September 10, 2006

Let's play catch up...

I can't believe it's been 5 years since the 9/11 attacks. I remember that day well as everyone else in America does I'm sure. I was getting ready for work and had the Today show on. I heard from the other room that a plane hit the World Trade Center so naturally I walked to the tv and told my husband (then boyfriend) to come and see. As we're standing there watching we're thinking it was just a mistake of the pilot and then we saw it. The other plane crashed into the 2nd tower. I couldn't believe my eyes. I didn't understand what was going on and for a brief second I wondered if it was the end of the world or something. At that point we both realized this wasn't a mistake, it was an attack. I can't believe that I saw that happen live on television. I was in shock, my husband was in shock and I remember driving to work feeling kind of scared and wondering what was coming next. That was a horrible day. To this day I still feel so sad and emotional when I watch the footage or hear stories of the families. It feels like it was yesterday.

I watched the movie United 93. I don't know why I watched it because I felt really apprehensive about it, but once it began I almost felt guilty about turning my head away at some points. I felt as if I had to see this reinactment out of respect for those people. I know that sounds weird, but it's true. I will not ever see it again. I saw enough. My heart breaks for all of those involved and that's all I'll say about that.

On to happier things. 10 days until GREY'S ANATOMY!!!!!!! Yay!!! I can't wait. Wonder if they'll do a DNA test on Merideth's panties. Ha!!! I'm still mad that they killed off Denny. Could he have been a more perfect character for Izzy or what? Sigh!!! She deserved and Emmy for that performance and was robbed......ROBBED I SAY!!!! I have never cried so hard over a television show. Well, maybe except while watching Oprah...but everyone cries watching Oprah.

Yesterday I spent most of my Saturday at school practicing my IV therapy skill which is coming up on Thursday. I'm already sick to my stomach about it and should really be practicing now...if I weren't a procrastinator. The skill consists of IV initiation, IVP (push) & IVPB (piggyback)administration and all of those good ole calculations. The IVP calculations are really messing with my head. I can't wrap my brain around some of the answers to how fast you can push. Ex: Push .75 of a cc every 15 seconds. Huh??? Can you tell I'm frustrated?

Last semester (my 1st semester of NS) I only failed one skill and it was the very last one. Ugh! It was catheterization and I failed it because my sterile glove brushed my shirt. I had no idea it did and went through the whole skill feeling ok. She let me go all the way through it then told me I failed. GRRRRRR! I almost cried, actually I think I did cry a little. I did pass the 2nd time with no problems though.

We already had our 1st was over the musculoskeletal system. (Osteomylitis, osteoporosis, arthritis, traction, meds etc...) I did pretty good on it. Missed 4 out of 40 and got a 90%, which is a B in my program. As if they don't make passing hard enough they have to change the grading scale....sheesh. I also already took my "required" math test. It was 10 questions and I missed one, 90% again) and I missed it because my nervous arse didn't round to the nearest 10th. I wanted to kick myself. Oh well. It's over with and I'm glad. 2 million more to go.

We had our 1st clinical last Thursday. Let me begin this story by telling you that last semester our clinical consisted of bed baths, physical assessments, passing oral meds, feeding, down time, down time and lots more downtime. This semester I feel as if I've been thrown to the wolves. My 1st patient was a young girl who had a complete hystorectomy and was fresh out of surgery. (Is this allowed or is this a HIPPA violation? I'm not naming names so I guess it's ok..... ) pt' they know I'm only beginning second semester? Do these people realize that I just had a 4 month summer break and never let nursing school or what I learned cross my mind once??? So my clinical instructor...we'll call her Nurse Intimidator. Nurse Intimidator must not realize that we didn't go over nearly as much as she thinks we did in 1st semester. She is going on and on about what is expected of us and sayinga lot of things we've never even heard of before. Gulp! I look around at my fellow comrade nursing students as if I'm in a daze and realize they look the same. Deer in the headlights. At least I'm not alone. At this point I'm terrified. This poor girl doesn't know what's coming. ME!!! I begin re-thinking my career choices. Garbage collector sounds great right now. Maybe mail carrier or something, anything far less dangerous that having someone elses life in my hands. I admit, under my cool, calm, collected demeanor I was scared. Scared I would forget to check something or miss something or look like a complete idiot in front of my instructor and my patient.

The first part went ok. I went in introduced myself and checked all vital signs. My patient tolerated it well....she was out stone cold. Sometimes being doped up on pain medication is a good thing. I noticed she had a heart rate of 130....(tachycardic) that's high. I'm even more scared. Her BP and respers were ok, but I also noticed her lungs sounded kinda wheezy, but what do I know..I'm only a nursing student. We talked about breath sounds for maybe 45 minutes about 7 months ago. I obviously need a refresher. Of course I chart all of my findings and report them to her real nurse. Did I mention I didn't see this woman but a couple of times all day? When I said we were in complete care of our pt, I wasn't kidding. The nurse informs her doc and she was set up for some more intensive tests. At this point I begin doubting my findings and hope I didn't miscount or mishear. (Is that even a word?) I go back in and explain to my near comotose (not really...she's just really out of it) patient that I'm going to take her apical pulse again and listen to her lung sounds again. I get a groan and what I think was a nod...good she's coming around a little. I get the same findings again....SHEW! Now what do I do??? MEDS!!! Is she due any!!? So I ask her..when was the last time you got any pain medication? "Mumble, Grumble..." Duh@ me. Why am I asking her? Why not just go look in her MAR (medication administration record). Idiotic moment #1 ...the countdown begins. And another thing..why isn't her nurse on top of this?? Does she know that I don't really know anything? Is she aware I'm new at this and don't even know where the bathroom is on this floor, not to mention the MAR's. And where in the hell is my instructor???????

I finally find her MAR after getting in about 5 other nurses way. (I realize how green I must look at this point). She is on all prn (as needed )medication. Hmm...I'm stumped again. Grrr@ me. I feel so unorganized. So I ask the nice nurse when her last med pass was. She informed me she's probably ready and to find out her pain level. So back to the end of the hall I march. Me: "Um..if you had to rate your pain on 1-10 with 10 being the would you rate it?" Her: "Moan, Groan...9." Me:" Ok, be right back."

Back at the nurses station I meet up with my instructor who states it's time for her meds and we go to the MAR to check what all she's on. Nurse Intimidator says she needs her Demerol and I need to give it. "No problem, is the bottle in her drawer?" Intimidator:" I'ts an IM (intermuscular) injection. She can't take oral meds because she's on a clear liquid diet." My idiotic moment # 2. Sigh! I knew she was on this diet, but don't ever remember once in class being told strict liquid diets can't even take meds orally. It's a common sense thing that normally I'd understand, but being in my clinical stress mode it didn't occur to me. So she gets the med out and hands it to me and says..let's go. It's an IM injection y'all. I have never done this kind on a real person before...only dummies and oranges. Furthermore, it was last semester and I needed a minute to refresh all the steps. I'm chanting in my head...aspirate...aspirate...aspirate. 90 degrees...90 degrees...90 degrees. Find greater trochanter, find superior posterior illiac crest, draw imaginary line, meet in middle and stick. She notices my pale face and tries to reassure me by telling me to pretend this is something I do all the time. Umm...Ok...

As I'm standing there over her mentally marking the target I'm thinking...... Who was dumb enough to put this needle in my hand? What am I doing here? Why did I get myself into this? So I take a deep breath, tell her it's going to be a little stick, I stick it in, aspirate, push the med and pull out and try to recap the stinkin' needle. ( I-D-I-O-T!) I didn't mentally rehearse that part. Ok...first of all let me tell you that we never had those fancy little over the needle locks in lab. We had to re-cap by sliding the needle in the cap without holding the cap. I wasn't use to it, but by the way Nurse Intimidator looked at me I won't ever do it again. I didn't stick myself ...thank you God. Other than that all went well with the injection and she said it didn't hurt. I can't believe it because it hurt me just watching. Later that day I ended up giving her another IM and a Sub-Q (only in the skin) injection. Most of the others didn't get to do any at all. I felt like a needle hog...but I betcha I'll feel more confident next time. I love you all...but while we're in clinical and within that pt's room we're walking that plank alone! Next time I'll probably not get a pt with any so it's all good. And by the way......who, besides nursing students, get all excited over injections, suctioning and other gross things of the like? Not too many.

The rest of the day was a lot like the beginning. Me running back and forth because I was forgetting little things here and there like...neuro checks. I'm telling was our first real clinical. How does this become second nature and how long does it take before you're comfortable doing this job? I felt pretty frazzled, overwhelmed and stupid most of the time and this was just with one patient. I was beating myself up afterwards thinking of the things I could have done differently, some of the dumb questions I would ask etc... you get the picture. Self-doubt is a bioootch. Although I felt like a child trying to play grown up I did do a few things right and did feel a little like a nurse a few times. I did hear those wheezes which happened to be because of atelectasis (collapse). I did initiate ambulation to get her bowels moving because she was having a lot of back and abdominal pain from gas, incision , not to mention to keep her from getting pneumonia etc... (She was supposed to be up moving around the before then but they couldn't get her awake enough.) Everyone tolerates pain differently. I also did some deep breathing and coughing excercises with her to get her to cough up all that nastiness in her lungs. She was a great patient and I felt lucky to have her on my first "real" clinical day.

Then I drove home and cried. I know it was the first day and I'm not suppose to know anything but feeling incompetent can do a number on you. I don't know why I put so much pressure on myself but I do. After high school graduation I went to college and flunked out. When I went back the second time I was in it to win it....hard core and went into the nursing program with about 40 credit hours under my belt and a 4.0 GPA. I'm not bragging, I'm just darned proud of my acomplishments. Especially while raising a family and keeping them balanced. Atleast I hope they are. He he. I guess this is what being a student nurse is all about.....stress. I read it, it was told to me and all the while I somehow thought it wouldn't be as bad. I was wrong. Dead wrong. It's fast paced and there is constantly something to do. Needless to say I do not still have a 4.0. I got a B in NSG 101 and it dropped me to a 3.8 because the class was worth 9 credit hours. You know what? I don't care. I worked harder and am more proud of that B than any A I've ever recieved. Regardless of the stress and my self doubt I know this is where I am supposed to be and no matter how tough it gets and how stressed and freaked out we get we still find reasons to laugh and find ways to laugh at ourselves. It's all good!!

SO......there you have it. You're caught up to date after 60, 890 words.

Until next time....


Drofen said...

Are you kidding me? Grey's Anatomy?!?

The only television show I'll admit to crying during is ER, and it was only one episode. The episode where Dr. Green dies.

Oh. My. God. I bawled like a little baby.