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:

"You make a living by what you get, but you make a LIFE by what you give." - Sir Winston Churchill

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