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.