The RN journey

These last few weeks have been extremely tough on me. After the death of a dear friend, my room mate dropping out of school, and making a couple bad decisions, I have emerged into spring break breathless, barely passing, and scythed. I have been told if I don’t catch-up and keep-up with my class in Capstone I will fail. Read the post above this one for more details. I need to back-track here.

The following are a couple of my discussion posts from clinicals (with some parts edited of course). 2/9/19 When we were watching a chemical code for SVT The nurse shift manager came in and was overseeing everything to be sure it was being done correctly. She even questioned the Doctor on his use of medication. I think that would be so awesome to know that much, and have that presence, and be respected as an authority to go so far as to question the Doctor in a code. That part was very interesting. I think all of those nurses present in that moment knew what they were doing, how to do it, and how to be calm of mind no matter what.

One of my patients was in pain due to a multitude of factors.  The nurse checked his pain medications and he couldn’t have more medication for an hour or so. She told him she’d be back in an hour to give him the medicine. It bothered me that this patient had uncontrolled pain and we were not going to sufficiently alleviate it in any way. I tried to help him reposition and he thanked me for trying something…… for trying something. This week I came to the tangible realization that, at the very least, we should TRY something to help our patients when they have a need. The psycho-social and physiological aspects of this interaction are irrelevant to this point. Doing nothing to meet a patients needs is just not an acceptable option.

This week seemed to be more challenging for me than usual. First of all we have to get up before the sun and my brain does not appreciate that. Secondly I have not been as clear minded this week. All of that aside both clinical days pushed me up against ethical and professional boundaries, provided many learning opportunities, and brought to light many personal strengths and weaknesses. The first day I was in the ICU and I learned a lot. I got to watch an extubation and listen to the mother who had no right to know what was going on with the patient. I had to be careful of what I said d/t our location and HIPPA. I did portray more uncertainty in my student role and lower confidence than I would have liked to this week. I also did not do a very good job of communicating what was going on with me to  my nurse on day and I didn’t even realize it until the end of the shift. I feel like I’m usually better at communication and multitasking than I was this Wednesday. I also do usually jump right in and portray more confidence than I did this week. I am still finding that balance.

Besides an extubation, this week I was able to watch a thoracentesis. The instructor helped me realize that, until now, I have been trying to meld head-to-toe assessments and body systems together when I’m documenting. I have wondered why it was so hard to document in a systematic way….

This week I was also able to comfort someone whose loved one passed away a few minutes after I had left the room. I had spoken with the patient moments earlier and tried to give her a few words of peace and comfort. She smiled a faint smile, so I knew she had heard. We are in a crazy field where you can walk from one room to the next and experience immense joy and then intense sadness. We hold peoples hands at some of the most pivotal moments in their lives and our own struggles are constantly suppressed. Nursing is not for the faint of heart.

-Faint of heart

There have been several failed quizzes and missed homework going around, and many people have barely passing grades that range from med surg to psych.
A classmate forgot her psych homework this week and was not able to turn it in late. That same classmate had a really bad migraine and missed class, I hope she turned in an assignment that’s worth 20% of her grade…

Switching back to the run down…… our leadership instructor thinks we need to stop what we’re learning in clinicals to jump up to take people to the toilet every 2 seconds, while still getting everything we are supposed to do done. I want to make an appointment with him this week to discuss this issue. Thank God I don’t have him again for clinicals. He’s a great classroom teacher but I wanted to jump off the balcony during clinicals last semester and that is not an exaggeration. I thought of every possible way out of that rotation and I very seriously considered most of them. It was not a good learning experience or environment.

Quick recap. Car got towed this week and we have no real safe place to park near the apartment landlords looking into it. Phone broke and I am trying to get a new one. I’m tired as hell right now and need to sleep because of long studying hours tomorrow. Monday morning will roll around for a big med surg test. We got our group project changed from teen depression to multi personality disorder, thank God.

I did go to the doctor this week and I am getting an acid reducer and anti anxiety meds from the pharmacy Monday. I feel like my body is holding the stress more than my mind right now.

-Right Now

I like psych. I like the teacher so far. Yes she requires a lot from us but that’s ok with me. We have psych Lab, psych theory, and eventually our half of the class will have psych clinicals. Heres the issue. I’m finding it crazy difficult to have psych theory backed into my med surg class. Zero time to review before quizzes and tests, especially if she runs over a few minutes; literally taking up all of our extra seconds. We have so much on our plates that EVERYONE, for the most part, is forgetting this and that and dropping the ball here and there. We just hope to God that where we drop the ball doesn’t end up failing us. So I got to school late with one plan in mind and find out I have two quick assignments that I better do real fast. Ok. So I’m working on this psych homework I had no recollection of and I turn it in after running to class 10 minutes late. Ok. So class runs over and I ask my class mate if he studied for the quiz today …. What quiz? he says. So as we walk to class. I’m trying to get a few key points into his brain and that’s literally all the review time we have. Sit down take the quiz. Ready or not. We all left today feeling defeated. Test next week, big test. Lots of class, clinicals, work and family moments in between and to top it off there’s an ever ballooning psych class that wants every second of our energy. I need time before the med surg test to review. This is literally insane.

-Literally Insane

I’ve hit the wall tonight. I sat down to study and I just couldn’t. For a moment I couldn’t see how graduation would even be possible. Sleep deprivation had me swearing like a sailor this morning and after 2 classes, on the spot class cancelation (due to winter), a long drive, a short nap, a hamburger, some popcorn, and working many hours later, life did not look too hopeful. I’ve been going in and out of the light at an impressive rate.

I just found out a good friend has aggressive cancer that has metastasized to the liver. I am definitely in denial and shock with a tad of anger, disappointment, and tears.

I had to make some changes to my schedule and I do feel guilty about cutting down my hours. I feel obligated to my boss and co-workers and it’s not easy to disappoint or feel like you’re not living up to every expectation, but the main concern right now is that I finish nursing school. Now is not the time for faint of heart and I know that. I’ve made 2 70%’s in the last week 1 quiz and 1 test. I can’t be making grades like that and certainly not at the very beginning of the semester. So I will change I will study more and harder and cut down hours and sleep less. Whatever I have to do to graduate in May. We are so close. Too close to give up on being successful now.

-Successful Now

So the weather was so awful school was cancelled from Monday- Wednesday…. I did get some studying done and a couple assignments turned in at a local cafe but I feel like this whole week has been a bust as far as school goes. Now we will be cramming and making up time for at least a couple weeks, and it’s still Sub zero temperatures.

This week I will stay in the appartment with some class mates Monday -Thurs and here’s the over view. Psych Lab and a med surg quiz right off the bat. I have assessments on the clinical floor tues and presenting an article. Wed more clinicals. Then case studies are due Thursday and I better review a couple skills for instructor observation…. After a long day of back to back classes Thursday I go straight to work and will try to do some of the care plan the next 2 nights on any down time. Sunday should (hopefully) be a family day and Monday will roll around again for Med surg test #1.

I just want to get through this…. I did apply for graduation this week and it is encouraging that week 3 is over (even if we didn’t learn much). I can tell I have come a long way towards the knowledge I need as an RN since the beginning of last semester, but I did fail an exam for the first time yesterday. Leadership class has been interesting so far and it’s neat to learn about the history of nursing tying into modern practices the role of a nurse and effective management. Our teacher (the clinical instructor that gave me such a hard time last semester) asked me (in class) what his preferred management style was and I told him dictatorship. He said “dictatorship????!” And the whole class started laughing because there’s a bit of Truth in it and he knew it too. Gotta call it like I see it.

I need to hurry up on the portfolio for that class…..

Well there are 14 weeks left to school and 2 of those are mostly holiday. Gotta love America.

-Gotta love America

This second week was a good one. Classes were good and slightly bizarre (which is better than bland). Psych lab is boring but things might change with that. Med surg is a lot to learn but interesting. Psych theory is interesting but seems long. We got to eat chocolate cake at 9am in class so that couldn’t be a bad thing. It was funny to see some of my class mates reactions to it though, but some of the things they said were not very nice. I mean do they have no decency and no filter? Speaking of filters, my mental filter leaves at 4am but it comes back when I wake up; I guess not everyone operates like I do.

Med surg lab was long but informative and practical. Pop syllabus quiz day one….. but hey it gets a grade in the book. None of my class mates have this blog info, so no heads up for the other half of the class.

Clinicals this week went well… And i really like our instructor. She’s very reasonable and up front with her expectations… We had a discussion post to do afterward, answering what suggestion we implemented and what our strength and weakness was. This was my post (slightly edited): Although I didn’t get a chance to document size, shape, texture, and color on anything, I did get to put my patient’s first. I did put their immediate needs above my own, and above the task of following the floor nurse at times. One patient had the worst matted hair I had ever seen. The nurses didn’t want to do anything about it, but It was actually tangled underneath their chin in a noose like fashion. I did feel hesitant to continue my struggle, and after I had untangled their neck, I went to discuss further intervention with the nurses. The nurses did not want me to do anything more so I did not. However, I didn’t see the harm in helping this patient look, and feel, a little more humane.

I think one of my biggest strengths is that I actually care about people and that they often can sense this about me. I usually have patients trust me quite readily; and not just the ones that are alert and oriented. I was able to gain trust, get along with, and even cover ground quickly with a patient who was not in their right mind, and was even a little paranoid. This made me feel needed and like I was making a difference.

If I had a list of strengths and weaknesses….. several would overlap. One of my biggest strengths can also be my biggest weakness. I don’t have a problem asking questions or talking to people, but I can be annoying, I can be overly anxious, overly loud, and just plain over the top. Sometimes I do speak before I think, then I back track. I noticed myself in this mode, right off the bat, on the hospital floor, so I did try to dial it down. This made me feel like I was not integrating well, and when I think about it, it still makes me feel like I do not fit in, will not fit in, and that I don’t even like my own personality anymore.

That was a sad note to end on….. So let me just say: Clinical week one was a big success over all; and when I left the hospital I was smiling like it was my last night in nursing school. End.

I was smiling because of our instructor. Because even though I don’t like clinicals, I literally was on the edge of life itself during last semester Med Surg. I can’t learn effectively and efficiently in a hostile environment. This semester, it will still be rough, as it should. But it actually seems possible this time around. And possible is doable is probable is passable is perfect. So smile and watch this last semester fly by. Ride the waves and enjoy it.

-Enjoy it

This first week flew by in a whirlwind of syllabuses, working, and finishing set up at the appartment. Mental note: bring toothpaste hangers and more clothes in general….

Classes:

Psych, psych Lab, psych clinicals

Med surg, Med surg lab, 2 med surg clinical

And a leadership class/ NCLEX review

This is going to be a crazy semester of care plans, papers, presentations, tests, projects, homework, clinical rotatios, and oh yeah, Nausea. There’s a good chance I may have an unplanned pregnancy to add to the mix.

It’s rough choosing the right birth control, and anything can fail. Choose carefully and choose wisely.

-Choose Wisely

We did go on a trip but with kids and being sick it turned out to not be what I had hoped. Now that we’re home, besides sick and working a few extra hours while I have the chance, the school and hospital are requiring courses to be completed prior to clinical rotation and those were due yesterday. So now I’m at the library trying to learn about the hospitals computer system. Im not paying much attention to it because I don’t care. I will not work at this hospital and if I do I will train then. This is my free time and it’s BS. I’m supposed to be reviewing pharmacology but it’s whatever at this point.

-At this point

Sunday night December 9th I was studying OB while my LPN friend studied pharmacology…. We studied for hours, desperately trying to keep focused on school and finish strong. I posted Remember by Lauren Daigle to our RN fb page as the song of the night.

Monday I passed both exams. One 91% and one 84% (I believe). My LPN friend failed pharmacology. It was extremely sad but she had focused so much on the other courses throughout the semester that it couldn’t be saved. Plus, from the sounds of it, the teacher isn’t the best. I decided to post “Not Today” by Imagine Dragons to our fb group.

Tuesday I studied for and took the online physical assessment final, with my RN friend that has been with me from the beginning of our journey. We both made a 90% on that test. Yay! My LPN friend took 2 more finals and did well! Passing those classes was a huge relief, but I was extremely worried about Wednesdays assessment. I practiced assessment on my non-nurse friend that night, she would be the one I assessed for Wednesdays final exam.

Wednesday morning was a Phi Theta Kappa volunteer hour. Then my assessment friend (who also signed me up for this blog) and I practiced till 1pm then waited in the hall till 130pm. The assessment did not go very smoothly and I made a couple mistakes, but I passed by some miracle. I wanted to cry walking out, and did actually. After dropping my friend off I drove straight to the other campus an hour and a half away from where we started so that I could study med surg with class mates. I could not focus. I literally got nothing accomplised, and I was shot for the day. I still had to turn in my final documentation using my phone at 10pm that night. I wished I could stay longer and study med surg with one class mate who was struggling in that class but I was almost useless. At the end of that long and stressful day the radio was playing “Chandler” by Sia and I was “just holding on for tonight.”

Thursday was our med surg final, the last list check off for semester 1. We reviewed our notes ahead of class but our friend still failed. We were all super sad for her, and that we would not go on together. It was a sadder get-together at Applebee’s afterwards, but still fun. We had some hope that they would let her through after the meeting this week but that hope has since been squashed. She will still graduate in 2019 though!

Now we are down to 3 ladies who want an apartment in town for next semester, which means higher rent, but it can’t be helped. The apartment entrance reminds me of a movie scene…. Literally right next to a bar, but we need cheap and practical. Being close to the college and the hospital will help. Driving long distance is a waste of precious time.

-Precious time

I’ve been going through waves of an fast paced emotional rollercoaster. I took 1 last test before finals today, and I barely passed but it’s ok!

Sometimes my class mates don’t realize how snubbed I feel when, as I am sending out a help cry, by asking if we can get together to review and the reply is “oh we’ve been doing that and we don’t need to practice.” Well that’s nice. I’m behind the curve and struggle to get help what’s new? 

On a good note “mass casualty” practice was today and it was fun. Our class mates were victims for the graduating RN class. I’ll tell you my part in it towards the end of the school journey. When it comes my turn to be the nurse in the mass casualty scenario I hope I do better than this graduating class! Just take charge, be confident, be bold, be brave. That’s all you can do.

5 finals next week. Monday has 2 OB finals, Tuesday physical assessment online final, Wednesday physical assessment check off, and Thursday Med Surg final and it’s over for now!!

-For now