Wednesday, February 26, 2014

The Nursing School Honeymoon Phase is Most Definitely Over

I know I just have the mid-winter "blahs".

Having finished psychiatry, I can say with relative confidence that this is most probably not an actual case of SAD - Seasonal Affective Disorder, as it doesn't quite impair my ability function. So I think its a lesser case of SAD, just called the "blahs" and "I'm really sick of winter -- an unseasonably cold winter that just won't let up".  Yes, I'm quite sure that's the technical/mental health terminology for what I have.  That being said, regardless of the actual diagnosis, I know for certain that a trip down south to visit some palm trees and sit on the beach would be *the* perfect antidote!  I promise myself that as soon as I graduate this degree, that will be an annual ritual to combat the February "blahs". :-)

On a brighter note, my first week of classes is finished. My final exam went OK and I finished overall with a mark that maintains my A average (whew!). My "dark cloud hanging over my head" nursing theory paper is now half written, and the second half is well mapped out.  That fact in itself is already lifting my spirits greatly.

My dear husband is only away for two more nights, and then I can go back to my role as full-time student and part-time mom, instead of full-time both roles. Ever since I became a mom and realized just how difficult it was for two of us to cope with a newborn, have I had a special place in my soul for single parents. I wish I could be of more help to my friends who are currently going through this nightmare experience that third year nursing school is, yet I'm barely keeping my own head above water these months. I will somehow make this up in the future when I graduate, as it really is a section of the population that I have a very tender and empathetic spot for. I'm a big believer in that "it takes a village to raise a child" philosophy, and I plan to put that belief into action as soon as I possibly can.

I have my first med-surg shift early tomorrow morning. We are to show up wearing "professional" clothes, not scrubs, so it remains to be seen just how long the day will be, or what exactly it will entail. But I do know that starting on our Friday shift, it will be all work and learning.  Our clinical instructor is an ER/trauma nurse, and she seems absolutely fantastic. I can see that this rotation will be probably the most difficult thus far, but with the instructor we have, I can also see this rotation being the one where I learn the most, and maybe, just maybe, will finally start to feel a wee bit like a nurse. I can but hope.

Off to make lunches for everyone for tomorrow, and then try to get some sleep before the 5:20 am alarm goes off.  And they're calling for more snow overnight.  It might make for yet another interesting (aka white knuckle on the highway!) drive to the hospital....

Future-nurse Kate

Friday, February 21, 2014

Worst Spring "break" ever

I'm almost beside myself with frustration, stress and worry. This was supposed to be our spring break -- reading week. We have a final exam in psychiatry at 9 am upon our return on Monday morning. And we have a huge research paper looming in nursing research. So those were my two goals for this and research/write a paper.

Instead, we're faced with 9 chapters of reading, innumerable Youtube videos to watch outlining various procedures and countless websites to read up on. All this for a lab quiz, that is due at noon on the Monday we get back to school.

This has truly been one of the most stressful "breaks" ever. Add to that, we're having some major issues with our oldest child, going through the agonies that are the start of the teenage years. The stress of that factor alone is almost unbearable to me. I'm not sure how that's going to play out in the coming weeks. But I will reach out for professional help if we need it, as this issue may be bigger than I can currently handle with my child (see, I've learned something from my mental health class!)

It's 4:15 am, and I've been up since 1:30 am, studying, simply because I can't sleep.

I'm really not sure, honestly, how I'm going to get through the next 6 weeks, without blowing my GPA that I've worked so hard to maintain at the A level, and keeping sane.  I truly just don't know.

The GPA is really important to me, for several reasons. One, it feels good to have marks reflect what I think I'm learning. And perhaps more importantly, it helps me get the consolidation placement of my choice -- certain areas of nursing, such as the NICU, L&D and Emerg (which happen to be my top three choices!), are only open to students with a good GPA.

In the big picture, if a student/new grad truly wants to get into one of those areas, they can eventually get there. However, being an older student, I'm well aware that my career time is much more limited that the new grad straight out of high school.  It's really important to me to get into an area that I love, as soon as possible, instead of wasting time getting there.  I've wasted enough time already getting into this field...I don't want to waste any more.

I'm going to try to go get some sleep now.  I've seen what serious sleep deprivation can do to the mind, during my psychiatric clinical rotation, and it ain't pretty.  And I'm not talking about "beauty sleep"!!!  I'm talking about the visual and auditory hallucinations.

Tuesday, February 18, 2014

Spring Break 2014!!!

The title of this post makes it sound like a fun week.  Alas, reality is quite different...

Yes indeed, Spring Break/Reading Week is upon us. Sadly, it resembles nothing like the media or pop culture portrays Spring Break. No wild parties, no bikinis, no drinking (well, maybe a bit!), no sand, no palm trees. Just snow, cold, textbooks and research papers. Wahoo -- we sure can party!!!  And this doesn't just apply to us "mature" students.  There may be a few gone South for the break, but I haven't heard of anyone going anywhere else than home.

Yep, that's the reality of third year, I guess. We have a final psychiatry exam waiting for us at 9 am on Monday morning, after our break. Most of us are taking this week to write our horrible nursing theories research paper. And our lab team for the remainder of the semester was kind enough to email us yesterday, to tell us that all the lab readings are posted, and that the first lab quiz is due at noon on Monday -- the same Monday we have our final exam.  I guess I'll add lab readings and lab quiz to my activities for this week.

So its not much of a break, but it is a break nonetheless.  At least there's a break from classes/shifts and the usual routine.  I'll take it, even if it doesn't involve palm trees, white beaches and fancy drinks! 

I'll just have to make up the trips/vacations I lost during nursing school, starting next year, when I graduate (next year!!!!!). 

Off to tackle my "to do" pile. I really want to make the most of this week off, and accomplish lots.

Happy reading during Reading Week!

On a different note, I've added another countdown element to my many countdowns (yes, I do love counting down to certain big events, like finishing nursing school!!!)

Only 150 more days of classes/shifts remain in our nursing school adventure...

Wednesday, February 12, 2014

Nursing Care Plan

I'm finishing up my care plan for my current rotation - psychiatry. I'm quite pleased to be able to say that writing these plans is becoming much easier. Maybe it helps that my first career involved much writing, but knowing which nursing diagnoses to choose for my patients is also coming much easier. It's actually fun to write these (I know, I'm weird).

It'll be interesting to see what the difference is between nursing school and real nursing, next year. These care plans are a great idea in principle, but are they really used across the board in nursing practice?  I somehow doubt that greatly. I can see them being developed and used in certain areas of nursing, such as maybe home nursing or rehab, but on a medical floor or even in psychiatry, I must say I rather doubt it.

Probably much of what we're currently learning will be nice to know, but not applicable to the realities of the work day. I love the ideas of giving "culturally competent care" and writing down goals that are "patient driven" so as to have maximum participation on the patient's part. Ideally, I sincerely hope to be able to include elements of such ideas in my daily practice, and I will really try, as I do see the benefits, but it remains to be seen to what extent such ideas can really be incorporated into practice.

And don't even get me started on nursing theories -- especially the grand theories!  I can hypothetically see the usefulness and how I could apply middle range theories and lower theories in my work. However, that being said, I do appreciate the work and thought and effort that the early nursing theorists, back in the 1960s and 1970s did, which helped advance nursing into a true profession, and not just a non-thinking role as "handmaiden to the physician".

I give the early theorists full credit and gratitude for that, because if nursing was today like it was 50 years ago, I most certainly would have stuck it out in my first career, guaranteed!  Nursing has come a long way in the past few decades, and I look forward to seeing how much further it will advance in my lifetime.

But I will still reserve the right to snicker at Roger's prediction that nurses will become "astraunettes" in the future, doing nursing practice in outer space.  But again, I give her full credit for her many ideas and thoughts -- think big or go home. She definitely thought big.

Back to my care plan and hopefully I can manage a short run this morning, before my afternoon class.

Life is good.  And Spring Break is next week, which is great.

Saturday, February 8, 2014

Inspirational Words for Today

"The odds may be one-hundred to one against you, but a determined person can do anything."
                                                                                        source: my 12 year old son

He just said that to me, as I'm sitting here with my head hurting from trying to understand and memorize so many nursing theories for Monday's exam.

Learning nursing theories is still a nightmare course. I'll most definitely, without any shadow of any doubt, leave evolving nursing theories to other nurses, in my future career.


Thursday, February 6, 2014

Another Shift - Another Code White

OK, to be completely honest, today was one of the scariest, must unnerving days I've ever spent on the job. Yes, there was another Code White called on a patient.

I didn't witness this one, but the build-up to it was almost surreal.

I'd often heard the expression, "the tension was palpable in the air", today I completely understood what that means, and how that feels.

Not only were all my fellow nursing students and I on edge, and feeling the tension, but so were many of the patients. I could see how distressing it was for them, who are dealing with severe problems of their own.

The patient in question was not doing anything outright that would raise red flags to prompt a de-escalation or medication. It was just a quiet building of tension that continued to grow.  It was a feeling unlike anything I'd ever felt before. I was so relieved that I wasn't there when he did blow.

Everyone was jittery and on-edge today it seemed - staff, students, patients.

I was so relieved to walk out of there this afternoon. 

And now I find I'm still having a tough time concentrating on my work assignments and to try to focus on the nursing theories exam that's coming up early next week.

One more shift tomorrow morning. Hopefully it'll be a new day, and a better shift.

Psych nursing is most, most definitely NOT for this future nurse.

Wednesday, February 5, 2014

Dreaming about Nursing

That's not the dreaming in the sense of, "I'd really love to go to nursing school and change careers" type of dreaming.  I had plenty of years of that.

Rather, its the "wake up in a cold sweat and gratefully gasp as waves of relief flood your body because you realized it was just a dream/nightmare" type of dream.

Yep, that's what I awoke to this morning. And forget trying to get back to sleep after that!

I had a nightmare about administering medications. 

One of my worst fears as a nurse, perhaps even "the" worst fear I have, is making medication errors.  They say its inevitable that every nurse makes med errors, and to be wary of those nurses who claim they've never made one, as they're the scariest ones, as they most likely don't realize their errors. But I digress.

In my nightmare, I was being a completely careless nurse. It was a busy nursing station, and the patients were coming up to it go get their meds (as happens in the psych ward at times, with certain patients). I was filling in or something, but it was definitely a new unit to me in the dream. I was chatting with one guy as I prepared his meds. Then I gave him his meds and that was that.


Except shortly thereafter, another guy came to the window and asked for his meds. I asked him his name, and then realized that those were the meds I'd just administered to the first guy -- whom I hadn't even asked his name, let alone checked his wrist band AND asked him his birthday.  Oh. My. God. (This was when the panic welled up in me, even in real life as this dream unfolded).

Then, to make matters even worse, when I told the nursing manager about my error, she asked me what meds I'd given the guy, and I didn't know!!!  I mean, I knew what the names of the pills were, and how much I'd given, but I had no idea if they were heart medication pills, or blood thinners, or antibiotics, or what - you get the idea.  This is how nursing jobs and licences are lost, and even worse, possibly lives.

I woke up around this point.  Heart pounding. I told hubby about it, still breathing gasps of relief that it wasn't real.  His comment was, "At least you've gotten this mistake out of the way, and learned from it."  Lol!

I still cringe when I think back to that nightmare.

The rights of medication administration have been drilled into our heads for awhile now.

The nurse must ensure he/she's got/giving the RIGHT:

route (of administration)
reason (for giving that particular medication)
documentation (after the medication is given).

I will definitely ensure that such a mistake ONLY happens in my dreams -- or rather, my nightmares.

My first career definitely did not come with this type of stress and responsibility...

Monday, February 3, 2014

Code White!

Yes, I witnessed my first "code white" on the psych floor -- meaning "violent patient". Orderlies and security came running.

What a strange and horrible feeling to witness something like that.

Only 4 more shifts to go.

Its been a good rotation so far. I've learned a lot. My clinical instructor couldn't be better. My group is awesome. I've met some really nice people, who suffer greatly in their lives, even if their problems aren't visible. But, this is not the specialty I see myself in.

Nope. Psychiatric nursing is definitely not for this future nurse.  Most definitely not.