Confessions of a Registered Nurse: May 2006

May 30

Surviving the prereqs

All nursing programs have prerequisites. These are classes you have to take before starting the actual nursing program, and while some of them apply directly to nursing, many of them don't. Here are some tips on how to get through these courses:

Microbiology ~ Think of this class as a new diet. Trust me, after seeing the things that grow off of a swab from even fresh food, everything in your refrigerator will be disgusting.
Anatomy & Physiology ~ Use flashcards and websites such as howstuffworks.com to help you learn the material. Every once in awhile, allow yourself a few minutes to sit back and think about how fascinating our bodies really are. When you take on this attitude, the class can actually be enjoyable.
Chemistry ~ Watch CSI every week. Once in awhile, you will recognize something that they say or do in the lab, and it will make you feel like you actually learned something.
Religion ~ Pay attention in this class. You will be praying a lot in nursing school for God to help you hold on to your sanity!
Texas History ~ Texas is the only state I know of that requires students to take a state-specific history course. The solution? Don't go to school in Texas.
Nutrition ~ Just in case the Micro diet doesn't work, taking this course will help you realize how unhealthy you really are.
Pathophysiology ~ Try not to diagnose yourself with everything you learn about!
Psychology ~ You will finally understand what is wrong with all of your friends.

I'm back

Isn't it weird how sometimes you don't even realize how burnt out you are until you completely crash? That's what happened to me last week- we had an online course that I completed early (I know, I'm such a nerd), so I flew to Dallas to spend the week with Mike. I planned on looking for hospitals to work at, going to lunch with friends, visiting my old neighbors, and studying for the NCLEX. What did I actually do? Nothing!! I slept in until at least ten every morning, read a few books that had nothing to do with nursing, watched movies, hung out with Mike, and listened to music. I rarely left the apartment. To most people, this would sound like a miserable and boring week, but it was exactly what I needed. But now life is back to normal, so I'm sure I'll have more stories and rants for you guys soon.

May 23

You know..

You know it's time to get a new couch when you find yourself giving your old one monthly "haircuts" to get rid of all the loose strings.

You know it's worth the effort to find your glasses before attempting to eat breakfast when you accidentally grab the sour cream instead of the yogurt. When you're blind they look the same, but definitely do not taste the same.

You know you shouldn't quit nursing school to become a pet groomer when you make your parents' cat look like this:

May 22

Hard to forget

One of the best (and sometimes worst) things about patients is that they each manage to touch our lives in some way. If they are pleasant to work with, you might find yourself in a better mood. This also works the opposite way- you could be having an amazing day and one patient can bring you down (thankfully, these patients are rare). Then there are those truly amazing patients who have more of an impact than just your mood for one day- you will remember them for the rest of your life. I had a patient like this last November. He was told that he only had six months to live, and November was six months ago. He has been on my mind and in my prayers a lot lately, and I hope he is proving the doctors wrong.

From November:

I went in to meet my new patient this morning, and he was a friendly older man. He asked for some coffee, and said that when I returned, he would have a surprise for me. I brought him his coffee and saw my present: a cute flower-shaped balloon. My patient was a clown, and he has been for thirty years. He has spent half his life making people smile. But today, he wasn't smiling. He was anxiously waiting for his liver biopsy results, worried that he would have to have some sort of surgery. A doctor finally came to talk to him, and when she left the room, I went back in to check on him. He was sitting next to his bed, shoulders slumped over, staring at the floor. I sat down next to him, put my hand on his hand, and said nothing. A few minutes later, he looked at me with tears in his eyes and said, "I have six months to live." He put his other hand on top of my hand. "How am I going to tell my wife?" The tears started streaming down his face. I felt them doing the same on my face. "I don't know," I replied. Several minutes passed in silence. "I know we all have to go at some point, but my kids! How can I tell them that I will not be here in six months?" More silent tears from both of us. Why is it that this kind, loving man can spend thirty years making people laugh and smile, and yet at this exact moment, the scariest and most awful moment in his life, there is no one who can make him smile or laugh? No words or balloons could possibly take away some of the pain and grief he is experiencing. Somehow, this made me feel empty inside. The one time my patient actually NEEDED something, I came up with nothing. I know there is nothing I could possibly do, but my heart is stubborn, and it won't acknowledge this. So I'm sitting here now, picturing my favorite clown lying in a scary, lonely hospital room, balloons probably long forgotten, and I cry.

May 21

Great nurses

Although I have talked a lot about nurses who failed to impress me, there really are many wonderful nurses out there. This is from my friend John:

When I did my day of observation in the NICU (Neonatal Intensive Care Unit), I worked with a nurse named "Bobbi." We had two patients, a 1 1/2 lbs boy, and a 3 1/2 lbs, two month old (also born at 1 1/2 lbs and 25 weeks) girl. However, down the hall another nurse, "Suzy" had sole responsibility for a 13 oz. girl. This baby was so tiny. She was one of a set of twins born at 25 weeks. Her sister had already died, and she was in a very precarious condition.

About 11 am Bobbi's phone rings. She then says, "Suzy needs help, wait here until I return." So I am standing there when about 10 minutes later two EMT's come rushing by with this full size gurney and go into Suzy's pod. I thought, "Surely they aren't going to use that full size gurney to transport that tiny little baby." Well about 10 minutes later they come rushing out headed in the other direction. On the gurney is Suzy, her scrub top covered in blood, and holding a blood soaked towel to her face. She had popped a blood vessel inside a nasal cavity, and was bleeding profusely. She and Bobbi couldn't get it to stop bleeding, so she was being transported down to the ER for treatment.

The other nurses gathered and decided how they were going to re-shuffle the work for the rest of the shift, as it was obvious Suzy wasn't going to be back. She had lost quite a bit of blood.

About an hour later I am in the hall when the doors swing open, and here comes Suzy, literally rushing back to her pod. She had on a way too big jacket to cover her blood stained scrubs. You could see cotton sticking out of both of her nares, and there was a strip of tape across the bottom of her nose to hold the packing in. Bobbi and another nurse stopped her and asked, "What are you doing here? Go Home." "I need to finish my shift," says Suzy. "No," said Bobbi, "We've got it all worked out and me and the other nurses are going to cover for you. It will be fine. Go home." Suzy looked at her with these steel cold eyes and said, "No one knows her (the 13 oz preemie) like I do. I need to finish my shift." That stopped Bobbi cold. She thought for a second and said, "You're right. We don't." With that she got out of Suzy's way.

I didn't think much of this at the time it happened, but I have thought about it a lot since. When I grow up, I want to be just like Suzy, who is so dedicated, and Bobbi, who puts pride aside to do what is right for the patient.

May 18

We're in this together

Our school sends us to hospitals all over the Kansas City area for our clinicals. We spend two weeks at each hospital, then move on to a new hospital with a different instructor. While this does have some benefits, such as seeing which hospitals we want to work for in the future, it does make clinicals extremely stressful. Once you start figuring out one hospital's system and where everything is, you move on to the next one and feel lost all over again. At our last clinical rotation, there was a slight scheduling conflict on our first day. Another nursing school had a clinical group on the same floor as us, and there were only eight patients. This meant that there were sixteen nursing students sharing eight patients. The students from the other school were in their ninth week at this hospital, so they knew their way around. They were in their junior year, while my classmates and I have only three months left of school. You'd think that we would be the ones who knew what we were doing, but that was far from being the case. These students knew their stuff! At first it was intimidating sharing a patient with someone younger and smarter, but within minutes, we all realized that this could actually be a wonderful experience. These students were patient, friendly, and actually taught us things that we didn't know. They could have rubbed our ignorance in our faces or showed us up to make themselves look good, but they didn't. They reaffirmed the message that I have been getting from you guys since I started this site: we are all in this together, and we will somehow get through!

May 17

You are getting sleepy

I love sitting by Rachel in class. She is one of the sweetest people I know, but that's not why I sit by her. The real reason is more evil and selfish. Rachel is free entertainment. She sits there in lecture, alert and paying attention while taking notes. But if you watch carefully, you'll notice that her eyelids start to shut, ever so slightly. Within a minute, they stay shut for seconds at a time, which signals the start of the fun phase of "class with Rachel" - the head tilting. Her head usually tilts to the right the first time, and she doesn't react too strongly, she just straightens back up and will be alert for almost a full thirty seconds. But then the left side of her brain starts feeling heavy, and her head will tilt over to that side. This startles her, and she will quickly straighten her head up and glance around to see if anyone noticed. Danielle and I are always looking forward at this point, trying our best to play it cool. We know that within seconds, Rachel's eyes will be closed again. When they do close, her head usually tilts backwards. This really scares Rachel, so she jerks her head forward and slaps her arms down on her desk to "catch" herself. She then looks over at Danielle and me, smiles, and says, "Was I falling asleep?" Sometimes we say we didn't notice, but at other times, we can't stop from laughing. I've never really understood falling asleep in class or while studying because unless I am extremely sleep deprived, this is never a problem for me. I think that karma has caught up with me for giving Rachel a hard time because over the last few days, every time I start studying for my HESI (which is tomorrow), I go through the exact same head tilting ritual. And it is not as fun as it looks! I actually fell asleep today after getting through less than a page in my book. I woke up and looked at the clock and almost had a panic attack, thinking that I was waking up tomorrow morning and that I had slept through my exam. I called Rachel to inform her that she was contagious, and she laughed and explained that her constant falling asleep during lectures or while studying is a classically conditioned response. It looks like you're at least ready for the psych section tomorrow Rachel!

It's about time!

Something amazing happened at clinicals: I learned a skill! Before you get too excited and start thinking that my school finally got its act together, let me explain. My patient was a girl with spina bifida. Her mother has become an expert at her care, and catheterizes her every few hours. I've been in nursing school for nine months, but have never put in a catheter (or even seen one done on an actual person). I asked the mother if she was ok with me watching her cath her daughter, and she not only agreed, but actually took the time to explain to me exactly what she was doing. She then taught me all about her daughter's different health conditions and how to best take care of each one. I was in awe over how much this woman knew, and at how dedicated she was to taking care of her beautiful little girl.

May 15

Quotes from the weekend

Mike came to town this weekend to have an endoscopy done to determine why he is having trouble swallowing. Before the procedure they administer a drug called Versed, which makes the patient sleepy and causes them to forget what happened. Apparently, the Versed does not wear off very quickly, which lead to some entertaining moments with Mike. Here are a few of the highlights:
~ The nurse called me back to sit with Mike while he was waking up. I walked over to him and held his hand, answering all of his questions (when did I get here, is the procedure over, how did you get here, etc). I stepped away from the side of the bed to look at the machine taking his vitals and when I turned back towards him ten seconds later, he smiled at me and said, "Katie! How did you get here?! Is the procedure over?"
~ Mike then wanted to know where his glasses were. I found them on a tray under the bed, and helped him put them on his face. About thirty seconds later, I asked, "Mike, where did you get your glasses?" He replied, "I guess they never took them off of me for the procedure."
~ Realizing that I could have some fun with this, I asked Mike to sing me a song. He chose a country song, and although I hate country, the song was wonderful. :) Unfortunately, his singing was interrupted by the doctor coming in to talk to him about the procedure.
~ The doctor was wonderful, explaining in detail what he found and answering all of our questions. Unfortunately, not too long after he left the room, Mike said, "I wonder how much longer until the doctor comes to talk to us."
~ Mike was lying on his side and after again realizing that I was in the room with him, he said, "Can I lay on my side?" I told him he was on his side. He again said, "Well, can I lie on my side?!" I asked him if he wanted to lie on his other side. "No! I just want to lie on my side!"
~ "Why are your eyes so big?" They've always been this big...
~ When leaving the building and swaying all over the place, Mike had a little run-in with one of the walls. He patted the wall and said, "I bet they have these walls here for a reason, huh?" I bet they do, Mike...
~ When exiting the building, I walked through the door first. After Mike walked through, he stopped and held the door open. "After you," he said, expecting me to walk back through the exit door. Uh, thanks?

Other quotes:
~ My little brother was rubbing the zit on his chin. He leaned over and said, "Whenever I touch my zit, it makes my ears hurt."
~ At my sister's graduation, they spent what seemed like half an hour giving awards. They had awards for everything- volunteering, having a 3.4 GPA for one semester, best attitude at clinicals, etc. During one award, they called the names of all but three or four students. It would have been quicker to just say, "Everyone but these students qualified for this award..." The audience was starting to clap less and less, and the students who qualified for every award were starting to look exhausted from standing up and sitting down every time their name was called. Mike, getting into the spirit of things, said, "And the next award goes to the student who took the fewest restroom breaks!" I don't remember what the next award actually was, but I don't think that he was too far off..

May 11

Laughter, the best medicine

One of my favorite patients during my pediatrics rotation was a beautiful teenage girl. She had come to the hospital for an outpatient surgery but was admitted to the peds floor for uncontrolled pain after the surgery. She said she was having severe pain in her leg, but her doctors could not figure this out because the surgery had nothing to do with her leg. No pain medication would get rid of her pain, which she always rated as an eight out of ten. Her parents live several hours away, and were unable to stay with her. When I did my assessment on her, she told me that her leg was numb and that she could not move it. She needed to use the restroom, so I told her I would help her walk to it. To get out of bed, she had to lift her leg with her hands and throw it over the side of the bed. When she finally stood up I helped her make her way to the restroom, and I was supporting most of her weight. On her way back to bed, she said she wanted to brush her teeth. I had grabbed a small tube of toothpaste before, so with me standing there with her, she picked up the toothpaste and squeezed it on the toothbrush. "This toothpaste looks gross. It smells bad," she said. Once she started brushing her teeth, she said, "Ewww.. it tastes gross." She continued brushing while I picked up the toothpaste tube. I looked at it for a second, then looked over at her and said, "Oh, no! I'm so sorry! I accidentally grabbed diaper ointment." She froze in place, her eyes got big, and she said, "WHAT?!" I smiled and told her I was just kidding. We both laughed and she finished brushing her teeth, smiling the whole time. When we walked back to bed, I barely had to support her. She climbed into bed without any problem, her leg miraculously healed.

May 10

Josh, our hero

You know that wonderful feeling you get when you pull into the parking garage and the perfect spot is available? It's amazing how quickly that feeling goes away when you get out of your car and realize that you are in a handicap parking spot. You start feeling even worse when you get back into your car to move it out of the handicap spot and realize that your car is dead. This is how Rachel and I started our day today after her car's starter picked the perfect moment to break.
Thankfully, Rachel's car didn't get a ticket and after clinicals, Josh agreed to help us start her car. Because it is a stick shift, Josh was able to put it in neutral, roll it backwards down the parking garage incline (which required us to stop oncoming traffic), and start it. We just couldn't turn it off because if we did, it wouldn't start up again. We were all cheering for Josh, our new hero, for figuring out how to start the car when Josh said, "Rachel, I need in your trunk to get my backpack." Rachel's trunk only opens with the key, which happened to be in the ignition, which needed to stay in the on position. Men!

In other news, I have decided to accept Nick Lachey's marriage proposal, just as soon as he realizes that he is in love with me. If any of you happen to know him or run into him, I would appreciate you letting him know this fact, because it might help speed things along (him finding out that I exist is probably a good starting point.)

May 09

Creative "explanations"

I have been sick the last few days, which is why I haven't been writing much. I do not want any of you to start having convulsions or tremors from "Katie withdrawal," so I decided I had to post something soon. But because I'm not feeling so good, I need your help on this one.

When someone asks you a question that you don't know the answer to, you are faced with three options: tell them that you don't know, pretend like you did not hear them, or make something up. I know that we all choose the third option on occasion, either for entertainment value or because we don't want to admit that we don't know it all. Do any of you (especially you parents out there) have good "explanations" that you have given when you don't know how to answer a question?

When I was in grade school, my classmate Allen was dared to run into the girls' restroom. Allen came out of the restroom with a confused look on his face. "Why does the girls' restroom have a metal box on the wall?" he asked. I explained to Allen that the teachers like the girls better, so they installed a candy machine in our restroom. Allen spent the rest of the day complaining that the boys didn't get a candy machine in their restroom too.

Your turn!

May 05

Skitzo vs the sprinkler

If you were betting on a fight between a living animal and a nonliving object, which would you put your money on? If you picked the living animal, you are probably right in most circumstances. Unfortunately, this is not the case when you are dealing with Skitzo, my adorable but unintelligent cat.
Yesterday, I was combing Skitzo outside and like always, he became angry and annoyed that he was being combed. When either of my cats get angry, they attack whatever is near them- a chair, my leg, the other cat, etc. The sprinkler is what happened to be closest to Skitzo while I was combing him yesterday.

With his ears pointed straight back, Skitzo walked up to the sprinkler. He sat down next to it and held out his paw, warning the sprinkler that it was going to get smacked if it didn't move out of his way. The sprinkler held its ground and did not cave under the pressure. Skitzo smacked the rotating part of the sprinkler, causing it to move away from him. "Take that!!" Skitzo was probably thinking. A second later, the other side of the sprinkler rotated around and tapped Skitzo on his back. Skizto jumped into the air and let out a shriek, then ran away from the sprinkler, defeated.
Stay tuned for Skitzo vs the kitchen wall...

Stress

I know this is probably hard to believe, but when I was in grade school, I was a dork. I was a tomboy who would choose playing baseball with the boys over gossiping with the girls during recess. Because of this, when the girls would hang out, they would exclude me. Although I didn't like them, this still somehow hurt. Instead of staying at home and crying, I found my own escape from the world- a small hidden pond in the woods by our house. I would spend hours every day out there exploring, catching frogs and turtles, and coming up with crazy adventures with whoever I was with.
I'm older now and have outgrown the tomboy phase. I've been a hard-working student who has completed nine months of an intensive, unorganized, frustrating, one year accelerated nursing program. I've been pretty stressed out lately, having to deal with a new clinical instructor every other week. Each new instructor has completely different ways of doing everything than the instructor before her. We have an online course that I have been trying to complete, but things keep going wrong with the way the course is set up, preventing me from taking the quiz I just spent the last two hours studying for. Thinking about finding a real job is stressful because although we only have three months left in the program, I feel like all I have learned is how to clean poop, give medications, and change bed sheets (and nursing consists of much more than these three things). I haven't seen my boyfriend since the beginning of March, and when I do get to see him next weekend, I'll be spending my time studying for a huge test. The list of things stressing me out goes on....

Well, maybe I haven't exactly outgrown the tomboy phase. Meet Fred, the frog I caught in my attempt to get away from the world. He peed on me a few seconds after this picture was taken, but don't worry, I know how to clean that up. Maybe these nine months haven't been a complete waste?

May 03

A little awkward?

Danielle and I were given the chance to work with the same patient on the mother/baby unit today. The woman we were assigned to was an adorable mother of three who had just given birth to a baby girl. Neither Danielle nor I have any children. We were told to go do patient teaching with the mother, which included instructions on breast feeding, bathing her infant, self-care, etc. As I mentioned before, this was the woman's third child. Danielle and I watched a quick video two months ago on giving a baby a bath, and read in our book about all of the self care stuff a month and a half ago. Let's think about this one- she's been through it twice, we both read about it awhile ago- she could have taught us! I understand the importance of teaching our patients how to take care of themselves, but when we really have no idea what we are talking about, it is slightly uncomfortable. Thankfully, the woman was wonderful with a good sense of humor, and she let us stumble our way through our teaching. When Mike has our babies in the future, I hope he is just as nice to any student nurses he may come across.

Confessions of a Registered Nurse

Sunday, June 13, 2010

May 2006