Oy, I am so over this semester. There, I said it. It's not that I dislike any of the courses, I'm just undergoing utter burnout from work/school stress. I just flat out don't care about my marks in Psychology. How bad is that? It's a totally easy course with a class average of 80%+ but I put zero effort into studying for the midterm and got 77%. I'm terribly ashamed but still can't summon the energy to care much one way or another. I've been engaging in a lot of self-talk lately trying to pump myself up for powering through finals. I have a Micro and Phys midterm on the week after next and I seriously need to study. I feel like I don't know anything! So that's my plan for this weekend: around the clock power hours.

I had such a great time at clinical this week! Because we had our hygiene lab the week before Reading Week, we were finally allowed to assist with patient hygiene. Well, everything except perineal care. It was our first full 8-hour shift and lucky for me my new shoes were finally delivered. They're some kind of New Balance walking shoe and because of my high arches I got some fancy inserts for them. I tell you, it was like magic. I was expecting all kinds of joint pain because I'm not really used to standing up for long periods, but I got home and my feet were a little swollen but not tired at all. And the next day I felt great! So far, so good.

I'm heading out of the house for some time well spent with my extended fam (we jokingly called it "Coffee Club" where we meet up at a Second Cup every Saturday and take over half of it for a few hours and catch up with everyone... and the name stuck) and later today I will be posting up the sordid details of my clinical experience as well as the, uh, metabolic-waste-ly fun of lab this week.

TTFN

One year later and I am a changed person. I have a steady, well-paid job that I am grateful for and which is allowing me to work through my education. I have many new friends and I have a sense of belonging at my school. I've weathered a long-distance relationship for 6 long months (soon to be 8!).

I've learned a lot about nursing, too. I always knew it took a special kind of person, but my focus was always in the heart of a person. I never realized how tough school would be or how many (oh God how many) long and lonely hours I would spend studying in the library. A nurse is a skilled job for sure, and with each passing day part of me is less sure that I could ever be skilled enough to do it. Another part of me is sure I can and can't wait to feel capable.

So to my readers, old and new, thanks for sticking around. We've still got another 3.5 years to go, though, so stay a while!

We then went into the med room and my nurse started getting all of her meds together. While I was hanging out in there it occurred to me - wait a minute, this nurse hasn't washed her hands yet. Not once. I had been using hand sanitizer like a crazy person (like I said, 5 skills, and I'm gonna do them right!) and my hands were all gunky so I went for a speed wash because really, she was leaving to pass meds whether I was following her or not.

Now, some of you might call me out for not calling her out on it. Yeah, I probably should have but it's really tough to correct someone that has 20 years experience on you and you've only known her for an hour, and you're just grateful that she let your useless ass tag along. It's not even like I'm a 3rd or 4th year student with the experience to go most of it alone. I'm just a lowly 1st year on my 4th clinical day who asks a lot of questions but can't help much! (I'm also a person who is insanely respectful of other people's autonomy. An attitude that clearly needs to have boundaries, but geez, I'm working on it, okay? :) Anyway Wardbunny and Kim helped me out for next time by suggesting I just ask for a minute to wash up before we do the next task and hopefully she'll get the hint.

So we passed meds to everyone and she asked me to hang out with Mr. F, the stroke patient in restraints. Uh... sure?

Technically, Mr. F was only in one wrist restraint because his right side was immobile. She went to untie him and said "Okay, Mr. F, I'm going to let you out of this restraint but you're not allowed to attack me, and you're not allowed to attack my friend. Okay?". He just looked at her but I really do think he understands more than he let on. She untied him and he was fine. She asked me to stay with him to make sure he didn't come out of bed. Apparently the day before he saw his breakfast but there was no one in to feed him yet, so he crawled out of bed (sort of - remember, stroke patient) and attempted to self-feed. His family wasn't too happy with that!

So I hung out by Mr. F's bed for a while, straightening this and that and basically puttering around waiting for her to come back. I could feel his eyes burning into my back and I was getting really weirded out so I started talking about nothing in particular. Mr. F had two responses he would give to a question. He would either nod slowly, staring into your eyes, or shrug his shoulders with palms upward as if to say meh, take it or leave it. 

I asked him if he was comfortable - nod. 

I asked him if he'd like the radio on - nod. 

I asked if it was a good volume - nod. 

I asked if he liked the station - shrug. 

I asked if he was comfortable again - nod.

Awkward.

So I saw there were some cards on Mr. F's table from various guests. Aha! thought I, something I can make small talk about that doesn't make me sound like I'm hearing voices.

I picked up a card and it was your generic get-well soon card. I read it to him and he nodded slowly, looking at me. Then it hit me - this card was from the Little Italy association! Mr. F is Italo-Canadian and now that shrug that he does is totally in context.

So for the rest of my 4 hour shift I hung out with Mr. F, making small talk about sweet nothing until he started asking me for something but for the life of me I couldn't figure out what it was! I don't even know if he was speaking English. He was so muffled it was hard to tell. He kept gesturing kind of wildly with his good arm and finally I was like... oh... are you thirsty, Mr. F? Nod. I wasn't sure if that was a nod yes or just an 'I'll agree with you because you're talking to me' nod, but I went with it. So I told my nurse that he seemed thirsty and she kind of gave me the so give him a drink expression but I'm not allowed to yet and aspirating a stroke pt 'because I wanted to help' is not exactly on my to-do list.

She went off on her break so I started following some other random nurses around. As I was carrying sheets for one of the nurses, a tech came running up to us and said "Are you an RN? I need an RN to take the Dr orders" and I shook my head and my nurse did too. After the tech left she muttered "I used to be an RN in the Philippines but here I am only an LPN". In case you weren't aware there is a huge hoopla because Canada took in a lot of foreign-trained nurses and told them they could be RNs here. Then we changed our minds because they couldn't pass the  CRNE and so we made them LPNs until they can pass the CRNE. So I felt super awkward, being an RN student as I am, with this woman who can't function as an RN here even though originally that's just what she was. I was trying to explain this to my boyfriend that although it sucks they were made bad promises, we can't just upgrade everyone to an RN position without them being able to meet CRNE standards. Not all countries train their nurses the same way and to give everyone the same responsibilities without having had equivalent training is just unethical. So I don't have a solution for that one. Good luck, government.

That about wrapped up my clinical day on Monday last. We had a 1-hour post conference in which we discussed our reflective journals which are periodic through the term. Yeah... about that - I failed it. I am so peeved about the whole thing. I wrote a good little paper and I thought it covered off all of the requirements but apparently a reflective journal is a whole different can of worms. Most of my group failed it actually. Most of the other groups got an easy 5/5, which is what I was expecting. My instructor said that it wasn't about passing or failing, but actually, it is. These journals are 20% of my final grade! So we're going to talk to the course developers and be like, dude, wtf.

Lab last Friday was so fun! We did a hygiene lab and we got kits with all kinds of goodies in them. There's a shower cap that comes preloaded with shampoo, and you can microwave it and wash someone's hair with it. There is also shaving cream, a razor, a toothbrush, toothpaste, mouthwash, tongue depressors, wipes, etc. My tuition dollars, hard at work. The lab was super fun though. I usually pair off with one particular girl and we have a blast roleplaying. We tend to get very animated and give each other stupid names. 

"Oh, Nurse Mindy, you're the best nurse ever!"

So we gave each other bed baths on arms and legs and that was a great experience, having it done on myself. It's easy to forget how cold even hot water becomes when it's on a washcloth. Also brushing someone else's teeth is a real challenge!

Anyway, that brings me to this week, where I'm doin' a whole lot of nothing and it's great. Semester end is in sights!

Some of you Twitterians may recall that I ordered a Littmann Master Cardiology stethoscope from stethoscopes.com a few weeks ago. I had it shipped to my aunt in the States so that I could sidestep the $100USD shipping fee. I totally call bullshit on that cost. I had purchased a guitar on eBay and it was shipped to me from Texas for about $40USD. Then, unfortunately, after I placed my order, I started reading all of these bad reviews online about the store, particularly how the guy who owns stethoscopes.com also owns magnafortis.com and those are just crappy scopes, and there were a ton of unsatisfied customers. My distrust was heightened when I called to inquire WTF was going on with my order and I could hear the guy huffing and puffing for 10 minutes while he looked high and low for it. THEN he told me that my engraving would not fit well on the Littmann scope but - surprise! - would look amazing on a Magna Fortis and he would be happy to upgrade me for free. Lucky for me, I had already read some pretty sketchtastic reviews on the Magna Fortis and was in a good position to say Hellllll No, give me my Littmann. So he gave in really fast (he must get that response a lot) and said he'd ship it out. True to his word my aunt received it today and hopefully it will be in my hot little hands by Friday of next week because we are starting vitals (I think). 

So there you have it - I'm pretty sure I got what I wanted from him but I'm not impressed with the whole process and all of those bad reviews can't be imaginary.

So! Where did I leave off? Ah yes, clinicals of last week. It was, hands down, the best clinical I've been to so far. We showed up for morning report at 0700, which means my clinical buddy had to be at my place for 0600. It was a crazy early morning. I'm definitely an evening girl. Not good! So we arrive just in time for report and there was a ton of us all crammed into that teeny break room getting report. I'd never heard it before so I didn't know what to expect. I guess I thought that all the nurses would take turns explaining their pts but it was just the charge nurse rattling off about all of them. I think there were about 20 pts on the unit so it took a while to go through. I probably should have been taking notes on all of the pts but it's still so early in my education that I don't understand around 90% of what I hear. Most of what I do understand is what I've picked up from reading blogs! Boy, wasn't I hot stuff when I was interpreting charting slang for my clinical buddies. ETOH, SOB, Ox3, OT/PT, etc. - woo hoo!

So I got to shadow a nurse for 4 hours which was so great. I can't believe how far I've come since my first day. You may recall how I was hyperventilating over a patient asking - gasp - me for help. Or how terrified I was about going into patients' rooms and trying to get them to talk about their lives. Last Monday, man, I was charging into pt rooms like I meant business. I was looking at their charts in the rooms (okay, just the non-responsive patients) and getting stuff DONE! Oh, it was a glorious feeling. So I paired up with my (preceptor?) nurse and got ready to sponge-soak it all in.

The skills that I have to this point:

• Hand hygiene! Hand hygiene at every opportunity! No nosocomial infections on my watch!
• Taking health histories
• Giving hand massages!
• Repositioning and possibly ambulating but I haven't actually done that yet
• Making beds (woo hospital corners!)

These are the only skills that I'm allowed to engage in on the unit and by God I am going to do all 5 of them TO PERFECTION.

Or so I intended.

Our patients for the day were 1 independent man in for knee surgery, 1 nonverbal stroke patient in restraints (probably d/t confusion), 1 MRSA isolation, and 1 DNR middle-aged person dying a horrible (in my opinion - sorry if it's not PC enough for you) COPD death.

First order of business was to take vitals which is not something I know how to do but I watched with interest. Most of the pts we used a machine with a pulse/ox finger clip and a BP cuff. We also took temperatures with a thin disposable color-changing strip. The MRSA iso we took BP manually with the most ancient sphygmomanometer that I've ever seen. This was, fo-real, mm Hg. The dying person had a heart rate of 140 BPM. It was crazy seeing someone breathing so slowly have a heart racing like that - although I guess that makes sense. It was just so sad. He was like a little shriveled skeleton in the bed and his belly button practically touched his spine. He was gasping with every breath. It gave me chills and I am still just so honored to be in the room with him during his final days so I have to thank his family for not batting an eye when I introduced myself as UgRN, SN.

Okay, my bus is coming so I will continue this in a bit. I'll post it now, though, so look for part 2 later tonight or tomorrow morning.

I wrote a Microbiology midterm yesterday, which went over pretty much like I expected it to. I don't know what was wrong with me. Burnout, perhaps. I just could not Pick Up The Book! I kept looking at it on the table all weekend but I lacked the willpower to do any studying whatsoever. So of course on Monday after clinical I did a power study in the evening and then on Tuesday during my breaks. I had a pretty good grasp of the content because of the way she actually teaches her classes instead of skimming the powerpoint slides and letting us figure it out. So thanks, Micro Lady!

So I think I did decently. Potential was definitely not achieved. Meh!

I write a Physiology midterm on Friday, and I have the same prof as last semester so I know what I need to be studying, and I know that I need to study asap because her exams are notoriously complex. Now apparently the nursing program has requested that she put in some short answer questions to "make it more like the CRNE". Uh, ok...

Other than that, clinical was really pretty uneventful. We were assigned a different patient and were to go and get health histories on them. My patient was an 87 y/o gentleman, bed bound and on NG tube feedings but otherwise mentally spry. I took a deep breath and didn't let myself be nervous this time. I peeked in the door, introduced myself, asked him how he was doing, and started asking him a few health history questions. He didn't really want to talk - he just gave me one-word answers - and I didn't really want to interrogate him! There were some awkward pauses and he said "Why don't you just watch this movie with me?"... so I pulled up a chair and we watched a western comedy together.

Good times, my good man, good times indeed.

However I was quite jealous when I found out that some other students got to transfer patients and help with bed making. I probably shouldn't have hung out with my pt for quite so long. But he seemed to enjoy it, and I'm not going to lie, I kind of enjoyed it too.

Here's what we learned in lab last week:

Yes, I am now certified to make the Best Bed EVER! And with someone in it! I wouldn't have known that was possible. And wow, it's a LOT of work. I was all sweaty by the end of our practice session, and it probably took me like 25 minutes to do. I feel sorry for my first patient to be subjected to that! :)

We also had a 1-hour presentation from OT/PT about their roles in patient care. "Refreshments" were served of delightful juices thickened to nectar and honey consistencies. It was downright nasty, FYI. The honey one just stuck in my throat and made me gag. I feel really bad for people on swallowing precautions...

Anyway, time to get back to Physiology. Good luck to you peeps heading into midterms! I feel your pain!