SANE/SAFE

People ask what my ultimate goal is within nursing.
I have a few.

I want to be a Sexual Assault Nurse Examiner/Sexual Assault Forensic Examiner (SANE/SAFE) because we need them, and we need them to be helpful, caring, respectful, and good at what they do.
And they should work in emergency.
And in a perfect world, we would never need them.

Here's another story, besides ones from my friends that motivates me. Read at your own risk. I kid you not. If you can't stomach these things, don't read.
I cried for an hour after I read this story.

It is absolutely horrible but there are some good souls left in the world.

And having the tools to help someone in this situation is most certainly my motivation.
Let's stop this violence before it starts, people.

The day pig(s) flu...

Well, it's happened.

Now we have a pig flu. We always wanted to see pigs fly, but with the swine flu, well, it's interesting to see what will happen.

I'm actually curious if the respiratory infection I've been fighting off is possibly due to the virus. The warnings are "if you've had contact with anyone from Mexico." Oh really? So, the entire state of California is at risk? Nice.

Seriously, I'm really interested to see where this goes, what the warnings end up being, and what our actions as students are.

MEPN is done in 6 weeks. I'm going to be an RN very soon, and that really really frightens and excites me at the same time.
I thought pigs would fly before this would end.
And I guess I'm right.

Let's Talk About Organ Donation, for a moment.

I just lost a friend who was given extra years of her life due to someone's gift. She received lungs about a decade ago from a man who had the courage to donate, and recently, at the age of 33, went into an episode of acute rejection, aspergillis infection, and had also developed cancer in her abdomen.

I miss her terribly, and am in shell shock.
I can't even imagine what your family is feeling.

Please, if you haven't, register yourself as an organ donor. If nothing else, I got more years of knowing my friend. She was a beautiful soul, a real fighter, and will be missed by many.
Anne James Ferrari, you have touched the lives of so many. I am so lucky to have known you. Spread your wings my friend, and remember us here. We'll see each other again.

Please, donate life.

And for those of you still here, live every day. Carpe goddam diem.

Here's a photo of her and her beautiful sister (who is also becoming a nurse. I love you, Beth):

The Cycle Continues

I'm backdating this blog entry, mostly because I like having Anne's sunshine smile at the top of my blog.

Friday, the 10th, I spent my first rotation in Labor and Delivery. Here's a summary of the experience:

My brand-new clinical instructor is moving very quickly towards us, somewhat breathless.
"Okay, Nicole, you and (male MEPN) are in the delivery rooms, and everyone else is in Post-Partum. Go change into these scrubs. And the women in those two rooms are pushing. Hurry!"

My cohort and I look at each other, high-five, and nod. Neither of us even had time to register nervousness- I mean, I had never seen a vaginal birth, only a C-section, and we have had about three lectures on pregnancy. New scrubs on, we stepped out, ready for the day.
For about ten minutes the nurses we were working with hemmed and hawed about the number of students allowed in one room, and I told him to go ahead- as a male, I know it's more difficult for him to be accepted into a delivery room. Not today. He merged right in to the room, needed and accepted. He had only been in there two minutes, when I hear a call for, "Hey can I get another person in here?!"
So I stepped in.
"Um, I'm a student, what can I do?"

A nurse looks at me, "Grab that towel and go hold her leg so I can hand tools to the doc."

The patient is in a traditional hospital-birth supine position, her husband is at her side. They are super cool, and very calm, all things considered.
"Hi, nice to meet you. I'm Nicole." Contraction.... "Okay, breathe deep with me, ready?"
And that was it. Off and running. It's 7:15 am, and I am helping hold this woman's legs open for a difficult birth, trying to remember what I can about fetal heart rate decelerations, next to her husband (who is also totally rad), watching the doctor work, realizing that this baby is in a little bit of trouble. And I'm watching the baby's head crown.

Holy Shit.

And I thought, silly me, that the head would be way smaller than it was.
The OB was very calm, and grabs the vacuum to help get this baby out. I see the FHR (fetal heart rate) is about 70.
Not so good.
Doc, very slowly but firmly. "Get Peds in here. Now."

A team of 3 superhero nurses emerge from the ICN, ready. They're setting up oxygen support, and the warmer.
The woman pushes again.
"Call Dr. XXXX. Get him in here." I realize that she's calling for the attending.
"Okay, now push. Hard. We need him out of there."
Attending arrives, steps back close to the ICN nurses.
Our laboring mama listens. Another nurse is pouring mineral oil and olive oil on the crown of the baby and on mama's perineum.
And all of a sudden, I realize just how huge that head is, because it's coming. Fast.
And just like that, there's another person in the room.
"Floppy baby."
Not a good thing.
He's blue and floppy, and the cord was wrapped around his neck, twice. Not 2 seconds into the world, this little guy is under a warmer, being rubbed down, suctioned, and bagged with oxygen.
The trio of superheros is working, hard.

It's almost too much to absorb. I look at mama, I look over at baby, and then I look down at mama and she asks me (and the doc), "Did I tear?"
It took every ounce of my consciousness not to look incredibly shocked.
Um, yes.
The OB: "It's not that bad."

Apparently, it's not that bad, but I have never seen a vaginal birth and I could not believe what a "not-that-bad" tear looked like. And the amount of blood that was associated with this process I was NOT prepared for.

I keep myself together, "Yeah, not that bad. How are you doing?"
And then I look at dad. "How are *you* doing?"

We start bantering, like we had known each other for a while. I glance over at the busy trio and the once-blue baby. He looks pink, to my relief. It's been almost 10 minutes.
Then we hear it... He cries!
I sighed, audibly. Everyone in the room noticeably relaxes.

They bring the little guy over to mom and dad, and let them say hi, but he was on his way to the ICN to be watched for a little bit. Both mom and dad are medically savvy, and they nod. Mom looks tired. Baby looks pink, warm and dry. He looks a little mad after being suctioned, and he's probably a little dazed.
"How long were you in labor?"
She looks at me. "31 hours."
My male MEPN companion and I look at each other and our jaws drop.
"Um, can I get you some juice?"
She laughs, and nods. "Yeah, that'd be great."
The OB is busily sewing up the tear. This mama had an epidural, which she relates is what helped her make it through. It's not even 8am yet.

And that was the beginning of the day. Literally, 2 hours later, I'm watching a C-section, then an hour after that, I'm holding the legs of another woman who didn't get an epidural because her baby was on the fasttrack into life. First baby, and she only pushed about 5 times. She tore, too. And let me repeat, NO epidural. Her baby came out with a loud cry, pink, and feisty. Good sign. The doc was trying to numb her up to sew her back together. Again, not a bad tear, but on my first day, it was pretty shocking.

At that point, I thought to myself, "Is there a third option?"
If I invent anything, it's gonna be a baby transporter beam, a la Startrek.
And I had a hell of a lot more respect for all the women I know who have gone through this process.

I then spoke to my Godsister, who is a NICU (ICN) nurse, and she relayed to me that usually women with epidurals tend to tear more often because they can't feel pain, so they don't allow themselves to stretch enough. Makes sense, naturally, when it gets too painful, you stop, take a breath, relax, let yourself stretch, and then begin pushing again. Huh. I am going to ask my prof about this (not that I don't trust my godsister, I just want to ask my professor).

L&D started with a rush of emotion.

So on the same day that I was there for 3 new people coming into the world, someone I really loved transitioned to another one.

Which is a wild head trip for me.

In the past few weeks I've lost a lot of people I've known. See my prior post about one group, but I also lost Shane McConkey, who was a trick skier filming in Italy, and fell. One of his skis didn't pop off, which screwed up his balance and from what I understand, his parachute was tangled in his ski. So he fell. 400 feet. He was only 39, and he was the most bitchin' landlord I ever had- he used to come over and drink beers with us, and his wife Sherry used to come visit as well. I remember how excited she was when she told us she was pregnant. Shane was awesome- he knew I was trying to improve my skiing and offered to ski with me, which floored me. Shane was a legend- he was Squaw's guy, and he was a friend to so many, and so down to earth yet nutty and fun. Total prankster, and totally loveable. He leaves behind his wife, Sherry, and Ayla, his daughter.

Too much.

It's a cycle. I haven't confronted death in a long time, and I've never seen birth like what I saw on Friday, so I guess it's time for reflection.

Side Note:

This is just wrong. I'm not sure if I should be frightened or in awe:


see more pwn and owned pictures

Spring has Sprung.

So, I had an epic adventure in Montana.

Actually, it's a long story, but suffice to say, it took a lot of creativity to get home.
I'm really glad I'm in Schedule A. We had a two week Spring Break, which was much needed- as much as psych and pediatrics was a lighter schedule than med-surg, the energy involved in caring for the patients was very intense, and I'm glad to be in the community health quarter with Labor and Delivery (babies! Yes!).
I'm placed in a TB clinic which is frightening but important work, and I'm curious to see how things unfold. Our issues in nursing class is also WAY cooler than I thought it would ever be- I am really diggin' the course already. Our dean is articulate and real, and for that I am very grateful- she rocks.

And I got a job! I started looking early. REALLY early- went to career fairs in October, checked out stuff in December, and I applied by happenstance to UCLA med center. Within 4 hours of submitting my application, I had an email that invited me to interview. I called immediately, and got an ICU interview. Then I called back and begged for an ED interview... those were not public, they were reserved for people with Emergency experience.
Awesome. I thought I bombed it. The unit director was very cool, but told me that there was only one position. I cried. I felt like, "wow, I'm great, but I'm going back for my MSN in a year or two, and that's working against me."
She hired two of us.
So, not only do I have a job, but I have THE job that I've wanted! Super super happy dance wiggle excited. So, I live in LA for a few years. Right on, I've always wanted to check out a beach town, and UCLA med center is a Magnet Hospital- they are amazing- and I love the vibe. The nurses, techs, and docs are color-coded by scrubs, so you can tell who's who when you ask for help. They're all about being polite, and I find that VERY important.
Super cool.

On the down side, a large group of people that my family knows died in plane crash in Butte, MT, and I'm just reeling. It makes starting the quarter a bit odd. Three couples and their kids, 7 children in all. 14 people. Senseless. And, because one of the members of the family owns abortion clinics, the idiot anti-choice people are protesting the memorial service tomorrow. I'm sorry, but there's a time and a place, and that's NOT it. Hmm, let's advocate saving unborn inviable fetuses, but celebrate your horrible heartbreaking loss of active children- WTF?!
I'm disgusted.

And a good friend of mine who had a lung transplant 13 years ago is in the ICU with an aspergillis infection. I am very very worried about her, and I know what that means. She's also fighting some other stuff off, and it's been a struggle for her. I've been waiting for facebook updates to keep me informed.

Doesn't make the first week of the last quarter easy.
There's a lot to think about.

*Deep breath*

I went to bikram yoga today for the first time in about a year. It was absolutely heavenly to be in shivasana and be mindful of my body, to focus on moving and on breathing instead of on running around like a madwoman.

Two friends of mine are beginning MEPN this year as well, both whitewater guides. I'm super excited for both of them, and it makes me happy to know that there are more female guides heading into the world of nursing. :)
Yeah!

Okay, that's the report. Stay tuned..