My New Favorite

Not my original today, folks. This is for my fellow nurses and nursing students.

My new favorite blog: Nurse Eye Roll

If you don’t get the humor, might I just say, nursing school isn’t for you.

Nurse Eye Roll is my therapy. Thank you.

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Infiltrating

I began my pediatrics clinical rotation last week along with Pediatrics and Obstetrics lecture. Thankfully, I was able to get the type of rotation where each student is assigned one preceptor and follows that nurse for an entire 12-hour shift one day per week rather than two shorter days per week. I would rather have one day that is super busy and tiring and one day off than two days that are busy and tiring. I always collapse after clinical, whether it has been 4 hours or 12 hours.

My unit has medical-surgical patients with various GI, neuro, and some renal patients. Basically, a smattering of low-acuity kids who either need to be diagnosed or are coming back for a few maintenance visits/procedures.

Lesson of this week: pediatric IVs.

I had been warned in both clinical orientation and in lecture, pediatric IVs infiltrate fast. FAST. Also, little people do not or are unable to tell you that something is wrong. A nurse must look at an IV site for redness and swelling every hour and before attaching new fluids or medicines, flush a small amount of normal (isotonic) saline so we can see and feel that the catheter is  still in the vein and not poking through into the tissue. Infiltration is a BAD thing with your isotonic fluids, let alone medications.

In my clinical, I was beginning my assessment of an IV in preparing to administer an IV antibiotic that is a known vesicant.* It didn’t have a blood return (not bad) and flushed rather easily. I let my nurse know that there was no blood return, but continued to set things up. My nurse also assessed the site and compared his IV hand with the non-IV hand; some edema was present. She flushed a little more saline through and asked the patient if it hurt.

“Ow, yes!” (Patient is a younger adolescent).

Nurse, “Yeah, we should probably start another IV then.”

Patient: “That’s okay, I’ll just live through it.”

Nope! It doesn’t work like that kid. On pediatric patients, especially those younger than 16, we just call IV team because veins are not as visible the younger the patient. The IV woman came within an hour, used her awesome ultrasound and placed a new IV in the patient so the antibiotic could be given safely.

The experience didn’t scare me, rather helped me see what else goes into an assessment and better techniques for assessing the pediatric IV. Some catheters are tiny; some only need 3 cells to occlude and clot. It was a reminder that early adolescents need to know the risks of their medications and why nurses check things that seem insignificant.

My next clinical is tomorrow. Hopefully I can remember all the assessment techniques for pediatrics and focus on other important things. Like playing Candyland with a patient.

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.

Cheese Fail

This is not cheese:

From the Kraft Velveeta Facebook page

From the Kraft Velveeta Facebook page

And neither is this:

Read on to see how these came about as rather relevant during the past semester.

Ah, student nurse clinical – where all the fun begins. I finished my Psych clinical with relative ease; not too heavy on the paperwork, observations completed. I was heavily appreciative of my instructor giving us a broad spectrum of the mental health system. We saw a few competency hearings in court; we traveled to a women’s prison (inmates have a higher percentage of mental illness than the population at large). I got to see the psychiatric equivalent of an ER/triage center and when I was on the floors, I would participate with group therapy as I was available.

And with a few comments and signature on a final evaluation, I was done. The next week, I donned my scrubs and showed up for Med-Surg clinical orientation for a cardiac floor. While cardiology would be emphasized more in the next semester, it was still a good experience in seeing the co-morbidities of diabetes and hypertension.

Co-morbidities: the domino effect, one thing goes wrong which causes another thing to go wrong, multiple problems occurring at once.

So, part of my learning experience is constructing and giving patient education. A lot of patients end up in the hospital not knowing why high blood pressure or diabetes is that bad of a problem. Um, yes they are.

I prepared some literature for a patient who needed encouragement to stop smoking (he had expressed an interest) and information on a low-sodium diet. I went in and asked him if he was interested in learning about some of his new medications and the new diet he would be asked to be on outside the hospital. A positive response. “Awesome! A receptive audience!”

I told him about some medications that he was on for high-blood pressure that helped with nicotine cravings, then moved into diet education.

“So, tell me what you eat at home.” The patient reported he cooks “normal” food of meat, potatoes, and vegetables while staying away from pre-packaged TV dinners and meals. “Good!” I gave him some general tips on cooking without salt. How stopping smoking would help food taste better.  I then directed his attention to the materials that I brought.

“Let’s focus on this column: the foods you can have.” I pointed out that fresh fruit is good, be careful which sort of vegetables you get, they can sneak sodium into them. “Now, cheeses. You can have a lot of variety of cheeses.” And serendipitously added, “You’ll want to stay away from Velveeta and Kraft American singles.”

His next question just about floored me. “What other kinds of cheese are there?”

“Was he serious? Is he asking that because he actually does not know of real cheese or just needs to expand his knowledge of varieties?I stammer in the next few sentences. “Well, you can have these cheeses listed here: cream cheese, cheddar…”

I have never been so thankful for my limited stage training. It was enough to help me keep a straight face.

We talk a little more about the lifestyle changes he’ll need to make. I try to encourage him to think small for the day: focus on the list of foods he can have and think what meals can be made with those.

“Oh, this lists ‘ground pork’! That means I can still have ham.”

FACEPALM! Me: “Nope! Ham is salt-cured. You’ll need to get plain ground pork from the store or a butcher’s shop.” I was rather thankful my back was turned towards the in-room computer at that moment.

Ever wonder why nurses look tired at the end of a day – we are the first line of defense in cases of common sense not being so common after all.

Neuro-Psych Nursing

I’ve finished my first few days of clinicals in “the looney bin”, which is exactly how a patient described his/her surroundings.

As I have mentioned in previous postings, patient privacy is of utmost importance. It’s not only due to the lovely laws collectively called “HIPPA” by all healthcare employees (including housekeeping and maintenance workers) that I stray from specifics, but also because behavioral and mental health diagnoses are sensitive topics.

One thing I do want to get out of your mind is that being a psych nurse is nothing like what you would see on the movie A Beautiful Mind or other show where barbaric treatments are implemented. So far, I haven’t seen or heard from other nursing students that syringes of sedatives are jammed into patients nor disengagement of staff from patients. I have yet to see a room on the unit as stark as in the movie Girl, Interrupted. There aren’t heavy decorations of any kind, but neither is there a sterility to the environment either.

My first day on a Psych unit was actually last week. My fellow students and I got to see various units in the entire department – the one I observed was subdued as it was lunch. We were just supposed to see how the environment (milieu) was set-up. What rules and regulations were in the unit for safety of the patients and staff? What activities were offered to the patients for their day? What was the goal for the patients in that unit?

The past two days, I was actually on the unit as a student nurse. With no instructor always present, I was not allowed to pass meds (not like there were really that many anyway.) Mostly, I observed the patients, attempted to talk with one, and observed the staff in their work and interactions. What I didn’t expect was my lovely vasovagal respons to kick in – again – for the silliest reason.

My particular patient was considering ECT (Electroconvulsive Therapy) for treatment. Before engaging in a conversation with my patient in regards to his/her thoughts about consenting for treatment, I decided to watch the video about ECT that the unit provides as information.

I found the video helpful and a great resource. My adrenal glands did not.

I don’t know if it was seeing an actual patient rather than an actor portraying a patient that set me off. Or maybe seeing an outpatient procedure with IV lines and knowing that regardless of the muscle relaxants and anesthetic, the purpose of the shock was to trigger a seizure. Whatever it was, I felt “the first wave.”

Crap. Seriously, I’m sitting down! I’m not in the room with the person! There’s no blood! GAH!

I’m fascinated by the video, but my adrenaline refuses to calm down. A second wave. Dangit! I know I’m a little tired, but I had breakfast and coffee. I start moving my feet, then bouncing my legs. I get down on the floor and start moving my legs. This helps a bit, but then I decide to sit back in my chair right as my instructor comes into the room. I attempt to tough it out and tell her what I’ve learned so far from the video.

Then, I cave.

Sorry I’m moving my foot around so much. I have a highly developed vasovagal response, and I don’t know what’s bothering me about this right now, but it is kicking in.

We talk through it some, then I request permission to lay on the floor and move my legs around. “Do your thing, you’re fine!” My instructor is a pretty cool chic; I hope that I can be as knowledgeable and passionate about my future nursing specialty as she is. I don’t give a detailed history of my vagal responses, just that it first happened when I was 14 and that I was “that nursing student” who passed out and spent her first clinical day in the ER.

And since my instructor is a practicing Psych nurse herself, she was encouraging me to do whatever I needed to bring my anxiety down. I shared with her that I was working with a counselor on campus as a prophylaxis for depression and that we had been working on self-care. Thankfully, since I was able to lay on the floor this time and pump my legs, I returned to “normal” in about 5 minutes.

I think once I feel the first few waves, there is a secondary anxiety of NOT wanting to experience an “episode” again. Yay – anxiety about anxiety. So, while frustrating, at least I didn’t end up in the ER again and have the unit wonder what the heck was wrong with the student nurse.

After that, I could get on with trying to converse with patients who had mood disorders and seeing the staff de-escalate threatening patients. I can’t wait until I get some time on the more intense wards or crisis units.

My Excuse for the Hiatus….

Sorry it’s been dull around here. It’s not that I haven’t had ideas for what to fill the blog-o-sphere with my version of noise – it’s a matter of time.

After December 12, I was officially free of this semester. Yay! But then I had about a week to fit in as much work and visiting local friends as possible. Work won. And when you spend about 10 hours of your day at a restaurant, you quickly lose sanity.

Then I traveled to Wichita, Kansas, by myself. Yep, me and the Toyota. And lots of snow on December 20. It was a great time to reflect on the impatience that dwelled in the depths of my soul. Then of all miracles, I actually enjoyed the time with my family – so alas, I didn’t sit in the corner with my laptop writing furiously over the unfairness of being subjected to the cloth vs. disposable diaper debates.

Here was my attempt at pity and humor on Facebook that is my current distraction for blogging. See ya on the other side…

Scholarship applications: (n.) an exercise in how to say the same thing (I’m a person who deserves money) in as many different ways possible without being redundant or desperate. See also: insanity, non-traditional student, no Ramen…ever, 18-more months of nursing school

 

Student Nurse Clinicals: Wrap-up

As of today at 2 PM, I finished my first round of student nurse clinicals. Due to HIPAA and the privacy that everyone is afforded, I have decided that a play-by-play for this experience is neither good nor necessary. And one of my first observations of how nursing school has changed me is that my life will never be the same; I will always have nursing in the back of my mind and as a filter for my activities.

This isn’t negative but rather a noticeable change in two specific ways. One: in regards to HIPAA, IF I talk about work or a circumstance, I stray from pronouns so that the person hearing the story will have to guess whether the patient is male or female. Then again if I mention something regarding a reproductive cancer – whoops! Two: I realized that my weekend or break ends 12 hours before my next shift, not when I go to bed and wake up. Why? I sometimes enjoy a glass of wine or cocktail with friends over a meal. If that is within 12 hours of my start time for a shift, my license is on the line.

If you’ve read the previous posts, you’ll know that I spent my first day of clinicals in the ER and received two staples in my head. The other three weeks were delightfully different.

In this first semester of clinicals, my cohorts and I were each given one patient to focus on for the morning. I was in charge of assessing my patient’s vital signs, ensuring they participated in their ADLs (Activities of Daily Living) to the full extent possible, seeing their nutrition needs met, and educating them or their family/visitors.

By the 4th week, I finally felt more comfortable with my assessing skills. I had a plan and a pattern; the electronic charting was still cumbersome, yet that was partially due to me needing to chart EVERYTHING possible rather than bare necessities. One of my goals every week was to make my nurse’s life easier – trying to think ahead, having a plan for the day, asking for help as needed, but making my decisions independently.

My patients were all very different from each other and had various needs and deficits in their lives. Some were emotional deficits, a lot of physical deficits, some lack of coping for family and friends. There were barriers between me and the patients. Some had little knowledge of English, some came from a culture I didn’t understand, some lacked comprehension of their situation.

But I had to continue to think critically – what could I do to make their life better for that morning I was assigned to that room? What care could I provide, with no judgement, that in the end would make that 30 minutes, hour, day, more bearable?

Mind you, this isn’t a romantic view of nursing. It was hard to see the patients with the various deficits, physical or mental, and to hear the stories or see the charting as to how they got there. I did a lot of inglorious and frustrating tasks. But I felt I made a small difference, that I learned more of the skills and technique of nursing, and that I did my job well.

As of 330 PM today, I crashed in exhaustion and now need to study for two finals tomorrow instead of write.

Student Nurse Clinical: Day 1

Heavy sigh. I was that nursing student. The one who is certain she is called to be a nurse, always ready with the answers… who faints on the first day of clinicals. This is an experience that shouldn’t start with a bang. I guess I’ll start from the beginning, rather than piecing it out and having you attempt cohesion at the end.

My first clinical day was about two weeks ago. I had to work at the restaurant the night before, but I willingly pulled the “I have to leave my house by 5:30 AM tomorrow” card on my manager. He cut me first from the floor, and I was grateful. It still took me a while to wind down, even though I got home around 9:30, but I got to bed about 11 or so and estimated I would get 6 or so hours of sleep.

I woke up at 5 AM before my 5:15 alarm. Dang. I got into my scrubs and grabbed some granola bars. I could feel my adrenaline already pulsing, so I decided to fore go my usual large coffee with cream. It was a rainy and cold morning, so I snagged an umbrella out the door. The drive was a good time to relax and think about the day.

I thought about stopping into the Hubbard & Cravens on my way to Wishard, however, I decided that coffee wasn’t necessary as I was still strung out on adrenaline. I met with my instructor and fellow students in our conference room; I felt a little nervous but it seemed normal. I might have been the only one in the room who did not want to be in pairs, yet everyone else wanted to pair up, so I consented by silence.

We got the KARDEX (paper information) on our patient and report from the nurses. I started feeling a little light headed with waves almost like severe exhaustion, so I shrugged them off and tried to busy myself. We were still waiting for our patient to wake up, so I chatted a little with the nurses. The next few waves came. Shoot, they were a little stronger this time. “I’m not going to vasovagal!” was running through my head. I thought I was thirsty, and I knew another thing I needed was to get the blood back to my heart and head. I tried walking around. I sat down with  my head on the desk. Thinking I might want a juice or soda, I tried to find the vending machines, but I only had a $20 bill. Dang. The water from the fountain tasted terrible. Thanks, Indianapolis.

About 5 minutes later, our patient was waking up, and I wanted to be brave. My partner and I went in to introduce ourselves and asked if we could start our vital sign assessment. I was feeling fine while taking the patient’s pulse and counting respiration rate; my extra energy had something to do. Right in the middle of my 30 second respiration count, a med student came in. The patient was having a procedure done that day and the student needed to complete a pre-procedure interview. All I was doing was standing around. Huge wave and the first sign of blurry vision.  I excused myself to find my instructor. I couldn’t think what it was that was starting the vagal response in me. The patient had some chronic conditions, one of which was renal failure. Dialysis was needed, and the current port for the dialysis tubing was in the patient’s neck. While I hadn’t seen that specific kind (Inter-Jugular or IJ tubes), I had seen ports on others before. I spent the last year giving medications by PEG tube to The Brain! Tubes should not have been a problem.

I finally found my clinical instructor and admitted that I wasn’t doing to well. I told her I had a history of vagal responses, but if I could go get some juice and walk around, I would be fine. Partial humility is always a bad idea. She consented, but right then I felt a huge wave and said, “After I sit down…” I turned to walk towards the welcome desk and chair.

The fuzziness began to clear, but it felt as though I was being woken up. I closed my eyes again not wanting to be bothered with the light and noise.

The THX sound check began ringing in my ears. People were saying my name, but I didn’t recognize their voices. I had no idea what happened. Then I heard a voice I recognized as my clinical instructor’s say, “She was on her way to the chair, when she fell and hit her head on the shredder box, taking the charts down with both of us.”

The first words out of my mouth, “YOU MEAN I DIDN’T EVEN MAKE IT TO THE CHAIR?!?!?”

Nope. I was on the floor against a wall. The right side of my head felt as though I had been hit by a rock. I was tired, dehydrated, and trying to explain my medical history with vagal responses when they would let me. My thought process is one that if I explain I have a history of these and I’ve survived them, then it won’t be a big deal and I can get back to work.

Why do nurses think that medical rules don’t apply to them?? (History = Problem NOT “Oh, she’ll be fine!”)

The staff around me takes my blood pressure. I tell them that I had a typical breakfast for me and, no, I don’t have diabetes. They check my blood glucose anyway. 100 thank you very much! (This is within normal limits) My blood pressure is a little low but not drastically. They ask if I’m ready to sit up. Yes, I’d like to try. I sit in the “fainter’s position” with my head between my knees; I hear an audible gasp. With the way my head is slightly throbbing, I make this supposition:

“I’m going to assume by that sound that there is blood involved.”

“Yes.” I put my right hand up to my head by the area that feels tender. A few drops of crimson. Dang. I can not refuse treatment now (yes, I’ve done that before when no blood was present. Again, nurses don’t follow the rules.)

Some one hands me a small container of orange juice. After a few small sips, I stare at the cup, “This is the WORST orange juice I have ever tasted.” It was more like melted concentrate. I try to be humorous (deflecting, anyone???) and tell my instructor, “Well, Jeni, you have another story.” She smiles.

They ask if I’m ready to get on the wheeled bed to go down to the Emergency Dept. I stand up slowly and make it. Then the tears of embarrassment come at the same time as the urge to expel any contents of my stomach. The Vagus Nerve (Cranial Nerve X) is involved with both your heart and digestive system, thus the blood pressure drop plus the nausea are typical. Someone hands me a small box of tissues, the offended sheets are put in laundry, and I’m wheeled away to the ED.

After the elevator ride, I’m asked the orienting questions by the admitting nurse. What is your name and date of birth? What month is it? Who is the president?

An admitting bracelet is put on my wrist, and I’m taken to the ER triage bays. I make the comment, “Yay, my first hospital bracelet since birth.” A nurse comes to place me on a monitor for heart rate and pulse oximetry. I look at the monitor, my pulse is at 50 which means that earlier it was much lower. (Adult pulse rate should be about 60-100). The resident comes over with a med student and does her assessment. Is my grasp even? Can I follow her finger to the 6 cardinal movements of vision? Am I able to resist her in my arms and legs? Can I tell her what happened? Do I have a history? She looks at my head; two staples are definitely needed. My instructor tells her part of the story. It’s at this point I find out that I was out for a minute or two and that the brief interlude where I felt I wanted to roll over a sleep was prior to me exhibiting signs of a small seizure. I explain that the seizure-like symptoms have occurred before and that I’m unaware of any seizure history except the few symptoms that occur in conjunction with my vagal responses. I think a few more tears fell.

A nurse comes by with supplies for blood draw and IV fluids. My vein that was found so easily a few months prior was not so that day. She had to really search for it before finding a decent draw. Ow. After the samples were taken, 1 litre of saline was put on a fairly fast drip into my system. I’m simultaneously encouraged and discouraged; I can handle a fast drip to replace fluids, yet it’s one more thing that tethers me to the bed. Another nurse came by, this time for a 12-lead ECG (apparently EKG is no longer the correct abbreviation).

Registration comes by. Emergency contact? Who can drive me home? Um… “Put down my parents, and I’ll figure out my life later.”

At this point, I’m alone in the bay as my instructor left to check on the others still on the floor.

I cry from embarrassment. I try to rest, which is impossible with COPD guy coughing behind the curtain on my right, the light above me, and a woman two bays over being on cardiac monitors. And my IV starts bothering me, but there are no signs of infiltration and phlebitis doesn’t happen in 20 minutes.

The resident decides I’m ready for my staples. Since numbing the area would take longer AND hurt more than just putting in the staples without an anesthetic, she irrigates and proceeds. It felt a little weird feeling both go in and pinch the skin together, but in reality, I’ve had mosquito bites be more annoying.

My instructor comes down with my backpack and report on the others. She reminded the other students that my incident was covered under HIPAA, therefore, they had to allow only me to share with others in our classes. I didn’t realize until she said it how relieved I was. I got her phone number before she left.

I texted my mom and The Frau as calling was impossible in the recesses of the ED. A few texts are exchanged with The Frau, and I assure her of a full explanation when I have better cell reception. The resident came over to check on me and see if I could walk around without feeling woozy. I passed the test. Woot. In the mean time, I decided to take a free HIV-antibody test because it was offered, and I figured I should get something for free out of this experience even though I live a low to no risk life. It came back negative. Shocker.

The attending physician comes over to check on me before discharge at 11:30, mind you I collapsed at about 7 AM. I assure him I feel fine and that my recent surge of tears is more from embarrassment (with a slight amount of failure). He validates my emotions and says they’ll do their best to get me out quickly. My discharge papers only list “syncope” as my diagnosis. No care or other instructions related to my staples. Hm.

I finally see the light of day after twisting through the labyrinth of halls to the outside. I call my instructor to let her know I’m out and half hoping she’ll let me return to the floor. Denied and without energy to argue, I consent to her wisdom.

I call The Frau and am put on speaker so her husband can hear as well. I walk back to my car while explaining the situation.

And, yes, I drove myself home. Yet another nursing rule broken.

My (Lack of) Stealth

I promised that with nursing school comes the student bloopers. Last time, I shared one that exercised my ability to keep a straight face in front of a confused fellow student. Now, it’s my turn.

Tuesday mornings my cohort meets for the lecture portion of Assessment class where we learn, well, how to assess patients. This involves the interview and the physical assessment of inspecting, auscultating (i.e. listening with a stethoscope), percussing, and palpating.

There are very few rules for Dr. W’s class as we’re second-time-around college students. One rule is don’t come late to class; if you come late, listen to the lecture in the hall and She’s a former Catholic nun with lots of stories. This means class is fun but also the potential for guilt is high – very high.

The Tuesday before Halloween, I was about 5 minutes behind where I wanted to be on leaving the house. I found a parking space in the far garage and began walking. With class at 10 AM on a Tuesday at a commuter campus, I get used to walking – a lot.

I did not realize until I started walking my huge tactical error for the day – my shoes. With socks sliding on the inside of my mule shoes and no heel strap to keep the feet in, I sorely underestimated my walk time. Also, the time change messed up my clocks, so I didn’t realize exactly where I was on the time of cutting it close.

I arrived at the door of the class as Dr. W was finishing her pre-lecture chat/check-in. Drat. She had technically started class. I set my stuff on the bench outside the door, and prepared for my listening of shame. A classmate mouths to me, “C’mon in. You can make it.”

I check. Dr. W is looking away. There is a desk a mere 3 feet from the doorway.

Why I choose to try and slide through two desks instead of taking the back one, I will never know. I’m not a waif.

Klunk-Screech-Klunk-klunk-Shuffle.

15-20 people and Dr. W look at my attempt-at-innocent face. The classmate who beckoned me giggles. I sigh and promptly get up. I think I said something like, “Oh, fine!” as I made it within a foot of the door.

Dr. W, “Sigh, Sit down.”

However, the first few slides of her lecture are filled with little jabs of “…you know, the stress caused by not getting to class on time” or “thinking of others when you don’t get to class on time.” She’s a nun, she’s knows guilt well!

At this point, I pipe up and say, “If it makes you feel any better, I do have a highly developed sense of guilt.” She only threatens to point a finger at me.

I wore better shoes the next week.

Assessment

Yesterday’s post was a bit depressing as to my current state of mind. I apologize if it brought you down, but saying anything else or attempting an uplifting post would have been severely faking it.

But today, you get a nursing school anecdote! Yay!

In yesterday’s assessment class, the instructor (a former Catholic nun who is very spicy – I love her!) was lecturing on the cardiovascular system. She was talking about pulse points and which ones we should know how to palpate: temporal, carotid, radial, femoral, pedal, and a few others I can’t remember at this time.

Anyway, we were told we would NOT find the femoral pulse on our lab partner, but rather practice on ourselves or “I don’t care, grab a stranger off the street and practice on them.” Giggle, giggle. A few of us exchange glances.

Under my breath, I say, “I don’t think that would hold up in court.”

My instructor stops. “What was that?”

Me, a little louder, “I don’t think that would hold up in court as a good defense.”

Apparently, as I was informed later, the entire class stopped and nervously awaited what was coming next. What actually came next was a story about another group of accelerated students, which had nothing to do with pulse points, but oh well.

Again, in case you need to know where to palpate the femoral pulse: put your fingers the outside of your hip where the femur meets the pelvis. On the front of your body, follow the lower pelvic line inward and down. This is also known as the groin area.

I’m certain that, “Hey girl, let’s palpate our femoral pulses” is next in line for the Ryan Gosling meme.

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Because we're all crazy. Someone just needed to say something.

Nurse Eye Roll

humor | honesty | nursey shenanigans

The Orthodox Clergy Wife by Presbytera Anonyma

the secret sisterhood of Orthodox clergy wives

Hiking Photography

Beautiful photos of hiking and other outdoor adventures.

Orthogals

striving for truth ... and normality

In All Things

"Grant us to greet the coming day in peace. In all things help us to do Your will..."

The Garfield Park Arts Center

The center for arts in Indy Parks

Heaven is at Hand

Struggling in Christ for Authentic Life

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