The Clinical Journal Entries started as a clinical assignment but then turned into tradition. Unfortunately, we are back into the assignment mode, and that takes all of the fun out of it. It will start out as a copy-paste from Word (the doc I emailed my professor) and now I get to tell you how the day really happened (or at least my uncensored and way-more-fun version of it)
This is our geriatric/rehabilitation rotation. I signed up for the only section that was less than an hour from my house, a nursing home in Akron. A solid 30 minute drive at 6:20am for an instructor who wants us there prior to 7am because "these patients are already awake anyways!" Right.
Now, I love old people. I'm a sucker for grandparents, and I even enjoyed working on the Acute Care of the Elderly unit for my first-ever clinical rotation. Old people, the elderly, seniors... however it's politically correct to call them these days, are full of stories and have such varying personalities. They're just like us twenty-somethings, only a whole lot smarter with many more lessons learned. They're so easily stereotyped, while to them, we're probably just as easily stereotyped. The more you're around the people who hit their '80s, '90s, or even 100s (101 - like one of our residents!) the more you realize that they're just people like you or me, only their bodies sometimes get worn out from this life and they need extra help. That's all. Alzheimer's and incontinence aside, forget about the hearing aids and teeth sitting on the counter... Each and every old person in the world has a personality, interests, dislikes, memories, habits, values, and fears. And, like everyone else, they just want to love and be loved.
Studying the process of what can go wrong in old age, however, is a different case. We have clients, not patients. They're here because they, the government, or their families are paying for their stay. They're here to get better so they can go be good Grandmas again. They're here to play games and sing songs until they go across the river. They're here because they are a little forgetful and someone needs to help them know to take their medicine. They might be here because their spouse died, their family couldn't take them, yet they couldn't quite live on their own. And then some have colorful rooms filled with photos and banners and flowers and things from the home they will soon return to. See, it's a different kind of place. It has a distinct smell and sound, and yes, there are medicines and health problems, but it doesn't feel like a hospital. Instead, nursing homes seem like big dorms for old people. And I'm a nurse, just not that kind of nurse. Just when I was getting proficient with tubes, needles, systems, IV pumps, intricate computer charts... I get dropped off on the doorstep of an old people dorm and am told to make myself useful and take assessments and give meds, charting it all in 4" 3-ring binders . Hand-charting aside, those things really don't take long. But this does - this takes 10 hours on our feet, looking busy, and some weeks we will have alert patients, while some weeks we may not even have a patient who can talk back. I'm the busy-busy-busy nurse, the one in the group who just doesn't slow down, so this might be a problem. I foresee a lot of craft events and afternoons spent at the group "Dining Room Movie." If I have to feed a few people or clean up after them, that's okay, too. If I have to smile at a mean old lady or help him clean his dentures, that's okay, too. And if I get to do a dressing change on a stage 3 pressure ulcer or get to go with a patient to see how dialysis works in our (rare in-nursing-home kidney dialysis) center, then it'll definitely be a good day! I just don't like the smell of that place, especially at 7am, and I really, really, really don't like being bored.
Today was just orientation, see the unit, meet the staff, here's-all-the-assignments-and-final-paper-i-want-to-kill-you-with kind of day. So next week, maybe something will change or I'll have some sort of different opinion. Probably, yes, most likely. :)
Oh yes, and because this is an assignment, I must state 3 personal goals, one with a clinical focus, one with a gerontological focus, and one with a rehabilitation focus.
Clinical: To increase my patient assessment skills (...Seeing how one of the only things we are doing here is, well, patient assessments, lol)
Gero: To be comfortable with dementia patients (Because let's face it - they're scary. I had one when I student tech'ed at General and it was a BAD experience)
Rehab: To help a patient work on skills so he/she can return to home (Because we do have a few "acute" older people, and we all know that homes are soooo much better than nursing homes!)
My next journals will be on activities I did with residents or random things the syllabus wants us to do ("Make a list of stereotypes of older people"), citing a website that taught me more about my patient's condition, citing a journal regarding one of my patients... ya' know.... just the normal fabulous stuff the professors sit at home and make lists of because they have nothing better to do. All while reading about 4-8 (50 page-ish) chapters of 2 textbooks a week. (Well, technically 3 textbooks. The one was so big they had to make Vol. 1 and Vol. 2. Not. even. kidding.) Whoooo!!!
And I need to rant just a little more to get "today" out of my system, because I'm tired and was up too early and am crabby from being bored and so stressed... I would have guessed a nursing home would be on the warm side, but this place was HOT. We toured all 4 (or 5?) "units" and went on two different floors, all the different wings, and there was not one single cool spot beyond opening-wide a window or a door. So next week, other than coming in swim-scrubs, I have no idea what I'm supposed to do. I figured it would be rude to steal an "out of it" patient and turn on their room A/C. Definitely rude. And mean. Neither of which I'm into being. But it's like, we can put nice warm blankets and Snuggies and jackets on them, yet we are not allowed to take off any more clothing without violating some kind of rule or law. Yes I have a tank top under my scrubs, but will they let me walk around in that? No, because how un-professional! Yeah, well then get a thermostat that works, set it where normal people set it, and try that for professional!
And to think if this was any other day, I'd have my reason for doing this, the hope of the ONLY one thing that I fought through this much school for already. But it's funny... we humans are odd creatures. I'm still fighting and even the faintest hope of my reason is gone. So am I fighting for nothing? Probably. Uh-oh, I can't let my mind go that way. K, turn this way...
5. More. Weeks. Of. This... And I wish I could say I'm getting the summer off, but I'm NOT. I will be spending 6 weeks taking what I should have taken January through last week but nervous breakdown'ed my way out of.
If I can keep going at this insane pace, I'll be done in 1 year, 1 1/2 months, making my grand total... 6 painful years.
And then what? A nanny who just happens to have a nursing degree? God help me! All I wanted was a part-time job that I loved (which could be nursing, yes, could be this....) and to work because of want and not need, with the ultimate goal of staying home with my children. Somehow all of my dreams got really mixed up into the life I have now. Add a degree and a part time RN job, keep the nannying, and I have everything in the dream except the kids... The kids I pour so much into are kind of other people's kids. Oh, and a husband... I think somewhere in there the dream was being married first. Yeah, and that's a sore subject right now. But yes, he would be present because I would be working because I want to, not because I have to, right? Remember that part? Not sure how this knot of "dreams" came to be, or how to untangle it, but we'll get there... look around, assess, reassess... intervene when necessary. Follow the plan of the Divine, foremost. Stay on for the ride, because it's sure going to be interesting how this one plays out!
(Sidenote - Nurses, did you know that after 2015, the MSN is no more? The next step is the doctorate of nursing practice I think. I'm not sure if they're moving CNS NP CRNA, etc. up to PhD level or what, but the masters will cease to exist. The nursing board smartypants are doing the physical therapist thing where all existing MSNs will be "grandfathered in" but anyone wanting to be a grad student has to work to PhD. So my plan is, you guessed it, to start my masters the latest day in my life possible before I can no longer get "grandfathered" in for my MSN.)
Here is a paper I had to write regarding Ricki Lake's documentary, "The Business of Being Born." At least skim through to see the stats... pretty shocking!
I can't believe I've had it done since yesterday. It's no mystery I'm itching to get out of this semester. I can't wait for break. I need this break. Plus, it's Christmas, and I love, love, love Christmas! I can't wait to just relax with my family, friends, and fiance. :)
I cannot stop watching this video and wishing I was there! Nikki emailed it to me. :) We're a mildly obsessed with Disney World and the Magic Kingdom.
Next up, do you realize Christmas is less than 12 weeks away? I have no idea how I'm going to pull it off this year, you know, while I'm busting my butt in nursing school and trying to even just barely maintain sanity. I have a feeling lots of you are feeling the same way, and I'm loving Simple Mom who has a plan. 12 Weeks to a Peaceful Christmas. (Yeah I laughed too at first, but I think she's onto something!) First up, Week 12: Prepare Your Holiday Budget and great topics each week until Christmas. She has plans and downloads, and I think I might just be able to pull it off. I love you, Simple Mom!
For some cute pictures of pets in Halloween costumes, you have to check out Good Housekeeping's 3rd Annual Halloween Pet Costume contest. I won't enter Haylie seeing how much she loathes any form of clothing, but I wish I could! She was a ballerina one year, a pumpkin another... but she just hated it so much. People like my cousin (Hi Heather!) will love this site so check it out. A great time waster too. You know, when you have a huge nursing exam in the morning... yeah, perfect for that! ;-)
Well last week was nuts, this weekend was packed (I took Nikki to the Taylor Swift concert - got floor tickets for her birthday), and this week is going to be no calmer! I'm excited though because on Friday at clinical, instead of working on the floor I get my "alternate experience" which is outpatient oncology. That means I get to hang out with the nurses there all day and see what I can learn. It should be really fun, and I'm excited about it. Then the following week is our last week of peds! The remainder of the semester is Maternal-Newborn Nursing, which honestly, I'm not looking forward to. But we'll see, maybe it will be better than I think. Hopefully so. So today I'm studying, tomorrow is class and an exam, my first experience with acupuncture (not even kidding), and then Wednesday I have my girls. Their mom made L Bug's 2 year old and Baby's 1 month appointment to be at the same time which means double shots, double screaming, double the fun. Good thing I have Thursday to recover, wait, scratch that, I have Thursday to finish my 12 page nursing paper which is due the following week. The fun doesn't end!
So I've been thinking lately... a lot. And I want to say "you never know what you have until it's gone," and "money can't buy happiness," and you know... all the lines. Life has completely changed for me over the past few weeks. I knew it would. I let it happen. But I have to say I'm still neutral, perhaps a little sad, about the changes.
My therapist says I should give this more time... past the first few weeks of school at least (this begins Week 4) ... before I think I'm totally flipping out and convince her that I need more meds.
But a month ago? I was ready to begin another semester working on my much more manageable Integrated Health Services degree, going to put Nursing off another semester, and that was going to be that. I'd still be a nanny by day, have a fair amount of free time (yet not "free" enough to do anything that big with, of course), and continue living my fun no-rules replication of last year. The "Health Leave" was working for me, I was finally doing better with my nerves. I was ready to start getting back into physical therapy again... Everything had a place, and my life was almost organized.
But we all saw what happened to that one.
I've been reading a 1739-page textbook since Saturday, completing every applicable NCLEX-RN practice questions I can find to get me ready for my Nursing exam in the AM, and I just turned down two new childcare gigs as well as left Little M's family. I'm exhausted, my nerves are on edge, and my mind is beginning to think of "after graduation," like it may actually happen in only a few semesters.
Right now, I feel like I don't have a free half hour to do anything, and I want to so badly. Good news, though, I don't think I wasted my sabbattical. In fact, I took great care of myself, got caught up on many appointments, treatments, etc. that had never been possible but never lost necessity. I got to stay at home and go to Disney World. I got extra close with my mommy and made time for old friends. I feel like I could have lived it up a little more, but I'm by no means disappointed in how it went, or ungrateful for the time that passed. But wow, I miss it. I drive a good hour to Cleveland every Friday and spend 60-100 minutes driving home 10 hours later. I hate that. I'm in four-hour-long lectures that make me wonder what thought they wouldn't be that unbearable. I do enjoy getting back into nursing, but even with my Nurse Teching job I had for almost a year, I'm more confident than ever that I do not want to floor-nurse. I want to go into policy or case management or maybe higher-level nurse management. But the thing about it is, we all have to start somewhere. We all have to pass that Pediatric exam in the morning.
And I just stumbled onto a big amount of money, I won't bore you with details, but it's a little unbelievable right now. I keep thinking what I want to do with it, and all I can think of is things like graduate from school, get through this class as if I had no health obstacles, and of course, get married. But money doesn't buy any of that. So I'll just be grateful for it, and for the special benevience of my father to take care of my education, and well, I'll finish this one of these semesters.
I wish the only thing I had to worry about this week was a doctors appointment tomorrow, and I wish I was more excited about being with my nanny girls (turning 2 this week, and almost 4 weeks) and of course Grey's 2 hour season premier on Thursday! But somehow that's masked with and I seriously have that many more weeks of clinical to go?
I miss a month ago... Life was more simple and pure.
Embrace whatever journey you're on now. Hopefully it will end up being better than you ever dreamed.
It was going so, so well until Fall '08 when I was rear-ended on campus.
Simply put, things spun out of control. Although it was hard, I decided to continue on schedule in the Spring of 2008, and looking back at the end of that semester, I was thriving. Physically, not so much, but I was doing fabulous in the Nursing program, making connections, making a difference, and it felt great.
At the end of the semester, I started interviewing for a Student Nurse Technician position, which I landed at a local city hospital. I don't remember much about that time, but I do know that I would have never guessed I wouldn't come back to campus for over a year after leaving it that spring.
For fall semester, I took Human Physiology at a regional campus in the evenings as I needed that to continue my clinicals and because of my continuing health problems, I struggled with the morning class in the summer and therefore dropped it. I struggled with it in the fall, too, again due to health, but I did eventually get through just fine.
Fall and winter showed increased health obstacles, so during the spring, I took an online course instead of clinicals, Health Care Policy, which I loved.
This Summer began, and I met with my Student Accessibility Services coordinator about special accommodations I would need if I were to restart my clinicals. I figured surely I'd be better by the end of summer, and I got everything all set for restarting them in the Fall. I even added them into my schedule.
When Summer was quickly passing and I was still facing health problems and two separate litigations, I questioned the practicality of my decision to return back to school in a degree track that knows no mercy. I obtained a "second opinion" on my sleep disorder, and after we made zero progress on that front, that's when I started to worry.
I decided to add a 2nd major (in addition to Nursing), Integrated Health Science with a focus in Health Services. A lot of the required courses would transfer from nursing, and the additional courses are within my scope of interest and the degree would be a nice addition into with my nursing career path. I took three online courses this summer, all for the new major - Health Introduction, Human Sexuality, and Sociology of Health and Health Systems - and I did well in all of them.
Meanwhile, Summer was nearing to a close, and I was just getting ready to schedule another round of physical therapy and my first round of acupuncture. Physically, I wasn't doing much, if any, better.
Any time I'd consider my re-entry back to Nursing, I had always thought of it to be a positive experience. I would be certain of my decision, I would be feeling better on all fronts, and I would be convinced it was the right time. This was not "the" time, so I decided it would be best to swap my nursing clinical courses for a few others in my IHS degree program. I was happy to find a great mix of four courses, and I was very pleased with my new fall schedule.
Then came last Saturday. I had off from babysitting, and I can't quite remember what sparked the idea, but I decided to look in our course program online. One thing led to another, and the end result was that my schedule now had clinicals back on it, swapping out the IHS courses and adding in a huge venture I honestly hadn't thought out.
I was very proud of what I did.
Until I thought about it.
Of course, I was going to go back to nursing school, but the condition was only once I felt physically up to it. I was going to make the decision before I ever went back, and I was going to have an entire summer to study, prepare, and just mentally get used to the idea. I was going to be confident with the progress of my sleeping disorder, back problems, and fatigue levels. Like I said a second ago, it was going to be "the" time. I was going to be convinced I was up to it.
Right now, if I had to be black or white on the subject, I'd definitely be closer to doubting my ability than being sure of it.
But hear me out....
I have a semester filled with two clinical courses, each comprised of a 4-hour lecture and a 10-hour clinical, one being in Cleveland. All said events are first thing in the morning, and we're not even discussing how early I have to get up for the clinical rotations. I'm talking hours before sunrise. Hours. I'm not lazy, but I was clinically diagnosed with narcolepsy (the validity could be disputed, but that's the diagnosis...) and as a result, will have to not only hear an alarm to get up, but I will have to take a major stimulant upon waking up if there is any hope of me staying up. The said stimulant makes me shaky, nauseous, tired (but not sleepy), and pretty much enables my body to stay awake while just feeling like a zombie. It's forced wakefulness. It triggers migraines and also anxiety, and I get a panic attack probably half of all the days I take it. (I only take it when I absolutely have to.) It is my most dreaded medication of all, and that's saying something. I have allergic reactions to all similar drugs except for a few newer drugs that I actually get no effect from whatsoever. So bottom line, to stay awake through an early morning lecture or all day clinical, it's all any doctor has for me, and it makes my life miserable.
Then there is my back. I have fibromyalgia, and at the end of a few hours of any activity whatsoever, I usually need a pain patch, a heating pad, a massotherapy session, a Percocet, or a muscle relaxer. When I worked as a nurse technician, 8-hour shifts put me in so much pain that I was on 4-hour shifts when I eventually went on medical leave. I saw an actual back specialist last week (in addition to my pain specialist who treats my fibromyalgia-related back pain) and have yet to hear anything on that. But the physical therapy and acupuncture I was going to start are no longer in the plans since I won't have time if I'm taking my courses and nannying.
In fact, I probably won't get to see my most important specialist while in school since she's now only seeing patients 2 days/week, and of course, they're the two days I'm busy all day.
But back on topic...
I can't forget about that little thing called "end-stage liver disease." Just those words enough usually grant any get-out-of-jail-free pass I'd ever need. And technically, because of my weakened immune system and excessive fatigue, I shouldn't be working in the hospital anyways. One bad germ and that's it for me.
With all this against me though, it's sort of like it makes me want to try harder. It makes me want to curl up in a ball and cry, yes - that, too - but then I think to myself, "No one is making you do this." It's my choice. Completely, totally my choice.
So then I curiously try to attempt to pinpoint why I'm even trying? Afterall, it was my favorite nursing professor who told me years ago, "Amanda, what kind of a nurse are you if you can't first take care of yourself?"
Well, because I want to get married. That's why. I want to get a good job (or not... because I can't even work 4-hour shifts, remember?) and get good insurance so that Jonathan and I can get married. I want to do something big. And yes, maybe a "wrong reason," but I want to prove a few people wrong and make a few other people really, really proud. I don't want to let down myself anymore. I don't want to let down everyone who is rooting for me... every day I find out it was a few more than I ever thought.
I don't know what I'm going to end up doing. My nerves are out of control just thinking about it - as hard as I try not to. (Mannn, am I trying not to!) I really, really hope I at least try. I need to give it a try so that way, I'll never be able to say I didn't at least give it my all. I believe with all of my heart that not trying is worse than trying and failing. I just don't know if I'm even strong enough to try yet... I guess I can fool myself and pretend I am - that has to last a few days at least!
Once again, we have more decisions in this complicated crazy life... the kind that don't have right or wrong answers. The kind I'm quite frankly getting sick of.
Until I change my mind again.... how about you can count me a few extra times in your prayers as lose all of my control and wholeheartedly jump right in and give it a try.
But is trying really losing control? Or gaining it?
The gate is wide The road is paved to moderation The crowd is kind and quick to pull you in Welcome to the middle ground It's safe and sound and Until now it's where I've been
Cuz it's been fear That ties me down to everything But it's been love, Your love That cuts the strings
So long, status quo I think I've just let go You make me wanna be brave The way it always was It's no longer good enough You make me wanna be brave Brave, brave
I am small And I speak when I'm spoken to But I am willing to risk it all To say Your name Just Your name, and I'm ready to go Even ready to fall
Wided-eyed Take this fowl compromise Why did I Try to keep it all inside
I've never known a fire that didn't begin with a flame And every storm will start with just a drop of rain But if You believe in me That changes everything
The softest things in the world May be harder than the hardest. Soft water can go through the strongest wall. Knowing this, I know the value of calm. Knowing this, I know the value of patience. Knowing ths, I know the value of persistence. . . . . . . . . . . . .Lao Tzu . . . . . . . . . . . .
Most days, I'm trying to practice the calm, while every day, I pray to God for patience and watch as it takes me through, and every day I wake up with persistence - a firm belief that I will do a anything in my power to make this a great day, to make healthy choices, and accept the things I cannot change.
This persisting thing can get pretty tricky, but if you want to keep your soul, heart, mind, or body, you have to keep your guard up and fight to protect it all. Do whatever it takes, you know?
Life's been rough lately. Finals just ended (I think I got an A in all 3 classes! Awesome for the GPA!) And now, everything in the world is going on plus now, big news, the possibility of starting clinicals in the fall (after a year long hiatus!)
Today I'm going to see Dr. Mazanec, a new doctor (just what I need, right?) who is supposedly the best doctor up at Cleveland Clinic for my specific back problems. Yes, I have my pain management doctor, but over time, it seems to be getting worse. I'd like to just get it better so "pain management" (muscle relaxers and opiods, trying to schedule physical therapy in around school) isn't needed AS much, because right now, it's out of control. My doctor does a great job at giving me the tools to manage the pain, but how about just getting rid of the pain? Well we'll see what the doctor says tomorrow. Then I have an ultrasound because of a big spot on my kidney that they "accidentally" found while doing liver scans. My specialist thinks it's a shadow, but we're going to check to make sure. Then I'm secretly hoping inside we'll have time between the two appointments to get lunch at the cafeteria! Cleveland Clinic has great food, or at least as far as I'm concerned. Oh, and their cookies are to die for!! (Make a mental note in case you're ever there!)
Looking ahead, especially if the clinicals work out, I have not the faintest clue of how I'm going to keep seeing all of my doctors since for one, they're all an hour away, and for two, I'll be in classes, clinicals, and nannying the other days. Plus add in things like massotherapy, physical therapy, and - starting on Friday - acupuncture. I know MY health comes first if I ever want to be a nurse, so I'm determined to take the best care of me while still being up to taking my nursing courses. I think that's easier said than done, but I miss my patients all the time so my heart knows where it needs to be. I just need practicality and logic to catch up with that heart. :) I have big dreams, people, and just because I have more diseases than you have fingers, that doesn't mean I won't achieve them. Might take me longer, and I might work harder than most, but I'll get there. You watch.
This week is a ton of crammed-in plans and events and appointments and then Monday evening begins my Genetics course and 2 online courses (am I trying to kill myself again?) plus whatever nursing I can squeeze into my schedule at this point. (But for sure, for sure clinical for 2nd half of semester.) But back to Genetics... I've been putting it off so long that I decided to make myself take it. I'm not excited about it at all, especially since it's an evening class. Yuck. All by Monday, I'm getting books for Nikki and I, organizing parking, schedules, all that fun stuff, AND I'm trying (semi-successfully) to remember to take my meds, get my rest, and try not to get stressed. (Stress = muscles tighten = back hurts BAD. I currently have something in my neck and haven't been able to move it to the left for 3 days now!)
Craaaaaziness! Thankfully my mom is awesome and is so excited about me going back to clinicals. She promised she'd help me with anything I need which helps so much because right now my room is a disaster, I've needed to do laundry for a few weeks now, I need to change the sheets on my bed.... you know, just little stuff that busy people can't seem to ever fit in.
So I'm busy, but blessed.
God give us patience today. Give us calm. Give us persistence. We'll keep on going even though the path looks cloudy up ahead.
I am 22 & currently spend my days nannying my itty bitties + going to college (working on my nursing degree, goal: pediatric oncology) & am honored to be a published writer in a nursing anthology & a contributor to many scrapbooking publications. i love hanging with my amazing friends, sister & family. i love my baby puppy haylie brooke and our silly doggie ri-ri. in my rare spare time, i read & get crafty. i thrive on organization, my mac repertoire, learning & absolute fabulosity. my favorite place in the world is paris. my favorite color is pink. i love being a nurse & i believe each one of my patients is precious. i'm a night owl & wish my lifestyle promoted such habits. i like lazy jammie days. i believe in god and am thankful for his hand on my life. i believe that life is too short to be anything but happy, & i’m thankful that a chronic liver disease + the effects of a car accident have taught me important values that most people learn far too late. i hope that the world will find hope, and my idea of a good day is one in which i made someone smile :)
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