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  1. TheNursingdoll

    Pros and Cons of Taking Evening Classes

    Evening classes are definitely an experience. Most campuses in the evening are the complete opposite of the morning and the evening students' hustle and bustle shuffling to and from class. Taking an evening class was always ideal for me as I never truly was a morning person (slowly but surely changing). I enjoyed taking an evening class last semester, and I can say it was quite a journey! Here is a list of the pros and cons of taking evening classes! Pros 1- Extra sleep One major perk that I had as a prereq student is that I've gotten extra sleep! While my classes started at 1pm and I would get up at around 10am or 11am (I went to bed some days at 5am), I lacked sleep. But when taking an evening class (during the first half of my course), I benefited from the extra rest. To add to this, getting 8hrs of sleep helps tremendously! 2- More time to study My evening classes started at 6pm, so after waking up and doing the basics (breakfast, shower, brushing teeth, etc.) I had more time to study, whether it was reviewing videos or quizlets. With the extra time for studying for evening classes, I can stay that I came to class more prepared than I normally did when my classes were in the afternoon. 3- More chill / laid back students When taking my evening classes, I encountered more chilled and laid back students. Most of my classmates were in their forties and up, and the rest were in their twenties. The vibe in the class was very chill and relaxed. The course actually helped and encouraged each other, which was a first for me! 4- More focused With more than 8 hours of sleep and studying the chapter before class started, I felt more focused. For people who are not morning people, going to an evening class will help them stay more concentrated! 5- More interaction with the professor In my experience, the teacher was much more engaged than usual. Because class either ended 5 minutes early or on time, the teacher was very eager to explain anything that caused confusion. Even sitting 30 minutes after class to talk about life and to explain material more! I took Microbiology in the evening, and my professor did work in this field, which really helped me understand the material. Cons 1- Excessive sleep/ Disrupted sleep cycle During the second half of the semester, I took advantage of the extra sleep to the point where it disrupted my sleeping cycle. I went from going to bed in the wee hours of the early morning to going to sleep at the crack of dawn. It took me several months to get to the point where I will sleep at a normal time. 2- Occasional boredom There were times during evening class, to where I want to either be in bed watching TV or going out to dinner. Sometimes going into evening class was very boring (depending on the chapters covered). 3- Long days I took a science class in the evening, I'd arrive an hour early to review, class started at 6pm, and sometimes we'd end at 9:45pm. It would be very grueling sometimes, especially when writing lab results and then looking at specimens under a microscope! To make a long day longer, I had other courses to study for as well. 4- Food woes If you're like me, you're usually hungry when you're about to leave class. In my community college, we are literally surrounded by fast food. While this seems awesome at first, it really isn't because you literally start craving it. 5- Social/Normal life is altered If you are a person who is very eager to participate in school, one thing I can say is that it's going to be changed. I was a part of clubs and had to depart and put more time into studying. Even the free time that I usually had during the weekends went into studying. How was your experience with evening classes? 🙂 References Comparing evening and day classes: 8 things you need to know Taking Nighttime Classes in College: 8 Pros and Cons
  2. Being a nurse today involves an enormous amount of autonomy and adaptability. Not only are we expected to think critically, we are a strategic part of the financial agenda when it comes to cost containment and reimbursement knowledge. With the "lean mentality" becoming a common theme in healthcare institutions across the nation, nurses have to become familiar with balancing quality care in a budget stricken culture. When it comes to nursing students right now, you may or may not have had all of your clinical rotations satisfied due to Covid 19, leaving you feeling vulnerable without that experience. As a new nurse, you may have been rushed through orientation and expected to perform autonomously earlier than expected, as the cost to orient new nurses is very costly. Despite these added pressures, I believe nurses need two things to be successful in the current healthcare culture: 1 - Know that change is constant, and to embrace it. 2 - Know that resilience is the key to finding our purpose in nursing and coping with the challenges we face. You may be concerned about feeling underprepared in your clinical environment. Or perhaps you're worried about the stress of the job. Maybe you're wondering if you'll ever get hired in a new grad program. It's possible that you're already a new grad and having a challenging time in the real world of nursing. Regardless of how you're feeling at the moment, practicing mindfulness and building your resilience in a number of key areas will help you learn to function better as a nurse. Understanding resilience is crucial. In a nutshell, resilience is knowing how to cope in spite of difficulties. It involves having emotional strength and an attitude that enables you to deal with challenges. For me it has meant finding meaning in the challenges, and making the most of the situation. In order to do that, you have to be willing to stay present when the stress rises and know what your triggers are so that you can stop your fight or flight response and reset with focus. In the following paragraphs I will provide typical challenges new nurses face and how this might look. Typical Challenges New Students/Nurses Face Time Management Even the most organized, calculated nursing care plan can be derailed by emergencies or other pressing issues. How to stay calm and coordinated as a new nurse who isn't sure how to manage the many tasks at hand may be tough, but these responses may help: 1 - Flexibility Avoid a rigid plan of care. Embrace change, as it creeps up repeatedly, throughout your shift and is very common. 2 - Stay calm in the moment Acknowledge your feelings, label them (anxious, overwhelmed, angry, etc) and remind yourself that it's temporary. Focus on what task is imperative and tell yourself that's your only focus for the moment. 3 - Think priorities Do what's necessary first, delegate and ask for help from your colleagues. Decision Making Novice nurses are new learners for a up to two years, so don't pressure yourself to know everything. Skill comes with experience, learning standards of care and policy and procedures. Resilience in this area includes: 1 - Focus on problem solving. Collaborate and inquire with others (mentors are great). 2 - Learn Learn from mistakes and set backs. 3 - Observe Observe tasks that you need to learn and seek out opportunities of growth for. Be a proactive learner. 4 - Debrief Debrief with a colleague, mentor, charge nurse, instructor, etc. when necessary to overcome barriers to growth/learning. Communication Under pressure we tend to regress to our most habituated ways of responding. When emotions are involved, problems arise the moment we personalize an interaction. Avoiding aggression and being passive is key. Tips on assertive communication: Speak for yourself, actively listen to the other person to understand, clarify or ask questions if needed, paraphrase back what you think you're hearing, then close the loop by responding. Goal is to problem solve while being respectful, professional, avoiding assumptions and validating another's perspective. If the other person does not engage in assertive behavior, stay grounded in your intentions and try not to take on the aggression they project onto you. Be open to feedback/advice. Be clear with your objective. Mistakes and Errors Being vulnerable when mistakes and errors occur is important for a growth mindset. We are human, mistakes happen and we shouldn't feel embarrassed or humiliated, rather we should learn from our experiences. Tips: Be accountable if you make an error Understand the lesson learned Research to learn what and why the mistake occurred. Before any task: Pause for focus. Consider what actions you will take. Concentrate on the steps you will need. Afterwards, check to ensure you followed the steps properly. In a high reliability organization, we call this STAR (Stop, Think, Act, Review). Techniques for Dealing with Stress Check in with a mentor to ask questions or debrief. STOP (Stop, Take a deep breath, Observe how you feel, Proceed with kindness and compassion for yourself and others). In high stress situations, take 6-8 deep, slow breaths in and out. It changes our physiology and resets our ability to refocus. Stay in the moment (mindfulness). It encourages focus on what you're doing and prevents anxiety about thinking about multiple things. Self Care-Essential for reflection and rejuvenation. Exercise, journal, massage, read, meditate, socialize, pray, hobbies, listen to podcasts, etc. Support System. Mentors, friends, colleagues and family. In Conclusion Being a nursing student or new nurse is filled with a variety of emotions and learning curves. Know that it will be challenging and expect that you will be stressed. Understanding how to cope is a large part of the battle, but also knowing what you drew you to nursing can be a good motivator in being a caregiver. My objective each shift is to try to make a connection with my patients, and ensuring that I do all that I can to provide them with thoughtful, intelligent, compassionate care. I deal with the stress of the environment by practicing many of the tips that I've provided. Balancing mind, body and spirit is essential in providing the best care that I can. So my advice is to make yourself a priority on your days off and fill yourself with the things that bring you that balance.
  3. MMikels

    My Journey to RN

    I returned to school in the Spring semester of 2015, at 29 years old, with the hopes of going to nursing school. At the time, I had gotten divorced just over a year earlier, and was raising my then 7 year old without any assistance from her father. I worked as a salaried manager at McDonald's, meaning I worked a minimum of 46 scheduled hours a week, but was expected to stay late whenever needed and take calls when at home, so was working closer to 55 hours a week. I also had an 18 year old step-daughter who remained my child even after the divorce, who lived with her boyfriend, but visited home regularly. I did not believe that I would have much success going back to school, but a close friend had just gone back the year before, and convinced me that it was something that I could do too. As most of the prereqs were available as online classes through the community college, I decided to give it a go. As I completed my prereqs, I became more confident about my ability to balance family, work, and school life. It made for many very busy days, but I knew my goal was worth it, and I reminded myself that I was doing this to give my daughter a better life, and show her what can be achieved with hard work. My friend that pushed me to go back to school was accepting into the nursing program in the fall of 2016, and I made a goal to complete my prereqs in time to apply for the fall of 2017. We also became closer than friends at that time, and although we each had very little outside support systems, we supported each other towards our goals. In the Spring of 2017 I was accepted into the nursing program, in the Summer of 2017 I got engaged to my best friend, in august of 2017 I officially started nursing school, and in October 2017 I found out that I was pregnant. It was quite a whirlwind of life changes. While in nursing school I continued to work full time, as did my fiancee. Our program required one 8 hour classroom day and one 10 hour clinical day. Originally I went to class on Tuesday, clinical on Wednesday, and then work 9 hours on Wednesday; however, the 19 hour shift became very difficult to do while pregnant, and generally I would not get home until 2am on Thursday, have Thursday off, and work at 4am on Friday. In my second semester I switched to work after my Tuesday class, have Wednesday off, and go to clinicals on Thursday. Working after either a class or a clinical day was necessary so that I would have one day off a week to do study and homework. This was almost always a weekday, so I could do this while my daughter was at school, and be available to spend time with her in the afternoon. In May of 2018, my fiancee graduated with his ADN, passed his NCLEX at the end of the month. The nursing program had a Summer semester as well. I continued to go to class and work full time. We welcomed our daughter in the beginning of June, and I was at our next scheduled class, 6 days after she was born. My fiancee and I got married shortly thereafter, and he started a job working in the critical care unit, while still working as a patent classifier, which allowed a mixture of office work and at home work. That Summer, my husband was diagnosed with testicular cancer, which thankfully was treated surgically and has not required radiation or chemotherapy at this point. Due to long childcare waitlists, I continued into my second year of nursing school as a stay at home mother. Going into second year, we also had a small group of the students become class officers, and I took up a spot as the class treasurer, and attended most of the student government association bimonthly meetings to represent the nursing student group. While I was home much more often, I lost my day for homework and study and had to change my study and school work habit to work around the baby's nap schedule. Through all of this, I graduated with a 4.0 in May of 2019, and in July of 2019 I passed my NCLEX in 75 questions. I spent those months after graduation working towards completing the entirety of the Kaplan Qbank questions, doing a minimum of 150 questions a day, and a maximum of 300 in a day. It was important to do questions daily to keep up with my content knowledge as well as to continue to get practice with the critical thinking aspect of the NCLEX questions. While I tried to do questions mainly when the baby was napping, this wasn't always possible, and sometimes I had to multitask questions with taking care of the family and house. The Qbank allows the user to do as few as 25 questions at a time, and as many as 75. Whenever I knew that I would not be able to fully concentrate on the test, I would only select 25 questions so that I would feel less pressure. When I knew I had time to really sit down and test, I would do as many back to back 75 question tests as possible to practice for the chance of getting 265 questions on the NCLEX. Currently, I have been working as an operating room nurse for almost 3 months, and am a full time RN-BSN student. The past four years have been a major rollercoaster of life changes, but I wouldn't change a thing for the world. My husband became a nurse at 38, and myself at 34. It is not easy to go back to school as a non-traditional student while working and raising a family, but it is well worth it.
  4. I've only recently started community service and clinicals and I swear to god I am close to begging my parents to allow me to take up Journalism. Now Nursing wasn't really my choice since I have a huge dislike for hospitals thanks to various past events that made me go back into one each time. When my first year started at my previous college, I really felt regret for letting my parents pressure me into it When I failed psychology (which I still complain about along with 40 other students), I had the chance to switch but I decided to stick with it since it seemed impossible with all the medical equipment my parents bought for me and that writing in tagalog.... is definitely a suicide attempt if I take up journalism. Now I have survived another one year in college and I was actually starting to like nursing just a bit, until my duty started. And oh. My god. I swear I am going to legitimately die. I am not joking. You know how we're taught about aseptic techniques? Yeah well.... no one uses that here. I swear even the med tech student that drew my blood for blood testing didn't even sanitize his hands in between patients. And he's a 3rd year student with a nurse who wasn't even 'trying' to watch while doing the same thing he was doing! My clinical instructor told us that my group would me stationed at the health clinic first while the rest will go to the community to find one family to interview. No one and I mean no one used gloves on the patients. Well vital sign in excluded since you can't really feel anyone's pulse that way.... We performed Leopold's maneuver and gave tetanus toxoid by doing intramuscular injections with- AHEM! No gloves. Nope! Nothing! My dad used to be a med tech before he retired and he was extremely mad when he found out. He even saw picture of my classmate injecting someone without gloves with the teacher watching and openly yelled to me about it. If he was able to send a complaint to that student I mentioned earlier and get the dean to talk to him about it, then I swear the same thing will happen if the C.I.'s try to discourage me into wearing gloves. One even looked at me weirdly when I was trying to demonstrate how to break a vial and 'inject' the dummy we had! The community was even worse since it mainly meant giving physical assessments to not only pregnant mothers, but children. And the whole community is filled with squatters in the area. I had the children and I was so close to wearing gloves until my instructor came in. What's with them and not letting me wear gloves!? Now I would like to complain about this, until I realized BOTH college's I've been to have put me into life and death situations. Especially when dealing with chemicals that can most likely kill me. Now here's the good part... the equipment we are being taught to use is ancient. The IV line is ancient. And that's saying something with how the tube itself if yellowish in color. We're doing a thing called Benedict's test in order to test the sugar level of a persons urine. I told my dad the exact same thing my teachers did, 'Even med techs still use this.' He thought I was joking until I showed it to him. And there's this thing we call a 'donut'. It's this weird, soft, round thing that is used to 'support' a patient, depending on what bed position they're put in. It was the first I've ever heard of it and the same goes for my auntie. And she's been a nurse for 10 years! Almost everything we're learning is outdated, and I am two years away from graduation. My plan is to go back to the US and never come back to the Philippines. Problem is, is that at the rate we're going I'll seriously be dead by then from whatever infection killed me. Can anyone PLS give me advice as to how I can convince ALL the nursing teachers to try to update the lessons they're giving us. Both the patient(s) and me are in danger at this rate.
  5. I was fortunate to land a job at the children's hospital where I became a student nurse tech. I never even applied anywhere else, which is ironic, since I never wanted to work with sick kids. Yet here I am, sitting in a Pathways Program with nine other new grad nurses reviewing for the NCLEX for the next week or so. One of the girls let me use her study questions CD and we all strive to grasp essentials of nursing. The main thing I realized is that the NCLEX wanted to know if I knew everything about everything. At least, that is how I felt. I had books, practice questions, rationales, and youtube videos all teaching me how to best prepare for the exam. I had the voice of that little Southern belle from the Hurst review sticking in my brain (I listened to her lectures over and over). We studied together, we crammed and quizzed, and then we scheduled and sat for our exam. I present my ID to the lady at the desk in the center where I am to take my exam. I have followed, to a "T", the advice from books on what to do the day before the NCLEX. I did not study a lick, and I laid on my couch all day reading a fun book I always wanted to read but couldn't since I was too busy with school work. I glance around at the other people here taking exams for other certifications. I notice the room is about the same temperature as the Antarctic. I shiver and pull my jacket tightly around me. I am told to stand on the "X" as my photo is taken. I am given a key and told to put my stuff in a locker. I am taken to a room with an attendant and asked to empty all of my pockets, roll up my sleeves, roll up my pant legs as they check for any evidence of cheating materials. I am taken into a room, given a pair of earphones, directed to a computer, and instructed to start when I am ready. I enter my information and hesitate to press "enter". I hear his voice in my head - the one who said, "You aren't smart enough to be a nurse", "The only reason you have a good gpa is because you didn't go to a "real" university". What if he is right? What if I fail? I roll my eyes in an effort to see the idiocracy of his statements. I made it this far, what else is there to do but take a leap of faith? I press "enter", and my first question appears. What makes me nervous is not being able to go back to review my answers at the end of the exam. I have to make the best choice now and then never think of that question again. I only have one shot at this question. I stare and I think about what immediately stands out at me as being wrong. I eliminate two. I am torn about the other two remaining answers. They are probably both right, but what is most right? I take a deep breath, and click. Then submit. Then read, exclude, deduce, decide, submit. For 75 questions I do this. I remember, at question number ten, I thought - "Oh, hey, something I know!" Then rolled my eyes (this is getting to be a bad habit) and plunged ahead. On question 75 I made my choice. Here is the fork in the road. If I hit enter and the exam is over, I have probably failed, but I could pass. If question 76 comes up, I still have a fighting chance. I could have a hundred more questions and have a better chance of passing, I think, so try not to be upset if the test is not over, I tell myself. I have my arrow circling the "submit" button, and I keep hesitating to press it. I sat there for minutes on end. Not so much worried about the answer for that particular question, because I knew that one...but not ready to face whatever the next screen will tell me. Not sure I can handle a blurb about the test being completed. I push away from the screen and take a break. I am just mentally trying to prepare myself. I want to get my phone from my locker and call my husband, but really, what is he going to do? I want to call my mom, who thinks that no matter what, I am smart. I decide that is stupid, I just need to dive in. Get it over with. I place my earphones back on and hit submit. Game over. Exam ended. Shocked and dismayed, I am just .... embarrassed and defeated. Just 75 questions and I know I knew....ONE. I turn in my earphones, grab my stuff from my locker, walk numbly to my car and climb in. I just started bawling. All this way - this long hard road - and I have to do this all over again? I head home, the long drive home, and pull out my study books. (I also poured me a drink, but that is beside the point.) I highlight things that were on the exam, and make some notes. I am preparing for my next attempt already. I will not be defeated. As I study on into the night, I get a nagging feeling that there is a chance that I could have passed. I don't want to let myself think that could be true, because I don't want to be crushed, but I just can't help but hope. maybe... At work the next day, I admit to my group that I did take the exam. I had not told anyone. One of the girls in my group had 248 questions on her exam and just found out that she failed it. She was already gearing up to retake it. Then they asked me if I tried "the tricks" to see if the BON still had me listed as a graduate nurse, or if I had tried to re-register for the exam again. These are supposed to be "tricks" that hint if you had passed or not. Apparently, you cannot re-register for the exam if you passed. I gave it a try, but was still not convinced. I could not re-register, so I had hope, but was just not convinced. The next day, I decided to cough up the money to find out early, when the nurses in the unit kept urging me. I pulled out my credit card, and with a crew of nurses behind me (which I did not want- just in case...) I could feel my apprehension rising as I proceeded through the pages to the final one that would give me my results. The crew saw it before me and they all started cheering and patting me on the back - I DID IT! I PASSED!! I AM A REGISTERED NURSE!!!!! Read the preceding chapters:Go to Nursing School? NEVER!! Ch 1 Culture Shock & Big Girl Panties - Ch 2 Pretzels, Puppies, and Physical Assessment Ch 3 Tales from the Crypt....uh.... I mean Clinicals. Ch 4 Give me a BREAK!!!! Ch 5 RN: Judge and Jury Ch 6 Virtual Reality Ch 7 Avoid Kids at ALL Costs! Ch 8 The End of the Tunnel...Holy Cow - is that LIGHT?! Ch 9
  6. yooniehime

    Don't Give Up On NCLEX

    Good day everyone I just want to say thank you to the allnurses community for their big help towards my nursing career. Starting from when I was so desperate on finding a school to finish my concurrency issues ( Med Surg, OB and Psych) and I know that I will still use this forum in the future. I'm a BSN- Philippine graduate of 2012, I took my local boards and passed. I went to America to start from scratch. My first step was to apply to the CA-BRN after some time I got denied due to the concurrency, I knew it will be a long journey. The fact that I know that I won't be able to take the NCLEX due to the concurrency, I searched this forum dated back 2014 and called all of the school listed in the BRN site of they offer the courses I'm lacking. I messaged people and asked around for schools while doing my research, I applied for the NCLEX-PN. I took it August 15, 2015, and got results on September 27, 2015. I passed. It took me almost all the time given and I got all 205 questions. I was again reading to the forums and thread on how I could manage to find a job as a new grad LVN without experience, I tried my luck on applying with every job ad that I saw and an agency replied and that's when my career started. I found an alternative to take the NCLEX!, I applied to another state because that was the trend that foreign grads do. (I applied to Hawaii because it's one of the easiest states that doesn't need much paperwork except the cgfns). I took the exam after I got the ATT and failed. I got all 265 questions and had all near passing. I was devastated. It feels like all my hard work will be useless. I rested from studying and focused on finding a school, I am once again desperate. There were some threads here that gave me school names, some programs. I applied to most of them. I was ready to wait for 2-4 years for it to happen. I was prepared for the worst case scenario. Around January I was in the list for a subject, I was happy I could at least take one. By March, I got an interview for the school and was told that I would be one of the Psych 7. who are the students who will be taking 3 classes for the semester. I was scared and excited at the same time because I live in Los Angeles ( Don't mock me- I don't drive) and My school is all the way in San Francisco. My dilemma was my tuition fee and of course how I would get to my clinical sites? I found out that I could use a private loan and got approved- solved! Then the professor gave us a list of my classmates, So I asked some of the psych 7: if we had the same schedule if I could carpool with them. Then I ask some other classmates their email and text. It all worked out for me. I live in the dorms and carpooled for clinical duties. After 10 weeks it was all done. I finished all the concurrency issue that I have. Now time to wait for the CA att. I took the NCLEX just to try again using my Hawaii att and I failed miserably. I did it a few times. Once I got the att from CA And took the exam in November and failed again at 195 questions. I keep taking the exam unprepared but I could see the trend and the area of my weakness. I need to start from scratch and take the exam seriously. I pushed myself in working a lot (I had 3 jobs), just to divert my attention. Then I realized that I need to just stick to 1 job while reviewing seriously for the NCLEX. December 2015, I found a job in Orange County a Sub- Acute job that would give me time to study on the day off due to 12 hr shifts. February 2016, I attended a review center while doing Uworld and Saunders book, but I only finished unit peds with the book, I answered Uworld religiously for a month. Even when I worked I answered 10-25 questions just to keep the building momentum. The first week of April, I finally finished my review classes. I do a small study group with some of my workmates, review mates. I refrained from going out to parties or if I'm going to one. I make sure that I answered 75-150 questions that day. I made sure I had enough sleep and energy to focus on studying top. The day before my exam, I still had to work, so after my shift, went home straight and rested. April 21, 2016 (Thursday)- I was scheduled to take my exam at 1 pm at Gardena. I finished at around 2:30 pm with 85. I was trying to keep myself from doing the PVT but I couldn't help it and I got the good pop up but I was not convinced, then I waited 2 days- Saturday, the 23rd, My name was on the breeze site. Until now I can't believe, I passed. To those who have been trying to pass the NCLEX and failed, Please don't give up. You just need consistency and focus on studying. I know you can do it. I am praying for you.
  7. Julie Reyes

    Avoid Kids at ALL Costs! Ch 8

    As it turns out, my favorite class is pediatrics. I have four kids, and know a little about basic things (age of immunizations, milestones), but I didn't know a LOT. And it turns out, I really do like to read the textbook and learn everything I can about these munchkins - but I am dreading the upcoming clinicals. I don't want to go to the children's hospital, I don't want to see sick kids, I don't want to see their pain or the pain of their parents. My patient is a newly turned teenager boy with Down's. He lives in the same city where the hospital is, but he is alone most of the time - his family isn't around much, if at all. Even though I have other patients to care for, I spend a lot of time with this one. He has the mental age of a 4 year old, and plenty of mood swings. I fell in love with this boy and to my great surprise, he began to trust me and follow me up and down the halls. One morning as I was getting report, I hear a squeal - "JUUUUULIEEEEEEE!!" I look up to see him running down the hallway in his 'tidy whitees'! He runs to me and wraps his thin arms around my waist and hugs me while he jumps up and down. I laughed and told him to go to his room and get some clothes on! I promised to come and see him in a few minutes. It just made my day. Later on, I have to give him an injection. I get him to take his other medicine, but haven't yet told him about the shot. I gently tell him, "OK, we have one more thing to do and then we can go and play." He looked at me with his big brown eyes and starts crying - he remembers - he gets it every day. He doesn't want it, and cries for his mommy, who has not been to see him in 3 weeks. My heart breaks. I ask him, "would you like to sit in my lap and read a book after, or would you like me to rock you and sing you a song?" He chooses both. He takes the shot, crying the entire time - but silently as if he is resigned to it. I put the sharps away, and sit on the bed, pulling him into my lap. He wraps his arms around my neck and cries. He is a little 13 year old, but he is a huge kid to hold in my lap. However, I am struggling today. All because of a little patient I had been caring for during the past several weeks. Her name is "Sarah" (not the real name). She was fixing to turn 3 years old. "Sarah" suffered from being a cocaine baby along with several syndromes. Just 2 weeks ago, she tested positive for cocaine. Yes, just 2 weeks ago. Sarah had a mouth the size of a dime, and her ears were literally on her neck. She had a feeding tube and a tracheostomy. When I would enter into her room, she clung to me. Either she would not let go of my neck or she would not let go of my legs if she were up out of her crib. She would hide in the corner from anyone else who was in the room, especially her foster family. She would just stare blankly at them and would hide behind me if I tried to get her to interact with them. I was very frustrated with them as they showed absolutely NO interest in her AT ALL. They just watched the soap opera on tv. I know that I can't save the world, and I know that I am not supposed to get too attached to my patients. However - I had a serious conversation with the CPS workers to see if I could take her home and be her foster mother (but I had not been approved as a foster parent). Of course, the case workers were very excited to have me apply and go through the process. I was determined to care for this little girl and give her the best chance in life. I went home and told my husband (didn't even ask) about my plans and he was concerned, but on my side. I was off for the next two days, busy doing my Care Plans and assignments. I went to bed and turned on the news to catch the weather before I crashed, and I saw "my Sarah's" face on the screen. I sat up in bed frozen. She was sent home with the foster parents and died in their care. The reason given on the news was that she "removed her tracheostomy". So today is a hard day, because I keep thinking of Sarah, but I know I can't save every patient - but maybe just make someone's life a little brighter, or ease their pain by offering a comforting touch or hug. I set my mind to the task at hand, to making a difference, to understanding what it takes to make a student nurse into a nurse who is compassionate but thinks critically, and has skills that save lives. Which brings me to where I am now - in the PICU, and it feels like "home". Somehow, I know that I am going to work here one day. I have written a story about my first experience in the PICU, you can read it at this link: Does God Make Mistakes? In spite of my reasons to never work in EMS again, and to go into nursing to avoid sick or injured kids at all costs, I have found my calling - surrounded by children on all sides. I am home. My journey begins! For the rest if the story, see Go to Nursing School? NEVER!! Ch 1 Culture Shock & Big Girl Panties - Ch 2 Pretzels, Puppies, and Physical Assessment Ch 3 Tales from the Crypt....uh.... I mean Clinicals. Ch 4 Give me a BREAK!! Ch 5 RN: Judge and Jury Ch 6 Virtual Reality Ch 7 Avoid Kids at ALL Costs! Ch 8 The End of the Tunnel...Holy Cow - is that LIGHT?! Ch 9
  8. It all comes down to the last exam of the quarter, the last one that matters at least. There's something to be said when there's a 10% difference in your lowest average score and the next lowest. I remember my first thought when the test landed in front of me, "This is it, the apex of my quarter. The singular point in my history that I may look back at and either be filled with regret or wonder why I ever worried." (Maybe not so eloquent as that: it might have possibly been, "AGH, I DON'T KNOW ENOUGH AND I'M GOING TO FLUNK THIS STUPID TEST THEN FAIL OUT OF SCHOOL! WHY DID I EVER THINK I'D BE GOOD ENOUGH FOR NURSING SCHOOL???") The feeling continued through the first page, onto the first few questions of the next and then with the scratch of #2's on scantrons and the occasional cough into a sleeve, I felt myself gradually slip into my comfortable test-taking mode. It was reassuring to know the material backwards and forwards, to uncover the question behind the question and really understand the importance of themes in nursing. ABCs. Maslow. MONA. Basics about how diseases, I's & O's and medications will affect the fluid and blood pressure of a patient I studied the textbook, online resources, practice questions, everything I thought might help but was still unsure how I might fare as I abruptly flipped the final page and with an anticlimactic finish, it was over. I knew the information, but many times knowing isn't enough. Being book-smart is great but it takes a certain kind of student, a certain kind of person to be nurse-smart. Take the knowledge from A&P, from the textbook, from clinicals, and then understand what is most important to pay attention to; the "most correct" answer. That's what separates a great nursing student from a mediocre one, or one that never makes it to the NCLEX. I did end up passing the class with my 82%, just over 2% shy of a failing grade and a drastically different future. I was prepared for either outcome; mentally composing a message to my cohort with encouragement and camaraderie. Preparing to lift their spirits as I would have wanted someone in that position to lift my own. There were three in my cohort that probably needed it. I prayed a lot those couple of days. Not just that I would pass, but that God would allow me to be content with whatever outcome He had for me. The thing about believing in a true Sovereign is that we may present our requests to Him with fear and trembling, but He will ultimately know the best outcome for us-the outcome that will bring the most glory to Him. I honestly prepared myself for what it would mean to me, mean to my family to be held back a quarter. To have my first out of two strikes against me, graduate 6 months later than I planned, and struggle with the knowledge that had I been a better student, I would not be in this position. The line between my responsibility and His omnipotence is a fine one. The situation I found myself in was ultimately one of my own creation. I let myself slack off to an impressive degree over my three weeks off for break and as a result sort of limped into the start of the quarter. My resolve during first quarter to not play a single game on my phone did not carry on to the second and as a result I allowed my study-breaks not only be stretched to unreasonable lengths but be so mindless that I was hindering my actual study time. I write this as an encouragement and a caution. I allowed myself to begin the quarter with distractions and struggled, limped along with those distractions until the completion of the quarter. From my mistakes, I caution current and future nursing students. Work as little as you need to and take out loans if necessary. With dedication and that higher paycheck, they will be paid back in a timely manner. You may think you're smart enough to carry on a full workload (I know the thought crossed my mind several times) but it's not worth risking failing out of a quarter or out of school completely. You'll find that scenario to be more costly in the long run. Spend time with family and friends but understand that it will be limited, and above all, designate that time. If you are only half-paying attention to both your family and studies all the time then you won't do well at either. It may be that you have to remove yourself from your textbook or notes during the time from family and it might be that you need to remove yourself (physically) from the presence of your family. Have an office? Use it. Library close by? Coffee shop (that you aren't distracted by)? Take advantage of those spaces but let your family know that when you are present physically with them, you are also present mentally. And the caution I wish I would have heeded the most: know your most powerful distraction or distractions, and if at all possible, eliminate those distraction completely (at least until you pass the NCLEX). If you need breaks-scratch that-WHEN you need breaks, watch a TV show with someone you love. Read a magazine that's easy to put down. Go for a hike with friends or family. Exercise. Don't binge watch a show, try to do homework while watching a movie, or say, "oh just one more game." From one future-nurse to another: know that this time in your life is going to be difficult but also know that if you allow it, it will whittle away unproductive character flaws that may still be clinging to you. This school isn't just about being the smartest in your class, that's only one aspect of it. Allow the flames of school to harden your resolve and craft you into an excellent nurse. And be sure to take precautions to prevent yourself from getting burned.
  9. Last night, my first class of nursing students graduated. It was a momentous and beautiful moment that really got me pondering the challenges and triumphs of being a nursing instructor. I decided to sit down and write out all of the things I wish my students could know, so without further fanfare… 1. Our greatest wish is for you to succeed. It is a common misnomer that nursing instructors have it out for students. We really try to give you all of the tools you will need to become successful. It pains us greatly when you fail. 2. No, we cannot be friends. Right now, I cannot be your friend. I am here to help shape you into a conscientious, critically thinking nurse. I would be doing a grave disservice to you (and possibly, your future patients), if I am easy on you. My job is to teach you and evaluate you on the concepts and skills that you have learned. One day we may be peers and that relationship will be different but right now, I have a job to do. I promise it does not mean that I do not like you. 3. Everyone has a unique and often difficult story. I know that you work full time during the day, your car can barely make it here, and there is no one to watch your child. My heart really does go out to you, and I will help you in any way that I can for you to be successful. If you put 100% in in my class, and I know it may be hard, I will always be in your corner. 4. Respect is earned and reciprocated. You are going into a noble, yet physically and psychologically difficult profession. Take it seriously. Take nursing school seriously. Respect your peers, respect your patients, respect your nursing instructors. It is a two way street with me, and I will hold you to your side. Insubordination is absolutely, unequivocally never okay, ever. 5. I see you texting. Listen, if it is a special circumstance and you absolutely need to text or call, that’s fine- outside my classroom. You may use your phones for research purposes not involving texting, Snap Chat, Instagram, Kik, Facebook, etc.. I know sitting still for often three and a half hours is difficult and tiring, but please save the texting and phone surfing for your break. 6. Do not bother to cheat. I am a mother of boys, I have eyes in the back of my head. Aside from that, you can’t cheat the NCLEX or for that matter, life. Just don’t do it. If I catch you, and there is a good chance I will, you will be expelled. It’s not worth it, besides, you do have it in you to pass the right way. 7. Please ask me questions. I am here to tell you what you need to know, and if I do not immediately have an answer, write it on the board and I will find out for you. It’s my pleasure to answer your questions and explain the rationale as to why we do things the way we do in nursing. Thinking like a nurse isn’t easy, it is often a process and I am here to help you discover that process and help guide you to the other side, so to speak. 8. I will ask you questions. I will absolutely ask you questions at random, often in the middle of lecture. Why? I want to know if you understand the information, and if not, I want to facilitate your discovery of that knowledge. It’s not because I want to embarrass you, or make you look foolish. I want to see and hear that you are learning. 9. I will hold you to the outlined academic program standards. Please don’t ask me to not mark you late, or give you extra points when you haven’t worked towards them. It is not fair to the students who are on time and who turn in their work on time. Also, when you are in uniform, I expect you to abide by the program’s rules that you signed: no jewelry, no nail polish, hair up off the collar, white shoes. Yes, I check. Do not leave the unit floor unless I give you permission, and do not disappear behind the nurse’s station. You need to be with your patients unless otherwise specified. I notice when you are not back on time and where you need to be. Turn in your assignments on time and without a story. Do what is outlined in your program contract and you will be all right with me. 10. I was once you. Yes, it may seem like 1000 years ago (actually, twenty), but I went through the very same program and had the same concerns, complaints, and stressors that many of you do. I get it. Because of this I am secretly cheering and rooting for you. I am really in your corner. When you do well on your test, I am happy for you, when you pass my class, I am ecstatic, and when you graduate, I am overjoyed for you. Words cannot express how wonderful it is to see my students on their very first day, scared and hopeful and to see them all the way through their journey. It is the best form of compensation, ever. When I see my students graduate, I see shades of what is to come- glimmers of the next wonderful generation of nurses in a sea of white caps, all smiles as they venture out into the amazing, yet intimidating world of nursing. My students, I only wish for you to succeed and accomplish all of the goals you set out to. I believe in you, I know you can do it! Sincerely, Your nursing instructor.
  10. As a nursing student, you don't have much time to yourself and your calendar ends up looking marked up with no empty spaces. I've learned that it is better to be over-prepared than under-prepared. It is very important to make sure everything is together before classes start because you may not get the time to get it together later. Set your sleeping patterns right, get peace within your mind, and make sure to remove all the clutter in your life. Over the last several days, I've put up a bookshelf in my room for nursing books, cleaned my room, did laundry, cleaned my book bag out, sorted my papers, and reviewed skills I think I need. Yes, I can be a little OCD but I truly believe that what I did will make my mind a lot more clearer for the upcoming classes. If you feel over-prepared, you will feel less anxiety. If you feel under-prepared, you will feel an extreme amount of anxiety. Now saying all that, if you don't get the time to do everything you think you need, it is okay. Write down the basic important things on a piece of paper and strive to do those things. Add 1 or 2 more things on the list if you accomplished the other things. This will make you feel very prepared and accomplished. I am not encouraging worry, I am encouraging diligence and wisdom. You'll need all the peace you can get, believe me. Now this is how I prepared/preparing for my second semester to start: Setting up an calendar with alerts Getting my books and skimming though them. Reviewing class notes. Making connections to people who will be in my class/esp. clinical group. Organizing the books I already have via book shelf. Cleaning my room, book bag, and etc. Making a budget. Things I needed to do this: Bookshelf for books. Google calendar. I put the event names like Lecture, Test #1, Clinical Orientation, etc. I put the places or room number at the college (which is very helpful!). And I also put the time of the events. I love google calendar! Once I put events in the calendar, it synch's with every device I use to check the calendar. It is very easy to work with and you can have the calendar repeat events weekly, bi weekly, or monthly. I set up alerts and reminders on the calendar also. Notes app. I make lists on this app and I use it to make a budgets also. The app is on my phone and laptop and it synch's! Facebook: For connecting with fellow classmates. I myself made a Facebook page for all the nursing students our first semester so we could initiate contacts and form a community. It is very helpful. So if you need rides, reminders, help or information, you go there! The books and notes for the classes you'll be taking. School supplies: Highlighters, pens, pencils, notebooks, erasers, flash drive, etc. Dividers and a binder: You need this so that you can organize your class notes. I use dividers to divide seminar, clinical, and lecture. I also use them to divide each unit. A support group of veterans: This is a important thing to have. If you know people who have been through the nursing program, make connections and ask them for advice. It has been very helpful to me to have 2 friends who are in the second year and my Godmother who has been through both years to help me out. Their wisdom is very much needed.
  11. There are some very major differences between taking classes in a classroom versus doing them online. The one difference that gets to me the most is the lack of a social life!!! I live in the boonies next door to some cows. My day starts off like everyone else's day - chaotic. My daughter has to be at school at 5 am for track and cross country practice. After I drop her off at school, I go back home and get everyone else off and on their way. Now it is ME time. I sit down at my computer to tackle the assignments at hand and handle pressing matters....which at the time means seeing if anyone left me any messages, sent me emails, or if I can catch any of my friends online to chat! Later on, I decide I better really get down to studying. My current class of concern is physical assessment and the upcoming - full blown skill assessment checkoff I have to go do at the university. Since I am kind of a slow learner, I am trying to make my life easier by learning all of the acronyms I can on things like the cranial nerves (remember that one? On old Olympus' towering top a fat vicious goat violated a hat - if you use the nice version). Of course, we have to assess every nerve in the checkoff. My advisor let me borrow some tools of the trade to practice at home with, and to use on my "patient". I am trying to convince my husband to be my patient with no luck (unless we play doctor, but AN is NOT that type of site!) - but he did let me practice my cranial nerve exam on him. Yesterday, I may have burned his eye a little bit, when trying to do the eye exam with the light thingie. I am pretty sure I will never have to do an eye exam on any patient I ever have...or test their taster for that matter...but if I ever have to, I will just have to review it before I do it. I just cannot see this information staying around in my long term memory... I am just trying to make it through the class and remember it long enough to pass the NCLEX. That may not be how most people go through school, but honestly, I am just trying to stay above water. I can't believe how quiet my house is when everyone is gone. It is what most people pray for - a little quiet so they can study! I just hate it - and I imagine to myself that all the lucky nursing students in actual school settings are having so much "fun" and HUMAN INTERACTION. Well - I will just have to study hard the rest of the day, I tell myself....I can talk to people when my family comes home! So - here is the thing....my daughter comes home first, and she is a teenager...a typical teenager who needs to have "space". I follow her around the house like a lost puppy. She sighs and asks me, "Mom, how was your day? Would you like me to watch a tv show with you? We can go to your room and chill out for an hour and then I have to go do homework." Yes, that is my daughter telling me she will spend some time with me before she has to get to 'work'. We get our pretzels and honey mustard and head to the room to watch Gilmore Girls, and I talk her to death during the entire show. She is all too glad when the show is over and she has done her duty of spending time with me! Haha! Poor girl, I torture her! By this time in nursing school, I have pretty much figured out how to study. I am very nervous for the checkoff though. I head to the university on the day of my checkoff. I found another girl in the program who needed to do hers as well, and we agreed to be each other's patient. I was the first patient, and then we switched off. I must say this very important point: if you ever have a chance to go second, do it! You can learn from the other student on what you want to do - and not do! I made it through the entire physical assessment, making a few mistakes and skipping a few of the nerves. I wrote out my assessment into the paper chart to show I know how to document. I did the happy dance all the way home because I made a very good grade and passed the class! The biggest reward for passing this semester is that now I will be able to start clinicals! I cannot wait to buy my very first set of scrubs! Nursing World - watch out - Julie's coming to town!!! My journey begins!For the rest if the story, see Go to Nursing School? NEVER!! Ch 1 Culture Shock & Big Girl Panties - Ch 2 Pretzels, Puppies, and Physical Assessment Ch 3 Tales from the Crypt....uh.... I mean Clinicals. Ch 4 Give me a BREAK!!!! Ch 5 RN: Judge and Jury Ch 6 Virtual Reality Ch 7 Avoid Kids at ALL Costs! Ch 8 The End of the Tunnel...Holy Cow - is that LIGHT?! Ch 9
  12. I slam the alarm off in a fury, covering my face with my blanket. I just can't do this job anymore. My run as a paramedic in rural county America for the past lifetime has taken its toll, but this past year I have earned my name as the "Trauma Chick" and "Chyna" - the female wrestler. Working as a paramedic has just been awful lately, for me anyway. Some of the horrible things I have done and seen in the past few years include: Assuming scene commander role of mass casualty incidents, (including a horrible 2 car - 8 unrestrained passenger head on collision. A baby's head was caught in a vise between a truck door and fender of the truck. The baby was hanging in midair like a horror movie pinata);Coding a 2 month old seizure baby who "fell off a couch"...it will never cease to amaze me how many babies roll off of beds or couches...;Scraping three teenagers off the highway in a single car versus tree massacre;A call for a male with a broken leg that turned out to be a man lying on his back with a slit throat and every bone in the body broken and sticking out at odd angles (he was catapulted from 100 feet while changing lights at a stadium. He hit the headache rack of the work truck and bounced to the chain link fence throat first, and finally stopped on a concrete sidewalk).Rescuing a 300+ pound female patient who was stabbed by her husbands family members during a family BBQ. She accused her husband of cheating, and with everyone drinking and what-not, a brawl happened. When we arrived, deputies had her surrounded protecting her from being killed by angry family - she still had a knife in her chest. We had to treat her in a bedroom and escape through a bedroom window. Of course, the house was a mobile home up on stilts. We had to balance her on a backboard and pray that no one would kill us in the process.One of my coworkers - a good friend of mine - was killed by trying to stop a fight. He was run over by a car and the wheels crushed his head. I didn't have that call, but I cleaned up the back of the unit after it was over - wiping blood off the walls and floor.I braved roaches and angry / territorial pit bulls; I directed young volunteer firefighters who created havoc and chaos instead of helping because they knew the dead and dying teenagers in the rollover accident; I fought countless obstacles that stood between me and my patient and threatened poor outcomes. I had drunk/overdosed/angry patients; I was beat up by a huge mammoth for blowing his high by pushing narcan (lesson learned!); I have cared for beaten wives and stabbed husbands; I relied on deputies to hold back angry relatives in family brawls. I have searched fields in the dark for any possible survivors after car collisions. I have been to houses that seemed like they should be in movies like the Texas Chainsaw Massacre. Houses in the middle of the night in the middle of nowhere - I had to pick up patients who had stroked out - or worse - all the time wondering who is staring at me from the behind the creaking hallway door that opens and closes slightly and leads to a pitch black room. I have slipped in brains and blood that had flooded the floor of the ambulance, and I have done chest compression on an infant with a crushed skull only to have blood come out of his ears with each compression. Faces haunt me at night - the teenagers that I couldn't save but fought with all my might as my partner and I battled The Reaper. The babies I could not get stabilized in the long trips to the nearest ED. My life as a paramedic is one long, unending nightmare. My alarm jars me - waking me from my nightmares to go to work. As I cover my face with my blanket, I decide I won't do it anymore. I just can't. I pick up my phone, call my boss, and I quit - just like that. I will never work as a paramedic again. Here I am, floundering through my days - picking up odd jobs that include housekeeping and babysitting and I feel like a failure because I don't know what to do with my life. I know I don't want to be a paramedic any longer, and I don't want to be a nurse - taking orders from a doctor or wiping butts and emptying bedpans (in my limited experience, this is all I thought nurses did). I REFUSE TO GO TO NURSING SCHOOL!! I trudge day in and day out for months on end, moping about like a lost failure. Months turn into years. I have no clue what to do. Finally, my husband has enough of my dreary misery. "You need to do something with your life," he says. "You are more than a house cleaner and babysitter." He encourages me to look at nursing again, because he thinks I would be good at it. I decide to call my sister-in-law who is a nurse, and talk to her about her likes and dislikes of her career. She sounds so happy and encourages me to go into nursing. I am worried, but maybe I can do it...as long as I never have to work with kids. I think I would probably be happy working in the ED at the trauma hospital. They don't take kids there - only adults, and I know trauma WELL. The idea starts to sound nice. Me - a nurse. I think I like that idea. I decide to take my chances and apply at the local junior college to knock out the basic classes. I am determined to give it all I have, and I actually am really excited about the future now. I have a purpose! I go to my advisor to discuss the steps of getting into nursing school. There are two in the city about an hour away from where I live, and I apply for the one that will give me a BSN. My advisor tells me I should make a Plan B and apply at both schools in case I am not accepted into my first choice, but I opt against it since I have a 4.0. I don't think nursing school will be much harder than my basics - how hard is it to change sheets and give shots? Plus, I don't like "Plan B's"! I just have to make this work out, I cannot fail my "mission". It is time consuming, but I jump through all the hoops it takes to get into another school and meet all the nursing school requirements. I applied, and I wait. You know THE WAIT - the horrible, gut wrenching feeling of dread and expectance, dread and desire, hope and fear all rolled into one massive burning fireball in the pit of your stomach. I am so frustrated of driving 30 miles to a post office to check the mail and find out THE LETTER has not arrived. Day in and day out I waited. I make the post office trip every other day for ....ever, it seems. What takes people so darn long to shove a piece of paper in an envelope and slap a stamp on it?! My attitude became snippy; my usually happy demeanor became partly cloudy with a chance of crazy. Now, here I am in the kitchen scrubbing down the cabinets (nervous energy). The door opens and in walks my husband carrying a fistful of mail. I freeze as he hands me an envelope that has the university logo in the return address spot. My hands shake as I take the letter from his hand. I look at him - this envelope holds EVERYTHING. My entire future is inside. I tear it open and stare at the paper. This wonderful, marvelous, beautiful piece of paper! I look up at him, and nearly collapse in his arms - I got in! My journey begins!For the rest if the story, see Go to Nursing School? NEVER!! Ch 1 Culture Shock & Big Girl Panties - Ch 2 Pretzels, Puppies, and Physical Assessment Ch 3 Tales from the Crypt....uh.... I mean Clinicals. Ch 4 Give me a BREAK!!!! Ch 5 RN: Judge and Jury Ch 6 Virtual Reality Ch 7 Avoid Kids at ALL Costs! Ch 8 The End of the Tunnel...Holy Cow - is that LIGHT?! Ch 9
  13. My scrubs are royal blue. As I walk into the uniform store, I cannot wait to try on the coveted scrubs! The sales lady walks over to me and asks me if I need help. I am bursting with pride as I tell her I need scrubs for my nursing clinicals. She smiles at me and leads me to the rack. Unfortunately, I am tall, and they have to order my pants. I wanted to cry! I go ahead and pay for them and buy the top so that i can sew on the nursing school patch. I am utterly disappointed that I cannot try on my ensemble and look in the mirror. Waiting flat out sucks, but as it turns out, I didn't need things to move along faster anyway. Since I am an eline student, I have to set up my clinicals by myself. I am required to contact the hospital clinical educator and do all the groundwork for setting up the clinicals at a hospital. I request one of their satellite hospitals nearer to me (30 miles) than the one in the big city an hour away. I did not realize I had to start this at least 8 weeks ahead of time! The school has never used the satellite hospital for nursing students, so there are a lot of formalities to be completed. And because everything was not done by the time clinicals were to start, I had to delay my clinicals for a semester. This was infuriating because it also delayed my graduation by 1 semester! I also don't have the benefit of having other nursing students there or a clinical instructor on campus to monitor me or help me with my questions or concerns, which is the downside of eline. I realize quickly, I am swimming in deep water on my own. I show up to the unit where I will do my very first set of clinicals about 35 minutes early. I am surprised that the day shift has yet to show up. So I wait. And wait. The day shift rolled in about 2 minutes until 7 am! Is this how they do things here? I used my time to review the patient charts, but as of yet, I have no idea what patients I will get. The nurses all come to the nurses station and I finally meet the lady who will be my preceptor. She is about a hundred and fifty years old and scowls at me when I am introduced to her. Right off the bat, she said, "I have five patients, you take This One and don't bother me." With a "deer in the headlights" look, I take her report info. "This One" is a 50 year old, 400+ pound patient who was involved in an auto-ped collision fracturing her pelvis, femur, and arm, and has a colostomy. She is in traction, in constant pain, and incontinent (well, I don't know how I could get her on a bedpan!), and I am on my own. I have never actually seen a 'real' colostomy before, and only through the textbook do I know much about changing or cleaning it out. I actually ask my patient how she takes care of the colostomy, and she is gracious enough to walk me through the process. The worst part of this experience is learning how to reposition her and change the diaper she wears since she has the fractures and is in traction. I learned (the hard way) to premedicate her prior to any of these interventions. I develop a great relationship with this amazing patient. I am so tempted to give her my telephone number and become lifelong friends with her. My heart really goes out to her because her kids don't live in the area and they are only able to come in on some of the weekends. She does have a lot of church friends who travel to see her, though. Today The Joint Commission is here for inspection. One of the officers (a retired general) stopped me to ask me some questions about what I am doing in my clinicals there. I tell him and explain exactly what patients I have and my responsibilities for the patients. He asked me about my school, and by this time, my preceptor comes by to listen to the conversation. I tell him that I am an eline student. My preceptor snaps, "I can't believe that they allow nurses to be taking nursing classes online, they can't be learning anything and it is a disservice to the profession." I am so shocked that I have no idea how to even respond, but as it turns out, I don't have to. The retired general responded, "Can you just imagine how hard it is for someone to be doing all of their schooling online and not have the benefit of going to school for face to face learning? And yet, this student nurse must take and pass all of the same exams that the face to face students must pass, and she basically has to be more motivated and focused on the goal." I smile at him as she huffs off down the hall. "Don't worry about her; some people should have retired a long time ago," he says. I feel a little lighter, now. Who knew that a face-to-face conversation with TJC could have such heart warming effects?! One of my elderly patients is due to be taken to a nursing home for the first time in his life. He had lost his wife not long before he came to the hospital. He is a true gentleman, an old cowboy who called me "ma'am" and wears his Stetson (cowboy hat) during the day when he is up in the wheelchair. His hands showed a life of hard work. He tells me stories about his wife and grown children. I talk to him for hours every day, and I hold his hand when he cries during the stories of his wife. I wish I could have met her, she sounds like an amazing woman. He confides in me and gets tearful when he says he doesn't want to go to the nursing home, but I guess that his kids can't or won't take care of him. At the end of every day, I started going by his room to tell him goodbye, and I give him a hug. I tell him I will see him on Monday. It is Monday. I am happy to be at clinicals and get back to my favorite patients. I get my assignment and notice I am missing a name on my assignment list. I ask the charge nurse about Mr. Cowboy, and if I can be his nurse again today. She looks at me and tells me he passed away Friday night. I stare blankly at her, not quite comprehending, and my heart sinks. He died in his sleep, she said. This is the first patient I have had that has died. I am not even sure how to respond, because I have to go and do morning assessments on my other patients. ...and I realize, this is the life of a nurse. You touch the lives you can, you try to help them get better, you make their time here on earth as comfortable and peaceful as possible. You do the best you can with the skills you have. Sometimes you win, sometimes you lose. I take in a deep breath and wipe my tears. And smile as I go into the next room. My journey begins!For the rest if the story, see Go to Nursing School? NEVER!! Ch 1 Culture Shock & Big Girl Panties - Ch 2 Pretzels, Puppies, and Physical Assessment Ch 3 Tales from the Crypt....uh.... I mean Clinicals. Ch 4 Give me a BREAK!!!! Ch 5 RN: Judge and Jury Ch 6 Virtual Reality Ch 7 Avoid Kids at ALL Costs! Ch 8 The End of the Tunnel...Holy Cow - is that LIGHT?! Ch 9
  14. Julie Reyes

    RN: Judge and Jury - Ch 6

    As I sit in the stands at my daughter's soccer game, I am furiously trying to catch up on my chapters I should have already read in my Maternal Newborn textbook. I feel the darkness of an unwanted presence hovering over my shoulder and look up to see my ex-husband. "Studying?" "Yeah, what's up?" "How is school?" he asks as he settles in for a conversation I have no time for. "Fine." "How are your grades?" It is at this point that I can recall the countless number of times he has told me that I am not "smart enough to be anything but a teacher" (his exact words - and he is a teacher). I remember the repetition of his dire warnings that I was stupid and would fail if I went into healthcare. I can feel the heat rising in my chest like bile. "School is fine, my grades are fine." "Really? If your grades are 'so fine', then what is your GPA?" At this point I am wondering if I can use my textbook as a weapon. However, I know the next words out of my mouth are going to be daggers to him and **** him off. "4.0". Silence. And then - "I guess that's cause you are not going to a REAL school". Yeah - that's it - a major university is not a "real school". But instead I laughed the sort of laugh you give when someone says something moronic. I thought how lucky I was that I do not have to deal with that anymore. I roll my eyes and turn my back on him, I have to study, and by study, I mean ignore him so that I don't do or say anything I can get arrested for. It's funny how quick tempered I get when I am stressed out. Nursing school will do that. I am on edge constantly. As I walk down the hospital hallway towards my patient's rooms to assess my postpartum mothers, I reflect back on the nurses I had after I gave birth. Nope, I don't remember any of them except one. I wonder if it was because there were so many new and exciting things happening in my life at the time - a new baby - and scared straight!! Would these new parents ever remember their nurses? Maybe. I assess the new mommies, help one of them learn to breastfeed, and walk back to the nurses station to fill out my reports. I actually have a huge chip on my shoulder at this time - I am tired, frustrated - I do not like this rotation at all because it is NOT my cup of tea. As I sit there at the desk, just barely tolerating existence, this huge, scary looking man walks in the unit and down the hallway. "What is this world coming to?" I ask myself. I have actually written about this - you can read the story at this link (it will help you to understand the rest of this story): I wish I were blind. I am glad I am done with my postpartum days and can move on to actually seeing a delivery. Maybe I will like this - or I hope I will. My patient is a 17 year old girl who is 17 weeks pregnant and in labor. Her mother and boyfriend are in the room, and the nurse I am following for the day is the most amazing LVN (yes - at this point in history, we used the term "LVN") - this girl knows her stuff. I cannot imagine what this poor mother is going through. She is scared and in so much pain. I care for her throughout the day, but I feel like a deer in the headlights myself. After hours of contractions, the baby is delivered. There is not a team to care for the premature infant, the baby has died in utero. My preceptor and I take the infant to another room and put his handprints and footprints in a tiny card. His hands are the size of the tip of my pinky finger. He is a little boy - all of his anatomy appears correct. He is so tiny, the width of my palm is bigger than he is. We want to take him to his mother to let her hold him, but we cannot put him in a blanket - it is too big. Instead, we wrap him in a washcloth. We head back to the room and as I hold the baby in the hallway, the nurse goes in to talk to the family and ask them if they would like to see the baby. Everyone refuses to see this little boy I hold in my hand, and I am confused. That was not the answer I was expecting. The nurse returns to the hallway and leads me back to the room we were in. We will have the tech care for the remains. Since the baby is not 20 weeks gestation, there will not be a funeral. I feel like I am in a fog - I don't understand the family decision to not see the baby - or how the young mother could be in the room laughing with her boyfriend as I hold the body of her child in the palm of my hand. I become frustrated about the decisions this family has just made! What is WRONG with them??? Then I remember the incident with the huge, scary man walking down the hallway the week before. I don't know the circumstances, I don't know the lives these people live, I don't know....anything! So how is it that I have put myself up as judge and jury? I take a deep breath and let out a sigh. I am NOT a judge, and I am NOT the jury. I realize this family is coping in the best way that they know how. I look down at the baby one last time and touch his tiny face. This is not at all a great day. My decision to never work in this area of nursing is sealed, and my admiration for the nurses who do has just been kicked up about a hundred notches. I have never been so glad to have a rotation end. The lessons I have learned about not judging others has been seared into my heart. You just never know. My journey begins! For the rest if the story, see Go to Nursing School? NEVER!! Ch 1 Culture Shock & Big Girl Panties - Ch 2 Pretzels, Puppies, and Physical Assessment Ch 3 Tales from the Crypt....uh.... I mean Clinicals. Ch 4 Give me a BREAK!! Ch 5 RN: Judge and Jury Ch 6 Virtual Reality Ch 7 Avoid Kids at ALL Costs! Ch 8 The End of the Tunnel...Holy Cow - is that LIGHT?! Ch 9
  15. Found this on my classmate's facebook page! Enjoy!
  16. retired_prtygirl

    On Being a Nurse By Destiny

    I graduated in 2006, from a prestigious school in the Philippines. I was a humdrum student then, not very booksmart but I made grades good enough not to get kicked out of my college. I passed college and proceeded to taking the NLE. I was lucky to pass that exam as I remember it was pretty difficult for my brain but voila! Luck. Most Filipinos are well aware of the 2006 board exam leakage, so if you took the exam during that year, you have three options, Just trust your original exam and hope that employers both in the P.I and abroad will not take notice of Take a quarter of the exam where there was a leakage on Take the whole exam again. My friends decided to take the whole exam again and dragged me into it. I was working full time as a nurse then so I did not have the time to study my bum off . I prayed to God that if I don't pass this time, that means I'm not meant to do this thing. LO and behold! I passed again! I was like okay I'm meant to do this. Two years later, as I was going back to the nurse's station, I passed the staircase and I had that thought of just running away from the hospital. I realized, I did not want to do this anymore. I was always tired and going to work started to feel like it was a chore that I did not want to do. I was reviewing for IELTS then for plans of going to the UK for a greener pasture. I got the NURSE burn out. The next week, I applied for another job. I decided to try to become a Flight Attendant. My older sister was a F.A. already so I was interested. By another whip of luck I got accepted , It was a tumultuous journey, I was not in great shape, my hair was blonde when my natural hair color was dark brown (I had to get it colored the day before the open day) I was fairly short compared to many but out of 14,000 aspirants only 15 was accepted for that day, I was one of them. My life decided to go to a different path and then again, I thought, I was meant to do this! screw being a nurse. In less than a month, I flew out of the country to venture on my new found path. I am now a flight attendant, I will love this job and this is what I was meant to do. or so I thought..(again) So there I was travelling the whole world for free, visiting places I never thought existed and see. I was having breakfast in London, lunch in Milan, dinner in Berlin. (This was a line from my previous airline to pull in some new applicants which was true just not on the same day.) In my days off, I would party like there's not tomorrow, live like nothing's gonna stop me. I get to experience how to live like a princess in some points, I did extreme sports, traveled to great destinations using my 90% off tickets, shopped like crazy, spent on shoes purses, jewelry etc and I did not save anything thinking I'm gonna be like this forever, I was selfish and I just thought about myself. I'm meant to do this, this is my destiny. Then a crazy thing happened. I got pregnant. In the country I was residing in, it was great deal if you're not married and you've got a bun in the oven. Rumors were if they found out you were pregnant and unmarried, you will be sent to jail, will have 100 whiplashes on your back, keep you in until you give birth and put your child up for adoption. Imagine the stress of keeping my baby in secret as I needed a month to fix all my stuff for resignation. I was showing when I left. I wasn't aware that I was pregnant until almost two months (what a nurse), I had my tight uniform adjusted twice to hide my belly. I made it back home to my lovely Philippines safely. So me and then BF decided to go back to the country as his work was still there, we made all the necessary paperwork and we forgot one thing. We still weren't married and we are not allowed to be staying in one house as the country law states. We needed to get married, I did not want to ever get married though. The thought of it gives me chills through my spine. But things change and Love does really make you do crazy things. We got married in the US as my husband (now) is an American. Plan was to get married, send paperwork to the Muslim country, go back there when were approved and my career would be a question mark. That never happened. My husband also tried to get work here in the US and by some weird luck again he got one and he got it fast. After making the necessary adjustment, we decided to live here and I felt like I needed to be a housewife. For two years again, I was the dainty housewife, learning my way from zero. I don't know how to do anything. Laundry, Ironing, cooking, taking care of the newborn, being a wife, its all new to me, everyday I feel like my head is going to explode because I have no idea of what I'm doing. I'm so clueless that there was a time burned the upholstery of our couch because I used an iron to dry the wet stuff on it. My self esteem was at it's lowest, I was losing my baby weight slower than usual ( even though I was breastfeeding), I feel ugly most of the time, I felt worthless. I felt like I wasn't doing anything with my life. I was never inside the house this much. When I was asked what do I do for a living I would always say, I'm a bum, I don't do anything. But one thing that I keep on forgetting is that being a mother is a task and a blessing. There are no day offs. Its a continuous process and seeing your baby smile and laugh and be the best he can be is comforting. More than any job can offer. I can't even believe I'm saying this because well, I never thought it would happen to me. Even though I've already settled in being a housewife, I never lost that itch or drive to be something else. I wanted to become a 2.0 version of me all the time. I wanted to become a better me, a better mother , a better wife and a better person for everybody else, I want to help and touch lives again. As I was thinking these thoughts, what better way to upgrade myself other than being a nurse? After all I'm still a nurse at heart, its just I've become rusty and clouded. I feel its still there. I decided to take the NCLEX. I studied for almost a year, on and off, studying, juggling my way between taking care of my child and being a wife. And also losing weight. It wasn't easy. One of the most stressful events in my life. NCLEX was a toughie, I had to learn and relearn all my principles and rationales, I had no nursing experience for 5 years prior to this. my head was blank. and I was questioning myself am I really meant to do this again or am I just pushing it. Starting from step 1 all over again, I inched my way back to the world of Nursing, my first love. I had sleepless nights, weeks. I had to study at night when everybody was sleeping and all the chores were done. There were times I just couldn't do it, since things just kept on happening. I had to wait for my paperwork from the P.I to be sent here which took months and then one day I applied for my ATT, got approved in less than a week, I had to take my NCLEX in less than two months. I was armed with nothing but a Saunders and Mnemonics book.I prayed again to God, If this was meant to be, I will be able to pass. I took the online Kaplan Course for the last month before NCLEX. IT wasn't cheap but it was definitely worth it. It was a big help. Most of the Qbank questions are NCLEX like compared to the other review materials I found. Everyday I was answering more than a 100 questions, I'm a fast test taker and I finished the Qbank a week before my exams. And I was like what am I supposed to do now. Nothing but pray and hope that things will turn out like how destiny planned it to be. The day of the exam, I got there early and settled in early. I was ready but not ready. I was ready because I'm tired of reviewing and I just wanted to get it done and over with. I wasn't ready to fail though. Took the exam with whatever brainpower I've got and found myself crying in the middle of the exam. I have no idea what these questions are about. I'm doing horrible. 75 questions rolled in. and the screen didn't turn blue. I turned off the number counter and just endured the hard questions like I'm Thor. I lost track of the numbers and then it just shut off. I feel like it was a 100 since I checked it at 80 something. I took off with a heavy heart. ready to tell the world. I failed myself. Almost a day had passed and I did not want to do the PVT trick. I felt like it was just going to increase my anxiety at that point, I'd rather see the real results from the quick results than rely on something that's just a trick. That I night I dreamt of opening my quick results on Pearson Vue. when I clicked submit, the site says "worried" not pass or fail. My brain works in funny ways to mock me. Here comes Saturday the day of doom. I sat in my front of my computer, took a deep breath and whispered a silent prayer. I prayed to every single religious entity I can think of. Jesus, Buddha, Allah, the Gods of India. My husband was holding my hand as if were waiting to become Powerball winners, we clicked submit together. I was covering my eyes then. Then I fell to the ground. PASS. I thanked everybody who prayed and encouraged me that day. MY husband, my almost two year old son, though he just wasn't the best study person to be with( he wants to play all the time) Kaplan, Saunders. It was again a stroke of LUCK for me. This vocation is still in my veins, runs in my blood. Im still a nurse! But this was just the beginning, as I haven't practiced for my than 4 years, I needed to take a foreign refresher course for six weeks in order to obtain my US RN license but all is well and done. I'm going to embark on my sort of new journey with high hopes and tons of Luck as usual. Thanks for reading my uber long story, hope this will bring good vibes.
  17. I hold the name tag in my hand and look at my photo. This is one of the rare good pictures of me, and I am finally ready to put it away. My days of clinicals are over. I fold my labcoat over my arm and walk out the hospital doors. I glance up at the cold November sky and take in a deep breath. What is this strange air I smell? Oh! FRESH air!! It's been a while - crammed inside 24/7 studying, or writing...or crying and screaming into my pillow. I am done! My exit HESI is behind me, my last exam and assignment completed and PASSED, and my graduation application has long been in the hands of authorities that will bestow my long coveted diploma. I have sent out my graduation announcements and have been planning my graduation "Tiki" party (my university is the "Islanders"). My husband will soon breathe a sigh of relief, and my kids will be so proud of me. I feel like I am in a dream. I think about some of my classmates that are already planning on when they will take their NCLEX. I am determined that no one will know when I am taking mine, because I don't want to tell anyone if I fail and have to retake it. I can't believe that after all that I have been through, I still maintain doubt in my abilities to pass exams....I wonder if that will ever change? I have been offered a job at, of all places, the children's hospital (if you recall from my previous chapters, I got out of EMS to avoid working with kids ever again). Somewhere along this journey, I found that working with kids, in fact, was exactly where my desire was at. So, with gratitude, I accepted the offer and was to begin the Pathways Program the first of the New Year. I walk slowly to my car thinking of my journey. The long days replay in my memory. The tears - the heartache. I recall - with a smile - my professor who told me it was time to "put my big girl panties on". Bless her heart - she pushed me to success. I remember the panic I had when I failed my first exam ,and the time I finally accepted that I may no longer be a straight A student - even conceding that a "C is the new A" at times. I thought of my kids pulling up alongside me at the dinner table with their homework, and we waded through homework assignments together, both rooting for the other to make an A. I wondered if the laundry would now be done before we had run out of clean underwear, or if I would once again cook a meal for dinner - a healthy meal instead of sausage mixed with macaroni and cheese...I thought of my little next door neighbor girl who I mentor - she would come over and look through my nursing books as I studied and she would try to read some of the big words. I remember how she would look at me like I was a hero of sorts. As I pulled open the car door, I took that badge off of my labcoat and put it in my purse. I threw my jacket into my backseat, then got in the front and shut the door. I looked around to see if there were any other people in the parking lot, and seeing no one, I squealed and screamed as loud as I could, the tears of joy finally flooding my eyes and falling down my face. I DID IT!!! If anyone saw me, they would have thought I was losing my marbles! I thought of calling my husband and sharing the joy, but for some reason, I wanted to just hold onto this "ME" time for just a little bit longer. I looked out of my window and up at the hospital windows. How could I even describe this nostalgic feeling - I have no words... I start my car and pull out of the parking lot. I do believe it is time to go shopping...for my GRADUATION DRESS!!! A few weeks later, my parents come to town, and my husband has my little TIKI bar built. My daughter and her fiance have made me the cutest graduation cake (island theme!) and another daughter has painted me a huge plywood board photo booth to look like a sunset on a beach. I am so excited for my TIKI party in December! Everything is planned and ready. Now all I have to do is get everyone in the car to make it to the dinner reservation we have before graduation. As we sit at the restaurant, my daughter informs me that her necklace broke and she just has to run over to the jewelry store before we go to the school. I am kind of put out and tell her that we can go later, but all of my kids gang up on me. So after we eat, I tell the rest of the family to go on to the school, I will wait in the car for the kids while they go into the store and get the new chain. I am rushing them. When they are done, they get in the car and I rush to the school. We are not late, I am just excited to be with my cohort. Dawn and Rhonda will be there - and they will also come to the party later! I have never even seen Dawn - she lives about 5 hours away, but through our eline classes, we have become good friends. Rhonda lives in town, so we have met several times. I park and start to gather up my stuff before I open the door. Before I get out of the car, my kids say, "Mom, we got you this graduation present!" They hand me a jewelry bag and I pull out a necklace with a pendant "RN" on it. I start to cry. Inside, I give my family a hug before they go sit down. I hold my dad especially close as I hug him - he had a severe stroke a year before and the first words he spoke after he was able to talk were to me as he held my hand and slurred a question to me, "Did you graduate yet?" He thought he had missed it, and there were tears in his eyes. Now, my graduation cap is decorated with "4 U Dad". There is a lump in my throat and I try to swallow it down. I am thrilled my best friend Rachelle and her family has come to see this. I am so proud of this moment - and I am overjoyed to share this time with my family and friends. Finally, we are lined up and we walk into the auditorium. My heart beats out of my chest. And as my name is called and I walk across the stage, I am sure there will never be another moment in my life that will feel like this moment. This is what light feels like! My journey begins! For the rest if the story, see Go to Nursing School? NEVER!! Ch 1 Culture Shock & Big Girl Panties - Ch 2 Pretzels, Puppies, and Physical Assessment Ch 3 Tales from the Crypt....uh.... I mean Clinicals. Ch 4 Give me a BREAK!! Ch 5 RN: Judge and Jury Ch 6 Virtual Reality Ch 7 Avoid Kids at ALL Costs! Ch 8 The End of the Tunnel...Holy Cow - is that LIGHT?! Ch 9
  18. Julie Reyes

    Virtual Reality. Ch 7

    My community class will be done different from the face to face students, since I am an eline student. I still have to go to do some clinicals, but the daunting task in front of me is to create a virtual community in which I will be the health nurse. Give a writer the task of writing - yay! Give a girl who has been banned from balancing the checkbook the task of creating a budget for my community health center....oh no!!! Fortunately, I don't have to face this mountain alone. I have two incredible sources of ammunition in my field. Dawn and Rhonda. Where one of us was lacking in understanding or 'how to' knowledge, the other one of us had plenty! We send each other our "virtual island tourist information" pamphlets, we proof read and critique each other's plan, and we crank about how impossible this task seems! Rhonda was off and running with her budget. This girl - the coupon queen of clinic budgets - should really be in charge of the country's deficit and she would whip it in shape in no time. I am not sure how she did it, but I wanted to ask her for a job application. When she let me proof read her budget, I went to my assignment - the part I had completed - hit "ctrl A", then hit "delete". There was no way I could pass with the dribble I wrote if this was the stuff that Rhonda was going to turn in. Except for the budget portion of my virtual clinic, I really like this assignment. Probably because I am creating my ideal vacation spot. Warm climate, laid back pace, lots of sandy beaches with those in the sand beach chairs and a waiter who brings you free drinks, brightly colored sailboats in clear turquoise water, white fluffy clouds, lovely civilians who have the cutest little shops, amazingly inexpensive - best food in the Caribbean - restaurants....my plan is to make it such a calm and relaxing place that no one will ever need a health care clinic.... When Dawn read my description, we decided it was time to plan our post-graduation cruise to the Caribbean. That girl has more energy than anyone I know! I think she is ready to book the cruise - I am pretty sure she has all of the fun stuff planned out. Undoubtedly, we spent way too much time discussing our vacation than we should have! This girl makes me laugh so much! I am glad that we all have each other to bounce ideas off of and sharpen each other - I think they make me a better student. That being said, I realize I have created a clinic that is not needed - because nothing bad ever happens in paradise, and that's ok with me; however, a virtual clinic that is not needed will not fly with your real life professor. I am instructed to go back and edit my perfect world and actually work in my virtual community as a nurse. I don't know about anyone else, but receiving these instructions from my professor really burst my bubble. Well - not really - I just hoped I could get away with it.... So, after much discussion with my partners in crime, I come up with some very real solutions to providing my virtual community with health care. I guess it only makes sense that there are going to be some real health issues that will take place in paradise. So, my clinic will provide the routine immunizations, prenatal care, well baby check-ups, and all that...but for all those tourists, I included first aid for those drunken brawls in the local night clubs, advanced life support for the retired folks who may have an acute MI, and lots of fun stuff like that, where maybe I will need a nurse practitioner on board. ....and in doing this amazingly hard (but fun) assignment, I realize that I could have never done all of this without my friends...and I am almost certain my journey into nursing may not end with "RN" behind my name, but maybe - just maybe I will go a little further. How did your friends help you in school? Did you ever have a class that changed your perspective and plans? My journey begins!For the rest if the story, see Go to Nursing School? NEVER!! Ch 1 Culture Shock & Big Girl Panties - Ch 2 Pretzels, Puppies, and Physical Assessment Ch 3 Tales from the Crypt....uh.... I mean Clinicals. Ch 4 Give me a BREAK!!!! Ch 5 RN: Judge and Jury Ch 6 Virtual Reality Ch 7 Avoid Kids at ALL Costs! Ch 8 The End of the Tunnel...Holy Cow - is that LIGHT?! Ch 9
  19. I sit in my car outside of the hospital where I'm doing my second term clinicals at. Tears are just rolling down my cheeks. They won't stop. In LVN school, we have 13 week terms. This is only week 7. The tears increase with this sudden thought. I cannot do this anymore. I want to drive to campus and quit this very instant. Instead, I drive home through the tears, remembering the horrible 7 weeks I've had... The last week of Term I, we all received our clinical assignments. I was so excited! I got the clinical instructor I was hoping for, at a site I was hoping for, life looked like it was going to be great in Term II. We even started at an acute care facility this term. I was tired of the nursing home. The first day comes. The group I'm with is different. All of them older than I am, except for two new girls who were restarts. I befriend them. There's all the wonderful paperwork, and video watching that comes with orientation. Then our instructor has us write down some things she wants us to know and use this term. She goes on to tell us how our day will work. I think I can handle things. She tells us that we'll rotate through Cath lab, ER, OR, GI lab and radiology. I leave feeling confident. That was the only day I felt confident. I started off the best I could. Introduced myself to the patients as soon as I got on the floor. Vitals, AM care. I read the charts completely. I knew my patients inside and out. I even went above and beyond what was expected of me. I would write out every abnormal lab, every medication, and learn all I needed to about both. I checked on my patients every half hour or so. I helped out my fellow student nurses when I could. Stayed on top of my paperwork. I was working so hard. I'm not exactly sure when my instructor started hating me, or if she disliked me from the beginning. But she broke me. Any answer I would give in pre or post conference would be wrong, or not good enough. But any other student who said what I said would be right. If I was passing meds that day, she would rush me through med confession and then accuse me of not knowing my medications. She always gave me the most complicated patients, which for a while I took in stride. I figured I was getting more experience. She would not allow other students to help me, but I was expected to help them. Checking on my patients every half hour wasn't good enough, she wanted me in a patient room at all times. I never rotated to any specialty. She would barge in on me when I was bathing or changing patients, and have a complete disrespect for my patients dignity. While I was doing AM care with one patient, she would go to my other patient rooms and find things wrong with them, then chew me out in front of all the staff after. The day I sat crying in my car in front of the hospital was one of the worst. By this time I knew she hated me. I still wasn't sure why. But she did. The patient load she gave me that day was just like any other. One total care, one was a custody patient (I was the only student to receive those, go figure), and one who had stasis ulcers on both legs and ulcers on the toes. I was to do wound care with her watching me. I asked the student leader to be there as well, for moral support. I gathered my supplies and headed into the room. I let the patient know I would be changing his dressings and asked him if he needed any pain medication. The patient was a dear old man, sweet as could be. Everything was set. I went and got my instructor. I set up and began. She stood there with a horrible look upon her face, as she always did when she was with me. I went through each step, talking with the patient while continuing. I got to a point where I was slightly confused about how to put on the medicated strip. I told her as much, and asked her how I should apply it. She just stood there. Didn't even respond to my question. My patient was also expecting an answer, both of us looked at each other and I just tried to figure things out. The patient became more aware of my instructors attitude towards me and attempted to converse with her. She gave him very short answers, not showing any interest in what he was saying. I finished up about 10 minutes after I had began. I will never forget what she said. She told me it took me too long to do the dressing change, that I was unprepared and I shouldn't be allowed to do procedures, period! She stormed out of the room. I stood there, in shock. I began to shake, out of pure humiliation and anger. I felt like an utter failure. The student leader looked at me and told me I did everything by the book. The patient tried to console me, he told me that I did a better job than most of the staff nurses before me. He even asked me what was wrong with the instructor! He couldn't believe an instructor would treat a student, let alone a patient, like that. I worked hard to maintain composure in the room, and throughout the rest of the day. When I arrive home that day, I thanked God for getting me there safely. I called my step-mom who is an RN and explained everything that had gone on in the past 7 weeks, topping the story off with what happened today. She talked me out of quitting, and told me some clinical instructors were just awful people. The next 6 weeks weren't any better. I still was kept on the floor. The charge nurse came to know me well. She even bragged to my instructor about how much progress I had made. My instructor just muttered something under her breath and walked away. She would call the director of nursing to come to our site weekly, for the main purpose of making me seem incompetent. I was accused of a medication error, which wasn't an error at all. The review she gave me at the end of the term was absolutely awful. By the end of the 13 weeks, my confidence was completely shattered. Term III started the week after. I was at a site which was about a hundred times more difficult than before. The patients were what we called train wrecks. Multi-system failures, diseases I'd only read about in textbooks, and more! How could I survive this if I couldn't survive the less complicated patients before? My confidence was gone and I had two instructors to impress this time around! Because of the way I was treated during my second term, I made sure I was always on top of everything. Meds, AM care, vitals, team work, documentation... while some students were struggling to finish up charting before post conference let out, I was done hours before we even started. I was doing everything I could to stay off the radar of my instructors. I just wanted to finish the term in peace. By the time mid-term evaluations rolled around, I was expecting the worst. I had never received a good eval, why should I be getting one now? My main instructor called me in, and I sat down. She looked at me, and asked me flat out how my second term was. I was a little confused by the question, but I told her. After I was done, she looked at me and smiled. She told me that she could tell that I tried to avoid her when at all possible, and had been curious as to why. Now she knew. She pulled out my evaluation. She proceeded to tell me that I was the best student nurse she had ever seen. She was highly impressed with everything I had done so far, my extensive knowledge of medications and lab values. The other instructor was impressed as well. Apparently she had a few complaints about every other student, but not me. I was floored. I was good? It was in that moment that I realized I was going to make it. My previous instructor, as horrible to me as she was, gave me motivation to be on top of everything, know everything about my patient and try to be the perfect student nurse. Even though nothing was good enough for her, she turned me into the best student nurse I could've possibly been. It was the worst 13 weeks in LVN school, but out of it came something positive, I knew how to be a good nurse. I think about that instructor from time to time. Because of her, I have the confidence to tackle just about anything a patient throws my way.
  20. Hello students, Here are some questions I have been asking myself: Do you get any orientation to the unit other than just showing up? Do you need to go in early or the night before the look up your patients and their meds? Are you expected to understand what procedures or disease processes or injuries are going on with the patient? Are you told how to comport yourself on the unit to get the best possible clinical experience? Are you aware that nurses do not receive extra pay to have you follow them around? Here, in my humble and entirely personal opinion, are some ground rules for nursing student hospital clinicals that would make it better for all of us: How To Get The Most Out Of Your Clinical Experience STEP 1 Introduce yourself to the nurse you are following!!! Yesterday I had one student in the morning and a different one in the afternoon. The one in the afternoon just appeared nearby and then followed me like white on rice for the rest of my shift. She never said one word to me, not even to introduce herself. Also, tell us how long you will be there and let us know when you are going off the floor. If you are leaving early because it's blizzarding outside, let me know that too, especially since you said you wanted to watch me do my shift assessment and now you are nowhere to be found. STEP 2 Tell us where you are in your program and be prepared. Yesterday my morning student asked me if my sedated, intubated patient was sleeping. As far as I'm concerned, if you are ready to have a clinical in an ICU, you should understand about how intubated or otherwise critically ill/injured patients are managed. She didn't know anything about the patient's history, condition or meds (she told me she hadn't even looked them up before coming to clinical). Sometimes the morning student is ready to graduate and the afternoon student has never been in the hospital setting before. This makes a difference in what you know, and it can help us to decide if we are letting you get anywhere near our patient. STEP 3 Go ahead and ask questions, but don't do it in front of the patient or their family. Nursing in the real world can be different than what you are learning. Not that you shouldn't have high standards -- you should, and so do I -- but if you think I'm doing something wrong, do not call me out in front of my patient/family. It will piss me off, especially if you are wrong (and you probably are, or at least you don't understand the whole situation). Also, I am busy, so do not monopolize my time with questions. If you have a lot of questions, perhaps write them down and ask your instructor later. STEP 4 It is not the job of the nurse you are following to find you to tell you about a learning opportunity (i.e., when you are parked at the nursing station or went on a break). If you want to know what I am doing, follow me. I will be happy to explain what I am doing, but only if you are there when I am doing it. You should do your part by being prepared to care for the patient, understanding what's going on with them, etc. STEP 5 Don't be in the way. It drives me crazy when I need to sit at a computer at the nursing desk to print discharge instructions or, well, anything, and all of the computers are taken up by students. The nursing desk is for work to be done. I know you need to do some school work on the computer, but pay attention to what's going on around you and concede your seat or your computer to someone who is actually there to do work. STEP 6 Help out if you can, and communicate with the nurse. Have a helpful attitude and ask if there is anything you can do to help. However, don't do anything with patients without the nurse approving it ahead of time. For example, if you want to give morning meds to a floor status patient with your instructor, I will probably be fine with that if you let me know first. I will also probably be happy to have your help with a patient bath, repositioning, playing with an unaccompanied child, etc. BUT STEP 7 Don't ever do anything with a patient unless the nurse responsible for them has cleared it. Once I had a student who went ahead and gavage fed my NICU baby because I was 10 minutes late for the feeding while busy with another patient. This was NOT okay! STEP 8 Do not stare at the patients like they are zoo animals. I had 3 female nursing students standing at the foot of my teenage male patient's bed. I was going in and out of the room doing some things and they just stood there and stared at him. How would that make you feel if you were that patient? Also, as noted above, you should be with ME if you want to know what I am doing, what supplies I am gathering, meds or lines I am preparing, etc. Not all nursing happens at the bedside. I realize this sounds like a long vent, and I guess it is. However, I really think that students will have better clinical experiences if they consider some of these guidelines. Obviously, I was once a student nurse years ago, so I have been in your shoes. I made some of these mistakes myself and now I can understand why the RNs I followed might have thought I was a pain! I have worked with some really great students over the years, and common among them was that they were professional, helpful, positive and prepared. You are going into a profession where much is expected of you, but where the rewards are tremendous. You owe it to yourself to have the best possible clinical experiences to prepare for your future career.
  21. Julie Reyes

    Give me a BREAK!!!! Ch 5

    You can only study so much before you go crazy, it seems. The words on the computer blur in front of me. I have done 200 plus questions from the NCLEX study bank to review for my upcoming med surg exam, and my mind is mush and my butt is numb. I need a break! I decide the one thing I really want to do is to mow the yard. I know - I need to get another hobby! But I like to be outside, and because of this, I am always reevaluating my call to be a nurse (and being stuck indoors when I love to be outside doing any type of yard work). I take off my pj's and exchange them for shorts and cowboy boots (ok, remember, I am an eline student, so I can study in my pj's all day - and I live in the country in the middle of nowhere, so you have to watch out for snakes when you go outside in Texas!). I grab the keys to the shed and head outside in the blazing heat. I am well equipped for my task with my baseball cap and mp3 player blasting tunes from the 80's. I open the shed and am disappointed to find that the riding lawn mower has 2 flat tires. Not to be defeated, I pull the push mower out of the shed and fill the tank with gas. I begin the fun of mowing my 1+ acre lot listening to "Wake me up before you go-go", and possibly skipping - looking much like a NERD bird wearing boots. I am happy - life is good! About 45 minutes into my workout, a rattlesnake slithers out of the grass in front of me and I freeze. I watch it move about 10 feet to my right and I think, "Oh, I gotta kill that!" I scan the distance between where I am, and where the shed is. I will lose the snake if I run for a shovel....the only weapon available is my mower! So, I give chase. Just picture this - me with my bony stick legs stuck in oversized cowboy boots wearing shorts and a tank top and my "John Deer" baseball cap, running all over the yard pushing a lawn mower in the same pathway the snake is moving. I swing right, then left, then right. I look like a crazy person high on LSD running from hallucinated flying monkeys.....You get the picture. I can just imagine what anyone might think if they drive by..."boy, that girl REALLY LIKES TO MOW HER YARD!" My mp3 blasts "Girls just want to have fun" (or was it "don't fear the reaper"..!?) and I am frantic to run over the snake - and frantic that I might run over the snake! Would it's fangs sling out from under the lawnmower and propelled into my meatless, bony legs??? Will I die from "rat poison"??? I may need to think this through a little better, but I really don't have time to debate! I HAVE TO KILL THAT SNAKE!!!!! I chase this horrible, venomous creature all over the yard and I cannot catch him. He is going to get away, and my kids and pets could get hurt if I don't kill it! He moves super fast and is on his way towards the driveway. I think, "Oh now I can get it easier!" (I have no idea why I think this - that is just a stupid thought).... But no...instead, this demon from the pits of hell (I HATE SNAKES) makes its way up the tree! It is at this point that I decide that my kids won't be allowed to climb the trees anymore! I never knew that rattlesnakes could climb trees! I guess I never thought about it, but the thought gives me the heebie-jeebies! Anyway, I finish up my yard work (keeping an eye on the tree at all times), trying to make the zig-zags in the grass into straight lines (wow, I was a lawn-mowing maniac - it looks like I mowed while a drunken mess trying to pass the sobriety test). I am happy to take an ice cold shower and attack my school work again. I decide that mowing the yard might need extra equipment in the future, and I am wondering if I have a holster and should carry a pistol....("you're my FAVORITE deputy"!)....(ah, Disney!) I am actually happy to be back inside, in the cool, and in the safe company of my nursing books. Ironic, actually, because I always thought it was going to be nursing school that killed me!!!!! It occurs to me - there might be safer/smarter ways to deal with study fatigue...How do you break the monotony? You might just save my life!!! My journey begins!For the rest if the story, see Go to Nursing School? NEVER!! Ch 1 Culture Shock & Big Girl Panties - Ch 2 Pretzels, Puppies, and Physical Assessment Ch 3 Tales from the Crypt....uh.... I mean Clinicals. Ch 4 Give me a BREAK!!!! Ch 5 RN: Judge and Jury Ch 6 Virtual Reality Ch 7 Avoid Kids at ALL Costs! Ch 8 The End of the Tunnel...Holy Cow - is that LIGHT?! Ch 9
  22. Follow my journey through nursing school - read Go to Nursing School? NEVER!! Ch 1 I am 43 years old. I have 4 kids - 2 in college, one in high school, and one starting 8th grade. I am on my second marriage, so the 4 kids I mentioned are mine, and my new husband brings in 4 more - 2 out of high school and 2 still at home. We have a lot going on. Football, soccer, track, band - extra-curricular activities for the kids means extra-curricular activities for me. With nursing school starting in the fall, I drop all of my odd jobs and focus on the kids and my one summer prereq course - pathophysiology. I am floored when I get my book from Amazon - or whatever site I got the textbook from. It is bigger than the family Bible! Anyway, I dive right into my class. Since I live an hour away from the university I am attending, I am doing all my classes online. Nursing school - eline... I am not sure this is the smartest decision I have ever made, but I am not working, and gas is near $4 a gallon at the time. Everything is expensive and we are short on money. With 8 kids - oy - we have to save where we can! The professor for my patho class is a doctor in the emergency department at the hospital I want to work at when I am done with school. He is really an amazing professor, and I am learning so much in the class. I don't have to study that much, because he is so great at the powerpoints and lectures that are posted. (Unfortunately, this professor is so great, and I am learning so much from his online lectures, that I set myself up for a rude awakening in nursing school!) Fall is here - the long awaited time to begin my first nursing classes. I have spent an enormous amount of money on the "required" textbooks - most of which I will never use in nursing school at all! I am a little shocked at how unorganized the eline program is. No set due dates, no set exam times. It is a semi-new program for the university, so I suppose they are just working out the bugs. However, the disorganization leaves me in a state of confusion. Adding to my disappointment is the fact that none of the classes are like my patho course! I dive into my classes (pharmacology, fundamentals, theory) and I drag textbooks to football and soccer games and read when my kids are not playing or... marching/drumming/or anything I should be cheering for. I have no clue how to study - I think I have been "winging it" until now, and from the syllabus for my courses, I am not going to be able to float through these classes anymore. So, I do what I think I should do - I highlight every single word I read...on every page. I should have bought stock in the highlighter company. Um...is it excessive that I have just highlighted all the pictures too - just in case!?! This is the part where I turn into an insecure whiney brat. How is it that the words in the pharmacology book are written in another language? Well, maybe it is English, but OMG, seriously? I don't have a clue what I am reading. That being said, I have become a thorn in my professor's side. I email all of my professors constantly, begging for clarification, explanations, and "please spell this all out for me" type of emails. I need someone to hold my hand so that I can make it through this! I have suddenly discovered that this nursing school business is for the birds! Apparently, nurses have to know more than just how to wipe butts and give shots....and it seems that the Board of Nursing is determined to make sure nurses know a lot about, well, everything! It is impossible, right?! With my first exam looming, I have developed intense heartburn and incredible anxiety! I am snippy and snooty with my family - I have no patience for anything or anyone. I am just not cut out for this! How in the heck is nursing school so hard?!?! My first husband was right when he said I am stupid and not smart enough to go to school - just like he always told me. This is really hard - I can't do this! I am FURIOUS that he might be right. I put off my first exam day after day, which is easy since there is not a deadline to take it. As I stare at the yellow highlighted pages in my pharmacology book, I think, "Just take the stupid exam!" I will never move on if I can't get passed this. I am terrified of it. I have no idea what to expect on it, I have no idea what I should know. What more can I do - I have studied all I can - well, I have read all the pages that didn't make any sense anyway. I put away my notes and my books and log onto the site to take the exam. One question after another "you gotta be kidding me" question. Um, I don't think that they took these questions from MY pharm book. By the end of the exam, I am in tears. I have no clue what just happened, but apparently, I got the wrong textbook. I submit my test and stare at the screen. My score comes up and I got a 58. OMG, I failed! I close my eyes and put my face in my hands. I am at a loss. I send a plethora of panicked emails to my professor. One after another, and another. I am not ever going to be able to get this - how the heck am I supposed to understand any of this...this STUFF??? I have NO clue how to study! My professor for this class is NOT teaching me! My patho professor was so good and this professor is ... well, is NOT my last professor! I whine the rest of the night to my husband, who patiently listens to me and then tells me for the first of hundreds of times, "If it were easy, everyone would do it". My kids can't believe I failed an exam, and I mentally see them slapping high fives to each other for all the times I have scolded them for any time they have ever received a poor grade (although they really were NOT doing that). Ugh, now what?! The next day I am still wallowing in my pity party when I received a reply email from my professor, who has apparently had enough of my "poor, poor me" helpless attitude. "Dear Julie, it's time to put your big girl panties on and get down to business" ("to defeat the Huns" - I always have to add those words when someone says that. Is it just me or do you do that too?). In hindsight, that was the BEST thing anyone ever told me! She totally snapped me out of my pit of despair! Somehow, I was able to pull myself up by my bootstraps and figure out this studying thing. I connected with others in the eline nursing program who helped me learn how to study and work through the coursework (God bless you Dawn, Rhonda, Erin, Lesley, Erica, Sarah, John, and Annie). I threw out the highlighters and I quit believing I could NOT do it and started believing I WOULD do it. I was able to finish my first semester with 2 A's and 1 C (it is hard to come back from a failing exam grade)! Hey - if Mulan can do it...! Somehow - those seemingly harsh words in the email from my professor made me look inside myself and find something I never knew existed - resolve, willpower, and endurance; the ability to overcome adversity and rise to the occasion - a skill that is needed by every successful nurse. I learned to quit whining and start working toward my goal. The road to nursing is hard, and it is a road less traveled, but like my husband says - it is was easy, everyone would do it. ....and I realized, this "big girl panty" thing - it rocks! My journey begins!For the rest if the story, see Go to Nursing School? NEVER!! Ch 1 Culture Shock & Big Girl Panties - Ch 2 Pretzels, Puppies, and Physical Assessment Ch 3 Tales from the Crypt....uh.... I mean Clinicals. Ch 4 Give me a BREAK!!!! Ch 5 RN: Judge and Jury Ch 6 Virtual Reality Ch 7 Avoid Kids at ALL Costs! Ch 8 The End of the Tunnel...Holy Cow - is that LIGHT?! Ch 9
  23. I'm in an accelerated "leadership" program (as they sometimes put it), which has us taking frequent ATI tests on top of classes. If you don't make the mark they want on the ATI, you lose 1-2 letter grades in the respective class. (Apparently it used to be that you outright failed, but they changed it so that A students who screw the pooch on the ATIs can keep going.) It's only the end of the first semester, and I've already hit a burn out point. I've lost my drive to study, and am despising classes. Don't get me wrong, I've been doing well and I LOVE the clinicals. I love getting to know my patients and helping them. I love all this hands on learning. Furthermore, I love the people in my cohort and most of my professors. They're smart and just good. It's a pleasure to be among them. But despite all this, I'm having a hard time focusing on studying. I've lost my drive, my love for the actual program. I hate that I have a 97 in patho right now, but there is a serious chance I will end up with a B since I haven't been able to get good studying in for the final. (And it doesn't help that our new and vague professor added 5 additional chapters right at the end before the final. And why in the world can't we download your ppts? I don't get that. And why do you quiz us on your lecture material before the lecture? I get that you want to make sure we pre-read, but it seems antithetical. And don't get me started on all the students I've seen come out of your office, wholly disheartened and questioning their career choices after one of your "pep talks".) I can't even study for that final right now because we have an ATI right around the corner. I basically have to choose between the two - in which do I want to keep an A, and which will I dangle over the sacrificial pit of B? And I hate some of these stupid ATI questions. Who cares if requesting a new antibiotic from the pharm is "fair, responsible, risk taking, or creative"? I mean, really? How the frogger does this help us become better nurses? We get hammered with little assignments and things to learn that seem a waste of time. Graded videos that don't really teach jack. Required and timed online simulators that we have to pay for and that really don't teach jack. I need to be studying diseases and foundational skills, not memorizing arbitrary "levels of critical thinking" or "the eleven nursing attitudes". What a waste. On top of that my life sucks now. My wife and friends are going to festivals, having game nights and dinner parties. Meanwhile I go to bed at 9-10 and get up at 5 every day to study if not hit a clinical. I get offered gigs that I have to turn down because I can't confidently make the time commitment. (I was previously an artist.) My foreign friends chat with me, and I realize I'm losing some of my language skills but can't do anything about it at the moment. I get asked to reboot old language projects, which I would really love to do, but again can't commit. I get ideas for new projects, and just have to jot them down and hope for the future. I loved A&P. I loved my chem classes. I was a top student in all of those and it was because I loved the subjects. Going into nursing school, I was excited at the courses. Pathophysiology, pharmacology, psychiatry? Yes, please! But what I loved I now loathe, and despair that there is a year yet of this accelerated program to go. The result? I'm irritated pretty much most of the time, and I've lost muscle but am putting on plenty of fat. Pudge McMe. So I Googled, "I hate nursing school". The result? What came back was a lot of nurses who say they love nursing but hated nursing school. It was actually really good to read that. Thank you. I may be coming to the conclusion that As are not so important anymore. What's more important is health. And that means both eating better and getting to the gym more, and getting involved in life. But this is easier said than done. I am grad school minded, and I will still fret if I don't feel A-lvl prepared for exams. Making myself get back on a good diet and exercise routine shouldn't be too hard, but getting involved in artistic projects again while keeping my grades up will be difficult. On top of that, the men in my family tend to die young, heart complications, average age about 55, so if I look at this schooling and grad, especially if I have to sacrifice living, to use the term as an expression of happiness and exploration and all the terms we typically associate in positivity with living, I sometimes ask, "Will the later years be worth the 10%+ of my portioned seasons I am giving to these studies?" (I'm middle aged, to boot.) Or maybe I'm ignoring the bigger issues. Like that I had a cardiologist appointment because out of the blue I started getting heavy chest pains when I jog, or because that dizzying arrhythmia I used to get once a month or so is now almost every day. Or that a week ago, right when I was having the cardiology appointment, I learned my sister tried to kill herself and was hospitalized. Or that I tried to make three appointments at two different clinics to talk with someone about all this, and they never even got back in touch with me. Who does that? So yeah, I'm having a hard time concentrating. It was getting harder before, I was already losing the drive, but now it's just practically nonexistent, the will to study. But I have to. Positive notes: My sister is getting help. She rejected it for a long time, but she's now accepted she needs help and is getting it. Cardiology results are not yet conclusive. I was able to go on a good jog after taking a bunch of magnesium. And while on my father's side all the men die young, on my mother's side we have some pretty stalwart longevity. I have an awesome cohort. I love my patients and have enjoyed clinicals. There are still many options for the future. My gpa will be just fine if I relax and make a few Bs. I have the greatest wife, who loves and supports me no matter what. Breathe. Stretch. Smile. Focus.