Semester Three, Week Sixteen (Aka: Done)

Somehow, I made it.

Amidst all the fears, tears, heartache, and struggle, I've passed third semester, with an A in advanced concepts of medical-surgical nursing, to boot.

One semester left. I graduate in less than five months.

What have I learned this semester?

1. God is present.
2. Even when it seems impossible, I can persevere, and triumph. 
3. I can do more than I ever thought possible. 

Medically I've seen or done:

• PICC line insertion
• IV insertion
• IV push meds
• Care of paraplegia/tetraplegia
• End of life care
• Cancer care
• Juggling four patients (assessing priority of care)
• Cath lab (stent placement)
• End stage renal failure care
• Care of the patient with heart failure
• Psychiatric care

This semester wore me out. It brought many disappointments, but also many victories. I wish, so much, that my heart was still in tact. While I'm delighted to be done with this semester, a part of me is burdened by other factors in my life, that I've come to realize, can only hide under the surface, but will pop up, always. 

I guess I struggle with why this prayer for nursing school was so easily, quickly answered, why I had such clear direction and understanding of what God was asking of me, leading me to do, when all the other aspects of my life are not as clear, and at best, confusing. 

What if all I ever have is a nursing career? What if the years of my life to become a wife and mother never come? Will I be the old maid who contributes all that I have to my job, only to come home to no one? This. This is what is on my mind today, December 15th, as snow lays on the ground, storm overhead, at long last on break, but not at rest.

~
I waited a few hours before posting this, and I took some time to think about life. Okay, so I'm not exactly where I wanted to be at this late stage in the game, but I serve a good, good Father, and He knows what's best for me, even if I can't fathom that this is best. He is perfect in ALL of His ways. So, I'll continue resting in His grip, even when I can't see, and I don't know. 

We'll talk again in a month or so.

Semester Three, Week Fourteen

Last day of clinicals.

The anticipation was high. I made it. I didn't love it, and it was perhaps my most challenging clinical yet, but I learned I can safely handle four patients, I can do IV push meds (always forbidden before this semester) and my knowledge base really, truly has improved.

It's funny though; on one hand I feel like "I've got this, nursing isn't that bad." On the other I'm like "I am going to kill someone. I know nothing! How the heck did I get this far?!"

Thursday evening, the primary nurse assigned to my patients ("my", ha!) has never liked me. I don't know what I did to her at the start of my clinical rotation two months ago, but she's been against me since day one. Actually, I do remember; I had no computer access, our patient's blood pressure was outside normal perimeters, and I asked her, when she had a moment, if I could pass along some info. She blew me off, then begrudgingly had me tell her, to which she blew me off again. The following week, she apologized for being so rude, as she "never does that" and I received the apology gracefully (if I do say so myself), but from that point on, whenever she was working, she'd a) ignore me b) scowl at me or c) treat me like I was a moron.

Attention RN's: I am here to be a help. I am here to learn. I am not a dim-wit, competition, or going to disservice you in any way. In fact; I am here to help. I am here to lessen your work load. I am here to make sure that you get what needs to be done, done. So, I'd appreciate a little respect, and for you to not cut me off, glare at me, or treat me like I'm less than human. Because I notice it, feel it, and hate it. So, thanks.

Completed my last med-surg exam (not my final) this week, with a 96%. The neuro exam was ridiculously easy. So at this point, barring some unforeseen disaster, it does appear as if I will be completing my third semester of nursing school, you know, the one that was promised to be the worst of the worst?

I feel as if I'm dreaming, constantly. None of this seems like reality. My clinical instructor told me that she could see me working as an oncology nurse. There's a thought. I don't know. The last month has seemed mindless to me. I'm trapped in my grief, and I can't summon up the...anything to care.

Monday. We'll talk Monday (or later), after the big, bad final (that I haven't really studied for/can't find the gumption to study for.)

Semester Three, Week Fourteen

I'm always in such a state of disbelief as the semester creeps to an end. It never feels like real life. One moment, I'm launched into the beginning of a semester, all the fears and concerns at the forefront, the next; I'm preparing for finals, ending clinicals, submitting paperwork and getting ready for a month off.

I'm struggling.

This year has been difficult.

I found out yesterday my friend's cancer has returned. And we're not talking a minor recurrence; we're talking stage four cancer with distant metastasis.

It really feels like there is a dark cloud over me; a heavy weight that cannot, will not be lifted.

Nine days, and I'll be done with third semester. I've completed pharmacolgy; had standardized testing to measure my knowledge against other nursing student's across the states. Incentive: If you do well enough, you get to skip the final. I remember hearing about that possibility my first semester of nursing school, and thinking I'd never get the grades to pass. Sure enough, no problem.

I have completed the last of this semester's Med-Surg lectures, on neuro disorders. There's something about declaring brain death that makes me feel incredibly uncomfortable and sad. Some of the tests to confirm said death are ancient sounding (reading the apnea test) while other's yet simply make me yearn for Heaven all the more. I'm tired of the pain, death, and suffering of this world.

One more week of clinicals. I really look forward to the end of that experience. I felt like a dunce during my clinical day yesterday, and just felt like I couldn't get it together. Though there was a moment when explaining what I heard on ausculation of a patient's lungs, that it felt real; here I was, so easily discussing rhonchi in the middle and lower lobes. Surreal.

We placed our fourth semester preceptor requests this week. I wrote "The reason I entered nursing was to eventuate in emergency medicine. It is my passion! I am willing to drive anywhere." I am hoping, praying for an ER preceptor spot. That alone would make my semester. If not (ever the Eeyore) I'm asking for anything but long-term care. *Shudder*

I'm just not feeling good enough for anything anymore. I can't snap out of the funk of losing my dog, and discovering my closest friend has cancer, again. The words of a friend stated a few weeks ago continue to echo in my mind "I keep you at arms length. You're a 'I'm in crisis' kind of friend."

Mix that in with the fact that I met a nice fellow over Thanksgiving break, got the commitment jitters and ran away faster than you can say peace. I'm a flight risk.

And so, nursing school. (I've been digressing a lot lately.) As of this writing, there are nine days, fifteen hours, and forty-two minutes left to this hellacious semester.

Semester Three, Week Thirteen

Hours after taking my exam on GI issues, highlighting diseases such as diabetes and pancreatitis, my dog, my wonderful, amazing dog of 12 years died in my arms, succumbing to complications from diabetes and pancreatitis. My heart is utterly, completely, totally broken. Presently, I could care less about school, nursing, or anything else, really. I'm broken. I can't stop crying.

But life goes on, doesn't it? Just because your world stops spinning, doesn't mean that anyone else's does. I've purposefully kept myself insanely busy this past week, volunteering in my friend's EMT class, going on a ride-along with my police officer friend, staying up as late as possible,

It was a crap week. I cried almost all day in class on Tuesday, and left early because if I didn't leave just then I may very well have imploded.

I didn't care that I did well on my exams; my second exam this week was a day after Cadie died, and all I could think was "This is the first exam I've taken without Cadie." It's the memories that kill me.

Clinicals were a comfort, though. I had a patient who needed extra care, and in a sense, I was able to pour out extra love on her, a patient who desperately needed it. I learned, once more, what nursing really means; it's stepping away from the "medical" side of things and recognizing before you is someone who is hurting, someone who has been defined for years by their diagnosis, and they've lost sight of who they really are.

I signed up for my final semester, and a part of me was in awe, while the other just couldn't summon up enough anything to care. So what that I'll graduate soon. So. What.

Returning to town yesterday, I buried my dog. She's in the front yard of my parent's house now, and I hate it so much. I hate that she died, I hate that she suffered, I hate that I feel this way, struggling to breathe, to function, to live. Making sure I eat one meal a day is a struggle enough on its own. I've (temporarily, I hope) lost the will to live. Perhaps that sounds overly dramatic, but I've known all along that once Cadie goes, a part of me goes, too.

I attended church last night and saw the dreaded boy I had dated this summer. He hates me something fierce and made it overtly obvious as I went to approach his (assumed) new girlfriend (an acquaintance of mine) to say hello. He not only purposely turned to walk away from me, he made sure to angle his back just enough away from mine in a dreaded effort to come off as casual and easy breezy. I noticed two things, 1) he's almost always wearing the same shirt 2) he has man boobs. So there.

It's not all about me, but it most certainly feels gut wrenching and world ending right now.

I waited all semester for this damn break, and now that it's here, I hate it and wish it would end.

Semester Three, Week Twelve

Another week, come and gone.

There were no exams, thankfully, but the additional hours of lecture were indeed excruciating. I only have about ten million slides to go over for Monday's exam, all on GI and endocrine related material.

My dog is sick again; presumed pancreatitis. She's worse off this time around than she was last time, and I find myself in a healthy state of denial, pretending like she'll pull through this again, even though she's presently lying at my feet and too weak to ambulate well.

I cared for a dying patient during clinicals this week. Their diagnosis was self-inflicted, and I recognized, how far too easy it is to judge. As I cared for him, I saw that this was a broken man, someone who took their addiction too far, but I also saw someone who is genuinely making an effort just to live. His family member also stated as such, and said she wants him to keep on going. His requests were minimal; to shower, to have lotion and chap stick, to have a breathing treatment for his wheezing and dyspnea when lying supine.

Nursing care requires love. It requires impartiality. It requires an open heart, and when judgement attempts to seep in, it is reminding yourself that at the core, there is a problem. A heart problem, a soul problem. As a nurse in training, I am so honored to be just a temporary part of my patient's lives, and (hopefully) showing them the non-judgmental love of Christ.

I once more was reminded of that yesterday, when rounding with the wound care nurse. A young patient, defined as an IV drug abuser with a raging infection, but I saw someone who is so lost, their cause (almost) hopeless. Their gaping wound as a result of drug abuse and infection was no match for the ache, the heart pain of a young addict who had a perfectly functioning body and was riddled with disease, once more due to addiction. As the tears poured down their cheeks, I wanted so badly to hug them; but was reminded of the need to remain professional, showing neither sympathy or judgement; just the facts, Jack. But there is no way on the planet that I will ever be able to remain that impartial, and so I silently prayed for the patient. I love secretly praying for people.

Another patient was recovering from their ostomy surgery. The wife was learning how to change the ostomy dressing and bag, and I commended both the patient and his wife on their willingness to learn, taking this life change in such stride. The wife shrugged, stating "What else can you do?"and I nearly had one of those blasted break down moments, wondering who would care for me if I was sick, if I needed an ostomy, or had a life changing event. Yeah, yeah, that's what your parents and sisters are for I hear you saying. But nothing [yet] has erased that deep void in my hear to have someone by my side in sickness and in health.

Sometimes it feels like I give so much of myself but receive so little in return. And this isn't about pity, or wanting recognition. Nursing life is hard work. It requires selflessness, but sometimes I wonder if I'm getting too prideful, as I recognize how "selfless" I am, yet still wish for more.

Semester Three, Week Eleven

Oh, that rumor mill.

So, remember when I inadvertently walked in on my instructors "discussing" (to put it politely) my class last week? Well. I made the error of telling two (2) people.

When I walked into my classroom Monday morning, people were talking about the event as if they had actually been there. Also, the story had been changed that our instructors hate our class and say we're stupid.

This exploded into threats of talking to the dean, people actually going to the assistant program director, demands for action via facebook, and a general poor attitude. The instructors are acting differently around me. At least, I perceive that as such.

My stupid mouth...

I thought my vision was slowly fading recently. Being concerned, I scheduled an appointment with an eye doctor. He told me my eyes are overly strained from all the dang studying I've been doing, and need "computer" glasses. (Whatever those are.)

My cardiac exam on Monday went exceedingly well; with extra credit, I received a 92%. Thank you, God.

I had a patient ask me if I was married. I replied "No" but that I pray for a spouse. She told me to pray to the Virgin Mary, and I wanted to cry, not because of any affiliation with the Catholic belief system, but because I have prayed, so much and so often for a spouse, and it yields no returns.

Visited the cath lab on Friday; it was really neat, even if I had no idea what I was looking at most of the time. I saw a stent placed, and watched as the right coronary artery went from being 95% occluded to wide open, thanks to a well-placed stent. Cardiologists and interventionalists are amazing. They make this process of stent placing look so easy, when most assuredly, it is not.

Now back in the day, when I was a newbie to medicine, I participated in a voluntary internship to gain some medical experience. I recalled visiting a cath lab all those years ago, and thankfully, I blogged about it. Re-visiting who I was once is pretty comical. Take a peek here.

I was naive in the ways of the world, and I sometimes wonder if I'll look back on this blog and chuckle at my naive self, again. Perspective.

I feel, sometimes, like the more I know, the less I understand. I also feel that nursing school is the best of times and worst of times. It's complex, really. One minute, I'm flying, the next I'm doubting my self-abilities. But I'm working my butt off for this. It's rewarding, challenging, joyful, and stressful. And it's worth it.

Five more weeks. Four, if you exclude the Thanksgiving break. I hope, I pray I complete this semester successfully. It most certainly is the most difficult of them all, to date. So much busy-work on any given week, that you can't really catch up. I wrote a three page paper on nothing. It was defining PICOT. Any paper that requires one to define an acronym is just about pointless. But I digress.

Five (four) more weeks.

Semester Three, Week Ten

No surprise, I didn't do very well on this weeks exam. (I've noticed a pattern; one week I'm rocking nursing school, the next I'm failing. Odd.)

I went to speak to my instructor about my grade (seeking clarification) and entered the nursing faculty suite, where all students are welcome, as instructors have an open door policy.

Searching for one of my two instructors, I heard something most disappointing: My instructors were dissing my cohort. I stood there, uncertain, as they mocked us, and then I found my instructors office.

I asked to see my exam, and as she went to retrieve it, the mockery continued. Apparently, we're not a very bright group, and don't even try that hard when we have group exams together (Untruthful, but hey.)

My instructor informed the lively group of the presence of a student, so they closed the office door to continue the gossip session, but really, the damage was done. I heard it. I'll never view them the same again. Ugh. Disappointing. Where's the professionalism they preach 24/7?!

I had a really good clinical week. My two patients were absolutely wonderful. I not only learned a ton, but felt like I was really understanding what it means to be a nurse. I helped the PICC nurse while she placed a PICC, and then the next day had the opportunity to go to interventional radiology for re-insertion of said line. It almost makes the hours of prep work worth it. ;)

Monday's upcoming cardiac exam is reportedly insanely difficult. I don't know why, but I have a peace about it. I've been talking to God a lot lately about school and my potential failure. Please know I do not want to fail, but should that be the case, I guess....I guess that means that there are other plans that I have yet to know about, and I will try, try again (But please don't let that be the case.)

I've been studying harder for this exam than all the other ones and finally fully understand the blood flow of the heart and the location of the major coronary arteries. I could discuss CAD, ACS, MI, UA, NSTEMI's and STEMI's at length....but who wants to hear that except for those who are working their butts off to comprehend this material.

I've been thinking a lot lately that my Creator, the One who created the heart can certainly assist me in understanding His perfect, magnificent creation. The heart is so amazing; more than we know, and I trust that the Lord will see fit to enable me with the knowledge I need to know.

I don't know what the future holds, but I know Who holds the future.

Semester Three, Week Nine

Good golly it's been a different kind of week.

For one, my baby dog has made a miraculous recovery. Thank You, Lord.

Two, I had some friends visiting, and wouldn't you know, I've realized; I really wish I had a family of my own. I wonder what it would be like to have someone love me. It gets lonely sometimes. Sometimes? Often.

Three, I finally realized that I was fulfilling the definition of insanity in my own life with a friend...doing the same thing over and over again expecting different results. I'm creating boundaries. Or working on them.

Had my first med-surg exam this week. I passed, not even sure how, apart from the grace of God because I hadn't really been able to study at all. Hoping this is an upward change.

Took a pharmacology quiz; 98%. Go figure. I thought I had failed it, based off of the obligatory "What did you get for _____" questions classmates are prone to ask post examination.

I have something sad to admit: I don't think I like my clinicals. The facility is great. The floor is okay. There's just not enough for me to do, and even with assigned two patients, I feel as if I am doing nothing. That is not to say that this clinical rotation is an easy one. My clinical instructor keeps us busy with prep-work, extra assignments such as teaching, charting up the wazoo (I suck at it, and it's frustrating me). It's just that after all is said and done, I'm left staring at the charting system, and wandering the unit, checking on my patients who clearly don't need my help.

A typical day: Pre-conference for one hour. It is here that we take a short exam on NCLEX questions. Then one of us teaches the rest of the group (One topic "nursey nursey" the second "clinical.") Handouts are required, so as not to half-ass the assignment and wing it.

After that comes a discussion of sorts, perhaps an ethical dilemma, problems within the health care system, what happens with medication errors, communication breakdown.

We then head up to our assigned unit where the day shift students are wrapping up their day. I'm envious. They hand off report, and wouldn't you know; the last two weeks I've been there, the assigned patients I've had have gone home, which means the hours of prep work I did was for naught.

Anyway.

Greeting patients, assessments, vitals comes next. Then charting in a system no one taught me how to use.

As the day progresses, we need to document input and output, meal intake, safety checks every two hours, evening vitals, making notes on our clinical paperwork....it's not very interesting. I personally am not challenged (with the exception of the dang charting).

And at long last, close to 11 pm nightly, we have our post conference where we discuss our "high" and "low" of the day and then, at long last, call it a night.

I want to enjoy it, I do. I just feel as if I don't quite fit in.

Maybe next week will be better. (Or the next two months of clinicals. Ugh)

Semester Three, Week Eight

I was right and wrong about my dog having a GI issue. Right, in the fact that she does have a GI related problem. Wrong in that what she has likely will kill her. She was diagnosed with pancreatitis last Sunday, and despite a slew of medical intervention has made little progress.

Losing my dog will be more than a grieving process; it will simply break my heart, halting normal every day function, ability to live happily for awhile.

I know. It's just a dog. She's more than a dog to me. She was my first and only dog. My constant companion. The one who slept in my bed with me for 10+ years until she got too old and decided to sleep elsewhere. She is my first canine love; the one who has been a faithful friend. From filtering out guys who were not good for me (she always knew, and let me know with a small growl) to providing me hours of joy, love, and learning, she's become such a part of my life, my heart, that losing her will simply not be okay.

This week was a difficult one. Class Monday-Tuesday, lab Wednesday, clinicals Thursday-Friday.

I couldn't pay attention in lecture. Not with my dog tanking, and concerned SOS messages from my mom who has been gracious enough to care for my girl while in school.

I drove nearly 600 miles this week, back and forth from my parent's home to class/clinicals, in an effort to provide some supportive care to my dog.

I left early Tuesday, missing my pharmacology lecture, but a few wonderful classmates really stepped up and recorded lecture and supplied the materials that were handed out in class. I received concerned text messages and encouragement, and felt thankful, so thankful that I have support.

The tears have been numerous, too many to count, and if this is possible (a fact I have yet to prove but believe) I think I dehydrated myself with all my tears and had subsequent increased thirst.

Studying was difficult. In between the three hours total of driving each day, and the complications that come with having a dying dog, school certainly took a back burner, despite my best efforts. I can't focus in ABG's when my dog is hyperventilating. I can't concentrate on fluid and electrolyte imbalances when my dog won't eat or drink.

I don't know if I'll enjoy my clinical site. It was okay, the last two days. Critically ill patients, but I have the evening shift, and not a lot is happening at night. I'm comfortable in the patient setting, doing assessments and what not, but like I said, focus is limited, and presently, I just can't conjure up the emotions to care about much of anything, save my dog and the impending heartache.

I have two exams next week, and I am somewhat concerned about passing them. I recognize that this may be an uphill battle for some time, and I'm hoping for lack of emotion, concentration, and determination to kick in at some point.

And, as if to make matters a bit worse, I had my thyroid checked (you know; the one that always causes me trouble?) and my TSH is almost 0. Yes, 0. The range starts at .4. No wonder I'm losing it.

Semester Three, Week Seven

Two exams.

One clinical calculations quiz (you know, the one that requires 100%; the one I almost had a coronary over just a little while ago when I failed it?)

First, some serious prayer happened this week, and may I just say that it really worked?

Psych final: 90%
Second pharm exam (remember; I failed the first one): 92%

Aaaaaand, clinical calculations quiz, oh, just A 100% ON THE FIRST ATTEMPT.

In fact, with that clinical calculations quiz, I flew through it, despite the advanced IV calculations. I was like "no problem". I re-checked my answers (despite knowing, internally, I had done it; the answers were correct).

That didn't stop my anxiety as I approached my instructor to grade the quiz (real time grading is awesome) and as she went down my ten answers, green marker in hand, page one, page two, she tells me I passed. I PASSED!!!!!!!!!!!!!!!!!!!!!!!!

Euphoria.

It truly was a phenomenal week. I followed some suggestions by my pharmacist friend to cut back on caffeine and sugar, and then of course, turned to prayer, and hey, here we are.

It's weeks like this that make me feel (once more) that I can do this.

My perception of this semester and my nursing goals are bi-polar; I get it.

Began Advanced Concepts of Med-Surg (fancy, right?) this week, and while the content was absolutely disenchanting, (think: fluids, electrolytes, dehydration, hypovolemia, fluid volume excess, fluid volume deficit, interpreting lab data, anemia, and shock) it feels......manageable, even if I can't tell you the differences between hypocalcemia and hypernatremia (actually; I could tell you a few things, but that's besides the point.)

And, a bit of a medical crisis hit me today; my dog, beloved, beloved girl has fallen ill. She's diabetic and today has not eaten in 24 hours nor drank in 6+ hours. Vomited twice, restless, and uncomfortable. My parents, whom I am staying with this weekend turn to me for medical expertise. All my years working in the veterinary setting prepared me somewhat, but the panic of losing my girl attempted to wiggle its way in.

I attempted to think like a nurse, even giving her veterinarian a comprehensive history and current status report. But, naturally, it was up to me to determine the course of action. Bring her in, observe her, pick up antibiotics for a possible infection, shot for nausea, and so on.

The nursing process assisted in my decision (Assessment, Diagnosis, Planning, Implementation, Evaluation) and I opted to pick up an antiemetic and monitor her.

Here comes the painful waiting stage; was I correct in my assessment? It's difficult, I'm learning, and I know this will transpire even once I'm a nurse dealing with sick humans. Did I do the right thing? Is my assessment, my findings correct? Have I missed something vital?

And so, the waiting game goes.

Semester Three, Week Six

I almost drowned this summer.

I remember bobbing along in the wave pool, both my legs having an untimely muscle spasm, while I was rendered helpless.

All I could do was float, hold my breath as the waves sucked me under and replenish my oxygen supply when I graced the surface before being pulled under again.

I remember having no fear, knowing the situation was precarious, dangerous, life-threatening.

I remember grasping on to the hooks on the side of the pool but being swept away by the waves with each attempt.

That's what this semester is like for me, I've finally realized.

I'm drowning.

I failed my psych exam this week. The content on substance abuse got me good.

But I still have hope: I have an 85% in the class, and all that's left is a final.

The exam was like the tidal wave; I think "I got this" when really, I'm powerless to the current underneath me, sweeping me away.

Next week is anxiety provoking: Psych final, Pharm test #2, begin med-surg, and another clinical exam coming my way.

I can do the math. I swear up and down that I can. I've been practicing problems. I know what I'm doing, and yet this week, the anxiety of my future was momentarily overpowering.

I was studying pharmacology and simply overwhelmed by the content. Adrenergic? Cholinergic? Sympathomimetic? What. The. Heck.

I almost took an over the counter anxiety reducer (who knows what it would do)
I almost took a shot of alcohol (I don't really drink, but I rationed; maybe it'll help)

My heart was racing, my stomach was sinking, my thoughts were rampant. Am I losing my mind or what?

It's the drowning sensation.

I realized the only thing I wasn't doing, and the only thing that would help was to lie in surrender to my Maker. To pray Scripture out loud. To surround myself with the One who knows me, who created me, who has not given me a Spirit of fear, but a spirit of power, love, and self-discipline.

It was eye-opening, humbling.

This battle isn't mine. I just think it is, act like it is. This battle is the Lord's. If He wants me to become a nurse, in His timing, I won't be, can't be stopped. It's His will, after all.

Naturally, surrendering is challenging. But I find my life when I lay it down.

Why, oh why, can't I remember this with every breath that I am?

~

I finished my psych rotation today. Termination, as they say, is hard. This rotation, though, taught me about mental health, and mental illness. I'm really sad for the milieu I leave behind, knowing that for them, their lives are (for the most part) going to be a continuous battle.

One client I connected well with, (we'll call him John) taught me that just because you have a mental illness, it's not what defines you. It's not what makes you. It's a part of who you are, but it's not your definition. John and I spoke today about being sensitive, and what that really means. He said it's actually being "connected" and I liked that, one, because I've been called sensitive my whole life, and two, it was practical.

John has great ambitions for life, and I wish I could follow his story in the months and years to come. But, I can't. So, just like the residents I "left behind" during my first semester, so too, are the clients I leave behind at the mental health hospital.

I hope to never forget what the milieu was like; the clients talking to themselves, getting irate over their meals, having hallucinations, security needing to be called on a daily basis. The 9 am meetings, where the clients rated their overall well-being on a scale of 1-10. The stretching led by clients that often involved very little stretching, but did include random body movements. Their coffee break; watery coffee served in small Styrofoam cups. Shadowing a physician as he held individual meetings with the clients, and taught me therapeutic communication, reading lab work, and deciphering fact from fiction. Group therapy, where hallucinations and interruptions abounded, and hours of conversations held at the small round table in the corner of the milieu.

It was an experience that expanded and stretched me, as a student nurse, but more than that, as a human being.  

I liked mental health nursing a lot more than I thought I would, and I think I'll miss it, too.

Mental health is a continuum, as they say.

Semester Three, Week Five

I had a better outlook on life this week.

For one, my test score for pharmacology was adjusted, so I passed. Barely now, but I passed.

Pre-adjustment, I met with my instructor who asked me what happened, because I "bombed" the exam. and not only that, I was the only one who failed.

I had a lot of company over this week, and it was fun, but exhausting.

Another exam in psych came and went. I passed, with a B. It's okay; class average was 78% (a C), so whatever I can take grade wise, I will grasp.

Somehow, I adjusted to clinicals, and while I don't feel totally safe on my locked unit, I feel semi-comfortable. There are so many mentally ill clients, and at the block party held for said clients, my heart broke a little. Watching these individuals who are held captive by their illness getting food, shuffling, some looking semi out of it, others looking trapped, scared, miserable. Granted, there were still some clients who had the time of their life at this party, but my heart hurt knowing that there were so many individuals present who are locked in their minds.

I've connected with one client, and most of the time they seem so "normal" that I forget that they are hospitalized, that they have a documented mental illness, that they have a long battle ahead of them. What separates "us" from "them"? What happens in their minds?

I had a glimpse today of my future. (Or at least what I want my future to look like.)

I was at work and was encouraged to go to the ER on a trauma alert.

I asked the attending physician if he felt comfortable with me observing. Waiting for the ambulance to arrive, the old feelings of years past resurfaced; the nervous anticipation, the sheer thrill of being present in an ER; a time of reflection of how far I've come in the years since I was a baby EMT with no experience and a false confidence in an effort to make an impact.

The patient presented; I observed. Generalized trauma from an accident. Observing EMS, the physician and nurses once more confirmed: this is what I want. This is who I want to be.

The thrill of being in nursing school *this close* to obtaining my dreams, being in this field that has truly changed my life, reflecting on personal growth, taking in the sights, and sounds.

Nursing is my dream, my goal. I am honored to be called to this profession, honored to serve and treat people.

Praying for progress.

Semester Three, Week Four

A year ago, I was in the throes of heartache. A relationship with someone I could have very well fallen in love with had ended a few months prior, and I am anything but quick to get over someone. I've been reflecting on how vastly different this school year is than last, and even this week, I've had a wonderful house-guest; the sister of the man I once thought I loved. This wouldn't have been fathomable or even feasible 365 days ago, and I'm so grateful for healing hearts and for time that truly does heal all wounds; just not always in the way we anticipate or hope for.

~

Anyway. This week sucked. I mean, I flat out hated it.

I failed my first pharmacology exam at a 76%. Passing is 77%.

Awesome.

I don't know what happened. For one, I got panicky with the damned math questions (I think I got them though) but I was way too nervous, and blanked. I literally knew nothing.

I feel like I am losing it this semester. Test wise, the anxiety I fought for years to overcome is coming back, and my fingers literally get numb now on exams, I can't breathe, can't think, my stomach sinks, and I lose all hope.

All. Hope.

It's bad. The worst I've ever experienced.

I wrote to my instructor asking to meet with her.

Her response:
"We can meet prior to class Monday or after class, if either of those times work for you. I would like to speak to you to see where you had issues, as this test was mostly a review of previous content, and you had a note card. I would like to know your thoughts regarding your grade and where you had difficulty."

Awesome, again. I am feeling like a winner. Not only did I fail, I failed the easiest test of all time.

I feel like a freaking idiot.

When I went to get the oil changed on my car the day after my fail, I almost began crying to the mechanic when he asked how I'm doing. Same when a kind woman in a bookstore inquired; I was rubbing my eyes furiously, willing the tears away so that my already diminished self-image would not be further beaten down.

Then I had my first round of psych clinicals. We've all seen movies where a psychiatric hospital is depicted. May I just say from personal experience, the movies are accurate.

I kept feeling like I was dreaming, walking the halls of this psychiatric hospital, seemingly out of place, heading to my destination where there is no escape.

I wish I could document more on what my clinical experience is like. It's challenging; dealing with the mentally ill when I can't comprehend what they truly are experiencing. Hallucinations, you say? All I know is mental health is on a continuum, and supposedly we all are just one break away from "snapping" if you will and having our own mental health crisis.

I have this fear that I'm going to be attacked or killed. These clients walk around their milieu, and who is to say that their command hallucinations aren't going to command them to kill me? I'm just saying. I guess I don't feel safe, but have to pretend that I'm totally at ease with clients threatening to lose it and demonstrating signs of deescalation.

A shout out to those who work in the mental health profession. It takes a level of dedication and patience most do not have.

Nursing school is a journey, and right now, while I am not thankful for it, but am dreadfully hoping and praying that I pass, I recognize, too, this is a time to cherish, because one day, I won't be a student. And I'll bet you anything, when I've worked my umpteenth twelve hour shift, I'll be looking back fondly(ish) at these days and wishing I could do it all over again. Ish.

Semester Three, Week Three

Another week down.

Of course, I only had actual class one day, but still, there was plenty to be done outside the classroom.

We had exam two on Tuesday, and it was a real doozy. Even my instructor announced that this one was a higher-level application kind of test. Awesome.

After the test, we have the opportunity to re-take the exam within a learning group (a group of my peers) and open-book the exam, together. We have an opportunity to earn three extra points. So weird.

My group got along really well the first time we had test review but this time there was a lot of friendly arguing, so I checked out. You could call that derealizing, if you wanted ;)

Exam scores were released when I was on a long walk with a classmate; by the grace of God, I earned another A.

Lecture on bi-polar, depression, and other affective disorders, but for some reason, my mind wasn't really there, so I took a lot of notes without comprehension.

Wednesday brought about a visit to an AA meeting. First, it was in a scary ghetto-like part of the area, where my classmate and I thought we were going to be killed. Second, AA meetings are a bit like I expected them to be. "My name is _____ and I'm an alcoholic." These fine people shared their stories and years of sobriety. It was in fact, impressive.

Wednesday continued on with more of the blasted pharmacology project, and ended nicely with an unexpected dinner invite from friends.

Thursday, I stepped away from the student role and met with a dear childhood friend of mine. She has cancer, but she's more than "just" a cancer patient. Nursing school has taught me to recognize that patients, whatever they are hospitalized for are not "The guy in 234 with diabetes" or "The old lady with dementia" patients are, in fact, people.

So, as I was spending time with my friend, a brief reminder of the drama I was encountering last week re-surfaced, and I recognized that sometimes, life is going to be painful. People will hurt you. My responsibility is to live as a Christ-bearer and maintaining peace, so long as it depends on me. Other's actions are their responsibility; they own it.

Seeing that, I chose to dance my troubles away with three little girls who have stolen my heart.

Next week, we have ourselves the start of mental-health clinicals!

Semester Three, Week Two

My worst nursing school fears realized: I couldn't do the math.

It was about 3:00 in the afternoon. I received my re-do exam, only having to complete two problems.

Two.

First one, easy.

Second one. I couldn't get it.

My heart, already racing, raced more. My fingertips became numb. My thoughts scattered. My hands began to shake. My thoughts were irrational, all over the place, nonsensical. I do know, repeatedly, I heard the words "This is it. You're done. You're not progressing."

My hands shaking so badly, I couldn't compute with the calculator. Finally, I arrived at an answer. I submitted my test. My instructor marked it wrong. I back-peddled, tried to explain myself. She re-wrote the problem, re-wording it. My hands continued to shake. My mind blanked.

I couldn't get it.

She tried again. Told me to breathe. Nothing.

Over, and over, extending patience.

I can't describe the anxiety; feeling, knowing this was my last call. There were no second chances. My instructor guided me. And then, after too much fumbling, I got the answer. I feel like a screw up. She passed me, telling me I have to get tutoring.

I know this. I know math. I worked too hard for this. How can it be? How can this be? What the heck happened? Hours after the catastrophe, I figured out the problem. It was ridiculously simple. I had just psyched myself out, acting out on what I've been afraid of for years.

Mental health is making me mental.

There's a project for advanced pharmacology (I like saying advanced; I sound like a genius, ha!) that a partner and I have to work on. It is going to be killer. This assignment is the worst one to date thus far. Hideous. Abysmal.

I've been taking some time to reflect upon my life in the last two weeks of this semester. Introspection is valuable, and as much as I don't want to make this blog about my personal life, I think this is worth writing.

I saw a picture this week of 15 people. I knew everyone in the photo, some better than others. Of the 15 people, I counted: I've burned bridges with 7 of them.  Seven. 

I've had a lot of personal growth in the last three years, but I hate looking back and seeing who I was. It doesn't matter how much I've changed, repented, turned away from the old me. The damage is done, and that's what eats away at me, daily.

Anyway, I'm in a situation currently that is begging me to burn some bridges, and it's eating away at me. I'm trying to remind myself that who I was is not who I am today. I don't need to burn bridges, even if it seems most logical. Even if I have to fight myself.

That's all. I had to get it off my chest. Now resumes Sarah, nursing student, whose main goal in life is not to fail nursing school.

Til next week. There's another psych exam.

Semester Three, Week One

I am an emotional masterpiece. Or wreck. Or whatever you want to call it. Or, perhaps in mental health terms, I am labile. Whatever it is, I am a ball of mania.

This week was emotionally, cognitively, and physically taxing. For one, I failed my clinical math exam. Yeah, that's the one that you have to get a 100% on, or you're done. I made a stupid error on two problems, miscalculating the dose. I have one more try on Monday. I have not come so close to losing it as I did on Wednesday. I feel like I can correct my error(s) and progress, but a little part of me doubts this.

I progressed on. My instructor would refer to this as utilizing my coping skills in reference to the crisis I was facing.

I have felt all week like I am going to fail. Fail mental health. Fail math. Fail nursing school. I was imagining what life would be like, failing. How I'd tell friends, family, co-workers, the random people who know how desperately hard I am attempting to complete and pursue my dream of becoming a registered nurse.

But I got to tell you, God spoke to me twice this week. Great, you think. She's making it spiritual.

Hear me out.

For one, on Wednesday night, in the throes of full-blown panic and anxiety regarding my impending first exam, I was invited to a Bible study. I replied to the invite that I couldn't; heck, I had a test to study for and that was clearly the priority.

And then, in a whisper, God asked me:
"Who's your Master?"

Well then, the choice was clear, and I attended and left feeling slightly refreshed and having things in better perspective. It didn't totally stop my mania, but it sure helped.

And so, I studied in the days to follow. And studied. And studied.

(P.S. My new living arrangements are beyond fantastic.)

Last night and this morning, the old fears came back in force, and I felt like the end of my nursing school career was coming to a rapid end. I imagined an impossible exam, unable to process higher application questions, slugging through, and failing.

I studied this morning before the test, which is uncharacteristic of me, but the pressure was real, it was on, and I had to give this my best effort.

So, I was freaking out, stopped studying because I had to be realistic; I either knew the information or I didn't. No other way around it. There I was, in a secluded area of school, and I spent a moment with God. I was panicking. My anxiety was palpable.

And there, in the calm, and in the quiet, I heard the Holy Spirit whisper, like a passing wind, "I am with you." In in that fleeting moment, there was peace.

I took the exam, nervous, shaky. I didn't know the first answer. The second was dicey. And then, it started rolling together, smoothly, and the fear became replaced with confidence and I submitted my exam.

Class policy allows us to then re-take the exam with our peers, in pre-formed groups, open book, open note. When our group went over the exam, I saw that I had missed only 5 or 6. And, so long as you have independently passed with a 77%, taking the group exam allows for three extra points to be added on to your grade.

Class average: 79%
My grade: 93%

It is here in the calm, the quiet that I have yet to find a way to release my anxiety. I still feel tense inside. So nervous I could puke. Optimistic. Cautious. Aware that this is only the beginning.

Progression.

Semester Three--It Begins

I'm one day away from beginning third semester.

I graduate in May 2016.

It's been a busy summer; I completed two online courses to progress in pursuing my BSN, and thankfully earned A's. I also had a "medical" summer with a definitive diagnosis and treatment of the knee problems I bemoaned over all last year. Turned out to be a simple tracking issue, and after three hefty injections under my knee cap, I am more or less cured.

I also had my wisdom teeth out, which turned out to be the medical disaster of 2015, with dry socket and infection.

I briefly dated someone, but that ended nearly as soon as it began once I realized how incompatible we truly were. It still sucks, though. Break ups always do.

I worked full-time on a med-surg unit and am really incredibly grateful for such a wonderful, challenging, educational experience.

At academic advising on Thursday, my advisor told me this is reportedly the most difficult semester yet. Upon inquiry, I was told that more is expected from a third semester student, knowledge is to be already a given (ie: they're not teaching you what you should already know) and my skill set is taken up a notch with more acute care.

The first eight-ish weeks of the semester are mental health, a course in which I have absolutely no background in, There's also advanced pharmacology and then later on, in October, advanced concepts of med-surg.

Initial thoughts are a) fear of failure b) fear of the unknown. I go through this every semester, and thus far, I've successfully convinced myself all throughout that I am going to fail. There's no other way to look at it. I am the future Miss Nursing School Failure. (Have I mentioned that I'm neurotic?)

Clearly, my trust in God is lacking, because even though He's brought me this far, I doubt He'll continue on in His faithfulness. (Awesome).

I received multiple grants and scholarships, so it looks like I'll be graduating with no debt, which is fantastic.

I'll be house sitting for third semester for $200 a month (another answered prayer) and hopefully having an abundance of time to devote to my studies.

I cannot exactly anticipate what this semester holds. I'm just ready to jump in and (hopefully) pass.

Off we go.

Semester Two, Week Sixteen (Aka: The End)

I have completed my first year.

What inspiring words can I write? (None)

I've enjoyed the last nine months. It has been a tremendous amount of work, and required a lot of me, but I wouldn't trade it for anything.

I truly have given nursing school 100%, and am continually committed to graduating, and being a nurse who knows her stuff, and has compassion, integrity, strength, skill, and knowledge.

In the two days that I have officially been on summer break, I have come to realize how much better I feel without the pressure to study 24/7.

I've made some lasting friendships, have been offered a full-time position on a med-surg floor, I'm taking two summer courses, including one to officially begin my BSN.

I'm a better person now. I think more clearly, feel confident, feel smart, and the small stuff just doesn't phase me anymore. I'm half-way to becoming a nurse, and anticipate that the best is yet to come.

Monday, after my final, I joined my friend who is part of a medical group for pre-med and medical students. She graciously taught me how to suture (it's not as easy as it looks) and then these two Italian doctor's here on their residency asked if they could join us. They then proceeded to practice their anterior approach spinal surgery technique. I felt, in that moment, like this is it. I'm going to make it. I love the medical field, and the opportunities to learn that have been presented to me are innumerable and unforgettable.

I occasionally get glimpses into my future, and this is it; this is what I want. My relationship with Jesus will always come first, but He has made it know that this is where He wants me, and I am so content to be in the center of His will.

It is a beautiful thing.

Semester Two, Week Fifteen

I found myself in a new form of hell this week.

At clinicals, the nurse I was following gave me an electronic fetal monitor strip and told me I'd be responsible for charting for this patient.

Now, you may think; eh, that doesn't sound so bad. But it was. It is. EFM is laborious, tedious, and mind numbing. Plus, I'm not going to be a labor and delivery nurse so why on the planet was I assigned to this task?!

An example: (from google, not from my clinical site, in case you were wondering)

Looks like a lot of squiggly lines, right? Well, for one, I can tell you that this baby is in fetal distress due to the variable decelerations, and the momma is having pretty frequent contractions. Thankfully, I also see some accelerations, but we've got to get this baby out, and soon.

My butt was kicked this week. It was truly a horrible week to be alive, and each day brought on a new, dreaded problem. Family issues on top of school issues, on top of psychotic roommate issues makes for one exhausted nursing student.

I had to take Monday off to be a witness in court, and that was a cluster you-know-what. Emotionally drained from that, I returned on Tuesday, took an exam in the afternoon (yuck), and tried to keep my chin up while simultaneously blinking back tears all dang day. Wednesday was EFM hell, a fetal demise (horrible), and I was scolded by my nurse because I was observing too much, and not helping enough. I'm sorry; I thought that holding a laboring mother while an epidural was placed, then placing a Foley, removing a Foley, obtaining vitals and holding mom's legs back while she was in active labor was participating.

Thursday was exhausting with finishing up clinicals and just when I thought I could power through the rest of the day, I attended my weekly Bible study only to realize it was a huge mistake and literally ran out the door to avoid exploding. <--- That didn't go over well.

I have assignments to complete today and my final pediatric clinical tomorrow.

I'm exhausted.

Semester Two, Week Fourteen

OB clinicals transpired this week. I was fortunate to witness a c-section and vaginal birth. While some folks determine after this experience that they never want to have children, I truly was stunned at the endurance of the human body, the struggle it is to come in to this world, and the fact that any of us make it here alive.

I also was able to cut the umbilical cord, and it was a fantastic moment, as I tend to live in the future, wondering if my cut has anything to do with if they'll be an "innie" or an "outie" (I don't think so, but hey), and if I'll ever see this child again at the some point in the future.

Day one was fantastic; I was paired with a knowledgeable nurse who took the time to explain the science behind labor and delivery. We poured over fetal heart strips, and I left feeling like I am one kick-butt nursing student. Day two, not so much. My assigned nurse wasn't interested in me, wouldn't let me do a thing, not even take vitals on mom, and so I left that unit discouraged. I did however witness a circumcision, and once more left with the thought that it really wasn't that bad. Maybe the baby was just exceptionally brave/non-reactive to pain.

Do I have baby fever? No. I'm just here for the ride, enjoying the last few weeks of nursing school, shocked and stunned that I am coasting into my final week and two days before I have conquered year one. There's much to do in the meantime, and with some perseverance, I'll make it through this next (crazy) week with few bumps.

Semester Two, Week Thirteen

Another week complete.

Phew.

Learned about heart defects this week in the pediatric patient.

We also discussed end of life care in a child, which was plain awful, especially in light that a young man from my hometown had killed himself that very day.

A dark week indeed.

I try to find hope in the midst of sorrow, but suicide gets to me. Kids shouldn't kill themselves. It wraps itself around my thoughts, my heart. I grieve for the loss of a life, and wish the clock could be turned back; I wish his life had been saved. I have trouble concentrating, knowing that many are hurting and there is nothing that I can do to help.

I remember when it felt like my world was ending. In comparison to others very real struggles, mine now seems but a dent on the surface.

I remember telling a handful of people, those I trusted what was going on, explaining the darkness of my soul, the hopelessness, the fear, the hurt.

I've learned that in crisis there are those who partner alongside you because they want the gruesome details, they want to know the story, and they'll touch base, making sure you're okay, but as time progresses, they stop. Is it because they stop caring? Never cared to begin with?  The calls, the texts, words of encouragement fade, even when you reach out to say "hey, I'm still drowning", you're no longer headline news. You don't matter. I've done this before. I too am guilty.

So, you learn to move on, keep it internal, progress with a smile and pretend like you're doing amazingly well, even if you're caving apart on the inside, screaming for a helping hand.

Granted, there are a few that I will remain indebted to for the years to come; the ones who stuck by your side and saw your tears, frustration, emotion and stood by you. I've learned that no matter how little I perceive a crisis, to that person, it very well may be gut wrenching and world ending, and people need to be comforted, lest they lose that glimmer of hope and end it.

Academically, I am still progressing. The final weeks of the semester are difficult, and for the first time in months, I took the evening off from studying on Monday, and went out. It was so incredibly delightful, there's no way to accurately describe it.

But the next day came sadness, and this week has had a dark cloud over it.

Monday, May 4th, I have to miss a mandatory presentation to my class, and an exam, because I've been subpoenaed to be a witness in the state case against my parents. Sometimes, I look at these stressors, and I thank God that my grades aren't tanking, because how exactly does one concentrate well on what a tetralogy of fallot really is, while being consumed with attorney meetings, impending testimony, planning on what to say, worried you'll botch it and send your parents to prison for something they didn't do...? God's grace. That is all.

OB clinicals begin next week. I just need to get through 48 hours of OB clinicals. As previously stated, this is not a course of study that I fancy, but it's a means to an end, so I am studying as often and as much as I can. It's working.

A young child came in to work today to visit their mother, and while it was evident they had croup, they also mentioned the child has not urinated much in the past 24 hours. My first thoughts? 1) check the fontanel for sunkiness, and 2) how much should she be urinating? Well my friend, the answer is 2 ml/kg/hour.

Nursing school is wonderful.

Semester Two, Week Twelve

"Do I need to write you a doctor's note for fear of success so you don't have to take your finals?"

This is what a doctor friend of mine asked me today, after I lamented about the trials of nursing school, and what if I fail, and what if, what if, what if.......

It's true, I realized. I cannot see myself as a success. When it comes down to it, I can't see myself as an RN. Or having a BSN. Or working in a nursing capacity.

So, hence the fear of success.

But, I've got three weeks left to the semester, then I'll take seven (!!!) credits this summer, work full-time, and start up second year in the fall.

Did I learn anything this week? Sure, I learned about all the various rashes/viruses that cause them in children (except for scarlet fever; that's a bacterial infection.)

I learned about hydrocephalus, both communicating and non-communicating, meningitis, ICP, and medical emergencies in the child. Did you know if a child is unconscious for any period of time, get them to a doctor ASAP, because it doesn't matter if they were out for 30 seconds or 30 minutes; they present differently with brain bleeds and hydrocephalus than adults.

In obstetrics, we covered post-partum hemorrhages. Sounds pretty dicey, if you ask me. In fact, all of child-birth sounds dicey to me. It's a wonder anyone is born alive.

I'm pretty annoyed with myself today. I had a patient pass out on me today, and I never thought to check her pulse. I merely gave her a sternal rub, tried to rouse her, and nothing. It wasn't until after the RN and doctor arrived that I realized how idiotic I was. You think you're advancing, and then....

:(

Semester Two, Week Eleven

During, and after my first OB/Peds exam on Monday, I was positive, positive that I had failed it. I was down in the dumps handing in my failing exam, but knowing that the knowledge wasn't going to magically re-enter my head at any time. I had no idea what it was called when the to-be-born baby settles into the pelvic inlet. I couldn't begin to tell you what the priority nursing diagnosis would be for a kid with RSV. I mean, there were so many things I didn't know, I couldn't even.

So, I waited, having the same pit-in-the-stomach fear that I had when I bombed my clinical calculations test last semester. I couldn't pay attention during lecture, and I was mentally preparing for what it would be like to repeat this semester in the fall. It was just so sad.

I get text message and email notifications when grades are posted (obsessive, I know, but after Med/Surg one, I couldn't take it anymore, checking to see if grades were up every ten seconds). So, there I was in lecture, and we were watching a YouTube video on epidurals, when I got the text "Your grade for OB/Pes Exam 1 has been updated...."

I never checked an exam score so fast. B. A high B. I freaking passed, much to my serious surprise. I don't even know how that was humanely possible. And yes, I keep my phone next to me during lecture. Not to peruse the internet, but to be apprised of serious situations, ie: my score being posted, and me being one step closer to not failing nursing school this round.

So, OB/Peds is just not for me, I've decided. Which is good, should I ever ponder if a career in maternal or child health is for me. It's definitely not. I am struggling in this class, because it is not keeping me engaged, and I find myself spacing out during lecture, frequently. Granted, I've got some personal issues going on, (but really, who doesn't...)

Part of my clinicals this week was assisting in hearing and vision screening, and it is was with some sadness that I realized: I'm old. I remember back in my teenage years, seeing adults such as myself and thinking that they were way up there age. Now, the teachers and aids are in my age group. I don't know; it just made me a bit sad that here I am in my upper twenties and I'm only in school to be a nurse. It made me feel ancient.

One part that really caught my eye was during my time in the health office. A child came in, with a history of diabetes and was clearly hypoglycemic. The health aid's hands were shaking so bad trying to obtain a blood glucose, that I stepped in, and took the blood sugar, which was alarmingly low. I remember that I used to shake quite badly when performing anything medical on patients, but for some reason with the start of nursing school, this has not (yet) happened to me. It's quite nice. Once more, I felt like I accomplished something today. A small intervention, but it's little glimpses of what I want my future to look like that make this seem worth it.

Four more weeks.
:)

Semester Two, Week Ten

Spring break was interesting.

I had my thyroid checked, and now I'm back to being hyperthyroid. Seriously, this thyroid gland of mine has not been under control since last summer.

Also, I mentioned to my doctor that I have intermittent mid-right quadrant abdominal pain. It wasn't that big of a deal to me, as I've been having it since October 2013. But, it was recommended to me that I have an ultrasound, which revealed a "2.8 cm lesion" on my spleen.

It was then recommended that I have a CAT scan. I did, and it revealed absolutely nothing. So, looks like I ingested poisonous oral contrast and IV contrast for naught. My doctor still wants me to see a GI specialist, though.

Sigh.

However, the highlight of my break was getting to see a c-section, a truly amazing, awe-inspiring experience.

It was back to the school grind this week, and I learned a few things, such as pelvis size impacts how easy (or not easy) it is for you to have children. Also, having cystic fibrosis makes it difficult for you to conceive. I learned how to read electronic fetal monitoring. Well, sort of. I can tell you about acceleration and decelerations, but my skill-set thus far is mighty limited.

No clinicals were scheduled for me this week, so I have had all day today to study. It's been great; I feel like I can get ahead. Except for calculating 24 hour fluid volumes and something to do with a physician ordering 1/4 fluids, etc. Why, why must this nonsense be so convoluted and complicated?! Argh.

Additionally, I have decided to take a 6 week online sociology course for my BSN. My gosh, if anyone had told me years ago that I should just do BSN instead of this concurrent program business, I would have listened. Well, maybe not. I used to be quite stubborn in terms of acadamia. Now I'm in concurrent program hell, freaking out about the loans I'll probably (definitely) have to take out, all for the hope that I don't up and fail nursing school.

It's not as bad as I make it sound. It's just work. Hard work.

Semester Two, Week Nine

Spring break comes early for me this week, and I could not be more delighted.

Of course, break isn't really break, as I have a plethora of projects to complete, and new topics to study.

I am not sure yet how I feel about Ob/Peds. We've covered the very basics; assessment of a newborn (babies are belly breathers; did ya know?!) assessment of the new mother, how to palpate the fundus of the uterus post birth (should be midline.) So far, it's okay, but not anything more.

There seems to be an awful lot of amount of work to do. Honestly, I've been given so many assignments and due dates this week, I am going to have to sit down and make (yet another) schedule.

And, it is true: Three members of my class did not make it through to this round. I think that's a total of six people we've lost along this insane nursing school journey.

I don't believe, necessarily that it's a question of intelligence. We got through our pre-requisites, right? And some of those classes, I didn't try my absolute hardest in, (like the time I stupidly decided to take A&P1  and Micro) and still passed. I don't understand.

I am tired. So inexplicably tired. My roommate commented last night that I have dark circles under my eyes and look either exhausted or sick.

Spring break shall have a TSH test in my future.

See ya in two weeks.

Semester Two, Week Eight

On my final evaluation for clinicals this week, my instructor wrote "don't forget where you started."

Thursday afternoon, I went back to where it all began.

I remember thinking years ago how all of this was impossible. When I completed my EMT program in 2009, it filled me with such pride, and yesterday, I ventured back to my old school, where my love of medicine was cultivated.

Where it all began

I ran into my former instructor who, astonishingly, led me into his classroom to introduce me to the current set of students working to obtain their goals. He told them I am proof that it does get better. My heart swelled with pride, as little ol' me was able, actually able, to give bits of wisdom.

Some days, I can't believe that I'm here. I'm in nursing school. I'm doing it. And I love it so much.

I also took a trip to the Starbucks I used to study at, meet my biology tutor at, dream of what it'd be like to be in nursing school at.

It was in this seat, that I dreamed. So, it seemed like an appropriate place to study for my Med/Surg final, which I am plum pleased to say that I passed.

Allow me to say it again:
I PASSED MED/SURG!!!!!!!!!!!!!!!!!!!!!

What a beautiful feeling.

I've heard that three of my cohorts did not pass; were not successful. I can only imagine their heartache tonight. I'll know for sure next week.

Ob/Peds began today, but it was just a lab.

The real coursework begins Monday, where another 7 weeks of fun await me.

Can I do it again? Seriously, can I?

Giving it 100% once more.

:D

Semester Two, Week Seven

My clinicals, while enjoyable haven't exactly been a challenge for me.

Until yesterday, when at long last, I gained the opportunity to place a foley cathether. Having only had the opportunity to practice this skill on mannequins, it was quite the pleasant surprise that the procedure was almost the same.

First catheter down.

I love the idea of becoming a nurse, more and more.

One more week of med-surg. Two exams next week, with the final (the final!!!!!!!!) being held on Friday. Then, the agony of waiting for scores to be posted. You pass, meaning you pass the class, it's the golden ticket to head to Ob/Peds lab. You fail, meaning you fail the course (76% or less), then, bye, better luck next time. I can't imagine having to repeat this course again.

Am I worried? Oh yes. I can imagine bombing the next two exams and dropping my grade down, so that I don't progress on. The devastation would be....devastating.

There's not much to write this week. I have a minor cold, my roommate is driving me nuts, I'm debating taking out loans to begin my BSN (and subsequently freaking out about said loans.) I'm broke, feel exhausted, and need a hug.

Hopefully by next Friday, I'll be here to tell you about Ob/Peds.

Semester Two, Week Six

I assisted a patient this week who was not assigned to me, but needed minor help. After everything was taken care of, I stood there talking to him. He had a fan blowing directly on my face, and some of my loose hairs were swirling around, movie-star style. (I was acutely aware of this.)

And yet, it took me by surprise when he asked me out.

For one, I'm not all that good when someone asks me out, and for two, I've never known how to respond to patient advances.

I flashed back to a scene in the Notebook (lame, I know) when the injured solider asks Allie out. She responds something like "Let's just focus on getting you better" so that is also how I responded. Then I high-tailed it out of the room.

This is medicine sometimes. Awkward moments and patients saying things they really shouldn't say. Handle it with dignity, okay? Head held high, smiles, confidence and never let them see you're about to lose your mind.

Nursing school is making me lose my mind though, I've decided.

Each week, after my exam, no matter how I feel when I turn in the exam (ie: awesome or OMG, I bombed this) I have to wait hours before the exam grades are posted. With each passing minute, my fears worsen (Oh no, what if this is it, what if I failed, what if, what if, what if........) and I can't focus on anything; my heart rate, anxiety, and general peace of mind go out of control. Maybe it is a control issue, but I have pandemonium every single week, which I've realized, isn't a good thing. You can't have that many catecholamines released into your body weekly without some serious repercussion. (Here's what catecholamines are)

I wish I didn't care, but with the class average for each exam going down, and everyone being what my classmate refers to as "frenemies", tension is high, people are cranky, and, we're all as a class slowly losing our minds.

Yesterday, we had class officer elections, and I "ran" for class secretary. I had two other opponents, and the one who wound up getting nominated was someone who joined our class a month ago. I guess that was an eye opening experience that my classmates really don't like me, as a whole.

But, and I am grateful to say, I have a handful of classmates who have become real, true friends, and I am okay with being friends with these girls who are not dramatic, who are kind, realistic, open and honest. I'm lucky with the few that I have to be able to count on them. One of them even invited me and some girls to Mexico for spring break.

Two more weeks of med-surg. Two. I hope to God I can pass the final two exams and make this class a part of distant memory. (Two bad I have to take continuing versions of this class in third and fourth semester....crap.)

Nursing school is kicking my butt, but I still wouldn't trade the experience.

Semester Two, Week Five

Second semester is like this: You're never ahead. There is always a constant influx of topics to study, memorize and master, pre-clinical prep-work, attending and doing well at clinicals, and attending lecture all while finding time to eat (preferably healthy) and sleep. What I formerly considered "busy" is now replaced with the insanity that is second semester. Heaven forbid you fall ill or have any type of situation that causes you to get behind. That happens, and you are royally screwed.

Another thing is, I have no money. I checked my bank account today, and I have approximately $187 in said account. I was supposed to receive a grant for school, and receive a decent refund, but the grant never was processed (Lost check? Who knows; still waiting to find out what happened there.) So, with my scholarships, I received a refund of $3.67. That's enough to get me through the next 11 weeks till the end of the semester, for sure.

I'll admit it, good food is hard to come by these days. I have a fear of becoming overweight while in school due to my a) budget b) access to carbohydrates (they're cheaper than protein!)

I was so hungry at clinicals the other day, I nearly snuck my patients plate of untouched french fries. But, reasoning that that was unethical, I refrained. Hunger is not a fun thing.

Lecture this week consisted of GI, endocrine and diabetes. It was difficult to stay alert during lecture. I am just frequently so exhausted; I think about sleep all day long.

I've increased my studying times, and spend nearly every waking minute doing something school tasked.

Another exam today; my first A for the semester (about time). I think I'm figuring out the critical thinking/NCLEX style of thinking. It's confusing, illogical and weird, but I can no longer reason on my own; it must be done the nursing way, or my grades suffer.

I'm having difficulty gauging where my classmates are, grade wise. I continue hearing rumors that "so-and-so isn't passing" but time will tell in the next few weeks as we approach the end of Med/Surg and begin OB/Peds. I've opted for pediatric clinical rotations first, reasoning I like children and I like the idea of understanding their complex body systems.

It's non-stop insanity over here. Hoping I pass; worried about the next exam. I don't really understand the GI system, nor does it interest me. I have a B in the class presently, so....

Semester Two, Week Four

I woke up Tuesday with my dreaded knee pain. In case you know, or even if you don't know, I have chronic knee pain, which interferes with everything in my life.

A patient commented to me, when she saw me leaning forward to tie my loose shoe "I used to do that too, and then I ruined my back and had to have surgery."

Well, kneeling down is an excruciating option, so I plan my time to remain upright as often as possible, trying to avoid the pain.

I had physical therapy all during Christmas break, but according to my orthopedic doctor, surgery is [likely] in my future.

This week, I was told by my assigned patient that I am a liar, have a non-comforting presence, and am doing everything wrong. It was like the nicer I was, the meaner they got. Each insult they hurled my way hit me like a ton of rocks. There I was trying so hard, and there they were shredding me to pieces. And the thing is, I was doing everything in my power to make sure they were comfortable. It made me realize: nursing is not going to be a cake-walk.

We had a lecturer this week who is not known for their gift of teaching. About half the class left, but what really annoyed me is that some ladies in my class decided to post statuses on Facebook making fun of said lecturer, and uploading photos, detailing how they were skipping class. I find it disrespectful to mock anyone on facebook, or on any other social forum. It just really bugged me.

This week, thanks to all the new knowledge that I have acquired, I have diagnosed myself with a DVT, CAD, and intermittent claudication in association with PVD. I may also mention that I am insane, and am loving all the information that is thrown at me daily.

I was successful in passing my Med/Surg exam today, thank God. A B is fine with me these days; an A would be prime, but I can settle for a B. As long as I pass, I am fine.

I heard once that you can forget about having a life outside of nursing school once second semester begins. I am finding this to be more true with each week that goes by. The time is flying by, I am studying like a maniac, and pretty much have no extra "spare" time. Even while having dinner with a classmate last night, we discussed nursing the entire time. I am blessed to have new-found friends to share this journey with.

Blessed.

Semester Two, Week Three

Last Monday, my roommate had spinal surgery. It was an outpatient procedure, but upon her arrival home, she was in very rough shape. Reporting pain as a 9/10, and persistent nausea and vomiting, I placed a call to the on call PA. Once more, the reality of my budding nursing career hit me as I passed along the information, using medical terminology (yay) ie: vomit instead of "throw-up", and as I described to the PA what her vomit looked like (I could tell they were trying to rule out a GI bleed), I realized: I'm slowly transforming into an RN, without even realizing it. The amount of knowledge that I am learning is incredible. I sound half smart these days.

Classes were interesting if not complex this week, and I found myself especially disheartened over the sexually transmitted infection lecture. The way it sounded, everyone and their uncle has 1+ STI, and there's nothing you can do about it, sorry. I found myself feeling quite concerned for my romantic future, as stupid as that sounds. I don't want an STI, even if it can be "treated" with antibiotics. What a sorry way to end my waiting game.

The nurses at my clinical site unfortunately do not like my student group, though I can take a gander as to why. I've got one classmate who is hopelessly lost in the nursing process and doesn't quite seem to understand boundaries. I came upon the nurses talking about our group recently, and they stated they "can't get anything done" because of us. When they noticed I had overheard this bit of information, it was stated "You weren't supposed to hear that" to which I retorted "Well, I sure appreciate everything you're doing for us."

I try. I'm learning, and very much enjoying my clinical experience.

I had an evaluation at my job on Friday, and with fear and trepidation, I entered into my manager's office, sure that I was going to be picked apart--my last job seared that fear into me big time. No matter what I did there, it was always wrong.

This time around, I was met with kindness, and offered a job as an RN upon graduation. What a delight to find that I am loved.

I have discovered that nursing is very humbling. There is something downright human about giving someone shower, and being a part of their vulnerability. I am so grateful for the chance to be a part of the humanity, grateful for the gifts the Lord has given to me.

While it's taking all that I have, there are moments, such as today, when I realize; nursing even nursing school is an experience all unto its own. I'm in it for the long haul.

 (Unless I fail.)

Semester Two, Week Two

My brain is fried.

My butt is kicked.

How do I go on for another 13 weeks? How?!?

Class Monday, then clinical prep work for 2+ hours, then clinicals all day Tuesday and Wednesday at 6:30 am with a 20+ minute drive into the city. Class Thursday, IV lab Friday. Attend those, and make sure you study.

Our first exam was yesterday, and while I passed (barely) I am wondering what happens if I happen to fail this portion of the semester. I've mostly decided if I fail that I will not re-enter the program again at a later date. That could change, but man, the humiliation of telling everyone "hey, I failed" coupled with trying (again) seems like too much. I'll become a phlebotomist, medical assistant....give up the RN dream much as that would break my little heart.

Something internally though tells me that I will pass.

I study like a maniac. I mean, I committed to passing. So, if I do fail, it won't be for lack of trying. I think in part what went wrong with yesterday's exam was that I studied the wrong material. I was prepared for everything but what I was tested on. That, and I guess I don't really have the best critical thinking skills. Awesome. I'll work on that, too.

Wednesday, during clinicals, I had a realization: I finally know the purpose behind what I was doing. While I was performing an assessment on my patient, it (whatever it is) finally clicked. I was all that and a bag of chips, as one of my professors used to say. I rocked that head to toe exam, if I do say so myself. For the first time ever, I felt like a nurse. When it was my long awaited day of administering meds to my patient, I knew what I was giving and why. I knew when administering rapid acting insulin that my patient needed to eat shortly after administering the medication. I finally understood, and it felt so amazing. There is a new found confidence in applying what I spent all last semester learning about.

I worry that I am not smart enough. This internal demon of mine, this uphill battle, this constant struggle of "You're an idiot and it's going to manifest itself" constantly makes an unwelcome entrance into my thoughts in lecture, clinicals, exams, you name it.

It's interesting, what we're learning. Heart failure, hypertension, CAD, PVD...I love it. Medicine has my heart. I want to get it, and so I study, study, study. It's just a lot. And I'm tired, so physically exhausted.

I just have to buckle down. I am determined to do better on the next exam in two weeks. I see this as a challenge. I am trying, I am giving 100%.

If it was easy, everyone would be doing it, right? It's (almost) worth the struggle.

Onward.

Semester Two, Week One

It began with a bang on Tuesday. Introduction, and then Fluid, Acid-Bases, and Electrolytes lecture. Meanwhile, throughout the entire lecture, I had no idea what my professor was lecturing on (H+? Acidosis? Alkalosis?) but I took the notes, imagining how I was going to tell everyone that I failed out in nursing school.

Wednesday, we had a math exam for clinicals. Pass with a 100%, you're still in the program, Anything less than 100%, you get one more try. Fail that, and bam, you're out.

I nearly died. For starters, my heart was flying and my hands were shaking throughout the entire exam, which really was only a quiz; 10 questions total. But, it was actually pretty easy, and I got a 100% on my first try. Hallelujah.

Thursday was four hours of lecture, and so it will go for the remainder of the semester.

And Friday was IV lab, where I learned about flushing IV's and changing bandages.

This semester is sure to kick my butt, and the amount of studying I have put in to try and even comprehend our first lecture is the rough equivalent to how much studying I put in grand total to the entire first semester. But, I can now recite to you the causes of metabolic and respiratory acidosis and alkalosis, and feel pretty confident in the rest of the material. First exam is Friday the 30th, so off we go. Insanity for the next 8 weeks of Med-Surg one, and Lord willing, once I pass that, we segway into Maternal Child Health.

The good news is, I still want to be a nurse. I just know this semester is going to be an uphill battle every step of the way, with lecture, studying, clinicals two days a week, and holding down a job.

Also, what's nursing school without a wee bit of drama?

Remember the cheating gal from last semester who duped instructors while passing clinical calculations? She also had a partner in crime.

Her partner in crime and I were friends on facebook, until she deleted me. I suspect she found this blog, which is okay, because I'm not keeping this blog a big secret.

Naturally though, I sent her a message; it read like this:

Hi ____,

I just noticed we're no longer facebook friends! Hope I didn't do anything to offend or upset you...if so, I apologize!

Anyway, hope your new year is off to a great start, and I'll see you in a few weeks! :)

She replied:

Heck no!! That was an accident. Ugh!! I requested you again. I think you accepted.

There's a couple problems here:

1) Deleting someone off of facebook by accident is almost impossible

2) She didn't actually request me again, so there was so way I could accept said false request.

So, thinking that maybe she was a little bit nutty, I took the initiative and sent her another friend request.

She denied it.

People, if you're going to delete someone off of facebook, don't lie about it. That's stupid.

Anyway, since school began, cheaters 1 and 2 now make sure to give me their best mean girl glares.

It's so intimidating.

Not. Ha! Drama is so fantastic.

Moral of the story is, don't cheat on exams, and don't be dishonest as you're entering into a very noble profession. Don't cover up a lie with another lie. And, if you're one of the cheaters and reading this blog, well, I'm not sorry. I will continue to be courteous to you, even if you try to give your very best glare, because I have morals. And I will become a nurse the old fashioned way: through not cheating.