all seven patients, and unless there is a trauma in the back, there is a respiratory therapist there as well. That's right- a seven to one patient to nurse ratio for children having TROUBLE BREATHING! For those of you who are not medically inclined, a patient's airway is the most important factor in keeping patients' alive, and children are known to go from respiratory distress to cardiac arrest in just minutes. Any one of my seven patients could quit breathing. When I am in the asthma room, I feel like I am holding my breath the entire time. Just keeping up on the hourly vital signs for seven patients keeps me busy- but then there are meds and admission papers and nursing notes and PARENTS to deal with. When I find out at the beginning of the shift that I am in the Asthma room, I say a little prayer asking God to give me the strength not to cry until I get to my car at the end of the day. Wednesday I barely made it to my car before the tears started flowing. I forced myself to return to work on Thursday, and was given a normal room assignment. Thankful that I wasn't in the Asthma room, I thought I was going to have a good day. I was wrong. My first patient was supposed to be a direct admit to the floor, but they didn't have any rooms available, so I had her for six hours. She was on a ventilator and was having difficulty breathing. Then they brought me a "Level 3" who ended up being admitted to the ICU, except there were no ICU beds available, so he stayed in my room. My next wonderful surprise was an autistic child having seizures, two of which he demonstrated for me in his room. When he started seizing, all I wanted to do was leave and never look back. How can I handle these three patients at the same time? I barely made it through the day without losing my mind. I guess I was hoping that they would save the severe patients for the more experienced nurses, but that is not how things are going to work. So here I am now, nervous about going to work, but somehow loving it at the same time. I know that I will get through it and am thankful that I have found a few experienced nurses that I can turn to for help. For now, I am keeping my fingers crossed that I start getting a few more Level 3’s my way, but that I will be able to handle the Level 2’s I am somehow destined to get. At least the level 2's make for good stories, as soon as I get the energy to write them....

November 2006

November 12

Prolapsed what? Where?

I dread seeing a patient being brought to my room by ambulance. Although the EMS guys are friendly, they usually bring difficult kids who are going to require a lot of attention. A few weeks ago I saw this cute little boy on a stretcher being brought to my room. "Prolapsed rectum," the EMS said to me as he walked by. I went into the room and heard the story from his parents. The boy had been constipated and was trying a little too hard to poop, and "something bad happened to his rear end." The mother was devastated and said she had never seen anything so awful in her life. I put on a pair of gloves, had the parents stand the kid up, and took off his diaper. Preparing myself for the worst, I looked at the prolapsed rectum. I didn't see anything. Uh, where else would a prolapsed rectum be? I stopped for a moment, panicked and wondering how I could miss something that should be so obvious. The EMS saw it, the doctors at the hospital he was transferred from saw it, and yet I was seeing nothing. Embarrassed and worried that I was misunderstanding the problem, I said to the dad, "Will you please show me what you are talking about?" The look he gave me screamed "you idiot" more than words ever could. "It's right here," he said, pointing at absolutely nothing. He did a quick double take and his face was quickly as red as mine. We shared an embarrassed laugh, and I left the room, relieved that the prolapsed rectum had fixed itself and that I wasn't as big of an idiot as I led myself to believe.
November 05

The end of the spider-catching cup

As some of you already know, I have issues with killing insects. I just can't do it. I always have to catch them in a cup and bring them outside. Recently I learned an important lesson- never attempt to catch a spider on popcorn ceiling. The cup won't lay flat against the ceiling and bad things can happen....
November 01

In an instant

The young couple entered the ER early in the evening with their brand new baby girl. She was beautiful and her parents could not keep their eyes off of her. They thought she had some kind of a virus- she had not been eating and had not had a wet diaper in over a day. They were nervous as all new parents are, but knew that we could fix their perfect baby and have her back to her happy self in no time. After the nurse and the respiratory therapist examined the girl, they decided that something was wrong and alerted the doctor. There was an immediate rush of people into the small ER room, and all the parents could do was stand back and watch. The baby was brought to the trauma room and within minutes the top cardiologists were at the baby's bedside. Pretty soon, a tube was down their girl's throat to help her breathe and they were headed towards the elevator to go up to the ICU. Their daughter would be having open heart surgery within hours. Watching them follow their daughter towards the elevator was heartbreaking- they were almost moving in slow motion. Their gazes were blank stares. This could not be happening. In the elevator, they were up close to their baby and able to see all of the medical devices she was attached to. The mother reached out her trembling hand to touch her baby, but pulled back, too afraid. After gentle reassurances from the medical team in the elevator, she again reached out her hand and had barely touched her daughter when the elevator door opened and the rush to save her daughter's life resumed. As everyone poured out of the elevator, the shocked parents stood there for a moment, the mother sobbing, the father fighting back tears. Hours ago they thought their daughter would be put on antibiotics. Now doctors were preparing her for open heart surgery. I don't remember the girl's name, and I can't remember what she looked like, but I know that I will never forget the expression on that mother's face, and how helpless I felt because I could not do anything to make her feel better.

October 2006

October 25

Now what?

Starting an IV on a small child is extremely difficult. In the two months I have been an intern, I have successfully started several IV's on school-age children, but none on an infant. A few days ago I had the opportunity to try again. Nervously I gathered all of my supplies. My preceptor (a nurse I had never worked with before) was right there holding down the baby's opposite arm and ready to take over if/when I was unable to get blood. Holding the baby's hand tightly with my left hand, I poked her right hand with the needle. Nothing. I advanced it slowly and to my surprise, saw a flashback of blood. With my tongue sticking slightly out to the side (it somehow helps), I advanced the catheter into her vein. Success! I removed the needle and applied pressure to occlude the vein (to prevent blood from spilling out of the un-clamped IV port). Although I was holding her arm, the baby was still able to squirm, and the IV catheter started coming out. Quickly I held it in place with my right hand. I stood there confused, my left hand occluding and holding the arm in place, my right hand holding the catheter. I needed another hand! Embarrassed, I looked at my preceptor and had to say, "I've never made it this far, I don't know what to do now!"
Lesson of the day: Some skills are a lot like a choreographed dance. Memorize each step of the dance before the actual performance!
October 23

Blue is bad

During one of my internship classes, we were told, "At some point, you are going to have a patient who is not breathing, and you will have to do CPR." This statement definitely caught my attention, but I was comforted by the knowledge that all I would have to do is yell, "HELP!" and five nurses would come running to my aid. You are never alone as an ER nurse because all of your coworkers are right there to jump in when needed. Unless you are alone in the ambulance bay, that is.
Last night my patient's mother requested that I bring her daughter out to meet her in the ambulance bay with the car. We do not normally do this, but since I was not busy, I agreed. I wheeled the patient to the back door and waited inside. After a few minutes I heard car tires screeching and the car horn blaring, not letting up. Wow, she's in a hurry! I started wheeling my patient down the wheelchair ramp when I heard a woman scream, "He's dead!" Uh, excuse me? Who's dead? This is not where you are supposed to drop patients off. I looked up and saw the source of the scream, a woman standing by her car in the middle of the ambulance bay (pretty much resembles a dark alley). I looked at the car and didn't see any passengers, so I assumed that the "dead" person was a young child. My training kicked in and I knew what to do: run to the car, grab the patient and run him to the trauma room. I put my patient's wheelchair in park and ran up to the car (I know, probably not the safest move). I opened the door to save the child's life and was shocked to see an adult man slumped over in the front seat. He was blue and not breathing. This is when my entire body froze and all I could hear was my heart beating. I had no idea what to do. He was too big for me to move by myself, there was no one in screaming distance, and the driver of the car was too panicked to do anything. All she could say is that he had overdosed on heroin, and she had no idea how long he hadn't been breathing. Thankfully, my patient's mother showed up and I yelled to her to take her daughter away. She quickly obeyed. That's when I took off running inside for help. I didn't know what else to do- my first code and there was no "code blue" button to push. My gut told me to never abandon a patient but my brain told me I couldn't handle this on my own. Thankfully the trauma team responded to my plea and came running to the bay area where they pulled him out of the car and onto the street. Even though we are a pediatric ER they were able to bring him to the trauma room and save his life. My preceptor Susan, after lecturing me about never going to the ambulance bay alone, told me that I should be proud about how I handled the situation. To be honest, I'm most proud of the fact that I somehow avoided peeing my pants! Hopefully, my next code will take place in the comfort of a well-lit, warm, code-blue-button-nearby, ER room.

October 18

Isis, my little angel

One important lesson I have learned so far about children is that even the sweetest and cutest child can turn into a little monster when they don't want to do something. Whether they are scared and don't want an IV started or they don't want to take their medicine, I have been shocked by how quickly they can flip their switch and go from talking about Ariel to kicking, screaming and spitting. The parents are usually embarrassed and upset when their child starts behaving this way. I never understood what they were going through until I took my little angel Isis to the vet last week. I knew she had a UTI, so after a lot of drama collecting a urine sample from her, I called around to find a vet to do a urinary analysis on it. None of them would do the simple test without seeing Isis first. I made an appointment and brought her in. Trips to the vet are never fun, especially for the vet. I put Isis up on the table and the vet tech walked in the room. Isis immediately warmed up to her, rubbing up against her and purring like crazy. "I need to take her to the back to weigh her and take her temperature," the tech told me. I replied that I was ok with that, but that Isis was just putting on an act and that she has a quick left hook. The tech smiled and said, "No, she's a sweetheart, aren't you Isis?" She picked Isis up and the moment the door closed behind her, I heard that awful high-pitched ear-shattering cry that cats can only do when they are extremely ticked off. This screaming and crying went on for at least five minutes. I sat there in the room embarrassed and wanting to cry. My poor baby was being tortured by that mean tech who was trying to take her temperature, and everyone in that office could hear her screaming. When the tech finally returned with Isis, she said, "Well, I don't need her temperature that badly... " I think I'll try that sometime at work- "Sorry doc, I didn't give Tommy his shot because he started crying and made a nasty face at me." I bet that will go over smoothly!
October 12

The joy of stubborn animals

The day after my NCLEX, when I was more stressed than I have been in years, Isis left me a wonderful surprise on the carpet right next to her litter box. She peed on it, twice. Some of you non-cat owners out there might not know this, but the smell of cat urine is extremely difficult to get out of carpet. I wanted to kill the little ball of fur. But I stayed calm and spent three hours cleaning it up. Five boxes of baking soda and two ruined towels later, the smell was gone. I had to accept the blame for the incident because I had been sick and stressed, and had not been giving her the attention she deserved. Plus, when I get stressed, so does she, so I can imagine what she was going through. I forgave her, Mike forgave her (he had no choice in the matter) and we moved on. I got home from work last night and there she was, "digging" on the carpet trying to bury her fresh new urine. "You can't bury your urine because you just peed on my carpet!!!" I screamed at her, knowing full well she probably only understood half of the words I was yelling. She ran and hid under the bed and knew to stay there for at least an hour. Things have been great here- I have been working a lot, but Mike has even been playing with her, so this is not a behavioral thing. That means that something is wrong with her, probably a UTI. When she had this a few years ago, the vet charged me a ridiculous amount of money to hold Isis in a cage all day waiting for her to pee on these expensive little beads in the litter box. I think we ended up paying $40 just for the vet to collect a urine sample, which of course Isis never provided (I don't know how she got so stubborn). I'm not throwing away $40 again, so I cleaned out a container of sour cream and dedicated my night to getting a urine sample from my cat. I get them from human infants, I can get one from my cat, right? Every half hour exactly, I would pick Isis up and place her in the litter box. She would sit there for a few seconds with her ears straight back and then make a run for it. Finally, on our sixth field trip, Isis started digging. I shouted to Mike, "She is finally giving in! Isis: 0, Katie: 1!" Once she squatted, I held the sour cream container under where the urine should be coming out. All of the sudden, she started making these funny movements with her stomach, and she stood up a little bit. Hmm... this is interesting... That's when she pooped. New score: Isis 1, Katie 0.
October 10

Would you like regular or decaf?

Some patients and their families think that nurses are waitresses in scrubs. They think that their request for a blanket should be their nurse's number one priority, because she couldn't possibly have any other patients with real problems, right? I had one of these patients the other day. The worst part was that she should not have even been in the ER, she should have gone to a walk-in clinic or her primary care doctor. But she showed up at the ER and was brought to my room, so I got to wait on her. Every few minutes the mother would signal me from the door. They needed a blanket, so I went and got a blanket. As I handed her the blanket, she said that they also needed towels. Why couldn't she have told me that before!? She wanted me to call the doctor at least every half hour to ask her questions. I can't bug the doctor while she is in with a trauma to ask how long until my stable patient is discharged! I don't know why I could not communicate this information to the patient's mother, but somewhere along the line we were not connecting. After the girl told me that she was in extreme pain, I got the doctor to write an order for IV pain meds. When I tried to flush the IV, the line was blown. I informed the girl that I would have to start a new IV or give the medicine as a shot, and she suddenly no longer had pain! She didn't have pain for at least two hours, until the doctor started talking about discharging her. While fetching yet another blanket for my patient, I noticed that another patient was being brought back to my other room, so I glanced at her chart. It said, "laceration to foot." The girl was wheeled into the room and she smiled and waved at me as she passed by. I relaxed a little bit, thinking that this would be an easy case. I went in the room and started my assessment of her. She had a make-shift bandage over her foot, so I put my gloves on and lifted it off. I could not believe what I saw- her foot was cut so badly that you could see the tendon to her toe. While I was examining her foot, her parents lifted the sheet up to block her view. I quickly understood why. These were some smart parents. I asked the girl to rate her pain for me. She said it was a two out of five. Had she had the chance to see how badly she was hurt, I'm sure it would have been a seven out of five! I just couldn't get over how different my two patients were- the one with nothing wrong with her was screaming "NURSE!!" every time I walked by the room, and even screamed at the top of her lungs when I took her temperature across her forehead. The patient with a cut down to the tendon was polite and never even complained. When going from the heavenly patient to the, uh, opposite of heavenly patient, I wanted to tell her how bad the girl next door was making her look. But I like where I work, and I don't want to lose my job yet, so I served her with a smile my entire shift. I was shocked and hurt when they stiffed me on the tip though..... Maybe that third cup of coffee was too cold?

October 05

Hi, I'll be your nurse today

At my sister's graduation ceremony, one of the speakers repeatedly instructed the graduates to "savor the first time you introduce yourself to your patient as a real nurse." I remembered this as I was walking into my patient's room my first day back in the ER after officially becoming an RN. I entered the room, proud, with my head held high. "Hi, I'm Katie, and I'll..." My proud moment was ruined by, "He threw up again and I think he might have had diarrhea." NOW I feel like a real nurse! This patient was an adorable boy who was having some gastrointestinal issues. The doctor ordered a stool sample, so the boy and his dad went to collect one in a toilet hat. When I walked into the room a few minutes later, the smell hit me instantly. I can just dump the whole container into a big biohazard bag and ship it to the lab, right? Wrong. I had to get this tiny specimen cup and pour the diarrhea into it. I put on my gloves, opened the container over the trash and attempted to aim everything into the little cup. I managed to hold back the gagging for about two seconds, but then the reality of the situation hit me hard. I turned my head away from my work and looked back at the boy, his parents, and his two uncles as they all stared at me from across the room. The looks on their faces verified that what I was doing was, indeed, disgusting, and that maybe throwing up would not be so out of line. That's when those wonderful gagging sound-effects started. Please don't throw up in front of your patient, I kept telling myself. After a few interesting noises that I've only heard from my cat when she has a hairball, I had the majority of the specimen in the ridiculously small cup.
Lesson of the day: The RN behind your name does not make smells any easier to tolerate.
October 02

The NCLEX

I slept until 11:00 today. I know for my younger brothers this is considered "waking up early" but when you are used to getting up at 5:20 every morning, sleeping past 9 is really exciting (and a little guilt-producing). But you know what? I'm allowed to sleep in this late because I have nothing to study for!!! It is the weirdest feeling to sit here and not have anything hanging over my head. I absolutely love it!
The last week has been very intense. Going into the NCLEX without the two weeks of solid cramming I was planning on was intimidating. I got lost on the way to Fort Worth for my exam, but I left two hours early and still made it there with plenty of time. Once there, I felt like a criminal. I had my profile picture taken and I was repeatedly fingerprinted. While I understand that these things are necessary, they do not help with test-taking anxiety! I'm sure some of you already know this, but how well you are doing on the NCLEX determines how many questions you get. There is a complicated formula that explains all of this, but I'll give you a basic explanation. You can get anywhere from 75-265 questions on the exam. If you are acing the exam or failing miserably, the computer will shut the exam off at 75 questions because you have already proven your competence or lack thereof. If at 75 questions the computer hasn't determined where you stand, it keeps asking questions until it can decide whether you have passed or failed. (If you want to read about this, click here). While taking the exam, I quickly realized that I did not know anything. There were only two questions that allowed me to think, "I know this!" All of the others were guesses (although many were narrowed down to two options). Around question 40, I determined that I had failed the test. I kept on going, trying my best to focus on the questions and to stop thinking about how I was going to break the news to everyone that I had failed. When I got to question 74, I started shaking. I hit "next" and it brought up question 75. Now I was really shaking. I could barely concentrate on the question - all I wanted to do was hit "next" and have the test shut off. I've heard that the screen just goes black when the test is done, so I was praying for a black screen. Suddenly, my vision started going fuzzy black around the edges. This is not what I had in mind when I was praying to see black!! Maybe I shouldn't have taken all those meds before coming to the testing center!! Thankfully, I didn't faint, but when I hit "next", I didn't see a black screen. Nothing happened. The background was blue and a little box came up that said, "Loading next item." NOOO!!!! It's bringing me to the next portion of the test. I had not proven myself and I was close to failing, I just knew it. But then a survey popped up on the screen. I was done. For about two seconds I was relieved and I allowed myself to start breathing again. But then it hit me. I only knew two answers! It shut off at 75 questions because I FAILED MISERABLY!!! I began debating whether or not I should tell people I had the full 265 questions so that when I tell them that I failed, it would at least look like I gave it a good fight. I answered the stupid survey questions (which is an evil thing to make someone do after they have failed an exam), stood up on my wobbly legs, and left. The next two days of my life were miserable. I have been told by several people that the TX Board of Nursing updates their website every Wednesday night, so if I passed the boards on Tuesday, my license number should appear on the website by late Wednesday night. I obsessively searched for my name every fifteen minutes on Wednesday. I did not get much sleep- I’d wake up and run out to the computer, only to see “no results” when I would enter my name. When my name was still not up by Thursday morning, I knew for sure that I had failed. I went to work heartbroken, hoping that no one would ask me about the exam. Unfortunately, that did not happen. Everyone wanted to know how many questions I was given. I decided to tell the truth and just resign when I got the official results back. I went to one of my internship classes and checked my cell phone around 8am, and I had a message from my dad. “Congratulations, on passing!” was the first and only thing I heard before I almost dropped the phone. I ran to a computer lab and looked at the website- there was a license number next to my name. I actually passed. After all I have been through, I was finally done. I suddenly had confidence, which I have been lacking for way too long. Now all I have to do is learn some clinical skills, and I’ll truly feel like a Registered Nurse! But don’t worry, I have a great teacher and I know I’ll be there in no time.

If you found this posting while searching for: failed the NCLEX with ___ # of questions, please click here: NCLEX Survey

September 2006

September 28

The results are in....

Did you notice my new banner? That's right, I passed!!!!
I'll fill you in on all of the details tomorrow after work!
September 25

NCLEX tomorrow!

I don't want to wait another month to get this test out of the way, so I went to the doctor to see why I am STILL sick after six days. I no longer have the flu, now it is just an upper respiratory infection. The doctor was awesome- she gave me a steroid shot, an antibiotic shot, and a prescription for Cipro (strong antibiotic) and some cough medicine with codeine so I can sleep tonight. The steroid shot hurt more than I was anticipating, and it still hurts now, but it will be worth it when all of my swelling goes down and I can breathe without fighting so much! The cough is a lot better than it was the other day- it really only affects me when I am lying down. So as long as I refrain from passing out during the NCLEX, I think I will be fine. And I won't disturb the people around me (I'll have cough drops just in case). Thank you all for your advice, you had some great points.
After getting one shot in each hip today, I have decided that I definitely prefer being the one to give the shots. I'm still a little bit nervous when I give a shot, so sometimes I say, "Here comes the poke," and then pause a second before I actually poke the person. The nurse did that today and it was really frustrating! I braced myself, then nothing happened so I thought, "Hey, that wasn't so... OUCH!!!" It startled me, so I jumped, which made it hurt even more. So I will make sure in the future not to do that to my patients! It's interesting the little things that you notice when you are able to experience a situation from the opposite point of view. I'm going to spend the rest of the day studying, I'll let you know how the test goes tomorrow!
September 23

Tough decision

One of the first things my preceptor said to me was, "This winter, you are probably going to be sick at least every other week. That's just what happens when you first start working in a children's ER." Why was she trying to scare me away before she even had the chance to get to know me? Does she not like my hair? Am I too short? Too annoying? Well, it ends up she wasn't trying to scare me away. Three days after her warning, I came down with an awful cold that lasted six days. When I finally felt better, I was relieved that I had paid the price of being around all the germs early and had it over with. I normally only get sick twice a year: my birthday and New Year's Eve. I don't know why it always falls on those dates, but I figured I had gotten my birthday sickness out of the way a few weeks early. As I'm sure you have already guessed, I was wrong. On Wednesday, my lungs started hurting. Within a few hours, it had spread to my entire body. I felt like I had been hit by a truck. I had the flu. Already. I still was not fully recovered from being sick last time! So here it is the day before my birthday and on my "power cram" weekend for the NCLEX (which I take Tuesday- I put the wrong date last time) and I feel completely awful. I have only put in a few hours of studying and can't concentrate for more than a few minutes at a time. I thought I'd be better by now, but I actually think I am getting worse (the awful cough that actually causes me to throw up just started yesterday). So, do I go take the NCLEX without studying, or do I push it back and have to worry about it for another month? Right now, I'm leaning towards taking it sick and without studying. I'm very anxious to get it off my mind! But am I making a huge mistake? If I fail, I'll be demoted to a patient care tech until I can take it again in a few months. But if I push it back, I might lose my mind, which would probably result in losing my job too......

Maybe I do have cooties. Anyone remember how to give a cooties shot?
September 18

Life as an intern

For some crazy reason, I was under the impression that after I finished school, life would be calm and boring. I think I was a little bit off on that one! Work is going well, but it seems like I am always there. I'm in a 14-week internship program, so I have class and I work with a preceptor (an experienced nurse who teaches me everything my school didn't). My preceptor's name is Tanya, and I really like her. She knows what she is doing and has a lot of patience, which is crucial, especially because it takes me forever to do even the simplest tasks.
I'm working in a pediatric ER, and working with kids is nothing like working with adults. When starting an IV on an adult, you enter the room, tell them you are going to start an IV, then start the IV. With kids, you enter the room, explain what you are going to do, answer a lot of questions from the kid and the parents, comfort the child while he cries before you even get the needle out of its package, then attempt to start the IV while the kid is being held down, and the mother, father, siblings, aunts, uncles, neighbors, and everyone else the child knows is standing there cautiously watching. No pressure, right? I shake just putting a band-aid on a child with all those eyes on me! I think it is absolutely wonderful that these children have so much support, and I wouldn't want it any other way, but it definitely makes things more uncomfortable when you aren't confident in your skills yet. So hopefully I get that confidence soon, because starting an IV will be much easier when I'm not shaking!

It seems like the kids I have worked with so far like me, probably because they think I am another kid too. Yesterday a nine year old boy asked me if I had a boyfriend. I didn’t think I looked that young…. And I thought nine year old boys thought girls had cooties. Whatever happened to cooties? Maybe the alcohol scrub gets rid of those....?

September 11

I'm a GN!!

Thank you TX State Board of Nursing for processing my GN letter the same day you received it (instead of taking two weeks)!! Maybe you guys could hear the panic and frustration in my voice and you took sympathy on me. Or maybe you were just really sick of me calling every single day to check on my status... Either way, I really appreciate all of your help!

Now if I could only get over this nasty cold.....

I take the NCLEX (licensing exam) on September 28th, so for the next few weeks, I'll be studying and working at my wonderful new job! Please don't get upset if I'm not around too much!

Congrats to Rachel & Jason on their engagement!! Jason, you are definitely a lucky man! Rachel is one of the most amazing women I have ever met. Rachel, don’t let Research dampen your excitement, keep bugging them and they will at some point send your transcripts too.

And to the staff at Research College of Nursing (I know some of you read this), THIS IS RIDICULOUS!! You need to send your students’ transcripts!! There is absolutely no excuse for sitting on them for over three weeks- you are causing people more stress than you can imagine.

September 07

Any school but Research!!!

Last night Mike and I played an awful joke on Skitzo. We told him that we were enrolling him in nursing school at Research College of Nursing. This news upset him so much that he actually pooped himself right there on the kitchen floor.


Poor guy! We thought that after all I have been through with the school, he would have known that we were just kidding. But obviously he took us seriously, and a temporary loss of bowel control occurred.
Lesson of the day: Don't even joke about sending someone you love to Research College of Nursing. It's not funny, and you might get stuck with a huge mess on the floor.

September 05

I hate being right

When she said she would overnight my transcripts on Thursday, I wanted to believe her. I really did. But I knew she was full of it, and I was right. At noon today, I got a call from the woman at the Board of Nursing letting me know that they still do not have my affidavit. I give up. I wanted to make this posting funny but seem to have misplaced my sense of humor. Don't worry, once this mess gets cleaned up, I'll find my humor again. And I will use it at the expense of the idiots who have made the last few weeks a living hell. Buckle your seat belts, administrators at my nursing school, and remember, you started it.

The good news is that I will not lose my job over this. My manager seems pretty laid back and understanding, and she said that I can continue with my internship, I just can't have patient contact. So until I get my GN license, I will be shadowing a nurse instead of doing hands-on stuff. This is completely fair and I really appreciate their willingness to work with me. The bad news is that this makes me look like a complete idiot!! I met one of the other girls in the internship with me, and she is taking her licensing exam on Monday. She graduated at the same time as me, but her school was able to figure out how to get the envelope into the slit on the side of the mailbox, while my school is still working on that task. So I will not even have my Graduate Nurse license and my co-intern will be a Registered Nurse. LOL..... looking good so far at the new job, huh?
September 04

Too many hoops!

I wrote out this long blog entry explaining to you guys why I haven't been posting lately. But after reading it before I posted it, I realized that is was way too negative and depressing to make you guys read. So I decided I will just give you the basic facts about what is going on, and I will post something again soon once everything is worked out and I am in a better mood.
~ After fixing the transcript fiasco two weeks ago, I thought my transcripts were in the mail and my Graduate Nurse (GN) License would be issued any day.
~ A woman in the HR department at my hospital called on Thursday to let me know that I am not officially a GN on the TX Board of Nursing website. I checked it out and she is correct. I called the TX Board and it ends up that my school never sent my transcript or the affidavit my dean was supposed to sign on the date of graduation. I gave her an addressed, stamped envelope and even included a sticky arrow pointing to the line she needed to sign. The directions were highlighted- there was no way for this to go wrong. But it did! She never put it in the mail.
~ I called the dean and her assistant and told them that they needed to overnight my transcripts to TX. The assistant said she would, but at this point, that is of little comfort to me.
~ So here's my current situation. Even if they did overnight my information on Thursday, it will take ten business days for me to be issued my GN license. I start tomorrow. What a great start to a new job, huh?! I'm not sure what they are going to do- they can't delay the internship program for me, so are they going to kick me out? I guess I'll find out tomorrow....