Oncology, ICU and the annoyance of cravings

Starting from the top…This week we are having our exam on Oncology, or as our instructor calls it “Altered cellular growth”. Basically its the cancer exam. This exam encompasses one day of lecture and one week of time to study. In other words, I feel like Im screwed going into this one. We had a guest lecturer, which is usually an excellent learning tool except this time the lecturer went at rapid pace and skipped back and forth over the topics. I felt like I wound up self teaching this entire topic, and since I was so lost from the lecture I was highly unmotivated while studying. In other words, it sucked monkey balls and Im thinking that my test score will reflect this lack of motivation completely.

Now onto the ICU. I spent last weeks clinicals romancing the ICU. Walking in I was not looking forward to working there, when I first started in Nursing school I desperately wanted to work in the ICU, but after spending the clinical rotation in the L&D I have since decided that I prefer womens health care. The ICU is full of very sick people who often have poor prognosis, and I am very sensitive to that. Dying people make me cry. Their families make me cry. It is just too hard. And my guess was correct, it was very difficult. There is just so much emotion in the ICU, people are praying and holding on to their loved ones, Nurses are scrambling to complete each task and to truly keep their patients alive. Its so hard.

The strangest part wasnt that the emotional aspect was difficult for me, but that there was just so much noise in the ICU and I was having a hard time focusing. Not the people noise, but the noise from all the machines, the beeping of the IV pumps, the dinging of the OG feedings, the whooshing of the ventillators, the sucking of the wound vacs and hemovacs, through all that I was just really over stimulated. I never thought I would be that way. I love the noise of the ED (emergency department), I love the hustle and bustle of a busy night with a full moon on payday in the ED. Those are the best nights. I dont mind the noise of people talking, screaming, yelling, arguing, laughing, crying. THose are fine noises. But the lack of voice and over abundant amount of electronic noise was so….distracting.

I loved the Nurses that I was blessed to get to work with. Those nurses are super heros, they deserve so much credit and I would love to be considered to be brilliant enough to join their ranks, but I just dont think that I am cut out to be one of them. Its a sad realization. A sad end to dream. But I suppose these are the types of things that you are supposed to learn while you are in school.

And now the last of my topics, the annoyance of cravings. Baby is keeping me from eating. And when I do find something that I “crave” by the time I make that food accesible I can no longer manage to gag it down. Im tired and totally missing eating. Its hard to be nauseas all the time, its wearing on my nerves and while I feel like I should be enjoying every minute I am lucky enough to be pregnant with this baby I am torn by being bitter that I am so sick. The mixed emotions combined with the hormonal moods are making me cry.

This weeks goal is to pull my SHIT together. I will spend this week getting back to myself. This is a good thing for both me and the Baby. I cannot wallow in this bad attitude for the next 29 weeks. I cant.

What are your goals for this week?

Dosage, midterm evals and the research paper

Today marks the quarterly dosage exam. For 5 quarters I freak out about this math test since I get horrible math anxiety and spend the week before it trying my hardest to relearn everything that I may have forgotten. Drop Factor, drip rate, Desired dose over dose on hand, etc. Every quarter I pass this exam with flying colors but spend days sick to my stomach about it.

This quarter is different. There are other things that seem so much bigger in the scheme of things (like dead babies, cramping, doctors appointments, and so on) so I studied a couple of hours but nothing like in previous terms. I take the test this afternoon so we will see if the new approach was effective. I feel pretty confident about it and I really hope that I did the right thing in maintaining my calm.

Tomorrow is my midterm eval for clinicals. I am really looking forward to this because I feel like I have been doing really well and really have the hang of assessment, diagnosis, planning, implementation, evaluation (ADPIE). I also feel like this quarter I have started to find my groove as a Nurse, I do my assessment in my own way. Its still systematic but instead of starting at the head, I start at the hands and got up and then back down to the feet. I feel that it gives the patient a little more “face” time with me before I start putting my hands on their heads. Im not saying its the best way to do things, but it works for me because I always start by shakking the patients hand and since I am there I can check pulses, cap refill, and strength. Im just happy that I found a way for me to make it work for me and still get all the neccessary things done. So I guess we will see tomorrow if my instructor feels like I am doing as well as I feel like Im doing.

I have a big research paper to work on this weekend. Not really excited about it, and even though I am still tossing back and forth about my topic I think I will just get on with it already. We were assigned the criteria to write the paper and the due date has to coincide with the topic we are discussing, and we get to pick the topic. I looked for interesting Neuro topics, but when the Neuro material was being lectured I was so busy with other things that I couldnt get it together. So we are now talking about Hematological stuff and I noticed that we didnt cover Hemochromatosis.

I had a coworker of mine who was diagnosed with Hemochromatosis a few years ago and I remember hearing and thinking how interesting it was. So I started looking into it and I think it would be worthy of my topic. Hemochromatosis an inherited condition where you absorb too much iron from food and it builds up in your blood. The excess iron causes damage to your liver, heart and pancreas and can lead to cancers, heart or liver disease and even death.

Interesting, right?

I think I find it the most interesting because I am iron deficient, and so the thought of having too much iron is facinating to me.

Alright, back to studying…..

Neurology makes my brain hurt!

This week we were focused on Neuro, personally I think that Neuro is almost as difficult as endocrine. There is just so many things to remember and also there are so many things that can go wrong!

Because of my cold/bronchitis that I was struggling with this week, and also because of the pregnancy fatigue I had a really hard time staying focused. Sometimes I just dont feel like I able to give it as much as I did before I was pregnant. I just cant pull the all nighters or study for hours on end anymore. Does anyone have any study suggestions for me?

Dont get me wrong, Im still studying my butt off. Its just that instead of sitting and reading for 5-6 hours straight, not its like an hour of studying and then get up walk around and try to eat something. Honestly I spend a whole lotta time trying to eat.

So back to Neuro…really.

Being sick while in Nursing school

There are some things that just suck beyond belief, and one of them is being sick while in Nursing school. It is so hard to stay home and take care of yourself because you really cant afford to miss any of the classes. On the other hand, you dont want to go to school and contaminate the entire class room.

I have a low grade fever, cough, runy nose, congestion, upset stomach, and I am just exhausted. I would love to stay home but I have a presentation to do today for my Ethics class. Today is my long day of classes, a really long day. I hope I can make it through.

The second part of this that is annoying is that with being pregnant, there is almost nothing that I can take (ok there is, but it doesnt work). So I have to tough it out. And Im gonna whine about it. Alot.

Its time to micturate

With Renal on my brain for todays exam I have to say that my increased micturation rate has left me thinking about renal about 22 times a day (I wish I was kidding).

I can only imagine how much worse this will get once the baby gets bigger! Instead I am left thinking more seriously, like there are not enough potty breaks planned into the nursing program. We get an hourly stretch and bathroom break, but I seem to need to go every 30ish minutes. This makes things very interesting!

Studying was very difficult this weekend as my brain was somewhere else and my attention span is that of a flea. Where I used to be able to sit and study for hours at a time with no breaks, I am now only able to read for 15 minute spans of time before I have to stop for either a bathroom break, or because I have been reading the same sentence over and over again and still dont know what it says.

I read about Angiotensin II for over an hour and I am still kinda foggy. I finally understand about Acute renal failure and Chronic Renal failure. And I have a very good understanding of UTI’s and Renal Calculi. Its the dialysis that I am totally stuck, there are a couple types and I have a feeling that I could read about it for weeks and still not get it completely.

This morning I have my exam in Renal, and since it is the first exam of the quarter I imagine that the score will leave much to be imagined. I always start the terms out with low scores, always. I think it takes one test and the fear of failing to get my arse in gear. So here is to hoping that I can score an 80% or better and that the extra brain cells in my uterus are able to help me retain some of the information!

Angel vs Blackboard

My nursing pogram has gotten really into using the hybrid classes this quarter. This all actually startedast quarter but has become predominant now.

When I started Nursing school the instructors would leisurely post paperwork on Blackboard for us to print before classes. Some professors used it, others didnt, but basically there was no consistency with even the ones who did use it.

This quarter is totally different. All the classes are hybrid, meaning lecture time in class and quizes are done at home online. On top of this they switched to a new system, Angel.

Now I found Blackboard to be unorganized and difficult to manuever. Angel seems so much better except tht it prefers firefox over the regular internet.

Does anyone else have any experience with these hybrid syle classes?

I love the online aspect! And it make me so excited to start the next leg of my degree!!

Dear Intrapartum paper,

You almost killed me. This was by far the hardest paper that I have ever had to write in my life. It wasnt so much the length of the paper that was difficult, but it was trying to decribe all the details of that delivery.

The delivery I was blessed to be able to participate in was so incredibly quick. The woman was such a rockstar that I could barely find things to say.

I have an entirely new perspective of “natural” deliveries.  I had always envisioned women screaming and yelling and groaning and looking just horrible. This fabulous woman really set me straight. She had barely a hair out of place and she made pushing look like no big deal. Her labor looked more like leisure. Im not kidding!

Now, I know that this is not the typical labor. This truley is more storybook than reality, but it was amazing to watch!

And documenting it in my intrapartum paper was nearly the death of me.

And I signed up for this torture why?!

I swear that it was just yesterday that I was talking about the magic of L&D, and how very much I am enjoying this clinical experience.

That was yesterdays yesterday. The real yesterday was HELL. I worked on the GYN recovery unit and was assigned a patient who I spent all night doing paperwork on. When I showed up in the morning she had been discharged. No big deal, or so I thought. Then I was assigned a new patient, instructed to complete a full data plan and concept map including two diagnoses and plans of care. The rationale that made no sense to me is that I would not be able to complete those tasks until last night, AFTER I had cared for the patient. And I won’t ever see that patient again.

Oh yeah, and remember that first patient…Well now I have to make up an evaluation to a plan of care I was never able to implement because she was discharged before I arrived. So NOW I have TWICE the F*cking work to complete. And I spent the day just shadowing my nurse and being her errand girl because I didn’t know any of the patients meds so I couldn’t admin them, and since I didn’t know anything about her procedure I couldn’t really care for her. AAARRRRGGGGHH!! I’m pissed.

Now, I get my new patient assignment in our nursery. I was so looking forward to this part of the clinical because I have tossed around the idea of maybe working in a NICU, so this would give me a taste. Instead I find that I was not provided the materials to complete the care plan. We were told that these materials would be placed online, and instead they weren’t. Frankly because SOMEONE isn’t doing their job.

I mean seriously people, I am expected to come to class prepared, so how is it that the instructors don’t have to be?

I feel like they have stuck my in a row boat without oars. They are not providing us the tools to succeed.

I’m so F*cking mad.

So now, at 0130 in the morning I am still attempting to complete my concept map for a child using an adult’s care plan. FAIL

I am attempting to fill out my lab sheet with values for my neonate using the lab sheet for an adult. FAIL.

I am attempting to plot my neonate’s growth and development without a growth chart. FAIL

I am going crazy from the lack of available tools. SUCCEED!

I cant bring myself to write about the Vagina….

Im having some writers block. In general I havent been able to get myself to start a decent blog. I have a ton of random things going on that are making me think in an incredibly unorganized manner. So here is my verbal/mental diarrhea.

My husband is coming home SOON! So soon that I can barely stand it! I cant wait to see him. Although it is making me incredibly distracted. I didnt realize how very much I missed him until the countdown to coming home got started and now I am going a little stir crazy.

I saw the most beautiful birth. And because of that I need to write a HUGE intrapartum paper. I cant get it started, I jsut cant begin the paper. The birth made me feel things that were wonderful and also that were incredibly painful. It made me wonder about alot of what-ifs, alot of whens, and a ton of maybes. It short, it confused the hell outta me.

I feel at peace in womens health and it makes me want to go further in my schooling to actually get my FNP or to become a midwife. I love Womens health. And I would love to work in a planned parenthood type environment. Many people may not think that is worthy but I think that the underpriveleged are the ones that I am made to help.

The weather is starting to get cold, and all I want to do is snuggle down and keep warm. I cant wait for this Christmas, as I will get to spend it with my Hubby and also with my amazing inlaws!

Wow, I feel a little better. Maybe now I can write that monster of a paper.

My study distraction

Falling asleep with your OB text gives you weird dreams

Really it does. I dreamt about vaginal deliveries and doing cervical checks. Very weird.

I cant wait to start school. Im so nervous and excited. I cant wait to get my hands dirty!! I love clinicals!

I heard that I got assigned a really hard Clinical instructor. She failed two people last quarter. She is known for having high expectations, but Im ok with that! I love it when the instructors are strict!

What is your favorite clinical experience?