Congrats!

This past weekend was exciting, exhausting, and filled with anticipation.  Saturday began with lunch at the hospital cafeteria with a former co-worker in honor of her birthday.  Her husband contacted me earlier in the week and wanted to send her on a scavenger hunt.  I was to be the messenger and to casually ask her to lunch at our favorite hospital, cause we're crazy like that.  I loved seeing her open her gifts and tears roll down her face as she read the card and the events for the day from her hubby.  After lunch I crammed some studying in for finals that were on Monday.  Later on Saturday I watch my niece and nephew while their parents went to a company Christmas party and I worked on a video for my little brother that he used to propose to his girlfriend :)  I got a call at 12:05am on Sunday from my brother asking me "watcha doin'?" and I heard Jess screaming in the background "we're engaged!"  2011 is going to be an exciting year!  Sunday was spent doing a few more hours of studying and going to an engagement party in honor of  Chuck and Jess.   I still can't believe that my little brother is going to get married!

A cup of cocoa

On a cold, rainy, November morning my little brother and I ran some errands around town.  After walking out of one store with bell ringers at each entrance we commented on the weariness of the weather and the dedication of these volunteers to be standing in bone-cold rain raising funds for an integral organization in the community.  At once, we both had the same idea.  We drove to the closest gas station and fixed two large hot chocolates.  We returned to the store we had just left and were on the lookout for the two men we saw earlier ringing the bells.  As I pulled up to the curb my brother got out with the first cup of piping hot, hot chocolate and handed it to the man.  Even though I could not hear their dialogue, I could read the man’s lips.  He said to my brother as he took his hands out of the warmth of his pocket “ Thank you!  Oh, this is hot!”  His smile, however, said much more.  We circled the lot once more to look for the other bell ringer, who had no doubt stepped inside to warm up a bit and as he emerged, my brother once again got out of the car and presented a cup of hot chocolate to the man.  I share this story not to boast about our good deed, but to share the smiles of two people who made my day much warmer and brighter. 

What can you do today to bring a smile to someone?

Psych Rotation-8 weeks

Daily Schedule: Mon. --> Lecture  Tuesday --> Clinical day from 0645-1315

Actual Schedule: meet at 0655 to get assignments and then report.  

What to wear: Polo and khakis

What's in my pockets:  keys for the locked units

Patient notes you'll be asked to write: GAD score, reason for admission, past history, meds

What to study: Depression, Schizophrenia, Bipolar 

A few unforgettables along the way:  This rotation has taught me to look for themes in conversations and to bring up those themes to the patient as a way to learn more about the patient and what it is they think is going on.    I like to think of it as acknowledging the "elephant in the room" and discussing whatever it may be.  There have been some interesting stories as to why patients were admitted, suicidal ideation, PTSD, psychotic breaks, etc. This rotation has forced me to be the one to initiate conversation, which as uncomfortable as it is, has been a learning experience for me.

Critical Care-12 weeks

I realized that I had not been keeping up a log of my rotations.  Here is the low-down on critical care...

Daily Schedule: Mon. & Wed. --> Lecture  Thursday --> Clinical day from 0645-1530

Actual Schedule: meet at 0645 to get assignments and then report.  Fortunately we did not have to research our patient the day before.  This was really great considering I live 45 minutes from this particular hospital.

What to wear: Scrubs

What's in my pockets:  Report sheet, med book, scissors, alcohol swabs, stethoscope, pens, snack

Patient notes you'll be asked to write: Pathophysiology of disease, VS, I&O, Careplans

What to study: Mostly cardiology since this rotation took place at a heart hospital.  Diabetes and renal issues also deserve a good look through.

A few unforgettables along the way:  I appreciated the opportunity to float to the ED, burn unit, wound clinic, etc.  What I will remember most about this rotation is how on the second day my preceptor assigned me two patients (a big deal for the second day and the first time I had more than one patient)  One patient was a talkative baptist minister and the second was a patient with early onset Alzheimer's who wanted to call home but couldn't remember the home phone number.  It was a mentally and emotionally heavy load.  I didn't have time to review meds. before my preceptor came around and I was blamed for something I didn't do.  The ten weeks that followed were filled with anxiety and fear that each clinical day would be a repeat of this day.  It was for sure traumatic to say the least.  I was so glad to finish this rotation.

Another unforgettable is that I actually saw a PA wearing one of these

Grief and Fear

C.S. Lewis in his writing,  A Grief Observed echos my feelings as of late.

"No one ever told me that grief felt so like fear. I am not afraid, but the
sensation is like being afraid. The same fluttering in the stomach, the same
restlessness, the yawning. I keep on swallowing.
At other times it feels like being mildly drunk, or concussed. There is a
sort of invisible blanket between the world and me. I find it hard to take in
what anyone says. Or perhaps, hard to want to take it in. It is so uninteresting.
Yet I want the others to be about me. I dread the moments when the house is
empty. If only they would talk to one another and not to me . . .

And grief still feels like fear. Perhaps more strictly, like suspense. Or
like waiting; just hanging about waiting for something to happen. It gives life a
permanently provisional feeling. It doesn’t seem worth starting anything. I
can’t settle down. I yawn, I fidget, I smoke too much. Up till this I always had
too little time. Now there is nothing but time. Almost pure time, empty
successiveness . . ."


So I continue onward peddling about different tasks and obligations, like a fine haze contemplating when I will be full again. 

The Crate

The Crate is a fundraising project put on by FAME (Fellowship Association of Medical Evangelism) that runs from October 1- November 9.  In each 24 hour period teams of 4-5 people will take up residence in The Crate relying on social media such as Facebook, Twitter, Blogging, E-mail, and text messaging to raise money for one of FAME's four projects.  Those four projects are:

• 
  
  
  • - Purchase an ambulance for a mission in India.
  • - Renovate an out-patient clinic in Haiti.
  • - Send a crate with medical supplies to Honduras.
  • - Provide scholarship funds for students in Ghana, West Africa.

Tomorrow morning beginning at 8 am, team "Lost Shipment" will enter The Crate to begin 24 hours of fundraising.  Throughout the 24 hours we will also be doing serving projects at the FAME warehouse such as sorting/packing medical supplies and making food bags that will be going to Haiti.  

Would you be willing to help us reach our goal of raising $1,000 in 24 hours?  To donate, go to www.give2thecrate.org  Also, follow us on Facebook!  Search for FAME under causes and keep up with team "Lost Shipment" as we conquer hourly challenges and post videos of our time in The Crate!

Collection

of a few of my favorite photos.

Maybe pediatrics is a possibility after all?

2008

2002

2010

1998

2010

2010

2010

2009

2010

Habit

I have a tendency to bounce my leg when I am in class or testing or really doing anything that involves sitting.  I don't know why I do it, but I do know when it first started.  I was a junior in high school in psychology class and I've been bouncing ever since.  So today before an exam is handed out my lovely classmates ask in not so quiet voices if I am wearing my noisy pants today.  The last time we tested on our boards I was wearing track pants and the swishing sound my pants made when I bounced my leg was distracting to everyone.  Of course, I didn't hear it until the end.  Oops!  The testing room today was quiet except for the mumbling and talking to oneself that came from another student.

What habit(s) do you have when in a meeting/class?  

The last first day of school.

Forget the shiny new shoes and the smell of a new backpack and sharpened pencils.  When you've been in school this long all you want is a good cup of coffee to start the year.

 My day began with me going to the SON (school of nursing) to find out why my clinical time had been changed.  I had registered to have my psych clinical the first eight weeks of the semester to get it out of the way but due to a lack of instructors and site availability I was moved to the second eight weeks.  I am registered for 11 hours this semester- a substantial decrease from the 15+ I'm used to carrying.  I even met with my advisor for confirmation that I wasn't missing anything.  She assured me that all of my requirements thus far have been completed.  Of course there were all of the other freak-outs regarding tuition, scholarship/loan requirements, who said what, a lot of sighing, and doubting--> all of which are to be expected.

I accomplished everything on my "to do" list for the day.  I am going to try to hold out as long as possible on getting the parking permit...

A sense of "whelm-ness" is hovering over my class of 9 like a storm cloud.  All of us have been put through the ringer and we're like abused puppies anticipating a beat down when instead we have a week to read one chapter or a nice e-mail from a professor that reads, "You all passed the exam with a 90 or above. Way to go!" Throughout the day we exchanged glances with each other as if we were saying "That's it?"

I hope that the drive to do well doesn't diminish over the next 16 weeks.  I also hope that what it is that I'm supposed to do next will be revealed to me.  All of the who, what, when, where, how, and sometimes why questions have yet to be answered and I am getting a little antsy about what to do next.

Jessica's Daily Affirmation

Adult Medicine II- 4 weeks

Daily Schedule: Monday and Tuesday--> Lecture 9am-3pm w/ exams every Monday.
                          Wednesday- Friday--> Clinical 6:30am-3:30pm

Actual Schedule:  On the Med/Surg floor whenever the instructor decided that she was bored and that there wasn't anything else to do or to be learned she would let us go early.

What to wear: Scrubs, comfortable shoes and support socks

What's in my pockets:  patient hand-off report, patient med. list, pens, stethoscope ( I think I used my stethoscope a total of three times on this rotation), change

Patient notes you'll be asked to write: VS, I & O's, safety

What to study:  congestive heart failure, pulmonary embolism, ostomies, hematology/oncology. A lot of what you study will have to do with the population of people that come in.  This particular rotation was in the center of farming/agriculture so there were a lot of older patients who worked until their bodies couldn't keep up anymore.

A few unforgettables along the way:  Discount on food/coffee! A patient of mine who saw the Pearly Gates.  Patient with a GI bleed who is a Jehovah's witness.  Some pretty awesome nurses and assistants who goofed off with us in the hallways.  Having the electricity go out in the hospital. Going to the county fair for a "community assessment."  This really was a time for us to get out of the hospital and eat our way through the fair.

This was a fairly laid back rotation without too much work, which was very much welcomed considering this was the summer from hell.  A word of advice:  Do not enroll in an accelerated nursing program unless you are absolutely, positively certain that you want to go into the nursing profession.  Just sayin'.

Pediatrics- 4 weeks

Daily Schedule: Lecture on Mon. and Tues. from 8am - 2pm
                           Wards on Weds., Thurs., and Fri. from 6:30-2:30

Actual Daily Schedule:  No real change from what is posted above.

What to wear: Scrubs.  It's good to have an extra shirt if you happen to be the recipient of any projectiles

What's in my pockets: Brains ( a tool to organize your day- the one in your head is good to have too), Assessment and medication sheet, pens, band-aids, granola bar.

Patient notes you'll be asked to write:  assessments and safety notes.

What to study:  I have been spending most of my time on the pulmonary unit.  I've been reading a lot about pediatric respiratory issues, pediatric interventions in a kid-friendly way.  Of course, all systems.

A few unforgettables along the way:  sitting in on a cranial reconstruction, seeing a patient with right lung agenesis (born with only one lung)

Curious things other students do:  1. text messaging- which I find is unprofessional. 2. talking to patients like they are adults. 3

I am tired exhausted of school.  The amount of information that is thrown at us is ridiculous.  I am so over this.

Row your Boat

After getting moved in to the new house, battling bronchitis, keeping up with patients on the ward and studying I was more than ready to call it quits.  Instead,  this past weekend a I dragged a friend with me and we went to the reservoir for National Learn How To Row Day.  The day was humid, steamy, and rainy.  After being briefed on the parts of a boat and some practice on the ergs we hit the water.   First on the barge and then on an eight-seater.  I was loving the latter until my seat came of the track and I couldn't do anything but just sit there.  Both times I was port side and I'm already comfortable with it. 
I must have done well enough.  I received an e-mail applauding my "Olympic-caliber" rowing.  I'm sure everyone got that e-mail though.  Who knows, I'm still young enough to go for Gold. 
An in effort to preserve what little sanity I have left I joined a running club that meets early in the morning on the weekends.  It is a 16 week program so it will take me into the better part of the fall semester.  I am looking forward to changes and seeing what is in store for me as these days go by.

OB- 4 weeks

I haven't finished this rotation yet but I'd thought I'd share what it's been like so far.


daily schedule:
M,T,F- 0700-1530 on wards
W,R-0900-1430 lecture
Exams weekly covering between 5-10 chapters.

actual daily schedule:
same as the daily schedule.

what to wear:
issued scrubs while on the wards and street clothes on lecture days

what's in my pockets:
small notebook, pens, pocket size OB clinical guide, stethoscope

patient notes you'll be asked to write:
depending on whether you're on L& D or postpartum there will be a lot of newborn and maternal assessments, pain control, and family, educational, and psychosocial assessments

what to study:
newborn assessments, postpartum assessments, comfort measures, pain meds

a few unforgettables along the way:
palpating the fundus.  seeing Goldenhar Syndrome.  examining the placenta. witnessing birth of new life.

curious things other students do:
text messaging.  be professional and turn your phone off.  i'm sure your ex-boyfriend's sister can wait.

little suckers

i need a break. last night i had a dream that leeches were on me.  you know the critters that were used in medieval times. i wasn't grossed out by it, more annoyed that they were on me.  getting them off was a challenge because of their little suckers having such a grip on my skin.  i know its disgusting.  Evidently, seeing leeches in a dream refers to something in your life that is draining the energy and vigor out of you.  The dream may refer to people, habits, or negative emotions that are sucking you out of your vitality.  I'd say school fits in well with this description.  if you have any secrets to replenish vigor and energy feel free to share.

Video

Nurses have loads of compassion...it's just that we don't waste it on family members.

Leaving Comfort for Courage

This is a great article by Jeanne Stevens.  I thought I would share it.




LEAVING COMFORT FOR COURAGE

By Jeanne Stevens | Soul City Church

Courage will always require an element of leaving. Leaving is just plain hard. When My 3 year old knows I’m about to leave he will often squeeze as hard as he can around my neck to lovingly manipulate me into staying one more minute.

I know how he feels—because leaving comfort for courage makes me want to wrap my arms around every ounce of safety in my life—hoping if I hold on tight enough that I won’t have to taste the pain of the leaving what I know is inevitable.

Leaving comfort and safety looks and sounds alluring and attractive - butthe attraction fades quickly—in fact I have never felt so vulnerable, small, and needy…. words that are not known for their alluring appeal.

Moving from comfort to courage will…
cause you to question your decision.
It will cause you to look around for the safety bars, seatbelt, and any kind of security button.

Moving from comfort to courage will…
cause you to try to make something happen.
Scheme, make phone calls, send out hail mary e-mails—anything to distract from sitting in the fear.

Moving from comfort to courage will…
cause you to doubt your abilities.
You will look at everything that you have failed at in the past … failed relationships, failed financial decisions, failed leadership calls—and you will wonder will you repeat those patterns and are they indicators to go out and look for comfort again.

Moving from comfort to courage will…
cause you to doubt the author of the calling on your life.
Thinking that God is too busy to take care of your little fear

Moving from comfort to courage will…
cause you to be jealous of your neighbors.
—who seem to be perfectly content with their lives. You will wonder if you are some sort of crazy person that has a unhealthy propensity to live on the edge.

Moving from comfort to courage will…
cause you to look for the easy way out.

Moving from comfort to courage will…
cause you to pray like never before.
Wonder if you know any scripture to cast out the inner demon of doubt.

Moving from comfort to courage will…
cause you to white knuckle yourself around anything that feels secure and semi safe.
—even though you know earthly security and safety is a mirage and the place where Jesus is, is most where you want to be.

Moving from comfort to courage will…
cause you to feel weak in the knees.
—a good indicator that you should stop standing up and get ON your knees.

Moving from comfort to courage will…
cause others to question you.
Especially those that have found security to be a bedrock to build their lives on. You will be misunderstood, questioned, and perhaps even seen as foolish.

So today, God, I feel every one of these fears. I am terrified… straight up terrified. I am calling out to you to be a voice of truth and freedom. Tell me to settle down, to trust you and to release every one of these fears into your arms of faith. I know it is impossible to invite others into a life of obedience if I am unable to live it myself—so today I am re-upping my commitment to obey and be faithful.

Jeanne Stevens serves as one of the lead pastors at Soul City Church in Chicago, IL. Jeanne is the author of Soul School and the soon to be released book, What Lies Beneath.

Some days I wish I had the hardcore-ness attitude and physical capabilities of Ziva and the intellectual forensic science capacity of Abby.

I'd be unstoppable.

The Office

Since my kid brother moved out a few weeks ago I converted his old room into my study.  It's primitive, don't get me wrong, in fact, the lamp is just for show. (I usually study by daylight)  Really, what more do you need then a table and chair?  Maybe some padding for the chair... 

 

essentials. 

Today I had a check off for administering meds and assessment report.  Fortunately, because of the weather the assessment report has been pushed back to Thursday.  Normally, check-offs are done in pairs.  Since I was the only student early to clinic I had the opportunity to go into check off alone.  For this skill, we were given a list of 6 meds for a patient and then had to spew off the mechanisms, interventions, side effects, calculate doses, etc.  I didn't spend a lot of time in preparation, partly because I knew the general information already, and partly because I was exhausted with tests and whatnot.  I walked into the exam room and sat down with the prof. and started in.  I knew the information and had cards prepared but I didn't want to read off the cards so I did a lot of mumbling and talking-it-out.  The prof was really great about everything and we even had some aside conversations about the drugs, real life experiences, etc.  In the end I received an "O" (outstanding) on the skills check-off.  I earned an "S" (satisfactory) in hand washing and somehow I got an "O" in medication administration?!   I certainly would not have given myself an "O".  At one point during the check off I wanted to stop and tell the prof. to mark me as "U" (unsatisfactory) and I would attempt the skill a second time.  I'm frustrated that I didn't preform as well as I think I should have.
Thursday is orientation at the clinical site and afterwards, we have our last skills checkoff; independent skills and systems assessment.  It's about to get crazy...

"There is a sacredness in tears.  They are not the mark of weakness, but of power.  They speak more eloquently than ten thousand tongues.  They are messengers of overwhelming grief...and unspeakable love."  
-Washington Irving

life

• finished first week of school.  63 weeks left.
• car broke down on way home from first day of school.  Was without a car for a week.  I have an awesome mechanic who was able to diagnose a faulty distributor and plugs, able to repair the problem and do an oil change, thus prolonging the life of a car with 250,000+ miles.  
• new friendships made at school + dividing homework assignments up and swapping answers = a little less stress.
• awesome classmate, Alyson who lifted my spirits up with a unexpected walgreens bag containing a new scientific calculator for dosage class, two valentine pencils, chap stick, and peanut butter and chocolate protein bars (a must for the late night patho. class)
• paying for a grande coffee and receiving a venti because they were out of the grande cups
• michelle's book comes out in march!  don't let me down, j :)
• interviewed for the city newspaper regarding school nursing program
• excited that University is opening the second medical school in the state.  Haven't decided what that means for me.
• meeting new warehouse manager for FAME and discussing ideas to get medical supplies from Louisville to headquarters.
• learning to protect my time (read: say "no") in order to read and study.
• still hesitant about my new assignment but remembering that God doesn't call the equipped, He equips the called. 

Jan 11- May 5---> Spring semester classes (15 hrs.)  If completed successfully, continue on to:
May 6-June 4---> Maternity
June 10-July 13---> Pediatrics
July 15-Aug 13---> Med/Surg. II
Aug 14-Aug 22---> Summer "Vacation"
Aug 23---> Fall Semester begins if summer semester is completed successfully.