Mixed insanity. Controlled.

I don't know what bothers me more: the fact that I saw/touched/witnessed a dead baby in the NICU or the fact that it doesn't bug me as much as I thought it would. I felt awful, but also like I was learning, looking at and touching this poor little guy. He was so small, infinitely smaller- he didn't even seem real. He had been born 10 weeks early, which had given him a lot of disadvantages.
The nurse told me the parents didn't want to see him. I understood. That's not the memory you want. She was in process of taking a handprint and footprint and photos to put into a memory box for them.
That did get to me. I choked up at that point.
He died of NEC which affects a lot of premies, unfortunately. His head felt really boggy, and his abdomen was distended. The nurse who had been working with him was sad, but she also knew she and the team had done everything she could. She felt like it was a difficult battle for 12 hours. Once blood pressure drops and your blood stops perfusing your vital organs, it also stops perfusing things like your GI tract, and that means you have fewer defenses/less circulation going to the places that need it. Even with the heavy antibiotics he had been on, it just wasn't working. Sometimes, it just doesn't. Sometimes no matter what you do, it's just that patient's time.
Sigh.
The rest of my day in the NICU was much less emotional. I got to hold some of the cutest, tiniest little people I've ever seen, including one who had Down's syndrome and was the most adorable little guy. He loved following people with his eyes. I wanted to love him all morning, but he had other plans: sleep.

I also saw babies who had successful heart surgeries, who were doing well. It wasn't all gloom and doom- and the level of care I witnessed in the NICU was AMAZING. The nurses were extremely aware of hygiene and of taking care of the entire family. I was highly impressed by their abilities to work with parents, and their deft abilities to calm the newborns. The doctors that came in where communicative and kind. One apologized for waking up a sleeping little girl, and promised, "I'll get her back to sleep"... and he did, gently rocking her. The NICU was a medical place with heart. I can understand why people work there, and I'm glad I was able to experience it.


This quarter is flying by. In fact, the year is flying by. We're almost 3/4 through the MEPN year and it's hard to believe. I feel as though I learn so much every day, and it's difficult to keep up blogging about it, partially because my free time is spent sleeping or writing papers, partially because it's tough to find the words to write.

If you become a MEPN, you'll understand.
Wow it's almost over. I keep shaking my head. But now the next problem comes around, and that's the lack of jobs for new nurses...

A New Year

It's been a while since I've posted anything, partially because MEPN makes you want to take all your extra time to yourself. There's hardly anything left to share with others some days because you are so exhausted, but that made vacation super fun.

We had six weeks off, which started at the end of November and ran through the new year. What did I do? Everything. Nothing. I slept about 12 hours/night for a week. I ate turkey. I hung out with my boyfriend and my family. I danced all night. I took ACLS and PALS. We went skiing, backpacking, eating, eating some more, and skiing again. Then, we danced all night on New Years' Eve and then went skiing.

It was spectacular.

School started again, but for whatever reason, it's not as daunting. We're past the halfway point, our class has formed friendships, and we sorta know what's up.
I'm even taking an elective this quarter: Wilderness Medicine, which I love.
I became a student editor for papers (for researchers in the MS/PhD programs), using a paper which earned me a less than spectacular class grade, which is a bit frustrating - obviously it was good enough to get me an editing job using APA format, etc, but the professors took off points for random stuff last quarter, which was never really itemized. Whatever. My GPA is still high, and more importantly, I've learned the things I need to learn. And I can do them well. That's way more useful. Remember, it's about concept *and* application.

This quarter is about Pediatrics for us, with some Psych peppered in at the end. I'm loving working with children, to the point where I'm thinking about working in the PICU at Lucille Packard. Of course, eventually I'd try to move to the ED at Stanford (which has a wilderness medicine section to it), but I want to try something different for a while which could help me in my learning process and my endeavors that still encompasses what I want to do.

The job market is abysmal for us new grads. Kaiser revoked their contracts with some of their new hires, and that's pretty startling for us who have to take a year (or more) off.
Sigh.
In any case, the immediate happens to be enchanting me. I'm loving my pediatrics rotation. What a wonderful thing, to relate to children, to play games and to help them feel better.
I love it.

Now, the other interesting thing for me is watching the new applicants be nervous for their interviews. I've been following on allnurses.com, and the threads remind me of how scared I was. Many of the MEPNs wish they could be there for the incoming folks, but we weren't scheduled for lunches this year. If you're interviewing, relax, get some sleep, and know that we're all wishing you luck.
:)

Love of Doing Nothing.

Six glorious weeks off. It's 11:20am and I have done nothing today so far, except heat up some soup my mom made me. My boyfriend and I are heading to the Hangar One tasting room in Alameda with a few other MEPNs today, just for fun.

Realizing that there's nothing due, that I can read for fun, and that I don't have to get up at 5:00am for any purpose is a fabulous thing.

Done with Med-surge quarter. Now: enjoyment. The big questions: To work or not to work, to ski, to travel, to sleep.

Ahhh, vacation.

For a Patient.

Because I could not stop for Death,
He kindly stopped for me;
The carriage held but just ourselves
And Immortality.

We slowly drove, he knew no haste,
And I had put away
My labor, and my leisure too,
For his civility.

We passed the school, where children strove
At recess, in the ring;
We passed the fields of gazing grain,
We passed the setting sun.

Or rather, he passed us;
The dews grew quivering and chill,
For only gossamer my gown,
My tippet only tulle.

We paused before a house that seemed
A swelling of the ground;
The roof was scarcely visible,
The cornice but a mound.

Since then 'tis centuries, and yet each
Feels shorter than the day
I first surmised the horses' heads
Were toward eternity.

-Emily Dickinson


Morpheus

Oh, Morpheus, give me joy till morning
For my forever painful love:
Just blow out candles' burning
And let my dreams in blessing move.
Let from my soul disappear
The separation's sharp rebuke!
And let me see that dear look,
And let me hear voice that dear.
And when will vanish dark of night
And you will free my eyes at leaving,
Oh, if my heart would have a right
To lose its love till dark of evening!

Alexander Sergeyevich Pushkin


"There's no place like home."
-Dorothy Gale, from Kansas.

Honoring one of my favorite patients, who will probably not make it 48 hours.
I think she recognized me for a second today. She smiled, for just a moment in her confusion and pain.
And then she simply said, "I want to go home."

Maybe I'll see her tomorrow. Maybe not.

Whatever happens, I am grateful to her and her family for allowing me to help them. I am grateful for their love, which teaches me to love in kind.
And I hope that when she does go home, she finds peace.
Sometimes, holding someone's hand is all you can do.

Namaste.

Feeling Alive and Radiant.

The above photo is of Upper Cherry Creek, of Cherry Bomb Falls, a Class VI section of whitewater that Will has rafted. I was part of his backpack support, which was incredible- It was a magical hike, although I was jealous that I didn't get to be in the raft (it was just him and another burly guy), but then it started snowing and I watched them run this rapid at 5pm in June in the Sierras at 6000 feet. In the snow. Yeah. I slid down the granite into camp on my ass, because wet granite is like ice.
It was one of the most difficult and beautiful backpacking trips of my life.

The past two weeks have been tiring - no, exhausting - but something has happened that awoke my spirit. I can't pinpoint it. Well, I can, but I can't publicly describe it. It's like being hit viscerally with this sense of knowing that's beyond a doubt, like walking into a room, seeing something or someone and feeling your stomach fall through your feet. I've felt like something has been coming for a while from the universe/energy/out of the blue/god/whatever, and every day just seems to get better and better, and yes, something has happened. I'm meeting more people who have my same values and interests, always exciting, but it's not *they* who are the cause of this vibrancy; I think it's the fact that my fire is lit up that's bringing them into my life. Know what I mean?
Like sometimes you meet someone and they're a mirror, and you know you have a lot to learn with that person, and that means you're on the right path.

And it's not just the people, - I mean, people definitely excite me, and I'm dorky that way- I'm always wanting to know what makes someone tick, and I'm always curious.

It's kind of the brat in me. I. Want. To. Know. Now. NOW.
Hee hee.

There are opportunities and places to explore and stuff to get involved in that had been tough to find- from medicine to community to job leads. Until the past oh, month or so. Like things are coming together.
I feel like an excited kid when it comes to everything, except a little bit smarter.
And a little shy. But that's another story.

I feel in love with life again.

Will and I are doing well. He came back, and we have deepened our love to a place I didn't think it could go. Honesty. I likes it. I told him some difficult things this week, and we've talked through them. I've never been able to be so raw with someone, and it's been amazing. I feel incredibly lucky to be with him.

Everything I'm doing feels like it has a purpose. This week, someone asked me to describe myself, and one of my words was, "Intense." He nodded and gave me some of his own stories, which I was surprised by. He's not the only person that I've had this same conversation with this week (although with him it was the most intentional and clearest). It's like similar people keep finding each other, over and over.

Intensity. I can't do anything that's not wholehearted. Even writing a paper has me mildly stoked (well, okay, pushing it- but the topic is good).

I keep looking back at what's made me feel the molecules of my soul in the past, and I want to share some of those things with you:


There is nothing like rowing the 226 miles of this river. I miss every day I got to be out here. I faced a change in confidence by rowing rapids that were, for lack of better words, huge, and by having to trust myself to take care of the people around me. I grew so much in the Big Ditch.
And at night, all you get is a strip of stars above you- the walls of the Canyon are so dark that they suck in light. You haven't known dark until you're camped here, and the stars tease you, winking, and if you're lucky, you might get to see a sliver of moon.


More Tenaya Creek at low water- same place my header photo was taken (actually this is looking up the creek instead of where our feet are, which is looking down), but in October. My best friend and I went hiking a few weekends ago, and I didn't realize how much I missed granite.


Rivers up in the Trinity Alps. Don't get me wrong, I love the Sierras. The Trinities have other beauty to them. This was the South Fork Salmon, and wow was it cold. I'm guiding here, on a little 8' drop that was super fun.


Oh yeah, and corsets. If you haven't figured *that* out.

And emergency medicine. And not writing papers. And procrastinating by blogging. And being bratty. And reading anything that's not studying material.

And opening to life.
Opening.

Strangely, for the amount of intensity that has been coursing through me over the past 3 weeks, I feel extremely grounded.
Just really, really...
Happy.

Letting the light shine on!

High in the Sky Apple Pie Hopes

Today is election day. I'm heading for an observation again in the hospital, in my ABSOLUTE favorite spot, the ICC-
and then I'm voting.

Yep. I'm voting.

Because an ANT can move a rubber tree plants. And people can change things if they work together.

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.
Four.
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.