Foot-In-Mouth Disease

Last Friday at the end of my shift, my nurse asked me what made me nervous about my second week.  I said I was worried about getting a complicated stroke patient.  When I showed up Wednesday night to get my assignment and go through my patient’s chart, what was next to my name under “Patient Reason for Admission”? Stroke, with history of dementia.

Nice one, Nurse Teeny.

It all turned out okay, however.  The stroke was relatively mild in the grand scheme of things and my patient was in pretty good shape, considering she is 92 years old.  Her “keystone issue,” as they say in nursing lingo, was more her self-care ability and determining whether she should be discharged home, where she (still) lives alone, or whether she needed more extensive assistance than her family could offer.

She was a bit grouchy  at times (favorite quote of the day: “I wish you would stop talking,” when I asked her if she enjoyed her lunch), but cooperated and even laughed and joked around with me in the afternoons.  And although she resisted when I took her vitals – an elevated BP required squeezing that cuff a little too hard for her liking – she never refused.

Next week is my mid-rotation evaluation.  Already!  And my nurse says I’m ready for a much more complicated patient.

‘Don’t know if this has ever been said in the history of nursing, but I love nursing school!

I Voted

One week to go…

I obviously have my own political biases but mostly I have this to say:

GO VOTE!!!

You Gotta Stick It

Med-Surg lab is all about learning new skills and then “passing” so that you can practice those skills safely in clinical.  Today it was injectables (intramuscular and subcutaneous).  And we got to finish up the afternoon by practicing on each other with injections of normal saline!  My first thought was “No way in hell!”  But then again, I’d rather my first injection be practiced on a friend/classmate with a non-lethal substance, than on an unsuspecting patient with a vial full of Heparin.  So I sucked it up and it was actually quite easy once I got over the fear of jabbing my poor partner.  As our instructor said, “Just commit to it!”

We also had our test on oral/topical meds, which we learned last week.  I passed!! This means I can start giving meds in clinical this week.  The hospital has this nifty computerized system that I can’t wait to start using.

Every skill we learn and “master” (cough, cough) makes me feel a little bit closer to nurse-hood.  And increases my confidence that I might actually in fact be cut out for this work.

On Your Feet

Oh Med-Surg, how do I love thee?

Thursday and Friday marked Week 1 of my first Med-Surg rotation. I’m on a neuroscience floor at the same medical center where I did psych – all of the patients have either medical neuro diagnoses (stroke, seizure, etc.) or are postop from neurosurgery. The nurse I am assigned to work with throughout my rotation is FANTASTIC! She is about my age but has been a nurse for 6 years – she is intelligent, patient and absolutely loves teaching. And she has this calming presence about her. After day 1, I turned to one of my classmates and said, “I think we can actually do this stuff!”

I must say, though, that compression hose are my best friends. Being on your feet for 8 hours straight is no joke. Running from room to room, answering call lights, conferencing with other staff in the hallway… Ouch! I’ve decided to also invest in one of those foot spa things – I had one when I directed weddings and it saved my poor tootsies.

My first patient was a woman in her late 40s, postop day 3 from lumbar surgery. She was totally open to being my guinea pig and her friendliness made my first hands-on care experience absolutely fabulous. It was a great way to get my feet wet. And I got to practice some skills – removed an IV, changed a dressing, and helped her shower. Pretty basic stuff in the grand scheme of things but I was pretty thrilled to put on those gloves and get to work. My nurse (“K”) also let me take the lead in post-discharge teaching, and filled in the blanks. We were a team. Our patient was discharged right as my shift on Friday ended, so we got to take her out to her car and see her off. She and her husband even gave us both hugs.

And the icing on the cake? As they drove away, her husband yells out, “Go Obama!!!” I knew I liked them.

Nurse Teeny = Slacker

Actually, for the most part I have been anything but a slacker.  But when it comes to this blog, a series of events have conspired to prevent Nurse Teeny from posting…

I did wrap up my psych clinical a couple weeks ago and was extremely sad to leave. Of course, with the chaos of the unit, our departure was rather anticlimactic.  Not that I expected trumpets and tears.    But as I was charting for the last time, the unit supervisor did say, “When you graduate and decide to become a psych nurse, give me a call.”  That was kinda neat.  And we did bring goodies for the staff, which they seemed to appreciate.  I absolutely LOVED my rotation overall but the problem with psych nursing is that you lose a lot of the other clinical skills, and it’s hard to change specialties should you ever decide to.  So instead, I’ll put the therapeutic techniques I learned to work in another area of nursing.  It actually turned out to be the perfect first rotation, because the communication and listening skills I have honed will be useful wherever I go in nursing.

The craziest part of my last day was the final evaluation I had to do with my clinical instructor.  She recently lost her mother very quickly to lung cancer, and right after her mom was diagnosed we spent a lot of time talking about my own experience with my dad.  During my evaluation last Friday, she talked about her mom’s hospice nurses and told me (without knowing anything about my actual goals) that given what she observed of me in practice and what she knew about my past experience, she thinks the perfect job for me would be pediatric hospice.

Whoa.  Spooky.

So after having my vocation confirmed once again by someone who didn’t know my plans (that has happened a lot since I started thinking about nursing), I joined my classmates for a fun night out to celebrate the end of clinical rotation 1.  Then I woke up at 4:30 the next morning and caught a flight home for a weeklong Fall Break.  Ah, the bliss.

Hah! Fall Break is an oxymoron apparently.  I literally studied for 7 days – wrote papers, played catch-up, studied for the dreaded Pharm exam that was this afternoon.  But I did take time off to have lunch with old friends, bond with my mamasita and her pup, and of course, spend lots of quality moments with S.  Those were the blissful parts and they were well worth it! I would have posted earlier and would have remembered more stories had I had Internet access at home, but the gods of technology seem to have cursed my mother’s house (again).

So now I’m back.  Classes resumed today.  My Med-Surg clinical orientation is Wednesday morning, and they throw us into the deep end Thursday morning.  Good-bye Tuesday afternoons with no class and Wednesday evenings to chill with fellow psych nursing buddies.  Hello Tuesday labs and exams, and Wednesday night chart reviews.  Goodbye professional dress, hello purple scrubs.

I’m excited to be doing more hands-on nursing stuff.  But boy will I miss those pukey adolescents!

That One

Boy, John McCain really hit one out of the park tonight.  For Barack Obama, that is.

While both candidates showed a relatively equal level of substance and knowledge, the most telling moment of the entire debate was when McCain pointed at Obama and called him “that one.”  How disrespectful, how demeaning, how rude.  He has a name, my friend.

And did anyone else notice how McCain told a young African-American man that he had probably never heard of Fannie Mae or Freddie Mac before the financial crisis?  Though I get where he was trying to go with the idea, the context and the dismissive way in which he said it made my stomach turn.

There are moments when McCain’s McGrumpy side comes out to play and it’s not very flattering.  And also not very presidential.

Obama knew his stuff, and his comments on fairness and sacrifice were genius, in my (albeit biased) opinion.  I’m ready for a new chapter in our nation’s history and I’m beginning to sense we may indeed be turning that page.

The alternative would be devastating.  You betcha.

Can It Get Better?

In process group yesterday, the therapist asked everyone, “How does it feel to believe that life is hopeless and nothing can get better?”

Silence.

Then, “Can it get better?”

More silence.

How tragic to be 15 years old and not know how or even if your life can get better.  How sad to believe that life is so disappointing, you’d rather be dead. How unfair it seems that these kids are so overwhelmed, so beaten down, so ill-equipped for life.

My client this week was 17 years old and had a history of sexual abuse.  Not only that, she herself was the product of a rape and her mother reminded her of this all the time.  It finally became too much, and she had a panic attack and tried to hurt herself.  As a survivor of sexual assault myself, I specifically asked to work with her, hoping that I could offer a unique level of empathy.  We’re not supposed to reveal our own histories, which I didn’t, but I believed that being able to identify could help me better engage her therapeutically.

It was actually much, much harder than that.  Watching her struggle brought back a whole new rush of emotions that I thought I had safely tucked away.  And knowing exactly how overwhelmed she was, I found myself struggling for the right words.  But I kept my composure and did my best, and when the one-to-one was over I felt that we had connected and that she felt safe.

But it was a hard shift.

6 Months of Bliss

Today marks six months from that first fateful coffee date with S.  Since that time, we haven’t looked back.  I can’t believe how fast it has gone, and yet I can’t believe it has only been half a year.  Because I feel like I’ve known him forever.  And my family seems to dig him too – aunt and uncle invited him to their debate-watching  dinner tonight.

Witness the following exchange between S and my mother…

Mom:  I want to tell my grandkids someday about the history Barack Obama is making.  And tell them stories about this debate and how I felt about it.

S:  You mean my kids?

If that wasn’t the most blatant revelation of his intentions, I don’t know what is.  It sounds like he caught mom a little off-guard, but in a good way.

Whoulda thunk it?  I travel all the way to Africa to meet my first husband, go through a painful divorce, and swear off looking into the future with anyone for a very long time. Then it turns out my perfect person was literally in my backyard all along.

When you know, you just know.

Darn Tootin’

Just have to get something off my chest really quick:  Sarah Palin makes me ill.

Okay, I feel better.