.: the way i see it :.: April 2010

Johns Hopkins Hospital is known to many as "the best hospital in the world." For a while now, I've wondered what part of the hospital these people were referring to... but my questions were finally answered at clinical last Friday. I've come to learn that the pediatric population we serve is far from normal -- we see the rarest of all diseases and syndromes on our floor, simply because no other hospital knows what to do with these children. Hopkins boasts some of the best specialists in the world, those who are able to diagnose and treat this vast array of "unknown" illnesses. I have to constantly remind myself that the patient population we see and care for on a daily basis are not typical of most hospitals... but it has definitely prepared me well for how to handle the unexpected. So when I learned that my young patient on Friday had been flown in from Saudi Arabia a few days earlier for skull reconstruction surgery after a car accident left many of her facial bones crushed (car vs camel... did not bode well for either), I was eager and ready to take care of her prior to her scheduled procedure. She was easily my most complicated patient to date, and there was a lot that I had to be aware of and monitor. I know she couldn't understand what I was saying (either because of her mental status or the language barrier) but I offered her words of comfort as I did her pre-op assessment. Her brother arrived shortly thereafter (he is the only family she has here), and I left them alone so that he could read through prayers for her. The time finally came, and we transported her down to the general pediatric OR. Her brother never left her side, reciting prayers and words of comfort in their Arabic language before she was wheeled into the sterile operating room. As I walked into the OR with my patient, I looked back to the brother, and realized that this was his sister that was now in our hands. It's easy sometimes to forget the immensity of our responsibilities as health care providers, and that moment made it very clear to me. Without going into graphic details of the 7-hour surgery, the doctors were able to re-assemble the shattered pieces of her temporal bone and reconstruct the crushed frontal sinus -- and I was able to witness the entire procedure from just a few feet away. It was incredible. Although I kept reminding myself that it was my patient underneath the sterile drapes, I was captivated by the pure "magic" that is surgery. It brought me back to my days in Advanced Anatomy... I had forgotten how truly incredible the human body is, and how fascinating the complex inner-workings and processes are that keep us alive and running. Aside from a brief 30-minute break to rest my legs, I observed the entire surgery, and it was quite an amazing experience. And what's even better - it was a success! She was transferred to the PICU after the operation, so I wasn't able to follow her, but the doctors were hopeful that she would recover. To what level, we aren't quite sure. I believe she has a few more surgeries scheduled before she eventually returns to her native Saudi Arabia, but I do hope that she pulls through.

Even though I feel such a strong connection and fascination with the realm of surgery, I realized that I could NEVER be an OR nurse. Standing next to the surgeon, handing him tools for multiple hours... the atmosphere was "relaxed" (everyone chats during the surgery, listening to music as they work) but the nurses don't ever meet the patient or the family, and they have no connection to the case they are working. It's just another chart and another surgery before the end of shift. I need patient interaction -- even if I don't see the end-result of my efforts caring for my patients, it's the relationships nurses can develop and the comfort we have the opportunity to bring while we work with these individuals. It truly is a calling, and I am so grateful for this opportunity I have been given. And I'm getting closer... 10 months down, 3 to go! Third semester will be complete by the end of the week (exams today and tomorrow, final peds clinical day on Friday) and then I begin my FINAL SEMESTER next Monday! We take our "Transitions to Clinical Practice" course, Public Health, and Special Topics -- which I found out will be "Fetal Surveillance" on Fridays! So perfect. I can't wait! But first... I have to make it through this week. Meaning I need to get back to studying.... until next time, take care all!

It's 8:30 am as I start into this entry... I just took a leisurely stroll to the Ro-Fo (aka Royal Farms, our local 7-11) and it's already 75 degrees outside! Whaaaaaat the heck. Apparently we missed spring and went straight into summer! It's been over 90 degrees the past 2 days, record highs for this time of year on the east coast. My goodness... we're just breaking records left and right! I really don't mind this weather though... just wasn't ready for it! Neither were my pasty white legs... haha. It will take some time before I'm brave enough to bear them in public. Just wish I had somewhere to lay out! Well... I should say that I wish I had TIME to lay out... our current schedule doesn't really allow for much free time, although I do have a day off today (AMAZING) so a friend and I are going to head out to Towson (it's a few miles north of here) to get out of the city for the afternoon. I'm looking forward to that... any time out of the city allows me to BREATHE. As much as I love school and this learning process, I think I'm definitely burning out... maybe it's Baltimore, but I feel like I'm falling into a black hole and I'm clawing at the edge trying to do anything to keep from being sucked in. Okay, so that may be a little exaggerated, but you get the point. I know that as soon as I'm out of this environment I will miss it, so I'm trying to stay positive and make the most out of the 57 days that I have left until I'm out of Baltimore... and I will say that I'm pleased with my efforts! The past couple weeks have been quite great actually, and my goal to stay PRESENT and appreciate these precious, fleeting moments of my life has really been a great motivation.

So. March came and went, another month of 2010 over. Just like that. I feel like I blinked and it was already April. Probably because the past few weeks of school have been a marathon -- I've really had to pace myself in order to get through the mess of exams, projects, presentations, and other miscellaneous assignments. But next week is the last week of this semester! Three out of four semesters, nearly complete. I have 2 more exams and one more presentation to wrap up this semester, and then it's on to my final 14 weeks! My classes will include Public Health, and my clinical experience in St. Croix will tie in with that course, and a "special topics" class (which I have yet to find out the actual topic... could be fetal surveillance or global health). My "Transitions" class also begins, which corresponds to my final clinical experience which I will be completing in Denver, Colorado. Have I mentioned that? Hmm... I don't know if I have or not! Well, briefly -- my final 7 weeks of the program (June 6-July 22) I will be living in Denver with one of my closest friends from UCLA, working at a hospital under the supervision of a nurse "preceptor." Basically, I shadow her on all her weekly shifts (I could even work nights, if that's her shift!) and over the course of the 7 weeks, I will slowly "transition" to complete autonomy as a nurse! It gives us an opportunity to have 1-on-1 guidance to prepare us for the demands of our future role and responsibilities as RNs. It will be a great learning experience, and I'm really looking forward to it! I haven't found out yet what unit I'll be working on, but I will be sure to share that information when I hear from the course coordinator (hopefully soon... it's not that far away....) So that's the final wrap-up of this whirlwind 13.5-month program. I've already finished 10 months.... the end is in sight... then I can work and get clinical experience for a year and a half in Utah before applying to their Nurse Midwife/Women's Health Nurse Practitioner program! I recently learned that I can get a dual-master's degree, becoming both a midwife AND a WHNP, which is a DNP program -- I'll be a "Dr." after all! That option will provide ENDLESS opportunities for me, and it's only 3 years... if I didn't think that getting experience was so critical to my success once I graduate from that program, I would apply to start next year... but I'm trying to take it slow. No need to rush! But I am EXTREMELY excited for that next step in my education... I've already been in contact with the program director, and I'll meet with her once I've moved back to Salt Lake, to make sure that I will be adequately prepared and that my application will be well-qualified during the review process. But... the first hurdle I have to overcome is finding a JOB. I plan to return to Utah in a few weeks to meet with nurse recruiters about future job opportunities for new grad RNs (it's slim-pickings these days for new grads, unfortunately, due to the state of our economy...) Actually, let me address this problem really fast. Most people are surprised to hear that there are very limited jobs open for new graduates, because people hear about "nursing shortages" -- SO. to clarify: there IS a nursing shortage, but because of the economy, many retired/part-time nurses are applying for full-time positions, leaving us new grad RNs out of the application pool because hospitals would rather not have to orient/train us (which is expensive) when they can hire experienced nurses. Frustrating. Our instructors/professors reassure us that this will change... eventually... as soon as the economy shifts, basically. But I'm exhausting my resources, and hopefully meeting with these nurse recruiters next month will translate into something.... aka a position on their L&D unit. We'll just have to wait and see. I wish the only things I had to worry/stress about were related to completing assignments or studying for exams, but I have to try to coordinate my life in Utah while I'm stuck 2,000 miles from where I need to be managing it. Just a tad bit complicated. It's all coming together though... I've sought out ample support from the Lord on this one, and I know that He's helping to guide me through this process.

In order to find balance amidst this mess of uncertainty, I've been trying to find outlets and ways to spend my time that allow me to appreciate the beauty of my surroundings on the east coast. This past weekend I was able to travel up to Pennsylvania to visit one of my mom's friends, Rikki, who lives in the countryside near Lancaster (Amish country). I was SO grateful to have a car and make the 1.5 hour drive north through the rolling hills of the green Pennsylvania farmland, and remind myself of what the east coast truly looks like. I spent Saturday and Sunday morning with Rikki at her home, a peaceful and serene slice of heaven for me in contrast to my life in the city of Baltimore. I was able to help her with the menagerie of animals she and her husband care for on their property, including 15 peacocks, 5 deer, 3 horses, 2 cats, and a charming dog named Betty Bird. It was exactly what I needed to recharge for these upcoming 2 months that I have left in this city. Aside from that escape, I was able to stay at my friend Rachael's house in Reisterstown (a suburb of Baltimore) last week, and participated in their seder dinner for Passover. Quite a neat experience, and I very much appreciated her parents and their hospitality as they welcomed me into their home and their service (which I was asked to participate in, so interesting!) I also made a trip down to DC with another friend, Dara, to experience the beauty of the Cherry Blossom Festival -- I'll be sure to post pictures below.

As much as I have loved the experience of living on the east coast, I'm quite ready to return to life out west. I'll definitely miss the weekend trips to New York though.... I think I need to squeeze in one more city adventure before I leave :] Well, the sun is out and shining brilliantly, I think that means I should take advantage and add some color back to my cheeks! Maybe do some "hot" yoga outside today... mmm that would be lovely. Wouldn't even need a heater! haha. Take care all! Namaste [: