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.

Looking forward

I am looking forward to be back to school. It was nice having a week off, but to be honest, I love the people I go to school with and I love staying busy and going to clinicals! I'm hoping that the rest of my OB rotation will be eventful! My first two days, nothing happened; which was great for some people, not so great for others, and very unfortunate for me! I wanted to cry. We only get 6 days in our specialty rotations (so six days in OB and six days in mental health) so you have to make the most of the experience. We only get one day in Labor and Delivery and my day two moms gave birth but I didn't get to see either because with one there were way too many people in the room and in the other the midwife didn't want students in the room (pouting face). So I'm hoping to convince my instructor to send me to labor and delivery again!! We'll see though. If nothing else I'll get lots of practice giving IM injections to mothers and babies!! YAY! 


Today I while I was at work, things were a little slow so I had time to think. I started to think about my mental health rotation. There's a lot of negative feelings, emotions, and thoughts about going into mental health. I think the hardest part is just talking to people. Our society is one that we try to avoid personal contact as much as possible. Not only do we avoid personal contact, we also avoid conversation with one another. Honestly, who likes to talk about "feelings"? No one really does...it's something we avoid, and even run away from at times! 


I also think that mental health in general still has a stigma attached to it. I was talking to my older sister about it and she was telling me about having heard this example be given...'If you have a cavity of course you're going to go to the dentist to get it taken care of. No one thinks twice about that. If you're bleeding from somewhere or something that shouldn't be bleeding you're going to go to the ER to get it checked out. If you're just not feeling great you're going to schedule an appointment to get a check up with your doctor. If you have just been diagnosed with diabetes you're going to schedule a follow-up appointment'. All of the examples I've just given you no one would think twice about asking "why" they are taking care of those needs. So why then, is there still a stigma to mental health? Why then is it looked down on for someone who has to be hospitalized because they have bipolar disorder and right now they're thinking about killing themselves. Why is it looked down on someone going through a manic episode to have to go to the hospital? 


I'd be lying if I said I wasn't nervous about this rotation. But what intimidates me more than the people is the way we're supposed to talk to these people. We're trained to have open-ended conversations with our patients. So instead of saying "Why are you here today?" we are told to say "What brings you here?". It's the talking and listening that I think is so difficult for everyone with this rotation. We have to offer ourselves to these individuals. We have to put ourselves out there and be willing to spend time with our patients and hear what they have to say. We have to care. We have to drop our guards and go out of our comfort zone and we have to listen to what this person who is experiencing physical, emotional, and spiritual pain. 


While I was pondering all of this a quote came to mind. I want to leave you all with it to ponder as well. I don't know who said it or where I've heard it but it's something like, "You know my name, not my story. You've heard what I've done, not what I've been through". 


P.S. this week marks the 10th week of the semester. That means only five weeks left of level three!!! HOLY SMOKES!!!

Okay so it's not all terrible...

I forgot to mention in my previous post that something amazing happened to me yesterday, and all that I can say is that it was a God-thing! I think He knew that I was going to need a blessing to help me get through the day. While I was sitting in the waiting area while my window was getting taken care of I received a phone call. I didn't recognize the number but still decided to answer. Much to my surprise it was a call from CNM saying that I have been awarded the Albuquerque Women's Club scholarship! I have never even heard of the scholarship, much less apply for it! I was told all I have to do is fill out a letter saying why I think it would benefit me, fill out the application...and bam...I've already been awarded it, so it doesn't have to be processed...It's like it all happened backwards! Who would've thought?! All I can say is, "Thank you God for such a blessing!!!" WOOT!!!! *happy dance* So even when it seems like things are falling apart and you don't know what to do...it's not all terrible. Somehow little blessings pop up all around us and keep us moving along!

I don't do breaks!!!

Let's just start off by saying I don't to breaks. Spring break might be more fun if I was with my big sister who lives in Florida (even though she's on a road trip right now), or if I had big plans, but no I'm here...in Albuquerque...and all that seems to happen when I have a school break is trouble.

I went to the zoo yesterday with my family and got sunburned (in 70 degree weather) even though I had sunscreen on, I ended the day with a massive migraine, and my car window that got rolled down on our way home from the zoo decided it wanted to break and wouldn't roll up.

So my sweet little brother (Sam) tried to help me fix my window. We were able to get the panel off my door and look at it and decide that it was the regulator that needs replaced and there wasn't much that we could do. So with much dismay we pieced my door back together and decided to try and call our local mechanic in the morning to see what can me done.

This morning I woke up at 8, which on break I'd normally sleep in until noon if I'm being honest...I guess having to get up at 4:45-5am on my clinical mornings is starting to change my sleep pattern...any hoot...when I got up and dressed I started making phone calls to the different shops to try and find out where to take my car. I knew that my breaks also needed attention since they hadn't been changed since I got my car and they were now starting to squeal. Around noon I was finally able to make some progress with finding out where to take my car. So I got my window back up while we wait for the regulator to get to the store (now I don't have to feel so naked with my care window rolled down).

Between getting my window taking care of and going to take care of my breaks my mom and I went to a little "hole in the wall" here in town called Sophia's Place. It's a little restaurant here in town that was featured on
Guy Ferrari's: Diners, Drive-ins, and Dives and I had been wanting to try! It was fun to try a place that we'd never been to..and the food was really good! :)

With a smile on our faces and our stomachs full of good food we made our way to Break Master's to get a break inspection. I was expecting it to be more expensive to fix up my breaks, but I never imagined they'd tell me it would be nearly $800 and that my transmission is on its last leg!!! ACK! So now I'm faced with trying to decide if I want to fork out the money to keep up my '92 Honda that only has 114,000 miles on it, or if I want to try and make it last until I graduate and have a job and can afford a new(er) car. I suppose the only question that matters is how long my car will last...

And that my dear friends is why I don't to breaks. It means you have time to drive around town and try and get general maintenance done on your car and find out it has vascular stenosis, type 2 diabetes, and needs its front toes to be amputated and a kidney transplant! Blah...so I hope everyone else is kicking back and loving their spring break. Enjoy it extra for me...at least I've gotten my workouts in..that counts for something!! :)

There's a foul smell in the air!

Oh six weeks how you're just flown by! I start my OB rotation at UNMH (university of new mexico hospital) which means that I successfully completed my med-surg rotation and passed!! :) There's a lot to be said for that...hahaha...actually my med-surg rotation was simply amazing! I wouldn't trade that experience for anything! Also with the switch of clinical rotations comes the mid-term! *DUN, DUN, DUN* For those of you who are wondering what one's house would start to look like when it comes time to study for an exam, please allow me to show you...it looks a little something like this...



My family was out of town over the weekend and so what did I do, well I cleaned off the kitchen table and claimed it as my own! That's right...this table won't be seeing a family dinner until after my exam has been completed!!!!

Everyone is nervous about this exam because one of our lecture instructors is new to our nursing progra, and the material he covered isn't going to be on our exam. He was supposed to cover our urinary disorders and all that he covered was the urinary system structures (which, if there was anyone that didn't know what the urinary system contains shouldn't even be in level 3) and UTIs (which again, if no one knows how to handle UTIs they should go back to level 1)!!! So we were all responsible for taking our learning into our own hands, so we shall see how that goes tomorrow! My motto for the urinary system is, "If there's a foul smell in the air, you probably have a problem down there!" hahaha...

What goes around comes around

What a fabulous past couple of weeks I've had...and life decided I needed a little extra icing on top of my cake and gave me a nasty cold! :( Blah! So I sit here with my kleenex piling up, a sudafed on bored, and soup on the stove! Everyone in my clinical group had gotten this nasty cold and I thought that I'd be the one survivor, unfortunately, we all know the saying, "what goes around comes around" and well...here I am, blowing my brains out! However, I absolutely love my clinical location and my clinical instructor and all of my fellow students! This has been my favorite clinical experience so far! Our days are always jam-packed with skills, skills, and more skills! Our instructor works her tail of running back and forth between all the different rooms. (you see, we're required to have our instructor with us for essentially any of the skills that we do) 


So far I've been able to give lots of IV pushes which includes reconstituting some meds, IM injections (including a massive 3 mL in someones hip (OUCH!), hanging IV bags (woot), I D/C'd a Foley catheter, I got to do deep throat suctioning, PICC line dressing change, other wound dressing changes, and much more. 


We all had to finish 3 complete care plans (the 14 page paper that outlines your patient, their background, and your plan of care for them...you know...the part of nursing school that every student leaps, whoops, and hollers with excitement for...NOT!!!). And now that we've all finished three complete care plans we now get to go into our clinicals "blind". Meaning, we go in like we're actual nurses *gasps and leans forward to catch my breath*. We get report from the leaving nurse and just go take care of our patients. It's really awesome!


Clinical days are so much fun yet very challenging all at the same time! Before anyone goes in to do their skill there are the personal doubts and that voice in the back of your head that says, "you don't know what you're doing, you're not ready for this, there's no way that you're going to be able to be a real nurse" but somehow, with the strength and words of encouragement from fellow classmates, you somehow gather enough strength and you go into that room with your head held high and with the belief that you can do it! Then at the end of the day you share how you messed up on the little things, excelled in the skill you thought you'd totally bomb, and then you move on!


Somehow we're wrapping up our 5th week already, which means that I only have one more week on the general surgical floor and then I'm moving on to labor & delivery and mental health! That also means that we're almost half way through the semester!!!!! Holy smokes! How did I get here?! Time flies when you're having fun right!!! :)

A part of something bigger...

I'd like to share what I think one of the best part of my clinical experience is. My group has to be at the hospital between 6:30 and 7am. Meaning, we have to make sure that we're there before it's time to get report. For those of you that don't know what report is, it's the time of day when nurses that have been with a patient for 12 hours gets to do the "hand off" to the oncoming nurse at the start of their 12 hour shift. It's what helps us nurses decide who we need to see first, whose doing great (or not so great), and it helps us pull ourselves together and prioritize the rest of our day! But that's not the experience I wanted to share with you.  ;)

I LOVE every morning pulling into the hospital! There's always a steady stream of traffic that works their way into the staff parking garage. Filling each spot at a steady pace. Then, as you step out of your warm vehicle, there's the sound of the car doors closing, cars being locked, and familiar faces making polite greetings. Crisp, cool, air fills your lungs and brings you the promise and hope of a new day.

Then, all at once, without any warning...it begins. The street is littered with nurses, physicians, surgeons, to your left is your friend in respiratory who always knows the best tricks to make your patient's cough be productive, if you glance to your right you see ortho and know that you'll be working with them to get your patient up and walking again. If you look in front of you you'll spot some fellow students whose green scrub pants, white top with the nursing student patch on it, and terrified faces give them away!

This is what I love about each morning. Nothing on the unit and with your patient remains the same. Each day always has it's own unpredictable occurrences. But one thing that you can be sure of, is that at the switch of each shift, be it 7am or 7pm you will find the littering of talented people walking across the cross walk, each contributing to the health and wellness of every human being that we may come across or encounter that day. I love seeing people that are passionate and excited to face their job each and every day!  

In all reality, it's really not anything super life-altering; and to an innocent bystander it may even be annoying, you know, having to wait as people cross the street..heck, I may be the only person that finds it exciting, but it sure does make me feel like I'm a part of something bigger!