Damn Cat. Damn Dog.

Nurse Teeny was bested by a feline this week.

I was innocently taking the dogs out Monday morning when our 80-pound chocolate lab’s ears perked up the moment we exited the building and spotted our neighbor’s cat hanging out in the parking lot. She then took off after her prey at full speed, giving me no time to drop the leash before I went flying through the air and landed face- and left hand-first on the asphalt. Ouch.  Got some sweet road rash on my cheek, hands, knees, and feet, not to mention puncture wounds on my leg from the keys that were in my pocket.

Landed me another trip to urgent care and an x-ray series of my wrist, which I could not extend or rotate. No fractures, but doctor’s orders are to rest, ice, take pain meds, elevate, and wear a brace for at least two weeks.

My only consolation is that this didn’t happen during a clinical rotation!  Happy Summer!

P.S.Apologies for any inadvertent typos. Being temporarily one-handed has really put a damper on my typing skills.

75% RN

Nurse Teeny is one semester closer to nurse-hood! We turned in our final group paper this morning, which was the last thing on my to-do list.  I’ve been in nursing school for a year.  It’s quite bizarre to think about how far we have really come in only 12 months.  And quite surreal that we’ll be taking the NCLEX in only 4.

The end of summer term couldn’t have come soon enough, as far as I’m concerned. Especially since we seem to be in the midst of a horrific heat wave, unusual for this neck of the woods.  All I want to do is either lie still with a fan blowing at maximum speed or live in a body of water.  Gross.

So what’s next for Nurse Teeny?  A blissful month off, that’s what!!  I’m flying home to see my mom for a couple weeks and to make some money by working on contract for my old job.  It will be nice to get a check I’ve earned, rather than borrowed.  The trip home will also include our second annual ladies’ wine tasting weekend.  Hello, air-conditioned Mercedes bus and bottomless champagne!    Otherwise I’ll be piddling around, spending some quality time with S (who has put up with my neglect very gracefully the past few weeks), and reading for FUN (who knew?).  I’ll also be scouring this apartment, which too has been woefully neglected.

As soon as it cools off a little.  For now, I’ll just try to beat the heat…

What I (Will) Do

Today for our final peds class we had a guest lecturer, a pediatric nurse practitioner who specializes in oncology AND is the director of the local hospital’s pediatric palliative care program.  Can you say my ideal job?????

Her philosophy about peds palliative care resonated and stayed with me all day.  It is so hard to explain to people why I want to specialize in end-of-life care, particularly with children.  People (even other nurses) scrunch up their noses and say “Why would you wanna do that?”

Perhaps because losing a child is one of the most painful experiences one can have in life.  Perhaps because it exemplifies family nursing.  Not only are you helping a child cope with an untimely death, managing their symptoms and giving them as much quality of life as possible, but you are supporting their parents and siblings and helping them navigate a confusing, heartbreaking, beautiful journey.  Perhaps because children can teach us so much about life and love and spirit.  Perhaps because dying children are still very much alive, and there is much to celebrate about helping them just be kids for as long as possible.

Pediatric palliative care nursing is NOT just watching children die.  It’s being with them as they live and die.  And learning much about ourselves in the process.  The fact is that children will die, despite our best efforts and our prayers and our hopes to the contrary.  But those of us who are called to be present with these children and their families are part of something bigger than ourselves.

What a gift.

Watch Your Mouth

Nurse Teeny is pretty fed up with this nonsense.

I walked into the faculty offices this morning to double-check my simulation time, and what should I overhear but a conversation between a classmate and a professor?

Classmate: “[Nurse Teeny] finishes her ATIs in like 20 minutes!”

Professor: “[Nurse Teeny] who?”

Classmate: “[Nurse Teeny's last name]. It’s OBNOXIOUS. And she gets 3s on all of her ATIs too.”

First of all, a point of correction. I have not in fact earned a 3 on all of my ATIs (a 3 is the highest proficiency level you can get). But then again, I don’t advertise my scores to the rest of the class. It’s no one else’s business, in my opinion.

But besides that, how completely inappropriate to a) Talk about me behind my back, b) Talk about me in such a negative light, and c) Talk about me in that negative light to a faculty member!!!! I walked out of the hallway shaking. Then I decided to actually stand up for myself and confront said classmate about what I heard.

She did apologize, for which I give her credit, but she also tried to backpedal and say that she was actually trying to compliment me and that I obviously didn’t hear the entire conversation. She said she was trying to point out to the professor that I was the “star” of the class. I pointed out that calling me obnoxious doesn’t sound very complimentary. She then said she didn’t recall using the exact word “obnoxious”. Yeah right. I heard it loud and clear. Then she said what she actually meant was that it was personally obnoxious to her that she was struggling over a test that I seemed to finish in no time at all. This is the same classmate who once asked me to sit and wait when I finished a test so I didn’t make everyone else feel bad.

I fail to see how finishing a test and leaving the room as quietly as possible is obnoxious. I also fail to understand why I seem to incur this enmity when I have done absolutely nothing to purposefully draw attention to myself. In fact, I have tried very hard NOT to draw attention to myself. I work my butt off, study hard, and do my best, which is all that I can ask of myself. I don’t compete to be at the top of my class, I compete to be MY best. I don’t try to finish tests first just for the hell of it, I just test quickly. Maybe I’m completely naive, but I’m baffled about how this can be so threatening to people. Of course, the culture of this program is something that has plagued me for months. Maybe I shouldn’t be so surprised.

Moral of the story for others: Watch what you say about other people. You never know who’s listening.

Moral of the story for Nurse Teeny: Keep standing up for yourself. You don’t deserve this.

Natural-Born Nurse

Yesterday was the end of my peds rotation…very bittersweet indeed.  It was pretty anticlimactic – since we didn’t have a consistent clinical instructor throughout the experience, we didn’t really have anyone to say “goodbye” to.  Most of the nurses didn’t even know it was our last day.  But nonetheless, I was sad to walk out that door and to my car.

My last shift was on the infant-toddler unit and I still felt a little discombobulated about the care, but boy did I love those babies!  I had a 7-month old who was discharged after undergoing evacuation of a subdural hematoma.  She was a DOLL!! Every time I peeked over the rails of her crib, she greeted me with a brilliant smile.  So easygoing and pleasant and adorable.  Then there was the 5-month old who was receiving antifungal therapy after his central line was infected with some kind of yeast.  He had the biggest blue eyes I have ever seen and he would just fixate on my face and give me a flirty little half-smile.  No wonder many of the nurses on the unit are pregnant or have little ones – this floor is bound to give you baby fever!

My third patient was 11 years old (overflow from the school-age unit) and had undergone open heart surgery to repair a problem with his aortic valve.  He was also easygoing and his mom was wonderful.

All-in-all, a very satisfying conclusion to my pediatric clinical experience.  I still don’t think hospital nursing is for me in the long-term, but being around kids really does brighten up my world.  During my final eval, my clinical faculty coordinator said she thought I belonged in peds (which was very reassuring), and called me a “natural-born nurse”.

Regardless of what comes next, that is a very positive message to come away with.

One more week of exams and projects, and then we’re free for an entire month!

What’s Done Is Done

‘Turned in my capstone request 5 minutes ago to the faculty in charge of placements. I decided to fill it out as soon as they sent it, in order not to psych myself out. Final submission: 1) Peds Day Treatment, 2) Adult Oncology, 3) Hospice (couldn’t pick more than one peds option).

So there you have it. Chances are we won’t find out the results until the fall semester starts. Time for another waiting game!

We Have A Winner!

Last night after an incredible day on the school-age peds unit, I was experiencing a vocational crisis of sorts. Those of you who know me (or read this blog often enough) know that I tend to get ahead of myself. But regardless, I was stressing big time about how to rank my capstone choices because I worried not only about whether I would learn from the experience, but also about what kind of job prospects it would present both immediately and in the long-term. If I did adult oncology, how hard would it be to eventually get a job in peds? But did I really want to work on a peds general floor?

The search is over, folks. I spent today on the peds day treatment unit. Un-freaking-believable. From toddlers to teens, from cancer patients to kids with genetic disorders, I saw it all today. Day treatment is where (mostly) outpatients go for infusions of chemo, rheumatoid arthritis treatments, etc., as well as procedures such as lumbar punctures and bone marrow aspirations. The staff there worked like a team, and the place was a well-oiled machine. Best of all, they threw me right in. I was helping with lab draws, setting up infusions, drawing up meds, taking periodic vitals, and observing/assisting with procedures all day long. The doctors were respectful and helpful. I was even part of a code today, which was a heart-wrenching experience (yet one that was important to have). Don’t worry though, the patient turned out okay.

The nurses really encouraged me to think about doing my capstone there because of the skills I would learn that I could take anywhere. They told me they’d have me doing IV starts and accessing ports in no time. Most of the patients have been coming weekly or monthly for a long time, so their families are familiar with the process and the kids know the drill. There are genuine relationships between the staff and the families. Who knew? I feel like it would be an amazing place to learn clinical skills while still practicing family nursing. I think I’d be more comfortable working as an RN on a peds floor if I was more confident in my clinical skills. On the other hand, I’d also be able to market those same skills to an adult oncology unit too (or cancer treatment center/clinic). So wherever I looked for work, I’d be in good shape. Chances are that when the time comes, I’ll apply to both options anyway and cross my fingers that something pans out. Then I can make that decision…no need to stress about it now.

Not to mention, they’re only open M-F, from 7:30 to 5:30, so no nights or weekends. Score!

So without further ado, here is my “short-list” that I’ll be submitting for capstone requests. Drumroll, please…

1. Peds Day Treatment
2. Adult Oncology
3. Peds Floor (preferably school-age)

I can already feel my anxiety level about this one simmering down.

No Habla Espanol

Imagine you are a 15-year old girl who just underwent a kidney transplant a few months ago. You are readmitted to the hospital because the doctors fear a transplant rejection. Imagine that although the danger of rejection is ruled out, they do decide to run a number of tests because you have a urinary tract infection. One of the tests determines that you have moderate vesicoureteral reflux…when you urinate and your bladder contracts, urine backs up into the ureters and kidneys, putting you at risk for repeated infection.

Now imagine going through all of that when you can barely comprehend, let alone speak, English. And your mom understands even less than you do.

That was one of my patients this week. We did have an interpreter for part of the day, but during the procedure to test for reflux (known as a VCUG), no one in the room spoke a lick of Spanish, adding to the emotional and physical stress both patient and mom were experiencing.

Back in high school, I decided to be “out of the box” and take Latin…for six years. Great for my SAT scores, not so great for enhancing my actual communication skills. Then college came and I had an opportunity to choose a language that would be more useful.

German. Smart thinking, Nurse Teeny.

We live in a society that is multicultural, and grows ever more so every day. And whatever the talking heads may say about requiring immigrants to learn English, it matters little when you’re standing awkwardly in a room, trying to educate a family about how important it is that a patient finish her entire course of antibiotics. If our job is to meet patients where they are, that most certainly includes being respectful and aware of cultural and linguistic differences that could affect the quality of care they receive. If we don’t speak the language, we most certainly have an obligation to make sure there’s someone who does.

As for me, I’m looking for ways to learn Spanish. Any ideas?

A Little Extra TLC

I may just have to stop watching HawthoRNe. Every time I see this show, I get a little more frustrated. I could just throw my hands up, stop analyzing its lack of realism and watch it purely for the entertainment value… Wait, I’m not even entertained anymore!

Last night insulted me as a nurse-to-be (and as a female). The plotline featured rumors overheard by Male Nurse about a colleague – Candy, the beautiful blonde who always wears the same pink scrubs. Apparently Candy shows her support for the troops by giving a little extra attention to her veteran patients. If you catch my drift… This “lending a hand” was one of the first scenes of the pilot episode and I was appalled then.

But when Male Nurse confronted Candy about her behavior on last night’s show, she defends herself by saying that it’s “something she can do” for our men in uniform. Apparently being deployed warrants sexual favors by your favorite medical professional. So what happens when you get a female patient who serves in the military? And don’t get me started on the dialogue. When Candy described the soldiers overseas as “strangers in a strange land”, I think I threw up a little in my mouth.

Don’t get me wrong, I have tremendous respect for the men and women who serve in our armed forces. I cannot begin to comprehend the sacrifices made by them and their families. However I may feel about the war itself, I have to admire their courage, sense of duty and commitment to protecting their fellow citizens.

But there are ways to show your appreciation for soldiers and veterans, other than degrading both them and yourself. They don’t need cheap TLC, they need excellent health care. They need to hear a genuine “Thank you.” They need programs that help their transition when they return home. They need to be paid a decent wage, and their families need to be supported. They need to be respected for their service and – I’m getting on my soapbox here – NOT be fearful of revealing their sexual orientation for fear of dishonorable discharge.

But Candy’s little stunt not only doesn’t impress me, it completely disgusts me. It’s unprofessional. It’s disrespectful. It’s demeaning to nurses and women everywhere. And the fact that the idea even entered the minds of HawthoRNe’s creators shows me just how truly out of touch they are with the nursing profession.

Sick Day

This week, the nurse became the patient…

I got hit with a nasty case of viral gastroenteritis on Tuesday and it just went downhill from there.  You don’t need to know the gory details.  Ended up so dehydrated by Thursday that I landed in urgent care, hooked up to IV fluids. The poor nurses tried to find a vein and after four miserable, painful attempts, they called in the big guns: a phlebotomist from the lab who went in by instinct and got it on the first try.  Fluid volume deficit + Nurse Teeny’s stubborn veins = one major league challenge (that’s an official nursing diagnosis, by the way).

My diet for the past 48 hours has consisted of Gatorade, popsicles, and oyster crackers.  I missed clinical today, and won’t make it to a friend’s wedding this weekend. And it’s so hot I just want to find a corner of my non-air-conditioned apartment and not move.

Happy freakin’ 4th of July.