I almost made it...

Yesterday was my very last day of ICU clinical. WAHOOOOOOOOOOOOO! I was just a little excited. I have really enjoyed my ICU clinical experience, but I'm tired and stressed and not having to stay up late on Wednesday nights to finish a huge assignment and then get up early on Thursday (usually about 5) to head up to SLC and be there until 7:30 at night will be so very nice. I still have Psych clinical for 4 more weeks, but that's twice a day, for 8 hrs, starting at 7:45 in the morning here in Provo. And there are no pre-assessments=best thing ever.

I was excited heading into my last day. Remember how in my last two clinical rotations I have had a light-headed or fainting episode? Well I hadn't had that this clinical. I was doing better! I had seen lots gross stuff and lots of very critically ill patients and I had been fine.

Then I went to the burn unit.

The first time we walked into my patients room it happened. I could feel my face starting to pale and my ears start getting fuzzy and my neck starting to get hot and sweaty. I don't know what it was. I hadn't even seen anything gross at all. I think it was the shock of having a pediatric patient. And then to see him in so very much pain.

I had to sit down, and then leave the room. They brought my juice and crackers like normal and had me go put my feet up and rest. I felt retarded. Gosh darn it! I had gotten sick without even seeing his burn.

I eventually felt fine and went in to help with dressing changes on another patient. Everything went smoothly and I didn't feel light headed at all.

Then I went to help with my patient's dressing changes.

Not only were these much more extensive and bloody, but again I had to hear him screaming in pain as the dressings were pealed off his wounds. It was so hard to hear him keep screaming hoarsely at us to stop because it hurt so badly and to see his little body shaking in pain.

I had to leave after about the first 20 minutes.

I was so frustrated with myself! I had almost made it through my whole intensive care rotation without having these silly almost fainting episodes. But it had to happen on the last day. Lame.

And then, what makes it even more ridiculous, I watched an admit that had so many more horrible burns than my patient. It was so nasty. It was bloody and smelly and hot and crowded and intense. And I watched the surgeons work and I watched the ART line attempts and I was perfectly fine. I don't understand it.

Two of my almost fainting moments have been when I was helping with a pediatric patient and having to see them in so much pain. But I love pediatrics. That's something I have seriously considered going into. That was my first choice for my capstone placement. Am I going to have issues with fainting when I have to inflict pain on my little patients? I don't know. I hope not.

There were lots of contributing factors yesterday. I hadn't really eaten any breakfast (I tried, but there wasn't much to eat that was quick and I was lazy and slept until the last minute), I hadn't drunk any fluids yet, and I already was feeling sick. Also, I've noticed a link between me feeling embarrassed and then feeling faint. I really think that has to do with it. I was feeling awkward and not knowing what to do because my nurse, although she was awesome, was not a very communicative nurse. So who knows? My clinical instructor said she had experiences like that in nursing school but she got over it once she was the nurse and she was in charge of the patient instead of just being an observer. And she worked in the ED for 20 years. So maybe it will pass eventually. At least it won't happen again this semester.

2 1/2 weeks.

We're 2.5 weeks into the semester and my life is already insane. I've been getting an average of 5.5 hrs of sleep per night. Haha, that looks like more than it feels, trust me.

I've had one shift of clinical in the Medical ICU. It was super interesting. I saw one cardiac arrest. My nurse had just gone to lunch, but I was able to go with the nurse that got the call. There were tons of people in the room. It was Code Blue-cardiac or respiratory arrest.  And luckily they were able to bring him out of it really quick. It was amazing to think that those nurses and doctors could legitimately go home and say they had saved a life that day. People talk about that a lot with the medical profession, but it was so obviously apparent on Saturday. It made me even more grateful that I'm studying nursing.

This semester has been different than any previous semester that I've had. I'm not quite sure what it is, but I think some contributing factors include how chill the teachers are when it comes to administrative issues, but how much they expect of you with the actual knowledge. They aren't as picky on some things, but they haven't babied us nearly as much in explaining assignments to the very tiniest detail. It is making me a little overwhelmed with how much I have to remember from physiology, pathophysiology, med/surg, and pharmacology. I am going to have to do a whole lot of reviewing this semester. If I end up having an extra semester because of a mission or timing with my GE's, I'm definitely going to try to take pathophysiology again. Physiology would also be super nice. Oh how helpful would that be!

And now I have a question:
I've been thinking about this for a good while. Whenever I start to date someone, I feel like I become a worse person. Obviously my schooling suffers because I don't have as much study time. But I also end up getting too little sleep (sleep deprivation that I can't blame on homework makes me feel really guilty), which leads to less effective scripture study and pretty much zero pondering time, less sincere prayers, not as much time spent with my family, less time to fulfill my callings, basically no time to exercise (this is pretty horrid when you're trying to train for a half-marathon), little time to be a good friend and spend time with all the people I would love to hang out with. This always leads to me feeling excessively guilty and overwhelmed because I can't be the person I want to be when I'm in a relationship. I'm not responsible enough. I don't have enough self control. I can't even do it all when I'm totally single, but it just gets 10x worse when I have a boyfriend. And this makes me sometimes feel a tiny bit of frustration at my boyfriend which leads to me being slightly grumpy and not very pleasant.

And so the question:
How can I date someone and still feel like I'm living a balanced life? How can I build a relationship with someone while maintaining my relationship with my other friends and family?

I don't know how.

The day I went to Prison

It was an experience.

I've never heard such dirty language. In combination to the CJC conference, I think I've heard all I can handle this week.

I could never work there permanently. I am much too sympathetic and easily deceived. Plus, I don't want to start swearing.

Some of the most intimidating things about it were the doors. One closes before the other can open to let you in. And then the one behind you closes and locks before the next one opens. However, almost the whole entire time I felt perfectly safe. I was with an officer, nurse, or med tech 100% of the time.

I got called a cute little blonde by an inmate.

I drew up a lot of insulin. Good practice, I guess.

I had no idea people could be so ingenious. The things you come up with when you have so much time on your hands...

I saw a whole lot of tattoos. Oh, and I learned how to make a prison tattoo maker. Crazy.

Somehow, as I looked at these people and tried to serve them, I could not reconcile the fact that they were so polite and seemed so normal and human with their awful, horrible crimes. As I looked at them my mind could not fully grasp that these people are the ones that have done the most awful things you ever hear about it. But they are still children of God! I believe they can still be forgiven because the Atonement is infinite. How, I do not know, but God does.

I got some pretty strange looks, a few questions, and a blunt "you guys look like deer in the headlights" comment :)

The inmates were all so different! Some were more reserved, others super outgoing and funny, some were not very respectful, some stared, and some were extremely polite, apologized for their language and tried harder to not swear in front of me. 

I really like officers. I admire them for their willingness to do something so emotionally draining every day. I admire the medical staff that work there. I really appreciated their respect for me as well as for the inmates.

For some strange reason law enforcement has a very real attraction for me. I don't think I'm tough enough to do it. Maybe someday :) 

Overall I enjoyed it a lot more than I thought I would. But I think that is because it is all so new and interesting. If I worked there permanently I think I would not like it at all. But I'm really grateful to at least have the opportunity. I just have quite a bit to process and work through. It was an emotionally draining week, that's for sure!

(I would post more, but I'm kinda afraid of some HIPPA violation or something... Suffice it to say, it was extremely interesting. The end.)

TRUST. or lack thereof

This week for my nursing internship I attended The Children's Justice Symposium. In case you don't know (I didn't until I decided to go into nursing), the Children's Justice Center is a place where children who are being abused can go to be interviewed, examined, emotionally supported, and assisted in any way possible. There is one here in Provo and I got to volunteer there my freshman year of college.

So, the conference I attended was all about child abuse: physical, sexual, mental, neglect, medical, etc. It was also about abusers: who they are, why they do what they do, what they think when they do it, and how you can protect your children from them. Sounds pretty uplifting, right?

This conference mostly consisted of Judges, Police Officers, Detectives, Child Advocates, Prosecutors, and other social workers. Not many medical professionals there, although there were some. I grew up in Utah, and was therefore quite sheltered my whole life. This group of people was rather rough. I haven't heard language like that very often.

However, the things we learned opened my eyes and helped me have an amazing level of respect for these people. What they deal with every day is horrifying. It is depressing. It is emotionally draining. It is gruesome, awful, and bloody. And I think it requires people to become a little rough around the edges to be able to handle the stress and the emotional and physical exhaustion.

I am a pretty trusting person in general. When I started college I probably could have rated myself about 90% trusting. I was suspicious of some people, of sketchy looking people, but overall I trusted the people I interacted with. During my first year of nursing (my sophomore year of college) we learned a lot about elder abuse. One day we watched a video about elder abuse and I left that class with my trust in others, especially men, greatly diminished. I could probably have rated myself about a 70%.

Over time my trust increased a little bit as the memory of the things we learned faded and as I again had hope in the good nature of people. However, after these last few days I feel like my trust in others has dropped substantially. Almost to the point that I'm starting to wonder if I will ever trust someone enough to marry them. I think this, too, will fade a little bit, but I think it's going to take a lot more effort on the part of anyone I date to show me that I can trust them. It is going to take a super-human effort on my part to let myself trust someone that much.

And because I am not a super human person, it is going to take a lot of help from the Lord. I am so grateful for the Atonement of Jesus Christ. I don't know where I would be without it. He can make everything right. Some day every wrong will be righted, JUSTICE WILL BE SERVED, but mercy will abound. Isn't that perfect?

Final Frenzy

The end of the semester is drawing to a close. And as it does my anxieties grow daily stronger. I have a test this morning (my second to last midterm), the choir Easter program I am in charge of on Sunday plus a talk I have to give (I haven't given a talk in church in a looooong time and speaking on Easter intimidates me), a final on Monday, a presentation and my debate on Tuesday, a big assignment due Wednesday, nothing really due Thursday or Friday, 3 finals on Saturday, one on Monday, none on Tuesday, and 2 on Wednesday. And then I am FREE!!!

Sound exciting? I agree.

I thought of this yesterday when I was talking to Sarah about grades, so to all of you worried about how your grades will turn out:

Debates+Politics+Ethics

Currently I am in an ethics class for nursing. Coincidentally my teacher loves politics almost as much as I do. Politics happens to be filled with ethical dilemmas. The combination of these factors results in quite emotional Tuesday evenings. Not "crying" emotional, rather flushed face, shaky hands, passionate, frustrating emotional. It is rather enjoyable except when I get so involved in something that I have a hard time stepping back and letting things cool off. Or when I am too tired to have such an adrenaline rush that day.

Today we listened to groups in our class debate 2 topics:
1). Should assisted suicide be legalized?
2). Should the development of a "savior-child" be legal?

We took polls in the class before the debate started and then after the debate finished and it was super interesting to see how people's opinions changed. Mine stayed constant, don't you worry ;)

I was going to write about each of these, but I need to study for a test tomorrow. My answer to the first is a no. There is a difference between letting someone "pull the plug" or choose to not remain on mechanical ventilation and actively proscribing, injecting, or administering something to kill someone.

The second one is a little harder. Here's an explanation of what this is: A child is born with or develops a disease/genetic condition (e.g. sickle cell anemia, leukemia, etc). The parents decide to have another child, but this time they are going to fertilize several eggs and do genetic testing to choose the one that matches the genes of their first child so his/her cord blood can be used to do blood transfusions for the sick child. So, they choose the one that matches and either discard the rest or pay $40/month to keep the rest frozen. This "savior child's" cord blood is then taken to help the sick child. If that does not work they may take more blood from the savior child, take bone marrow, or do other invasive procedures that do not harm the savior child beyond the pain of the invasive procedures and the risk that always accompanies such procedures. So, to the question, "should this be done"? My answer is no. Unless you plan to use (develop?) all of the other fertilized eggs. The question "should this be legal" is a different matter. I don't like government getting involved in this like this, so in the end I might say yes to this question. But that in no way means that I think it is an acceptable thing to do.

Okay, there are my answers to those, what do you think? I would love to hear your thoughts.
Next week I am debating whether or not medical marijuana should be legalized. Thoughts?

My new workout + my valentine's day companions

I discovered my new workout today as I began my valentine's day evening activities:

In case you can't see, these comps were "Wong's Nursing Care of Infants and Children" and "Pathophysiology: The Biologic basis for Disease in Adults and Children." Basically they're the biggest books I've ever owned and thus make up my workout for the evening. p.s. Do you see that nasty bruise on my right arm? Yep, that's from shooting ;) p.p.s. let's not notice my obvious double chin in this picture. okthanks.

In actuality, my real Valentine's day evening was going out to dinner with Taylor. We went to Brick Oven and it was so good! I had the Alfredo Lasagna. YUM! The date wasn't much like I expected it though :( I had a really hard time talking to him tonight. Oh well. He is super considerate, it's great.

Ok, back to creating my patho tree for RSV: Respiratory Syncytial Virus, the most common cause of bronchitis and pneumonia in children. Just FYI.

Boys and the NICU

The World Turned Upside Down

"If buttercups buzz'd after the bee,
If boats were on land, churches on sea,
If ponies rode men and if grass ate the cows,
And cats should be chased into holes by the mouse...

If summer were spring and the other way round,
Then all the world would be upside down."

This supposedly was sung when Cornwallis, the British general, surrendered to the Americans at Yorktown during the Revolutionary war. It would also be appropriate to have this played before every date I go on, because I feel that this explains my dating life right now. Did these boys go crazy? My world definitely turned upside down and backwards. In reality, I'm not going on that many dates, it just is a lot more than I am used to. In my last post I talked about how I was getting super nervous about some of these "second" dates (which have now become third dates) but something happened over these last few days. I've lost all interest in boys. Weird, huh? Oh well. Maybe I can pretend I got a boyfriend. Would that solve it? Or that I have a mission call? Ok, those are both lies. Can someone please talk sense into these boys? They really don't want to date me, they're just really confused and have a completely wrong impression of who I am. They want to date other girls that are actually interesting and who will actually be interested in them back. Ok, thanks.

On to more exciting news: I was able to have a shift in the NICU (neonatal intensive care unit) today! It was really interesting. Those babies were so tiny! I couldn't believe it. Some of them were as early as 23.5 weeks. That is insane. That means that they were about 3 months early. And they are surviving! Watching these babies made me want my own so much more than labor and delivery did (haha, maybe it's because I wasn't having to watch the super painful birthing process before I saw them...). I just wanted to hold them and to love them and to help them get healthy. I was reminded again of the sacredness of life. These precious babies are all God's children, He is aware of them, and He loves them all! 

Some things I learned: 

The most common problem seen in the NICU is respiratory difficulty. When babies are born prematurely, they don't have any surfactant in their lungs. Surfactant normally allows your lungs to expand easier, so in these babies we have to help them breathe. They are on  a lot of breathing treatments: ventilators, the CPAP, nasal canula, and several other types of oxygenation that I can't remember. 

If a preterm baby has too much oxygen (to help solve his/her respiratory difficulties) it can cause retinal damage and make them go blind. Hence they have to be VERY careful about how much oxygen they can give them--just barely enough. 

They sometimes use the umbilical cord vein as an IV. Interesting, huh? 

They have a lot of different kinds of incubators to keep the babies warm depending on their needs. It is really incredible, actually, how much we can do.

Ok, that's all I really want to write about. I love babies.  I need to go to bed.

 Sleep tight! :) 

Oh, one other thing. Did you know that the reason they put erythromycin in babies eyes when they are born is to prevent chlamydia and gonorrhea infections?! These are sexually transmitted diseases, for goodness sakes. I understand that STDs are dangerous and are becoming more and more of a problem, but to have this become standard nursing care for every baby seems really sad. And why, then, do they dislike if you opt out of this treatment? Oh, and the Hep B vaccine? This is also for a sexually transmitted disease. What is this world coming to? If a mother has no STDs, if she is very healthy, why is she criticized if she decides to opt out? Chill out nurses! Okay, that's all.

Third time's a CHARM! not

In my entire life I only remember getting light-headed/queasy/clammy-feeling 3 times. Remember the last time it happened? I wrote all about it here. Yeah, it was super embarrassing and humiliating but hilarious at the same time. I thought I'd learned my lesson and had experienced my "I almost fainted" story that every nurse (and doctor) has, but I was so completely wrong. It happened today. However, the third time I felt this horribly disturbing, I-have-no-control-over-what-is-going-on, feeling I was dumb enough to assume that it would pass if I looked away and thought about something else, made sure to bend my knees and took deep breaths. Wrong again! Because this time I actually FAINTED. Totally. Completely. I was out. 

Despite your assumptions that I was seeing something terribly gruesome and bloody, the culprit was actually the silly, inconsequential thing of watching the anesthesiologist put in an epidural. Yeah, super wimpy, I know. 

The funny thing is that I went in and watched a c-section as soon as I was "recovered" (aka face was no longer deathly white, my BP was back up, and I was no longer clammy and dizzy). And I wasn't bothered in the slightest. Despite the cutting, the blood, the splashing fluid, the cauterizing, the snipping, the pulling, the emerging baby, and the stitching back up. Yeah, I'm ridiculous. 

If you want to know what it feels like to pass out, read on (don't worry, I'm going to describe it, not share something sickening that will make you pass out) 

I was standing in the room, it was about 6:45 am, observing my nurse interacting with the patient. My mind started imagining me in this situation, with my future husband supporting me as I'm about to deliver a baby. The anesthesiologist walks in and starts to prep her skin for the epidural. "Oh, no bid deal, I've seen them come out and I'm definitely comfortable with needles," I thought. He gets his tray ready and then I see it. This black and white striped, thick, extremely long needle. "Whoa, that's a really big needle." He numbed her up with a small needle first and then takes this gigantic thing and shoves it into her back. And she doesn't even flinch. "That is really weird, I can't believe she doesn't feel that going in." Suddenly I started to get a little light headed. "Look away, take a deep breath, think about something else, and you'll be fine," I kept telling myself. So, I started day dreaming (or so I thought). I was very absorbed in this dream when suddenly I hear someone say, "are you ok?!" I cracked my eyes open and the first thought that popped into my head was, "this is a weird dream, I'm glad it's not real life" and then, "oh my goodness, this is real life and I am on the floor in the hospital with all these green scrubbed people looking down at me. I must have fainted. How embarrassing!"  Of course they call for help and give me juice and make me feel even more humiliated about it. And the dad-to-be is over there asking about how I'm doing instead of paying attention to his wife. Darn body, what's wrong with you? 

Like I said, after that I watched a c-section (this was a very strange thing, but really quick), saw another vaginal delivery, inserted my first catheter (yay!) and then went home. It was a very eventful day, and 100% great except for my fainting episode. 

Lesson learned: sit down when you feel light headed! You won't win this, no matter how hard you try.  However, this experience was far less embarrassing than the last time, when I really didn't faint. But being completely realistic, I was really blessed not to hit my head or get injured when I fell. If it wasn't for that, I'd say fainting is the way to go instead of drawing all the attention to yourself by saying you're about to faint...

Here's to hoping this will never happen again. Cheers! 

p.s. This was my last day on Labor/Delivery. :( But, next week I'm in Pediatrics!

Babies

Today I witnessed a miracle. It was beautiful. It was awe inspiring. Today, for the first time in real life, I saw a baby born. 

Today was my first day of clinical. It started off rather sobering, but ended up so well. I was able to "help" a mother with the delivery of her brand new baby. I saw the labor from just before she started pushing until she and her baby were taken down to the Mother/Baby unit. It was very different than I had expected, despite having to watch videos of a birth many times beforehand. 

Pushing took so much longer than I realized, even though I've heard about grueling long deliveries. It was tiring (and I wasn't even doing the work!). I couldn't believe my eyes when I saw that little head, covered in hair, starting to emerge. I kept thinking to myself, "how in the world is that a baby?!"It took a while for the rest of the body to follow, and there were a few concerns about possible complications, but everything went smoothly in the end. In the last few minutes, as that Mother was pushing so hard, and as the baby's shoulders, arms, torso, and legs suddenly came through, I couldn't believe that a brand new person had just entered the world. And I watched that tough Mamma and that tired Daddy beam as they were able to hold this new member of their family. 

Some people would describe that labor very differently. It was quite bloody, slightly gross if you think about it, very painful, stressful, long, tedious, and, occasionally, disheartening. But seeing that brand new human being, that child of Heavenly Father, makes it seem like it would all be worth it (I can't say it does, I've never experienced it ;). Throughout the day, as I heard sad stories about babies who didn't live, or miraculous stories about babies who lived when not expected to, I thought a lot about this quote:

“When God wants a great work done in the world or a great wrong righted, he goes about it in a very unusual way. He doesn’t stir up his earthquakes or send forth his thunderbolts. Instead, he has a helpless baby born, perhaps in a simple home of some obscure mother. And then God puts the idea into the mother’s heart, and she puts it into the baby’s mind. And then God waits. The greatest forces in the world are not the earthquakes and the thunderbolts. The greatest forces in the world are babies” (quoted in The Treasure Chest, edited by Charles L. Wallis [1965], 53).

I learned a lot of new things today (a LOT) and I thought about a lot of things. But I think the greatest thing that happened today was a reminder of how beautiful, and fragile, life is. 

Elder Neil L Andersen, a member of the Quorum of the Twelve Apostles of The Church of Jesus Christ of Latter-day Saints gave a beautiful talk last general conference entitled Children. I was reminded of that talk today. Here is one of the quotes that I love from his talk:

"It is a crowning privilege of a husband and wife who are able to bear children to provide mortal bodies for these spirit children of God. We believe in families, and we believe in children.

"We express deep gratitude for the enormous faith shown by husbands and wives (especially our wives) in their willingness to have children. When to have a child and how many children to have are private decisions to be made between a husband and wife and the Lord. These are sacred decisions—decisions that should be made with sincere prayer and acted on with great faith.

"Let us humbly and prayerfully seek to understand and accept God’s commandments, reverently listening for the voice of His Holy Spirit.

Families are central to God’s eternal plan. I testify of the great blessing of children and of the happiness they will bring us in this life and in the eternities" (Elder Neil L Anderson, Children, November Ensign, 2011).  


I saw just a little bit of that happiness in the hospital today.  And I was reminded again of how much I want to have children. It was a hard thing when I thought that day would come so much sooner and then it didn't. I don't think it will come for a long time. But I'm so glad I get to experience a little bit of that happiness through others' experiences. 

And I'm no so much more motivated to study, which is always a wonderfully needed thing. Yay for clinicals! 

p.s. Here is a beautiful talk by President Hinckley as well: Behold Your Little Ones

New Semester: Winter 2012

This semester I get to study these: Labor/Deliver, Mother/Baby, and Pediatrics.

I am so excited! This is where I have always dreamed I would work, where I hope to find what I love most. I start clinicals on Wednesday this week. I start out in Labor/Delivery, so last Wednesday we had a "birth simulation lab." It was so cool! Pregnancy and delivery are such miracles! It blows my mind every time I learn something new about how well the body prepares for and functions during labor. In lab we practiced how to measure how dilated and effaced a woman is. It doesn't seem very accurate, basically you're just guessing. Good thing they don't have student nurses do that in clinical!
We learned about what we need to assess when we care for a pregnant woman:

• Fetal Heart Rate
• Vital Signs
• Dilation and effacement
• Spotting
• Position (never flat on her back!)

Questions: 

• Has your water broken?
• How hard are your contractions? 
• How far apart/close together are they? 
• How is your pain? 

Interventions to relieve pain:

• Re-position 
• Dim lights
• Relaxing music
• Massage (I am so excited for this one--I LOVE giving massages!)
• Walking
• Baths

I'm sure I'll learn a LOT more when I start studying for reals and when I actually get to see a real live birth. 

Questions for any of you who have given birth: 

~Would you let a nursing student (a complete stranger) watch your delivery? 

~What makes a good labor/delivery nurse? 

~What interventions were the best in helping you relax/relieve pain? 

~Were there any super annoying things that nurses did that I should know to never do? :)

 I'm also in a conducting class, a New Testament class, and History of Creativity 2 (with Jason, my new Bro in law). I think it's going to be a good semester :)  

And I'm going...

To Provo, Utah!

No, it's not a mission call (that will be next July), it's for my nursing "study-abroad" for next Spring. I will be working with the at-risk population here in Utah. We will be working in the Jail, in the Prison, with the Children's Justice Center, and other places. It will be a really good experience. I'm kind of sad that I'm not going somewhere foreign (like Russia, Finland, Ghana, India, Taiwan, Ecuador, or Tonga) but I feel like this was the one I was supposed to put as my first choice. So it will be good. Definitely an adventure, right?

Last day of clinical (for the semester)!

Warning; Gross nasty (but super cool) descriptions ahead...

Trying to get a picture of these awesome green scrubs. 
I would've gotten a better one but I was afraid some nurse
would walk into the dressing room and see me and would 
think I was crazy...

Yesterday was the last day of clinical for this semester. Yes! There are mixed feelings, however. Sad to be done and sad that our clinical group is over but so happy that this semester is wrapping up. This next semester will be fantastic too! But yesterday I was in the OR again. And it was really cool. Here are some of the things I was able to see:

• An actually uterus. And ovaries. I was blown away by how small the uterus was. How in the world does it stretch big enough for a baby to fit inside?! That is such a miracle. The uterus really is one of the most amazing muscles in the human body, I finally agree ;)
• Lots of cauterized flesh. That was gross. But super interesting how it works. They cauterize all the blood vessels that they've cut to decrease the blood loss. 
• Fat tissue. This was probably the grossest thing. And the surgeon told me that it is really greasy, making it harder to work with the tools during the surgery. And the tech described in wonderful detail how the balls of "adipose tissue" fall on the floor and make the floor really slippery--hence stiletto heels are the safest thing to wear in an OR. Riiiiight.
• Lots of stitching. I was so surprised that the surgeon was able to stitch that mess of tissue back up, making it actually look how it's supposed to look after removing such large amounts of fat. 

I use all of these books at least once a week.

And other random happenings....

• The surgeon asked me if I was from a polygamist family when he found out (because he asked--I don't usually go around telling strangers about my big family) that I was the 7th of 13. 
• They asked me if I wanted to put in a catheter into a teenage boy. Luckily they were joking and didn't really need to put a catheter in. Phew! 
• The hospital environment can be SO horrible! That is my biggest complaint with nursing. Some of the people are so crude and disrespectful and I felt super uncomfortable. Thankfully they told me they were trying to be more careful with their language when they found out I was a BYU student.

These books were definitely mainstays for almost every assignment. Especially the drug guide...

 

And that was my day at the hospital. The last for a few weeks. But we start the 1st day of school at our new clinical site. And we're doing pediatrics and labor/delivery. I am so excited. You don't even know :)

What has nursing done to me?!

I have always been very much a farm girl. I was tough. Nothing grossed me out--manure? It's just a part of having animals, blood? not a bid deal. I've seen animals die, and although it was sad, I knew it was a part of life. I didn't care about getting dirty--in fact, I almost liked it. 
 
Well, today I had clinical again. And I did a bunch of stuff. I pulled out several IVs (and got blood on a gown--I'm so good at that...), removed two catheters, did an assessment, gave medications, gave a flu shot, watched an ultrasound-guided drainage of a cyst (that was cool), and had a doctor ask me to help him change a dressing and remove a drain (my reaction: "of course I would love to!" thinking to myself "oh my heavens, a doctor just talked to me, an unimportant nursing student!). It was a good day :) And everything I did was very clean--always put on gloves, always used sterile bandages, throw away things that fall on the floor, wash hands often--whenever they feel dirty, and avagard in and avagard out.

Then, when I got home (after I woke up from my nap), I went out to help my Dad with a new cow. She was SO dirty! Apparently the dairy she was at was all cement, and she had slipped and fallen this morning and then couldn't get up on the slippery surface, so we brought her here because she does fine just on dirt. But because she was on the ground all day she was such a mess! I held her rope while Dad sprayed her off with a hose. But all the while I kept wanting gloves. And when my Dad cut her long, stringy, wet, manure-covered tail and handed me the ends to throw away, I could barely grab it because I kept thinking I needed gloves! My Dad found a bloody spot on her back and was feeling it to see what it was, but I could not bring myself to touch it without gloves... And afterwards, when I let go of her rope, I was wanting to avagard so bad! It was ridiculous. It is definitely not because I've become a germaphobe--that's not it. It's just the rules they pound into our head so often that are conflicting with my "farm girl" habits. Never touch anything that could be contaminated without gloves, never touch bodily fluids without gloves, and ALWAYS avagard before and after every and any type of care.

Somehow I'm going to have to figure out how to change out of my "hospital/everything needs to be clean" mode when I'm out on the farm...

Nursing students: pitiful!

I found this on this blog (I hope they don't mind that I'm stealing it) and I thought it was funny. But the reason I thought it was so funny is because I know it's so true (I can SO relate)--so it might not be funny to anyone besides nursing students. But just in case:

You know you're a nursing student when (FYI--I only left the ones on here that I've actually noticed myself doing/thinking...)

You can discuss a stage 4 decubitus ulcer over lunch and not think twice about it

You look at people and immediately think...they have nice veins!

You diagnose yourself with whatever ailment you're studying at the time

You study until 1:00am and get up at 5:00am to study some more

You can cry in front of your classmates because you've seen them all cry before too.

You live off of snacks out of the vending machine

Two of the four test answers are correct but you have to pick the most correct answer (hate those)

You point out all of the medical mistakes on television shows

You write everything in nursing shorthand

You look at your paper cut and notice it is scabbing and think to yourself... epithelialization phase.

You forget what it's like to have free time....what's that?

You let your classmates stick you because they need the practice

You get excited when you hear an S3 or S4 in someone’s rhythm

You empty you scrub pockets and find alcohol pads, saline flushes, tape and gloves in them

You hear someone say they've been sick and you immediately begin to ask them to describe their symptoms to you in minute detail

Whenever you talk about someone (in good ways, not gossiping...) you consciously think about not breaking HIPPA

You had a fantastic day because you successfully inserted several IV's!

Ok, some of those are funnier than others--maybe none are funny to you, but perhaps you just got a better sense of what nursing school is like right about now ;)

That can't happen to ME! I'm gonna be a nurse!

It happened. It really did. I was so embarrassed! I was so mad that I was bitterly laughing at myself for about two hours after. And this is why:

I ALMOST FAINTED IN THE HOSPITAL! 

Can you believe it? I have only had that light headed, voices fading, ears ringing feeling ONCE before in my whole life. And it was because I was in a lab, trying to cut my finger enough to get some blood for the test we were doing. 

Today, I have no idea what set it off. I was in the Emergency Department this clinical. I had just finished watching the Tech put in the IV (and fish around for a while before it actually went in the vein) and draw out the 5 vials of blood.  But I had seen that multiple times already in the hospital.It may have been because I only ate a dry piece of bread and a peach for breakfast. I think it was the combination of me saying something stupid to the tech while she was putting in the IV and getting embarrassed, seeing her fish around in the arm for a little while to find the vein, and me not eating a very good breakfast.
The Nurse I was following asked me to help her put in a catheter. I had just barely started feeling my blood drain from my face and my fingers get a little tingly but I tried to will myself out of it. It didn't work and I told her I needed to sit down for a minute. Good thing I did because all the sudden my face went completely white, my vision kinda got blurry, and sounds were getting fuzzy. She looked at me and said "Yes! Goodness, your face is as white as your scrubs! Let's take your blood pressure." So, she grabbed the cuff of the patient's arm and got my blood pressure. It was 84/52. Normal for me is about 110/60. She was appalled. She called for a wheel chair and then I was appalled! 

So...I got wheeled into a room, placed in a bed, hooked up to the monitor, and made to be horribly embarrassed. I had to eat cookies and drink juice and sit in there for about 45 minutes. And the whole ER knew that the student had almost fainted. Humiliated? Yes. Frustrated? Yes. Had any control over that? NO! I was willing myself so hard not to get dizzy and faint and it didn't work! But, because that happened, I found out from almost every other nurse/tech/ER Doc that it had happened to them once when they were in school too. So that made me feel a little less embarrassed. But still. 

And so it happened. I hope that that will be my "once upon I time that happened to me ONCE!" story. And I now have much more sympathy for people who say they can't handle needles or the sight of blood. I guess sometimes getting faint is out of our control.

Edit:
I forgot to say that after this had occurred I put in an IV, filled those vials with blood, pulled out 4 IV's, and helped a patient get changed, dressed, and cleaned up enough to go home. And I was fine. Just so you know. :)

IV's!

Today I inserted my first IV. Ever. Also, I was injected with my first "IV" (I have had my blood drawn once before...but that doesn't really count). It was awesome! I loved it :) I was so nervous, but luckily I got to be poked first and that took away my nervousness. Brittany consented (again) to by my partner. She was great! I wanted to be able to post pictures of this monumental occasion, but, alas and alack, taking a picture is the last thing I think about when Brittany's blood is squirting all over my gloves.

To help me remember all the things we learned in lab today, I wanted to summarize it on here. It may be quite boring, so don't read on unless it interests you :) Here we go:

IV stands for intravenous. Intravenous therapy is so important as it is the fastest way to get electrolytes, fluids, antibiotics, and other medications into the body. Because of that, it is also very dangerous--once it's in, there is no correcting things, so don't make a mistake! IV's are so important in surgery (being able to replace fluid as blood is being lost), in emergency situations (dehydration, fluid excess, etc.), and having a better way to regulate medications or fluids in the hospital or clinical setting.


When you insert an IV you need to pick a vein that is elastic and healthy. You always see IV's in the forearm, but apparently you're supposed to start as distal (furthest down the limb) as possible. So you start on the hand if they have a healthy vein there. You do this so that if a vein bursts or becomes occluded and you need to move to another you still have options. If you started more proximal (further up on the limb) all the veins below the injection site couldn't be used because the blood flow would already be messed up. SO...today we started on the hand. Here are the steps we learned (I gave them my own numbering and grouped them in that way that made sense to me):

Step 1: Wash hands
Step 2: Introduce yourself to the patient, identify the patient (you know when nurses ask you about a million times to tell them your name and date of birth?), ask about previous IV experience, and explain the procedure.
Step 3: Gather supplies

Step 4: Put tourniquet on the patient to back up blood to find a good spot to stick-once found, mark the spot with either your fingernail or a sterile pen.
Step 5: Remove the tourniquet to allow blood flow again to the limb
Step 6: Clean the area with Chlorhexidine liquid application to kill the bacteria and allow to dry
Step 7: Prep your saline flush, open dressing and gauze
Step 8: Put the tourniquet back on-making sure you don't touch the area you just cleaned
Step 9: Put on gloves
Step 10: remove cap from needle, place thumb to pull skin taut, position your body directly in line with the place you're inserting the needle, put the needle directly on top of the vein, warn the poor soul you're poking, and PUSH.

Here is a depiction of pushing the needle into the vein.

This is the catheter-it shows all the parts that I'm talking about. The cannula is the "hub," the knob is the "safety" to retract the needle, and the blood chamber is where, obviously, you'll see the blood flash.

Screw on the Saline Flush

Once you're in the vein you should see a flash back of blood. When you see that, insert the needle a tiny, tiny bit farther. Then, while still holding everything stable but without touching the skin you've cleaned, advance just the catheter up to the hub. Then, using your non-dominant hand (making sure you still hold on to the catheter with your dominant hand!) remove the tourniquet, apply pressure with your middle finger on the vein just above the catheter (to stop the blood from squirting out all over), stabilize the catheter with your first finger from your same hand--it's kinda a loooong stretch (remember, no touching the skin or it becomes contaminated-only the hub of the catheter), let go with your dominant hand and push the safety to retract the needle, dispose of that in the "sharps" container, grab the saline flush, remove cap with just one hand (make sure you keep it sterile), and screw on to the catheter.

Whew! Can you tell that it's kind of a stressful process? You then flush it with saline to make sure the vein is not occluded, secure it with the dressing, and date, time, and initial on top of the dressing (you have to change the IV every 72 hrs) and from there you can attach whatever it is you need to be putting in the vein.


And there you have an inserted IV! You have to watch the site carefully to make sure the vein or the skin around the insertion site has not been irritated and to make sure the fluid is actually going in to the vein. Watch for redness and swelling to make sure there isn't any clotting or emboli.

And, because we've learned it so SO many times (to make sure we know how critical it is), know that you never NEVER never never  allow anyone to push potassium chloride. It is fatal.

Anyway, I hope that someone learned something about veins and IV's and that this information is better cemented in my brain.

And in case you're wondering-the veins in my hand refused to cooperate, so Brittany had to move up my arm to the AC (antecubital fossa aka the spot right where your arm bends :). Brittany had much better veins in her hand, I just accidentally forgot to put pressure on the vein before I pulled the needle out...and blood went everywhere! I still need to practice a lot, but, surprisingly, it was fun (is that sick?), and I really want to get good at it. You're only allowed 2 tries in the hospital you know.

ttfn, ta ta for now!

The Semester is OVER!!

So, I haven't written on my blog for a long time. You know why? Because school has been super super busy. But guess what? It's over! Until tomorrow. But the nice thing about Spring and Summer terms is that I'm not really going to be a nursing student. Don't get me wrong, I love the nursing program, and I love (most of) the things we study. But it will be nice to be a "normal" college student for 2 terms :)

But, looking back over the semester, there were so many more things I could have learned! And so, to make up for the things that I didn't master, I am going to try to spend a few hours a week reviewing this past semester's material.

Spring term will be super fun. I'm taking Statistics, Church History, Guitar, and Jazz Dance. I'm excited. And so, although this blog contains the word "nurse" in the title, for the next few months it won't really contain posts that are applicable to stated title. Maybe I'll change it for the summer. :)

Life

It has been interesting, learning about the process of aging. Gerontological nursing is not a very happy, uplifting area. You learn about all the hard things that happen when you get old; the loss of friends, loved ones, hobbies, physical ability, senses, possessions, etc. Basically every thing that makes life worth living. Or so it seems. I've thought a lot about this lately, about the purpose of life. In my class "Nursing Care of the Older Adult," one of the students mentioned briefly that one of the hardest things about getting old is that you lose the ability to serve people in the same way you used to, to work the same way you used to, to be useful to people like you have your whole life, that the process of changing roles from a caregiver to a dependent care receiver is a very humbling, hard thing.

As I've thought about this aging process, however (losing loved ones, losing your ability, possibly having pain for the rest of your life), I've realized how blessed we are to have the Gospel. If I did not have a knowledge of what life is about, of the importance of building your own character, of always striving to be better, the importance of family relationships, and, most importantly, the faith that God knows everything and he knows what is best for each individual person, I would probably just drop out of everything and give up. There is so much uncertainty, so many things I do not, and probably will not, ever understand. So many things that don't make sense to me, and the only way I can be okay with that fact is having the faith that our loving Heavenly Father wants the best for us, that he is watching over and guiding us in every small detail of our lives. And that makes life worth living :)

Shots

On Wednesday I had my first experience giving shots. And, the end result is that I have so much less stress than I did before!

I have been really worried for months that I would not be able to give shots without getting dizzy or faint. All growing up I was fine with needles and blood, but in the past year, the 3 times I have had to draw my own blood for labs, or had to have my blood drawn for a test, I have gotten really light headed and shaky. I wasn't sure if it was because of the blood, the needle, or because I was a wimp and didn't like the pain. But I was worried.
So when I went to class and was able to give three shots with quite long needles to a real live person, without passing out, I was quite excited.

We learned about the parenteral routes (injecting medicine into a tissue) of med administration:

• ID shots or intradermal (into the dermis) are what they give for shots like the TB test, where they need to be able to assess the reaction of your skin to whatever substance they injected into you. 
• IM or intramuscular (into the muscle) are the shots you get for most other things: immunizations, flu shots, strep shots, etc. 
• Next week we'll learn about Sub-Q or subcutaneous (just below the dermis) injections. You use these to administer things like insulin to a diabetic patient. And then next semester we'll learn about IV or intravenous (into the vein) shots.

We gave the ID shot in the forearm. The way to figure out where to give it is to go three fingers down from the elbow joint (on the front or your arm). You insert the medication just below the surface and it creates a little bleb, or white bump on your arm. We did this one first and it was probably the most painful because it basically rips your skin apart in the one little area. We gave the IM injections on the deltoid muscle and the ventrolgluteal muscle.

Poor Brittany gave me all my shots and we realized quickly that I bleed a ton! When I stabbed her she hardly bled at all, but when she poked me I was gushing. The worst/funniest time was when she was getting ready to poke my thigh. I was expecting her to practice once with the needle cap on (like we had both done on the deltoid and I had done on her ventrogluteal) but she didn't need to. So, when I felt the needle I was so startled that I jerked and she had to pull the needle out. It hardly hurt at all, but there was blood everywhere! So, she cleaned it up, got a new needle, and had to do it again. Sorry Brittany!

But it was awesome! Definitely a good experience overall. Thinking back on it I can't believe I was able to push those 1 1/2 inch needles all the way up to their hub into Brittany's muscle, but now I know that I definitely can do it. And I am starting to fee like a real nurse! :)