Sunday, January 30, 2011

The Student Nurse's Prayer



























Written by Meredith Joyner

Reading vs. Napping | the ever-present conflict

Heading into the 3rd week of the semester, and it's just been so hard to get motivated to do readings and study guides. Not sure what it is. Hoping I can shake it, otherwise this is going to be a miserable semester!  Maybe it's that I've not been alone in the house for the most part since before Christmas with the coming/going of the homeowners. I enjoy having them here, for sure, but I'm not used to studying when other people are around. Next weekend they leave, I'll be back to living alone and hopefully I'll find some sense of normalcy and pattern. I also think warmer temps will help. I think the fewer blankets I need to sit comfortably while studying--the better. Right now, I start reading and then all I want to do is curl up for a nap! ack.

Also, every morning in the waking hours (6-9 am) when I'm still in bed and trying to snooze, I find that I am basically dreaming/thinking about care plans and patient care. It's not real patients or real situations--I think it's really that I am subconsciously stressed. I don't really think about it much during the day, it's just when my mind is so relaxed...that it gets to pick the topic. This happened during the first part of last semester, and eventually I chilled out and was okay. I personally wish my mind would focus on something much more pleasant and relaxing, like vacationing in a log-cabin in the mountains during spring or fall.

This coming week we'll be doing our first full Working Care Plan for this semester. I'll go to the hospital on Tuesday morning and find out my patient assignment and then basically spend an hour or so reading the patient's chart and door-side chart. Then I'll come home and work on the following:
  • One page pathophysiology of the patient's primary medical diagnosis.
  • General Assessment (from data collected from charts)
  • Med Chart --have to go through each drug patient is on and explain why they are on it, possible side/adverse effects, along with dosage, route of admin and nursing assessments (monitoring) needed. This semester, two students (each clinical day) will administer their patient's meds and have to be prepared to know what drugs are for and how to administer them
  • Lab/Diagnostic Chart--basically we have to note any abnormals and explain why they are abnormal in our patient and nursing assessments needed.
  • Select 3 nursing diagnoses based on above assessments each with one realistic, desirable Patient Outcome for our patient care day.
  • For each Nsg Dx/ Outcome will then need to determine multiple nursing interventions (assessments, meds, treatment, teaching...) that are realistic and directly linked to the Outcome Statement.
  • Then we are to create a "to do" list for each clinical day so that we don't forget any aspect of patient care.
  • ...and a couple more bits and pieces that won't make sense to anyone reading this.
That's the paperwork we'll be doing. However, we'll still have to review the patient's treatment plan (current orders) to see if there are any skills that we will need to perform (IV, wound care, catheters, etc...) and review those so we'll be ready if opportunity arises. We are basically doing ALL patient care (bath/oral care, linen changes, all assessments, and do all treatments except meds (unless our day to administer meds) for our patient.

Then after clinical we'll come home and have to evaluate and revise our Care Plan (did client meet desired outcome? if not, why and then revise. Then on our 2nd clinical day of the week we'll turn it ALL in for our instructor to review/grade and continue with same patient (if patient has not been discharged). We'll be doing 8 or 9 full Working Care Plans this semester (total of 16 days of patient care) and we have to get a Satisfactory on 2 of them. 

We also will be doing another Nurse-Client Interaction (documentation of therapeutic communication) this semester. That has to be done before Spring Break. We'll also be doing a full history & physical assessment of one of our clients (without prompts/documents).  I need to start preparing for this, but I'm not really sure how. This will definitely produce anxiety-induced dreams in the coming months, I'm sure.

Not this coming week, but the next, I am scheduled for my OR day. I'm so excited. Not all sure what they have planned for us. Not sure exactly what it will look like, but hope I'll get to see something I've never seen before (how about a transplant!!! :) ).  When I was in one of my anatomy/physiology courses, we got to pick a Learning Experience type of thing and I connected with a friend of mine who worked in the Heart Cath lab...so I got to see a couple oblation procedures...so I'd really like something different from that! But as far as I know, we don't really get to choose what we see. It's all pretty much whatever the hospital coordinators are able to schedule us for. We have a written assignment that we have to submit for that.

This clinical prep and patient care is on top of the weekly lecture/reading components and also my Pharmacology class. It's overwhelming, but I'm trying to keep reminding myself:

1. Take it one day at a time. Breathe.
2. You are a student--you are not expected to know everything or be "experienced" yet.
3. These are all learning experiences--take full advantage of them!
4. You are smart, you can do this...heck, thousands of students graduate from nursing school each year and pass the NCLEX.

Well, I guess I'd better get back to my readings (even though I don't want to).

Cheers.





Friday, January 21, 2011

The Importance of Hugs

Today I was at my clinical site for clinical orientation--basically where we learn what will be expected of us. We had already received a good bit of info this past Wednesday when we met with our clinical instructor for two hours. Today we covered what we had not finished on Wednesday. A lot of sitting and listening, lots of questions and clarifications. Each of us signed up for post-conference presentations on a home remedy (mine: not sure yet), an herbal supplement (mine is Valerian), and two alternative therapies (mine: accupressure/accupuncture). Also each of us will host a "seminar" about a particular topic (instructor-directed). I got "Why Care Plans?" and will be the first to present. We also did a hunt/find on the unit (where can you find this/that?). Then we stopped for lunch (several of us had low blood sugar/weakness by this point). After lunch there was more sitting/listening/questions related to nursing documentation and the forms we'll be using on the unit. 

After clinical I stayed behind to see if I could figure out how to get wireless access on my iPod Touch and that took MUCH LONGER than necessary. I spent a long-while trying to figure it out myself, made some progress with one wireless network, but then got stuck with the hospital wireless. So then decided I better call the help-line. But before I could do that, a man from my church saw me and came over to talk (I learned his wife was having surgery and he was waiting to find out when he could go up to see her). We probably talked for about 30 minutes--including a conversation about nursing caps. I finally called the help-line, but apparently there were a number of wireless issues/outages today and so the help-line was barraged with calls this afternoon. After another 20 minutes or so of being on hold, I just left my number for them to call back. On my way out of the hospital, they finally called me back, just to find out that I really needed to talk to the hospital computer helpline for my 2nd problem, not the university helpline... finally got the issue resolved.. I'm not sure what time I finally left the hospital to grab the bus, but the sun was definitely moving towards sunset. Needless to say, I spent WAY to many hours at the hospital!

On the ride home, I finally let myself start to process my day and what I'm feeling about this upcoming clinical experience. I'm basically feeling overwhelmed, anxious and a host of other emotions. I'm dealing with the uncertainty of joining a new unit (clients will be in the trauma/ortho focus), adjusting to a new clinical instructor (who has high expectations--which I love, don't get me wrong!), increased requirements for our care plans. There's also a lecture component that goes with this clinical and we haven't even had our first lecture yet (that's Monday). Plus add on a whole other class---Pharmacology! I'm definitely not whining or complaining. I'm simply overwhelmed and feeling the weight of my responsibilities. We all have moments when we wonder if we're going to be able to rise to the challenge. Reality is that this is not a shock or surprise to me. I knew in advance that this was going to be a tough semester with increased responsibilities and expectations. I didn't know exactly what the increase was going to look like, but I knew it was coming.

There are so many emotions involved. And likely some hormone changes too! There are feelings of inadequacy, deep down wondering if I'm going to be able to manage it all. The age old questions of "What have I gotten myself into? Is this really what I want?" pop in my head. Terrifying questions of "Am I going to end up falling behind, dropping out?"  I also think there's a good dose of grieving going on too. Grieving my loss of free time. Grieving this return to student life (feels like going backwards sometimes--although I know it's going to open many doors). Grieving loss of personal/social life. Grieving being single and needing to be responsible for myself and knowing there's really no one looking out for me. Feeling and grieving that I'm un-covered.

So, this evening, by the time I was pulling into my neighborhood, I was thinking "I seriously need a hug or a good cry to let go of all this pent of emotion and anxiety. Actually, I'm so close to tears, that a hug will probably easily send me into tears."  I drove up to my mailbox, opened it, and found my name and address scrawled on an envelope. I thought, "Yay! a personal card!" and turned the envelope over to find the address of my church on the back flap. Still sitting in my car, grateful for the distraction, I ripped it open. Immediately I remembered my actions on Sunday. I had been in a hurry to leave after the worship service, but went ahead and took the time to fill out a Prayer Request form asking for prayer for my upcoming semester. Inside was a note from Pastor Mark. "Joy, we are praying for you- praying that the Lord sustains you, protects you, and strengthens you throughout this semester..."  Barely through the first sentence, the tears came. Hot and salty.

I was hungrily eating up the words, crying and again marveling at the Lord's provision. It was His hand that moved me to fill out the Prayer Request form. It was He who gave Mark the words to write. It was He who controlled the hand of the postal service to deliver it today--the day I needed it most. If I had received it yesterday or even tomorrow, it likely would not have had the same meaning or have touched me as deeply or profoundly. It felt like God's arms reached straight out of heaven to hold me--to HUG me. What was I saying just minutes before I opened my mailbox? Oh yes, "I seriously need a hug or a good cry..." I got BOTH.


Now we all know that hugs do not actually fix anything. There is nothing about my circumstances that have changed. I still have a challenging semester ahead. I still have stress and anxiety in regards to the coming semester. But hugs have their own unique power. In her article, "The Importance of Hugs", author Randa  Williamson-Maloy says, "A hug provides solace, safety and tenderness." (She says a lot more than that about hugs, so I totally recommend reading the full article.) It's true, while my felt need at that moment was for a hug, in essence I really wanted someone to say "I'm here. I'm listening. I'm not going anywhere. I've got you." That was the hug from heaven. Mark did not say any of those things, he was simply responding to my request for prayer. Mark's note was the means by which I was reminded of God's constant presence in my life. His love for me. His sovereignty. His omniscience. His strength in my weakness. His compassion. His friendship. His mercy. His grace.


And what about Mark's prayer for the Lord to sustain, protect and strengthen me? In a really wonderful and real way, I'm already tasting this! God used Mark to breathe the reality of God's presence into my soul, which I desperately needed. This evening, I have been sustained and strengthened, and my heart has been protected/guarded from the Evil One's desire to isolate me, and make me to think I'm alone in this. The evil one wants me to believe that I'm on my own and that I've been abandoned or forgotten by my Heavenly Father. He's the one who whispers to me "You are on your own, you have to go it alone." Lies.


I admit that I have prayed weak prayers, likely even half-hearted prayers, for God to grab hold of my heart and life. And I'm tasting this. Today. In this moment. What a gift. God, you get the glory.

I want to close this post with some verses that the Lord brought to my mind this evening. 2 Corinthians 4: 8-9 (NLT) "We are pressed on every side by troubles, but we are not crushed. We are perplexed, but not driven to despair. We are hunted down, but never abandoned by God. We get knocked down, but we are not destroyed..."  Here's it is with the entire chapter--but in The Message translation.

2 Corinthians 4 (The Message)
Since God has so generously let us in on what he is doing, we're not about to throw up our hands and walk off the job just because we run into occasional hard times. We refuse to wear masks and play games. We don't maneuver and manipulate behind the scenes. And we don't twist God's Word to suit ourselves. Rather, we keep everything we do and say out in the open, the whole truth on display, so that those who want to can see and judge for themselves in the presence of God.
If our Message is obscure to anyone, it's not because we're holding back in any way. No, it's because these other people are looking or going the wrong way and refuse to give it serious attention. All they have eyes for is the fashionable god of darkness. They think he can give them what they want, and that they won't have to bother believing a Truth they can't see. They're stone-blind to the dayspring brightness of the Message that shines with Christ, who gives us the best picture of God we'll ever get.
Remember, our Message is not about ourselves; we're proclaiming Jesus Christ, the Master. All we are is messengers, errand runners from Jesus for you. It started when God said, "Light up the darkness!" and our lives filled up with light as we saw and understood God in the face of Christ, all bright and beautiful.
If you only look at us, you might well miss the brightness. We carry this precious Message around in the unadorned clay pots of our ordinary lives. That's to prevent anyone from confusing God's incomparable power with us. As it is, there's not much chance of that. You know for yourselves that we're not much to look at. We've been surrounded and battered by troubles, but we're not demoralized; we're not sure what to do, but we know that God knows what to do; we've been spiritually terrorized, but God hasn't left our side; we've been thrown down, but we haven't broken. What they did to Jesus, they do to us—trial and torture, mockery and murder; what Jesus did among them, he does in us—he lives! Our lives are at constant risk for Jesus' sake, which makes Jesus' life all the more evident in us. While we're going through the worst, you're getting in on the best!
We're not keeping this quiet, not on your life. Just like the psalmist who wrote, "I believed it, so I said it," we say what we believe. And what we believe is that the One who raised up the Master Jesus will just as certainly raise us up with you, alive. Every detail works to your advantage and to God's glory: more and more grace, more and more people, more and more praise!
So we're not giving up. How could we! Even though on the outside it often looks like things are falling apart on us, on the inside, where God is making new life, not a day goes by without his unfolding grace. These hard times are small potatoes compared to the coming good times, the lavish celebration prepared for us. There's far more here than meets the eye. The things we see now are here today, gone tomorrow. But the things we can't see now will last forever.




Wednesday, January 19, 2011

Semester Three | Up and Running with Blessings

Okay, so I haven't posted my most up-to-date "expense report" yet. Sorry. I guess I was successful at resting. :)  The semester officially started yesterday, with today being the start for me.

Today the semester opened with our semesterly (new word) Dosage Calculation Test. 10 questions. Must get at least a 90% to pass. If a person does not get at least a 90%, he or she has one opportunity to retake it. Must pass or be kicked out of the program. So went in at eight this morning to take the test. Only a couple tricky problems, but felt really good about it. Results were posted this afternoon and I got what I hope for: 100%.  So far, I have not missed a dosage question yet --not on the semesterly test, nor on the lecture tests (there are usually a few on each test). Feels REALLY good. Dimensional Analysis, I tell you. That's how it's done.

After our test this morning, we split up into our clinical groups and met our clinical instructors. I really like the clinical instructor who I've been assigned to. I believe I'm going to learn a TON from her. I'm assigned to the ortho/trauma unit this semester and we will be doing patient care twice a week. This semester we are given our patient assignment the day before clinical and we have to complete/present a working care plan (too much to mention here) prior to our first clinical day. We then care for our patients. yay! After clinical we then evaluate/revise that same working care plan and then provide care again for same patient (hopefully) on the second clinical day. It's going to be a TON of work with the lecture component and clinical prep PLUS pharmacology. I really hope I can manage it all. If it proves too hard to do well at both, I can drop Pharmacology and take it during the summer. But there are a number of reasons why I'd like to have my summer free--namely my desire for a social life and the possibility to take a medical mission trip somewhere. We'll see. It's been a VERY long time since I've taken ten credit hours (oh, about 15 years!). So grateful to not be forced to work while in school. I learned today that two people in my clinical group have been and ARE working full-time! ack! How do they do it? I'm totally in awe.

For the next couple weeks I've got my standardized patient (SP) gig. I've been doing it now for a few years (a friend hooked me up when I was without a job after returning from Liberia). It has not only been a fun way to make money, but it's also a great learning experience! Every time I participate, i learn something new! And this evening, when I showed up early for training, the director of the SP program invited me to participate in a pelvic exam training session designed for 2nd year medical students this Saturday! I am sooooo excited! I guess she (the director) has gone through the training (as a non-medical person) and thought it was an amazing experience. I believe it will include both male and female pelvic exams--up close and personal, not Powerpoint, video or a dummy...this will be the real deal with real human parts! Because I'm an outside participant, I can choose if I want to just observe or if I want to actually practice the exams along with the medical students! It seems weird to say that I feel blessed for this opportunity to observe/practice pelvic exams! But I do. I probably wouldn't get this experience unless I was going through a Nurse Practitioner program or something similar. I will have an OB/maternal course/clinical my last semester, but think that this learning experience will far surpass what I'll get in our school clinical. I'm psyched!

Lately I have been counting my blessings and feeling so grateful. I am humbled by the Lord's provision and continued care for me!  In no particular order, here are some of the things that I am feeling grateful for:

  • A wonderful place to live rent-free!
  • A generous scholarship for school!
  • The luxury of not needing to work!
  • Transportation that is very reliable and paid for!
  • Income possibilities (seasonal job, SP gig, pet-sitting)!
  • Supportive family and friends!
  • Strong, healthy body!
I have been enjoying the reminder of the blessings in my life. Because it is soooo tempting to look around and think the grass is greener (husband, kids, house, dog, size 6 closet, hair/skin/nails to die for, blah, blah) in someone else's life, but what I've come to believe is that we ALL have gotten to be very talented artists. We've become really good at painting our brown, stiff weeds a pretty shade of green so that the weeds don't looks so bad and maybe even from a distance, they look like lush green grass. However, the reality is that we've ALL got brown patches and yes, in some seasons we actually do have beautiful green grass in a good bit of our yard, but in other seasons, it doesn't matter what we do, the yard is just brown and ugly. And if we can admit it...we'd notice that sometimes the weeds aren't doing so well. And we are ashamed. We live in fear that we are being compared, that we are missing out, that we have been swindled- Who took my grass seed and gave me weed seeds? So even if someone has the hubby, kids, house, size 6 closet with hair, skin and nails to die for...there's likely some brown patches they are ashamed of and trying to hide. To realize this, it's  not to make ourselves feel better. It's to realize that the grass is NOT greener. 

So I feel very grateful that the Lord has enabled me to see the blessings in my life! They are gifts. Undeserved gifts. But the real gift is having a grateful heart. And believe me...next week I will probably be back moaning to the Lord about my perceived lack. He is so good. Why do I doubt that? Why do I think He does not know what's best for me? And that it's always for my good. We can't see the big picture. We can't see how He's working it out for our good and His glory. I have to fight daily the notion that I know better, that I know what's best for me. But I don't. So I trust Him, or TRY to, praying that my faith will increase and I will live faithfully where He's got me. 






Tuesday, January 4, 2011

Semester Three: Coming Soon!

Hard to believe that semester three is right around the corner. Tomorrow is the last day of my seasonal job and then I'll have just over a week to relax and get ready for the semester. As of today, we STILL do not know our clinical assignments for next semester. Therefore we can't even register for our main class (lecture/clinical). A little frustrating, but at least we do know that all the students will have the same clinical days (Wednesdays/Fridays) with lecture on Monday morning.  I expect we'll be hearing from the organizing faculty next week, at the latest.

My Christmas and New Years were really nice as I got to spend time with my sisters and their families. And it's been nice to earn a few bucks and have access to a wonderful discount working for an electronics store (at their distribution center). Two to three days per week was what I opted for and that was perfect. The work has been tiring (walking and constantly moving ALL day long--just like nursing!) and there were a number of days when I wished that I had someone at home to give me neck and feet massages. It's been good though. I really enjoyed the other seasonal workers. The managers liked me and asked me if I would be interested in staying on. But with school, there's just no way. My time is simply worth more than the little bit of money. But since they liked me, I'm going to ask that they put me on their call-back list for next year's seasonal help. (Makes me wonder what kind of work I can find to do this summer since I have no classes.)

The next week and a half, I will focus on resting and getting ready for next semester. I have a list of things that would be nice to do before the semester starts. Including purchasing text books, dropping donations to Goodwill, changing my windshield wipers, washing my inside/outside of my car (hoping for some unseasonably warm days), dealing with neglected outdoor plants, lunches with friends, set up my "life/study schedules" for next semester, and get started on my training schedule (running) and hopefully getting the sore muscles over and done with before classes start.

A bit nervous about how this next semester is going to go. Not full blown anxiety, but I'm certainly thinking about it. Two classes this semester instead of just one--and the 2nd class is pharmacology---which is just naturally tough b/c it's LOTS and LOTS of memorization. I'm going to do my best to stay plugged into my Bible Study group--as they naturally are a source of encouragement and potentially my only predictable social engagement from week to week (aside from church on Sundays). I'm undecided at this point, but I may decide to switch to worshiping at the early service just to give myself more time on Sunday afternoon to study. However, there is a friend who I'd like to get to know better, and that friend attends the later service--BUT unfortunately is an irregular attender, so it might not make sense to force it. BUT I really do like to sleep late. :D   hmm???

My next post I'd really like to do an update of my nursing school expenditures through end of last semester. Now that is definitely going to be a crowd pleaser. Just kidding. Just a little something for those who read this blog because they are considering nursing school.

Cheers,
Joy