uh I am half way done with nursing school?

Jenny and I on our last day of our first year of nursing school!

Ummm... I'm not sure how this happened, but I am done with my first year of nursing school! It's a complicated mix of emotions: accomplished because I finished what most older students consider the hardest quarter of the program (or at least so I think. We'll find out when grades come out), excited to start all my summer projects, relieved that I get a break, and almost sad the program is going by so quickly. I didn't start feeling melancholic about the program being over until our med-surg professor made a little speech before the final, saying how we had such a great group dynamic, and telling us to support each other because there is a lot of lateral violence out there. If this year flew by that fast, what's to say next year won't?!

Another thing I've been realizing is how unprepared I will be for the workforce when I'm done with school. Nursing school is intense, and there is no way any 2-year program can expose you to everything you might encounter in the real world, let alone, have you become comfortable with it. By the end of clinical this quarter, I was kind of like, errrrr, I haven't gotten to do all my skills I learned in interventions yet!! I know I still have another whole year, but honestly, I think nursing school teaches you a lot of theory, and the majority of actual 'nursing' work you do will  be on the job training.

This year has been so crazy fun and challenging. Now it's time to bum out and rejuvenate before September comes!

How Kathie and I celebrated the start of summer- BOGO Chipotle on their outdoor patio!

Last day of MedSurg clinical

We survived, guys...

Wednesday was the last day of medsurg clinical. It feels so good to be done and to have one acute care clinical under our belt. It feels kind of surreal because part of me is not ready to say, "I'm in my 2nd (and final!) year of nursing school". Part of me feels like I don't want to ever leave the safety of school and another part of me feels like "I don't know anything yet!", but a third part of me thinks I need to make some money and pay off student loans.

The great thing about clinical groups is you become really close with the select few who are at the same hospital as you. In a cohort of 80-some people, it's nearly impossible to meet everyone in lecture, but clinical is small and intimate, and you are so out of your comfort zone that I think people bond over it. It might be having shared the common experience of a code brown or starting care plans only to find out your patient was discharged the second clinical day (AKA start over and throw out 4 hours of work). But I think it usually comes down to grumpy people- grumpy patients, grumpy nurses or grumpy family members. You bond over the fact that you dealt with the same grumpy nurse who saw hated having a student and talked about it in post-conference. It's like group therapy, only free. I really feel like there is a special connection within each clinical group because there's an understanding that each group has that the rest of the cohort doesn't. It's kind of weird to think that we're the only ones that got to experience this hospital, and that our group of 6 will never be together again (well, possibly in another clinical, but highly unlikely). 

I started to realize that nursing school is a different experience for every single student, even those from who go through the same program, and even more so than the nuances that students in other non-nursing programs experience. Sure, we all have the same classes to take and clinical to do, but all our clinicals are at different places, caring for different populations, working with different nurses, clinical instructors and patients. There is a lot of variability in each student's experience. It can become frustrating because sometimes it just seems like others are getting so much more out of clinical than you are. Some students are just in the right place at the right time and get all the patients needing an NG tube or a foley cath. I just remind myself all the time, "It's okay!". As long as I'm learning something still, I'm progressing and that's fine with me.

PS. I did a couple really cool things this quarter and I'm going to list the notable ones for my own memory's sake! I really need to write down these stories in a separate post, but for now I will list them so I'll remember: giving a suppository, dressing changes, taking out an NG tube, a serious code brown

Thickening skin

Me and my clinical group... sike! we don't wear nurse hats.

I'm not sure how many other people feel like this, but I really dislike that feeling I get the first day I start something new. Like the first day of a new job, or the first day at a new school, or really any first day where I'm in a new environment and I don't know anyone. It's scary- and nerve racking and I'm kind of excited, but I more want to just throw up. That's how I feel at clinical every week.

This quarter, I'm at the hospital for 2 8-hour days, plus 1 evening before to collect patient information for my nursing care plan that's due at the end of the week. I basically just go into the hospital, log on to the computer, close my eyes, point to a name on the patient list and hope that they're still going to be there the following two days. No one is really there to tell you which patient is likely to be there and which patient is likely to be discharged, or which patient is going to be really nice to you or which is going to hate that they got a student. You just blindly chose and go home to start your 15 page care plan. The next day, you sit in the meeting room where the nurses coming on-shift meet to figure out who has which patients. The nurses ignore you, do their thing and leave the room, which signals you that it's time to chase down the RN that has the patient you chose last night, and tell her (or him) the great news that she (or he) has a student nurse that will be following them around for 8 hours! This is the part that I literally dream about the night before, the part that determines how you are going to feel for the next 2 days- when your nurse looks at you, smiles and says "Hi, nice to meet you!" or looks you up and down and says "ok, get a chair".

There are a couple inefficiencies in this system

1. Should your patient get discharged by the next day, you wasted a bunch of time working on that care plan because you are starting over, baby! Honestly, I feel like it is a waste of time to come the day before to chose a patient. Today 3 out of 6 of our patients that we chose yesterday were discharged, meaning half of us had to chose new patients. When we're real nurses, we're not showing up the day before work to check out our patients- we're gonna show up to work and have 30 minutes to figure out 5 patients.
2. RNs don't know they're getting a student until the start of their shift and some of them see students purely as dead weight that will slow them down. I really hate that feeling of being in someone's way. It makes me feel super incompetent and useless. Some RNs don't even talk to their student... Others are superstar RN/teachers and love students!!! RNs should volunteer to have students- this would decrease anxiety on both sides. Students would know they're assigned to a nurse who wants to have a student and nurses who don't want students don't have to have them.
3. Students, especially students in their first acute care rotation, are scared as hell! I don't need to be babied, but it would be nice!!! Just kidding. I don't need to be babied, but a general outline of what was expected of me would have been nice. I had no idea how to read the electronic documenting system, and how to read the medication schedule, and how often I had to document vitals and interventions. I figured out that I had to when an aid or a nurse or my teacher finally asked, "Why didn't you do this?". Because I didn't know I was supposed to, that's why.

I remember at the nursing program orientation back in September, I asked one of the instructors how receptive clinical sites were to students (yes, I really hate the feeling of being out of place THAT much), and the professor said, "Yes! Clinical sites love students from here because they demonstrate a deeper level of critical thinking, blah blah blah". Of course they'd have to say that!!! Whatever. Bleh, I'm sorry. I don't mean to be complaining. I know everyone else is dealing with this too. I know it's not personal and I'm working on getting that thick skin. I'm pretty sure everyone in my cohort has already had a mental breakdown (crying included) this quarter so I know I'm not the only one who could use a callus. It's okay, at least I'll always have Ryan. Good night.

First med surg experience

highlight from week 1: saved a baby snail from a dry tree

Spring quarter started last week, and I purposely have not posted anything about school because I have been so overwhelmed. The past 2 weeks have been a serious emotional roller coaster. I've felt every emotion that I think I will experience while in nursing school- from bitterly crying to unexplained inner peace, to undoubtedly predicting my failure and then to complete optimism about my career choice and future. When I started school, I told myself I wouldn't let academics take over my life and make me feel awful because I just hate basing my life's value on just one thing.  Ha! I may have slightly failed. I have definitely felt like complete crap about myself, lost sleep over it and had high blood pressure the past 2 weeks.

Anyway, I am coming off a GREAT day so I'm feeling good. There are so many things I want to remember about today. Today was my second day of my med-surg rotation so I followed my assigned nurse around and saw so many cool things. I watched a suppository medication administration which was administered while the patient's family was in the room and I couldn't help but smile!! 1) because what is funnier than putting your finger in a stranger's rectum, and 2) because I was genuinely so excited to see a real med pass! I'd never seen a suppository med pass before- in lab, they made a makeshift rectum out of a cup, a rubber glove and some rubber bands.... I was trying my hardest not to smile, because the patient's family would probably be like, 'wtf is wrong with this student nurse'. I saw so many IVs: healthy ones, infiltrated ones- I even got to feel fluid rushing through the patient's vessel by placing my fingers above the IV site, while the RN pushed saline! I saw an IV dressing change and realized blood does not bother me at all.

Not quite yet, but getting there

The best part about today was having the nurse I was assigned to. She was so friendly and real with me, not to mention helpful! She pulled up labs for a patient and instead of just eyeing what she needed to and continuing with her work, she turned to me and asked, "So as a nurse, what lab values are important?". She introduced me to all the patients as a student nurse and talked me through everything she was doing- setting up a PCA, precautions for all the meds she was passing, when to call the physician- and occasionally asked me questions, "What is metformin? Why can IV meds cause a burning sensation?". It really allowed me to practice some critical thinking in a safe environment because she's not the one grading me. By the end of my shift I asked her how long she'd been a nurse, and she said she graduated in 2013. She was so knowledgeable, I would have never guessed! She left me with some encouraging words- that yes, you'll have harsh instructors and preceptors, but you'll also have awesome ones, and that's just how it goes.

I think one of the worst parts about being a student nurse is feeling like you're a bother. When RNs are not receptive to you, not introducing you to the patient and hardly acknowledging you, it just feels like you're in their way and slowing them down. As a student, I think it's hard enough feeling like a fish out of water, but feeling like you don't know how to swim and all the other fish are swimming away and you're just trying to catch up? That makes your 8 hour shift feel like a 12. So glad I got to end the week on an awesome note!

I've written so late it's Friday! Happy Friday everyone.

Not over yet

I have 2 tests down with 1 to go, and I feel so out of it. I took my pharmacology final on Tuesday and we just got our grades. I feel like now that that's over, I don't care! I worked my butt off in that class and it paid off, but now I'm like, so what? It doesn't really matter what grade I got because we're all going to get jobs after we graduate anyway. I am very laid back compared to my classmates about tests and grades, and I hope it doesn't come off as unmotivated, but this driving desire to get a 4.0 is a self-inflicted stress! Even after you get it, so what...? Life continues and no one sends you a cake or flowers.

I should really be studying and preparing for my last final, but at this point, it feels like there is little use. It'll be about nursing interventions which is very important, but this basically sums up that test that I'll be taking tomorrow and the gerontology test I took yesterday:

Is the answer A? A and C? A, B, and D? or none of the above? Or wait, all of the above?

Also, I just spent 30 minutes on Pinterest reading Ryan Gosling's Hey Girl memes, silently shake-laughing to myself. You know that kind of laugh where all you hear is the person trying to breath in air, and they're kind of shaking? Yes, that kind. I think this one was made for me.

Thanks Ryan

Happy Thursday. Spring break, you're so close...

Last day of older adults clinical

Yesterday was the last day of our first clinical. Everyone was really happy and our instructor brought in donuts, so everyone got a stomach ache, but even that couldn't get us down. I don't think most of us enjoyed that clinical very much so we were kind of excited to move on to other types of clinical settings that we had more interest in. To me, nursing homes are really sad.

I think there is a handful of special nurses who truly feel called to geriatric nursing and I am not one of them. I was excited to be done with this clinical, but surprised myself with how sad I felt leaving my residents. Most of them are very dependent on the CNAs for all their daily activities and due to problems in the entire system (money, cost, time, people, etc.), they're basically just left alone all the time.  Say each CNA has 8 residents at a time. On an 8 hour shift, the aid would average 1 hour with each resident. In a 24 hour day, each resident would only have 3 total hours of help from a CNA. Imagine being completely dependent on someone for everything: to stand up, to go to the bathroom, to push your wheelchair, to eat, and you only had that person there 3 hours everyday. It leads to isolation and depression which just exacerbates existing  health issues. For this clinical, I didn't really feel like I did much physical 'nursing', just assessments and keeping the residents company. I felt like I made the biggest difference just sitting and holding old ladies' hands. But this extra time with each resident is only possible when you have a group of 10 students dropped off at your facility on top of your paid CNAs, RNs and admins. But if I was actually a nurse or CNA working at the facility, I would never have time to sit with a resident and talk to them about anything. It's not about finding more caring RNs and CNAs: its about fixing a system and finding or making more resources.

Anyway, this week felt like a milestone: finishing our first clinical with our med-surg clinical on the horizon. I'm pretty excited to get into the hospital next quarter and see new things.

Most important decision of the day: which donut to eat

Before I got into nursing school, I'd always see these pictures of groups of girls in scrubs who were in nursing school and I thought they were the coolest. This is one of those pictures, but I don't feel as cool as I imagined those girls were...

pokes, sticks, injections

After getting stuck

For the past week, we've been learning how to do injections and practicing it on each other! It's actually a blast and we feel super cool and nurse-y. We practiced intradermal and subcutaneous injections on hot dogs and oranges, before practicing on each other. We did intramuscular on each other and it seemed like everyone just closed their eyes, held their breath and "darted" the needle. Yes, that was the actual term they used to describe how to stick each other. Today we did blood glucose testing and that there is my actual blood glucose level an hour after lunch!  Even though we're all holding our breath and my blood pressure is crazy high all lab, doing all these things for the first time is so exciting!!! It feels good just to get the first one out of the way so that when we actually do it on patients, it is a little less intimidating, but I'm sure we'll all still be freaking out then.

On another note, can I just mention the weather right now? The last couple days has been below freezing. It has literally been 25 degrees and my face is permanently frozen. I think my toes are semi-permanently discolored too. Spring please come soon.

View from my commute

craft time > assessment time

Today was our third day at our gerontology clinical site. Honestly, gero clinicals are very slow. It's our first so I'm not really sure how much I can do or how receptive the employees are to students. There are 10 of us students at the specific site and we're each assigned a resident to do assessments on and to follow around all day. There's not that much structure in terms of what we need to do exactly during the day, but that's pretty nice because we can just do whatever we want and see whatever we want!

Since we started coming on Wednesday, the activity coordinator started scheduling activities for Wednesday morning. Today we made Valentine's Day decorations for the old people to hang on their doors. I had a blast because my resident didn't want to go so I just made a bunch for all the other old people who couldn't make their own. I made a really hipster one for one of my favorite residents that read "Yes", "Cool Kid", "UR Cute". I showed it to him and then hung it on the back of his wheelchair. I later found out that he was wheeling himself around pointing to the back of his chair to show everyone. I'm pretty sure that's the most effective thing I did today. I had so much fun with these foamy stickers that I permanently borrowed some to make my own Valentines. I love crafts. I hope there's another good one next week.

Nursing Career Fair

Nurse Swag

Today I went to my first career fair ever! A career fair, on a SATURDAY... It was nursing specific which was really neat because it catered specifically to nursing students at all levels. There were both potential employers and nursing schools and tons of free paper and pens. I felt like a real grown-up by the time I got home because I had gotten a tote full of nurse swag.

Honestly, I was was jittery and nervous, and I'm pretty sure I came off as totally awkward to some of the recruiters. It's okay though because I wasn't really looking for employment so the stakes weren't high. I was just trying to get my name out there, which wasn't very successful either because I only gave out 1 of the 10 copies of my resume. Most of the hospitals looking for CNAs or hospital assistants told us the same thing anyway: apply online. So I didn't really get much out of it, but it was nice to get one of those under my belt so next year when I'm about to graduate, I can go in knowing what to expect and what kind of nursing I want to go into.

As for now, I'm a blank open slate! I had thought I wanted to go into community nursing when I started school, but now that I'm getting exposed to all these different aspects of nursing, I'm really open to anything. I'm hoping as I go through my program and have clinical placements in different fields, I'll find a field that I fall completely in love with. We'll see!

Health care's future

First time passing medication

New fav book: Davis' Drug Guide for Nurses.

 Today in lab, we practiced passing meds for the first time. It sounds pretty easy, but right before our faculty member let us practice with the med cart, she word vomited about the importance of preventing medication errors and the 6 rights to giving medication and how our final exam includes a physical exam of us passing meds and how if we mess up, we fail the class and fail out of the program and will be $30,000 in debt with no marketable career skills... Just kidding about that last part. She didn't actually say that part, but I'm pretty sure everyone was thinking it. So everyone got really nervous doing it in front of our instructor and over thought things. I'm not sure if it's because I don't care as much because I know it is practice or if it's because I am actually confident, but I felt strangely calm about approaching the med cart and messing around with all the different stuff on it. Basically what I got out of today's lab was check, check, check, check, check, check, check, check, check, check that you have the right med, dose, route, person, time and documentation. Also, question physicians because they're human too and they make mistakes! Actually, since I started school, I am more skeptical of all healthcare professionals...But more on that some other time. Happy Friday!