In honor of Nurses Week… I now understand why we have an entire week dedicated to a hardworking, selfless, and compassionate group of people. And it doesn’t matter what level of nursing you are either.
As a Student Nurse, you are faced with hours of lecture, hours of clinical practice (God forbid you miss one clinical day!), and hours of homework after that. Of course, you’re prone to the social aspect of college life, and you want to squeeze in time with family, friends, and your own fitness goals. On top of that, you try getting the CDC’s recommended hours of sleep for your age group (which is typically at least 7 hours for the average adult). I had calculated the different number of hours I spent in college sitting in lecture per week, which would range from an average 16-21 hours. Clinical rotations and discussions would take up at least 20 hours. Homework, not including studying, would take about 16 hours. Then you include studying, which was pretty much the rest of the week because in nursing school, you never knew when you’d have a pop quiz for extra credit. And honestly, every point mattered. And it’s said that with every hour of lecture should equal about 2 hours of studying outside of class and completing homework. For instance, a 4-hour (or 4 credit) class, you should expect to study at least 12 hours out of the week. This didn’t include any of the time that you had to take to meet with group members and work on group projects, or go out of you way to spend an hour at a nursing home facility with a resident to complete a care plan for them (curse you Well Elder project!) And finally, all the student committees that people would push onto you so you’d become a “well-rounded” student and help make your college better.
Have you noticed that I haven’t made a comment about your own activities of daily living? Showering, eating, exercising, and socializing all become these tasks that we somehow integrate with our studies. I remember walking up and down the stairs of my college during our ten-minute breaks just to say “at least I walked today…” When I would study at home, I’d do 20 reps of some exercise I could do on my yoga mat every time I finished a section. Then when it was time for me to move onto the next subject, during my 20-minute break, I’d do Blogilates. You laugh now, but for me, that’s all I could manage to fit in when I was preparing for tests. On the weekends is when I’d go out for runs, or when I managed to finish everything early. “Socializing” became study sessions that involved a glass of wine and pizza. But shout out to all you nursing students for doing your thing! Nursing school is its own beast, and it can only be conquered by someone as strong and dedicated as you! I got through it, so can you!
But now that I am an official Registered Nurse, an Army Nurse at that, I have found more time for myself. It is a great feeling when you can go to work, make a difference, and then come home and relax. Granted that I do not live with my husband and I don’t have any kids yet… This just means I still get to enjoy “me” time. I am, however, excited to see how mixing family and work will be, and I know I’ll be able to power through that obstacle because of my awesome time management skills. (Thank you Nursing Gods for this hard-earned blessing). And the Army has also taught me some awesome things about nursing that I probably would have never learned anywhere else. I’ve learned to accept patients that come from combat zones and I’ve had to be the friendly face that gave them comfort in an unfamiliar place. When we’re working, we don’t think about these things. But when you look back on who you’ve helped, I can guarantee you almost every time, you’re that friendly face that made a difference.
Being on “my own” hasn’t happened quite yet. I am still in a residency type program where I have another, more experienced, nurse backing me up as I go about my day. Which is what I love about team nursing. You don’t have to take on everything by yourself because you know there’s a skilled LPN/LVN or tech/medic (very helpful people!) to have your back. I think that media has somewhat skewed society’s view on what happens in hospitals. For instance, Grey’s Anatomy… Please understand that it’s very rare that your Dr. McDreamy is the one that comes in and starts your IV and gives you medications. As nurses, we are your messenger. We are the power players of the game, with our one goal: to get you better. And doctors are the ones telling us the game plan. I’m not trying to talk down on doctors at all, but I do want people to understand the role that nurses play in the hospital. I’m not going to be the one to tell you your diagnosis. I’m not going to be the one to make decisions for you. But I am the one that will be there when you need someone who will listen to you with an unbiased opinion. I will be that person who will ask you what I can do to make your day just a little better, while you’re lying in our hospital bed during what could be one of the worst times of your life.
When I first graduated nursing school, I had the honor of having nurses in my Washington family give me words of inspiration. Many of which were the same words of inspiration that hold true for every Nurse, no matter if you’re a Student Nurse, a Licensed Practical/Vocational Nurse, Registered Nurse, or a Nurse Practitioner. Every one that I’ve met with one of these titles, is probably one of the hardest working human beings I know. The top three most helpful pieces of advice I’ve heard are:
In the three years that I’ve been emerged in the nursing realm (as a SN and RN), I’ve had the privilege of working with experienced nurses who give me nothing but amazing career advice, insights on personal experiences, and real down-to-earth stories. Many of my experiences as a SN tested my boundaries for whether I could take on the title, and I am glad that I am still powering through as an Army Nurse. There are days where I feel like I could have done better, but that only makes me try harder the next day. I come in with my game face on, ready to conquer my assessments, charting, and navigating my way through medical jargon. Because I am privileged to work with my patients and help them through their illnesses. I am privileged to work with an amazing organization, the United States Army, and help treat the Warriors that I can so proudly call my Brothers and Sisters in Arms. Being a nurse is difficult, but I wouldn’t trade my career for the world.
Happy Nurses Week to all you amazing nurses out there! We appreciate everything that you do!
It's been a long time since I've posted, but I feel like I need to right now. There comes a point in someone's life where they have this grand realization of how lucky they are to have what they have. I'm extremely lucky to have met some of the greatest, kindest, most compassionate, and caring people in the nursing program. I've had the chance to make friends with people who have the same drive to help and serve people in a way that could ultimately change their lives. I'm surrounded by people who will disregard the color of your skin, the status of your home, the beliefs that you hold, or whatever other characteristic there is to you, just so they can save you. They will provide care no matter what. They will see beyond what the rest of society sees, and they will realize that they are helping a human.
Those are my friends. It's not always the funnest job. It's not always the easiest job. There are times where we have to tough it out during the moment, and then find a corner to cry in later. There are times where we cannot handle it, where we think we will break from the sheer heartache this job holds. But we remember that there are moments where good happens. There are moments where people's lives are reset, where first breaths are taken, where cure is found. Those are the moments my friends live for.
My friends live their lives on the edge, to dance a fierce tango with life and death, doing whatever they can to achieve the best outcome for our patients. My friends are hard workers. My friends are selfless. My friends are compassionate. My friends are caring. My friends are some of the greatest people that I know.
And when I sit back and think of how lucky I am to have a support system that consists of my friends, I kind of tear up, because I'm so happy to know that I am so blessed.
"It is better to prevent, than to heal." It's a French saying that you could apply to many situations. Whether you're thinking about the health of your body or the health of your heart. It's better to act ahead of time and take the appropriate precautions to protect yourself than it is to try and fix what's been broken. But if you're constantly taking precautions, when are you ever going to be brave enough to think that the risks are worth it? It's such a fine line that you're walking on. The constant notion of "is it really better on the other side of this situation? Is this really worth it?"
They say "it's easier to ask for forgiveness than it is to ask for permission." Is it really though? In my life, I've always felt that it's insanely complicated to ask someone for their forgiveness, because the damage has already been done. You've already hurt yourself and whomever you're asking forgiveness from. If you've ever had someone hurt you and ask for forgiveness, I'm sure you know how hard it is to give them the same amount of trust and forgiveness that they're asking for. Things are never the same after you've been hurt by someone. They say those types of things make relationships stronger, but isn't there a point where hurting each other is completely detrimental to the relationship?
To be honest, I don't even know where I was going with this post. Lately, I've been filling my days with school, work, and nights out with my friends. Yet I still feel like something in my life is missing. In all honesty, I think it's because the one person that I really could confide in isn't here. The one person that really understands the way I think is thousands of miles away. The one person that understands all of my weird jokes, my extravagant, abstract thinking, and vast emotional mood swings isn't here. My very best friend is so far away, that he isn't here to help me think straight. So I'm here constantly putting myself in situations that could potentially hurt me in the long run. I'm here making and losing friends at a constant rate. Lighting flames that aren't meant to last. Friendships that are so short that you couldn't even consider them friendships. Nights that run into the early mornings, and days that seem to be too short to pull myself back together. Thoughts that run my mind into a crazy whirl of emotions at night. Stuck between knowing what I want and knowing nothing at all. Stuck between feeling like I've been doing everything right and feeling that I'm wronging so many people. Stuck between having a group of people that I can hang out with but missing the actual friendship.
I don't even know. In one month, my very best friend, my main man, will be back in the US, and everything will fall back into place. I'll have my partner in crime back to do hood rat things with me.
I am completely blown away by the ignorance that some people have about the duties and roles of a nurse in any medical care setting, whether it be at home, in a clinic, or at a hospital. For anyone that's ever been in any type of check-up or has been admitted, please think about who sees and tends to you the most? Who is the most hands on with you, educates you, checks in on you every hour, answers your every call, etc? Nurses. As nurses, we are the patient's direct link to all other providers. We are there to advocate for you when you feel like you are up against too much to handle. We are there to help you be comfortable. We are there to catch the little things the doctors will never see until they read about it in a note.
For someone to belittle our positions in the health care field is beyond me. Nurses do not just "put band-aids on patients" and call it a day. Nurses do not just clean patients up, and change linens. Nurses do not dilly dally in the hospital. We are constantly on our feet, checking our patients, carrying out the interventions, assessing the patient, and communicating with everyone else. We are there for you if you need someone to listen to you vent. We are there when you are in pain. We are there when you need help. I have been in a room full of nurses to see the beginning of life and listen to the sounds of a baby's first breaths. I have also been in a room full of nurses to see a man breathe his last few breaths. We get down into the dirty parts of the healthcare business. We're there on the front lines of your health. That is our role. Do not belittle my colleagues, do not belittle our profession.
& Remember - Nurses choose needle sizes and catheter gauges. So you should play nice.
I've finally ended my month of shenanigans in Hawai'i. It's crazy because I wasn't excited to get back to the island until I step foot on the island. It's like my heart knew it was back to where I first lay my own roots down. Hawai'i is definitely one of the places I will always call home. My month in Hawai'i was far from vacation and relaxation. A majority of my stay in Hawai'i was spent in the hospital learning how to take care of women who were experiencing greatness with their families: childbirth. In the past years, I know that I've always been great with children. I am a nanny. I take care of kids who are the age of just a few weeks old to children who can read and write on their own. I have always been drawn to the nurturing call of motherhood (but I'm obviously not ready for mw own!) The experience that I had in the Labor and Delivery Unit at Tripler Army Medical Center was probably the greatest experience I've had since I've started my nursing career.
The experiences I had were life changing. The strength that these women have to make it through the trauma that they put their bodies through is incredible. I have never seen so much strength in so many women. It's a unit where modesty is the least of anyone's worries, and where women are placed in a very vulnerable state. With doctors and nurses who come in and out of the room to check on they are progressing, to the bombardment of health-related questions, to having their business out in the open literally stretching and testing the limits. I have the utmost respect for mothers who bear the scars of childbirth, because I know that I haven't come up with the strength to put myself through it yet.
The babies! Oh the babies. The beautiful, innocent babies. The sound of their first breath to the escalation of their first cry. The grip of their first hand hold to the sight of the first time they open their eyes. Babies have been the peak of my nursing care. They melt your heart as soon as you see them.
I have been blessed to be a part of such an amazing care team at L&D TAMC. I have been blessed to have such a great mentor who believed in me to be the nurse I want to be. I have learned so much from the staff and found so much courage in myself.
I cannot wait to start this next semester. I am so happy with my life decision of becoming a nurse.
Now I've met a lot of people in my life, and with that, I've heard many horror stories. I'm not the girl that is always open to watching horror movies. It's because at night, my brain can't seem to let go of the images that frighten me therefore keeps me up with my eyes wide open. When I was younger, the nights I had trouble sleeping because of scary thoughts, I'd squint my eyes and look at flowers on my computer until I fell asleep. Horror stories to most people are the ones of the supernatural. The stories that have dead young children playing in your house, and teaching your kids to kill you. They're the stories of mass murders done by a crazy, rich person who seems perfectly fine on the outside, but bathes in blood on their nights off. Those are the normal horror stories. The not so scary horror stories. The stories you tell on dark, stormy nights just to forget about when the sun comes up.
The horror stories that frighten me the most now are the ones that I hear while on shift. The back stories behind why patients are admitted to our floor. The horror stories of "they'd been laying in a pool of their urine and feces for three days before someone thought it would be a good idea to check on them." The horror stories of elderly patients having a stroke with no one home. The horror stories of psychiatric patients losing themselves so deeply, that they harm themselves to try and get rid of it all.
Some people watch television shows thinking, "oh that would never happen... wait does that really happen?" It does. Although the media creates a hyperbolic medical scenario for their shows, crazy things do happen to real people.
The things that keep me up at night are no longer people climbing on walls with their heads turned backwards. It's not the creepy children who sing creepy lullabies and stare at you while you sleep. The thing that haunts me at night is the thought of someone that I care for going through the situations some of my patients have been in. I couldn't imagine...
I am not entirely sure if it is just always my lucky day to experience things when I go to off sites, but so far it's been that way. This week I had my chance to see how it would be like to be an ICU nurse, and there is no doubt that "intensive care unit" is definitely intense. The first day there was not as exciting as I'd hoped it would be. Many of the patients were stable, and just recovering from surgeries. My second day in the ICU though, was a complete turn around. There were two patients that were in the ICU because they were in a comatose state.
Patient number one was an older male, who was brought in three days prior for seizures. He was ventilator dependent. He had no reflexes to verbal and physical stimulation. When I saw him, he was a very limp patient. He had no movement. His pupils did not react to light. Nothing. The only part moving on his body was his eyelids. His eyes were twitching the smallest amount, and to anyone else, it probably would have not been caught. Since the nursing team at the hospital is so vigilant, they notified neurology and wanted to see if he could get an EEG for possible status epilepticus. Status seizures are ongoing seizures. They do not stop. Surely enough, he was seizing. The neurologist thought it would be best to medicate the patient to see if the seizure would slow down or stop, and then to cool the patient to prevent any further brain injury. The family was there the entire time, and the question of, "what do you want to do with his life?" came up. It was tough to see the patient's wife and kids have to make that decision. Very, very tough.
Patient number two was a young female who was brought in the night before. She looked like she had been abused. Her family claimed to have found her on the sofa, pulse less. They called 911, and the paramedics performed 40 minutes of CPR on her. She had lost her pulse 4 times in the time span of travel from home to ED. The neurologist also went to see her. She did not need to have an EEG. The neurologist performed the caloric test on her. That is when you put ice cold water into a patient's ear (only if you're sure they're comatose!) and it should make the eyes react a certain way. She had no response. She was completely dependent on the ventilator. She had no movement in any limbs. No reflexes to light or pain. Her family was nowhere to be found. They had left the hospital after she was admitted into the ICU. It seemed to be the sad story of abuse and neglect. That was even more painful to see.
10 minutes before my shift was over, I heard it over the loud speaker, "TRAUMA TEAM TO ICU. CODE BLUE, ICU ROOM ###". It was mind boggling. We had just come out of the room after inserting a foley catheter into the patient. Not even 15 minutes later, he's coding. The nurse runs out and says, "grab the charge nurse now." We ran to get the charge nurse, and ran back to the room. All I heard was, "jump in on compressions!" I had never moved so quickly in my life. I gloved up, and quickly started pushing. HARD and FAST, HARD and FAST, his rib just broke... I just broke his rib. He's leaking. HARD and FAST. That's all I thought to myself. I looked him right in his face. This man was huge. He had already been having trouble breathing, and all of a sudden he wasn't breathing. It seemed every second that passed, another person from the code team was entering the room. People were moving so quickly, but they were so calm. I switched out with another person. It was hot. I took off my jacket and said I was ready. We did almost 4 minutes of compressions, and defibrillated once. We kept pushing. After that, he had a strong femoral pulse. I tried hard to keep myself from crying because I was so happy that we had gotten him back.
Although I lost a few patients yesterday, it was nice to know that I could end my day saving a life.
So I don't think I have ever been the type of person to take into money a lot. From a young age, I was always good about saving money for "just in case" emergencies and it turned out to be very helpful in many situations. When I was going in for school the first time around, I wanted to go into culinary because I felt that I needed to and that cooking made me happy. Despite what everyone told me about me not being able to make a lot of money because I had to "start from the bottom" and stuff never had any impact on my decision to continue. When I decided to switch my majors and attend school for nursing, everyone then changed their "you'll never make enough money" to "wow you're going to be bringing in so much." This completely infuriates me.
I'm not going into the medical/nursing field to make money. Yes, it'll be nice to bring in more than what I've got. It doesn't mean that I'll be living any different. I want to make history in the field I'm going into. I want to be known for my accomplishments, not the house that I live in or the car that I drive around. I want to be known as the person who has great work ethic and is great with patients. I want to be known as the person you need to go to if you really need help because my skill is beyond amazing. I want to be the one to help save someone's life. I don't want to be the one who is there just to be there, and then come off as a person who doesn't even care about patient care but only cares about the money I'm getting from it. It's irritating to see people in the field of nursing and not care about their patients. Everyone has bad days, yes. But if you come into the field, then you should definitely love it or have a passion for it.
Yesterday was my second day in rotations for the OR. I walked in as excited as I was the day before. I already knew that my second day in the OR would be riveting, but not as much as my first day. Regardless, it was general surgery and orthopedics for the day! I walked up to the nurses station and met with Mary. To my amazement, she remembered my name the entire day, and included me in conversations. I was able to observe three surgeries for the day: a hernia, an infected knee being drained and having the joint replaced, and a hip fracture repair.
The first surgery was on a young man who looked like he was in his early or mid-twenties. He had a hernia, which in simple terms, is when a body part is in the wrong area of the body. The most common hernias occur with intestines going out the wrong hole. While preparing the patient, the anesthesiologist called me over to his little section of the room. "Have you ever seen someone be intubated before?" I had seen someone intubated, but I had not seen it from the anesthesiologist's point of view. He had me place my chin on his right shoulder, and gave me the grand tour of a human's throat. I was shown the epiglottis, which is cartilage that moves whenever we swallow. It pretty much is a safety for eating so food or drinks go down into the esophagus, rather than the trachea which leads to the lungs. (Could you imagine, well, you probably have had that terrible feeling, where something goes down the wrong tube... Terrible right?) Then the anesthesiologist pushed the the epiglottis and showed me the vocal cords. As soon as he showed me, he quickly shoved the tube down the guide, and voila! the patient was intubated. The standard prep for the patient was completed, he was cleaned and draped, and the surgeon was called in. A tall, robust man walked through the door ready to go. He plugged his phone in, started his pandora playlist, scrubbed in, and immediately got to work. "Let's do this, I'm done with hernias for the day, this is my fifth one." Four incisions were made, where tubes were inserted as guides for scissors, or cameras. The surgeon taught me everything on the screen, and the technique for finding your way around. It was not what I had imagined it to be. The body is a completely confusing maze, where you can inject air into a body cavity, opening places you think are supposed to be sealed shut. It only took the surgeon 45 minutes to find his way and place a mesh lining to prevent further hernias. He really was done with hernias for the day.
The second surgery I went into was for an infected knee. The patient was a large woman who looked like she was in her mid-forties. She was obese, and required two knee replacements. She had her right knee replaced one and a half weeks ago, and had gotten a MRSA infection through one of the stitches. I stood in with my classmate. We all looked like duckies in the OR because if a patient it tested positive for MRSA, they automatically become a contact precaution. Contact precautions require the healthcare team and anyone entering the room to don a yellow gown and gloves. We also wore masks, as protocol for all operating rooms, and I wore a duckbill mask. So I really looked like a duckling. The surgeon was an older man, he talked through his surgery on what he was doing, but then a joint specialist talked us through when the surgeon had to focus. The surgeon had made an incision large enough to span the bottom of the femur to the top of the tibia. He exposed the entire joint of the knee. What he had to do was try and remove as much infected tissue as he could. Infected tissue looks like mottled, darkened tissue compared to the vivid, fresh red tissue when healthy. He did this by suctioning it all out and snipping out pieces of the tissue that would hinder healing. He then poured a diluted solution of iodine and normal saline into the knee to rinse it out. This solution would kill any infection that was in the knee, and the patient would also have to take a regimen of antibiotics to help any infection that wasn't reached through this cleaning process. After he cleaned the area, he popped out the old spacer between the knee, and inserted a new one. The spacer allows the patient to move her knee as if she had the normal synovial joint fluid, and it also provided her more stability since she was a larger patient. As soon as he was done inserting it, all he had to do was close her up.
The third surgery was a female patient, who looked like she was in her late fifties who had a hip fracture that needed to be repaired. In our J1 semester, there were three things we learned: 1) Confused patient? UTI. 2) Seizure, coma, death. 3) Break a hip, get pneumonia, die. Although these small sayings may come off as very, very crude "jokes", the possibility of them being true is outstanding in older patients. Think about it. Breaking a hip would cause an older patient to be hesitant in ambulating (moving around). Pneumonia can be prevented by ambulation (which is why most surgical patients are highly encouraged to walk even if they are in pain. If not, pneumonia will build up in the lungs and the patient would have ineffective gas exchange, will get too sick, and die. The surgeon that came in was a tall man, who looked like he was in his early forties. He seemed to be a very joking doctor, very open, very obnoxious, very outspoken. The room was very crowded because this was an orthopedic case that required the TFN kit (Titanium Trochanteric Fixation Nail kit), and an x-ray.Everyone in the room had to don lead vests for the operation. Every movement that the surgeon did, the x-ray tech had to take a shot to see how we were doing. It was basically going in blind. The surgeon used a drill to put a guide rod into the patient's femur, and when it was double checked had almost made it through the entire length of the bone. (The femur is your entire upper leg!) "Wow, I was not expecting that. She's as hollow as a chocolate Easter bunny." This patient had severe osteoporosis, very common in post-menopausal women. The patient had that rod placed through her femur, and had it nailed in, with a nail that would span the length of the neck of the femur to the head of the femur. It was a very bloody procedure for having only three small incisions that weren't longer than 1-2 inches each.
I think the two greatest lessons I learned from my second day of rotations in the OR was every surgeon is different and has their own style in the OR room, and that surgery has come a very long way with technology and treatments. From day one seeing a traditional open heart surgery, to the next seeing surgeries done via camera in a body cavity. It amazes me! I am greatly blessed to be a part of a field where there are really no limitations.
It's very bothersome to hear or read when uneducated people tell others that their medical problems are "not that serious". Yes, it may be light humor online when there are memes that talk about diabetes and it'll have a photo of a child eating mounds of french fries at McDonald's, but when you stop to think about it, those conditions aren't funny at all. Diabetes, whether it's type 1 or type 2, are complete game changers for people who have it. There are so many things that need to be taken into consideration when you have it, daily routines made for medications, and if left untreated can result in dire consequences. I've only poked my finger once with the needle that is used to do capillary checks for glucose, and I couldn't even take it! Imagine having to do that to yourself 3-5 times a day! Sometimes even more.
I just read a friend's Facebook status talking about someone saying that her child's HLHS condition "isn't that serious"... HLHS is a condition that effects the left side of the heart. Do you know what the left side of the heart does? It supplies the rest of your body with blood. I'd like to think that were a serious disease, especially when it's present at birth, and numerous surgeries must be made to correct it. It really saddens me to think that there are people out there who say completely imbecile things about topics that are weighted so heavily in other people's lives.
As a student nurse, I know that I have got the longest journey ahead of me in health care for when I earn those letters "BSN RN" after my name, and maybe "BSN RN MD"... In the short time that I have spent in the hospital, it really touches my heart to know that there are people with all of these ailments that still try to fight so hard for life. It pains me to know that there are people who are taking their health for granted and then having the audacity to belittle those with serious conditions. But of course... Nothing is "too serious" until it happens to you.