What I learned in nursing school

In the aftermath of graduating from nursing school, I had a little bit of time to think about all that I’d learned. I would like to emphasize “little bit.”

In my prerequisites, I learned a few more parts of the body (or at least the scientific names for them), the intricacies of how our bodies work, and the microorganisms that both help and wreak havoc on our world.

In nursing school itself, I was presented with the basic tasks of nursing care, the most common diseases and the nursing role in treatment and management of that disease or condition.

In finishing nursing school, after everything I’d learned medically, I really could say one thing:

Nursing school taught me how hard it is to see and love people the way Christ sees and loves them.

I can’t look on the multitudes of patients and have compassion on them the way Jesus did. In fact, most of my patients, their social and family situations, and the diseases they have anger me. They are lost in a world that most have created for themselves and think that modern medicine will wave its magic cure-all wand. Most of my patients see a problem and drink their livers to oblivion before middle age or claim horrible pain in order to get heavy-duty pain meds.

The videos healthcare organizations produce that show CLEAN and HAPPY patients in a well-lit, freshly constructed hospital room are lies. I’m sure there are some fantastically happy patients. Mine tend to have odor and hygiene problems, emotional disturbances coupled with medical issues, and placed in rooms that are showing their age.

So, if you’re going into nursing, know from this new nurse and the vast amounts of seasoned veterans – it is a worthy profession. You see “the stuff of life” as Call the Midwife says. And it’s not all brow sponging and baby kissing. It’s hard emotionally and physically. And you learn more about yourself and your limitations than you ever thought possible.

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The Questions

I’m in an accelerated nursing program. It is geared specifically for people who already have a bachelor’s degree in another field and want to receive their bachelor’s in nursing rather than an associate’s degree. A common question in the first semester is, “What was your previous degree?”

But then, people decide they want to know you more. They now have two options:

1. “Why did you leave ______?”

2. “What lead you to nursing?”

I know that I’m having a bad month here in Ray of Sunshine Land, but for the love of God, these questions are getting on my nerves.

So, let me answer them for you –

1. I didn’t like teaching; I liked interacting with the students, and I liked singing. Teaching those concepts was draining the life out of me. Oh, might I mention a few colleagues made my life a living hell? Yes, teachers can eat their young as well. I found that I was selfish with music – I need it to be my relaxation. I don’t see music and arts as the first thing that people need for their lives. Public education bad days

2. I had a quarter-life crisis. Got tired of doors slamming in my face. Wiped the slate clean of my options, looked at my skill set. Thought about nursing, pursued it and doors opened. Loved the opportunities. Most every clinical I end thinking, “Maybe this career track is for me?” It fits my preferred M.O. as I like to be at a place and just go. I’m not an 8-5 for 5 days person.

And last thing while wrapping this up, I’m tired of hearing, “you’ll always have a job” from people who think they know healthcare because they had their immunizations. Kind of like the people who think they know education because they were students. Nurses are generally the biggest part of an organization’s budget. We are generally the first to feel budget cuts. Yes, there are always healthcare jobs. There are always teaching jobs. They just might not be what the person prefers to be doing in their career.

End rant. Back to studying.

To The Babies I Held on My Birthday

Obstetrics clinical rotations began this past week. Day 2 was Wednesday, July 17 – my 31st birthday. Here’s what I was thinking that day.

Dear Little Ones,

Welcome to the outside world. The past week was filled with a lot of change for you. You are still dependent on your mother for nutrition and warmth, but you are now breathing on your own. And this time it’s air, not amniotic fluid. Your heart and lungs have gone through intense change and you are still causing your mom hormone and physical changes in this post-partum period. Your dad, while not new to this, is still in awe and thankful that the both of you are safe.

You didn’t know it and probably never will, but I took care of you on my birthday. 31 years ago, I was the new bundle of joy. I’ve seen pictures but time fades colors in the pre-digital photography era. I have to wonder if my face looked like a model for a porcelain doll and if my lips were perfect cherry red as yours are. As I held you, I didn’t mourn that I have yet to push a new human out of my abdomen. I was overwhelmed with a distinct sense of hope for you and wonder.

What delights will you bring your parents? How will you and that big brother I saw earlier get along? Will you color on the walls or play in the mud? Will you break hearts or have your heart broken? What will you be so passionate about that could help your corner of the world?

I hope sincerely that you will not disappoint others, but you are human, therefore you will. Thus, I hope more that you learn to ask for forgiveness and extend it. I hope you are able to see Truth and want it for you and others.

As I hear the news of what the world is throwing us – the suffering isn’t new but you are. May your eyes be opened gently so you don’t see too much at once, yet just enough that you are able to have compassion and help as you can.

It is wonderful to look upon you just being you. Content that your needs are met.

Thank you for that gift of seeing life simply when it is complex. My only regret is that I can’t tell you this for when you’ll remember nor can I leave your parents a note – that would just be creepy.

May the Lord have mercy on you daily.

Your Student Nurse

And in case you, the reader, are wondering, here’s from 31 years ago:

laurababy

Patient Simulations: Medical Student Edition

Thanks to technology, student in medicine, nursing, and other patient care roles can be put thought simulations with patient mannequins. “Mission control” is behind a two-way mirror and can “talk” for the patient, monitors are “connected” to give real-time data, and a lot of sterile saline is used as various medications.

Last Friday, rather than work the floor in my clinical rotation, I volunteered to be a nurse during medical student simulations. These students just entered their 4th year of med school and were beginning their month of ER rotations. The role of the nursing student was to act as the nurse for the simulation: assess, advocate for the patient, collaborate with the physicians, and administer medications while the doctors continued to formulate a care plan. We were not being graded or evaluated, the med students were.

It. Was. Awesome!

My fellow nurses and I got one other benefit over the doctors: we were able to go through the simulations twice. Group 1 rotated from 8-10 and Group 2 rotated 10-12. The first simulation was a practice for all of us – what was I to ask the doctor? The patient? Focus on in regards to care? What information did I need to assist the doctors and the patient? Because of the nature of simulations and how much students should not know before participation, I will refrain from specifics of the scenarios. All three were common emergencies, and one involved pediatrics. I was thankful for two semesters of Med-Surg, so I was way more comfortable with these scenarios than I would have been in January.

I felt as though I hit a stride as a nurse that second time around – the other nurse and I knew the outcomes and what to watch for while the med students were new to the situation. Also, the group the second time around had a GREAT sense of humor. I was asking for more clarity in orders: how much oxygen do you want? What drug and what dosage? Is that an order or an idea? Do you really want to give that heparin sub-Q when the patient already has IV access? By the way, your patient has below 85% Oxygen saturation for the last minute.

At the end of the day, one area stood out: patient advocacy. During one simulation, the benefits of morphine were being debated. Yes, the patient could have been given it, but it doesn’t improve mortality. Thus to a doctor’s mind, there was not convincing enough evidence to warrant a morphine administration. With Group 1, I didn’t push back on the students to order a pain killer. With the second group, I questioned.

“He’s in a lot of pain. Could we give him something for that?”

“Nah. Morphine doesn’t help long term.”

“What about Fentanyl or something else.”

(Voice from speaker) “The simulation is over.”

In post-conference, we talked about the simulation, when drugs were given, and the plan of care. We were about ready to leave when I stated my point. “Just one thing from the nurses. When it came to whether or not to give morphine, I know it does not solve the root cause of this patient’s problem, but to that patient, his pain is why he’s here. Giving half to 1 mil of morphine will ease anxiety, knock the pain down, and to that patient, you are doing something. As nurses, we’re trained to assess and we’ll hear a lot about a patient’s pain. Again, it’s not solving the root issue, but you are doing something. And that will get you far with them.”

My point was not ignored. Instead, the medical school instructor VALIDATED my point.

“That is a good point. As medical students, you need to know that by the time the nurse has time to call you to change or up the pain meds, she’s heard about it at least 12 times.”

I could have kissed that man.

Bullied: Part 1

Do you remember the first time you saw yourself in the mirror and finally had a shred of hope that you just might be physically attractive and desirable? That you were not the despicable and horrible human that others kept saying you were for so long?

It was the summer I turned 15; my family had moved back to Kansas the previous year after 6 ½ in South Dakota. While I had a minor disappointment with a boy the past year, I had been getting some attention from others and had successes in extra-curricular activities about my confidence. I was uncertain on what to do with compliments. If I said “Thank you,” I feared I would look like a snob, but if I ignored them, it would be rude. I think I usually stammered or tried to shrug things off.

It was a day I had very little planned. I was still in my PJs at the breakfast table when my brother came from the basement. He thought I was wearing a casual sundress for the day and is a pretty cool guy when it comes to his sisters. He asked, “Where did you get that dress?” in the way that men from my family say with uncertainty on how to word a compliment, yet in a way that the women know the men noticed.

“Um, Jeff, these are my PJs.”

Him: “Oh.”

After that comment and finishing breakfast, I walked back to my room to change into my real clothes for the day. At the end of the short, narrow hallway was an oval mirror. I caught a glimpse I had never considered before. It wasn’t an imaginary catwalk to my room, or a trial run of how I would saunter through The Mall. Just enough of a second glance to where I could say, “Maybe I’m not fat and ugly.” My self-esteem and self-perception were still hovering above empty, but there was something about those 10 feet down the hall that gave me hope. Not everyone was out to be better than me. My obvious features of height and hips were not necessarily a negative. And maybe my acne-prone face and shoulders weren’t as horrible as others made it seem.

I still had plenty of emotional breakdowns between that moment and now. I still considered shopping a war and personal assault. The number on the size was all-important as to how I felt about myself for the next month or so.  Some hurts have scabbed over, yet I’m reminded of their scars at the most random times. Just when I think that I’ve answered all the questions and satiated the emotional holes left from my middle school years, the emptiness slinks in the cracks on bad days.

The mid-90s seemed more concerned with sexual harassment and whether or not kids knew about HIV transmission. The line between “kids being kids” and bullying had not gotten the attention of the past 10 years. Sometimes I wonder how I would feel if I could have stood up for myself in the schoolyard. What if one day I would have just punched someone in the face? What if I could sue for the therapy bills not covered by insurance? What if I had taken a few more sick days or convinced my parents to get me out of that school?

What happened cannot be changed. But I have hope. Not because I saw myself as pretty one summer day, half my life ago.

Because I’m learning to forgive people that I will never see again and who will never know how deeply their words cut to my heart. Because I can look at the world around and know that God created things that are good. Because I am to look and myself and say that I am the chief of sinners and forgive others’ trespasses, debts, and sins.

It is not easy, nor should anyone be demanded to produce these results overnight. Be filled with Truth to combat the lies. That is the first step. The other steps will follow, but always seek Truth.

Criticism and Failure

The past two months, I’ve had a multitude of opportunities to fail and/or receive criticism in various situations. Work, school, home…and on really good days, I have received it in more than one place!

failureI do wish I actually had some words of wisdom to pass along for those of you who feel down due to your professional or personal shortfalls. Wouldn’t it be lovely if, in the multitude of personality inventories, we were also given hints on how we best receive confrontation and others noticing our flaws.

The word “failure” seems so final. Maybe because it’s associated with tests and information that you’ll never see again. You have no other opportunity to prove yourself capable. Situations are eased if you can call something a flaw, short-coming, fault – but never failure.

Some things, such as burnt cookies, I can look at and say, “It’s fixable. No one got hurt.” But if I make a mistake at work, I might not be told about it in front of a patient, but I do have to make it right and go back in their room to do whatever is needed. Or I need to come back later and fix charting, etc.  And it always seems that all my mistakes happen with one patient or one nurse each shift.

Then there’s school. I have yet to “bomb” a test, but there have been many times that I did not process the material well enough to get the grade I wanted. Or I didn’t do my paperwork well enough. There’s definitely an internal pressure that I have to make nursing work. I should be a good nurse. Good nurses are good students. Well, I haven’t exactly felt like a stellar student this semester. I love the patient interaction. I loathe the books. But I need the books to improve my patient interaction.

And at home, when I’m forgetful of my jobs and duties, I want to make excuses or cower in my room, fearful of others’ disapproval until I can prove that I am responsible. Well, at least until the next time I royally screw up.

With both self-imposed and other-imposed expectations, it’s been rather rough. Then to top it off, my finals week coincided with Holy Week. Great. Now I’m academically and spiritually mediocre.

I needed Pascha. Not just so Lent and the fasting could end. Rather, I needed to reminder that everyone needs to come to Pascha. The point of Pascha is to celebrate our Hope that Christ has Risen, He has defeated Death. No one, not even the strictest of monastics “does Lent well.” Regardless of your short-comings, your faults, your lack of virtue or sense, your failures – you come and receive the light.

I fear how many times I will need this lesson re-taught to me. Yet, thankful that God’s grace and mercy will be a constant presence as I am criticized or as I fail. It won’t be pretty. It will never give me a feeling of “Joyous day that I am told how I let someone down!” But I’ll take what I need to the cross and rest in the Hope of Christ.

Still Going, Still Waiting

I woke up Saturday morning thinking about The Brain and Stewie. It has been a while since I wrote an update on his condition and life in their house. Stewie keeps me and a few other close friends posted on their daily activities and The Brain’s downward progress. Until medical research gives the world another picture of disease progression, there’s only one way for a person with ALS to progress  – downhill.

Saturday, shortly after I woke up, I thought of The Brain and all that has changed for him and Stewie since I left them in August. And I finally did something I’ve been needing to for about a month – I cried. The Brain is such a fighter, and if it weren’t for BiPAP machines that help him breathe, I am certain he would not still be alive. The news of this last week is that The Brain is losing more control over the last of his voluntary muscular functions (I’m toning this down for those of you more squeamish). He’s also battling over-production of saliva along with less ability to swallow. The risk of him falling out of equipment to help transfer him in and out of his wheelchair grows everyday. What he can eat without choking is a dwindling list. When he sleeps, his breathing pattern changes.

Someone asked me recently what I thought his timeline was, beings that The Brain has outlived every one of my guesses. I could only respond by saying the disease is a waiting game. Lungs with less than 10% of their usual function that are hardening will eventually stop oxygenating his body. For now, only one day at a time.

I’m heavily distracted tonight. Some of it is Lent (Remember, I’m Orthodox. Easter/Pascha hasn’t happened yet). Some of it is school – Oh, the guilt of my studying doused with heavy distractions never being enough. But I know part of my mind-wandering is The Brain and wondering how he is really doing.

How odd to be in the midst of Lent with The Brain and Stewie always in the back of my mind. This is a time of spiritual refocusing that culminates in the proclamation that “CHRIST IS RISEN FROM THE DEAD TRAMPLING DOWN DEATH BY DEATH. AND UPON THOSE IN THE TOMBS BESTOWING LIFE!” So, here I am to be celebrating the Risen Christ and the Hope he gives us over death, yet, each day greets The Brain with the reality that he is closer to death. While each of us is closer everyday, how much more sobering to see a person for whom it is a present reality rather than a passing thought.

During the Paschal service, we are reminded of the power of our Hope in Christ. “O Death, where is thy sting? O Hell, where is thy victory?”

It still doesn’t mean that while The Brain is alive I don’t feel the sting of his or Stewie’s suffering.

My other projects

Some friends and I recently began another blog, and I finally wrote my first post!

More fun to come on TRS, but nursing school has been kicking my rear along with all the new orientation classes at my hospital job.

My 30s

The narcissist in me likes to see how people find TRS. It amazes me that months after I posted 100 Things to do in your Twenties, people still hop over here because they Google similar phrases.

Well, as of the middle of July 2012, I was 30. I pouted for a week or so before; I lamented that marriage and babies were not mine, yet. But I also feel as though I had some new things coming. A life that was not finished being lived. And an urge to tell those entering their 20s that birthdays are milestones, not grave markers.

So, while not as extensive, epic, or entertaining – here are some things to do in your 30s. Take them, leave them, tailor them to yourself. Whatever you do, live a rich life.

  1. Learn about insurance beyond your car. If you own a home, you probably have home owners insurance – great. For those who rent: renters’ insurance should run about $10-15 per month. $120/year is a small price to pay in the event your apartment or rental house goes up in flames. What about health insurance? Life insurance? Somehow, our generation will pay for extended warranties and insurance on our phones, stereos and other electronics, but we won’t pay a few bucks per month to cover our burial expenses if we die from an accident. Learn what insurance you need and is a good expense (disability, renters, etc.) and which is a scare tactic (mortgage).
  2. Build retirement savings. A little now turns into a lot later. I would like for Social Security (if my generation even gets that in 30 years!) to be my play money, not my utility bill money.
  3. Learn a language where you could survive a day of touring the country on your own – German and Greek are the front runners for me. Then again, Church Slavonic, Romanian, or Arabic wouldn’t hurt either. We’ll see.
  4. Go visit the United States (or other places in your country of residence). South Carolina is at the top of my list as my brother lives a block from the beach – tour guides and place to stay…Win! I also want to tour the West Coast. I keep meeting people from the PNW and California. I’d love to see Napa Valley, the Pacific Ocean, and ride a San Francisco trolley.
  5. Save a few thousand for future education endeavors. Whether it’s continuing education for your job, a nifty conference, or a class at a community college – put some money aside and deduct it from your taxes that year.
  6. Spend time with the next generation. This might be your own child(ren), niece(s)/nephew(s) or young child of a close friend or Godchild. Find something that lets said child know they are loved and appreciated. This doesn’t always have to be an expensive gift. A friend of mine always takes out her nieces on their birthday and buys them a classic book. Once, I took a friend’s daughter out to tea. I try to send my nieces and nephew a birthday card and Valentine’s day gifts. I’m still getting to know my Goddaughter, but if I see a little something that she might like or can carve out time to be at a school program, I oblige. There’s no way I can be the aunt/godmother that I would like to be with distance a big factor. But remember how awesome it was to get mail when you were little? Exactly.
  7. Learn to forgive.
  8. Seek out mentors – personal, professional, etc. Pursuing excellence is an accomplishment in and of itself.
  9. Read a book or two from high school English that you muddled through on the Cliff’s Notes. If you devoured everything from English, get a math book and work a few algebra problems or geometry proofs. Or grab a science book and work a chemistry conversion or rediscover the biology classifications (Kingdom, phyla, order, etc.)
  10. Budget. Save and pay cash for your next car. Work a plan to get out of debt and stay that way. (I recommend Dave Ramsey as a resource, but there are plenty of others out there.)
  11. Conquer a fear whether rational or irrational.
  12. Get some updated photos by a professional photographer. Find someone who goes with your personal style. If you’re like me and don’t have engagement or wedding photos, get some good head shots with a kick. I did this recently in January – partly because I needed some pictures for professional and outside interests, and also because it’s fun.
  13. Volunteer with an under-served population. TRS recommends finding an organization that serves those who are homeless, those who have a mental illness, or those who have a disability. Break your stereotypes surrounding a population with which you have nothing in common.
  14. Love others where they are at.

Any other suggestions, thirty-somethings?

The Merry-Go-Round of my Professional Life

I officially left full-time music education on December 31, 2007. I officially stopped my path to vocal performance in October 2009. Regardless of those dates, I never left music. In fact, I’ve become ever increasingly grateful that my roommate had a piano begging to be used in her house when I moved in this past August.

I told my parents multiple times in the past 5 years, “Thank you for the investment in my music lessons because it’s helping my income tremendously now.”

As I’m typing this, I’m on break in a recording studio surrounded by other full and part-time professional musicians. We’re recording demo tracks so choral directors across the nation can pick up a packet of single copies of music with a CD and hear all or bits of the songs before buying for their choir.

Even though I “never left music” in that, I still taught private lessons, sang in my church choir, started learning Byzantine chant and notation, I definitely tried to minimize my exposure to the professional-diva-types of musicians. Thankfully, those types are few and far between. Jumping back into this world, I got some new views from the sales side of the music industry:

A) Having listened to my fair share of these demo tracks in my teaching days, I thought the tracks were rather dry because they were recorded that way. Rather, they are dry because we are sight-reading and patching sections together. We’re not going for artistic excellence, form, and musicality; we’re going for correct notes, rhythms, and some diction.

B) I don’t miss some of the personalities in the music business. The Talkie Tammys who have to comment at every cut-off or pause. Or the singers who are really into recording and can’t control any impulse to dance around. Stereotypes exist for a reason.

C) Patterns. When you aren’t rehearsing the patterns on a daily basis (teaching, personal practice, performance, etc.) you forget that most composers follow similar patterns in their writing. The days I was in the studio, I felt I was “working harder” than others who were still actively singing, practicing, and sight-reading these styles of music.

I’m thankful for my musical side. It has been a gateway for me to meet fascinating people and enriched my life. I just find it funny that as I’m entering a new career and seeking out opportunities to improve in that field (student nursing job, yay!), my former career is still applicable and keeping the lights on. Who knows, later on nursing might be the way I can fund some awesome music project in the future.

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