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Thursday, November 1, 2012

Farewell Target!

You wouldn't believe how long I've waited to write this! My days at Target and in retail are over! I have been hired onto the General Medical Unit (GMU) at Presbyterian Hospital. Where 140,000 people apply each year and only 1,200-1,300 are hired annually! My last day at Target was 10/28/2012 and my first day at Presbyterian was 10/29/2012. However, before I move on to bigger and better things I would like to take a few paragraphs to reminisce on the things I won't miss, the things I will miss, and what I'm looking forward to! Sounds like fun, right?! Let's begin:

What I won't miss: 
  • People coming to me in the fitting room and asking, "did my (kid/spouse/sibling) go in there?" ...I always held back a sarcastic remark and bit my tongue so I wouldn't say something like 'I have 7 people back here, have no idea who you are, and have no idea who your kid is!' Instead of saying that I would simply say, "You know, I have no idea, you're more than welcome to go back and yell their name!" :D
  • Parents dropping popcorn on the floor, picking it up, going to put it in their mouth, then re-thinking that idea and giving it to their children instead. What's even better is when they leave the popcorn on the floor and roll their carts over it multiple times and then come to me and say, "oh, there's some popcorn crushed all over there!" 
  • The sound of people rustling through clothes/hangers on my freshly zoned rack. Don't they know how hard I worked to finger space all of those items? 
  • Finding half full or empty Starbucks/sodas hidden on shelves, under clothes, and left dumped on the floor. There are trashcans for that!
  • Phone calls on the holidays asking if we're open...the funny thing is that they have to listen to our greeting which tells them that we're open!
  • Guests coming up to the cash register saying, "Make sure those come up the right price...the sign says 5 for $20!!!" ...if they ever took math they'd know that the original price is $4 which means they will most definitely ring up 5 for 20...I simply tell the guest, "Oh trust me, they will ring up the correct price!" :D 
  • Holidays...'Nuff said!
  • People trying on 29 items and not getting a single item and not hanging up anything...so rude!
  • Individuals dropping items on the floor, looking at me, looking at the item, and proceeding to walk away from the item! Yeah, I saw that!
  • Tables that have folded items on them...you better take a picture while you can because as soon as you turn your back the tables are a mess all over again!
  • Activewear - more specifically - zoning and putting those items away...in active wear you have 5 pants that are almost exactly the same, but one has a thicker waist band and the stripe down the leg of the other pant is just a little thicker than the other one!
  • Managers...when you tell them something it goes in one ear and out the other...Managers motto is: Do as I say, not as I do!
  • Retail and the people who shop it!
  • The paychecks
 

Alright...onto a brighter note...Here's what I am looking forward to:
  • Being able to shop at Target!!! :D
What will I miss?
  • I will miss the friends that I've made along the way...let Target continue to motivate you to get a college education and get the heck out of retail!!! :D
 

Monday, October 1, 2012

Take a moment...

Alright...so I just thought I would share a little piece of my mind...here's a candid moment with Maggie! :) 

As most of you know I'm taking a math class right now so that I can go on for my BSN and first of all can I just say how crazy it is to go from taking classes that are specifically for your major and then going back to pre-req classes...but that's besides the point. 

This is a hybrid class so that means that you have to read your book, do the homework, and then come to class to 'fill in the blanks'. Well that's all fine and dandy if people would do the homework..however..people don't! 

There's a person in my class who has a particularly difficult time every class and today was no exception. While it was a hard subject if you had read the material prior to class it made way more sense while the instructor reviewed how to solve the problems. However, like we humans tend to do, this student still wasn't understanding how to solve the problem. They asked the instructor to explain why she was doing what she was doing and how she got to a certain step and the instructor answered with slight sarcasm...this then fed the students frustration so she wasn't even able to focus on the problem at hand and just became irate. So the instructor looks at me and says, "help her with that will you?"...and she went on to the next part of the lecture. 

So I'm sitting next to this student who is beyond help at this point as she is just completely frustrated with the problem, teacher, and situation. I tell her to take a deep breath, and to start from the beginning...well it just wasn't happening...she couldn't start over...she couldn't let go the fact that the teacher had completely dissed her...and she certainly couldn't see how it was possible to solve this type of question. She was beyond consolable and as tenderly and kindheartedly as I tried she didn't want to have anything to do with my help. I simply told her, "I'm sorry, I see you're frustrated and I hear that you don't understand how to solve this...when you're ready to start fresh, I will be here!" Well, she didn't speak to me the rest of class...cool...I could focus on the lecture.

What did I gain from this experience?

Sometimes we all just need to take a moment and put everything into perspective! I don't know if that student had prepared for class (she could have and just didn't understand the concept)...and I don't know if my instructor had a bad day or what (because she acted like it)...and I'm sure I could have worded things a little better (even though I thought I did a good job)...but come on people! We're all human! It's so easy to get caught up in a moment and think about ourselves...we're all guilty of it...but next time you find yourself in a crappy situation...take a second...take a breath...put things into perspective...and carry on (hopefully in a more compassionate manner)!!

So this, my dear friends, is the moral of my story: The next time you're in math class...sit by someone else! (hahaha just kidding) On a more serious note...when you find yourself (or a group of individuals) in a tight spot, remember that it's okay to take a moment!




Friday, September 21, 2012

I can add a couple letters to my name!

A near empty bank account and a couple of years worth of complete dedication all worth adding the two letters "RN" to my name! That's right..I'm a registered nurse. You can go to www.nmbon.sks.com  and click on license verification and look me up. Unbelievable. I can hardly believe it. 



I was at a friends house holding her precious newborn when I got the picture message from my friend that had tested the same day with me. Her name was up...which could only mean one thing! I carefully pulled my phone out of my pocket being as quiet as I could be, I waited patiently for my phone to load the webpage. I then waited patiently again for it to reload after I entered my name (trying to keep in perspective how lucky I am that I only had to wait about 42 hours until my name was up on the board of nursing website while both of my grandmothers had to wait weeks to get something in the mail saying that they had passed). Then the page came up with my license number and I did the most amazing silent dance you've ever seen!! :) That's right...I've got moves you've never seen! 

It's so exciting hearing from all of my friends their success stories with the NCLEX! I would like to know the statistics of my graduating class and their passing the boards because we're some pretty amazing and smart (good looking and hilarious I might add) people. 

Now we're all saying prayers as we submit our resumes and hope to hear something soon from our prospective employers! So until such a time comes that's all folks! :D

Margaret Rosecrans, RN

Thursday, September 13, 2012

My Date with Destiny

A huge sigh of relief, a pat on the back, and a round of applause! My NCLEX is behind me!! I'm still waiting for official results, but according to the Pearson Vue Trick, which is pretty legit; I passed! I'll explain more about that shortly, but, let me give you a little detour through my NCLEX experience. 

August 29, 2012:




I received my Authorization To Test (ATT) which meant I could schedule my NCLEX. Initially, I took the soonest date open which was September 19, however, the next day my friend said she was able to register for the 12th...so being the anxious person I am, I looked online and sure enough, they'd opened up a sooner date to test, so I took it!

I made a decision this day to tell only a select few that I would be taking my NCLEX. I didn't want people badgering me on test day with questions etc. as I knew that would only make me more nervous than I needed to be! That was the best decision ever...so for those of you who have the NCLEX ahead of you, that may be something you want to consider! But then agian, maybe it's not...who knows! :)

August 29-September 10 included non-stop studying and practice-test-taking! Thanks to Kaplan who I took a prep-course through. Every day I was doing at least 150 questions a day that were all application and analysis type questions (translation: they were the type of questions that are above the line of passing on the NCLEX)


Tuesday, September 11, 2012:
 

Well I believe it's needless to say, but just coming out of nursing school I'm about as broke as they come. So while some people are able to afford a massage, a dinner out with the family, anything relaxing and that requires using money, well, I couldn't afford that! So, I made my own relaxing day! First, I went on a morning walk with two of my best friends (who both took their NCLEX with me) and after our lovely walk we went to the building where we would be testing. This helped ease our anxiety and familiarized ourselves with the place we'd be taking our life-changing test! Then afterwards we went out for lunch, because there's some delicious melt in your mouth chocolate chip cookies from Paradise bakery (aka Panera Bread) when you're a little stressed out! Then I ran some errands and came home and cooked/baked the day away! Then my little brother and sister (who had no idea that I would be testing the next day) came over and enjoyed dinner with me and my mom. After dinner as my siblings played hockey downstairs making as much noise as possible...I went upstairs and started to wind-down for the evening and start my relaxing evening....I stepped into Spas by Maggie. There I did a hair wrap, face mask, I painted my toes and fingers, I got skin that was so soft thanks to Avon's skin-so-soft...I even shaved my legs...that's right! I was living on the edge. At least I knew that if I didn't make it through the next day, I at least looked (and felt) nice! 


Such a great evening! I took a melatonin and hit the hay..because I had a date with destiny the next day!

September 12, 2012: 

I woke up to the sound of my alarm and actually had a smile on my face! I knew that this morning meant all the waiting was over with. It was time to put my test-taking skills to the test...and my nursing judgement I suppose! :) So I started things off with a quick morning jog. I didn't have a lot of time but knew a couple of endorphins would do wonders for me! It was a beautiful overcast, fall(ish) morning...perfect for a run and the NCLEX!!



 Then it was to the shower, throw on some clothes, eat a breakfast for champions (Jimmy Dean d-lights of course), and I was out the door to meet up at my friends house! Me and my girls decided we needed to do something in the morning together to help the time pass until we had to go take our test, which wasn't until 1pm. So we got together and watched a movie, drank a lot of water, peed more than one normally would, danced like some crazy women, ate a hearty lunch, and then we were on our way!





I drove there with stereo playing my test-taking music to help me get "pumped up." I said one more prayer (actually I'm not sure I ever quit praying throughout the day) and I pulled into the parking lot of the Bank of Albuquerque building, where my testing would take place. Destiny was right in front of me! Destiny was right in the palm of my hands. This was finally happening. All my schooling, all those years, those long nights, those dreaded care plans, those tears, the sweat, it was all being put to the test. It was my day to prove I'm not going to be a killer nurse! 

 

 We went down to the basement, checked in with the friendly lady that had so kindly helped us out the day before when we had a little tour of the place! We read the instructions on correct and incorrect behavior and so on and so forth! I was fingerprinted...the palm of my hand was scanned my purse was thrown into a locker, and then I was taken to my own little cubical where I proceeded to take my test. Now the NCLEX is a hard test to describe. But it's a minimum competency exam and you have to get 60 questions above the line of passing. Questions that are considered above the line of passing are application and analysis type questions. The test starts you off at the line of passing and then depending on how you answer you get an easier or harder question ect. You can have anywhere from 75-265 questions. You're given 6 hours to take the exam. At 2 hours the test has a pop up that suggests you take a break and there's another pop up at 3.5 hours. Any break you take is on the clock, the exam doesn't pause! Once your 6 hours start, it doesn't stop or pause! I knew that if I got to two hours that I would take a break, and I would take one again at the 3.5 hours if it took me that long. With each question I took a deep deep breath and moved on. Forgetting whatever questions I had answered and focusing only at the one on hand. However, things were going smoothly (I was pretty sure I was doing well because all of the questions were application/analysis type questions..like the ones I had practiced with Kaplan). Yet, when I got to question 75 I told myself, "It's okay Maggie, you're going to get 76 questions and that will be okay. More questions just means you're still in the game so don't freak out" So I clicked next and the screen went blue and a few seconds after that it came up with a screen that said, "you have completed the NCLEX examination. Please proceed to take this short survey" That was it! I was done in an hour and forty minutes and in 75 questions. Every NCLEX-taking student's wildest dreams! I held up my hand, the proctor came in and escorted me out, I "palmed out" and I was good to go. 

My friend Candice had gone in a few minutes before me and I saw her go out shortly before I did. Larra went in after me so she was the only one left taking her test! I ran out to my car hoping that Candice hadn't left yet...and I found her in her car trying to do the Pearson vue trick. Essentially you try and register for the exam again and if it comes up with a pop-up then that means you passed but if it lets you put in your credit card information then that means you failed. So we were doing that and we both got the pop-up! It didn't let us put in our CC information!!! Then we started to call people and tell them we'd finished the exam and we tried the pearson trick and it didn't let us register! Then shortly after we had been out our friend Larra came out!!! We all got 75 questions and we all got the pop-up!! Shock, joy, tears, adrenalin, more shock, terror, excitement, it was all pulsing through our veins. We decided we need to go share some appetizers at Gardunos to let the whole situation settle in! 




While I don't have official results I'm hopeful that I passed my boards and will soon be a registered nurse. Now I just wait. I'm still contemplating if I want to pay the extra ten bucks to get the quick results. I almost don't want to because I think it's lame that they want to nickle and dime us...nursing school did that enough to us already! So I'm content with waiting...for now...

 




So that's it! I had my date with destiny and it was better than I thought it would be. It didn't make me bawl my eyes out and it didn't make me scream. I think I had reasonable expectations for the exam and now I will wait...and see how patient I really am! Congrats to me (pat on the back) and a huge congrats to my friends that took it with me...WOOT! and Congrats to all my other friends that already took their boards and passed and best of luck to those of you who will be taking yours here in the next few weeks! If you need something to pass the time...bake...and go on to pinterest! Those are great ways to spend time. I did more baking today...I think tomorrow a run is in order....



...so until official results are in TTFN...ta-ta-for-now!

Friday, August 10, 2012

I have brains in my head

I went through 16 months for an hour and a half long pinning ceremony?! That happened way too fast. I blinked and it's gone! Now it's time for me to move on and transition from student nurse to novice nurse. My studying is not yet done, however! I still have to study for the big test..the NCLEX. For those of you who may not know, the NCLEX, is the state board exam that every single nurse must take (ADN or BSN) to become a registered nurse (RN). I have a week off, to party; and then it's right back to the books...*sorry mom, I'm going to be 'reclaiming' the kitchen table again shortly*

The pinning ceremony was lovely. There's something very personal and exciting when you know almost every single person walking across the stage. It's exciting being able to cheer everyone on as they walked across the stage and got pinned as Graduate Nurses! There's something very satisfying looking at all your instructors from various levels and stages of your nursing school career and being able to look them in the eyes and say "I did it!" (When really on the inside you just want to say 'hahaha take that I did it...how do you like me now?!'...or maybe I was the only one that wanted to do that?!)

We all go to take the Florence Nightingale Pledge which goes a little something like this:

"I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care." 

My favorite part of the pledge, personally, "I will abstain from whatever is deleterious and mischievous." I was, however, a little sad that it meant I had to say goodbye to my wild and crazy past (hahaha...because you all know how crazy I can get...Going out to the movies and going to dinner is about as crazy as I get). 

So...my tips for you future nursing students: 

1 - Expect the unexpected...things are not going to happen the way you planned or how your instructor said things would go. You're going to have last minute changes, you're going to have to adapt, improvise, and overcome. It's not the end of the world! Take a deep breath, do NOT complain to your instructor, and go with the flow!
2 - Make time for yourself and your family...no, there's not a lot of free time! Choose a day where you can forget about your upcoming exams, never ending list of required reading, and utter chaos that comes along with school. You'll feel better after spending some R&R with your family.
3 - Go for a walk...it's common knowledge that you gain your freshman 15 all over again while in nursing school, however, a walk a day can keep the pounds away! It's also a great time to allow your mind to wander, go blank, or do whatever it pleases as you walk through someone else's green pastures! Also, it's free therapy! I don't know a single person in nursing school that doesn't jump on the opportunity to get something for free!!! :)
4 - Try and get a job as a tech...yeah the pay may not be great, the work is dirty, but it gets you experience working with patients...and it can be an "in" for you when it comes time to find a job as an RN! 
5 - Heed your instructors advice...while some instructors do enjoy the site of weeping students, almost all of them want what's best for you. If they're telling you that you're not doing something right it's not because they're "nit-picking" it's because they're your instructor. They want to see you become the best that you can be and reach your full potential...plus they realize their lives may be in your hands one day!! :)
6 - Never be above anyone else...we're all in this boat together. Some of us are a little more weird and awkward (and sweat a lot more than your average Joe). But we all have the same doubts, fears, and excitement running through our heads. The sooner we realize we're in this together the better we will be. Nursing isn't a competition.....it's collaboration (That should sounds familiar)...the moment you think you're better than someone and don't have the time to show someone the ropes...that's when you become the nurse you never wanted to be. 
7 - My advice is never ending...but if I told you everything then you wouldn't learn it for yourself!! ;)

So I will finish this post of the way our Nursing Director did for us tonight at our pinning ceremony:

"You have brains in your head.
You have feet in your shoes.
You can steer yourself in any direction you choose.
You're on your own.
And you know what you know.
and YOU are the one
who'll decide where to go..."
- Dr. Seuss

Thursday, August 9, 2012

I am a graduate nurse!

Nothing I say or do can prepare you or make you fully understand what it's like to go through nursing school. I can try and explain it until I'm black and blue in the face, but if you don't go through it for yourself then you'll never fully understand. But without adequate support system you're screwed! :) To put it bluntly! It was a rough 18 months. But somehow, by the grace of God, I have survived nursing school! HOWEVER, the end to my nursing school career was no without it's drama. We couldn't wrap up our final like any other normal person and then get our grades like a normal class would. No, please, allow me to share with you what my past 18 hours has been like! 

Well, I suppose I should start a little before I took the final. I was eating dinner with my mom and all day I had just a feeling of anxiety, nervousness, and fear of the unexpected. It wasn't really towards my final exam because that was going to happen whether I liked it or not, but I was more anxious about the fact that I'm about to be a real nurse, I'm about to take on the responsibility of someone's loved one. Their life is essentially in my hands (not completely but figuratively). And realizing that is terrifying. So, while I was eating with my mom, I experienced a terrible anxiety attack! For those of you who have never had one, count your blessings...I was wishing I had a benzodiazepine to take!!! It started with just an overwhelming since of anxiety out of nowhere...then numbness overtook my body...then my heart started pounding (even though my blood pressure was only 110/62 and my pulse was only 62)...then afterwards you just feel exhausted and can barely lift your arms up..and I just got waves and waves of this attack! So, that's how the night before my exam went. Yuck...so I calmed myself by watching NY Med (LOVE that show!)

So at approximately 0809 I pulled into the CNM parking lot to take my final, nursing school final! I got to the testing center where all of my fellow nursing school students were waiting in line to get checked into the testing center. My anxiety started to go down and I was feeling more "at home" and relaxed! So we all got checked into the testing center and then we had to wait for them to sit us down at then put our codes into Black Board (where we take our tests) so that we could take our exam. Eventually we're all put into our exams and then...our...computer....starts...to...freeze...and....it....took...over....a....minute...to...switch....to....the....next...question.....

No joke! Every student was trying to get a hold of one of the test proctors to tell them about the computers freezing up on us, but all that they said was, "I'm sorry, there's nothing we can do." So in an hour and a half I had only completed 30 questions...and we had 2 hours and 30 minutes to complete 140 questions. Yeah right! So the proctors were able to get in contact with our instructor who gave us 2 extra hours to complete the exam. To make things even better there were multiple questions that had grammatical errors, incomplete questions, and none of the right answers. As if we didn't have enough anxiety already! So after about 2 hours and 40 questions the computer finally started to kick into gear and wasn't freezing up on me. It took me over 3 hours to complete that exam and when I pressed submit I just knew I failed it. I was just reading the questions, not really pondering it, and giving my answer and going on!

Normally after an exam we can see our grade right away, however, our grades didn't show up so we knew that meant it would be a while until we saw our final grade. Some of my friends were kicked out of the exam and had to complete the exam all over again! Most of us had an emotional breakdown. We expected to have a sense of completion and the sense that we were finally done...but none of us had that. It sucked. 

I went to lunch with some of my great friends to try and lighten the mood, but things just got worse there, our orders got messed up, some of us got over charged, and a place that normally has great food ended up having terrible food (although it could have just been that we had a bad day). So that just fed our bad moods. I decided to go to the mall and do some retail therapy, yet, even that wasn't doing the trick for me. So I went home and decided it would be a good idea...yeah...not! The watermelon was sliding all over the place and I threw a hissy-fit like a child and slammed the knife on our sink and put a little dent in the knife. My poor mom had to take the knife from my hand and say, "Maggie, just walk away!" Yes, real mature. I went up to my room, cried, and slept for several hours!!

That night around 10 or 11 pm we got an announcement from our instructor saying that the IT problems messed with her system so she was having to go through all of our exams one by one to evaluate them and she said she hoped to have grades posted by 8/9/2012 sometime in the afternoon. 

So this morning I got up at 5:45 and went swimming with one of my nursing school buddies, went and got breakfast, went to the mall (where retail therapy really did happen this time). I then went to lunch with some of my family, then I did it...I check my phone! Grades hadn't been officially posted but I had a total grade showing up, but the awful thing is that my total grade was 72% (which is technically failing). I knew that it couldn't be right because she was still working on our grades and nothing had been released but I let my nerves get the best of me and I started freaking out! I mean, who fails level 4?! That's just not heard of. So I was texting another friend and trying not to work myself into a frenzy so we decided to meet up! There we vented to one another and checked our phones waiting for our grades to be released! The grades were finally release after 1900. AND....I got a 92% on my final and a 90% overall in my class! I'm pretty sure I peed my pants and made the entire restaurant think there was a fire somewhere because I screamed and then cried!!! Every single emotion you can imagine was running through my body! I finally felt what I had hoped to feel yesterday...elation! 



So...this is it! I'm a graduate nurse. Tomorrow I get pinned (and we all get to have a good laugh when my instructor says my name....hahaha). I have to shave my legs so I can wear a dress!! (I know that may be TMI but I haven't had time to shave because I spend all my time studying). I'm also going to sleep!!! But the truth is, I'm never not going to be a student. Healthcare is an ever changing field and you never learn everything. I'm going to be learning something new every single day for the rest of my life, plus I'm already registered for my NCLEX prep course through Kaplan...and...I'm registered for a math class that I'm going to need to be able to go on for my BSN, so even the school part of it isn't done. But like I have said and will continue to say, "one day at a time." Trust me on that one...I'm a nurse!


Wednesday, August 1, 2012

Don’t let someone else’s experience (good or bad) be your own experience


First I must start this post by saying, “I have so much to share and say and I’m at my breaking point in the semester, so I’m extremely excited, and crazy and my thoughts are scattered…so I suppose my warning is that this post will most likely look like my brain = a jumbled mess!!!!” So…you’ve been warned. Continue to read with caution!

Come on nursing school buddies...we can do this!


I cannot believe that it’s a matter of days until graduation. I just finished my last lecture (so much fun to say), I have one more final (a week from today), and then it’s to the pinning ceremony and a graduate nurse I will be! There are approximately 222 hours or 13,339 minutes until the pinning ceremony. This semester has been a blast. I think level 4 is the epitome of nursing school. It's hard, it's fun, it challenges you, it pushes you to your breaking point, and then it shows you what you can be and what you're capable of. While most of it was organized there were still the moments when you had no idea what time something was going to happen, when a case study was due (or when it would be open), there were times when you had no idea what your instructor was talking about. That hasn’t changed. However, in the middle of my last lecture (I told you I like saying that!) I had an epiphany!!!

This was my great revelation: Don’t let someone else’s experience (good or bad) be your own experience. You have to experience things for yourself for the first time. If you let someone else’s experience define your own experience then you’re missing the entire point. We go through things in life (this doesn’t apply just towards nursing school) that make us who we are. If we let someone tell us what we should feel, how we should act, or what will happen then we’re missing the experience and the opportunity to learn and grow and become a better person. I went into level four just knowing it was going to be rough and hard and terrible because of all the negative things I had heard about our coordinator. When in reality, it was a phenomenal semester. Yes, the material is hard, yes you still have to choose the best answer out of all the correct options, but what else is new?! Before I started level four I had to tell myself that I can’t let other individual’s past experiences determine my own experience. I had to go into this semester with an open mind and knowing that I wasn't going to let someone's past experience rule my last semester of nursing school. I had to experience it for myself and then I could decide what I thought of it, but not until I'd been through it myself. 

Some of you may just be laughing at my realization but honestly feel like I had a huge revelation today. I think of the most common question(s) people ask one another is, “How was it? What was it like? What should I expect? Was it hard?” In some cases those are good questions to ask…but in other aspects if we know exactly what to expect and if we know what is around the corner then we lose our ability to think critically. We lose the ability to hone in on our survival skills. Those are important parts to each person’s existence (and we also don't know what someone else went through to have the experience that they did). So there you have my words of wisdom for the day…and just this once I won’t charge you!!! ;)

Our clinical coordinator who does the majority of our lectures is phenomenal. I love her lectures. I feel that they’re excellent, they make since, they’re organized, and they do help us prepare for the exams. Well, anyways, before class started we had a presentation by the people of Hurst who do an NCLEX preparation class. After our presentation our instructor said she was going to call roll, but that this was important because she was going to be double checking that she could pronounce our names correctly for the pinning ceremony. So my dear friend leaned over to me and said, “I dare you to ask her to call you by your full name (with a huge grin on her face)” *side note…for those of you who may not know my full name is Margaret Sarah Elizabeth Rosecrans…just a bit of a mouthful, but a great name regardless*    So not one to shy away from a challenge I accepted. (I had the full intention of telling her after I gave her a hard time that I was just kidding and wanted to see her reaction). So she called my name and said the usual, “Margaret Rose”N”crant”z” …I politely corrected her and told her “Rose-crans” and then she asked if I wanted my middle initial “S” to be announced too..to which I replied with a stoically straight face, “Actually I was wondering if you could say Sarah Elizabeth…Margaret Sarah Elizabeth Rosecrans”…and she smiled and said, “oh of course” and starts putting it into the computer…now by now all my friends are laughing and the class is kind of giggling and I tell her, “I’m just giving you a hard time”…the only problem is that she didn’t hear that part!!! Yeah, who’s the funny one now?! And she continued on down the list. I decide not to make a big deal and just go with it because it would give us all a good laugh anyways right? Well, after lecture I decide to just go tell her that I was pulling her leg and that she didn’t really have to say my full name. When I tell her that I was joking she says something along the lines of, “ARE YOU SERIOUS? NOPE! I’m going to say your full name, add a couple extra names and the end and maybe even throw in the third somewhere…you better be at pinning ceremony!” hahahaha…and a little while later she said, “Oh you made my day, I can’t wait for the pinning ceremony” So there we have it. I left my mark in the world of nursing school! I can’t wait for pinning ceremony. I think it will be perfect since I am at the end of the alphabet, so everyone will be in need of a good laugh! :D

Oh what else?! Well, I’m attempting to overcome the overwhelming anxiety that I feel knowing that I have to start putting in my resume! I was looking at jobs yesterday and it just blew my mind that in a week I’m going to be eligible for an endless array of opportunities. The sky is the limit…and let me tell you…I’m more than ready to turn in my two weeks at Target. While I’m grateful for the fact that they worked with my school schedule and it paid my way through nursing school, I absolutely abhor the world of retail. I’m praying I will be blessed with a job as soon as possible so I can go turn in my two weeks and kiss that part of my past goodbye!
I think the general consensus going around is that everyone is in complete and utter shock that we’re graduating. It still hasn’t hit me and I don’t know that it will until I take (and pass) my NCLEX and start working! It’s intimidating and terrifying and exciting and a complete miracle! Aside from the anxiety attacks that hit every once and a while we’re all on cloud nine. I think the saddest part of finishing nursing school is saying goodbye to the friends we’ve made. I love going to school and learning with my co-students, I love the friendship and the strong bond we’ve all made, I love every aspect of every individual I’ve met along this journey. I can’t wait to cheer each one on as they call their name at our pinning ceremony!
What is it Dr. Seuss said, “Don’t cry because it’s over, smile because it happened” or something along those lines! I’m smiling because I know it’s just the beginning of amazing friendships, adventurous career, and knowing there’s never going to be a dull moment in this career.

I suppose I have one last thing to say…I know you all are wondering what I’m like when I’m at my breaking point right?! Well, let me just give you this little look into the life of Maggie during finals…yesterday I was walking with my friends to our vehicles and the entire way I just broke out into song for every reply I had to say, I used my obnoxious “target lady voice” (from SNL by Kristin Wig), I broke out into a couple of dances…and during my last dance routine I went to jump…and my backpack strap snapped…thankfully nothing (and no one) went tumbling down. It was just another one of those hysterical moments shared with some amazing friends when everyone so desperately needed a good laugh.  

this is how I felt I looked as I danced! ;)


Ahhh…I suppose that brings me to my last bit that I have to share…if you’re going to survive life…be able to laugh at yourself. I could be a big sourpuss right now after all the laughing that has happened on my behalf, but the truth is…life is funny…and if you can’t laugh about it you’re in for a miserable time! :D So go laugh!

Wednesday, July 18, 2012

23 days and counting....

I hardly have time to catch my breath let alone write a new post!! There really hasn't been anything too exciting these past couple weeks to share though. Last week we didn't have clinicals because we had our lovely pediatric HESI exam and practice med-surg tests. Thankfully the pediatric test doesn't count as a grade, however, next week we take the HESI med-surg exit exam that counts as a test grade. I don't know if I've explain what HESI is so I'll explain now. HESI is an NCLEX prep test and predictor test. We've had to take HESI exams each semester. In level one we took the fundamentals test, level two we took the geriatric test, level three we took maternal, psych, and pharmacology, and for our last HESI's we have the pediatric and then the Med-Surg exit exam! There's only been one test that I haven't scored above the 850, so all-in-all I've been pretty happy with my scores, but I'm still nervous about the med-surg test since we don't really have a way to study for it. 


I can't believe I'm almost done. You know it's really amazing to finally be reaching a goal that I've had my entire life. It's hard to believe that it's actually happening and that I'm not just hoping to make it to the end. The end is near...23 days and counting...






If I think about it too much I get so overwhelmed with how much I have to do! I need to get in contact with old clinical instructors to see if they will write me a letter of recommendation, I need to finish my resume, I need to get signed up for my NCLEX-prep class, I need to plan my graduation party, I need to write a letter to send out to my family and friends announcing my graduation (since we don't get a commencement ceremony in the summer I decided I'll just send out a letter to my family and friends, maybe including a picture, saying I've made it)!! ACK! So much to do and so little time! 

Questions people ask me all the time is, "how do you do it?" Want to know my answer? I don't know! My best advice is to take it one day at a time. If you focus on how much you still have to accomplish it's so easy to get overwhelmed (I say to myself as I look at my list up above). I just take everything one day at a time!!!! If I still think about the fact that I want to go on for my BSN, that I may have more pre-reqs that I'll have to take and that I probably want to go on for my Masters I easily get overwhelmed; but I know that if I take everything one day at a time and one step at a time everything will eventually fall into place and my goals will be reached!!






So, my plan for the next 23 days? Take it one day at a time..try and take advantage to every free moment, remember to take some time to enjoy myself and my family, and hang on for the ride..because ready or not...here I come!!! 

Friday, June 29, 2012

I got a flashback!

Where did June go? That's what I would like to know. Somehow the days, weeks, and months just keep flying by...and I don't have time to catch my breath! 


Well I've had a change in attitude since my last post. Today at clinicals I was working with my primary nurse and when things had slowed down for me I reminded her that if she had any skills or tasks that she should feel free to delegate to me as needed..especially if she had any IV's that needed started!!! I told her that no one in my clinical group had started an IV yet and as soon as she heard that she said, "WHAT? Are you kidding me? Well, your first one isn't going to be on a patient! Come on..." So we went into an empty patient room (along with a couple other fellow classmates) and we all had the chance to start an IV! :)


Let me just say starting an IV on an actual human being is nothing like my awful experience with that stupid mannequin!! I got everything set up and she helped me look at all my different options for starting an IV and after she told me that she hates starting IVs on the back of the hand I proceeded to start one on the back of her hand! FIRST STICK! I was so excited as I just barely got the needle in there and I GOT A FLASHBACK!!! WOOT! I advanced the catheter all the way in, put pressure on her vein, pulled the needle out...and she proceeded to bleed...thankfully it wasn't a large amount of blood and I didn't panic (I didn't even sweat!!! HOLLAR!!!) and I got everything hooked up and flushed her vein...yes, I had a good line! I didn't blow the vein or anything! All of my fellow students got the IV in on the first stick too, only they didn't make a bloody mess like I did!! :) 


So then a few minutes later my instructor was walking by saying that a patient needed some blood drawn and would any of us like to do it, so I jumped on that like my life depended on it! Went in there with confidence and got the stick on the first try again! I also think it might have helped that it's tiny needles that you use to draw blood!! :) Good 'ole butterfly needles! I filled up my tubes and that was that...again no pouring of sweat episodes so that was a huge relief! 3/4 of us today got to start IV's and do a blood draw!


I think my greatest advice is to just have confidence. If you don't show the patient that you're nervous then they don't freak out and it makes the experience a lot easier. So...for those of you who need an IV started or some blood drawn..I'm your girl! Now if you're dehydrated or don't have veins that pop out and yell my name, then that might be a different story, but practice makes perfect right?!?! 


So I can sleep now knowing that I'm not a complete oaf when it comes to IVs!!! :) That's a huge sigh of relief!!!



Thursday, June 21, 2012

Experiencing difficulty...

Well, Exam one is done. That's all I have to say! You know, it's level four and we should have a handle on the dang exams right? Somehow I studied for a harder test though and managed to study the impertinent material. Ugh. However, I'm not the only one that got bit by the testing bug, so I'm not too discouraged!!

Well, I wasn't too discouraged until I got into the classroom today where we have our simulation week clinicals. One of the first things our teacher says is, "So you guys are going to take an exam, don't worry...it's just an exam!" (as if her smile and statement "don't worry" would really calm us down and make it that much easier) Nursing students + post-exam + no coffee + unannounced exam = lots of fun...NOT! We all sighed, moaned, (some cried), or stormed out of the room, and others (like me) just laughed. Just when you think you've got a handle on it...things like that happen and if you don't laugh it seriously eats you alive!

So we made it through our exam (which wasn't even for a grade) and actually learned a few things from it...and then it was time for starting IV's. Fortunately but also unfortunately we're not able to practice on one another and only get crappy mannequin arms that seem to have shark skin to penetrate! I was really looking forward to this lab though, I was excited and confident in my ability...well...so I thought! Allow me to set the scene:

We're in a small classroom (with 6 patient beds) and there are about 16 of us in the room..  2 of the mannequins aren't IV accessible so there were about 3-4 people per bed. Now, this building has been under construction the entire time that my class has been in nursing school...unfortunately for us we also seem to get the crap side-effects of the construction (hammer-jacking, fires, no available restrooms, no air conditioning). Today we didn't have any air conditioning. So we're in a little room (with no ventilation or air conditioning) and students all over the place are nervous so the room just continues to get more and more humid and muggy. Okay...so there's the scene.

We were paired up with students that had already put in IV's and they were to "teach us" about techniques for starting IVs, accessing veins, what-have-you! I somehow managed to miss that part of the conversation. I was gathering my equipment and when I went over my fellow classmate was already starting to insert the IV. He did a pretty good job, you know, it took a little maneuvering of the needle, but he got the flashback, advanced the needle, and had a patent line! So, then another guy (who has had practice with IVs) inserted the IV without a problem!

Now it was my turn! Honestly I wasn't nervous going into it...I mean it's a mannequin and they're quite acquainted with us nursing students and tolerate being poked quite well! ;) So I gather my equipment and the moment I take the cap off of my needle bullet drops of sweat start dropping off of my face! But I go for my stick..nothing. I maneuver the needle around trying to get into the vein and I can't make it happen. I pull back and go at a deeper angle, nothing...(I'm right over the vein mind you so I can't imagine what the problem is) I try and go in at a more superficial angle and still nothing. So I decide to pull out and try a different vein! Dang it. I was so frustrated...and my shirt collar was soaked in sweat by now. So as I'm getting ready to go in for my second poke I have an audience and my instructor by my side.  I'm now nervous and slightly irritable but determined to get a successful poke! So I prepare myself again and find a different vein and go for the kill. I'm right over the vein, it felt like I went in and...nothing. No flashback. So again I try to manipulate the needle to get it into the vein...nothing! So my instructor steps in and decides to try and help me out..she tries and tries and doesn't have any success. I pull out again.



I decide to take a break at let someone else give it a go. So another guy gives a a whirl and...success. Immediately, first stick, he gets it in and has an immediate flashback, advances the catheter, and has a patent line! Now I'm just furious! Thankfully by the time I get to try again my crowd has dispersed among other happening around the room so it's just me and my instructor! By now I'm determined to have a successful stick! I will not be told no! I can just imagine these veins getting a kick out of all of my attempts that have just been in vein...hahaha...get it? Vein!?! They're sticking out at you, yelling at you to poke them, daring you to stick a needle in them, and then what do they do??? They make a fool out of me! But I was not to be made a fool of any longer. My nursing instructor was by my side and I grabbed that 18 gauge and went straight for the AC ( antecubital )...What do you know? I got a handy little flashback! Ugh. I guess the third time is a charm! I'm hoping that my simulation experience is not any indication of how it will go in actual clinicals. Now I'm realistic about the fact that I will blow a vein on an actual patient, I'm going to make them bleed all over the place..but gosh darn it I'm going to get that catheter into the vein! So, I have one more day in our simulation lab and then it's back to the real world..and I'm ready to tackle some veins! So until then...

Monday, June 18, 2012

Yikes!


I keep meaning to write a post but there just never seems to be enough time in the day! I keep reminding myself (as do all of my other nursing school friends) that it was just one short year ago that I was sitting in our lecture hall...hands trembling, forehead sweating, and doubting my ability to crack those ridiculous test questions. And now, here I am, with eight weeks left until I graduate! My hands don't really tremble, I think I will always drip sweat from my forehead, and those test questions still give me a run for my money! But the difference between now and one year ago is that I've acquired a whole lot of knowledge, a descent amount of skills, and a little more confidence in my ability to care for an individual as a whole! 


I can tell in class and in clinicals that our instructors are pushing us to "spread our wings and fly". It reminds me of what my mental health clinical instructor always reminded us of..."you guys have all the tools you need...you just need to use them the right way!" .... What she was really telling us was use the think system...stop relying on us (instructors) to give you the answer. You know the right answer, you've been taught everything you need to know..now just put two and two together!


I can tell that this semester is centered around fine-tuning our skills and habits and making us trust our instincts, use our critical thinker (aka our brain), and go and do what we're supposed to do! 


This semester for clinicals I'm back at the VA on their cardiac telemetry floor (aka...everyone is on a heart monitor). The first week we had our first and last careplan of our nursing school career!! WOOT!!! Can't tell you how exciting it was to be able to turn that puppy in; and no, I didn't look back! It has been a lot of fun being able to do everything for our patient. There's no more wondering, "am I allowed to do that?" This semester my hurdle to jump over is going to be starting IV's! I wish I could bring equipment home to practice on my family, but I don't think the hospitals, CNM, or my instructors would be too happy with me for doing that. But thankfully my clinical instructor will be sending all of us to the ER where everyone needs an IV and by-golly I am going to start a dang IV! I've had several different opportunities arise and they fell through for various reasons...but no more! If nursing school has taught me anything it's that I have to advocate not only for my patient but for myself. If I can't look out for myself then how will I be able to look out for anyone else? 


Well, I have my first exam Wednesday...YIKES! I was studying hard the past few days going over all of the cardiac information that was supposed to be on the exam and tonight my instructor posted an announcement saying that all the cardiac material was going to be moved to the second exam!!! Needless to say I was extremely disappointed and frustrated that all the studying I'd been doing for the past few days was in vain and could have spent reviewing all the other information that's going to be on the exam. However, thanks again to nursing school, I've learned that you just gotta roll with the punches and move on. So no use complaining right?! :D I think the best thing I can do is go to bed and get some much needed shuteye!


So there's my update! Oh, and for those of you who are curious, baring any setbacks or unfortunate events; my pinning ceremony (aka graduation since the summer semester doesn't get a commencement ceremony *tear drop*) is in 54 days!!! ..not like I'm counting!! :D  

Tuesday, May 22, 2012

Way too fast...


I'm back from Florida, my baby brother graduated from high school, made it through my last first day of class, and this summer is flying by way too fast! I had an amazing time in Florida! I wish everyone could have the opportunity to meet my sister and her family! They're simply amazing and I couldn't have spent my break any better! One evening I went with my sister and nephews to the beach to enjoy the evening and the sun setting...and it will be my "happy place" whenever this last semester gets too stressful to handle I'll imagine the sand surrounding my skin, cradling my body and taking on the shape of my every curve...the waves crashing on the shore, carrying on a conversation with my sister, listening to my nephews laugh, and not having a care in the world...

"Enjoy it while you can"...that's what everyone says...be it a vacation, having a baby, peace and quiet while everyone is gone, the ignorance of childhood...enjoy it while you can. I'm learning to heed those words of wisdom to the best of my ability. I enjoyed every moment of being with my sister, brother-in-law, and my stinking adorable nephews. I've enjoyed every moment of being in nursing school and learning as much as possible. I've enjoyed every moment of watching my siblings succeed in life and achieve their goals. I learn every day the importance of trying to enjoy everything to the best of my ability...and when things don't go the way I planned...I try to find something to smile about...even if the only thing I can smile about is the fact that tomorrow is a new day!

No one can explain how fast everything flies by once you start your program of study. My siblings and friends always told me that once you get into your program and start doing what you've set your mind to everything just flies by; but I never thought that it could really happen this fast. A year ago I was anticipating the start of level 1. I was completely oblivious to the struggles, heartache, stress, joy, friends, white hairs, and all the other odds and ends that one encounters in nursing school! Somehow, by the grace of God, and the help of family and friends, I've almost made it to the end.

Despite all my preparation, panic begins to set it. Reality finally hits me right in the face and I realize that in a few months I'm going to be a "real" nurse. I won't have my instructor down the hall from me to run too when I'm not sure of myself (granted I will have co-workers to ask questions), I won't have the excuse that, "I'm just a student"...no, I'm going to be the nurse. I'm going to be the one in charge of peoples' loved ones! It's an intimidating reality..but I'm ready for it!

                          This is how everyone feels during the CCT exam!

However, before I'm able to relax, I have to make it through the CCT (dosage exam) first! You know, the exam that you have to pass in order to continue on in the semester...it's only a slightly big deal! I've put in my hours of studying though and I'm ready to ace the exam! All that's left now is for me to get some shut eye...so until next time...sleep tight and don't let the bed bugs bite!


Tuesday, May 1, 2012

It's happening...

Well first things first...I have a love/hate relationship with breaks! I'm so thankful that I get to go to Florida to see my sister, otherwise I would be going crazy with myself! I love going to school and having a set schedule, seeing my friends, learning, and going to clinicals! I love all of it and I hate it when I have nothing to do! I've cleaned my room and reorganized my books, hung up clothes that were just thrown onto my desk, vacuumed up those annoying goat-heads that I continued to step on each morning, I also managed to take my massive stack of books and school supplies that were accumulating on the kitchen table and hearth...it looked like I did nothing but bask in the presence of my nursing school books 24/7. I also managed to finally got my bed back up to my room (with the help of my older brother, little brother, and little sister)....it had been downstairs for a while because my mom had back surgery a few months ago and wasn't able to take the stairs, so we brought my bed downstairs for her to sleep on...she has been able to take the stairs for quite a while now, but it was just a matter of having enough muscles around to get my bed back upstairs!! :)   


So cleaning and getting reorganized was a plus. However, one of the big reasons why I don't like break...it means you have lots and lots of time. Which includes time for your mother to look at your head and realize that I have WHITE HAIRS!!! ACK! Well, I suppose I can say that I was able to maintain a white-hair-free-zone for 21 years and 8 months and 12 days!!! I thought my first white hairs would be more traumatic, but the truth is, I earned every single one of those white hairs! She's only found two...and I haven't gone looking to see if I can find more, but all I'm saying is that I will wear those white hairs with pride! Each one tells the story of the stress of nursing school, the chaos of everyday life, the sorrow of a broken family, the hope of what's to come, the strength it took to make it through the rough days, the courage it takes to face each day..and never knowing what the morning will bring! 


I suppose you could say that it's happening...I'm getting old :D ..because hair color is what defines our age right?! (hahaha) Whenever I see someone with a head full of white hairs I think to myself.."now there's someone that has lived a full life and has seen heartache and struggle...and survived" It reminds me of a quote by Mark Twain...I think it goes something like this, "Age is an issue of mind over matter. If you don't mind, it doesn't matter!" Of course I'm being sarcastic when I say hair color defines our age...but I think society looks at it that way...I guess I'm just trying to raise my objectivity ;-)

Wednesday, April 25, 2012

Keep an eye out 'four' me...

Today was a great day...because I'm moving on to level Four, the last of the levels! I got an 86 on my final and an 87 overall so I'm very happy with how this semester went!


I was at the final review today and was talking to some fellow classmates about our inability to describe this semester! I think the best description we came up with was, "phenomenal". It seems like ages ago that I was deep throat suctioning my patient and doing my PICC line dressing changes. It seems like a lifetime ago that we were sitting in on our OB seminars! 


What's even more mind blowing is that one year ago I was shaking in my boots counting down the days until I started nursing school! One short year ago I wasn't the person that I am today. I was naive, timid, frightened, and unsure of what I was getting myself into. However, along the way,  I've gained confidence, knowledge, wisdom, strength, and amazing friends!!!


So what is one to do while I'm on my four week summer break?! I'm going to go to Florida to see my big sister and little nephews and brother-in-law! WOOT! Keep an eye out 'four' me on the waves! I will also have to find some time to study for the CCT exam that we get to take at the beginning of each semester! :) 


You know, finishing each level is amazing, but what's even better than passing yourself is hearing about and seeing all of your friends move on to the next level! I'm overwhelmed with excitement, pride, and joy each and every time I hear that one of my friends has made it through the semester! I've said it before and I'll keep saying it...nursing isn't about one person doing better than another...it's about becoming a team, uniting, sharing knowledge and wisdom with one another, and helping each other stay above water! 


I'm excited for next semester to see what it will bring. It's rumored that we won't have our preceptorship (where we're the real nurse with a full patient load and do all the care for the patients). They say that there aren't enough spots to place our enormous group...but they're hopeful that they'll be able to work something out. We shall see what this last chapter brings...until then...I'll leave another funny comic with you all about preceptors! Hahahaha...hope you enjoy!



Monday, April 23, 2012

Is it really the end?

So what can I say other than, "is it really the end?"...Last week I finished off clinicals and listened to my last lecture. On Friday I had my 3 HESI exams. I can't remember if I've talked about HESI before, but each semester we've had to take these exams. They're said to be NCLEX prep exams and predictors for how we will do when it comes to taking our state boards. In the past two semesters these exams have counted as grades, but since there were 3 this time they didn't count as a grade! The exams were on mother/baby, mental health, and pharmacology. I was most nervous about pharmacology but rocked it, so I was extremely happy about that! 


Tomorrow is my final for level 3!!!!!! HOLY SMOKES! I can't even describe this semester. It has been a fun, exciting, eye opening, and all around awesome experience. I loved my clinicals, I loved my level 3 coordinator...and there was very little drama. It was a very smooth semester and I loved it...but I shouldn't speak too soon seeing as how I still have to make it through the final! 


But before I go I just wanted to share with you all a cartoon that I found!!! Thanks to my rockstar med-surge instructor I became a pro at getting those pesky, unflickable bubbles out of a syringe...you just gotta let it know who the boss is!! :)







Gives a whole new meaning to being objective...

"Just keep your head low and don't say anything"
"She's unreal...and it's absolutely terrifying"
"Just do your homework"
"Don't be dumb"
"Be respectful, don't say anything that you don't know what you're talking about or can't back up"
"She's scary...it's scary...it's hard...people cried..a lot!"

These are things that students were saying about their experience in mental health and their comments about the instructor. Going into mental health, as I have mentioned before, has such a negative connotation to it. There's such a stigma attached to mental health and even going in as a nursing student I was still having a hard time letting go of that stigma, well, that was until now...

So here's my journey through mental health...day one...we were all sitting in the main lobby of the hospital waiting for her to show up and we're all discussing what we think it will be like, pondering what might happen, deciding who we thought the student would be that she would "pick on" etc.  And then she arrived. It was quickly made clear that we are in no way, whatsoever, to question her. For example she told us to all go put the new parking permits that she had for us in our cars. Someone else, however, decided to say, "There are other students that need parking permits, why don't we just give them to them." to which she replied, "Do not question me. I know what I'm talking about. Unless your parking permit says exactly what mine say then you are to go put these in your car." ......Needless to say we told the student that was 'talking back' to just shut up and do what she says and not questions her! It took a while for some students to learn not to question her authority or to question if she was right or wrong....but once everyone realized that she knew what she was talking about and was there to be a resource for us things started to be a little more smooth!!! :)

At UNMH they do ECT (electroconvulsive therapy) on patients that suffer from depression. Our instructor sent several of us down each day so that we all got a chance to see how that happens (I'll talk more about that in a bit). So she sent the students that had a background in mental health to ECT and then the rest of us went to the in-patient part of the hospital.

Prior to "letting us loose" to go speak with patients our instructor took some time to ask us all what our fears were. Those included, but wasn't limited to: being afraid of what to say to the patient, being afraid of "setting them off", being afraid of the unknown and how the patients would act....the list was endless. So we were reminded first and foremost that every patient that is "committed", so to speak, is there for one of three reasons; they're a risk to themselves, a risk to others, or grave passive neglect. It's not easy to be hospitalized on an in-patient mental health unit. Secondly, we were reminded that any question we had for them has already been asked and they're essential questions. We were also reminded to never go in the patients room, if the patient started to get agitated we were told to tell them ,"thanks for your time" and walk away. We were prepared and given information to prepare us as much as possible. I think it made some of us feel a little more intimidated and a little less sure of ourselves and what our experience was going to be...but ready or not...here we went...

Now, in this rotation we don't perform any hands-on care with the patient, no giving meds, no doing head-to-toes. It's simply a chance to watch how things are done, talk with the patients and hear their story, watch and listen in on their group therapies (including art and dance therapy). We were given two things to try and find out with each patient that we spoke with. We had to decide if they were there with a cognitive or mood disorder and why they were admitted (e.g. risk to self, risk to others, grave passive neglect).

My first day I was sent to the geriatric ward. There I had the chance to talk with three different patients. One was there for risk to self, another was there for grave passive neglect...and the other I couldn't quite figure out! :) I had the chance to participate in dance therapy...which was a very humbling experience for me and all of my fellow nursing students. It was an extremely emotional day, to say the least, and an eye opening experience. We were encouraged to try and increase our objectivity and the way that we looked at our patients....something I'm still working on and learning about! I got home and had a massive migrane, I cried, tried to take a nap, but couldn't, got dressed to go for a walk, but never made it out the door. It was a really hard day!

Day two...was a little better. I was still intimidated but feeling not as hopeless. First thing I got to go to ECT! That was a really amazing experience. Somewhere in the back of my mind I still imagined ECT as being a patient tied down on a board, with huge electrodes stuck to their head and just a weird, terrifying experience. It was completely opposite. For those of you who don't know ECT is used for patients that suffer from severe depression, schizophrenia, and in some cases, mania. It's used as a last result for these patients when their medication just sin't working any more. The patient is put under a short-acting anesthetic, they're given a muscle relaxant so that their body doesn't convulse while experience the seizure. A blood pressure cuff is blown up on the patient's foot so that the muscle relaxant can't reach those few muscles that way you're able to watch the seizure and count how long it lasts. Once the patient is completely asleep the doctor then puts the electrode on the top of the head which causes a seizure to go from head to toe. The seizures I saw lasted about 20-40 seconds. Once they've had the seizure the patient slowly begins to wake up and they're then taken back to their room! The procedure itself is only about 10 minutes. It's very fast...and not nearly as traumatic as I had imagined.

After ECT I spent the rest of my day in art therapy. Essentially they set up several large tables, put lots of paper around them and have all kinds of paint, chalk, pencils etc. The patients are let out of their wards and allowed to come out and express their emotions on paper. There was a professional musician there playing the cello, so it was a very soothing, relaxing, enjoyable set-up. I had the chance to speak with a couple patients...one was in the middle of a hallucination, one was delusional...and it was so heartbreaking. So you can guess how things were when I got home..I had a a huge migrane, I cried...and so on and so forth!

The other two days got better! It was still an extremely emotional experience, but I was learning more about these patients. They aren't there because they're bad people, and they're not there because they're awful people....they're there because they have a real sickness and they have real problems that need to be treated and need to get under control. This experience really gives a whole new meaning to being objective and being open to see things with a new perspective.

All-in-all...mental health was an exciting experience. I had a phenomenal instructor that did an amazing job at teaching us about mental health disorders and how to increase our objectivity when working with patients. She taught us how to better use the tools that we already had in our toolbox! I think I can speak for my fellow students by saying that we all left these clinicals with a greater sense of confidence in our abilities to interact with our patients that are going through a mental health crisis. I can say that it takes an amazing person to be able to work every single day in the mental health unit...and that person is not me!

So there you go....that was my mental health rotation!!!

Friday, April 6, 2012

I turned to mush by the end of the day

This semester is just flying by I feel like I have no time to spare anywhere along the way! I already had my three weeks in my OB rotation and I'm half way through my mental health rotation too!! So let us catch up:

My OB rotation was so different from what I expected. In ways I felt like it was a let down and in other ways I learned a lot about myself. However, before I get ahead of myself, let me tell you how this rotation works...There are so many different aspects to OB. People just assume that it's only labor and delivery, but there's also mother/baby, the nursery, OB specialty (high risk) care, OB operation room, OB triage etc. We had a chance to kind of rotate as much as possible through these different units in the six days that we were there. 

My first day I was in the specialty care unit. That's where they have women that need close monitoring during their pregnancy. That can include (but is not limited to) women that have preeclampsia, heart disease, kidney problems, cancer...the list is endless. That floor was boring. Just saying...maybe it was just because there wasn't much for me to do, but I don't know if that's the floor for me. You just go and ask each mom, "Are you having contractions? Do you have any vaginal discharge? Have you been feeling the baby move?" and that's about the extent of your assessment. Then they have someone come in and do a non-stress test on the baby's heart rate. So first day was kind of a bust. 

Second day my instructor sent me to labor and delivery thinking that would make up for the boring day on the specialty care floor. So I was extremely excited for the chance to finally get into the field that I'm wanting to go in. The nurse I was with was phenomenal, but my patient was not progressing. She had been on pitocin for several hours and nothing was happening and she wasn't having any change. She already had an epidural so she couldn't get up and walk around to try and help get things going so they decided to strip her membranes, stop the pit for 4 hours to give her uterus a chance to relax and to allow the pit to completely clear out of her body and then after 4 hours they were going to work it back up and hit it hardcore! Unfortunately for me, after her four hours were up I only had one more hour on the floor, so I again, didn't get to see anything. There was a mom that was delivering down the hall, but another CNM student was already in there (and let me just say at UNMH which is a teaching hospital your room ends up being filled with residents, attendings, students, and family). So since it was so full they said I couldn't be in there. So I stood outside the door and listened to the mother. I could hear by the sound/tone in her voice when she was crowning, you could tell when she was doing a good job at pushing, and then there's one huge yell and then the cry of a baby. Even though I didn't get to see anything it was still fun being with an amazing nurse, and getting to listen in on someone else's experience! 

Day three I got to go and be on the mother-baby unit. That's where momma and baby go after the delivery and stay until they're discharged (baring no complications and that baby isn't in the NICU). I was with the charge nurse that day so I didn't get to see anything too exciting. Something that's crazy about that unit is that you have 4 rooms, but 8 patients. Because you're having to assess both mother and baby and provide education, make sure mom is doing okay feeding baby...basically the needs on that unit are endless. 

Day four I was in the nursery. I got to give IM (hepatitis B) injections to baby, do the PKU (heel pricks), and hold babies. I also got to watch a circumcision, which surprisingly, wasn't as traumatic as I thought it would. For those of you mom's out there...baby hardly even cried. The only time he cried is when they're tugging on the foreskins and that's not really because it hurts (since they're numbed up), but more because they feel the pressure of them tugging. When he got the snip there wasn't even the slightest cry...so there you have it! :) Something sad about the nursery (or just OB for that matter) is how much drug abuse you see. Especially with  UNMH being the hospital that takes anybody and everybody you just see anything and everything. There are constantly babies in the nursery that are going through withdrawal. They come out and some of the babies are put on methadone and then tapered off. There were moms that would come in to delivery that had just shot up with heroine before coming in. There are moms that are treated with methadone throughout their pregnancy and the baby will come out and need to be tapered off. Methadone is an opioid pain reliever and is used to treat withdrawal symptoms in people addicted to heroin or other narcotic drugs that cause a "high" associated with drug addiction. So you have babies that come out and they get scored and based on their score they may or may not need methadone to help them with their withdrawal. 

What does a methadone/withdrawaling baby look like? It's very sad, but they have tremors, an extremely high-pitched cry, rapid breathing, poor sucking, yawning, stuffy nose, sneezing, they have raw chins from itching their chin, they sweat. It's just a very sad situation and picture. For me, that was the hardest part of this rotation. It's so hard to see women come in that way and it's terrible to see infants who have no control over their situation come into this world already addicted to a drug. For me that was so hard to see and I found myself with this anger that surprised even me. I had to remind myself that I didn't know what that woman was going through and I had to remain objective to her situation, but at the same time you can't help but just cringe at the thought of her having a child. 

While we're on the lows of OB I also just want to mention how sad it is to see children having babies. I saw an age range from 13-40 years. I would say that over half of the population having babies are under 17 years old. It breaks my heart to see girls that haven't even lived, that don't even know what it is to be a kid having babies. It breaks my heart and it just blows my mind the thought of someone my baby sisters age having a baby. One of the younger mothers said, "so it's like okay if I like put the baby in the shower right? Like the baby will be okay in the shower?" That's another thing that just makes me cringe just at the thought of these children having babies. 



So nursery had its ups and its downs...on the upside I got to hold babies for hours...I turned to mush by the end of the day. There's nothing like having a newborn on your chest and having them fall asleep as you rock with them. Their tiny little hands and tiny little feet...it's all you can do to not just squeeze the living day light out of them! By the end of that shift I was going to have a baby for everyone in the world...

Quick side note on the PKU...it's all about making gravity work for you and being patient. Wait until there's a huge drop and just let it drip onto the paper. Otherwise you're milking that baby's leg and trying to get them to bleed and fill in the circle, but all you gotta do is gently hold that leg/foot and let gravity work its magic. 
 
Day five I was back to labor and delivery to try and see some babies be born, and I was lucky enough to see two deliveries. One was completely natural and the other momma had an epidural. For both mom's it was their first babies but neither pushed for more than 30 minutes. I was hoping to see the delivery of twins, but her labor wasn't progressing and they were starting her up on pitocin...I would have stayed if I could have, but I couldn't, so I didn't! But let me just tell you there's something awesome about experiencing and being part of a woman's delivery. It's such an awesome and natural thing. There's so much raw emotion that goes into it. Watching the different phases that the mother (and father) go through..there's just no words to describe it. The smell of the delivery room is like nothing that can be described. You just walk into a room and you know...you can feel, hear, and smell it. All your senses are involved and it's such an emotional and simply amazing thing to be able to witness and help a woman through. I'll be honest though the nursing aspect of labor and delivery is cool. I like it, but I'd much rather be the one getting dirty and delivering the baby...just saying...nurse midwife sounds like fun to me! 

Day six was more of a reflection day. We went over a case study that we had to do, we talked about the experience and what we thought about OB overall. And that was about it...that was my OB rotation in a nutshell.