Instagram post

Last weekend, my sister helped me set up an instagram account. However, because I still am in the Stone Age and only have a flip phone, my computer won't let me add anything, follow new people, or let anyone follow me. 

This doesn't bother me too much because I can still follow Taylor Swift....

Back to the point. If I had a working Instagram, I would put up a post today that might make you all a little jealous- which would obviously be the point. I would be following the perfect example of a twenty-something girl who's trying to figure out life on her own. I ask you now to use your imaginations and picture this: 

*A picture of a cute mug filled with coffee with just the right amount of cream, a crockpot filled with deliciousness, my cute boots strategically in the picture, and probably an open Bible.* (I would probably move my crockpot to my cute table just for the aesthetically pleasing effect- even though that doesn't make any sense). Then my caption would be, "Love days like this. #Blessed #Ilovefall #Nofilter" 

Truth is, I don't really like fall. Truth is, I only wear my cute boots because they feel like warm hugs on my feet. Truth is, I make coffee everyday and I still can't get the perfect amount of cream. Truth is, I have no idea if the crockpot recipe will be delicious or if it will be a train wreck. Truth is, there's no filter because I don't really know how to use one. Truth is, I am blessed. :) 

Nursing story of the week. There was a patient that I admitted to the hospital and stayed there for about ten days. I had her for maybe four shifts. She was a tiny ninety-something woman. I loved her. She was one of those patients who needs that little extra love. I had the same quality of care, but I would sit by her bed and hold her hand for a minute each time I went into the room. I spoke gently to her and listened to her concerns. When she was about to be discharged, I went to say goodbye. She took my hand and told me she loved me. Worth it. 

I don't have a clue..

People are weird.

Exhibit A: Patient comes into hospital complaining of severe chest pain, patient starts showing a deadly arrhythmia on the heart monitor, nurses run around trying to make sure that the patient doesn't drop dead. Patient is so angry that the doctor won't order their pain medication that they leave AMA (against medical advice). Later, nurses find out that patient figured out how to manipulate their pacemaker to simulate the lethal rhythm. (We're on to you buddy)

Exhibit B: Patient with copious amounts of hair on his arms and chest is going home. Nurse goes to take out IV and proceeds to pull on hair (I try my best, but what can you do?). Patient squirms and winces. Nurse tries using alcohol wipes and scissors to minimize the discomfort. Patient takes matters into his own hands and pours his cup of cold coffee onto his arm. ( ?!!??!?)

Exhibit C: Patient is in the hospital with blood pressures above 180 (normal is 110 or 120) and blood sugars of 280s (normal is around 100). Patient refuses medications. When nurses attempt to educate patient about dangers of high blood pressures and sugars, patient gets upset and tells them that nobody understands their body. (I didn't go through four years of tough schooling for nothing!) 

I have more to post, but frankly I'm exhausted and want to watch Dancing with the Stars and go to bed before 10:00. I'll post sooner rather than later and make it up to you. Thank you to everyone who encourages me to keep writing. 

-C-

My soapbox- one of many to come

Warning: This shall not be the most entertaining of posts. You have permission to go back to Facebook if you'd like, and I promise I won't be offended.

 I'm stepping onto my soapbox now. These are all just my opinions.
 
 Here it is, if you or a relative are in the hospital, you should have a conversation about advance directives. If you are elderly or have an elderly relative in the hospital, you should have a conversation about what treatment you or they want in a medical emergency.  So few people have this conversation at the appropriate time. These kinds of conversations are scary for most people and it never seems like the appropriate time to bring it up.

  There are some very old patients on my unit. As you know, age is just a number. There are people who are 94 and act like they're in their 60s. Others are in their 60s and look and act so old. I get this. However, even if your 90 year old mother has been in great health her entire life, you should talk to her about if she wants CPR if her heart were to stop beating or who should make decisions for her if she can't make them on her own. If there aren't orders for this, things can get very complicated. When done correctly, CPR breaks ribs. Depending on a ventilator to keep breathing doesn't make for the highest quality of life. If your 85 year old father wants everything possible done to keep him alive, by all means do it! However, this conversation needs to happen.

   There are a few distinct barriers that come between this conversation. Who wants to bring up the question, "what happens when I'm dying?" No one! BUT, if I'm 96 with heart disease and my heart stops beating, I think that I've lived a good life and I'm headed to a better one. Please don't crack my ribs to keep me alive for another month in a lot of pain. Another thing is that families often believe that if they have this conversation, it means they are giving up. They might believe that if they make their parent a DNR, (do not resuscitate) they think that people will stop treating her. This is not true. The healthcare team is not giving up. We're trying to help you live the rest of your life with dignity. Also, doctors have a LOT on their plate and these conversations aren't the first thing they think of when they walk into a patient's room. Most patients and families are under educated about their options. Finally, a lot of us don't want to admit that we're mortal- especially for those who aren't assured of their future with Christ. My argument is that unless Jesus comes soon, we are all going to die and we don't know when that is. Talk about it with your family.

I'm done now. I apologize for the rant. I have a good story coming up soon so stay tuned!

-C-

Makes me giggle

    I've had this conversation with a few different people recently and I'm going to try to put it in writing which may be difficult and I might be tempted to switch subjects in the middle of the post but the topic made me laugh in real life so I'm going to try it and I want to see how many of you were going to criticize my run-on sentence before I told you that I was doing it on purpose cause I didn't want to do the work of coming up with new sentences that still sounded interesting. Hehe.

    One big part of my job is doing assessments on patients. Obviously. I have my little routine down that I believe is very efficient (cause who would I be if I weren't efficient?) and I've learned a lot. Assessments are very important for establishing baselines and assessing changes. They become second nature. However, for patients who have never been in the hospital before (a number which is drastically decreasing), some of the things I do are unfamiliar. When it's unfamiliar, some patients do things that I find funny. I shouldn't laugh because how are they supposed to know? But I still end up giggling in the hallway as I leave the room.

Here are a few examples:

- I bring out the stethoscope and say, "I'm going to listen to your heart and lungs now." Before I even place the stethoscope, they start taking deep breaths. Most of the time this isn't a problem, but some of them only have the capability to take 3 or 4 before they start feeling dizzy.

- I do neuro checks on patients who have shown signs of a stroke or seizure activity or something else related to the brain. A neuro check has me making sure that the patient can use all of their limbs effectively. I test their strength by having them push and pull their limbs against my hand. (Pull your arms up, push your arms down, etc.) It's a quick and easy way to see if one side is weaker than the other. My favorite is when I have them squeeze my fingers and then they don't let go. I'm pulling my hands away and my patient is desperately trying to prove to me that they're strong and that they can hang on.

- Another neuro check feature is having the patient flex and extend their foot. They're lying in bed and I tell them to push their feet against my hand. Easy enough. Then I tell them to pull their toes towards their nose. For whatever reason, patients do not understand this concept. I remember one patient in particular who couldn't understand what I was asking until I grabbed her foot and imitated the motion so she could do it for herself.

- The elderly of this world are obsessed with bowel movements- the color, the consistency, the frequency... I feel like it might be the most exciting part of their day.

- I giggle a little every time a patient apologizes for the way their feet smell or look. Sometimes they really should be apologizing.....

- I can't tell you how many times I've had a conversation about how warm OR cold my hands are as I'm touching their feet.

- I ask people if they're having any type of pain. Frequently they say no. Then I'll start asking other questions and they tell me about their extremely tender stomach that I can't touch cause it hurts too much..... Umm.... That doesn't count as pain?

- I choose to giggle when a patient and their family member start disagreeing about symptoms and histories and medications. As the nurse, I often feel like I'm stuck in the middle of an argument. I just wanted to know if you had a bowel movement yesterday!

That's all I can think of for now. I'm sure there will be more installments in the future :)

-C-

FAQs

When talking to people over the past couple of weeks, I've found myself answering the same questions- which isn't a bad thing by any means, but I think that I could kill many birds with one stone and answers the FAQs.

How's are things going? 
This question always makes me laugh a little. It's going really well? Do you want to have a twenty minute conversation about "things" or do you just want to check up on me and make sure I'm not crying myself to sleep every night? I don't mind answering either way, it's just the general vagueness that makes me laugh. Things are going well. Yup.

Do you like your job?
Yes. Very much. I come home from a 12 hour shift exhausted and energized at the same time. It's still hard for me to believe sometimes that I'm actually getting paid for this. It's really hard work and emotionally draining, but so fulfilling.

What's your unit like?
Like I mentioned in a previous post, there are a lot of very sick patients on my floor. I can learn a lot from the different things going on. The nurses on my floor seem very friendly and like I can get along with them very well. A lot of the night nurses are new grads like me which could be really fun. I kind of hope that we'll all stick with it and gain some comradery as we figure out nursing together.

When do you switch to night shift?
I just found out the answer this week. I'll move to night shift the first week of November. It is all within the timeline they gave me, but it sure seems like that isn't very far away. Yikes! Prepare to meet zombie Caroline.

What do nurses actually do?
Ha. This is a terribly difficult question to answer in a satisfactory manner. The literal answer is that I assess patients, give them medications, chart, talk to doctors, and perform some skills. When I say it like that, it sounds so lame. There's so much more that I do that can't be counted or quantified. I promise.

How's your apartment?
It started out cute and is getting cuter! It's not quite as barren. I have internet. Today I hung up some stuff which made a difference. I got a microwave this week, and my roommate has moved in some of her furniture, so it's filling up. No issues so far.

Have you met your roommate? Has she moved in yet? 
I have met her! She seems very sweet and I think it will work out quite nicely. She's moving in on Saturday. This has given me a few weeks to kind of settle in and figure things out.

Do you like living on your own? 
Loaded question. As most of you know, I'm close to my family and would love to someday form a little family community where all of our backyards meet and I can pet/babysit my sibling's little creatures. In that respect, I miss my family a lot. However, I am thrilled to be working and being productive. It's an exciting new chapter of my life that I am enjoying a lot. There are so many new things to figure out and explore on my own. So in that respect, I'm loving this. I can go to concerts, cook new recipes (and no one will ever know that I messed it up), I can have people over whenever I want (once I get some chairs for my kitchen table), I can be a hermit or social depending on my mood. Yes, I like living on my own.

Do you think you'll stay at your hospital? 
*At this point in the conversation I inwardly think, "How in the world am I supposed to know that?" but I still try to be a polite human being.*
Maybe! I think it's a great hospital where I can learn a lot as a nurse and have the opportunity to grow in my career if I want to. I like the location, I like the learning environment, and I like the different ways I could pursue different things when the time comes. However, I have only been there for less than a month. I have no idea what the future holds for me or where it will take me. We'll see.

Hope that clears some things up! See ya soon!

-C-

Hit the ground running

    Whelp, I've worked on my floor for 4 days now. Thanks to my experiences at Mayo and Northwestern, I was able to take on a lot in a short amount of time. The last two days I had the full load of patients and did nearly all the work. My preceptor was there to support me, and when there was something new, she would help guide me through it. My preceptor is very knowledgeable and is great at remaining calm in stressful situations. I'm thankful to be with her cause I feel like I can learn a lot, but I can also learn how to do it without stressing out too much. I'll be on orientation for about 10 more weeks. During that time, I'll mostly be getting comfortable with the way things go on the floor and trying to get experience with things I wasn't able to do during nursing school (patients with traches, inserting IVs, different medications, etc.)

     My floor is a telemetry (cardiac) floor, but the patients I'm working with are very sick people. Compared to Mayo, it isn't as specialized, so I get a wider variety of patients.  I think that this is a great learning environment cause I get to see a lot. However, the patients often have a lot of complications and frequently have a poorer prognosis.

    Here's the thing: confidentiality is a huge issue which makes blogging a little difficult. However, I find the biggest problem to be that although I have so many experiences and so many stories, it's hard to share them in a way that is as meaningful in writing as it is in real life. Each day I learn something different and I am changed a little bit. You'd think that I'd have all kinds of stories about funny or difficult patients, but everything that is changing me is in the little moments. I'll try to give some examples
-I explain something to a patient and they say, "Why didn't anyone tell me this before?"
-I read a note in the chart that says my patient's wife died earlier this year. This makes me understand his attitude a little more.
-I hold a patient's hand cause they're nervous while they're getting an IV inserted. I tell them to take deep breaths and try to distract them. When it's all over, they squeeze my hand.
-A family member calls me in tears because they're worried about not being their for their loved one. -A patient down the hall dies and family members are crying in the hallway.
-A patient cries out for help and when I ask her what I can do for her, she asks me just to stay with her.
-I need to take a deep breath and wait a minute before I go into a room so that I can treat a persistent and overbearing family member with cheerfulness and patience.

These are just a few examples. I do have funny stories and sad stories and stories of patients who drive me nuts. But for the most part, it's all in those little moments. I'll try to be a good blogger who doesn't bore you with the same kind of material all the time, but I can't promise anything. :)

Caroline RN

   Yesterday was my first day actually on my floor. MY floor! Overall, it went really well. I pretty much followed a nurse around all day and tried to learn my way around the floor. However, there were a couple of highlights.

1. I got to put in a foley catheter, draw some labs, and change dressings on a stage 4 pressure ulcer. I've been trained in all of these things in nursing school, but I didn't have a lot of chances to try out my skills.

2. I made an observation early in the day during an assessment. I mentioned it to my nurse and made a suggestion. At first, nothing came of it, but later in the day, it turns out that I was right! This might not be a big deal, but it boosted my confidence in my own skills.

3. I officially and professionally signed my name Caroline RN on multiple occasions and it actually counted for something. A nurse would ask for someone to come double check blood orders and instead of sitting there feeling useless, I was able to say, "Oh yeah! I'm a nurse! I can do that!" So that was fun.

4. I have once again entered the world of holding hands, calming patients, calming families, critically thinking through situations, smiling as I enter an isolation room even though I just walked out, rubbing someone's back for two minutes, washing my hands until they are raw, and caring for patients in a holistic way. There is nothing better.

See ya soon!

-C-