I'll keep this short because I was on a weird shift last night at the ER to try and cover the peak times, and then I went to my other job today, and I'm trying to catch up on sleep before my 0800 class tomorrow.

It's crazy to look at my syllabi and see all 400-level courses.

This fall semester is my final lecture-based term; Jan-Feb is my consolidation and then Mar-Apr is my PRECEPTORSHIP!

I put in my preceptorship placement requests yesterday after a lot of serious thought. Basically, after much deliberation and longing to try every specialty but being restricted to only 3 choices, I finally decided on Oncology, Cardiology, and Corrections.

A few that fell on the cutting room floor were PACU, ICU of all types including CCU, public health particularly women's sexual health, and a brief daydream of something extra crazy like OR. I also didn't consider asking for Emergency since I wanted to try something new.

Why not critical care? Although I'm tremendously interested in it, and I KNOW I'd learn a lot, I spent a lot of time reflecting on the criteria to excel in my preceptorship. Some of those things include initiative, the ever-elusive "critical thought", and transitioning to a grad nurse role. I honestly don't think I'd be able to excel in those criteria in ICU. Yeah, a 10-week preceptorship would be an awesome orientation to the floor, but really, it would just be an introduction. In my final preceptorship I'm expected to be a grad nurse. I feel like I'd spend so much time being a fly on the wall, I'd be too afraid to get in and get my hands dirty, so to speak.

The choices I picked are ones that I think have opportunities as a newbie nurse to actually show some initiative and capability as a health care provider.

We had to provide some rationales for our choices, and these were mine:

1. Oncology: My interest in Oncology stems from both the prevalence of cancer diagnoses across all patient populations as well as my family’s experiences with cancer. I feel uniquely prepared for a preceptorship in oncology nursing as I am currently completing the ONDEC course through the Alberta Cancer Board. I am also a student member of the Canadian Association of Nurses in Oncology (CANO) and will be attending the CANO conference** in Halifax this September to learn more from dedicated Oncology Nurses about their specialty. In return for receiving a travel grant, I have agreed to write a journal article for one of CANO’s publications and I am hoping to write about my preceptorship experience and transition from theoretical knowledge into practice as a graduate nurse.

2. Cardiology: I have worked as an undergraduate nurse in the Emergency setting over the past summer. I have tremendously enjoyed working in the ER and have found that one of our major patient populations are either experiencing acute cardiac changes or have a history of cardiac/vascular pathophysiology. Having worked closely with several former Cardiology nurses, I admire their extensive knowledge of this specialty. As I have been invited to stay with the ER after I graduate, getting first-hand experience with this specific population will be extremely educational and give me confidence when working with new-onset cardiac concerns in the ER. My RN coworkers have commented on my willingness to get involved and ask questions to further my understanding, so I believe I could meet the required objectives to excel in this placement.

3. Corrections: My first post-secondary program was in Policing, of which I completed 50% of the course credits. I still have a strong interest in law enforcement although I am geared more towards prevention and rehabilitation rather than apprehension. At the ER we also had several inmates transferred to our facility for treatment. I believe that with my educational background and ability to respect and work with corrections patients without judging their histories, corrections nursing would be a unique opportunity to make a positive impact in an underserved population.

**In other news, as you read, I am going to yet another conference! There are just so many opportunities for students to get involved in Nursing. I have some other projects I'm excited to tell you about. But that post will have to wait until, at least, I get a decent night's sleep :)

WaHOOOOoooOOO FOURTH YEAR!!!!!!

So it was SO FREAKING BUSY the other night. The back was stuffed full of sick people and new ones were coming in the door so fast we had two nurses out double-triaging for almost 2 hours. The theme of the night seemed to be chest pains or lacerations secondary to kicking glass/tables/sports equipment.

There were the usual WTF visits, like the mom who ABSOLUTELY had to get her kid "tested" for celiac disease in the middle of the night. At the ER. Where people were practically hanging from the rafters in the waiting room. The urgency? Well, she Googled a new diet and wanted to start him on it the next morning... "Can't I just see the doctor real quick?"

"No. I'm sure the other 25 people in the waiting room would like to see the doctor 'real quick', too." Then, after lipping off the triage nurse, she stormed out. Bye...

My first-ever witnessed case of military PTSD tonight. Query attempted suicide on benzos and ETOH. All I can think of is he had no other means to numb the chaos in his mind.

I don't necessarily believe in what the military *does*, but I do support the men and women who stand up for their country in one of the most honorable ways possible and the sacrifice they make in that choice.

But I think the sacrifice goes far beyond a tour of duty and service on the front line. I think that the military completely fails its troops once it's time to re-enter civilian life. In absence of psychological intervention, soldiers turn to any variety of things to numb their thoughts and dreams, and too many of them end up dead.

Thanks for serving your country, here is a sense of manly bravado, zero coping skills and tons of bad shit to deal with. Bye bye now!

Seriously, so sad. I just want to go all "The Cell" on him and hop inside his mind and bring some peace there.

-- from the cellular desk of undergrad RN

And I'm still troubled by it.

A young woman was brought in by police a self-inflicted laceration. At first it just seemed like your run-of-the-mill angsty teen cutting.

So I brought her in, pulled up a chair, and said..... "start from the beginning".

And she talked, and I listened, and she cried, and I held her hand.

http://www.twloha.com/vision/

Turns out this young mom, just a few weeks postpartum, was beat up by her husband. Lumps and bruises all over her. We had an inservice last term from a nurse who works in a women's shelter who talked about the dangers of strangulation in family violence; she had a big hand-sized bruise across her throat.

"But don't write any of that down," she said. "My hormones got the better of me. I was asking for it."

I told her about her resources and her options, but she didn't want to hear it. She didn't want to acknowledge that her husband laid his hands on her, hurt her, scared her. Hurt her so much that she told me "if he hurt me, why shouldn't I hurt myself?" and she cut herself to cope.

I know family violence happens. I know that women statistically have to ask for help 7 times before they commit to a change... but part of me just wanted to shake her and say "you can do better than him! He CAN'T do that to you!"

I know all that but I still wanted to go and knock him out. I was really upset and talked about it with my fellow students and nurses, but man. I'm really bothered by this one.

At the end of it, I told her that if she EVER felt like she had nowhere safe to go, she could come to our ER and we'd take care of her. She burst into tears. What more could I say?

You need to know that rescue is possible, that freedom is possible, that God is still in the business of redemption.  We're seeing it happen.  We're seeing lives change as people get the help they need.  People sitting across from a counselor for the first time.  People stepping into treatment.  In desperate moments, people calling a suicide hotline.  We know that the first step to recovery is the hardest to take.  We want to say here that it's worth it, that your life is worth fighting for, that it's possible to change.  - To Write Love On Her Arms