Monday, October 27, 2008

Turning Seasons.

When you are in clinicals, or are working in an acute care setting, you will understand why I love that LOL cat.

Fall is here. It's getting colder, we're getting a little bit busier, although there are only four weeks left of this quarter.
Papers are due soon. The last time I wrote a paper? About 9 years ago, so the foray back into APA format has been somewhat like a jog down memory lane after gaining about 85 lbs. I feel out of brain breath. Make sense?

Someone said that MEPN is like running a marathon. Nah, running marathons involves sleep. A lot of people take "mental health days" here and there, and I have to say I wholeheartedly agree.
This last weekend I went over to the eastern Sierras with my best friend, and we camped out in Jeffery pines and Aspen trees that were golden with the sunset. We hiked around at 7000 feet at the same place my headlining photo is from, and there was no water in the creek. It was awesome, to say the least. I was reminded why I chose nursing as a career path- it fulfills my love for patient care and (hopefully) allows for having a life. I have to live outside. Have to. Non-negotiable. My boyfriend and I are already planning some backpacking trips once I'm out of school.

Wow, four weeks left in this quarter.
Then we're halfway done.

Today I looked around at everyone and just had this moment where I realized how much everyone has learned- people were so nervous, so unsure of themselves when it came to talking about patient care, not to mention actually doing it - and now everyone trades information and speaks to each other like, well, like nurses.
It's really really cool.

Since my last time in, I spent some time in the ED (emergency department to those of you who don't speak medicine), which completely re-lit a fire under my ass. I loved it. Working in emergency always ignites me, and I even got to do some charting under the auspices of my nurse preceptor. She challenged me to do an assessment on an ortho patient (yes!- easy, what I *always* used to do while patrolling), who had a bad bicycle accident. I did a full assessment, checking my patient's neuro function, asking if she could remember what happened, did she lose consciousness, etc. I assessed her breathing/ribs and cardiac function. I checked all peripheral pulses and cap refills, paying special attention to the one distal to her injured forearm. Very carefully, I wrote down my findings, scared shitless - I mean, it was on real ED charting paper from a major hospital, and my words become legal. After sweating for a few minutes, I figured, well, hell, if the RN I'm working with doesn't like what I'm charting, she can shred this and start over.
I got praise. I was stoked.
I also got to hold traction later, working with a doctor who had a gentleman with an obvious shoulder dislocation. We didn't get it back in. I've reduced a few of those in the field, and when I saw this one, I thought to myself, "Ooo. That's bad..." so when it didn't go I wasn't surprised.
We had such an amazing variety of patients: people with liver dysfunction, people in withdrawal, abdominal pain, an Acute MI (heart attack), that I saw only briefly on my way out when my shift was over- there were so many people in the room that I wasn't able to be a part of anything anyway.
I also inserted a Foley on a guy who was having a rough night. I'm sure that didn't help. The night was busy.
I'm not a night person, but I was completely awake. Our observations are only 3pm-11pm, but I stayed until midnight, ecstatic to be back "at home."

Other than that, I think the program has been relatively manageable this quarter. The final papers are kind of a pain, but they're almost done.
Back to back 12 hour clinical shifts are tough, and for each student they're tough for a different reason.

I'm thinking about doing a quick advice column for things I've learned with the MEPN year so far.

Sorry this posting is so disjointed but one reason I haven't written in a while is lack of sleep and personal time. I got personal time this weekend, but sleep is yet to come...
Oh yes, and Halloween is coming. No we don't get out early from clinicals.

Thursday, October 9, 2008

Love, Bluegrass, and Tears.

Ah yes, 5th week of "schedule A's" quarter, and I'm deep in Med-Surg nursing. Still on the transplant floor. Still doin' my thing.

Last weekend I rode on a float in the LOVEfest parade down Market St in SF. If I could find a photo of me on the Spundae/Skills float, I would, but alas, I was in my EMT pants and a T-shirt, although I had my hidden orange fur and sparkley pants in my bag. I was supposed to volunteer from 11am until 4:30, and ended up staying until 6pm. We had so many calls- lots of overly intoxicated people on various substances, and I was running around with oxygen on my back trying to help them. Doing the quick assessments was actually kind of fun, because it brought back my EMT skills and I was surprised at how comfortable I felt in that environment. A lot of people thanked us. Afterwards, I found some friends and danced until about 7, went home, and drank a margarita. Sweet.
Sunday I went to Hardly Strictly Bluegrass since it was only a mile or so from the house, and had a fantastic time just chillin' with close friends. Listening to Iron and Wine play was magical, as was dancing with the girls to Greg Brown. Awesome day.

Today was a tough one at the hospital. Last week, I took care of a patient who was hoping for a good diagnosis. He didn't get one. He has an inoperable state, and at this point, he has been referred to Hospice care. He'll be here for a few more days, and I'm going to try to be with him tomorrow. His wife is phenomenal, and I cried with her for about 20 minutes this afternoon. There's not much time to give, but what I have, I will.
I can't go more in depth, but that still makes me tear up. Knowing that your parter is going to pass, knowing that you are going to pass- given "time" to do what you need to do... Is it a blessing? He has the opportunity to say what he needs/wants to the people he loves, yet it's limited.
His wife looked at me and asked, "Why is it that we only find out who truly loves us when we're sick or dying? Life is so short- time goes by so fast and we keep promising each other that we'll get together, and it takes something like *this* to make it happen. Why?" She paused, looked at me, and said, "Enjoy every moment you can. If you learn nothing else as a student, enjoy every moment you can."
That's when I started crying.
I hugged her.
In the middle of the hug, my stupid cell phone started vibrating, and we both laughed and laughed. Perfectly ludicrous.
They've been married for 40 years. I've been with my boyfriend for 2.
My heart aches for them.

And then there is that question: how *do* you go back into the hall and help your patients after that? How? My heart was heavy, but I got elbow-deep into poop (literally- and discovered a pressure ulcer and worked to prevent skin breakdown) and tended to the needs of someone else who is, very literally, dying.

Bad word on our floor, but seemed to be the word of the day.

All we can do is love openly, celebrate the time we have, and be here for each other.
Those words from my NP friend echo through my head: "There's not a day that goes by where I don't hug a patient or am there for a patient. I give good news and bad news. When I've lost my ability to emote, then it's time to move on from this."

I'm just getting into it, and it's heartbreaking and beautiful all at the same time.

This weekend I'm at a wedding. A beginning. I think I need it.