Confessions of a Registered Nurse: January 2006

January 31

Psych rotation

The hospital at which we are supposed to do our Psych rotation will be closing down soon. Our class has its own private discussion board, and someone brought up the question of where we would do our psych rotation. Julia, a shy and quiet woman in our class, replied with an address. The address looked familiar, but I didn't think too much about it. I was just curious how she knew where the rotation would be (our school doesn't tell us things until the last minute). A few minutes later, it suddenly occurred to me: she had posted the address to the building where our faculty and administrators' offices are.

Although I think that is funny, I have to disagree with Julia on this one. I doubt they would have us work with severe psych cases like that until we have had more experience.....

No sleep

I feel like I didn't get much sleep last night. I actually went to bed by 10:30, but all my crazy patients always needed something! I woke up panicked several times because I forgot to give someone their medicine, a patient had a heart attack, or a doctor was yelling orders at me I couldn't understand. As soon as I would fall back asleep, I'd be working with several new patients. This same thing happened when I was a waitress- I would fall asleep and all my customers would need things, and I would always be messing everything up. Can't I at least get some time off in my dreams?! And if time off is not possible, it would be nice to at least be a super-hero nurse or something! Not one who stumbles around and messes everything up...

January 30

Anatomy

When taking Anatomy & Physiology (A&P) last year, I worked hard studying all of the diagrams in our book. I memorized picture after picture, and even used those A&P coloring books to help me memorize all the unique names of our body parts. Most textbook pictures look similar to this:

I'm sure you can imagine my surprise while watching my first surgery when I realized that our muscles and bones are not actually color-coded! Everything looked the same, there were no pretty colors distinguishing the teres major from the teres minor!! ;) So for you A&P students out there who want to actually apply those diagrams you are memorizing to real people, go to this website. It quizzes you on the parts of the body using a cadaver. You non-medical people might want to pass this one up!

Click here.
On the body on the right side of the screen, click on an area (ex: head)
Check the boxes you want to be quizzed on (Muscles)
Click "Start quiz" and wait a few seconds

January 29

Why Dr. Google can be bad

Last night as I was brushing my teeth, I noticed these two weird bumps on my neck that bulged out when I leaned over. They are not lymph nodes, so I was curious to figure out what they were. I went to Google and typed in a few descriptive words, and started reading the summaries of the results to find the closest match. I almost had a heart attack when I read in one summary that bumps on the neck could be larva that had migrated to an area just under the skin where they would mature for three weeks. WHAT?! I clicked on the link and was directed to a Q&A forum on ferret care. That's when I decided to call it a night and go see a doctor (not a vet) sometime in the near future.

January 28

I almost looked smart

Because I am a student, I am not allowed to give any patients their medicine without either a nurse or my clinical instructor present. When my instructor is the one there when I give medications, she will ask tons of different questions- why is my patient on this medication, what do I have to watch for after giving my patient this medicine, how does it work, etc. I always look up my patient's drugs and write down all this information before I call my teacher in to help me administer them. However, there have been very few occasions where I have been able to answer all of her questions. I am starting to notice that my instructors know a lot more than me about these meds, but I still push myself to beat them at this little game.
A few weeks ago, I needed to give my patient a medicine called Toradol. This is a strong anti-inflammatory drug (Ibuprofin-like) used for pain after an operation. I looked everything up in my handy palm computer, and asked the nurse to help me administer the Toradol. She asked me what two lab values I need to look up before administering this medication. Hmmm... that actually wasn't in my drug book. So I went and looked in another drug book- still nothing mentioning lab values. I tried a few more sources and went back to the nurse and admitted I did not know. She informed me you have to check the BUN and creatinine levels (these indicate kidney function) because Toradol is excreted by the kidneys, and if they are not functioning correctly, the drug could build up and reach toxic levels. After hearing this explanation, I checked the patient's lab values and went to find a syringe to administer the drug with. My clinical instructor saw me walking down the hall with the bottle of Toradol, and stopped me to quiz me. "What lab values are you going to check before giving this?," she asked with a huge "I am sooo going to stump you on this one" grin. I replied, "His BUN was 8.2 and his creatinine was 1.0, so it is ok to administer the Toradol." Her jaw dropped open, she said she was very impressed, and I smiled politely and walked away. As soon as I was safely out of her site, I did a little celebration dance. Ha! I finally got to look smart!! I know what a few of you are thinking - I should have told her that the nurse had already taught me this. But in all honesty, would you have told her? I didn't think so. A few hours later, I was sitting at the computer doing some charting with my nurse when my clinical instructor walked up to us. Out of nowhere, the nurse said, "Oh, I taught Katie about checking lab values before giving Toradol."

At this point, I was way too involved in my computer charting to look up at my teacher (at least I tried to pretend I was too involved and didn't even hear their conversation) but I could feel the burning in my ears and cheeks as they turned bright red. I was caught. One of these days I will look smart. But until then, I'll settle for just getting through one day without looking like a complete idiot.

January 26

200,000 hits

Congratulations Kristen's Chronicles, you are visitor number 200,000! Click here to claim your free iPod! ;)

In honor of my site reaching 200,000 hits today, MSN made some changes! I am still trying to figure everything out- so far I have changed my communication options to "No One" - so please don't be offended if you request my personal information and don't hear back from me- I won't even see that you sent a request. I'll look into that stuff later and possibly change it back.

January 25

Signs you still have a lot to learn

Earlier today, I was in the room with two of my classmates when an elderly patient passed away. His RN had to make sure he was truly gone by listening for any breath or heart sounds for one minute. She listened and heard nothing. As she was leaving the room to find a second RN to verify her findings, she told the three of us to listen too. Hesitantly, we all stepped forward with our stethoscopes and attempted to listen. Danielle and Trisha went first, and I watched from the other side of the bed. Within a second, both of their eyes got really big, and they looked at each other. My heart rate started increasing. "Did you hear that?" Danielle asked. They both had heard a heartbeat. Curious, I also listened to his chest. But I didn't hear a heart beat, I heard bowel sounds. Yes, in his chest I heard bowel sounds. The nurse reentered the room to find three stunned nursing students standing there like deer in the headlights. We told her what we had found and she smiled really big and instructed us to all listen again. Both Danielle and Trisha placed their stethoscopes on the patient and began listening. The nurse calmly said, "Girls, try listening without your thumb pushing down on your stethoscope." (Your thumb has a pulse). Both girls removed their thumbs and after listening quietly for a few seconds, stood back up with bright red faces and agreed with the nurse's findings. As for me with the bowel sounds heard in the chest? I am hearing my joints creak as I move slightly while holding the stethoscope in place. She had me lightly touch the stethoscope to his body and I no longer heard the weird noises. Had we not been through that embarrassment today, we would have continued making these same mistakes! I'm sure that nurse will never forget us!

Later on that day, I needed to talk to Danielle. I entered her patient's room and found her standing there, face bright red, a half full urinal in one hand. Her nurse was in the room too, laughing hysterically. Looking closer, I noticed that Danielle had a wet streak across her shirt and something wet on her left arm. As I was starting to put the pieces together, Danielle said, "I think I have bad aim!" Enough said. :) (And in case you don't get it- some mothers experience this same sort of thing when changing their baby boy's diaper....)

The Moment

There is one event we all worry about at some time or another: our own death. Where will I be at the exact moment my soul leaves my body? Who will be there with me? I hope I am somewhere comfortable surrounded by the people I love. Looking at one of our patients today who was near death, I was wondering what he thought his moment would be like. I'm sure he's thought about it over the years- but did he ever imagine that at his moment his family would be "too tired" to come be with him? Or that three nursing students would be the ones determined not to let him die alone? Thankfully, his moment was very peaceful, just a single tear down his cheek and he was gone.

January 24

But I'm volunteering....

The RN I worked with today: Katie, are you good at putting in IV's?
Me: Well, I put one in my sister's boyfriend over Christmas.
RN: You've only put in one IV, and it wasn't even while at school?!
Me: I am volunteering eight hours this weekend.
RN: What does that have to do with this?
Me: Uh, I can tell you about the demographics of Kansas.
RN: And this makes you a good nurse because.....?
Me: Ok, how about I tell you about my instructor's three dogs- we talked about that for half an hour one day in class.
RN: I still don't see what this has to do with IV's...
Me: Oh, I get it. What if I told you lots of stuff about the environment? We sat through a three hour lecture on that!
RN: Security!!!
Me: No, hold on!! I can draw you a concept map about starting an IV!!!
RN to security guards: Please track down this poor nursing student's faculty, and throw them all in the psych ward. It's not only for their own good, but for the good of all nursing students and their future patients.
Me: It's about time! Now about that IV, how about instead of me being forced to volunteer for eight hours this weekend, we work on putting in IV's? I have a feeling that practicing things that will actually affect my patients is far more important than this ridiculous stuff our school has been making us do.

January 23

They pulled a Blockbuster on us

Do you remember when Blockbuster first announced "The end to late fees"? They had all those commercials with people celebrating in the streets, dancing and hugging. Well, we had a similar event at the beginning of this semester. During orientation to our Professional Practice II course (Clinicals), the instructor stood in front of us and said, "You no longer have to do any concept maps!" To those of you who are fortunate enough not to know what a concept map is, you are very blessed. Concept maps do help us in our understanding, but they are very time consuming when we have so much else to do after clinicals (such as our care plans and drug look-ups). So when our instructor finished that sentence, the celebrating began. Maybe it wasn't as dramatic as those Blockbuster commercials, and maybe there wasn't actually dancing in the streets, but we all were extremely excited and relieved that we were finally getting a break. Unfortunately, the "End of concept maps" was way too similar to "the end of late fees"- it was a marketing ploy to get our hopes up just so they could crush us all over again. It ends up that the director of the course does not want us to do concept maps, but our individual clinical instructors get to decide. And knowing my luck, I get the instructors who love concept maps!! But like Blockbuster, we won't call them what they really are in an attempt to make people happy (Blockbuster now has "Restocking fees" instead of "late fees"). So I guess now we have "Maps with concepts".

January 22

Professor Snyder

One of my favorite psychology professors, Rick Snyder, passed away a few days ago from cancer. Professor Snyder taught a class called "Individual differences" and wrote an interesting book about hope. Before coming to his class, I would sit through other lectures and learn about all the things that can go wrong with people's minds. It was wonderful to come to his class and have the opportunity to focus on what was right. Over the last few months, I have thought a lot about the things he talked about while dealing with my patients who were in pain. He taught us (and did experiments to prove) that we are able to tolerate pain better if we have hope. Thanks to him, I know the importance of keeping my patient's spirits high and not letting them give up hope. He will be greatly missed.

January 21

We all do stupid things

I know that we all do stupid things. I just seem to do more than my fair share of them. While visiting Mike's family in St. Louis over Christmas, I was taking a shower while Mike was out for a run. I have very thick, long hair, and I happen to be extremely short. This is not a good combination for the type of shower head they have, because it spreads the water out in a big circle, and the farther away from the shower head you get, the farther away the streams of water are from each other. So at five foot ten, you would be hit with all twenty streams. But at five foot one and a half, I was only hit with two little streams. Because of this, I could not get the shampoo out of my hair. I tried standing on my toes to get hit by more streams, but this didn't help too much. Hmm... I'm a college graduate, I can figure this one out... I know! Why don't I wash the shampoo out of my hair using the faucet for the bathtub? I'm going to get really technical here and describe their shower: it has that thingy that you pull up on to get the water to switch from the bathtub to the shower. I pushed down on that and the water started coming out of the tub part at full power. Perfect! So I got down on my knees and was getting all of the shampoo out of my hair. When I was done, I went to stand up but couldn't. My long hair was tangled around the thing you pull on to make the water come through the shower. Oh crap. In a panic, I tried desperately to untangle my hair, but I could not get it out. I couldn't even move my head enough to look at how my hair was tangled. I tried to feel behind me for the razor, but thankfully I couldn't find it. At that point in time, I would have much rather cut off a hunk of hair than have someone in Mike's family kick down the locked bathroom door to come save me. Even though no one knew what was going on, I do not think I have ever been that humiliated in my life. I sat there for a few minutes imagining the stories that would be told for years to come about the time Mike's crazy girlfriend got stuck in the shower. I decided I should wait for Mike to get home before I started screaming for help, at least then he could be the one to come laugh at me. This is about the point where I started praying. I acknowledged that God had a great sense of humor, and asked him when he was done laughing to please get me out of this one. Thankfully, with the combination of my desperate prayer and having time to calm down a little bit, I was able to untangle my hair. In the future, Mike and his family will have to deal with my smelly hair, because I will not even attempt to wash it in that shower again. That, or I'll bring my own shower head with me.

Dangerous!!

Willie ~ I checked this one off my list! ;)

January 20

Uneducated students?

I just read an article on CNN that all college professors need to read. Click here to read the article. Some researchers did a study on about-to-be college graduates, asking them simple questions that relate to everyday life. Could they calculate a tip? Figure out if they had enough gas to make it to the gas station? The results of this study were surprising to the researchers, but not to me. While at KU, I noticed that in all of my classes, we learned about fascinating and complicated things. But we never took a step back and learned about basic, everyday life things. For example, I took four semesters of Spanish. Once I was finished, I could order a fancy meal at a Spanish restaurant. However, if my house was on fire or my friend collapsed and was not breathing, I would have no idea how to communicate my problem in Spanish. Isn't being able to say, "Send a fire truck, my house is on fire!" more important than knowing how name all the animals at the zoo? In my psychology classes, I learned all about some fascinating disorders, and what medicines are used to treat them. But I never learned what to do or say if my friend told me they were thinking about committing suicide, or what to say to a grieving mother who just lost her son. These are the things I am more likely to come into contact with in the real world, and yet they were ignored because they were too basic. Unfortunately, my nursing school has this same problem. We spent several hours discussing the environment, yet only spent one hour (which ended up equaling one practice poke per student) on starting IV's. Hmm... which one is more important to me as a future nurse...? Well, I have to get back to my reading on the Chaos theory. Somehow, it is going to make me a better nurse. Hopefully it comes in handy when I mess up doing an IV from my lack of practice, which will cause my patient to get upset, which will cause an increase in his blood pressure, which will cause........

Nursing schools

Last weekend, I went out to lunch with a woman named Shelby, who will be going to my school in a few years. She had tons of really good questions about our school, and many of them were things I too had been wondering about before my program started. I really enjoyed meeting with Shelby, and hope I didn't scare her away from nursing school! :)

If any of you students out there would be willing to give the future students at your school advice, please leave a comment to this post and give your school name, your first name, and your email address. If you don't have a hotmail account, please see my January 11th posting "want to leave a comment" and follow the steps I have listed.

And he stole my heart...

Happy three year anniversary Mike!!!

Thank you for the flowers. They are beautiful, and according to Isis, they taste great. I love you and can't wait to see you again in a few weeks!

January 18

I saw your heart!!

I am still in complete awe over what I have experienced this week. My patient had heart surgery yesterday, and I got to watch up close. I spent the day taking care of this man, and then I got to see his heart, right there in front of me. I can't even explain how weird and cool that is. After his surgery, he was returned to the ICU, so I got to take care of him again today. I can't get over this simple fact: Yesterday this man's heart was stopped for several hours, and today he is joking with me. Amazing!! I have learned a lot from this guy, both about the body and about being strong. I can't even imagine how much fear he was in when they had him laying on that operating table before the procedure started, but when I walked in to the OR, he managed to flash me a huge smile and wave. If that were me on the table, I would have been frozen stiff!

Yesterday before the surgery, he was NPO (not allowed to eat/drink anything), but every time I entered his room, he would ask me for water. I helped him brush his teeth, and was overly dramatic about not letting him swallow any of the water- so the whole drinking thing became an inside joke between the two of us - I was no longer the student nurse, I was the water Nazi. When I first walked into his room this morning, he had two tubes going down his throat to help him breath, so he was unable to talk, but he still managed to make me laugh. When he saw me, he started waving his arms around like he desperately needed something, and since I didn't have anything for him to write on yet, I was trying to guess what he needed. After many failed guesses, he smiled as much as he could with all the equipment on, and then he pretended to be holding a glass of water and taking a big drink. Ha ha... nice try buddy! People like him, who are able to keep their sense of humor and stay motivated, really inspire me. Can you tell I'm having a better week?! I can’t wait to see how much he has improved by tomorrow. He’ll no longer be NPO, so I think I’ll bring him a huge glass of water with a pretty bow wrapped around it. ;)

Edit:

I received a wonderful comment to this post from cerebralgraffitti, and I wanted to share it with you guys:

"you have stumbled across the truly awe-inspiring and humbling nature of our profession ... i cannot tell you what a humbling and soul-full experience it was (when i was a hospital nurse) to walk such a profoundly life-altering journey with an individual ... my dear, you did not just see that man's heart ... you walked inside it ... you 'touched' it, so to speak ... that is the thing ... this very primordial and intimate connection that we forge with our patients ... that keeps me in this profession, despite how truly devastating and sorrow-filled walking these journeys with our patients may be ...

i wish for you ... that this amazing, humbling, radiating feeling never, never leaves you ... it is what makes a nurse, i think ..."

January 17

The ghost

Last night as I was about to fall asleep, Skitzo, who was sleeping next to my pillow, suddenly stood up and was very tense. He was staring at something, and I couldn't figure out what, so I turned on the light. That's when I saw Isis sitting on the floor staring up towards the ceiling. I looked in the direction they both were looking, and again there was nothing there. At this point, I just thought there was something on the roof they were listening to. But then their heads started to follow this invisible thing, and they were both moving their heads together- they saw something I wasn't seeing. I know it wasn't a bug or something of that sort, because they would both have tried to catch it. Instead of being playful, they were really tense and completely freaking me out. All of the sudden they both ran out of the room. I grabbed their bag of treats, and for the first time ever, even treats couldn't get them back in that room. So there I was, a 24 year old woman, sleeping all night with the light on. I know for sure that one of two things happened last night: there was a ghost in my room, or these two cats put their heads together and played one damn good trick on me.

January 16

We've come a long way...

Scooter's Mom left me a comment reminding me how far I've come since school started. This got me thinking about the things I actually have learned instead of just focusing on the things I still do not know. Here are a few things that haven't happened since school first started:
~ I haven't gotten upset and thought I was a complete idiot because I couldn't even hear my own heartbeat with the stethoscope (it was set to the bell instead of the diaphragm)
~ Natalie hasn't felt anyone's neck and said, "The thalamus is non palpable". (The thalamus is located in your brain- the thyroid is located in the neck)
~ I haven't turned anyone's arm purple while taking their blood pressure because I couldn't get the cuff to deflate (I know, I should have just taken it off, but in my panic, that simple fact slipped my mind)
~ None of us have used scissors instead of clamps and spilled IV fluid everywhere. Thanks for that lesson, Diane! ;)

Other lessons:
~ When a male patient asks for the bedpan, I always clarify if he really needs the bedpan, or if he actually wants the urinal (this makes a big difference in terms of cleaning up a huge mess)
~ When I need a confidence boost, I know to hang around patients who are on Verset. I had no idea so many people loved me!

January 15

Adding a few pounds....

The next time I go to donate blood, I am going to do something few women have done before: I am going to lie about my weight by ADDING a few pounds. Have I lost my mind? Well, that depends on who you ask. But in this instance, I think I am being wise. Here is what happened on Friday- I went to donate blood and when the woman poked me with the needle, no blood came out. She obviously was new (karma, huh?!), and I told her not to worry about it, just to take the needle out and poke me again. She went and got her supervisor, who informed me that because I do not weigh 125 pounds, they are not allowed to poke me twice. So, my options were to give up or to let them dig around. Not realizing what I was getting myself into, I let them dig. After what felt like fifty jabs, the blood started to flow. Probably due to all the trauma from the digging, my blood clotted with only a few ml to go, and so they were unable to use my blood. What a pain!! So now I have a huge bruise on my arm, I think I broke a few bones in Danielle's hand from squeezing so hard during the "let's rip Katie's veins apart" episode, and I lost a lot of blood for nothing. I will go back and try again in three months, but this time, I will lie and say I weigh 125. Is this rule some sort of punishment for little people!? If any of you medical people can explain this rule to me, I would appreciate it. But until then, I officially weigh 125 (please don't tell on me)!

Edit: A picture from one week later:

PDA

One of the best purchases I have made this year was my Tungsten E2 PDA. It fits in my scrubs pocket, and I downloaded several free drug guide programs from the internet. I carry it with me at clinicals, and whenever I hear the nurses talking about drugs I don't recognize, I just type the name in my PDA and find out everything I need to know about that drug.
If you are going into nursing school, I highly recommend getting a PDA, and make sure it is a Palm OS. The Pocket PC's look a lot nicer, but from talking to my classmates, I have heard that the Pocket PC's are not compatable with a lot of the free downloads out there (such as the flashcard website I love).
If you do own a PDA, here are the links to some great free downloads:
www.epocrates.com
Drug guide with Nursing Implications
Flashcards (use with Studystack.com)

January 14

First week in the ICU

This has been an interesting week. Before our first day of clinicals in the ICU, I was feeling confident that I would walk in there and know everything. I got A's in all but one of my classes last semester, I started an IV on an actual person over Christmas, and I had completed all the assigned readings. I was going to shock everyone with my skills, confidence, and knowledge. This delusion was shattered within the first half hour. I met the nurse I was assigned to, and it was obvious she had not been informed that she would be working with a student, and that I was not a welcome surprise. I can't say I blame her for not wanting a student- her job is to take care of her patients, not to baby-sit me and spend the time and energy trying to show me how to do everything. She instructed me to go in the patient's room and do an assessment on him. Hmm... where do I even start?! We did head to toe assessments on our classmates in October, but those were over an hour long, and we were just pretending like we were assessing them- we had the whole thing memorized. But now, there is a human being laying in that bed in critical condition, and I am supposed to assess him!? What did I get myself into? I don't know anything!!! I felt like a complete idiot all week saying "I don't know how to do that, will you show me?" Even after watching something being done, such as tying restraints, I still wasn't able to do it on my own right away. I know this is normal, but I hate feeling incompetent. At one point, the nurse was explaining a complicated procedure to me, and I was so overwhelmed trying to keep all the steps in order that I just wanted to cry. My patient, who was heavily sedated, thought she was talking to him, and he kept nodding his head and saying, "Yes, I understand." When the nurse left, I asked the patient, "Did you really understand all that?!" He said, "Nope, I just didn't want her to get mad at me too."

My clinical instructor was absolutely wonderful, and has only been a nurse for three years. Because of this, she knows exactly what we are going through, and remembers what it is like to feel like you don't know anything. The only problem is that she is responsible for nine students, so we each only see her once or twice a day. This leaves the responsibility for teaching us on the nurses, and a lot of them don't want to be teachers.

Although I felt worthless all week, I did end up learning a lot. I now know that when a patient is confused and you have to take his temperature, tell him to close his lips around the thermometer. If you say, “Close your mouth,” he will do just that, biting down on the thermometer. I know that vanilla ice cream can make a patient’s day, and I have seen the pain forgetting to wear a seatbelt can cause a loving mother. I was surprised to see that a code blue is handled exactly as they show it on ER, and was amazed by how well the code team worked together - they almost looked like choreographed dancers who just happened to be saving someone’s life. I learned that some of the most difficult, yet most loving and unselfish words a daughter can say about her mother is, “Please stop the compressions.”

I hope I actually retained some of the skills I learned this past week, and that I am able to apply them next week. And to all you ICU nurses out there- I completely respect you! I don't know how you do it every day, and I am in awe of those of you who can stay calm no matter what is going on around you. Please remember if you ever get stuck with a student nurse that we are extremely nervous, and that you do certain things twenty times a day- so yes they are easy and obvious for you, but for a nervous student, anything can seem 100x more complicated than it really is.

January 12

Tips on using an elevator

This lesson is courtesy of one of my favorite classmates:
When you first enter an elevator, push the button displaying the floor number you would like to go to. This will cause the doors to close and when they open again, assuming no other buttons were pressed, you will be on the correct floor.
If you enter an elevator and the doors take a few minutes to close, and then several more minutes for them to open again, pay close attention when you walk out of the elevator. Do the pictures on the wall look the same? What about the number on the elevator door frame? Was the number the same as the floor you were just on? If so, this probably means you forgot to press the floor button. Get back on the elevator and try again. With some practice and hard work, you will get it!!
Don't worry, I'm sure many nursing students who have to get to clinicals at 6:45 AM have been stuck in elevators before too.

January 11

Blogs by students in any medical field

If you are a student in any medical field and would like to post a link to your blog, please do so here!

Lessons

When placing your patient on a bedpan, make sure the back of his gown is not tucked in underneath him (and thus between him and the bedpan).

When you go in to meet a patient at the beginning of the day and he says to you, "I think you have a bird in your tree," don't ask him what tree. Just tell him thank you, and that the bird is allowed to be there.

After leaning over to listen to a patient's heart, hold the end of your stethescope (or remove it from your ears) when you stand back up. If you fail to do this, it might hit the bed rail and really hurt your eardrums.

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January 09

Mysteries solved

Have you ever wondered what happens to the Keebler Elves after they have eaten too many cookies and no longer fit in their tree house? Well, I figured it out today. They start working for a company called TortureRUs. What do they do for this company? They write test questions used on the health management exams at my college. This explains where my tuition money is going, because it clearly is not going towards clinical supplies or intelligent faculty (with a few exceptions). You are probably asking yourself, "What do the Keebler Elves know about nursing?" Very good question. They know nothing about nursing or about writing exams. This all might sound a little far-fetched, but it is the only logical explanation I can come up with for some of the idiotic questions we had on our exam today. Somebody please put these elves on a diet so they can go back to making cookies!!

Thick skin...

Hi everyone,
I appreciate your comments on my last post, and just want to explain what I meant by #3. When I said, "Every day we see nurses with skin that is way too thick, and we never want to be like that," I did not mean that every nurse with thick skin is bad. I agree, most student nurses are too sensitive at this point, and we do need "thicker skin." However, there are nurses whose skin is way too thick. This is what I don't want to be, and I don't think any of you are like that. These are the nurses who have completely lost their compassion, and honestly treat the patient like an object. When one of my patients was told she was going to die, the RN who was assigned to her did not even enter her room. She sat in the nurse’s station telling all the other nurses, "Did you hear 602 (not actual room number) got twelve months!?" as if it was a basketball score. She didn't stay out of her room to give her privacy, it was so she could gossip with the other nurses. Her skin was so thick that she didn't even think about the fact that her patient might need someone. I have seen nurses who, after hearing a patient say they are scared of their upcoming procedure, just shrug it off and say, "You'll be fine," and leave to go talk about the nurse on the 5th floor who was caught stealing narcotics. Would it have hurt her to explain the procedure and let them know that they would not be alone? No. Or there were the nurses my friend Julie had to deal with, who when her patient was having a seizure and she screamed "Help!" from the doorway, actually looked at her and said, "That's not my patient." WHAT?! Yes, people are actually like this. And I don't think they started like this- I think that over time they developed this attitude towards patients. Maybe these nurses will never go home at night and cry over a patient, but I would rather cry every night than lose my ability to care about other human beings. So when I say, “too thick skin,” this is what I am talking about.

I have also seen nurses who inspire me. I worked with one woman named Anne, and I could tell that her patients thought she was an angel. She has found that perfect balance between being compassionate but not bringing the pain home with her. That is my goal. It will probably take me a long time to get there, but having friends or family who simply say, “You need to get a tougher skin,” is not going to help me reach that goal. I actually have not had my loved ones say this regarding my patients, but a few of my friends' families have, and I know it is upsetting. So, if your loved one is a student nurse, please understand that this process takes a long time. There are going to be nights where we want to cry. It is a shock being thrown into the middle of things and dealing with death and suffering. Please comfort us and listen to us. Don’t just act like we need to get over it and move on. And to all you healthy-level-of-thick-skin nurses out there, please do not think that I am talking about you!!

January 07

So your loved one's a nursing student....

Here are some tips for those of you who are lucky enough to know a nursing student:

(I put this list together from listening to my classmates and from comments I have received on here- this is not directed at my friends or family!!)

1. One day we will hate nursing, the next we will love it. We are allowed to have mood swings like this, so please don’t point out our inconsistencies.

2. When we complain about our evil teachers, just listen to us and give us sympathy. There are some things we know we can’t change, but we still need to vent.

3. When we are upset by something that happened with one of our patients, don’t just tell us to get a thicker skin. Every day we see nurses with skin that is way too thick, and we never want to be like that.

4. It won’t hurt you to let us practice some of our new nursing skills on you. Well, once we get good at them it won’t hurt you… (Sorry about the blood pressure cuff incident, Michael!)

5. Most of us are broke. So please don’t invite us to go do expensive things and then act offended when we say we can’t go.

6. Please realize that we have a lot of reading and homework to do every weekend. I know for non-students, the weekend means relaxing. But for a lot of us, the weekend is our chance to attempt to catch up.

7. Although we have a ton of work, we do need the opportunity to let off some steam. So if we told you on Friday we couldn’t go to a bar because we needed to study, don’t get upset if you see us watching a TV show or at the mall on Saturday. That might be our only break for the day, and we would probably lose our minds if we didn’t take an hour away from the books every now and then. And unfortunately, we often do have to weigh things against studying- “Should I go spend money at a bar and stay out until two AM, or get fifty pages of reading done and then relax and watch movies tomorrow?” Please don’t be offended if we choose studying.

8. Don’t ever use the line, “Well is your school more important than ME?!” You might accidentally be volunteering your arm for IV practice the next time you fall asleep. You wanted attention, right?!

9. If we are stressed out about a test don’t just say, “You always say that and then get straight A’s. You should quit studying and go out.” Maybe your statement is accurate, but had we stopped studying earlier, as you were suggesting, we would not have done as well. You are always welcome to say you think we will do fine, but don't try to pressure us to quit studying when we don't feel prepared.

10. Don’t compare what we are going through to what you went through in school unless you majored in something in the medical field. If you are an accountant and you didn’t fully understand something in school, you might mess up someone’s finances. This is a big deal, but your mistake will not kill someone. Ours might.

11. Bring us plenty of chocolate, especially Reese’s peanut butter cups.

Calvin

In my opinion, psychiatry is a wonderful field. I know many people who have been helped by drugs such as Ritalin and Zoloft. So please do not think that I am posting this as an attack on psychiatry or anyone who uses Ritalin. I am just posting it because it made me stop and really think about things.
Please click here.

Isis's foot

Isis and Skitzo make it difficult to get any work done. I was sitting here studying earlier tonight when I heard them fighting. I looked to make sure they were ok and realized what was going on: Skitzo was trying to bite Isis's foot. Of course, Isis wasn't happy about this, but was too lazy to get up and move. So she just laid there smacking him while he tried to bite her. This continued long enough for me to get my camera and take pictures. I posted them for you HERE. You might want to view them with the speed turned up a little bit- it makes the action shots even better!

January 05

Self diagnosis

One of the biggest problems with my psychology and nursing classes is that I have diagnosed myself with a lot of the things we have studied. I'm sure you have probably figured out a few of the possible psych disorders just from reading my site. But thinking I might have obsessive compulsive disorder or multiple personalities was never scary. Thinking I have some of the things we are studying in my nursing courses can be pretty frightening. For example, I had a slight pain in my chest after eating dinner a few nights ago. Heartburn? Nope. I was about to have an abdominal aortic aneurysm rupture. My bad headache the other night wasn't just a headache, I was about to have a stroke. When I didn't have a stroke, I wasn't relieved, because it just meant I had an inoperable brain tumor. After re-reading what I have just written, I have just made another self-diagnosis: hypochondria. See, this is never ending!!
I know I'm not the only one who does this- what have you guys diagnosed yourselves with?

New Grandma:

Congratulations Vanita on becoming a Grandma!!

Book buying time

Since many of you are starting a new semester in school, I thought I'd share with you my favorite book website: www.bigwords.com
This site compares amazon, half.com, abebooks.com, barnes&noble.com and several other websites for the best price (including shipping cost). The only problem is that it does not search active ebay auctions, so you should go to ebay.com and enter the book's ISBN number separately.

January 04

The evil photo album

Apparantly, we have an evil photo album in our house. Thankfully though, we have Super Isis to save us from this awful album.

We can't figure out what Isis thinks is wrong with this photo album, but for some reason, she keeps pulling it out from the stack of albums against the wall and trying to tear it apart. There is a picture on the front cover that she has poked many holes in. We will put the album back with the others, and within a few hours, it will be on the floor again with several new holes. Well, at least she's busy ripping apart photo albums and not throwing up on the carpet, right?

Did you know...

~ You should never give Aspirin to children. Some Pepto Bismol-like products contain aspirin, so be careful with these!

~ You should never give an infant honey, not even just a little bit on their pacifier.

~ St. John's Wart can make the birth control pill less effective.

~ Depo Provera should only be used if all other methods of b.c. are inadequate, because Depo causes a significant loss of bone density.

~ You should not use Tylenol or Aspirin while drinking to prevent a hangover.

Bla..

Do you guys ever have one of those days where your teacher is so disorganized and confusing that you would have learned more by staying home and watching Sesame Street?

January 03

Cat alarm clock

I am sure that many of you cat owners have come to this same conclusion before: the most effective alarm clock would be one that imitated the noise of a cat about to throw up. When I hear the beeping of my alarm clock, I slowly and painfully make myself wake up. But when I hear that distinct hacking, I am up, alert, and searching for the closest thing to put under the cat to catch the vomit, all in under a second. At about 4:30 this morning, I guess I was a little too quick getting up though, because it scared Isis, so she started running while throwing up. The result? An inch wide line of vomit stretching about three feet on the carpet. Stupid cat!! I have to clean it up right away, not because it will stain, but because Isis will find something around my room to "cover" her mess up with. She will drag clothes, paper, towels, whatever she can move with her little paws, and attempt to hide what she has done. Does anyone else have an animal compelled to do this? She even hides Skitzo's messes. Sometimes when cleaning the clothes off my floor, I find her nice little presents. If my room is actually clean and she can't find anything to hide it with, she will just sit there and attempt to dig a hole in the carpet. She is declawed, so it doesn't harm anything, but it's really annoying when I'm trying to sleep! Animals are so much fun!!

January 02

Just setting up a Technorati account...

Technorati Profile

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Disclaimer

I have run into a slight dilemma with this site. Patient confidentiality is a huge deal to me, and before I had many readers, I wasn't worried about confidentiality as long as I never mentioned what hospital I was at or the names of my patients. But now that there are more of you out there who have seen what I look like, I have started to worry that someone at a hospital might recognize me and see what patient I am working with, then later read about my day- therefore violating my patient's confidentiality. It's too late to just take down my picture, so I have come up with a different solution. I will write about my clinical experiences the same as I always have, but I will not publish them on the same day I write them or in any particular order. I also might write about things my classmates experienced. This way, if you see me working with Mr. Jones on Monday, and check my site Monday night, you will have absolutely no way of knowing if I am talking about Mr. Jones, the patient Danielle had, or the patient I had two weeks ago.

I love all of the replies I receive from you guys. Over my break, I spent almost 30 hours replying to all the comments in my guest book. I didn't make it all the way through, but I do plan on replying to the rest of you as soon as I can. I did intend on replying to everyone who commented on here, but very quickly discovered that this was an impossible task. Therefore, I will only be replying to comments in my guestbook. I do read every single comment you leave with my stories, but I will not be able to reply to those. So, if you want to hear back from me, please post something in the guest book.

Sunday, June 13, 2010

January 2006

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