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!

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!

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 :-)

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)