Technology

During the first few weeks of school, I found out that we would be blogging for one of our course assignments. Initially, I didn't understand the point and I thought it'd be just another thing to add to my list... the long list that is, in nursing school. As time went on, I learned how much I appreciated the blogs, and now that the course and semester are coming to a close, I realize how important these blogs were to us. It was hard being in clinical with only a small group because we didn't know how everyone else was doing in their own groups, and the blogs really helped to let us stay tuned in on our other classmates and how they were doing. I felt like the blogs also gave people a platform to express themselves differently, and maybe in a way that they felt more comfortable doing so. If I had to take the course over, I wouldn't change a thing; I think the blogging was really beneficial.

Critical Thinking... I suppose

A couple weeks into acute care, I had a patient who I had no idea what to do with. Among a long list of diagnoses and a complex significant health history, I was a bit overwhelmed with the case.
She had been admitted to the hospital for a GI bleed, but it was not her first. In three months, she had suffered 7 GI bleeds and had to have an EGD procedure each time, where they go in and laser the lesions in her intestines to stop the bleeding. The doctors call her case that of a "watermelon stomach." The first thing I thought was, 'well why does this keep happening?' How can we make it stop? My patient had anemia and a very low hematocrit in junction with Congestive Heart Failure and a history of AFib, a pacemaker, and an artificial mitral valve. Clearly, she had significant cardiovascular health problems and because of that, she was taking Warfarin. She needed to take an anti-coagulant regularly to prevent blood clotting and increased cardiac output.
Because of the blood thinner, the lesions in her intestines were more apt to bleeding when they might have otherwise been able to heal and be fine. I listened to the doctor speak with my patient about her choices and how she wanted to spend the rest of her life, as she was an 86 year old. Simply, she could cease taking the anti-coagulant which might solve her recurrent GI bleeds, but she'd be at an increased risk for clotting or possibly having a stroke. On the other hand, she could continue with the Warfarin but have a possibility of bleeding out from the GI bleeds.
After the doctor would leave her room, the patient would look to me and ask me what I thought she should do. I never gave her a straight answer, because I myself had no idea which route to take. I believe I have a strong sense in critical thinking and I have been successful when determining the priorities of my patients and other general situations, but how does critical thinking allow us to choose our way to die? I mean, inevitably, this woman is going to die and it's rather a choice she has been given on how she would like to pass away. How do we as nurses use critical thinking to make a decision like that? The textbook just doesn't hold answers for things like this.

Trapped in the Elevator

Those of you in my clinical group have already heard about this, but I figured I would share it with the rest of you.

So... it's the first day of clinicals and I'm nervous, anxious, excited and have hundreds of thoughts running through my mind. It's nearly 1:00pm and I haven't even taken a bathroom break, needless to say a lunch. I realized that I'm a half an hour away from our post clinical conference and I still haven't gotten my flu shot. I tell my nurse where I am going and head to the elevators on my floor. After I get into the elevator, I push level 1 and stand there for a while wondering why it's taking so long.

A few minutes later, I have pushed every single button in the elevator except the fire/emergency button. I have pushed the "open door immediately" button and have still gotten no result. Finally, the elevator drops suddenly and the door opens in a basement looking area. I get out and walk around, and have no idea where I'm at. I try to get back into the elevator but it won't even open up. I finally make my way outside and re-enter the hospital and head back up to my assigned department.

Moral of the story.... don't use the In-Service Elevators.

Acute Care

Acute Care; what a change of pace from long term care. In the hospital, I have different emotions coming over me, similar to that of our first day in long term care. I am overwhelmed, nervous, excited, stressed, and anxious. It's a bit nerveracking being here but I know I will get used to it and feel more confident as the experience increases. I worked with a patient who had a foot of her colon removed due to diverticulitis and another patient with kidney failure who was trying to make a decision whether to go on dialysis or not. It was amazing how everything we have talked about in lecture and skills lab thusfar came together in a day. It made me realize how important our lectures and classes are, that the topics discussed are actually relevant to what we need to know in real life! Even stuff I don't feel confident in, I still understood the general concept of it. We were looking at the charts and the patient's electrolyte levels and I could differentiate which ones were high and which ones were low. I could do a physical assessment on a patient with less anxiety and pressure that I had in long term care for our checkout. I'm nervous, but excited for what's ahead.

Last Week of Long Term Care

I can't believe this is our last week in long term care. What a shock. I can remember the first day and how nervous I was to even shadow the CNA on my wing. I remember how I felt the first time I assisted with pericare and cleaning up an incontinent patient after a BM. I remember how anxious I felt when doing my first chemstick. Now, after just 6 days in our LTC rotation, I am so much more at ease. I still don't feel 100% with everything but I know that practice and experience will make it much easier to get used to and feel more confident with. Good luck to all of you in our last week!

Ethics and Morals in Nursing Care

Today in our health assessment class, we discussed the ethics and morals of standard nursing care and how we need to care for our patients in regards to them. Several times throughout the lecture, I felt my eyes welling up with tears as I could relate to some of the topics we were discussing. One of the major issues discussed was suicide as well as physician assisted suicide. A classmate brought up the question of whether or not someone should go to heaven or hell if they chose to end their own life. This hit close to home as my own grandmother committed suicide.

When my mom was 16 years old, my grandma decided to take her own life, privately and shockingly. She had recently been put on numerous anti-depressant medications that my grandpa would later find out, were wrongly prescribed and were not doing their job. She began to feel very inadequate as both a mother and a wife, and in her mind, thought she was doing the best thing to end her life. No one in her family saw it coming, as well as her friends. She was active in her church, which brings up another controversial issue. As part of the catholic church, my grandma's beliefs included the following regarding suicide:

• "Everyone is responsible for his life before God who has given it to him. It is God who remains the sovereign Master of life. We are obliged to accept life gratefully and preserve it for his honor and the salvation of our souls. We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of."
• "Suicide contradicts the natural inclination of the human being to preserve and perpetuate his life. It is gravely contrary to the just love of self. It likewise offends love of neighbor because it unjustly breaks the ties of solidarity with family, nation, and other human societies to which we continue to have obligations. Suicide is contrary to love for the living God."
• "If suicide is committed with the intention of setting an example, especially to the young, it also takes on the gravity of scandal."
• "Voluntary co-operation in suicide is contrary to the moral law."
• "Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide."
• "We should not despair of the eternal salvation of persons who have taken their own lives.
• By ways known to him alone, God can provide the opportunity for salutary repentance.
• The Church prays for persons who have taken their own lives."

After everything my grandma had done for her church, they offered no support to her family after her death and refused to take any part in her funeral arrangements because of they way she had died. I believe this is why my mom and uncle may have steered away from church in general.

Despite everything, I do not agree with the generalization that people who take their own life will go to hell. There are many instances in my own beliefs where I think people are hurt and confused and do not know any better. Suicide is never something that anyone is happy about doing or thinks about to hurt someone else. It's often a quick and rash decision that is indicative of that person's chronic pain, often emotionally. My grandma overdosed on oral pills and it was believed that she may have taken the pills at one time, and then regretted her action soon after, but she was too secluded to get help or do anything about it.

There are so many different circumstances and reasons for why people choose to do things. I think it is important for us as Christian Nurses to remember this and not stereotype people or generalize situations. Also remember that your beliefs are not the same as someone else's and if you do believe that someone who commits suicide will inevitably go to hell, be cautious of how and where you say that. Someone else may be listening who will take great offense to that.

Thankful

While sitting at home with my roommate, I realized just how thankful I am for our group, Buntain School of Nursing 2010. I think I sometimes get distracted and forget how amazing our class is. My roommate, who goes to the UW, was telling me about some of her classes and professors. One professor frequently swears at them, using the "F" word and "fag" all throughout their class. To me, I cannot believe this is even allowed, or legal for that matter. It was funny comparing our professors, hers who swear at them and ours who pray for us. Not only am I thankful for my professors, but for my classmates as well. I think our cohort is very unique in how close and supportive we are of eachother. I think this is so cool, and I think it is something we should strive to maintain. No cliques or judgments, as well as no competition; this group is amazing. And rare. I love that I feel comfortable going up to any classmate of ours to talk to. Every single one of us was brought here through different circumstances and paths, yet we are all in the same place right now, and for the next 2 years, our paths will coincide with one another. It's important to remember that none of us are in this alone, we're all going through the same thing together, and we're all here in support of each and every person in our class.

Clinical Rotation 1

Anxious. Sad. Scared. Nervous. Uncomfortable.
Those were my first thoughts and feelings that arose this week at the start of our first rotation, long term care. I don't know whether it was because I was expecting something completely different, or because I do not have a lot of experience; but regardless, it was very hard for me. This might not be how anyone else is feeling, but straight from the heart, this is what has really been bothering me. I can understand the few patients that I have seen there who are A&O and I can understand why they are there, but the majority of the patients I've been working with are confined to their beds, cannot communicate with you, and seem like they are in excrutiating pain. If I was in their shoes, I wouldn't want to be alive still. I understand this is heavy stuff and that I'm going out on a limb here by voicing my opinion in this situation, but I just don't get what the point is of living when you cannot remember who you are, what you are doing, and to live in total pain everyday. To me, there's just no point.

Nursing This Far...

When I asked myself how I felt about nursing so far, I couldn't think of just one answer. Many different things popped up into my head as I began to think about the question. I think that after we graduate and go out into the workplace, whether it be right here in Kirkland or overseas in places like Africa, we all have the opportunity to make a difference in someone's life. How many patients are we going to be able to see a day? Maybe a few in long term care? Or if we work the emergency room, maybe 50 patients in a shift? Thinking about these numbers, I realized how many different people, from all walks of life, we will be able to see. And the fact that we can come into their lives during some of their most vulnerables moments, we'll have the chance to share the gospel and just care for and love these patients in some of their darkest hours. I think this is incredible, and I really hadn't thought about this until I started this year of school. I always knew that I wanted to help people, but never did I fully realize the extent to which I'd be able to do so. I believe that even if my patient is on their death bed, and I as well as the doctor know that there is nothing remotely possible to save that life, if I could bring them to know God and establish a relationship with Him, even if it was only for the next few hours they were alive, this, I think would be the greatest achievement I could contribute as a nurse.
Another thing I've learned so far is humilty. Not in the sense of fessing up to something I did wrong, although that is important too in some situations, but in the sense of being a role model. I am going to school to become an RN, to educate people on things such as diet and nutrition, proper activity and exercise, and stress management. How hypocritical of me to teach these things to my patients when not even I can follow them and practice them in my life. I think that one of my goals this year is to "practice what I preach" and try to incorporate what I'm teaching my patients into my own life.
I know that this blog was only supposed to be a paragraph, but when asked how I felt about nursing so far, there was no way I could contain it to anything shorter than this.