Saturday, July 31, 2010

Wrong side of the bed... where I woke up on Thursday!! Granted, I am aware that we are completely in control of our own attitudes.....more words of wisdom growing up from my mom....but I'm pretty sure I threw that out the window when I got up! Ah, it was my fault that I was so tired that morning. I procrastinated on my careplan that was due and typing/researching for 22 pages on Wed just didn't cut it! So when I crawled into bed at 12:30am and set my alarm for 4:00am I was already ticked. Thank my alarm when off and I am pretty sure there were tears.

Thankfully, Trav and I both made it out the door dressed and with breakfast by five. I knew I had a long day ahead so I called the Butterfields, knowing that with the time change they were awake. Talking with Maddie and Savi turned my mood completely around. Let's start the day!

This clinical day was different. Instead of one patient, we were assigned two. Double the medications to learn & give, double the daily care, double the research, and double the trouble! Our instructor wanted us all to pass meds to both patients in a two hour time frame. Well, for students this is an impossible task. If it wasn't required that before passing meds we had to list the side effects, classifications, reasoning, and teaching for each medication ( mind you the average pt at the facility is on 20 meds) than we might have made it. Eh, maybe. I was really exited because I was up to give IVPB (hang piggyback antibiotics) and IV push narcotics. Those would both be something new for me to try. However, our medication passing went waaaayyyy to slow and my patient's couldn't wait for my instructor to get to my turn for their pain meds and ATB, so I missed out.

IV push


I enjoyed the two patients I did have and I was able to administer meds via G-tube and give insulin injections. Have I mention I love giving injections? It's definitely a thrill. Especially when you go quick and you no the patient felt nothing but a slight prick. The patient in bed 1 had been at the facility for 120 days. At one time she was a very successful career woman but she abused alcohol causing her liver to now be shot. From her excessive drinking, she developed a seizure disorder and suffered from a bad fall. That fall caused an intracranial hemorrhage (bleed) that left significant damage. She was given a trach, artificial airway, and she still has it. She is unable to clear all her muscou/secretions, so when I went in to do her morning assessment, her chest was covered in an inch thick pile of mucous. Poor thing! Who lets someone sit in that?! Frequent suctioning was performed all day. Suctioning through a trach is a sterile procedure, fyi.

Suction Kit

My patient in bed 2 was alert, oriented, ambulatory and mostly independent. She was in due to a pretty massive wound that required her to be hooked up to a wound vac. (I will save you from a picture of that!) She is a smoker and would take frequent breaks to head out side for a cigarette time out. We have to respect our patent's wishes and their lifestyle, but when she asked me to walk to halls and find her a cigarette, I had to redirect the conversation. It was nice having a patient to talk to though and who wasn't comatose. Once I had finished assessments and care for my patients, I stopped by the room of my sweet patient from a few weeks ago. This is the man who is on his way to recovery and I wanted to check on his status. When I popped my head in, he was up in a chair finishing breakfast and about ready to start occupational therapy. He looked great! Plus, he remembered me which totally made my day. I chatted with him for a little bit. He wasn't able to answer all my questions or formulate a response but that's ok. I can see he is progressing which is awesome.

Another week at Kindred down with only 3 more left. Crazy how fast time has flown. And, a total blessing how each week brings a new set of confidence, new fears to overcome, and new lives to make a difference in.

Monday, July 26, 2010

Healing Begins - Tenth Avenue North - w/lyrics

Another one of my favorite artists and songs! I often hear a song that really means something to me and I hang on to it, playing it over an over! I go through "songs of the week". This one is this weeks and I just love it.

Music was always my passion and I miss it. It was a way for me to express myself. Music makes me feel and moves me. One of these days I will find a way to be involved with something musically again. Until than, I will just soak up the good music that is out there.

Sunday, July 25, 2010

We love Bass Lake!

Here is a photo collection of the few days we spent at the lake with Cindy's family! It's a great tradition and we look forward to it every year!

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A day in the NICU


This term, I am in an OB clinical as well as med-surg. For our OB rotation we are at UCI medical center and it is GORGEOUS to say the least! Have you seen the "Grey's Anatomy" episode where they find the Dermatology unit and are so in awe of how peaceful it is? Well, the lobby of UCI is identical to it. I want to take a magazine on my day off, grab a latte, and just relax. During OB clinical, we spend each day in a different unit. I started out in the NICU with my friend Vanessa. I fell in love at first visit. 


         NICU is like walking into a whole different world of medicine. It is highly specialized and an average nurse cannot float to the unit. Everything is small. I know, sounds funny, but I am used to dealing with "large" tubes, large people, and a completely different environment.  At first glance, it seems to be a room full or tubes and machines that are so foreign but when taking a closer look they all start to make sense. 

I had a fantastic nurse, Jen, to work with. She was a great teacher and thought out loud the whole day so I would learn. I wasn't able to do much but she kept me as involved as possible. We had two babies for the day and she did an assessment on one, than had me do the other. We gave meds, changed diapers, fed through a bottle and oral gavage, and loved those lil premis.  

My niece, Zoey, was in the NICU when she was born. While she wasn't as critical as most of the babies there, I did get a feel for the unit at the time and I remember loving it than as well. 

I really fell in love with the NICU. My heart tells me that working in pediatric oncology is where I am supposed to be but I've never been in the unit, so I realy have no idea what it is like. However, should that not end up being in the Lord's plan for my nursing career, I pray that a door into the NICU would open up because I think I could make a huge difference there. My cousin, Rochelle, and I had a long talk about nursing, the NICU, and oncology. She is one of few who doesn't think I'm crazy when I say oncology is my passion, instead she replies with " I totally see you there." We were talking about how in the NICU and Onc units you become a huge part of the patient's stories because you build relationships and you don't just see them one day to have them discharged the next. I think that is one of the big reasons nursing is for me. I want that relationship with my patient's. I want to be their advocates, their teacher, a counselor to them or to the family, a listening ear, smile, or gentle touch, and a caregiver. I'm not sure where I will end up next February, but I am very excited to step into this role.

Saturday, July 24, 2010

2 years down...Forever to go!

This past Tuesday we celebrated our 2 year wedding anniversary in Bass Lake! Can't even believe it's been two years! The Lord is good and they have been a fun filled 2 years where we have been challenged and grown alot as one. We love looking back through our wedding pics and remembering the day. One of the greatest things was having all the nieces and nephews play such a huge part. Most of my memories from the day include one of the kids and I just love that!

Here is to another 50 + years together! We are excited to see what the Lord has planned for us in our 3rd year and where He will lead us! Thanks to all of you who shared that special day with us and who continue to support and love us! You are so appreciated and we love you!

 What a fabulous day!!!! :)

Be strong in the Lord....

I LOVE this song! I blast it when it comes on the Fish! Hope you enjoy it as much as I do :)

The words are so powerful, reassuring, and comforting.

"Don't forget why you are here. Take your time and pray"

It's getting better....

finally! Thursday ended up being this great clinical day that I was not expecting.As soon as I received report from my RN, she let me know that my patient needed a straight cath for a urinalysis and urine culture. Sweet! Starting the day off with a new procedure is not too shabby. I've done regular indwelling, Foley catheters before but never a straight cath. I've also only done one female cath and it was unsuccessful. The patient was young and in labor with no epidural or pain meds and it was just not going to happen.

I stood in the hallway and talked through the procedure with my professor than headed in. I had my cath kit and I examined the patient first to find my landmarks. Let's just say, the female genitalia is much different on a live person that on the mannequin in skills lab! I than began prepping my sterile field. I donned my sterile gloves and continued with the steps. My first try was unsuccessful but I wasn't upset about it. My patient had an atrophied urethral meatus that had shift to the side and it was pretty hard to see at first. Plus she was so contracted bilaterally on her upper and lower extremities, my instructor was literally holding her legs with her elbows because it was so difficult. On the second attempt with a new sterile field, I nailed it right away. It was such a thrill to see urine filling the bag. I took my sample for the lab and we were good to go!
My patient had a seizure disorder and I ended up putting pads on her rails. She had contractures and was non verbal. Due to her difficulty swallowing, there was consistent, copius amounts of this frothy mucous bubbling out of her mouth. I suctioned her constantly all day. She also hadn't had a bowel movement in 2 days so I administered a few stool softeners. They worked ! She pooped! My friend Gem, who helped me clean her, and I were so excited when she pooped you would have thought we had won the lottery. We changed her and her bed, only to have her go again! Yes! Great job! We waited a bit, just in case, and than cleaned her back up. I felt proud...weird I know....but the meds worked and now she doesn't have an uncomfortable tummy!

I was able to pass her meds through her g-tube and felt 100 x more comfortable than the last time. My teacher even praised me for knowing my meds and their info. Gem and I teamed up as a bed bath team to help each other bathe our patients. They are hard to move with their trachs and tubing....and it's just hard trying to roll a patient who is immobile.

Overal it was a great day. I felt as if I had overcome some fears and challenges as well as tried new things. I don't know what next week will hold, but it can only get better!

God is good :)

Expect the Unexpected

It would only make sense that my team lead day would not go as planned! The week of I had really bad neck and skull pain. I was ignoring it, while taking no medications of course. Late the night before my clinical, the pain became really severe. I couldn't even lay my head on my pillow. I fell asleep with an all around my head, hoping it would help. I woke up at 2am and though my head was going to either explode or fall off. So I decided to just get up for the day and went and watched tv. I ended up taking alot of meds that conked me out till I woke up for clinical a few hours later.

In a way it was a blessing that this happened when I was team lead so that I didn't have one patient who wouldn't receive the best care from me. However, on the day of I couldn't move my neck in any direction. Pain became so bad it made me sick....and I have a weirdly high pain tolerance. I never take meds and I just ignore headaches. My classmates were great at understanding and made sure to make fun of my robot form!

I had a schedule ready for the day with a flow sheet on each student and their patient's information from admitting dx to allergies, meds, and other pertinent info. The medication times were set for who would pass when and it totally failed! I was pretty bummed. Our teacher has us rattle off the med names, drug class, side effects, and what to monitor for, for each medication. Let's just say, it takes a loooong time. Plus, with students doing new forms of med passing such as IV push or IV piggyback, it's bound to go a little slower.

Overall though, the day went well. I managed to work through all the pain and was able to assist all of my classmates with whatever they needed from bed baths, to bouncing procedure steps off each others, to just be an extra set of hands. I don't have the personality of a leader but I tried my hardest to portray one that day!

I ended up leaving clinical to going straight to the ER. I wouldn't have gone if my pain hadn't been so bad I couldn't think and my neck had swelled up so much, my throat was closing and I couldn't swallow. Steroids, muscle relaxers, pain meds, antibiotics, and a CT scan later I was diagnosed with a bacterial infection that had hit everywhere from my sinuses down to my neck. Needless to say, a trip to Bass Lake the next day healed me completely! :-)

Here's to working on my leadership skills!

Wednesday, July 14, 2010

Team Leader

Ah yes, it's the eve of another Thursday in the life of an RN student! :-) This week is a little different for me. I still had to head to the hospital today, but I did not pick out a patient. Why you may ask?! Because tomorow I will take on the role of Team Leader. The role of team lead acts much like a charge nurse would on the floor. My peers patients are also my own. I will be available tomorrow to help and assist with anything they need. Tonight, I will be putting together a report on each patient to rattle off to our instructor in the morning. I will need to set up a med pass schedule so it flows in the morning. 

Leader positions are not my strong point but I am excited for this challenge and new role tomorrow. I think I will learn alot, as I will have my hands in 7 different patients and their needs instead of just one. Prays for effective leadership skills and great teamwork tomorrow would be great!

To trying new things,

A newbie team leader

Hup Holland Hup

Go Holland Go!!! I will admit to jumping on the World Cup bandwagon! I usually don't watch soccer. Trav would have to bribe me or promise to sit through a chick flick later if I watched the game. I'm all for watching if I know a player or we go see a friend's game, but it's not a sport I follow. However, I do like the World Cup. The excitement, close games, countries uniting across the world, crazy fans.....I  love it! This year, Trav's "roots" made it to the finals! I was pulling for Germany to beat Spain because I thought it would be so cool to watch the teams from our heritage play each other.

So, due to the fact that Holland made the finals, I instantly acquired Dutch roots. :) I have none in me but I am happy to inherit through marriage a little Dutch and even more excited to pass that heritage on to our kids one day! We were both pumped for the final game and decided we wanted to "experience" the game someplace other than our living room. We both love San Diego and haven't made a day trip down there in awhile. Our cousin, Josh, gave us some great tips on places to watch the game. We headed down on Sunday morning, decked out in our orange of course, only to find that everyone else had the same idea we did. The British soccer pub we had wanted to go to had been sold out since 8am! Crazy! Plan B came into play as we changed locations to Oggi's in Point Loma. It was right by where Josh and Bekah lived so they met up with us for lunch and to cheer on the Netherlands!

After the game, we swung by their place to check it out. What a gorgeous view they have over looking the harbor! They gave us some inside pointers on things to do in the area and thankfully, directions too! It was really fun having the chance to hang with them and we look forward to spending more time at Bass Lake together! Trav and I journeyed to Ocean Beach and took in the atmosphere. Hippie comes to mind but we loved it! Bekah recommended this delicious smoothie place with great acai bowls. The bowl looked delish but it was huge so I stuck with an acai smoothie that was to die for! If you haven't tried acai, it's a must! 

After walking around we headed over to Balboa Park. Love at first sight? I think so! What a great place it is! You feel as if you are in a whole different country. 
  Museums line the streets where street performers are working to make a few bucks. Families with kids running around, people walking their dogs, and students studying on the grassy lawns that scatter across the park. We walked around probably the entire area, even ending up on a Palm Canyon hiking trail that was gorgeous. 

One of our favorite stops were these little huts representing different countries. We weren't able to go inside because they had closed, but we peaked in the windows.
It was a great day-cation! If you are in the San Diego area, stop by Balboa Park!

Tuesday, July 13, 2010

Behind the Music

I have loved this song for awhile. It helped me see through some tough things that were changing around me. I fell in love with it even more when I dug deeper to see what the inspiration behind the song was. It's amazing. It still makes me cry every time I watch the videos but well worth it! There are more videos you can google that continue on the family's story.

Enjoy! The song is wonderful....the story is miraculous.

Med-Surg Day #2

Last Thursday was spent back on the med-surg floor. Thank you for all who said a little prayer for confidence! I definitely felt it as I walked through the doors that morning. I was assigned to a fantastic nurse, Joey. I've been really fortunate with the RNs that I have been assigned too because they have all wanted to teach instead of placing bed linens in my hands and telling me to go for it. While I don't mind doing bedside care at all, I love to learn and watch, catching any new procedure that i can.

My patient was a delight. A 71 year old man who had recently had a intracranial hemorrhage. He is on his way out of the facility which is exciting. When he was admitted in May, he was in acute respiratory failure and immediately placed on a trach. Just recently, the trach was removed, allowing him to breath on his own again with no supplemental O2. There are some lasting effects of the hemorrhage though. He suffers from left side neglect, favoring his right side for all activities. He had tremors as well which he takes medication for but they still interfere with his ability to care for himself entirely. When I went in to introduce myself he was fast asleep. I really don't like waking patients up. I know I had to since he needed his vitals and the breakfast tray had arrived. He was pretty slow to wake up but once he did, I introduced myself and had him try to repeat my name. It took him quite awhile since his cognition is still pretty delayed. He did however grab onto my hand and squeeze it as hard as he could. I let him know he was extra special today because he had his regular nurse AND a nursing student, so he would be spoiled for the day!

Before I had the chance to assist him with feeding, the occupational therapist came in for his morning work out. It was really helpful to see her working with him. I was able to grasp what he was capable of and where he struggled. I even made note of certain things so I could make sure to work with him on them throughout the day. It's pretty interesting how life works. We come into this world and are placed in diapers, strollers, need to be fed, and our start out learning on simple, child games. I than see people towards the end of their life who are again in diapers, use wheel chairs, need help with feeding, and are back using child toys to restore their motor skills and cognitive thought. After OT was done, it was time for my patient to eat breakfast. I wanted to make sure he did as much on his own as possible....i was simple there to make sure he didn't aspirate and help when needed. I opened everything and asked what he wanted first. IN a soft whisper he said, "coffee". My kind of guy! With the rest of his meal, I encourage him to "stab" things with his fork and than bring it up to his mouth. He did so well! I felt like a coach cheering him on with every bite he grabbed on his own. He even opened his own straw and I went crazy with excitement! I felt like a proud parent watching him attempt and accomplish new tasks. You see, for each one, it led him a step closer to not only being discharged, but also regaining independence, self esteem, and a part of his past life back.

After breakfast, speech therapy came in. It was a new therapist and since he did now know her, he shut down. I tried encouraging as well but he wouldn't have it. My instructor came in soon after to pass meds with me. Although he is not fed through his G-tube, it is still intact for medication purposes until he is cleared to swallow his meds. I said a quick prayer for confidence as my instructor intimidates me like I never have been before. As I went through the list of his meds with her and rattled off the classification, side effects, and reason for taking it, I gained a little more confidence. I began taking each tablet from the medicine cabinet and I was pretty pumped to be doing all the dosage calculations in my head. I was shaking though and I tried to make light of it with my instructor but she shut me down. Awesome. Kick me back to the curb lady. After crushing the tablets and getting everything set up to administer, the nervousness set in. Back in LVN school i could pass meds through a G-tube with my eyes closed. Well, that's gone. As I went to flush the tubing, I realized that the extra lumens were different than I had seen. I thought I had closed off the right side but was soon proven wrong as water shot out the side! Holy cow my heart stopped. My instructor was ticked! I felt like an idiot to say the least. NEVER in my life have I done that! I moved on ad continued to administer the meds by gravity through the tube and flush again. I could see how annoyed my teacher was. The thing is, we are all students. We all make mistakes. If she hadn't of intimidated me and made me feel so uncomfortable, I probably wouldn't have slipped up at that time but it was bound to happen. I KNOW she made mistakes when she was in school, but man, she made me feel awful. Confidence = shot out the window!

Aside from the mess, it was a great day. I truly enjoyed each minute with my patient. After lunch, I stopped in to check on him. I gave him his meds ( with no spills!) and than stayed to talk. I would ask him a question and wait for his reply. It was interesting because his eyes would move side to side, than his mouth would move as if he was speaking but nothing came out. You could see him searching deep into his thoughts to figure out how to say what he wanted to. Everything is delayed and he knew what he wanted to say but couldn't figure out how. When he would finally answer I would squeeze his hand so he knew I was proud and than continue on with another one. I felt a sense of pride for him that day that I haven't felt before. In just the short time I was with him, I saw improvements. The OT was walking through the halls later on and stopped to talk to me, asking how the day was going. I filled her in on his accomplishments and how great he was doing. She grabbed my should to thank me and said he hadn't been talking at all these past few days. I hope when I head back this week to stop in and say hi to him. He may not remember me, but I will always remember him.

I drove home that night with a heavy heart. I remember this feeling from before at the end of a clinical day. Emotionally, it is draining. I used to head straight to the gym right after clinical to burn off anything I was feeling before heading home to family. I'm going to have to start that again. That day I just blasted the FISH so loud it pretty much drowned out my thoughts.

My words of advice for today are: Love, love, Love those close to you. You just never know when everything will change. What you have one day, you might not the next. So tell them you love them every chance you get. Hug them. Cherish them calling you by name. And make the most of each day. Whether it is folding laundry or going for a walk, it can be taken away so quickly. Here was a man who had everything and in the blink of an eye, a vessel in his brain burst and now he is fighting to be somewhat of the person he was before. So go hug your family. Tell them you love them. And seriously, live each day to the fullest. Starting now :-)

Monday, July 12, 2010

Lou Gehrig's Disease

We are currently going over the Neuro system in my med-surg lecture. If you haven't heard of Lou Gehrig's disease, it is pretty devastating.

If you have a few minutes, this is a really sweet story of a couple who fought through the disease together. I love inspirational medical stories like this.

Tom's Dream: A World Without ALS (A Love Story)

Wednesday, July 7, 2010

A new day

Tomorrow offers a brand new day on the med-surg floor.I'm excited to be back at the facility but I have to admit, after my lack of confidence freak attack last week, there is a small amount of anxiousness to tomorrow. I headed over to the facility tonight to pick my patient. After picking up a chart, I set to work taking down his history, diagnosis, and medications. From the looks of it tomorrow will be a great day.

He was recently weaned from his trach and was discontinued from being dysphagic today. ( having difficulty swallowing) He was placed on a mechanical soft diet with thin liquids and a 1:1 feeding. Meaning.....I will get to feed him breakfast and lunch. I actually really like being able to sit and feed patients. It's another blessing to being a student because I have the time to be with them and let them eat at their own pace instead of rushing through it because there are more patients to tend too. He suffers from L sided hemiparesis....paralyzed on the left side....from a stroke so he will need extra assistance with ADLs. ( Activities of daily living) Along with many other health problems he has a seizure disorder and Hep C. This will be my first time with a patient with both of these.

If you get a chance, pray for some confidence to head my way tomorrow! I don't like this feeling of nervousness! Pray for my patient and that I can do my absolute best to help him tomorrow and make his day just a little bit better.

Now, I must sleep! I've researched his medications and my careplan ( 21 pages!) that is due tomorrow is finished and man, she is a beauty!


An anxious RN student

Tuesday, July 6, 2010

The Fourth

I love the 4th of July! I have such good memories of this holiday from growing up. At our old house on French street, the whole block would get together for a block party. Kids would ride ride their bikes, run back and forth between homes, and those were the days of using sparklers! Moving to the Rivertrail house brought even more memories. The day would be spent at the pool and playing outside. My sisters and I would help my mom in the kitchen making dessert and preparing dinner. We would sit on the back patio, shucking fresh green beans, chatting away while my dad was grilling on the bbq. The 4th of July truly is the " All American" family day with those wonderful summer nights. Every year, for as long as I can remember, my mom makes the same dessert and I anticipate it all year. After whipping up a delicious batch of brownies, the fun begins! She would set up a station on the counter and Trav soon learned what a treat it was. He quickly was the first to get in line. After putting the brownie in her holiday blue bowls, we would load up with ice cream, strawberries, blueberries, cool whip, nuts, chocolate sauce, and you can't forget her lil flag candy toppings to polish it off!

On top of the dessert, Trav and I soon started our own traditions when we were dating. We started going to Peralta Park for their firework show. We always went early because we loved the atmosphere and would talk about one day taking our kids. The park fills up with families. Kids are running around playing frisbee, tag, soccer, football, you name it. There are booths selling snow cones, hot dogs, and other typical 4th food. Than, everyone finds their spot on the field and waits for the show. It's actually really good....and not cheesy!

This year, the 4th started out a lil rocky. The day before I had to say goodbye to my dad. It was a total killer. And on Monday, I said goodbye to my Millie girl. Leaving AZ this time was harder than I could have imagined because this time, I was leaving so many people I hold close to my heart. I would be coming home to a place where I could no longer drive 10 minutes to see my parents or know that I have them nearby. My morning was bittersweet as I listened to my sister and her girls plan their 4th of July activities for my parents coming over. We did however eat 4th of July waffles which were wonderful! Trav surprised me at the airport...I thought he was working! He is pretty sweet and knows exactly when I'm sad and I don't even have to say it. Sometimes silence is best. I was pretty teary eyed on the way home and he just sat and held my hand which is just what I needed. I wanted to crawl into bed so I could wake up and have everything be fine, but of course that is not the way to cope with things. Trav's parents were having a bbq that afternoon. I'm very thankful they are close by.....and that we have nephews here too! It makes holidays that much better! The ache I felt inside was soon soothed when we walked in the door to see Huddy's smiling face saying, " Ehhhmmmmmaaahhh!" Have I mentioned it totally melts my heart to hear him say my name?! Van man soon showed us how brave he is now that he swims without a life jacket! What a stud! While the tears were still a breath away, it was great having the Hardeman clan together to celebrate. Katie brought dessert and it made me so happy because it was close to my mom's! It was delicious...angel food cake, berries, cool whip, and ice cream. Yum!!

You can't have 4th of July without fireworks and since Peralta had already done their show, we found that Fullerton High did one right by our house. Van man took a good nap so he would be able to go! Heidi and Dan came by and we walked on over. Ok, I should say trecked on over! After getting to the school we realized we had come in from the wrong side. Oops! So, we climbed though bushes, trees, and along side a hill to get to our spot! It was fun and the fireworks were awesome as usual. The best part was hearing Vans comments about each one and seeing his excitement!

Hope you all had a wonderful 4th of July and enjoyed time with family!

                                                                     Yum! Flag Waffles!
                                                                   Tessa loved her waffle!!!!
                                                                 Waiting for fireworks!
                                                                         Funny face!

Confidence Please!

Whew! The first day is done and under my belt!! What a day it was! After four hours of sleep the night before, I was seriously praying for some strength to get me through the 14 hours ahead....ok, and an awful lot of coffee!! It was a somewhat "rusty" first day but I think that is expected. We all needed a day to get used to the routine and the facility as well as what is expected of us. Figuring out the organization of the med room, iv room, and clean utility is enough to take a whole day!

My pt was a delight.  She suffered from multiple medical problems. Having dementia, she needed to be re-oriented to the time and place quiet frequently. She was pleasant and simply just wanted someone to be there with her. She had recently been transferred from a SNF and she was extremely malnourished. Her entire body had loss all muscle mass, completely atrophied. Each bony prominence displayed a  pressure ulcer. To me, it's unacceptable. I understand that being malnourished with multiple medical problems puts you at a high risk for decubs.....but covering the whole body? She should have been turned every two hours, heel protectors placed, supported by pillows and checked frequently because an ulcer can go from Stage 1 to unstagable all too quickly in a patient like her. But now she is suffering severe discomfort and having difficulty healing.

Anyways, I think I will sum up the day for you in positives and negatives because there was an awful lot of both!!!

Positive: I was involved in pt care! I've really missed the pt interaction and it felt so good to be working with a live person and not a mannequin!!

Positive: Our facility offers FREE coffee and flavored ( hazelnut AND french vanilla) creamer all day!!! Heavenly?!?! I think so!

Negative: I realized that I lost all confidence as a nurse. In the time between graduating my LVN school and now, it somehow flew out the window and I would love to get it back! Before, I was so sure of myself with med passing, dosage calcs, G-Tube feed changes & meds, and so much more. I walked into my pt's room, looked around, and literally thought, " Holy cow. I've forgotten it all!" I'm really hoping with each clinical day I gain some confidence back!

Positive: My pt had diarrhea. You just re-read to see if it was a positive or negative, huh? Ha! Well let it be was a positive! You see, at the facility there are 20+ pts to one CNA. care can often be overlooked. I'm glad to have my sweet pt because with frequent bowel incontinence she is prone to more skin breakdown, infection in her sacral ulcer, and simply being uncomfortable. Aside from that, her dignity gets taken away each time as she has to sit in it and just wait for someone to help her out. Would you like that?! Nope. Me either. So, it was pure joy to clean her each time right away while making her feel comfortable and that it was simply not a big deal.

Negative: I didn't get to change her IV. It was due to be changed but my RN I was working under had been off the floor for 3 months and wanted the practice again. I felt a little better though after she blew 3 veins before getting it. The pt was fragile and the veins were hardly visible. It would have been hard for me to start it being so inexperienced.

Positive: I worked with an awesome RN. I couldn't have asked for someone better. She made sure to take the time and explain everything she did. She question me which was scary but good because I do need to know the rationales for everything that is done. She was so great in teaching me lil tricks to save time and a way that wasn't confusing. I feel pretty blessed to have had her.

Negative: I was driving an empty house...and was about to get off the freeway to see my parents and share about my day. But, they are in AZ  so I quickly got out of the turn lane and headed home. I'm going to miss that. Walking in the front door to see them sitting at the table. Joining them and sharing the joys and challenges of the day as they offer support.

Positive: I watched a condom cath put on as well as wound care on bilateral cellulitis of the lower extremities. I know it sounds like nothing but I love the opportunity to see everything no matter how big or small it is.

Negative: I MUST get contacts! I don't know what happened but while watching wound care on a friend's pt I had the most embarressing experience. It was an isolation room, so we all ad a mask on. It's always fun wearing a mask and glasses. Anyways, while assisting with setting up supplies I must have breathed weird because the air shot up out of the mask, fogging up my glasses! I couldn't see a thing! Don't they have defrosters or snap on wipers for moments like this.

Positive: I was able to give patient and family teaching. Since my pt suffers from dementia, she comes in and out of reality, so I was thankful when family stopped by  and I was able to talk with them. My pt hadn't been provided good oral all. She was hesitant to let anyone else provide it for her, stating" My niece will do it when she comes on Sunday." Poor oral hygiene can lead to great complications. So, I was able to instruct the family on daily oral care with swabs because the mouth is a an environment for bacteria to enter and travel....causing cardiac problems is a major concern.

Positive: I felt that even though I lacked confidence and elt a little overwhelmed, I still made a difference in her life that day. I was someone who had the extra time to sit with her, hold her hand, clean her, and simply smile. THat is a positive of being a nursing student. We arent' juggling a handful of patients. We are able to really focus on the ones we have. It's truly a blessing.

Today may not have been picture perfect. It may have been a little rusty and confidence lacking. But it's a learning process and that's why we are here, in school, to learn and grow into fabulous RNs. Let the clinicals continue!!

Untill next time,

A confidence-seeking RN student