I have to confess, I have a new addiction. Hopefully by admitting it, I can better control it. My name is Laura, and I am a SOCK addict. Yes, socks. I've realized that they are the only part of my uniform that I can really have any control over, so I've found enjoyment in purchasing fun knee-high patterned socks to wear with my classy Danskos and attractive unisex scrubs. Not that you can really see the socks, but that makes it even more fun -- to wear the brown socks with green and yellow pastel stars, completely mismatched from my outfit. Love it. I know, I'm such a rebel... gotta break free from the masses somehow, right?
SO... I find myself on another Sunday evening, relaxing comfortably in the tiny lofted nook that I call my bedroom on the 3rd floor of this quaint rowhouse... I love it here. This space allows me to escape.. to focus.. to BREATHE. It has been a "home away from home" and I am grateful for that. It's amazing how a house can become a "home" and really bring a sense of peace and comfort into your life.
This past week really changed my perspective and boosted my confidence - I finally feel like becoming a nurse is my CALLING and that I have the knowledge and skills necessary to take on the title of "RN." Up until this point... my focus has been primarily on learning the skills necessary to care for the physical needs of my patients... whether that be learning how to administer IM injections, starting IV meds, doing appropriate physical assessments, etc... but this past week in clinical gave me a new outlook on the real impact my presence can have on a patient. I had two different patients between Thursday and Friday, and two very different diagnoses to prepare for. My first patient, an older gentleman, was suffering from fluid volume overload, as a result of his long-standing history with congestive heart failure and associated complications. He was being discharged, with his wife and daughter present to assist him with all the educational points we had to go over for his home medication regiment. He was well-versed on his cardiac meds, but we reiterated the importance of maintaining a healthy diet in accordance with what his cardiologist has outlined in addition to taking his medication on a regular basis. Although he was suffering severe consequences of a lengthy battle with this commonly terminal disease, he was in good spirits because he was able to leave the hospital and return home to be with his family. With not much to do for my patient, I spent most of the day out in the hall, reading up on his various comorbidities (other illnesses) and studying the lab values that result from those diagnoses, just to get a better understanding of expected abnormal values with certain medical problems. While I was standing near the nurse's station, I overheard a young woman talking with one of the floor employees about a failed attempt to obtain an autograph on the pages of a book that she was clutching to her chest. The clerk asked what had happened, and the girl replied "Oh, he seemed quite busy and not too happy to be interrupted. It's okay, I'll be seeing him tomorrow for my residency interview." The clerk offered to hold the book for her, and talk with this VIP about signing it when he was not so preoccupied with work. The girl thanked the clerk for her offer, but declined and quickly walked off the unit. I turned to the employee, curious as to the identity of this person that the girl had bombarded with requests for an autograph, only to find out that it was Dr. Ben Carson -- head of Pediatric Neurosurgery here at Hopkins, and well-known around the world for his successful separation of two sets of conjoined twins who were attached at the head (as well as multiple other complex, and successful, neurosurgeries). He has written a few books, and has had a movie made about his life ("Gifted Hands" for those who might have heard of it). Yes, he is a big deal. And I would normally not find fault in requesting a simple signature on a copy of one of his books (much more respectable than any Hollywood celebrity) BUT the timing of this situation was probably not in the best interest of this current resident applicant. Wouldn't you want to focus the attention of your interviewer on your own accomplishments and honors, rather than addressing his list of accreditations? That's just my opinion... but highlighting quotes from his book to discuss with him hardly seems like an appropriate topic of discussion for an interview. Who knows, maybe she'll manage to impress him... but I feel it safe to say that she should start looking at other options. All in all, it was quite funny to witness... my first experience brushing up against the elite physicians that Hopkins is so widely regarded for.
As for my second clinical day, I had a much different experience... because my Thursday patient was discharged, I was assigned a different patient on Friday, and I had the opportunity to choose which patient I would like to work with, as long as the diagnosis was different from the previous medical problems that I had worked with. I looked at the list of patients, and one in particular stood out to me. I reviewed this elderly woman's chart to learn that she was living alone, with limited contact with any family, and was quite overwhelmed with the worsening of her medical concerns. She was diabetic, had history of high blood pressure and congestive heart failure, but was currently dealing with the clinical sequelae of end-stage renal failure. She was retaining excessive amounts of fluid, and her renal clinic decided it was best for her to be admitted to the hospital for further observation. She was placed on "contact precaution" due to the presence of VRE (a very serious drug-resistant bacteria, worse than MRSA) which requires any individual who enters the room to don a gown and gloves - thereby limiting any chance of cross-contamination between patients, as well as protecting the health of the workers. Because of these precautions, many people are deterred from entering these patients' rooms because of the added hassle and time needed to put on a gown and gloves. I decided that I would take it upon myself to spend the majority of my shift in her room, caring for her needs and making sure that she was receiving adequate and appropriate care. Over the course of that day, I busied myself about her room, ensuring that all the physician and nursing orders were completed, but instead of focusing strictly on my technique and efficiency and accuracy, I focused on gathering more information from her about her health history in order to better understand what brought her to the hospital. It was during this time that I realized how much I have learned over the past 8 months of school - I was able to integrate my knowledge into coordinating her care, according to what she was telling me. Focusing on her as a PERSON rather than a patient really opened my eyes to how important nurses can be in guiding the outcome of a patient's experience. I stood by and watched as two different interns (physicians) entered her room and barely acknowledged her before jumping into some complex discussion about some of her presenting signs that indicated fluid volume excess. They didn't include her in this conversation, even though they were obviously discussing her current physical state. Later on, I stood by as another resident attempted to find a vein from which to draw blood for a test, and he literally poked and prodded her frail little wrist at least 10 times.. and no, he did not stop once to apologize or acknowledge that he was inflicting pain on this poor woman. After he walked out, I looked at her and apologized for his apparent lapse in judgment and appropriate bedside conduct. It was frustrating. But I did all that I could do to ease her obvious discomfort... gave her a foot and hand massage, and talked with her about her life outside of the hospital. As I left the floor that day, she took my hand and looked into my eyes with sincere and genuine appreciation, and offered her gratitude for my willingness to stay with her that day. It was as a tender moment for me, probably the most meaningful experience I've had out of my clinical rotations to date. As I went home that night, I had time to really think about the impact that nurses can have, and how grateful I am that I have discovered my calling in this world. I can't wait until those skills and assessments become more second nature (as I have already started to witness) so that I can focus on attending to the needs of the PERSON behind the medical diagnosis. I may not be able to cure their physical ailments, but I can provide a safe and comforting environment that can impact their overall experience, and hopefully provide at least a temporary relief of their suffering. What a blessing and privilege I have to be a nurse!
WELL... after that lengthy soapbox moment.... I will leave you all for now, it's now Monday afternoon (when I am finishing up this entry) and I have some prep work to do for a new class that I'm starting tonight -- Breastfeeding! I'm soaking up all the knowledge that I can in order to better prepare me for my future in L&D and, eventually, Midwifery. It should be an interesting class... and because I am completely unfamiliar with this important aspect of Maternal/Infant health, I feel it would be very worthwhile to spend my Monday evenings gathering more information to take with me to my future career. So exciting, this pursuit of knowledge... I love school! haha. Okay, leaving now. Have a wonderful week!
- Laura Newman, (future) RN
Monday, January 25, 2010
Sunday, January 17, 2010
newsflash from charm city:
It's Sunday afternoon, and I find myself reflecting on the past week while preparing for another to start. I look at the items scattered around my desk... 3 saline IV syringe flushes, a bottle of hand sanitizer, 2 bottles of lotion, a pile of alcohol wipes, scattered papers that dictate current labs and medication orders for my last patient, various nursing textbooks... that basically describes my life in a nutshell right there. I would say that this past week was more-or-less uneventful, but there is one quite important update that I have for you all...
Although I had a feeling that I would eventually return, I didn't realize it would be so soon... I have decided, after much prayer and deliberation, that I will be returning this summer! Many reasons factored into this decision... but now that I know I want to pursue my master's degree in midwifery at the University of Utah, it just seems silly to ruin my residency status by staying out here an extra year or so to work. And, on top of that, I don't want to take my boards twice... getting licensed out here only to have to re-take the exam in Utah just seems like a huge inconvenience. There were a few other factors that finally pushed me to make this decision, but I am at peace with this new turn that my life is taking. I know that the Lord is guiding me, and that there is a reason I am meant to return. Many people think I'm jumping ship, that I couldn't handle life out here on the East Coast.... but that's not the case! I do love it out here, and I know that I will miss it once I am back in the Salt Lake Valley, but I feel like I've experienced what the Lord wanted me to while I was here, and now it's time for me to continue on to the next adventure. So... after getting settled in the great city of Baltimore, it looks like I'll be packing up and making the trek out west. But I still have a few more months to enjoy life out here, and I know that I will be making the most of it!!
SO. Aside from that minor development... life has been pretty routine the past week. School is quite time-consuming right now, and there isn't much of an end in sight... I have two exams this Tuesday, and then my first Care Plan for Adult Health due on Wednesday. Needless to say, I'll be spending my "holiday" tomorrow at school. This "Care Plan" that I speak of... it's not anything to be taken lightly. Especially for Adult Health. We take our patient from this past week in clinical, and we have to put together an entire plan of care for that patient based on their priority nursing diagnosis and problems that we are responsible for treating. These "nursing diagnoses" include anything from pain management, ineffective coping, nonadherence to treatment directions, and so on. In past clinicals, this diagnosis is usually quite straightforward... but for the unit that I am working on now, the "general medical-surgical" patients encompass a wide variety of problems. For the first time, I had a female patient who was my age... she was suffering from spastic paresis (temporary periods of unexplained muscle spasms/paralysis of the legs) and gastroparesis (intractable nausea/vomiting), aside from a myriad of other medical diagnoses. She is what the hospital terms a "frequent flyer" -- she is in and out of the hospital often, and comes to know nurses and doctors by name. For the most part, this descriptive term is used to describe those who have multiple health issues and can't help but visit the hospital on a high frequency basis. For some, however, they develop an apparent "addiction" to the hospital environment and the attention that they receive while there that they can't imagine life any where else. So... they concoct these "symptoms" and find ways to return to the hospital. I don't mean to say that they don't have these feelings of pain or sickness, but for many, their bodies are so closely intertwined with their psyche that they work themselves up into a state of illness. It's quite fascinating, to a certain extent. After spending two days with my patient, I watched her very closely and her pattern of behavior, and recognized a very deliberate and manipulative attitude regarding her care and what she wanted done for her while she was in the hospital. I don't want to say that she was exaggerating her stated symptoms, but I have my theories... either way, I have to write up a plan of care for how I must care for her while she was in the hospital, and my priority problem for her was imbalanced nutrition -- she refused to take anything by mouth because it would make her sick, and all her medications were given through IV (which gave me great practice on administering meds via IV push). She also complained of severe abdominal pain, and requested narcotics to treat her symptoms, as they were the only medications strong enough to cover the pain without causing her to be sick... but, after a lengthy course of narcs last year, she was weaned off due to a high tolerance build-up, and had severe withdrawal which caused her to be even more sick, so the physician did not want to go that route again. She threw quite a fit when she couldn't get what she wanted... which made us slightly suspicious that she was drug-seeking. That's the tough thing about pain -- it's completely subjective, and we have to treat it according to how the patient describes it to us. You can have a patient in obvious excruciating pain, and they rate their pain at a 6/10 because they've been in worse pain in the past. Then, you'll have a patient (like mine this past week) who is talking and laughing one second, then reporting her pain as a 10/10 -- the worst pain imaginable -- and requesting strong pain medications. And for many pain medication orders, we are given a range: 2-4mg morphine Q3H, based on pain score. If they are in more pain, we give them more pain medication. There is no assessment that we, as nurses, can perform in order to definitively say how much pain the patient is actually in, so we must go by what they report to us. Surprisingly, most patients under-report the amount of pain that they are experiencing, but there are the select few that, for whatever reason -- be it low-pain threshold or desire for stronger meds -- report higher pain scores in order to be treated. Nurses are constantly put in this difficult position, to judge the situation and care for the patient as they see acceptable and appropriate. This can be a difficult responsibility to have, but I much rather prefer to have this type of relationship with the patients and really understand what it is that they need versus what they want, or what their medical diagnosis may dictate that they may need. In many situations, we are the patient advocates -- we recognize what the patient needs more than the physician, and we are able to relay this information to the appropriate provider. Unfortunately, doctors are too focused on diagnosis and treatment plans that they forget to actually assess the individual from a holistic perspective and take outside factors into account for their current physical and psychological state. Working as a nurse and learning more about the patient's history and lifestyle choices allows me to gain a greater understanding of the person behind the medical problems and usually helps to better serve the patient. It's an interesting and complex dynamic, and I'm appreciating these opportunities to prepare myself for what lies ahead in my future career. Aside from the complicated profile of my patient this week, I was able to attend two very interesting procedures with her: first was a gastric emptying study (which she was unable to complete because she couldn't keep the food down) and then second was an EGD - they put a scope down her esophagus and into her stomach to take a look and see what might be causing the irritation and constant vomiting. In addition to looking around, they injected her pyloric sphincter with BoTox to prevent it from closing -- in essence, the BoTox prevents the muscle from contracting so that the food moves through her stomach more rapidly and has less chance to be regurgitated. It's a newer, more experimental procedure, but she had it done last fall and it seemed to help so she was at Hopkins specifically to have this done again. That's one thing about JHH -- we're able to witness procedures that are still being closely studied and investigated, as those patients who come through the doors of the hospital are usually at their last hope and will try (almost) anything to alleviate their ailments. And I am grateful that it is a teaching hospital, as the physicians are much more willing to explain their procedures while they are performing them. The two doctors (one attending and one resident) that did the EGD for my patient were more than happy to include me in their discussion throughout the procedure, and I appreciated that. It was so fascinating... I was transfixed by the image on the monitor of what the small camera was viewing as it traveled down the GI tract... and once it was in the stomach, I could see the waves of peristalsis move through the muscle wall -- it was fascinating. I am in constant awe of the complex systems that control our bodies and their function... have you ever stopped to really think about how perfectly our body systems must coordinate their efforts in order for us to live? No matter how many times I learn about the various physiological processes that occur in our bodies, it never fails to amaze me... and only serves to further strengthen my testimony of the Lord and how perfectly He has organized this world.
WOW. Another soapbox moment for me! I just get typing and don't realize how much I've written. But I really need to get studying... I have so much to get done over the next 24 hours! Goodness... pray for me. haha. The only thing that keeps me sane is yoga -- my current goal is 30-straight days... I've hit 11 already (not including Sundays) and I feel FANTASTIC. Seriously. It really helps to keep my mind focused and helps reduce my stress. I have really developed a healthy addiction to the "hot yoga" craze out here -- 90 minutes in a 95-degree room... it's quite the workout, let me tell you! I don't think I've ever been in this great of shape, and I absolutely LOVE it! I could just continue on this trend for a while... why stop at 30 days?? :] Anyways, have a great week all! Until next time....
I'm moving to Utah!
Although I had a feeling that I would eventually return, I didn't realize it would be so soon... I have decided, after much prayer and deliberation, that I will be returning this summer! Many reasons factored into this decision... but now that I know I want to pursue my master's degree in midwifery at the University of Utah, it just seems silly to ruin my residency status by staying out here an extra year or so to work. And, on top of that, I don't want to take my boards twice... getting licensed out here only to have to re-take the exam in Utah just seems like a huge inconvenience. There were a few other factors that finally pushed me to make this decision, but I am at peace with this new turn that my life is taking. I know that the Lord is guiding me, and that there is a reason I am meant to return. Many people think I'm jumping ship, that I couldn't handle life out here on the East Coast.... but that's not the case! I do love it out here, and I know that I will miss it once I am back in the Salt Lake Valley, but I feel like I've experienced what the Lord wanted me to while I was here, and now it's time for me to continue on to the next adventure. So... after getting settled in the great city of Baltimore, it looks like I'll be packing up and making the trek out west. But I still have a few more months to enjoy life out here, and I know that I will be making the most of it!!
SO. Aside from that minor development... life has been pretty routine the past week. School is quite time-consuming right now, and there isn't much of an end in sight... I have two exams this Tuesday, and then my first Care Plan for Adult Health due on Wednesday. Needless to say, I'll be spending my "holiday" tomorrow at school. This "Care Plan" that I speak of... it's not anything to be taken lightly. Especially for Adult Health. We take our patient from this past week in clinical, and we have to put together an entire plan of care for that patient based on their priority nursing diagnosis and problems that we are responsible for treating. These "nursing diagnoses" include anything from pain management, ineffective coping, nonadherence to treatment directions, and so on. In past clinicals, this diagnosis is usually quite straightforward... but for the unit that I am working on now, the "general medical-surgical" patients encompass a wide variety of problems. For the first time, I had a female patient who was my age... she was suffering from spastic paresis (temporary periods of unexplained muscle spasms/paralysis of the legs) and gastroparesis (intractable nausea/vomiting), aside from a myriad of other medical diagnoses. She is what the hospital terms a "frequent flyer" -- she is in and out of the hospital often, and comes to know nurses and doctors by name. For the most part, this descriptive term is used to describe those who have multiple health issues and can't help but visit the hospital on a high frequency basis. For some, however, they develop an apparent "addiction" to the hospital environment and the attention that they receive while there that they can't imagine life any where else. So... they concoct these "symptoms" and find ways to return to the hospital. I don't mean to say that they don't have these feelings of pain or sickness, but for many, their bodies are so closely intertwined with their psyche that they work themselves up into a state of illness. It's quite fascinating, to a certain extent. After spending two days with my patient, I watched her very closely and her pattern of behavior, and recognized a very deliberate and manipulative attitude regarding her care and what she wanted done for her while she was in the hospital. I don't want to say that she was exaggerating her stated symptoms, but I have my theories... either way, I have to write up a plan of care for how I must care for her while she was in the hospital, and my priority problem for her was imbalanced nutrition -- she refused to take anything by mouth because it would make her sick, and all her medications were given through IV (which gave me great practice on administering meds via IV push). She also complained of severe abdominal pain, and requested narcotics to treat her symptoms, as they were the only medications strong enough to cover the pain without causing her to be sick... but, after a lengthy course of narcs last year, she was weaned off due to a high tolerance build-up, and had severe withdrawal which caused her to be even more sick, so the physician did not want to go that route again. She threw quite a fit when she couldn't get what she wanted... which made us slightly suspicious that she was drug-seeking. That's the tough thing about pain -- it's completely subjective, and we have to treat it according to how the patient describes it to us. You can have a patient in obvious excruciating pain, and they rate their pain at a 6/10 because they've been in worse pain in the past. Then, you'll have a patient (like mine this past week) who is talking and laughing one second, then reporting her pain as a 10/10 -- the worst pain imaginable -- and requesting strong pain medications. And for many pain medication orders, we are given a range: 2-4mg morphine Q3H, based on pain score. If they are in more pain, we give them more pain medication. There is no assessment that we, as nurses, can perform in order to definitively say how much pain the patient is actually in, so we must go by what they report to us. Surprisingly, most patients under-report the amount of pain that they are experiencing, but there are the select few that, for whatever reason -- be it low-pain threshold or desire for stronger meds -- report higher pain scores in order to be treated. Nurses are constantly put in this difficult position, to judge the situation and care for the patient as they see acceptable and appropriate. This can be a difficult responsibility to have, but I much rather prefer to have this type of relationship with the patients and really understand what it is that they need versus what they want, or what their medical diagnosis may dictate that they may need. In many situations, we are the patient advocates -- we recognize what the patient needs more than the physician, and we are able to relay this information to the appropriate provider. Unfortunately, doctors are too focused on diagnosis and treatment plans that they forget to actually assess the individual from a holistic perspective and take outside factors into account for their current physical and psychological state. Working as a nurse and learning more about the patient's history and lifestyle choices allows me to gain a greater understanding of the person behind the medical problems and usually helps to better serve the patient. It's an interesting and complex dynamic, and I'm appreciating these opportunities to prepare myself for what lies ahead in my future career. Aside from the complicated profile of my patient this week, I was able to attend two very interesting procedures with her: first was a gastric emptying study (which she was unable to complete because she couldn't keep the food down) and then second was an EGD - they put a scope down her esophagus and into her stomach to take a look and see what might be causing the irritation and constant vomiting. In addition to looking around, they injected her pyloric sphincter with BoTox to prevent it from closing -- in essence, the BoTox prevents the muscle from contracting so that the food moves through her stomach more rapidly and has less chance to be regurgitated. It's a newer, more experimental procedure, but she had it done last fall and it seemed to help so she was at Hopkins specifically to have this done again. That's one thing about JHH -- we're able to witness procedures that are still being closely studied and investigated, as those patients who come through the doors of the hospital are usually at their last hope and will try (almost) anything to alleviate their ailments. And I am grateful that it is a teaching hospital, as the physicians are much more willing to explain their procedures while they are performing them. The two doctors (one attending and one resident) that did the EGD for my patient were more than happy to include me in their discussion throughout the procedure, and I appreciated that. It was so fascinating... I was transfixed by the image on the monitor of what the small camera was viewing as it traveled down the GI tract... and once it was in the stomach, I could see the waves of peristalsis move through the muscle wall -- it was fascinating. I am in constant awe of the complex systems that control our bodies and their function... have you ever stopped to really think about how perfectly our body systems must coordinate their efforts in order for us to live? No matter how many times I learn about the various physiological processes that occur in our bodies, it never fails to amaze me... and only serves to further strengthen my testimony of the Lord and how perfectly He has organized this world.
WOW. Another soapbox moment for me! I just get typing and don't realize how much I've written. But I really need to get studying... I have so much to get done over the next 24 hours! Goodness... pray for me. haha. The only thing that keeps me sane is yoga -- my current goal is 30-straight days... I've hit 11 already (not including Sundays) and I feel FANTASTIC. Seriously. It really helps to keep my mind focused and helps reduce my stress. I have really developed a healthy addiction to the "hot yoga" craze out here -- 90 minutes in a 95-degree room... it's quite the workout, let me tell you! I don't think I've ever been in this great of shape, and I absolutely LOVE it! I could just continue on this trend for a while... why stop at 30 days?? :] Anyways, have a great week all! Until next time....
Sunday, January 10, 2010
hopkins: behind the scenes....
Picture this: It's 6 am, and the sun has not risen above the rooftops of the rowhouses quite yet... I open the door of my home, icy wind brushes my hair across my face - it's just another morning in Baltimore, and thankfully it has stopped snowing. I step out onto Washington Street, and walk north toward the hospital. The ice crunches under my fashionable Dansko clinical shoes, and I watch as my breath creates a white cloud in the brisk morning air. I pull the hood of my down parka over my forehead and tighten the cord to keep my ears protected from the chill. I force my hands down into my pockets and fumble for my iPhone, realizing that I hadn't started my standard morning music mix before putting my gloves on... number one drawback to having a touchscreen phone! I pull my warmed fingers out of their cashmere and leather cocoon and scan for my current favorite artist: Carrie Underwood. Perfect morning pick-me-up before clinical! I look ahead and make my way toward campus, realizing that I have another 20 more minutes in the 10-degree weather before I can defrost in the computer lab of the SON building... maybe if I push it, I can make it in 15... that is, if I can keep my legs moving quickly enough to keep them from freezing. I scan the sidewalk in front of me, ensuring that I don't step on a patch of ice that could lead to serious pain in my sacral area. I have trained my brain to focus on the rhythm of the music, and coordinate my movements accordingly... keeping occupied doesn't allow me time to focus on the cold... that and wearing 5 layers of clothes. My arms extend slightly out to the side, bringing to mind thoughts of "A Christmas Story" and that makes me smile. Anything to keep warm! I make my way up through Butcher's Hill and see the Hopkins Hospital looming on the horizon... my first day on Halstead 8: ADULT GENERAL MED-SURG. Am I prepared? Can I manage my patient and my time on the floor? My mind races... Hepatitis C. Cryoglobulinemia. Fungemia. C-Diff. Hemodialysis. ESRD. GERD. I see the doctors and nurses flooding the front doors to the hospital, and I make one last stop in the SON building to review my notes and plan for the day, hoping that I can remember the skills and assessments I will need to perform and interpret. As soon as the feeling starts returning to my fingers, I pull out my clipboard and scan over my patient's profile... I take a deep breath and accept that it's going to be a long day...
That was a little insight into this past Friday morning. Needless to say, I survived my first day on the general med-surg floor! I was slightly overwhelmed and intimidated, but I greatly appreciate that we are given our patient's profile in advance, so that we can be adequately prepared for our duties and responsibilities in caring for our patient's specific needs. My patient, bless him, kept me on my toes. I was busy from 7 until 1, including following him to a procedure in the ECHO lab where they did a TEE - transesophageal echo - to scan his heart for any signs of infection with a probe that went down his esophagus. Quite an interesting procedure to witness, especially when the machine wouldn't calibrate! It's slightly funny... we rely on advanced computers and technology to perform these medical exams, and then get frustrated when they freeze up... they are computers after all! I chuckled when the doctors tried to "turn it off and on" to see if it would restart itself... haha. Unfortunately, they weren't able to fix the problem, so another machine from a different unit was brought in to use in the interim, and thankfully that machine worked. After the delay, my patient received good news - despite all his other ailments and health issues, his heart was in great condition. And believe me, he needed some good news. His initial complaint of fluid overload, as brought on by end-stage renal disease and liver failure as a result of hepatitis C (which he contracted from a hospital blood transfusion) was exacerbated by hospital-acquired infection at an IV site and an allergic reaction to a medicine he received as treatment while in the hospital, causing severe itching over his entire body. He was a bit withdrawn at first, and I wasn't surprised... I don't know how much patience I would have with the hospital staff after all that! But at the end of the shift, I wished him well and thanked him for allowing me to work with him that day, and his reply made it all worth it... to hear appreciation for simply taking the time to listen and care -- that is why I am entering this field. I know that my weeks ahead won't run as "smoothly" as that first day did (although it was far from smooth...) but it gives me hope that even with my "limited" experience and relative feeling of inadequacy, that I can come out the other side with a sense of accomplishment.
Aside from clinical, school has definitely kept me busy! I'm really excited about my class that focuses on nursing for newborns... we went over neonate assessments and what to expect, and how to recognize any abnormal signs or unexpected symptoms... SO much information. But this is the first class where I am excited to read and actually WANT to purchase the textbook for my own library to have as a reference... I know this is where I need to be! Spending an extra 10 hours a week in class for an elective... that has to mean something, right? haha. Aside from that class, my Adult Health class is focusing on major health issues that plague our society. First on the agenda: OBESITY. Not sure you want me going into that, I could be on my soapbox for a while! Let's just say that over 1/3 of our country is considered obese, and it's not getting any better... for the first time in our modernized world, this current generation of kids has a shorter life expectancy than that of their parents. Main culprit: TV and video games. GET OUT OF THE HOUSE AND GET ACTIVE! And while you're at it, throw out the CheezIts and Oreos.... goodness people. But enough of that (for now at least).... it's time for me to get my study on, SO.... I will leave you all until next week! And here is a parting quote that I heard in one of my classes, that I thought was so appropriate and I just have to share:
That was a little insight into this past Friday morning. Needless to say, I survived my first day on the general med-surg floor! I was slightly overwhelmed and intimidated, but I greatly appreciate that we are given our patient's profile in advance, so that we can be adequately prepared for our duties and responsibilities in caring for our patient's specific needs. My patient, bless him, kept me on my toes. I was busy from 7 until 1, including following him to a procedure in the ECHO lab where they did a TEE - transesophageal echo - to scan his heart for any signs of infection with a probe that went down his esophagus. Quite an interesting procedure to witness, especially when the machine wouldn't calibrate! It's slightly funny... we rely on advanced computers and technology to perform these medical exams, and then get frustrated when they freeze up... they are computers after all! I chuckled when the doctors tried to "turn it off and on" to see if it would restart itself... haha. Unfortunately, they weren't able to fix the problem, so another machine from a different unit was brought in to use in the interim, and thankfully that machine worked. After the delay, my patient received good news - despite all his other ailments and health issues, his heart was in great condition. And believe me, he needed some good news. His initial complaint of fluid overload, as brought on by end-stage renal disease and liver failure as a result of hepatitis C (which he contracted from a hospital blood transfusion) was exacerbated by hospital-acquired infection at an IV site and an allergic reaction to a medicine he received as treatment while in the hospital, causing severe itching over his entire body. He was a bit withdrawn at first, and I wasn't surprised... I don't know how much patience I would have with the hospital staff after all that! But at the end of the shift, I wished him well and thanked him for allowing me to work with him that day, and his reply made it all worth it... to hear appreciation for simply taking the time to listen and care -- that is why I am entering this field. I know that my weeks ahead won't run as "smoothly" as that first day did (although it was far from smooth...) but it gives me hope that even with my "limited" experience and relative feeling of inadequacy, that I can come out the other side with a sense of accomplishment.
Aside from clinical, school has definitely kept me busy! I'm really excited about my class that focuses on nursing for newborns... we went over neonate assessments and what to expect, and how to recognize any abnormal signs or unexpected symptoms... SO much information. But this is the first class where I am excited to read and actually WANT to purchase the textbook for my own library to have as a reference... I know this is where I need to be! Spending an extra 10 hours a week in class for an elective... that has to mean something, right? haha. Aside from that class, my Adult Health class is focusing on major health issues that plague our society. First on the agenda: OBESITY. Not sure you want me going into that, I could be on my soapbox for a while! Let's just say that over 1/3 of our country is considered obese, and it's not getting any better... for the first time in our modernized world, this current generation of kids has a shorter life expectancy than that of their parents. Main culprit: TV and video games. GET OUT OF THE HOUSE AND GET ACTIVE! And while you're at it, throw out the CheezIts and Oreos.... goodness people. But enough of that (for now at least).... it's time for me to get my study on, SO.... I will leave you all until next week! And here is a parting quote that I heard in one of my classes, that I thought was so appropriate and I just have to share:
"You make a living by what you get, but you make a LIFE by what you give." - Sir Winston Churchill
Sunday, January 3, 2010
*TWENTY-TEN*
H A P P Y N E W Y E A R ! !
As much as I love the feeling of a fresh start at the beginning of a new year, I always feel a let down after the end of the holidays... Christmas brings with it such joy and spirit, and just as quickly as it begins, it's over... and the focus shifts back to maximizing productivity, with an increased emphasis on overhauling our lives. Granted, "New Year's Resolutions" can be motivating, but unless it's practical, more often than not they are forgotten before the end of January. I'm not the biggest supporter of the "Resolution" movement, only because I like to think that I can make changes to my life and follow through with them - no matter the time of year. It's amazing - I've found a way to make the most of change... I now thrive on it; it gives me more purpose and direction in my life. Speaking of... I have made a huge decision regarding my future, and taking a different direction: I have decided to forgo the Nurse Practitioner program at Hopkins, and instead will work toward acceptance into the Midwifery program at the University of Utah. It has been a very drawn-out and prayerful decision, but I know now where my passion lies, and I feel that it would benefit me (in many ways) to pursue the rest of my education at the U. It is a very reputable program, and the environment there would provide me with a great deal of experience and a variety of patients. Prior to starting that program, however, I plan to work for at least 2 years, in order to have a stronger foundation and understanding of the field. That leaves me with another huge decision... where shall I work? I have been pondering this difficult decision and praying about it, and I will keep you updated as soon as I figure out where I am meant to be.... whether that be here in Baltimore or back in Salt Lake, I'm not sure. I know the Lord will give me direction as He sees fit. Seems slightly funny that I travel all the way out to Baltimore to return to Salt Lake, but the Lord has His way of handling things... I recognize the many reasons I was meant to be out here in Baltimore, and I am grateful for the opportunities I have been given and the experiences I've had, but I've learned not to argue or question the path the Lord has prepared for me, no matter how convoluted it may appear. But I still have another 2 full semesters of school ahead of me, so I have to stay on track and focus on the task at hand! And they aren't wasting any time... I start classes tomorrow, and I already feel the pressure of the course work that will be required. I'm excited to start again, I just hope that I am prepared adequately for clinical this week... I have been placed at Hopkins Hospital, on a general Adult Health floor, and we will be expected to be on top of all our patient's assessments and meds... I keep reminding myself that it will be overwhelming at first, but with time and exposure, it will become easier. At least coming out of this rotation I will feel much more like a nurse! And I'm excited to finally be working at Hopkins... finally I'll be able to learn what all the hype is about....
But today is still technically Winter Break. So, although I am mentally preparing for school to start, I am still trying to enjoy a bit of my freedom! And I want to fill you all in on the holiday happenings in my life... it's been a busy past couple weeks! I already told you about the snowstorm that we survived 2 weeks ago (really? only 2 weeks? wow...) that shortened my trip to California, where I stayed with one of my dearest and oldest friends, Brenn (we go waay back to 4th grade!) for a few days. It was so good to see her, after having her out here for our historical exploration of the Chesapeake region back in September. I hadn't been back to California in over a year, so more than anything, it felt great to be "home" again. We ventured back to our old stomping ground, Westwood (Brenn and I were roommates while at UCLA together) and then traveled to Malibu to visit my mom's beautiful residence (with Pacific Ocean views, no less) and visit with the monkeys that her friend Monique owns. There are 7 in total... and we had a wonderful time getting to know them all!
A majority of our time was spent in Hermosa Beach, near Brenn's lovely little home... we treated ourselves to a Bikram session, massages, and shop therapy. Much needed, and deserved (I think), let me tell you!!
And then it was time to head up to Utah... and Brenn decided, on a very spontaneous decision, to join me for a few days in the winter wonderland of Salt Lake after Christmas weekend! I was so happy to have her up to visit. Christmas came and went, and I was grateful for the time I had to spend with my family. Especially when we all made the trip up the canyon to Snowbird for some time on the slopes! It was (albeit windy) a gorgeous day on the mountain, and we had a great time exploring the runs off the tram. The rest of the weekend was relaxing, and it was great to visit with family and friends in the Salt Lake area. Brenn arrived on Monday afternoon, and I had such fun introducing her to life in the snow. We went to Brighton on Tuesday, her very first time snowboarding, and I was impressed with how well she managed on the mountain! She was determined and motivated, despite spending a majority of her time on her back.... haha. Greg came along with us, and we were all pleased with the conditions... light snow fall, making for smooth runs down, but also adding to the picturesque scene of the frosted mountainside. We were definitely happy to return home that evening and put our feet up in front of the fireplace... such a wonderful way to defrost. We had intended to head up to Park City on Wednesday, but a snowstorm prevented us from making the trip... our little shoebox of a car wouldn't have made it up the canyon! A bit disappointing, but we made the most of our time in the valley. She was so excited about the fresh snow that coated the ground outside our house, and I was surprised at how much I missed that climate! Snow in Utah is idyllic... in Baltimore, it's just depressing. haha. After Brenn left on New Year's Eve, I was feeling a bit sick, so I spent that night in bed! So sad. But I know that if I had tried to go out, it would have been miserable. I know I'll have plenty more NYE's to enjoy. The rest of my time in Utah was spent relaxing around the house, enjoying time with Greg, as I took advantage of my remaining freedom before returning to "Charm City" - which is currently under "weather watch" for gale-force winds, which I can hear whipping around our house! I don't even want to know how cold it is outside... currently, accuweather.com says that it is "27" degrees outside, but with the windchill, it's about 7 degrees. GAHHH. When I arrived back in town last night, it was 0 degrees. ZERO. Really?!? What I would give for the "freezing" temperatures of Salt Lake right about now... save me! haha. But I signed up for this... so I'll grin and bear it! Even if that grin is frozen across my face... and with that, I'll leave you until next weekend -- I'll have plenty to discuss after this first week of classes is over! Here are a few parting shots from the past few weeks:
But today is still technically Winter Break. So, although I am mentally preparing for school to start, I am still trying to enjoy a bit of my freedom! And I want to fill you all in on the holiday happenings in my life... it's been a busy past couple weeks! I already told you about the snowstorm that we survived 2 weeks ago (really? only 2 weeks? wow...) that shortened my trip to California, where I stayed with one of my dearest and oldest friends, Brenn (we go waay back to 4th grade!) for a few days. It was so good to see her, after having her out here for our historical exploration of the Chesapeake region back in September. I hadn't been back to California in over a year, so more than anything, it felt great to be "home" again. We ventured back to our old stomping ground, Westwood (Brenn and I were roommates while at UCLA together) and then traveled to Malibu to visit my mom's beautiful residence (with Pacific Ocean views, no less) and visit with the monkeys that her friend Monique owns. There are 7 in total... and we had a wonderful time getting to know them all!
A majority of our time was spent in Hermosa Beach, near Brenn's lovely little home... we treated ourselves to a Bikram session, massages, and shop therapy. Much needed, and deserved (I think), let me tell you!!
And then it was time to head up to Utah... and Brenn decided, on a very spontaneous decision, to join me for a few days in the winter wonderland of Salt Lake after Christmas weekend! I was so happy to have her up to visit. Christmas came and went, and I was grateful for the time I had to spend with my family. Especially when we all made the trip up the canyon to Snowbird for some time on the slopes! It was (albeit windy) a gorgeous day on the mountain, and we had a great time exploring the runs off the tram. The rest of the weekend was relaxing, and it was great to visit with family and friends in the Salt Lake area. Brenn arrived on Monday afternoon, and I had such fun introducing her to life in the snow. We went to Brighton on Tuesday, her very first time snowboarding, and I was impressed with how well she managed on the mountain! She was determined and motivated, despite spending a majority of her time on her back.... haha. Greg came along with us, and we were all pleased with the conditions... light snow fall, making for smooth runs down, but also adding to the picturesque scene of the frosted mountainside. We were definitely happy to return home that evening and put our feet up in front of the fireplace... such a wonderful way to defrost. We had intended to head up to Park City on Wednesday, but a snowstorm prevented us from making the trip... our little shoebox of a car wouldn't have made it up the canyon! A bit disappointing, but we made the most of our time in the valley. She was so excited about the fresh snow that coated the ground outside our house, and I was surprised at how much I missed that climate! Snow in Utah is idyllic... in Baltimore, it's just depressing. haha. After Brenn left on New Year's Eve, I was feeling a bit sick, so I spent that night in bed! So sad. But I know that if I had tried to go out, it would have been miserable. I know I'll have plenty more NYE's to enjoy. The rest of my time in Utah was spent relaxing around the house, enjoying time with Greg, as I took advantage of my remaining freedom before returning to "Charm City" - which is currently under "weather watch" for gale-force winds, which I can hear whipping around our house! I don't even want to know how cold it is outside... currently, accuweather.com says that it is "27" degrees outside, but with the windchill, it's about 7 degrees. GAHHH. When I arrived back in town last night, it was 0 degrees. ZERO. Really?!? What I would give for the "freezing" temperatures of Salt Lake right about now... save me! haha. But I signed up for this... so I'll grin and bear it! Even if that grin is frozen across my face... and with that, I'll leave you until next weekend -- I'll have plenty to discuss after this first week of classes is over! Here are a few parting shots from the past few weeks:
[Rockefeller Center tree]
[Mary Poppins on Broadway]
[Snowstorm on Washington Street]
[Snowbird]
[sibling love]
[Brighton]
[Snowfall on 1500 East]
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