JUST TOOK NCLEX!

Well I just took the fuckin NCLEX! It shut off in 75 questions and I feel like I bombed it. I got the good pop up with Pearson Vue, but that does nothing to quelch the feeling of failure. I'll keep a glimmer of hope in this cold dead heart of mine though, just in case.... Now to drink!

3 days till NCLEX

I feel like if I look at one more multiple choice question I'm going to go cross eyed

I have been doing U-world mainly and scoring in the 60-70%s, then today I started using NCSBN because I had heard that some of the questions on their sight are identical to some that show up on NCLEX and I am just bombing their questions. What a horrible feeling!

I am still trapped in this horrible cycle of: get bored doing nclex questions so I check out what the job market looks like, see great jobs that I would love to apply to! Freak out about not having my resume together, realize that theres no point in making a resume if I don't pass nclex, realize I've spent an hour procrastinating studying for nclex, and start those nclex questions back up!

I've also started eating my stress about nclex, which is probably the most enjoyable thing about getting ready to take this damn test! Frozen yogurt, gummies, popcorn, tacos... will going to get it postpone my having to do questions for any length of time? Then yes, I'll eat it.

NCLEX Bound!

So I done and graduated.

I thought I would have at least a few weeks to goof around, pre-occupied in my own amazement at actually graduating nursing school, but I got my approval to test just 4 short days after graduating.

My heart started racing as soon as I saw the email in my inbox saying that I got the go ahead to take the NCLEX, shit got real real, real fast.

I signed up for the soonest possible date to take the NCLEX, June 21st. Thats three weeks away. So, here goes nothing! I'll be trying to cram back into my brain all the information that seems to have just flooded out of it during my one week of not being in school.

"I want to talk to my fucking mom"

My last day of preceptorship was this past Sunday. I think I really liked the ER! But I never can tell with hospital nursing. This whole having more than two patients, many of which can be actively trying to die or become seriously disabled is rather stressful. But I loved the patients, I loved starting IVs, I loved starting to make connections about patho and symptoms and labs and meds. I even loved simple triumphs, like having the confidence to just put some 02 on a patient with CHF whose sat was hovering in the low 90s, I didn't even ask my nurse if it was okay first! Baby steps over here.

There was such a high population of ETOH/behavioral issues/SI/homelessness, most of which were really sad cases and I had a hard time reconciling how the staff treated them with my own personal beliefs. I'm sure you get jaded pretty quickly in that kind of setting, but jeeze...

Anyway, some less sad highlights:

Gentleman in his early 20s with crappy tattoos and a bad attitude was shooting up and I guess a bystander called PD saying he was trying to OD which the kid denied. Anyway, he's been in the ER forever at this point and is getting super agitated, and wants to go home, but he was 5150'd so he's stuck there. He spends most of the shift trying act tough "I could kick all your asses if I wanted to." And then at some point peak frustration yells out "I want to talk to my fucking mom" and I couldn't help but laugh.

Did my first NG tube which brought up almost a liter of nasty dark brown liquid.

Pt who did a ton of coke, cut off a police car whilst flipping them off.
Charge RNs response "is that not okay?"

Also, had a pt who presented with cough, recent h/o flu like symptoms. BP was 80s/40s but he wasn't symptomatic, we were giving fluids and he was getting a septic work up. All of a sudden a tech calls us in and the guy is totally restless and his 02 sats drop, so we get him on some 02, call the doc over, and just then the lab calls to say the guys troponin is 4.somthing, repeat ekg shows ? of st elevation, so a code stemi gets called! I got to follow the pt to the cath lab (he turned out not to have any blockages, but the cath lab rn was hilarious and called everyone including the pt "bro").

Now all I have to do is a Kaplan review with my school and then wait for the BRN to give my date to test.

Job wise, there is a job at the clinic that I work at, Tues-Fri, 8-5, PTO, full benefits, great pay, with people i like, that my boss pretty much said I could have. But I dont think Im gonna take it. It does feel incredibly idiotic to turn down a set up like that, particularly in todays job market, but I think I gotta get that hospital experience in now or I never will. Unless no one ever hires me. :/

ER Day 2 (Feelings)

Today my preceptor was the Trauma Nurse, she documents and assists in any traumas that come in. Struck out on that front, but we did run around helping out everyone else.

I got two more IV's in on the first try which felt great, but I'm just waiting for my beginners luck to leave me for someone else.

A patient in the hallway was getting very agitated and needed to be restrained, I saw one nurse who was designated to restrain her head, start massaging the pts neck instead of forcefully holding the pt down, which totally changed the pts demeanor and calmed her down. I thought this was such a great idea, but when I looked around me I saw every other nurse rolling their eyes.

Later...neck massage nurse had another patient who they were going to need to restrain...confused and kept trying to get out of bed, not very redirectable since no one spoke his language, sitter wasn't helping much. Old Neck Massage had our confused man set up with some televesion that she pulled up on the computer in the pts language. It totally worked for a while. Again, I thought, wow what a great nurse, she's really trying to do everything in her power to not restrain this guy. She did end up restraining him in the end, but a big debate ensued about how many restraints, and my nurse along with every other nurse there thought Neck Massage was out of her damn mind and should have restrained this guy forever ago. Neck Massage is new to the ER, but not a new nurse, she has been a floor nurse (not sure where) for some time. The more seasoned ED nurses kept saying, "you're not in kansas any more hun". Not sure how I am left feeling, my gut says that Neck Massage was in the right, but I see the logistics of where the others are coming from. You can't let a patient like that suck up all your time trying to reroute them so you wind up ignoring your other patients and falling behind.

I am having fun in the ER, despite being constantly terrified of screwing something up. All the nurses and support staff have been incredibly friendly and supportive. I think as I get more comfortable in the setting I'll have even more fun. But, I think I'm more of a Neck Massage at heart, and less of a Seasoned, and thats okay. I can have fun in the ER and decide its not for me.

That's one of the hardest parts of nursing school for me, struggling to accept where my strengths are, and accepting that my interests and skill set are not necessarily hospital material.

1st Day in the ER

Thought I was going to barf all over the ER waiting room while I waited for my preceptor.

Once I met her, all my fears went away. She is so nice, encouraging, and supportive and I am very lucky to have her as a preceptor. She already started scheming on ways to get me hired into the ER there. Fat chance, but the sentiment is sweet.

I dropped an 18G into someone with huge veins, but I got it on the first try and I felt good about that!
Straight cathed a 90yo woman
Saw nurses save the hospital a butt ton of money in the form of an intubation kit: Medical Alert called for an OD who has been given Narcan x4 in the field without response and is being bagged by EMS. The doctor waiting wanted to open the intubation kit and all the nurses advised her not to, since its against their hospital protocol. Doctor complained and complained. Then the guy shows up sitting upright and talking :)

Moving Forward

For the past 8 years I have been telling people, "I'm going to be a nurse!". And every year I spent on my schools waiting list family, friends, strangers would ask me, aren't you a nurse yet? No.... still working on that one. Well the day is almost here! I am all done with my classes, done with lectures, done with tests! It feels amazing, especially since I maintained a 4.0 GPA for all my nursing curriculum. There was a time in my life when A's felt unatainable.

The only thing I have left to is my preceptorship. 120 hours in a Level 1 trauma center. I have so many feelings about that... mostly terror. I've been reading the website icufaqs.com which is well worth a read for nursing students, even though the format is so strange (downloaded word docs) and it is certainly outdated. I've also been watching lots of procedure videos: foley catheters here I come!

My last week of psych was a great one. We had two new patients on the floor, one bipolar 1 having a manic episode, the other major depression with psychotic features. Our bipolar friend spent his days singing michel jackson and whitney houston and the star spangled banner (and nailing every.single.note.) and our depressive friend spent his time sitting in the corner not talking to anyone until we befriended him. Then we spent the whole two days playing cards, sharing stories, and he even taught us a great card trick. It was hard to leave, not only these two but all of the other patients too. There are no activities for them to do on the unit, except for 1 hr of OT every day. It felt good to have our company appreciated, and to know that we could help someones day drag on a little less by providing diversion. Psych nurses we did not become, but it did feel like we made at least a small difference.

Psych Week 4

Psych is starting grow on me, I am getting to know patients and having a good time talking/ coloring with them.
We spend a lot of time coloring, and every single time that we're done coloring, the patients always clean up the mess we have made appropriately. All the papers get gathered, pens get put away correctly in their packaging. Every single time. Even the patient who is making inappropriate sexual gestures at every body while he is cleaning up.

This week my instructor decided to join us some in our art-making. When it comes time to clean up, she shoves 20 pens into a container that holds 10 pens and bails with her papers still strewn about everywhere.

In another news, I finally got placed for preceptorship and I will be going to a Level 1 Trauma Center ER. FUCK  Yay!

Psych Week 2

During an excellent collaging exercise coordinated by yours truly, a patient found a picture of a dog that she really liked and wanted to add to her collage.

A mental health worker approaches and asks to see the picture, the patient kindly forks over the picture for her to look at. The mental health worker walks a few steps away. The patient asks for the dog picture back, the mental health worker says no. The patients asks a few more times, and then eventually shakes her head at the mental health worker and continues collaging.

This is the same patient that last week told me she likes to eat her own poop.

Psych Rotation, Day 1

1. A girl swallowed a pencil, was also caught taking the wire out of her bra to swallow.

2.   PT: "I love eating my poop" 

      Me trying to be therapeutic: "tell me more about that..."

      PT: "Well it's the only thing that helps me get a tan"

      Me: "Have you considered sitting out in the sun? To the best of my knowledge, eating poop                 doesn't help you tan"

      PT: " Well it also tastes good!" brief silence followed by a fart.. *giggles* "I farted"

You know the drought in California is bad when...

I've been a terrible blogger. In my 4th and final semester of nursing school and I have managed to blog a total of 0 times! - Edit: I'm such a bad blogger that I forgot that I had indeed blogged multiple times, like 3!

Nursing school has been a long, terrifying, and wonderful experience, but I can't fuckin wait to finish. I've done better than I thought I would in both clinical and theory classes, but still lack any sort of clinical confidence. I have come to loathe my med-surg rotations. I like to think that its not me, its that I'm always paired with nurses who are burnt out and hate students, but in truth, the more time I spend in the hospital, the less I like it. I have seen so few nurses in the hospital that looked like they actually enjoy their jobs! It's incredibly discouraging for me, I love to love my job! I love feeling competent and capable of helping people to better understand their medical problems, and providing comfort to those that are frightened. As a medical assistant I got to do this every day, as a nursing student, hardly ever. And I don't see many nurses that are doing it either. With 5 patients nurses hardly have time to talk to their patients at all, unless they have a relatively healthy case load, and no total care patients.

There have been some funny moments:

-You know the drought in California is bad when...

              You're patient won't let you get rid of the suction containers full of fluid drained from his chest because he wants to take them home and use the fluid to water his plants! 

-This couldn't have happened after we learned psych content?

               I had a patient with bi-polar disorder which I didn't bother to look up to much about before clinical because, hey, I know what bi-polar disorder is- sometimes you're depressed, sometimes you're really stoked, end of story. Having just gone in depth about bi-polar disorder I had many light bulbs go off when remembering this one patient. Any time I went in to talk to him I couldn't get him to focus on anything. He kept asking me to get him the telephone numbers to car dealerships in San Francisco (far away from us), he was jonesing to by a new Lexus. I would be sitting down charting and all of a sudden I would see a flash of yellow out of the corner of my eye, and low and behold it was my patient. Jogging down the halls in his yellow gown, yellow socks, and IV pole- with Cyndi Laupers "Girls Just Wanna Have Fun" blasting out of the phone in his pocket. The charge nurse turns to me and says, "isn't that your patient?" and I proceed to follow him around the floor all night with a wheel chair, pleading with him to sit.

I have only 2 weeks left of med surg, and then I have a 5 week rotation in Psych, which should produce some interesting stories. After that, I will be doing my preceptorship in the ICU at a local community hospital. I have had a terrible time of trying to decide where I want to do my preceptorship, I have little desire to work in a hospital after graduation, but I have been told by a few teachers that they think I would do really well in an ICU setting. ICU is very interesting to me, and I have enjoyed all of the day rotations I have been there, but the thought of working in a hospital just sounds so unappealing. I'm considering this my last ditch effort to try to like hospital work. I would love to work for hospice, or for a homeless outreach program, seeing people in the field. Maybe some day...

For now, the ultimate nursing goal, is for me and my fellow nursing friend to open up our own hospice house, our House Of Death we like to call it. It will be out in the woods, and will double as an adoption center for dogs and cats. We will offer palliative medicine, palliative music, and palliative sex. There will be lots of baking.