The RN journey

Wednesday: I am sitting in the doctors office for possible strep throat. My tonsils are swollen and have white patches on them. We are learning the ears nose and throat assessment at school….. It seems like every week I have something going on with the system we assess. The class probably thinks I’m a hypochondriac….. even I am wondering about that….. but the symptoms are clinically provable this time. So….. z-pack for me and the doctor suspects mono. I thought that was an interesting diagnosis theory….. I know I haven’t kissed anyone interesting since I got married but who knows, maybe a fast food worker spit in my food…. you never know.

Monday and Tuesday night I was at work… and after sleeping I was working to finish my care plan and other clinical papers… I’m stressed because this is my first assigned care plan in years and I have never been great at them…

Now Thursday: med surg. Feeling sick and tired….. went to class. It isn’t that great of a class…. we really don’t have the appropriate class time to go over the material or even just hit the main highlights….. it’s a lot. We have to study and learn it all on our own for the most part. I know several students are frustrated. There was a pop quiz over the eyes and ears and I got 9/10! The one I got wrong was on a medication of course. My friend and other class mates didn’t fair as well….. Last week of med surg clinicals for the semester….. thank God. Clinicals are more stressful than anything else. Our OB rotation coming up should t be bad though, and it will give me time to get my pharmacology act together.

– Get my pharmacology act together

Monday OB and physical assessment with my favorite teacher so far. Those are the only 2  classes I really feel like I’m learning in. She’s such a good teacher and a good nurse. I just love her so far.  We went over head and neck for our physical assessment. I need to practice these every week so when final gets here I’ll be ready.

Tuesday was studying and doing some Nclex questions I worked Tuesday night, and had some significant family issues going on.

Wednesday after sleeping I got up and took a med surg exam. It’s proficiency rating which is different…. my actual grade was 71.7 my friend made the exact same thing incidentally and was discouraged until we realized we were are at level 2 proficiency which is a 91.4%.

Today Thursday the 27th. I woke up and fell back to sleep. Exhausted I got up, and got the kids ready to go. Another day of med surg class. It was ok. We are learning what to do for stroke and Bell’s palsy etc…. When class was finished I completed other small assignments in the library. I also posted the following in the discussion for clinicals:

My clinical experience this week was stressful. Life is stressful, but healthcare is one place where the stress is really at. Always more unknown than known. I don’t see an end to the stress honestly. My hair is falling out for real, so if I come to class bald one day, you’ll understand what happened. Maybe I’m focusing so much on my weaknesses that I can’t see much strength at this moment.

There should never be an end to becoming a better version of yourself personally, professionally, and intellectually. Working towards a better and broader understanding. Always being honest with yourself and working on the weakest points… We don’t want to be weak, but we always will be in some way. Signing “Titanium” won’t actually make us bullet proof.

My clinical rotation this week was hot and cold. I have always loved the ER…. Is ED a Michigan term? because the first time I read that I literally thought to myself, “those politically correct idiots.” Anyways….. The second day was hell, but honestly I expected as much. Two good days in a row is a rare thing, not to mention, it’s med surg. The floor I was on is just another step down, and I suppose following around a nurse who doesn’t want you underfoot is a level below that. Sad that you have to CYA at every turn, because you’ll either get kicked out of nursing school, loose your license, or be blamed for killing someone if you don’t. I have thought over several “easy ways out” this week, and I decided that I have never taken an easy way out before and I shouldn’t start now. Even if I just teach CNA classes with my RN, I should try to see this thing through. I have too much to loose.

Am I crazy to be impressed that during the LPN year people learn everything from how to wipe from front to back to RN level pharmacology? Maybe a pharmacology would be nice instead of English or political science. I’m trying to get a handle on this. It will not be overnight, and I feel like no matter how much I stress on the clinical site, or off of it, to review and memorize and write down specific drugs and classes etc…. I won’t be questioned until I’m not ready AEB life. I can’t tell you how many hours I wasted on flashcards, and the best I can figure is that they must have fallen out of my pocket at some point. I’m not going to do that again. I can’t. I’m just not going to give a drug unless I know everything I can about it. I don’t care if I piss the nurses off, or whatever. If I don’t take the time to review it, I will not be giving it. They are kicking me out of the library so I guess I better give my pain scale rating. I don’t know what to think. On track for RN maybe we’re looking at 5 out of 10. Pharmacology 2 out of 10.

if you want to hear an awesome cranial nerve song go to this link and skip about 4 minutes in. https://www.youtube.com/watch?v=TdxjUuERPv4

The other song on repeat this week is You Say by Lauren Daigle. Just trying to get some inspiration. If you think this post is sad, you should have read the one I deleted on Monday.

So that’s the post we’ll see what comments I get on it tomorrow… why does tomorrow have to be friday? – have to be Friday

Taking care of people, and the theory of taking care of people are actually quite different realities. That’s on of the big reasons I believe in observation only clinicals, with a very small exception. Nursing students are forced to practice theory with every step by the book. That’s fine, but it doesn’t always work. People make mistakes, they forget things, and until you’ve done something 1000 times in the real world you’re not a pro. Also the added stress of those judgmental eyes aimed at the back of your head will make anyone nervous. Being nervous helps people not think clearly. Oh but they need to learn to work under pressure…. yes they do, and they will, when they have a lisence saying they understand theory. The nurse who orientates a new nurse for a month on the hospital floor can watch them do the skills. She is the same nurse who would “watch over” the students training.  She is also the one who would rather sit back while someone else does her work. At least when training time does come around, the one being trained has their own RN and is legally employed but the hospital to do patient care and management.

School is a joke. The only classes that aren’t “self taught” in my eyes are Maternal and physical assessment Lab, taught by the same instructor. The others we discuss what we’ve learned, and we attempt to apply our skills in clinicals; but we’ve been back to school 1 month and their shocked we don’t have the drug book memorized. They have no intentions of teaching RN level pharmacology. They actually expect LPN students to learn everything from how to wipe front to back, to RN level pharmacology in 1 year.

A quick recap on last week before another one kicks off.

Monday was OB class then physical assessment. Physical assessment gets harder every week this week we learned about, memorized, were checked off on, and wrote out our clinical findings for a comprehensive eye exam. I worked Monday night 7p-7a. I worked Tuesday night 7p-7a. I got a little OB studying in there but not much.

Wednesday I took the OB exam. I made a 91.6% and my friend mage 96% I believe. Don’t know how we did it, but we’re happy.

Thursday I was anxious all day in anticipation of clinicals. I went to the college and worked more on the discussion post that was due Friday instead of reviewing med surge chapters like my friend was. I should have. First thing in class everyone was handed a blank piece of paper and told to write down what they learned from the chapters we are looking at in classe today. Great. Turns out she didn’t have them turned in, but she was seeing who was prestudying the chapters for her class like we should. So basically read it and come to class to discuss and work on weaknesses. I know we all will do better this week. Not sure how I feel about it but I understand the logic for either argument. We’ll call that argument preteaching and postteaching.

So that was Thursday. I turned in the discussion post before leaving the college, and off I went.

– off I went

Saturday clinicals were awful. Ill go back and recap the previous week in the next post. I have been so busy with school that TV, posting here, and even family are (often) not an option. Friday was an Awsome day of clinicals. I was allowed to float to the ER to observe there, and I loved it. I had a great nurse I followed and it was amazing. Love ER. I love the atmosphere, the teamwork, and the collective “our” patients mentality. Health care workers in unison. I had stressed all day Thursday in anticipation of clinicals, and I was pleasantly surprised that Friday wasn’t hell; but I knew it was too good to last.

I got stuck on a floor Saturday with an experienced nurse. She’s a good nurse, but the ones who are fresh out of nursing school are more apt. to understand, they are usually more helpful, and try to teach you knew things.

The short straw is often drawn; it happens. I have no idea how to explain my experience without details, but as a student nurse we often aren’t “allowed “ to give care, or medications and certainly NOT without THAT specific patients nurse in the room. So you can imagine the problems that could arise…. Also nurses don’t always appreciate us hindering their day.  Long story short, after a frustrating day I was pushed over the edge, and not allowed to walk away and calm down. Soon I was hyperventilating in the hall choking to suppress my sob. I was ushered out onto the balcony by staff. I don’t like being weak, I don’t like breaking down at work, or anywhere non-private, but I did; and I cried on and off for the next 6 hours or so, with a headache to follow. Tylenol.

I want to walk away. I want to be done. I don’t want to continue, but as long as there is hope left I have to keep putting one foot in front of the other…….

-One foot in front of the other

Thursday and Friday night I stayed up late making flash cards and trying to get into my brain what I had been told to learn for clinicals this week. Each day came and went without the expected knowledge assessment; instead, we were caught off guard when asked to do an SBAR and a head-to-toe physical assessment on someone….. ok….. great to review on the spot right? We could have planned ahead if we would have looked farther on the clinical schedule, but I guess we didn’t.

So instead of being able to enjoy the experience and watch the nurse in action, on Saturday,  here I am stressed out about what medication questions I’ll have at some point, trying to get all pertinent patient information memorized, and wondering am I thinking critically about their disease processes and issues? When really all of that worrying and memorizing in the moment was a huge waste of energy because the day would take a different turn. I did fail but I was ok with it because I was closer to passing than I thought I would be. I can pass it next week. I am still worried about all the unknown though, it’s hard not to be. It’s seriously curbing my “learning” experience to be constantly stressing over what I don’t know.

I walked into college 3 weeks ago as an LPN…. I truely feel like, in the clinical setting, from day 1 there has been little tolerance as to the chance of making that transition to RN gradually…. I have to be an RN NOW.

It doesn’t matter that we’re in physical assessment class right now, we should already be able to do a by the book clinical assessment. I just needed clarification on “ok you’re learning the RN level assessments but you are expected to execute the LPN level assessment at this time”…… I like our clinical instructor, I really do; and I appreciate him, and the fact that he IS being reasonable, but he’s stressing me out with this constant front wall he’s got going of “you should know everything about everything already.” I hear from previous students that he’s one of the best. My gracious. Are we going to survive this year?

Do you know what an awesome instructor looks like? I can tell you. I had one for my LPN year. It is literally not possible to have an instructor/teacher better than she was. Supportive, easy going, caring, reasonable, and of course knowledgeable, I sure wish she could be here now….

It would be so nice if the focus of clinical was more teach teach teach not test test test. I can’t believe it’s only been 2 weeks of med/surg clinicals. The next 3 weeks can’t go by fast enough as far as I’m concerned.

– I’m concerned

This week has absolutely sped past us in a whirl-wind. I’ve decided below is the 5 repeating phases of nursing school (they apply to any difficult program, or even life).

1. Grip

2. Deep breath

3. Brace for impact

4. Impact

5. Exhale

1. Grip

Another impact is coming, ready or not. Don’t make me give you a nursing diagnosis of impaired ability to cope related to stress.

Monday

I sat in Maternal class and listened about certain conditions and issues women can have, while freaking out inside because I may be personally looking at 1 or more…. meanwhile our local OB/GYN is double and triple booked for provider appointments currently…. Not good for the community as a whole, I must say. Taking my mind back to school, physical assessment class was last hurdle. It’s not a bad class, and yes it is literally 1 semester on how to do proper full body system assessments. I think we could spend at least a year on this alone.

To end my Monday’s I now have an extra curricular class I go to for physical exercise, and destressing. I know it’s “more time away” from my family, and I do tend to overload my plate, but I want this. Besides more oxygen in the brain right?

Tuesday

I slept in and spent time with the babies. I got some online homework done in preparation for the first med/surg test. Worked all night.

Wednesday

I slept half of it away. Then made myself get up to go study at the college. I often study side by side with my LPN school friend or with my new friend from RN school. They were both stressing that night. The RN class was bracing for the 8 chapter impact Thursday. Acid base imbalances don’t seem as scary as when I first looked at it though.

Thursday

I got to the college as soon as I could to review the study guide for med/surg test 1. Many class mates were there doing the same. We headed to the computer lab and took at seat. 50 questions, praying through it. Not as bad as I had feared. 80% was my grade, and I am thankful I passed. Many passed and many of my class mates did not fair so well. My friend made 74%. Right under th 75% passing grade, and in need of remediation. We reviewed some of the questions and rationales in class and then it was over. Not a bad day at all. I actually really liked it. I rushed off to the Dr. Office for my appt. then after checking in with my family I left to McDonald’s to make pharmacology flash cards beside my LPN school friend. I have to make cards because I don’t remember the drugs like I should. Part of the perils of being out of nursing school for years, and going back. I stayed out really late. Clinicals are Friday and Saturday. At 0645 be at the hospital 45 minutes from my house. Brace for impact.    – Brace for impact.

I think our clinical instructor was born a little “smarter than the rest” and I mean that with the utmost respect and admiration of the sheer working, functioning, and brute force knowledge in that beautiful mind. The evidence suggests that he is not the common “98% hard work needed” case. Maybe I’m wrong, but I don’t believe so. It’s hard for him to understand how normal people forget things, and how we can’t remember what we should know. I made a few absolutely stupid mistakes today; like thinking I set my folder down and forgot it when that was not the case. It’s embarrassing to have a completely stupid memory lapse….. I know I’m tired, and have personal health issues going on, but who doesn’t? Maybe if I change my diet, if I read more, memorize more, and sleep more consistently I can improve my mind; but I’ll never have a gifted mind. What is realistic for me is to struggle tooth and nail, put in the 98% hard work, and pass these classes; still by the grace of God.

On top of the tests and assignments coming up, I have to review and relearn all the main drugs, including mechanism of action, review and learn cardiac rhythms, know the oxygenation process completely, review lung sounds, and memorize all steps to these new procedures/ assessments. We are learning disease indicators, indications, contraindications of treatment, in depth care plans, and other broad spectrum focuses…….

Wouldn’t it be nice to drop out?

Today was our first day in the hospital, and we got the grand tour. No real patient care yet, but honestly I’m ok with minimal student nurse care taking…. I won’t go into my rationals at this time.

I’m going to sleep. I speny a few moments with the family after clinicals today, then off to McDonald’s to use their WiFi and study with a friend. Nursing students really need a good support system to make it through. Whether you’re single, married, or (especially) have kids, you need friends/family backing you; if at all possible. I have a good support system, but I might need a miracle.            – a Miracle

I have been so busy that I couldn’t legitimately prioritize making a post. Here is a recap of how my last 3 days have gone.

Wednesday. Personal and family necessities  had to be addressed. I studied Med Surg when I could and then stressed over (and worked on) an assignment I thought was due Thursday. It was on acid base balance that we just reviewed in class. I’m still trying to see all the big picture health connections…..

Thursday. After that acid/base lecture we grabbed the provided ice cream social goodness and went to the student nurses meeting; so we could have our picture taken with brainfreeze as evidenced by cringe ridden faces. That may, or may not, be an exaggeration. The student nurse meeting was informative on upcoming raffles etc… for fundraising, and information on upcoming events. I then went to the library and did more review and preparation for clinicals Friday.

Friday. Today. First day of clinicals. We brushed up on a few skills in the class room and went into detail on nasogastric tubes and IV’s; including IV push medications. I like our clinical instructor, very upfront, and reasonable. However, when we first sat down for introductions, and then we moved to expectations, I had a serious moment of contemplating an exit. He was talking about what we are expected to know for the drugs we give and wow. I felt like there was no way I can get myself to standard on the medication knowledge in a week….. I’ve been out of school, but we don’t have pharmacology on the RN level, so those of us who are rusty now have some serious pharmacology to do on our own on top of the actually required class assignments and exams….. Maybe it wouldn’t be so serious if we couldn’t be expelled for 3 lapses in memory under pressure. So we HAVE to know that we know our medications……

I stayed out late studying tonight. Clinicals in the morning early…. carpooling with my other community LPN friend. 45 + min drive to the hospital. Will be there at 0645 bright-eyed….. or just WIDE-eyed more than likely. 8 ch. med surg exam thurs 10 ch OB exam the Monday after that. Clinicals Friday/Saturday. Work Tuesday night shift.     – Night Shift

This weekend held the last allowable slacking moments for the remaining semester. Now it’s time to be serious or quit; and I don’t want to quit.

Clinicals start this week, and there is so much to do before those hours collide with me. I was originally upset with my Friday/Saturday clinical schedule, but over the summer I was able to grow used to the idea. Thankfully, these hours will only last a month or so, then change again.

I did work this weekend, but I now have to cut my hours down further. I have been working nights and days in the same week. A large number of scrub wearers do this. Who knows what the physiological effects are, or what the taxation on the mind is? Although I can’t pinpoint it, I know I haven’t been immune to this taxation. I love my job, my coworkers, and my patients, but I want out. I want to move on; and having my RN would mean that I could. I like change, and challenge. I also like mundain, and laid back too though…. I am in search of a balance, just like the rest of the wobbly 2 legged creatures.

Maybe my mind is more naturally divided than most. I start reading new material and think to myself, “what am I doing???” “Am I crazy??”, but when I understand the concept or remember something new, it gives me a huge sense of accomplishment, and much needed encouragement. Wouldn’t it be nice to save lives, and know what you’re doing? Can I be that smart? In my mind I hear “Study to show thyself approved.” I know, most of the time, “talent is 2% gift, and 98% hard work”.

-Hard work

I spent hours studying yesterday. 45 pages to the electrolyte chapter and 8 chapters on our first Med Surg exam 13 days from now. That’s just 1 class. My family wondered why I was gone so long yesterday. I wonder why….. I can’t study much at home; I’m too distracted, and I don’t have the right mind set. I leave the house to “get something done.”

Every day I do more Nclex practice questions. That’s what will be used for the board exam. After this Labor Day weekend my time will be even more valuable, and my situation more serious. I don’t want to get behind or overwhelmed, but it’s nursing school. I have always said nursing school is like shooting yourself with a taser, you don’t know what to expect the first time, but you sure don’t want to do it the second time. Maybe those who go straight through it don’t have that issue, but I’ve been out of a program for some time now and was not looking forward to going back.

– Going back