My Life in Lynchburg

Done

2010-05-12T17:15:00.002-04:00

I would just like to share that I took my last final this morning. I am done with college, done with nursing school.

I SURVIVED!

Thank you all SO much for your 4 years of prayer and support in this journey. God has blessed me so abundantly these past 4 years through you; I cannot imagine going through nursing school without such amazing parents and family. I can't wait to celebrate graduation with you all!

Weddings

2010-04-30T22:32:00.007-04:00

It's wedding time! A few friends are getting married after graduation, and my close friend Kelsie is among them! She is getting married in July, and I couldn't be happier for her. I had a great time celebrating with friends the soon-to-be Mrs. Josh Saefkow.

Kelsie was my roommate freshman year and has been a great friend and study partner throughout nursing school :)

Congratulations Kelsie!

Weekends With The Cousins

2010-04-19T18:05:00.031-04:00

A few weekends ago, Katie came down with Mom and Aunt Becki for a visit (during the time of the rat) and tour of the nursing department! We had lots of fun walking around campus and Katie was able to come to some classes with me. Thursday we went to my Bio Medical Ethics class and learned about abortion issues. Friday, we went to my Advanced Critical Care class and Katie was able to go through an assessment of a trauma victim with chemical burns and a big piece of wood impaled in her chest, then got to run a code with us and do chest compressions and bag mask ventilations. She had a great time, and I was glad to have her hang out with me!

Here's Katie learning how to prime an IV line and hook it up into the IV pump. Aunt Becki had just said, "Look! She flicks the tube just like a nurse!". Ha ha! How did she know there's a special flicking motion that you learn in nursing school?

Our OB/Neonate ICU simulation lab: the babies here can have pulses, become hypoxic (lack of oxygen, and you can see their lips turn blue), and you can see the umbilical cord's 2 arteries and 1 vein. See the placenta at the bottom right corner?

Kaie got to learn how to manage and take out an IV. She would love to tell you everything you would like to know about it, so just ask her next time you see her!

Here is a special device used to illuminate the veins when you can't see them to put in an IV. All the dark lines here are Katie's veins in her elbow. She has a nice juicy one there in the middle:

Last weekend, Mom, Matt, Bryce, and Brandon came to visit! Brandon wants to be a veterinarian, so we took a tour of the anatomy department and nursing lab and then went out to spend some time with the animals of Lynchburg.

We went to the Virginia Safari Park. It's a zoo filled with all sorts of animals from around the world, and they just roam around in open fields that you can drive through.

We were able to feed the animals through the windows, but most importantly, Brandon was able to see how he would be able to handle caring for the gentle creatures of this earth.

First, he put himself in the hooves of the animals he would be caring for:

Then, he practiced his technique on Bryce, who was a healthy, spry 16 year old eager for the experience:

Then it was off to the field, where he could truly practice his assessment, diagnostic, planning, implementation, and evaluation skills:

"Do you think I'm white with black stripes? Or black with white stripes?"

("C'mere little buddy! Lemme see ya!")

("How're you feeling today?")

"I've been better. Can you see me from back there? Do you want me to say 'Aaah' or anything?"

"Are you the doc? I've got this weird green stuff coming up when I sneeze ...."

"Well, someone told me my tongue was purple."

He's a natural.

In all seriousness, Brandon really loved the animals, and he'll be a fantastic Vet! He wasn't afraid to call any of the animals over with a "Hey, little buddy!", and he didn't mind getting sneezed on by an Eland!

Matt and Brandon after getting sneezed on:

Bryce had a good time with the animals too!

This moment was special. This little guy had bad breath, but just wanted something to eat! I guess Bryce couldn't make it as a doctor; you're not supposed to show your true feelings on your face for the patient to read.

I even think Matt enjoyed himself. Here he is challenging what he called "The Alpha Male", who stood by the side of the road and waited for people to stick out their bucket full of feed. This animal would take a few gentle nibbles, then his eyes would get big and his pupils would dilate and he'd grab the side of the bucket with his mouth and pull until the person could hold on no longer! There were empty buckets scattered all around his feet. Brandon was the first to experience the brute, but Matt was determined not to let the guy win.

Brandon:

Matt:

We had fun pulling ahead after dealing with this guy and watching as the next car pulled up and had the bucket pulled from their window!

I thought this camel had rabies, but he was just eating a whole feed bucket, silly guy!

The exotic bird house:

Feeding the giraffes:

On the way back from the Safari Zoo, Brandon updated his status on Facebook about the experience. He later got a call from Aunt Michelle, and this is what we all got to experience listening to Brandon's side of the conversation in the Jeep:

"Hey, Mom did you see my Facebook status? Go on and look at it......... No, it's a 'Nah-zee'........... yeah, I got sneezed on by it....... No, a 'Nah-zeeee', that's how it's spelled, N-A-Z-I."

I looked at Matt and said, "A Nazi?"

Matt and I just looked at eachother and laughed, realizing that his Facebook status read, "I just got sneezed on by a Nazi". Brandon thought it was funny too :)

It was hilarious. We looked up the animal in the brochure from the zoo and saw that the animal was called an "Eland".

After the safari zoo, we went to the Toby Mac concert on campus. Toby Mac went to shool at Liberty, and he always gives a great concert. Opening for him was Skillet, a screamer/hard rock band that named themselves after a frying pan, and insists on playing very very loud. Their fire effects made us feel like we were in a skillet! Bryce and Brandon thought they were the best of the night. Mom, Matt and I liked the end of their last song the best.

Watiting for Toby Mac to come on!

Best quote of the week from Brandon at the Safari Zoo: "This is better than Grove City! Sorry, Matt."

ATI - RN Predictor

2010-04-15T11:16:00.005-04:00

We seniors have taken our last ATI test! This ATI exam does not affect our grades, like the tests did last year, but it does predict how we will do on the NCLEX exam.

The NCLEX exam is the test you take to get your RN license. It is a computer adaptive test, meaning that the next question given depends on how you answered the previous question. So if I get a question wrong, the next question will be easier (and probably concerning the same topic), and if I get a question right, the next question will be more difficult. There is a "passing bar", and as long as you stay above the passing bar you are considered to be "minimally competent in nursing", and you pass! Our teachers keep telling us, "You are all... minimally... competent." :)

To explain this bar, think of a ladder with a red rung smack dab in the middle. We all start at the minimally competent rung. If I get the first question right (a question that would be considered to test minimal competency), then I move up a rung into the passing zone! But the next question is harder now, and if I get it right, I move up another rung! The next question I get wrong because it's about a drug I've never heard of before, so I move down a rung, but I'm still above the red one, so I'm still passing. This keeps going; up and down and up and up (hopefully), and as long as I end up above the red rung when the test is over, I'm good.

Some NCLEX facts to scare us:

The NCLEX exam is written by nurse specialists who are experts in a cotent area of nursing.

All content is selected to allow the beginning practitioner to prove minimum competency on all areas of the test plan, and tests your judgment and discretion and ability to think critically and solve problems.

Minimum competency questions are most frequently asked at the application level, not the knowledge level.

Questions and answers are written in such a way that you will not be able to predict or recognize the correct answer.

The answer choices have been extensively tested, and the people who write the questions make the incorrect answer choices look attractive to the unwary test-taker.

So, I took the ATI exam consisting of 180 questions. I even used the Decision Tree for a few of the questions, and it helped! In order to pass the test for school, we needed to get a 70% or higher; this would put us in the high 90th percentile for passing the NCLEX exam the first time.

At the end of the test, my results showed that I got an 80%.
My predicted probability of passing NCLEX-RN on the first attempt: 98%!!!!!!

Mean Score - Nationally: 71%
Mean Score in the Program: 70.7%
My Percentile Rank - Nationally: 91
My Percentile Rank - Program: 91

The biggest thing I need to work on: Pharmacology.

The Interview

2010-04-13T18:23:00.003-04:00

I had typed out the story of my interview last night, only to accidently delete it. I guess this really isn't a good excuse as to why it's taken me a whole week to update everyone about what happened! Sorry! And thank you all for your prayers :) Here is everything I can remember about what happened last Monday.

This interview was probably the weirdest and biggest thing I've ever done.

Weird because: It's a big-girl job. It's part of "the real world". It'll be what I do till I'm in my 60's.

Big because: It's a big-girl job. It's part of "the real world". It'll be what I do till I'm in my 60's.

So here's how my day went: I woke up and put on my best black pencil skirt, light blue striped collared short-sleeved shirt, and black heels. Boy did I look professional. I was so excited to be walking back into the doors of Johns Hopkins; it's always a great feeling, less so when it'll be job time and it's 6:00 am (actually still a great feeling, it's the alarm going off at home at 5 that is less than ideal).

It was also great to be back in the NICU and see everyone I've worked with. I enjoyed looking on the boards to see which babies were still there that I have cared for, too :) Such cuties!

The first thing I did was meet with a nurse manager and talk about my ethical issues with abortion and active euthanasia (where the actions taken by the medical team directly cause the death of the patient, rather than the removal of medical treatment and allowing the illness itself to cause the death of the patient [Passive euthanasia]). Active euthanasia, a form of physician assisted suicide, does not happen in the USA except for in one state, but I wanted to cover all ethical situations that I would be unwilling to participate in after learning about them in class this semester. After the nurse manager explained to me how my scheduling would work (work every-other weekend for the first year then every third after that, working half of the holidays, working 8 and/or 12 hour shifts), we headed over to a conference room where there were 3 other nurses waiting for us! I interviewed with all 4 of them, but it wasn't as frightening as I thought it would be because I knew them all and they were kind!

The interview started with me telling about how when I was in middle school, I saw a TIME magazine article about a neonate and the nurses in the NICU, and I told my mom that "this is what I want to do!". I explained how I love children and feel that it is an amazing experience to be able to care for the most helpless. I also told them how I came to work at Hopkins and how I love being a part of such a distinguished team.

The majority of the questions were based on previous clinical experiences or asking how I would handle certain clinical situations. I was able to tell of my missions trip to Guatemala, where I translated spanish and worked all day long (the question being if there were ever a time where I had to move-move-move all day). I wasn't asked to give my weaknesses, but I was asked if there were a time where I felt overwhelmed, and I told them that there has not been a time that I can remember where I was not able to do the work required of me (and I attributed that to the fact that I have had great fellow nursing students and instructors who were always willing to help me if I needed anything, and that in my down-time, I can be of help to others).

An interesting question that ended the interview was if I felt my CNE experience at Hopkins has helped me with my Leadership clinicals here in Lynchburg. I have felt that my CNE experience has been a great help and that I have been able to see both sides of patient care and learn how that care differs when I am practicing as a nurse. I also told them how I would tell myself, when first starting in the NICU here at school, that I needed to have a teachable spirit and be quiet and learn... that there was much I could learn from my preceptor who is an expert in her field and has much wisdom. They asked for examples of how things differed from Hopkins and I told them how there is about 5 patients in the unit here at school compared with the 45 at Hopkins! I was also able to remove an umbilical venous catheter (an IV line placed in a vein in the umbilical cord) from one of my patients (nurses do not perform this at Hopkins) and how I feel guilty eating my lunch with the other nurses in the unit (this isn't allowed at Hopkins!). They thought that was funny, which was a nice way to end the interview, in my opinion.

All-in-all I feel the interview went well; but I do feel like I repeated myself at times. It was weird after the interview feeling that there was nothing more I could do but wait for their decision. They still have 4 more people to interview (I was the first) and they won't know how many positions are available until they get their budget back for the unit. But it really is nice to know that it is in the Lord's hands and that His will for me will be done! So I'm not feeling anxious... there's simply no reason at all to "worry about tomorrow..." :) Plus I've got NCLEX to think about, and actually there is worrying involved with that. Baaah!

Before heading back to school, Matt and I had lunch at a fun Greek restaurant in Baltimore. I tried really, really hard to pay for it all, but Matt insisted. What a nice brother ;)

P.S. - I have some amazing pictures from Mom, Matt, Bryce, and Brandon's visit this past weekend, but I've lost the cord that transfers my pictures to my computer. So until I can get a new one, I'll have to just tell you - the pictures are worth waiting for.

The Decision Tree

2010-04-03T13:06:00.006-04:00

I'm in the process of finishing out the last semester of my college life. There is no greater feeling.

One of my classes is a review course for the NCLEX RN test I'll be taking after I graduate. We are learning how to answer questions and get the right answer (easier said than done) even when we aren't sure what the question is asking, or when we feel that every answer option is right! After each class, we all feel stupid.

More on what the NCLEX test is like later. First I want to show you what it takes to answer one question.

The Decision Tree:

Here's the best example I could find in my book to go through the Tree with. Try to go through the steps yourself and see if you can get the right answer!

Question:

A child has just returned to the pediatric unit following ventriculoperitoneal shunt placement for hydrocephalus. Which intervention should a nurse perform first?

(A VP shunt is put into the head to drain CSF fluid that the baby's body can't drain by itself; Hydrocephalus is a big word for fluid (CSF) on the brain).

1. Assess intake and output.

2. Place the child on the side opposite the shunt.

3. Offer fluids because the child has a dry mouth.

4. Administer pain medication by mouth as ordered.

The Decision Tree:

1) Can the topic of the question be identified?

Yes - Proceed to step 2

No - Read answer choices for clues. Identify the topic question. Proceed to step 2.

Topic of the question would be... PRIORITY intervention for VP shunt. On to step 2!

2) Are the answers assessments or implementations, or both?

- A mix of both? Read the step/topic of the question to determine if it is asking you to assess further or implement. Select correct answer.

- Are all answers assessments or implementation? Proceed to step 3.

With this question, answers are both assessment and implementation. 1= assess. 2= implement. 3=implement. 4= implement.

I think we need to go to step 3.

3)Maslow's Heirarchy of Needs - Physical or Psychosocial needs?

Does Maslow fit?

No - Are all answers physical? Proceed to step 4. Are all answers psychosocial? Proceed to step 5.

Yes - Eliminate psychosocial answers (they will never precede physical needs! Pain is considered a psychosocial need). Do physical needs make sense? ABC's (priorties of patient needs; Airway, Breathing, Circulation).

We can eliminate some!

4) All answers physical?

No - step 5

Yes - ABC's

There is nothing about the patient's airway or breathing...

5) What is the outcome of the remaining answer?

Is it desired? Select correct answer.

Desired outcome is correct functioning of the shunt and being sure it drains the CSF.

Whew. That's quite a lot of work for one answer! Which did you pick?

The correct answer is....

2! Placing the child on the side opposite the shunt prevents pressure on the shunt valve. Intake and output will also need to be assessed, but that isn't the nurse's priority. The child is usually on nothing-by-mouth status until bowel sounds return/able to eat. Pain medications should be administered by an I.V. route initially postoperatively.

Very rarely does it seem that there is a clear-cut answer, even when using the tree. I hear that some have felt that all they did during the NCLEX test was make educated guesses. I am sure that these test taking strategies help, even if only to make educated guesses!

Things To Do:

2010-03-24T21:32:00.003-04:00

1. Find a yellow outfit for Grace's birthday :) Yay!
2. Begin studying between 4500 and 5000 NCLEX review questions (for my nursing exam when I graduate).
3. Laundry
4. Get two clinical instructor recommendations, a transcript, and new outfit for...
5. ... my interview at Hopkins!!!!

I have an interview with the NICU on Monday, April 5th, so be praying for me as I mentally prepare for this; I'll be interviewing in front of a few people this time. Thankfully, I'll know them since I've worked with them over the summer and winter, but I'm still nervous! This is such a huge opportunity for me, one that I am so thankful for and excited to begin. I've really come to LOVE Baltimore more and more the longer that I've been away from it. I can't wait to get home and settle in and start this next chapter of my life at home, and at Hopkins if that's where the Lord leads me!

I just want a crab feast, to go to an O's game, to get some ice cream at the Prigel Family Creamery, sleep in my enormous fluffy cloud bed, and be around YOU all again. So... for now... I'll see you for Easter; but in 52 days, I'll see you whenever I want!

I Found It In The Kitchen

2010-03-20T20:45:00.002-04:00

Gross.

I got home from spring break Wednesday night, in the dark, and had to walk into my house all alone. I walked into every room with a broom making tons of noise, even looked under my bed, but saw nothing. The last room I went into was the kitchen, and as I turned my head to look at the floor, I saw a little rat butt poking out from under the cabinets... my cabinets actually... and I sucked wind. I found it odd that the mouse was still in the middle of the kitchen after I had been making so much noise with the broom, so I walked to the other doorway of the kitchen and looked in from a safe distance. There it was, grossing me out. So, I called home, and Matt picked up. I think he loved that he picked up the phone and got to hear me in such a panicked state. Here's our conversation:

"The rat's in our house!"
"What?"
"Eeeeh, is Mom or Dad there?"
"Hahaa No."
"Ewww it's in our kitchen."
"Ok...Heehe haha!"
"It isn't funny I almost walked on top of it!"
"Yeah? And how does that make you feel?"
"uuuhhh, ewww! ok..."
"April, talk to me"
"I'm all sweaty and my armpits are itching, that's how it makes me feel."
"Ha haaa! Are you looking at it right now?"
"No I walked away. EEEh. Ok. You get to play this for everyone because I'm sure it's being recorded."
"It is. Ha."
"Alright, I'm gonna hang up now and call Dad."
"Alright, one second though, Dad's at work. Ummm another question, do you have a crush on anyone?"
"Do I have a crush on anyone.... haha, no."
"Hahaha."
"Eew I'm so creeped out Matt I have to go, I have to call Dad."
"Alright, what's Dad's gonna say?"
"I don't know, I'll call the landlord."
"Call up one of your dude friends and tell them to come over and get it."
"Alright, aaah. Ok bye."
"And then block the entryway so It doesn't get out of the kitchen."
"It's dead!"
"Oh it's dead?!"
"Matt, I think so, I'm not gonna go close to it, but it's not moving, EEEW!"
"Call one of your dude friends. Call the one that broke the Jeep window because he owes you, and me."
"Ok."
"Alright."
"Ok. Everyone's on spring break, but alright."
"Alright, bye."
"Bye."

There it was folks. And in case you couldn't tell who-said-what above, Matt's the one who kept saying "ha ha".

It'll Be Funny One Day, Right?

2010-03-14T14:22:00.002-04:00

Update on the mouse situation: well, it's a rat.

My roommates and I have a rat living in our house, and my nightmare of stepping on the body of a vermin almost came true. We had set out a couple mouse traps to catch the little guy Lindsay saw in her room. After weeks of no success, we assumed he went back outside after all the snow melted. Some time last week, I was home alone, in my room with the door closed and heard a loud chewing noise coming from somewhere in the kitchen or dining room. I ventured out with as much bravery as I could gather while being home alone with a "mouse" but soon realized that the noises were coming from inside a wall. Eeeew! My roommates started hearing the noises throughout the day as well.

So, this past Thursday night, I was getting ready for the arrival of my mom, Aunt Becki, and cousin Katie for the weekend. While I was in my room I heard the wires behind my desk shift. I convinced myself that it was nothing and continued getting ready for my family to arrive, when I heard them shift again. As quickly as I could, I threw open my door and ran out into the hallway, screaming "The mouse is in my room!". My two roommates ran to my rescue, one of them kneeling down to look under my bed and the other walking around and making noise with a broom. I was standing at the doorway really grossed out. Then suddenly, we heard scurrying and a big, ugly, black RAT ran behind my desk and out the doorway.... towards my feet.

I screamed and jumped in the air as I saw this "not a mouse" hover under my feet for a split second in all the confusion, and all I could think to myself was, "I'm going to land on it and feel it under my feet! (read previous post)". Thankfully, I did not land on top of the rat, but ran instead back into my room and jumped into the middle of my papasan chair. Mom, Aunt Becki, Katie arrived soon after this mess.

We were all in the hallway and my roommate started opening a cereal box. I thought that the rustling of the cereal bag was the rustling of the rat, and when I gasped, Mom, Aunt Becki, and Katie thought that it was the rat coming out. I can't even begin to describe the scene. Mom and Katie screamed but both maintained a stellar composure when compared to what was going on next to them with Aunt Becki. She lost her head and started jumping up and down on top of Katie, screaming and spinning; she told us later that she twisted her ankles and momentarily lost her vision! Needless to say, no one wanted to sleep on the floor that night, so we all went to a hotel. Over the next couple of days I was discovering more and more rat poop in my room, under my bed, and in my closet.

The exterminator (I now feel that exterminators are very, very brave men) placed sticky traps and rat poison throughout the house. Hopefully, when I get home, the rat will be dead! Hooray!

Of Mice And Women

2010-02-18T16:48:00.002-05:00

Yes, I have legs so pale they are almost transparent. But, this is what I look like every night while getting ready for bed, because we have a mouse in our house.

And yes, it knows we are afraid of it, and yes, it probably lives in our walls with an army of 500. And yes, I refuse to walk around the house without shoes on, because if I did, the mouse would know, and scurry across my feet (or, in my process of jumping and screaming, I would accidently land on top of it and feel it under my foot).

And I'm sure that the mouse can get into my room despite the fact that I have found a new use for my school books; blocking the crack under my door.

It turns out my fan sounds just like a chitter-chattering mouse.

And yes, when I heard there was a mouse in our house, I mentally went through Dr. Seuss' Cat in the Hat, Fox in a Box, Mouse in a House rhyme.

And yes, I am quite certain that this mouse knows how to climb into washing machines, cabinets, bath tubs, beds, and toilets. And for that reason, I take deep breaths before entering any room of the house, and I whistle under my bed each night to see if a little creature responds.

My Goodview Room, With A Good View!

2010-02-06T15:50:00.004-05:00

Here's my house on Goodview Street,

before:

and after:

I'm watching "Say Yes to the Dress". I have a little entertainment corner, with a TV, bookstand, and chair to read in.

Behind that is my dresser with some of my favorite pictures of my travels on it. My bed wall was boring, so I put up a painting from Australia.

My desk, across from the window, full of things to distract me from doing my schoolwork.

And last year's The Office calendar is hanging on my wall.

My door and closet...

... and a lose up of the awesome mirror my dad custom made for me!

My view outside my window is so pretty in the spring, our neighbor has a large garden, and there is a bush just outside my window that grows beautiful pink flowers.

But right now, the view is nothing but snow! We have about a foot so far, and it's supposed to snow every three days or so for the next couple weeks.

Leadership Clinical

2010-01-29T13:48:00.004-05:00

I have gotten my Leadership clinical assignment and it is..... the Neonatal ICU in Lynchburg! My plans for carpooling to Richmond didn't work out, but I am still thankful that I will be able to work with neonates this semester. I pray that God uses this clinical time to help me feel more comfortabe as I begin caring for these patients as the nurse, and not the CNE. I hope to be the kind of nurse that can be trusted by my patients (or the mommy and daddy in this case), their families, and the staff I work with! I am excited to begin my time in the NICU developing my crital care skills!

Update, Senior Year

2010-01-25T19:48:00.002-05:00

It's hard to believe that it's my senior year already! This place has become my routine; when I go HOME I feel out of whack! I forget to take my medicine, I eat "weird" food (not raw food)... I can't wait for home to be my normal routine again. Not so I can eat normal food and forget to take meds, but so it can become my full-time life again.

This semester has been super easy so far. I am in Community nursing, where my clinical experience involves 4 Mondays of working with a hospice nurse. It will be a new experience for me, but I am curious all the same. My Leadership class will have 5 clinicals, one weekend every month, from 7a-7p. I haven't heard where I will be yet, but I signed up for the NICU here in Lynchburg and the NICU in Richmond, VA. It is most likely that I will be going to Richmond because I have 2 other friends that signed up to be in the same hospital. Our professor should want to take advantage of 3 students willing to drive and stay in Richmond together. It would be a fun weekend for us to hang out together and have time with eachother before graduating. My Advanced Critical Care class has just a handful of students in it. It is a much more personal class, where we have discussions on what we are learning and have lab days where we run through codes and trauma cases. There are no tests in this class either! Lastly, I'm in Biomedical Ethics. This is an interesting class because it will help me to be able to back up my opinions better; like how I feel about abortion, physician assisted suicide, euthanasia, etc. These are issues that I will have to face in the NICU, probably even during my interview!

Each of my professors in my classes said that we will get out of this class what we put into it, meaning that getting an A should be easy, heh heh heh. Yay! I would love to get straight A's this semester!

Just a few more months left!

Go Ahead, You Can Laugh

2010-01-05T17:15:00.002-05:00

The road to becoming a nurse is not without its troubles and concerns. On occasion, the learned nursing student will self-diagnose her/himself with everything that s/he has learned in class.

I am not the exception. I might even be the extreme.

Over the past 3 and a half years, I have self-diagnosed, at one point or another, believing it to be true for any amount of time, the following conditions:

1. Supraclavicular Nodes (feeling one of these is bad news)
2. A Blood Clot (that was not too long ago)
3. Leukemia (I had a total of 1 symptom)
4. Spontaneous Cerebrospinal Fluid Leak (because I had a runny nose)
5. Urinary Retention (turns out I just didn't have to "go")
6. Pre-Ventricular Contractions (actually this wasn't too far-fetched, but I still didn't have it)
7. Atrial Fibrillation (which would cause a blood clot, sooo...)
8. A blood clot, again
9. Ventricular Septal Defect (this is a BIRTH defect, I was 20 when I "acquired it")
10. Anemia (like the serious kind)
11. Chronic Fatigue Syndrome (again, not too "out there", but not entirely accurate)
12. Crohn's Disease (just a little tummy ache)
13. Meningitis (my neck really hurt, okay?)
14. Umbilical Hernia (after a big day of eating...)
15. Melanoma (some people pronounce this as "freckle", as in my diagnostic case)

I won't even go into things I learned in my Psych class.

Lucky for everybody else in the world, I keep these diagnoses to myself, until now.

Also, don't meander onto GOOGLE Search when you have any of the concerns listed above, it's just not helpful... or when you have a runny nose, a full tummy, an ache or pain...

Christmas Vacation

2009-12-22T13:04:00.002-05:00

I have loved being home for a white Christmas! We haven't had snow this early in the year in a while. Grace and Leah loved playing in the 20 inches we got over the weekend while they were here spending the night, and I'm glad that the snow came early enough that by today, the roads won't be too icy when I head into work.

I've had a decent break from arriving home from the end of the semester to getting back to the NICU. As always, I am excited and ready to get back! I am not scheduled to work Christmas (my last time saying that in a while) and I am off the day before (and day of) Mandy's wedding.

My trip to Dr. Brody's yesterday revealed a completely healed liver and bile duct! I got the complete work-up (meaning he used all of his machines on me :)) and he found that my heart, kidneys, and adrenals are the next up to be worked on. My adrenals were a 32 on his chart, which is the highest it can be, meaning that they are very fatigued. Those 4 years of having Mono with no immune system to fight it really took a toll on all of my organs! They each tried to fight it! The great news is that I will, at some point, be cured from all of these ailments, Lord willing! I am so thankful for two parents who are willing to take me to a doctor 2 hours away and pay for my treatment so that I can get better! Thanks, Mom and Dad!

When Life Gives You Lemons...

2009-12-11T19:28:00.003-05:00

... do the Master Cleanse Diet!

That's what I've been drinking for the last 10 days. A precise mixture of water, lemon juice, grade B maple syrup, and cayenne pepper, which I forgot to buy when I took this picture to share with all of you food-eaters.

This diet also includes drinking 2 tsp. sea salt in 4 c. water each morning and senna tea at night. It really wasn't too bad until 2 days ago, when I just couldn't get 'eating food again' out of my mind. I even made a list of the meals I want to eat when I am done this diet!

Today is my last day of the lemonade mixture, and tomorrow I spend the day drinking orange juice. Sunday I can have vegetable soup (drinking mostly broth), which I made on Wednesday night so I could feel like I was going to eat; it has been sitting in my fridge and it smells so good whenever I open the refrigerator door. Monday, my friend Kelsie and I are going out to lunch, and then I am heading home on Tuesday.... which means that Mom, Dad, and I (all 3 of us have been doing this diet together) are going to Chili's Tuesday night where we will become ravenous, and we won't apologize.

I finished my last final this afternoon. It was Nutrition, which I was most nervous about, and I got a 90%! Highest test grade in this class of the semester! I will pass :) My Psychology test went well this morning, and I have been enjoying not having to do any school work!

See you all soon!

Finals and Senioritis

2009-12-09T17:13:00.005-05:00

I have all 3 of my finals this week. I actually took my first one today; Critical Care. It wasn't that bad! But I'm always careful to say that, because the outcome of the test is always a surprise to me. We were given a take home final for Critical Care as well, which I am half-way through. This test involves 3 patient scenarios and questions concerning their care. We are allowed to use our notes and books, and we have had a week to complete the 12 question packet.

Friday, I have my Psychology final at 8:00am, which I have yet to study for. I'll get a B in the class as long as I pass the final. My last final is in Nutrition, and I have to take it online by 5 pm. I am most nervous about this test! It has been the most difficult class for me this semester because of the way the teacher asks the test questions. It's set up like this:

What is.... blah blah blah?
a) one
b) two
c) three
d) A and B
e) A, B, and C

Ya get it? I can't stand it. I'll probably pass the class, but it won't be a good grade!

It's so hard to study! I just want to get home for Christmas!

I'm coming home on Tuesday and am looking forward to stuffing my face with lots of food.

Tennessee

2009-12-01T13:48:00.007-05:00

Here are some pictures from my recent trip to Tennessee! I had a great time visiting with Laura and Logan and their precious little girl, Aydah.

Aydah is such a bundle of energy, just like Grace or Grae! I had fun playing with her and getting to know her more. She stops and stares at the TV whenever "Flo", from the insurance commercials, comes on; she loves her! Aydah would always wave bye-bye to me when Laura was carrying her into her room for a nap. It was adorable.

It was important for me to remind Aydah that half of her belongs in Maryland. She had no complaints after tasting her first Berger cookie while sporting her Orioles tee. Thanks to Laura's pregnancy hormones, she was liking chocolate and had a cookie too! And Logan is learning to deal with the fact that Maryland is awesome (just teasing ya, Logan!).

Aydah has a special smile for the camera:

While we were spending Saturday night and Sunday with Logan's parents (who made an amazing BBQ, sweet potato fries, salad, and home-made ice cream dinner), Aydah spent a few minutes saying "cheese" and modeling for pictures.

Monday we went to a pumpkin patch and picked out a pumpkin. It was a muddy day, but we had fun... and some more BBQ.

It was such a fun weekend! I was so thankful that I was able to spend time with Laura and her family after not seeing them for a while. Hopefully we will all be able to see each other again before long!

ATI

2009-11-14T11:33:00.003-05:00

Guess what today is? It's ATI testing time! Remember last year? Hahahahahah! Guess what else? ATI doesn't count for seniors -it doesn't affect our grades this year. That means, I didn't study one tiny bit. I actually forgot we had testing today. This is gonna be a great day; Level 1's all around!

The only bummer is that I actually have to study for my Critical Care test today. I wish our other tests didn't count towards our grades. But on a lighter note, I am coming home in just 4 days! I can't wait to eat some good Thanksgiving food (Mom, I hope you're the one making that green bean casserole; it's so yummy!).

.... MY PIN!

2009-11-10T22:22:00.006-05:00

I'm so excited! My nursing pin came in the mail today! I ordered this on September 18th and have been anxiously awaiting its arrival. It's another reminder that I'm almost done with nursing school! WOO HOO! I bet my Mom (with her "mother's heart") is glad that I'm almost done, too.

So beautiful:

The back has my initials and year of graduation:

Here it is with my senior ribbon:

Sophomore nursing students get blue ribbons to wear on their uniform, juniors get red, and seniors get the red, white, and blue.

Yummm. The look of the light at the end of the long, long, dark, long, tunnel.

9 Days And Counting!

2009-11-09T21:44:00.004-05:00

I got 9 more days to go and I'll be on my way home for Thanksgiving! I'll get home late on the 18th and I can't wait. It's been a long time since I've really been home for a good break, and not just for a weekend. There's not too much for me to do until then; I have one project for my Preceptorship class due this week, and a Critical Care test next Wednesday. That, that's about it (Bubba from Forrest, Forrest Gu-ump).

My preceptorship project is a power point on aortic balloon pumps. What's that? Well, its a long thin balloon that is inserted in the leg, fed up the aorta all the way until it is resting close to the heart. The balloon blows up when the heart is relaxed, and deflates when the heart pumps. This basically allows the heart to rest a bit. Do you think just that will get me 15 slides?

Also, while I'm home, I'll be heading back to Johns Hopkins NICU! I am so excited to get my baby fix! It's so nice that they kept me on as an employee so I can work for them during my breaks.

Whelp, see ya (Lloyd, Dumb and Dumber)

April Wilson, Photographer

2009-10-31T20:59:00.010-04:00

I have been having a fun time as Liberty Nursing Student Association's photographer. Yesterday, I shadowed the juniors while they had Simulation Lab. This lab takes the place of one of their regular scheduled hospital clinicals.

I can remember how nerve-wracking it was to be in their shoes, not knowing what was going to happen to Sim Man. Everything that happens is as if you were really in the hospital taking care of a patient. First, you receive report from the night nurse. She "just so happens" to not know some things, forget to tell you things, etc. Questions are allowed, but sooner or later, the night nurse "goes home", and you're left feeling quite alone. Each student gets a role; there's an RN, a CNA, a Family Member, and a Recorder (someone who records the time the RN does anything).

Here's Sim Man. He talks. He Coughs. He vomits (not really, but he makes the noise of vomiting)! His chest rises and falls with his breathing and you can hear his belly, heart, and lung sounds. He can have clear lung sounds, or he can have rubs or crackles or other adventitious sounds. His heart can have murmurs. His belly can be hypo- or hyper-active. His pulses can be strong, weak, irregular, or absent all together. His vitals are on the monitor, and they can all go up, or down. He'll even respond to all of your questions.

It was so fun watching and remembering when I was in Sim Lab. It was all the same. The moment you pull back the curtain and enter the room, you're nervous and just sort of look at Sim Man, not knowing what to do.

Eventually you step up, and start to assess. And just like when I was in Sim Lab, the first thing Sim Man complains about is pain and nausea. And before you can think of what to do next, he throws up.... a lot.

And soon, Sim Man becomes unresponsive. His vitals start changing; heart rate increases, blood pressure goes down, oxygen saturation goes down, what's going on with Sim Man!!!! You literally have no idea what to do. You just... stand there and look at eachother, look at Sim Man, look at eachother again. Ummmm....

Let's call the doctor! (Behind that double sided mirror is the teacher who is making Sim Man do everything) This part of the clinical is to teach that when you call the doctor, you need to follow certain steps, like give the situation, background of the patient, review the given orders, etc.

You can see on the monitor here his heart rate is 79 (green), oxygen is 91 (yellow), respirations are 12 (white).... soon, the girls will see that he needs supplemental oxygen that is hanging on the wall. Right now, they are listening to a strange lung sound.

Here's the worst part; everything is being recorded. After lab, they will all watch it together and talk about what they did well, what they need to work on, and what they completely forgot to do! When my group was being recorded last year, I was the CNA. I was on my way to tell the RN that the patient had a pressure ulcer starting on his bottom, and as I walked by the camera, I sniffed and rubbed my nose; and I was super close up to the camera. It was sweet.

Today, LNSA tailgated! We had fun grilling hotdogs and giving out food to LU students and their parents. It's parent's weekend!

Students were dressing up for Halloween, and when this guy ran up the street, we had to call him over. I asked if he was on a solid foods diet before we gave him anything to eat. I'm a critical thinker like that.
Batman also stopped by for some nourishment. I made him do a Pepsi Challenge, like they used to do on TV. I told him that if he could figure out which one was Pepsi and which was Coke, he could have a free hotdog. This was a ploy, because the hotdogs were already free.

Whate'er My God Ordains Is Right

2009-10-16T12:51:00.002-04:00

Whate'er my God ordains is right,
Holy His will abideth.
I will be still whate'er He does,
And follow where He guideth.
He is my God,
Though dark my road.
He holds me that I shall not fall,
Wherefore to Him I leave it all.

Whate'er my God ordains is right,
He never will deceive me.
He leads me by the proper path,
I know He will not leave me.
I take, content,
What He hath sent.
His hands can turn my griefs away,
And patiently I wait His day.

Whate'er my God ordains is right,
Though now this cup in drinking,
May bitter seem to my faint heart,
I take it all unshrinking.
My God is tue,
Each morn anew.
Sweet comfort yet shall fill my heart,
And pain and sorrow shall depart.

Whate'er my God ordains is right,
Here shall my stand be taken.
Though sorrow, need, or death be mine,
Yet I am not forsaken.
My Father's care,
Is round me there.
He holds me that I shall not fall,
And so to Him I leave it all.

Vacation

2009-10-13T20:02:00.003-04:00

I ate like a normal person this past week. A healthy, normal person, but still normal.... plus some Berger cookies and real peanut butter. Also, ice cream.

And I'm not going back to the way I was before Tennessee, I tell ya. You can't make me! I won't do it.

My refrigerator was empty when I got back, so I went to the store and bought:
1 green pepper
1 red pepper
green beans
sweet potato spears
apples
pears
bananas
Horizon organic milk (thanks, Uncle Bobby!)
Ezekiel bread and tortillas
organic pasta sauce
organic canned chicken and chicken thighs
organic lettuce

See? You can't make me. I did it by myself, but I noticed I was a little bit more grumpy leaving the grocery store than I was when I entered it.

Come on, digestive system! Fall in!

Fall

2009-10-06T15:24:00.003-04:00

It's fall break time! Tomorrow, I will be heading down to Tennessee to visit Logan and Laura (Thomas) Abbott and their little girl Aydah. I can't wait to see them! It seems that every time Laura comes to Maryland for a visit, I'm in Virginia. We usually only miss eachother by a couple of days, too. It's such a tease.

I'll be with them for 6 days. I can't wait to leave tomorrow, grab a Pumpkin Spice Latte from Starbucks (because they're all the rage, and I like to keep up with what's cool), and start my 5-6 hour drive down south.

And what's in my bag for this vaca? Why it's each and every season from The Office, of course!

The day after I get back from break, I have a Critical Care test over the Respiratory System. By the way, senior year is fantastic! It's much less stressful than last year. Senioritis has also set in. I missed a class today.

Because I Can't Make You Wait Any Longer...

2009-09-30T09:23:00.001-04:00

That's a shadow behind the right side of my head.

So, do you like it? Don't you think I look more like Heather and Erica (Dahlke) Epple now? I do!

Code Blue

2009-09-28T23:43:00.002-04:00

I went over to "The Dark Side" this past weekend; that's what they call working the night shift. I worked in the Cardiovascular Recovery Unit (for my Preceptorship nursing class) Friday, from 11pm-7am, and Saturday and Sunday, 7pm-7am. That's why I'm up right now! At 11:46 pm! I'm not sleepy!

Friday and Saturday were pretty slow. I was caring for a patient who was doing great and sleeping through the night. The only thing that I really needed to do was assess every 4 hours and check up on/get urine output every hour. But... in the middle of the night on Saturday going into Sunday morning, I heard over the hospital-wide intercom "Code Blue, (#) floor, (unit name)" My preceptor looked at me and said, "Wanna go? Look for the room with all the people in it." Off I went, just down the hall from where I was. Turned out that the patient had more of an episode of distress rather than an actual code (which is when the heart/lungs stop working). I hung around for a few minutes then went back to my unit. Not 30 minutes later, I hear the Code Blue call again, and I go running. I exit my unit's doors and see 3 other nurses running down the hall; with a Code, nurses from many floors respond, as well as respiratory therapists and a few doctors. This time, the patient was coding. When I entered the room there were 3 other LU nursing students there as well; one of them being my good friend Kelsie, who responded with her nurse from another unit. The respiratory therapists were bagging the patient at the head of the bed (giving him air through a face mask), the nurses were getting drugs from the Crash Cart and pushing meds to try to get the patient's heart functioning while one nurse was doing chest compressions. Then, the nurse doing compressions called one of the LU nursing students to switch out with her, then Kelsie switched out with that student to do chest compressions as well! It was such an adrenaline rush. The doctors had to shock the patient because the patient went into Ventricular Tachycardia, a fatal arrhythmia. I was hoping to be next in line to do chest compressions if anything else happened, but the patient needed some tests done to determine what the extent of the underlying problem was, so I had to head out of the room and get back to my unit. But boy, it was so interesting to be "part" of the code. It made me want really want to be an ICU nurse! NICU, PICU.... we'll see!

Just A 'Snip'pit

2009-09-20T21:38:00.001-04:00

RUF

2009-09-18T22:02:00.004-04:00

Love. It. (I hear Mom saying "I told you so").

But here's the deal, I actually have time to go enjoy myself on Thursday nights as a senior. Last year, Thursdays were dedicated to writing 20-35 page profiles, beginning the project around 2pm and finishing around 9pm. **shivvvvver** Soooo glad to be done with those.

As I mentioned before, this meeting began with Opal Hargrove from MTW speaking to us about opportunities for a summer program/spring break missions trip. One option is in the middle of Mexico where we'll do construction work, another option is Cherokee, NC where NCPC has gone before (these are both for a spring break trip). The trip I am excited about is to... GREECE. If we went to Greece, it would probably be over the summer for a week or so. While in Greece, we would be serving the community by picking up trash each morning (evangelism is illegal in Greece so this is a good way to serve). Another amazing opportunity in Greece is a ministry with girls who have been trafficked (sp?). I really hope to be able to go on this trip with RUF! We'll see where God decides to take us :)

Remember When...

2009-09-16T17:00:00.004-04:00

I miss Guatemala. It's hard to believe that it was nearly 3 years ago that I went there on my missions trip. I was looking through my pictures today:

I miss these little kids! They are so cute. Tomorrow I'm going to an RUF (Reformed University Fellowship) meeting a little early to hear an MTW missionary talk about opportunities available to students. Maybe there will be something I can participate in this summer; the last summer I have before entering the working world! We'll see if there is an open door for me somewhere in the beautiful world!

To Grandmom, Pop Pop, Mom-Mom and Poppy

2009-09-13T10:24:00.002-04:00

HAPPY GRANDPARENT'S DAY!

What a blessing to have such wonderful grandparents in our lives! Lots of love!

What I Should've Said Was...

2009-09-04T15:46:00.005-04:00

I learned something in my Mental Health class today.

Anyway, this has to do with those "brain burps" you have when you're discussing hot topics with someone. Here's what I learned about why you always feel you come up with better things to say after a conversation has come to an end.

Ever been in a confrontation-type conversation (that sounds nicer than asking if you've ever been really angry and arguing with someone) and couldn't think of what to say until it was all over?

Here's why: when you are in any such type of discussion, your pre-frontal cortex in your brain slows down as the limbic area is in overdrive. This means that your IQ (part of the pre-frontal cortex) actually goes down when you're angry! That's why you can't articulate when you are in the moment and why afterwards, when you calm down and your pre-frontal cortex comes back up to par, you can think of what you wish you had said!

God's way of helping us hold our tongue.

Funny, huh?

Cardiovascular Recovery Unit

2009-08-29T13:51:00.005-04:00

Umm, yes, please, I'd like to work with children. Thanks.

Today was my first hospital shift/experience of my senior year. This clinical was for my Preceptorship class on the Cardiovascular Recovery Unit. Patients come to this floor after they have open heart surgery to recover before they are transferred to another unit. And boy, what a day! There were only two patients on the floor (the floor has only 6 beds, but surgeries are done only on weekdays), who were transferred to another area, meaning that our floor could closed down for the weekend (again, because there are no surgeries on the weekends to have to stay open for). My patient had a CABG (pronounced like "cabbage"), or Coronary Artery Bypass Graft. In this surgery, a vein, usually the saphenous vein from the leg, is taken to form a "bridge" over a damaged area of the heart in order to restore bloodflow. My patient was so sweet and recovering well.

I realized today that I was still in CNE/Neonatal mode. For example, yesterday in our critical care lab, I was asked how many mL's of air to put into a patients NG tube (the tube that goes in their nose, down to their stomach. You push in air, and if the tube is correctly placed in the stomach, you can hear a burping noise over the stomach through your stethoscope) and I was close to saying 2 cc's, when I realized that that was the NICU in me talking. The adult answer is 30. THIRTY?! Gee whiz, that's a ton! So anyway, today on the floor I got slapped with a giant brick wall of reality with flashing lights that said, "now you're a nurse, not a CNE".

But I learned a few new things, and was even able to do my very first central line dressing change on a real human. If you remember back when I did my IV lab, a central line goes directly to the heart. My patient had the kind that went into the jugular vein on the neck. Changing the dressing, and doing so in a sterile manner, is important for infection control.

I also learned how quickly I can forget about the noises adults make when they cough up phlegm and mucous from their lungs.

Now, today was a "slow" day since both patients were a few days out of surgery. If I'm there when a patient comes directly from a procedure, I will be able to see and do a lot more. Not only will I be able to see a 4-6 hour open heart surgery, but I will be able to care for the patients afterwards, when they have breathing tubes, chest tubes, drains, catheters that go in their neck and run half-way through their heart.... lots of learning opportunities to come, I'm sure.

But raise your hand if you think spit is more cute on a baby.

Two For One

2009-08-26T16:39:00.007-04:00

This post is actually going to be two posts. Why only write about one topic and then have to wait a few days to write about another when you'd rather just write about both, right now?

Ok, the first post is titled "No More Babies"

Hello Johns Hopkins NICU! I miss you.
I miss the 35ish babies that were there when I left, and I think about them.... probably every day.

Last semester, I signed up for the Critical Care Program. This included taking Preceptorship this semester, where I follow a nurse at our local hospital for a total of 90 hours. I signed up for the Intensive Care Nursery and hoped hoped hoped I would be assigned a position there. Guess what. While waiting for news of where I would be placed, Hopkins spoiled me. I now crave the 45 bed unit of the cute little ones. But, I figured the ICN here (20 bed spots?) would help me to see if I was really fit to be a Neonatal ICU nurse; the fact that the majority of the patients here are not as critically ill as those at Hopkins, I figured that I would still enjoy the experience. (I am NOT saying that the Neonatal ICU here is not good, but it is not a level 1 NICU, and I really enjoyed the cases that Hopkins dealt with).

Well, today we got our assignments, and I am in the Cardiovascular Recovery Unit. At first, I was bummed that I would not be working with any babies, but I think I will enjoy my time in the CVRU. I hear that it is a very interesting floor, full of learning opportunities. And, bonus!, this class has no class time, we just go to work and write journals about our experience after each shift.

Ok, the second post is titled "Today, We Celebrate"

Celebrate what? Eating. Food. Eating whatever I want, and whatever I can, for dinner tonight. Only Mom and Aunt Beck-a-Roobie can truly understand what I mean when I say that I don't like Blessed Herbs. 5 days of no food is too much, man.

So after class today, I stopped at Sonic's, just on a whim, and got a Caramel Mocha Java Chiller. Or something like that. It was gone within a few stop lights. I did show self-control when I only scraped the lid with my finger and not the whole cup.

I've been planning what I would eat for dinner ever since I knew I would be doing this whole fasting thing. I thought;
"Pizza?", yes.
"Mac and Cheese?", yes.
"Mexican?", yes.
"Bacon Cheesebur... Ok, wait. Don't go crazy April. Get a Domino's PASTA BREAD BOWL!", yeeees. Another bonus - it comes with a free chocolate lava cake.

Now I'm normally all about healthy, pizza on a sprouted grains crust, but tonight I'm going for the un-healthy, non-organic three cheese mac and cheese in an oven baked pizza crust.

It was everything I'd hoped it would be.

Tomorrow? It's all back to my favorite diet and yours, RAW.

Senior Year Begins

2009-08-22T17:10:00.002-04:00

I'm back in Lynchburg, ready to begin my last year at LU. I have finished moving into the new house, which is really starting to look nice! Pictures coming up soon.

My classes don't start until Tuesday, but I already have a clinical for my Critical Care class on Friday. I don't know why I always imagine having a week off of clinicals in the beginning of the semester... it never happens. This clinical will take place in our brand new Critical Care lab from 12-3pm! I don't know where I'll be in the hospital for clinicals yet, my first choice being the ICN (Intensive Care Nursery, a.k.a Neonatal ICU), but hopefully I will find out more during lab.

Also, we have found a third roommate! She will be moving in tonight!

So Much Time, So Little To Do

2009-08-17T16:31:00.002-04:00

Scratch that, reverse it.

Once I get home from my last summer shift in the NICU tonight, 'round 8pm, I have to start packing up to head back to LU! Luckily, the majority of my packing is clothes and random odds and ends. Mom, Dad, and Matt are home now packing up the big items, like my couch, loveseat, chair, and dresser.

I haven't begun packing anything yet, and we leave tomorrow at 6 in the morning! I'm excited to go back, and hoping that this year will be a lot more relaxing than last!

Thursday, A Long Day

2009-08-14T21:20:00.005-04:00

My day today began at 5:00am when I decided to hit the snooze button 7 times. I started getting ready at 5:28am and was out the door by on minute before 6. I was planning to stop by Dunkin' Donuts for a bagel but accidently took a really slow route (which I never ever take to get to work, boy I guess I was really tired!) and ended up just heading straight to 95S. Once I got to work, I finished taking my medications and headed out to wash my hands, under my fingernails, and up to my elbows. It's 7am.

Head into the nurse's station and print out the census. 31 patients. 14 empty bedspots.
Check the census to see who is receiving formula and who is receiving breastmilk. Go to bedspots of babies of whom we don't know which feeds they are receiving and figure it out/place breastfeeding info packets at the bedside. It's 7:20.

Check the emergency equiptment: 3 emergency bags, 3 crash carts, transport monitors are plugged in, transilluminators for IV access uses are plugged in, EKG machine is working and full of paper and electrodes, defibrillator is working and has pedi-pads, adult pads, gel, and paper. Sign my name, It's 7: 35.

Walk around to see if anyone needs help. Help take pictures of a baby, ones that look really nice. Our printer is broken. Head over the the NICU offices to put the pics on the computer but the printer paper doesn't work, too grainy; not as good as they should be for the parents. Go to Labor and Delivery to use their printer, pictures look nice. Receive info from the L&D nurse on professional photographers that give their time to capture last memories; God is good, I've been trying to think of ways to ensure beautiful pictures for families, and He layed out my day so that I could pass such info along to our nurses in the NICU. Place pictures in memory box. I've stopped looking at the time.

Notice a baby de-saturating, turns out she spit up, so I change her shirt and blankets while I talk with her. Run an IV through tubing. Start to make name tags for babies who don't have one yet. Almost lost my goldenrod color crayon, which is the perfect color for winnie the pooh and lions. Watch and listen as doctors make rounds. Go to the storage closet down the hall and get a pop-top isolette, grab an incubator, two IV poles, and set them up in empty bedspots 32 and 14. Grab some fruit from the cafeteria. It's 11am.

Grab the elevator key and run to open the elevator for a baby going to the OR. Help prepare a baby to go to MRI. Each of the 3 IV lines need extension tubing so the metal IV pole can be outside of the MRI room. Run down 3 floors to MRI to grab 9 packs of extention tubing, run back up to the floor and run the fluids through. Un-plug the baby's bed and IV pole, grab extra blankets and diapers, get suction tubing for the baby's breathing tube, get the emergency bag, call the nurse practitioner and let her know we are leaving for MRI. Help the nurse, Nurse Practitioner, and two Respiratory Therapists to MRI. It's 3:00.

Get back from MRI. Its 5:00.

Put 15 or so sets of vital signs in the computer; we took vital signs every 5 minutes while at the MRI procedure. It's 5:20.

Go to "lunch" break until 6.

Re-stock emergency bag with what was used at MRI; a 1mL syringe, a needle, and some syringe caps. Help by getting vitals on 2 babies. It's 6:55.

Go to my locker, head down the escalator. Go home. It's 7pm.

Get home at 8. Exhausted. Don't even feel like typing full sentences.

And Matt didn't save me any pizza for dinner. "Not a slice", he said.

That's ok, I can't have pizza anyway.

The Countdown Begins

2009-08-10T17:59:00.003-04:00

I am 8 days away from returning to Lynchburg and my final year at Liberty University! These past 3 years of college have gone by so fast, and it's hard to believe that I will be graduating!

I just received an e mail from my 3rd roommate. It turns out that she is unable to return to school this semester. My other roomie and I will be on the lookout for a third roommate. This was unexpected, but I'm sure it will all work out, and we hope our friend can return for the second semester.

I have 7 days to go in the NICU. This summer has been amazing. Johns Hopkins is such an exciting place to work. I have seen so much and been able to spend my days holding and caring for adorable little ones. God's incredible design is so evident in the small 24-weekers we admit. These early babies are amazing to watch grow outside of the womb, and the medical doctors and nurses have so much knowledge of how to help the babies develop. There is one little baby that came to us at 24 weeks and is now 2 months old. The baby is growing and improving so much and I love knowing that it was God who sustained him! There are so many other amazing things to be seen, and it shows me how God's design for the human body is perfect, and that any alteration in the body's systems causes a problem of one kind or another. I will miss being able to learn at our nations #1 hospital while I'm back at school! Thankfully, we at LU are able to work at great hospitals with fantastic teachers.

This year, I will be the photographer for the Liberty Nursing Student Association. Heather taught me how to set my camera to take a great picture. Thanks Heather!

Keep up with everything we are doing this year at www.lunursingstudents.blogspot.com, or you can follow the link to LNSA on the right hand section of this page!

The Swine Pneumonia

2009-07-23T15:29:00.004-04:00

At Dr. Brody's yesterday, he found that the swine flu I had a couple weeks ago has become a slight case of pneumonia. I came up as a number 16 on his scale; 32 would be considered "walking pneumonia". No biggie, it should be knocked out within a week.

In other health news, I'm getting much better. My mono and ebstein-barr viruses (the virus that causes mono) are still gone, so after 4 years of mono, I have now been mono-free for a month!

"Hello, my name is April,"
"Hiii Aprilllll."
"I've been a mono-sufferer for 4 years, and today marks my first month clean."
*clap clap*

Dr. Brody did, however, find that my bile duct is clogging up with thick bile (a result of where my mono settled) and that my digestive system is still pretty messed up. My heart/vessels are still some-what collapsed, but I no longer have the heart of a 80 year old (like I did in December), now I'm down to having the heart of a 40-50 year old. Yay? The good news is..... my heart muscle itself is not damaged, nor is my aorta (the pretty important large vessel that delivers blood to my body).

Though "recovery" is taking longer than expected, I have felt a change for the better, and hopefully I'll be in the body of a 21 year old before I turn 22!

Gracie

2009-07-06T23:13:00.004-04:00

Grace giving Mom Mom a ponytail:

Grace... not taking a nap:

I'm A Survivor

2009-07-06T22:38:00.004-04:00

I am proud to say that I had the swine flu at the same time as Rupert Grint... from the Harry Potter movies! What does this mean? My theory is that one day, my dreams of being an actress will come true, and instead of all of Hopkins knowing I'm contagious, the whole world will know.

I was diagnosed with Influenza A/H1N1 on Tuesday afternoon, after making an appointment to get checked out half-way through my shift in the NICU. My test came back positive within a few hours, where it can take up to three days to be conclusive. The results gave me a 7 day ticket to the basement where I could cough away from the family. May I suggest the following things: Frost Nixon, I Love Lucy re-runs, M*A*S*H re-runs, and my new favorite show 18 Kids and Counting (I love that family!).

I am heading back to work tomorrow morning for an 8 am appointment where I will hopefully be cleared to go back to work that evening. I have missed being able to go places this past week, but have certainly enjoyed cheating, in a pretty hard-core fashion, on my diet. I'm off the bandwagon folks, and have not yet been able to pick myself up and jump back on.

The NICU has been very supportive of my situation, understanding and ensuring me that this could happen to anyone and not to worry. I feared for two little ones that I had held during the one and a half days that I was at work and sick (thinking then that it was a sinus issue). There are many teams in place at the hospital to make sure that anyone exposed to an infectious disease is well taken care of, and everyone seems to be just fine! I am excited to get back to work; I have been thinking about those babies!

Victory Jam 2009

2009-07-04T21:22:00.018-04:00

I'm fresh from a week at Harvey Cedars Bible Conference in Surf City, NJ. Every year, New Covenant gathers with other PCA churches from Maryland for 5 days of insane fun! It's for middle schoolers, but all of we college-aged counselors and youth pastors enjoy the camp just as much, if not more! This year, I went as the camp "nurse". Duty called within the first few hours of camp when one girl fell on the rocks and sliced open her knee, requiring 12 stitches; and may I just mention that I had guessed that she would need 10, whereas Mr. Don guessed 9 and Joel Loftus guessed 8. That's why Mom and Dad pay the big bucks for a Liberty University education, so I can show up my youth pastor and friends with good guesses.

Monday night, Brandon came wobbling up to me with a dislocated pinky toe. May I just say, this was the best experience I had that week, and I laughed myself to sleep that night; I'll try to do this story justice in writing, but it was a "I guess you had to be there" experience. But away we go:

We were outside around 11:00pm for a fire drill, when I hear someone say, "Uh oh, April, you might wanna look at Brandon, here he comes!" I walk up to Brandon and he tells me to look at his toe. It is at a 90 degree angle, going the wrong way. Brandon is.... whimpering? giggling? I couldn't tell; anyone who knows Brandon will understand the fact that he looks exactly the same when he laughs as when he cries. His little face scrunches up and he sort of whimpers. My first question was, "Are you laughing or crying?". He was laughing. I told him he needed to go to the hospital to get it reduced, or put back into its socket, because I sure didn't want to fix even what possibly could be the smallest socket in the human body. I wouldn't want to try something when only knowing the theory of how to fix it, but Mr. Don didn't want to take the trip for such a menial injury. Turns out that a counselor standing with us was a Marine and had learned basic first aid, including care for dislocations. So, Brandon sat sideways on a nearby bench with his injured left leg up on the seat. I, remembering a splinter injury Brandon once sustained while I was baby-sitting, stratled Brandon's leg and held it down (might I explain that in order to remove his splinter, both Aunt Michelle and Uncle Freddy had to sit on Brandon lest he hit the ceiling). The Marine was settled at the toe. Here comes the moment. Just as the Marine asked if Brandon was ready, someone threw a ball point pen between Brandon's puffy cheeks, I turned around to watch Brandon's face, the Marine tugged, and Brandon let out a brilliant "Aaaaahoooowwww" straight from the chest as he, still, sorta giggled and smiled. It was a sight, and I wish you all could have been there. His toe back in place, I was much too happy from the moment to remember to do my job as a nurse and check that there was life-blood coursing through his toe. As I was lying in bed thinking about this, I figured that if his toe fell off in the middle of the night, it would be a great ending to an already fantastic story (just kidding).

The rest of my week was filled with changing the dressing on the stitches, putting on band-aids, handing out water and ibuprofen, and sending two more people to the hospital; one with an infected and fractured foot, another with a neck and spine injury. It was an intense week, but lots of fun. While no one was in need of my service, I watched the kids play from my window and enjoyed bible studies and skits.

This was some raw organic strawberry watermelon juice, which, believe it or not, goes sour just as quickly as raw strawberries or watermelon would.

I'd sit and read while the kids played X-Games outside.

Here we are playing the Green Grenade Gangster Gnomes in water balloon volleyball:

Some encouragement from the sidelines:

A bible study:

And a quick attempt at a pyramid:

The thing about being a counselor, or nurse, or adult at Victory Jam, is that there seems to be this invisible brick wall that comes out of nowhere in the middle of the week, and hits you in the face.

Here's my room:

Complete with a bunk bed for any sick kiddies.

I had to take my own food because of my special diet I'm on right now:

The proudest moment came on Thursday as our very own NCPC middle schoolers swept in the final relay race of the X-Games (a competition of pool and beach games between all the churches) and won the first place prize! It was a big day for the Blueberry Bagel Pandas.

Home Sweet Home

2009-06-03T13:06:00.002-04:00

I'm home! I've been home for a couple weeks. My big 'ol bed is delicious.

I started up a 4 week microbiology intensive after the semester ended and left 2 weeks early so I could start work at Hopkins. My teacher is nice enough to send me quizzes and tests through e mail. I should be done class by the end of the week!

I've been at Hopkins doing orientation since last Tuesday. I started orientation on the floor last Thursday but stayed in a conference room going over protocol and basic information for the NICU. This past week, I've been on the floor getting to know the staff and learning what my job will be like this summer. It seems the majority of my time will be spent organizing/storing/keeping up with breast milk. This includes finding out if new admissions are going to be breastfed, printing and keeping up with labels that are put at the baby's bedside and on their bottles, freezing and thawing milk, and fortifying milk with extra calories. I may even be able to feed the babies! I'll also be setting up IV nutrition for the babies and doing "cares" (or vital signs and changing diapers) every few hours. At times, I'll be able to take babies on "field trips" to CT and MRI scans, and anywhere else the baby may need to go in the hospital. It will be a fun summer, sad at times, and very eventful; there are all sorts of cases on the floor.

Still in Lynchburg

2009-05-18T20:36:00.002-04:00

Yep, I'm still here. I'm 3 days away from "finishing" my Microbiology class and heading home! I'm taking a 4 week Microbiology intensive; 2 weeks here at school, and the next 2 weeks through e mails at home. My teacher has been very helpful and understanding towards the fact that I have to start work on May 26th, and has agreed to let me take quizzes and tests through a proctor (a.k.a. parent) at home.

We took our first test today, and it was hilarious. First of all, I was nervous beforehand as he was handing out the exam, even though I knew that it was more than possible to get an A just by studying the previous quizzes. But, nursing school has messed me up. All of us (the nursing majors in the class) were feeling the same way and laughing about it. After the test, we all gathered in the hallway and compared answers. But let me tell you, it feels really good to get an A on a test again. I got a 94%! Which is a solid A, not barely making an A like in nursing where it has to be a 93% or above. I've gotten an A so far on every assignment, knock on wood! What a great change of pace!

The weekend will be here before I know it, and I will finally be home for the summer. I'll see you all at the Farm on Saturday!

My House, Part III

2009-05-14T19:43:00.005-04:00

Though I've moved out of the house on Braddock Drive, I can't help but feel incomplete because I haven't showed you what the kitchen looked like! How could I have procrastinated so ba.... oh, wait, Pharm.

Ok, here's the last bit of the house I lived in for my Junior year; a year which has washed out any memory of what life was like before entering such madness.

Here's the front door!

AAAHHHH!!!!! (Psycho music in the background). What is this picture missing?..... thousands and thousands of ants!

If you were to look to the right, you'd see the living room. If you walked straight aheah....

... and turn left...

you'd hit the laundry room!

If you would have walked straight, you'd have seen the game/tv room.

And if you would have turned right, you would have headed back into the confusion of the craft room/living room/5 door option area/hallway to the bedrooms.

But we won't go there.

The Results Are In....

2009-05-06T16:25:00.002-04:00

I PASSED PHARM!

Woo hoo! I needed a 77% in the class to pass, and I got.... a 77%. I made it interesting, that's for sure!

Oh yeah, and I passed my other classes too.

Now I'm a senior!

Last One!

2009-05-05T09:34:00.003-04:00

I just finished up my Bible final and will soon hit up Jazzman's for some coffee so I can get going on my studies for OB test, which is today at 3:30. This is my last final of Junior year!

Yesterday I took my Med/Surg final, which was a collaboration of questions from our previous tests, so it was pretty much the best final one could ask for :)

Grades may be up (are expected to be up) later tonight, so I'll try to let you all know the "outcome" later!

Waiting Is Difficult

2009-05-03T23:27:00.002-04:00

While I am enjoying being able to spend a few days with Mom and Dad (they are down helping me move into my new house), I can't help but worry about my Pharmacology final grade. I thought that I only needed a 70% in order to pass the class, but after calculating my other quiz and test grades, it turns out I need an 81%.

Of course, it is possible that I have achieved an 81%, but the way I felt before, during, and after the test makes me feel like I am right on the line. I go through ups and downs while waiting for Wednesday to roll around, and I keep praying that I wouldn't worry, because why should I fret over God's perfect plan for my life? But it's so hard sometimes when His plan doesn't follow what you expected. Look at me! I don't even know if I failed yet!

The test was 100 questions, so I can afford getting 19 wrong. I'll let you know what happens! Thanks for your continued prayers as I finish out this school year. It means so much to know I have family and friends lifting me up, especially now :)

Pharm is Over!

2009-05-01T21:16:00.003-04:00

I'm glad to say that the Pharmacology final is over. I think I took the whole 2 hours to complete it. It was very hard, and I didn't feel too good after finishing it. But, God has a plan for me, a path for me to follow, and we'll see where He'll take me Wednesday; which is when I'll find out my grade.

Thanks so much for all of your prayers! They were felt!

Oh My...

2009-05-01T14:06:00.002-04:00

Just 4 more hours left until the Pharm final. I wish I had one more day to study.

OB ATI Grade:

2009-04-30T11:24:00.001-04:00

75%, Level 2!

Yay! ATI is over. Now, it's time for the finals.

Pharm is tomorrow from 6-8 pm!

Last One

2009-04-30T10:29:00.001-04:00

Here goes nothin'!

OB ATI starts in one minute...

Med/Surg ATI Grade:

2009-04-29T11:13:00.003-04:00

Yep. Level 1.

No surprises there. No big deal, either. Like I said - priority is Pharm Final!

And tomorrow - OB ATI.

Round 2

2009-04-29T10:01:00.004-04:00

I'm back in the same chair, at the same computer, waiting to start my Med/Surg ATI test.

I haven't studied.... not one bit.

I have been way too concerned about studying for my Pharm final on Friday to study for this test, or for tomorrow's. We'll see how I come out of this one.

I just had someone say to me "Don't say you're gonna fail. All the right answers are in front of you."

No, one right answer is in front of me, in the midsts of 3 wrong ones!

Pharmacology ATI Grade:

2009-04-28T13:16:00.002-04:00

70%... which is a Level 2!

This means that I keep my current test average; I don't add or subtract 5 points. This is fantastic because I expected/prepared myself for a Level 1, which would have meant needing at least a passing grade (76% or higher) for the Pharmacology final in order to pass the class. Now, I still have an 80.6666667% test average and can handle getting a grade that is a little lower than passing on Pharm.

But let's hope for a grade that is higher than 76%.

Thanks for your continued prayers. That's 1 tests down, 6 to go.

Ready, Set....

2009-04-28T12:20:00.002-04:00

I'm in the computer lab room, waiting for the test to start!

Catch 'Ya On The Flip Side

2009-04-28T08:45:00.000-04:00

3 hours, 43 minutes... and counting....

Update

2009-04-25T21:47:00.002-04:00

I just finished a day that started at 9:00 am with studying for Pharm ATI. I took a break at 2:30 to get a TB test read (negative!), then came back to study some more.

At 9:00 pm, I enter the kitchen to find that there are more ants than I've ever seen; scurrying along in our sink, on the walls, on the window, under platters, and inching their way near the stove. No thanks, they aren't getting to my pantry. I had to use 3 wash rags to wipe them all up after drowning them in insect-killer spray, which doesn't really say is useful for killing ants, but it still works; it's not meant for humans either, but I'd probably stop moving if someone sprayed it in my eyes. Then I used 2 more wash rags to clean the walls and countertops with clorox and soapy water. Then I went to start the dishwasher and found more ants. What's going on? "We're being invaded!" (name that movie).

In other news, I took a break from studying yesterday to go to lunch at Ci Ci's Pizza. I cheated on my diet! The reason for the lunch was to get together with next year's Liberty Nursing Student Association board to talk about next year's events in the nursing program. My friends are the presidents for next year and they recruited me to be the photographer! I am so excited for this position! I'll document all of LNSA's events through photos. I'm thinking about getting a new camera (I think my mom is rolling her eyes at me through cyber space). The way I see it, I wanted to get a new camera for graduation anyway, so maybe I could get it a year early? I don't know, I'm running through my options.

Anyway, after that study break, my friends and I went over Pharmacology a bit longer then hit up Blockbuster for an educational movie (it really was). And wouldn't you know it, there was a question on the ATI practice test that I got right because of watching that movie! I probably could also have studied the information, but a movie is much more fun.

I can't study anymore tonight. I feel like I need to go shower and get the feeling of "ants crawling all over me" washed away.

*shiver*

Finalized ATI times:
Tuesday - Pharm ATI 12:30
Wednesday - Med/Surg ATI 11:45
Thursday - OB 10:30

Please pray specifically for my focus and concentration while I prepare for the Pharm ATI and final. This is a big thing that I have lost over the past few years, but am slowly getting back! Thanks to some Acetyl L. Carnitine and Phospholipids! :)

New House.... Again. For the Last Time.

2009-04-23T19:20:00.001-04:00

This.... is the house I will be living in next year.

The Lake House fell through when the city of Lynchburg learned that there would be 5 unrelated girls living there; to have more than 3 unrelated girls in a house in Lynchburg is not allowed. So, about a week ago, we split up, and 3 of us started searching for another place to rent in the middle of having to study for OB and 6 finals. In the nursing world, this would be considered "a stressor". In the nursing student world, it's considered "AAAHHHH! NO TIME! NOW I'M GOING TO FAIL EVERYTHING!"

After searching around and looking at many houses, we finally found the one that would be our home for the next 12 months. It's in a quiet neighborhood just 10 minutes from campus, if you hit all the red lights, and probably 10 minutes from the hospital as well.

Here's the house:

As you walk into the living room, there's a cute little shelf that is also a door to the attic. One of my housemates will have her bedroom up there.

There's even a small porch off the attic (with no stairs off of it) and plenty of storage space. Here's a picture taken from the porch looking towards the bedroom and stairs to the living room.

Down the hallway from the living room is my room.

If you walk straight out of my room, you'll head into the kitchen. (No pictures of my other housemate's room just to the left of the kitchen door.) We'll get to the kitchen later. First, if you turn to the left and go into the room next to mine, there is a spare room that leads into the laundry room. The laundry room leads into the sun room, and the sunroom has a door to the back yard.

Sorry about the strange dots from the flash. I was taking quick pictures. The doorway there to the right goes to the laundry room.

Here's our (one and only) bathroom: (if you looked through that window, you'd be looking into the sun room.)

Here's the kitchen. The colors in this house are so nice!

The other door off of the kitchen goes into the dining room:

We were thrilled to see that it was a swinging door :)

The dining room:

And we're back to the living room!

That's it! It's a beautiful house and it will be nice to live in next year. But for now, it's time to put my nose back into my ATI book!

OB Test 3 Grade:

2009-04-23T09:01:00.001-04:00

94!

That's an A!

(First ATI test on Tuesday - Pharmacology)

Mother Baby Week 3

2009-04-22T20:03:00.000-04:00

The last Mother Baby clinical!
The last clinical of Junior year!

This week, my patient was a new admission, straight from Labor and Delivery. She was rolled over to our floor with Dad strolling along behind her, pushing their little bundle of new baby joy in the crib. And boy did they look tired.

They had been laboring (I should say she had been laboring) for over 24 hours. With an admission, you simply slide mom over from one bed to another and get report from the L&D nurse. Yay! You're admitted! Welcome to Mother Baby! Estimated time of discharge: 3 days. My name's April, I'll be working with your nurse today and I'll be taking care of you!

Everything went on as normal from there; vital signs, mommy assessment, pain rating, check the belly. Quick Chart every 2 hours. I set dad up with some fresh sheets for his bed and explained that I would be doing an assessment on baby. Again, like all new parents, they looked at me like, "You have to take the baby away?". I had to perform a Dubowitz as part of my assessment, but I decided to postpone that until the afternoon; so I took baby's vitals and checked his fontanels, skin, belly, muscle tone, heart, lung and belly sounds, etc. where mom and dad could watch.

Another question you ask frequently on the floor is when and for how long the baby fed/how the baby did feeding. This baby was a champ. I had a hard time keeping up with my charting of the "Intake and Output"! And all that milk has to come out the other end. Poor dad got a lot of practice doing each sticky diaper change (you remember how the first few stools are meconium? The sticky green/black stuff?). It was fun to watch a first-time dad with a diaper. His exact words were, "They said we could expect maybe one bowel movement today." - that was with the 4th or 5th diaper change of the morning/afternoon. I got a couple, too, while doing assessments. The baby also wet the bed a couple times, soaking through most of the things in the crib, and I was able to encourage dad and cheer him on as he learned to change the baby's clothes (which really is a lot of fun to be able to do).

When the afternoon rolled around, the mom and dad had some visitors. Handling babies can stress them out, changing their heart rate and making them really tired. I debated whether or not to take the baby out of the room to do the assessment real quick before having baby get passed around to the first-time grandparents... so my nurse and I decided it may be best to get the assessment over with (so it would be accurate), then give the family time with the baby without needing to disturb them farther. As I walked into the room, mom was handing the baby over to grandma, and I had to take the baby away. I felt so bad! But they were very understanding.

I rolled the baby to the nursery and did a second assessment and the Dubowitz. The Dubowitz scale measures the baby's neurological and physiological development compared with his/her gestational age. A premature baby would have a lower score than a term baby. The assessment takes a while for a first-timer like me, and every so often I'd see dad waltz by the nursery window and smile.

**EXCITMENT!** I was able to autonomously practice something I learned while on the floor - while listening to the baby's lungs, I could hear gas bubbles stirrin' up. I also saw that the baby was trying to swallow the gas bubbles (and baby sure had been eating, but I hadn't seen any burping). So, I scooped the baby up into a sitting position in the crib, put one hand on the chest and cheeks while my elbow was resting in the crib, and gave some productive pats on the back and rubs on the head (which helps the baby to relax so they can get the bubbles out). I've burped babies before, but it just felt so... "nursey" :) haha.
Dad walked by while I was doing it, and when I later took the baby back into the room (I felt terible at how long I deprived those grandmothers the pleasure of holding their first grandchild) I mentioned that the baby was a little gassy and may need to be burped more. I was able to teach them how to recognize when signs of needing to be burped and the best way to do it.

Then the baby had another meconium stool.

Schedule

2009-04-21T10:13:00.001-04:00

Keep the LU Nursing class of 2010 in your thoughts and prayers:

Tomorrow: OB test, 7:40 am
Tuesday 4/28: Pharmacology ATI test, 12:30 pm
Wednesday 4/29: Medical/Surgical ATI test, 8:30 am
Thursday 4/30: OB ATI test, 10:30 am
Friday 5/1: Pharmacology FINAL
Monday 5/4: Medical/Surgical FINAL
Tuesday 5/5: Bible and OB FINALS
Done-ski.

It's so mean. 7 tests in a row.

ATI tests are like NCLEX practice tests (the NCLEX test is what you take after you graduate to get your nursing license). Our grades on the ATI tests count as a test grade in our classes. Grading for the ATI is divided into 3 levels, Level 1,2, and 3. If you get a Level 1, you take the average of all your test scores in the corresponding class and subtract 5 points; that becomes a test grade. If you get a Level 2 on the ATI, you average all of your previous tests grades, and that becomes your score. A Level 3, you add 5 points to your average.

For example, I have a 90% test average in my Med/Surg class from my 3 previous tests. If I get a Level 1 on the ATI, I'll take 90 minus 5 points, and my 4th test grade for the class will be an 85. If I get a Level 2, my 4th test grade will be a 90, because that's my current test average. If I get a Level 3, my 4th test score will be a 95. I'm not worried about this class, there's no time for that.

Why do I not have time to worry? Because the medicines I'm taking are suppressing my sense of worry and stress? Maybe, but no.
I've no time to think about Med/Surg because I'm worried about Pharm. If you read below, you'll see I only got a 72% on my last test, and I'm still trying to get over it. It's like a paper cut, and the thought of that test is the lemon juice. My average in that class is an 80.6666667% (OUCH! I found another paper cut!). So a Level 1 would put me at a new test average of about 79%. This would mean I'd have to at least pass my final (passing is a 76%) to pass the class. People don't generally do well on Pharm ATI. I was building a nice cushion with my test grades so I could handle a Level 1 on ATI, but last week's test blew that cushion right up, blew it into smitherines, outta the water, into oblivion. *POOF* - - - need I elaborate more?

*KA-POW*

I'll know where I stand with OB tomorrow. I'd like to get above an 85% on the test tomorrow. People generally do well on OB ATI.

Matthew 6:34 "Do not worry about tomorrow, for tomorrow will worry about itself."

:)

"Here We Come, Dorothy!"

2009-04-17T21:56:00.001-04:00

There were a lot more Dorothys than she expected.

"Be gentle with Dorothy."

"Take Dar-see out?"

"No, Dorothy needs her water!"

"And then we walked inside, and we had to find Dorothy out of a million fish. And then we put her in a bag and the guy wrote on it with a marker. And Uncle, guess what! We saw blue and green birds. And then I held Dorothy and shook her bag out of excitement! Then Poppy and Bryce put her in her house! And then I fed Dorothy and she ate it!"

Rats!

2009-04-16T12:22:00.000-04:00

Was it Charles Schultz that said there is no reason to ever have to say anything other than "Rats!" when something bad happens in life? The quote goes something like that....

Let's apply this principle to my day:

5:17 am after deciding to sleep for another hour - "Rats! My phone alarm is going off again, I thought I set it to only go off once."
6:00 am - "No time for a shower this morning. Rats!"
7:20 am - "Rats! My car won't start, I wore out the battery.... RATS!"
8:40 am - "We can use our Bible for the Bible quiz? Rats! I don't have my Bible!"
10:00 am - "Rats! My Pharmacology test is in half an hour!"
10:30 am - "This test has nothing to do with what I studied. RATS! RATS! RATS!"

(current time) - "I got a 72% on the test."

"Rats!"

Mother Baby Week 2

2009-04-14T12:23:00.000-04:00

Yesterday was my second of three 12 hour shifts on Mother Baby. I had "couplet" responsibilities, which meant I took care of both Mom and Baby. Last week I only had a Mom and helped with a new baby admission while I had some time.

I was again responsible for vital signs and a complete assessment of my Mom in the morning; this meant waltzing into a room and having, not just to wake up a sleeping new Mommy, but her husband, a brand spankin' new Daddy, as well. But I'm always pleasantly surprised at how well the new parents take to being woken up around 7:50 am. This is a good sign, because just wait till you get home, new parents!

This Mom was a C-section because of Failure to Progress, meaning that she didn't go into spontaneous labor on her own. She was 40 weeks and 3 days, so just past her due date. She was induced with Pitocin and taken to the OR. I think she was a section because the baby was 9 lbs. 12 oz.... but I don't know. I probablly should have. Since she was a section, she needed a second assessment in the afternoon in stead of just one in the morning. Between assessments I quick charted on her, which I think I've mentioned before?... it's basically just a quick check to ask about pain and make sure the patient is safe. I was able to give Mom some Motrin throughout the day for pain.

Her Baby was rolled from the nursery by the doctor before I could do an assessment and taken to Mom so Mom could try feeding. I wasn't able to do my first assessment until 10:00, and I did it in the room with Mom and Dad watching because I don't think they wanted her taken away to the nursery. You could tell they just wanted her to stay in the room so they could hold her and get to know her.

I felt the fontanels, or soft spots, listened to the heart, lungs, and belly, took her temperature, checked out the umbilical cord, felt the little soft tummy, noted that the baby was pink, checked her diaper (poor Dad found the "blow out" before I got to do the assessment, he was such a sport. He picked up the baby and I heard "Eeaaaa" (how do you spell that noise?) and he revieled a poopy finger), and noted a little Sacral Dimple at the bottom of her spine. I also cleaned the Dimple out, there were leftovers of the "blow out" in there. The doctor wanted to do an ultrasound later to check for any spinal cord abnormalities. I also checked the baby's muscle tone and movement (she moved just fine, so there probablly wasn't anything wrong with the spinal cord). And one perk of the job was that I got to pick up the little one. That's only everything I've been waiting for! It's fun to be the one to pick her up, wrap her in two blankets, and deliver her to Daddy's waiting arms. So cute. Baby got three full assessments during the day and at least 2 "quick charts". I got to give her Erythromycin gel in her eyes twice during the shift because she was having some yellow discharge.

Another great clinical day. One more to go, and clinicals are over until next year! That's the Senior year, by the way ;)

Happy Easter!

2009-04-11T21:21:00.000-04:00

"And in case I don't see ya, good afternoon, good evening, and goodnight!"

Beautiful Creation

2009-04-10T18:27:00.000-04:00

The best feeling comes after taking a nursing test. I step out of the classroom and I feel like Dorothy, coming out of her house after it landed in Munchkin Land (taking the test would be a twista! a twista!). It's like seeing color for the first time. Everything is beautiful. You see little munchkins sleeping in giant flowers, giant round lollipops, pink bubbles that turn into good witches from the North.

I drove home after my test on Wendesday (84%... good, Mom!) and started doing the mound of dishes flowing from our sink and countertops. But outside the window the sky was so blue, and the clouds seemed much more appealing than the bee I almost grabbed that was hiding on a dirty spoon.

As I was walking back inside, I stopped to take a few shots of some pretty flowers outside our house. The colors were amazing, and they were just beginning to open.

The next day, I had to run home before heading to the hospital to get my patient information because I had forgotten my lab coat. On my way back out to the Jeep, I noticed that the flowers had opened up completely, so I ran back in the house, and got my camera.

I was on my way out this afternoon to turn in an assignment for OB class when I noticed that it had rained. The flowers had closed back up, but still looked so pretty.

The little rain drops looked like bits of sugar, which may be why I'm so drawn to them. I miss surgar, but we have a love-hate relationship at the moment.

There's something about flowers. It's like they draw you close to them so you can appreciate their intricate beauty. You can't take a picture of a flower without making it a close-up!

Mother Baby

2009-04-07T10:59:00.001-04:00

Yesterday was my first of three Mother Baby clinicals. For 3 consecutive Mondays, we spend a 12 hour shift taking care of both Mom's and Baby's needs.

Yesterday, I was only responsible for my Mom (next week I'll care for a baby, then the third week for both Mom and Baby). At 8am I took her vital signs, checked her belly, rated her pain, changed her sheets, and charted my assessment. This was her third baby, so she was pretty self-sufficient. I "Quick-Chart"ed on her (re-assess and document her: pain and where the pain is/how it feels, location in the room, what she is doing, who she is with, if her call bell is in reach, bed low position, IV site is working, ask if she needs anything to drink) every 2 hours and whenever I entered her room. Later in the afternoon, I checked her belly again.

Since my patient was doing just fine, I was able to help with the admission on a newborn. The Labor and Delivery floor was packed with 5 C-Sections, one of them being twins! We got a section baby and a few of us got to help our instructor assess the baby for admission. Since it was a section baby, her lungs were a little "juicy" because she wasn't squeezed coming out (like normal delivery babies are). She had a couple short periods of respiratory distress where she was grunting and flaring her nose, but she was okay. We listened to her heart and lungs, took her temperature, blood glucose, head circumference and length. We also had to rate her on the Dubowitz scale, which assesses her gestational age and neurological function: we look for her reaction to light and sound, movement and muscle tone, reflexes, and behavior. We could see how she sat in Mom's tummy; she was most comfortable on her back with the legs both to one side, right leg crossed over the left. She was such a lady. We had to re-take her vital signs every 30 minutes. A few of us got to bathe her, and I was able to measure her head and length, take her foot prints, give her a vitamin K shot in her leg, take a blood glucose, and put on her first little diaper.

All babies get a natural increase of Vitamin K on their 8th day of life. Vitamin K helps your blood to clot. Do you know what else happened on the 8th day of life in Biblical times? That's when the little boys would be circumcised. God made sure they would have a surge in the clotting factor for that day! I love learning little things like that.

All in all it was a fun clinical experience. It's neat to get the babies in the nursery fresh from a C-section, then have Mom rolled up to the window when she is out of the OR and see her expression as she looks at her new baby for the first time! I am looking forward to these next two Mondays!

Hopkins Update

2009-04-01T07:33:00.000-04:00

So last night, I get another call from Johns Hopkins. Again, it was the NICU nurse manager that interviewed me for the CNA position. He called to say that, because of the economy, most of the floors in the hospital are having budget cuts and are therefore required to cut back on new hires. This wasn't too much of a surprise for me (except for the fact that I was already told that I got the job) because the floor that I was on last year isn't hiring any new people... at all.

This doesn't mean that I no longer have a job, but it does mean that I may be transferred to another floor that is able to hire more CNAs. Right now, they are going through all the applications of the people they have already hired (like me) and are going to pick 6 people to work during the summer in the NICU.

"So you're telling me there's a chance...?"

I'm guessing I will get a call later on in the week, or sometime next week, to let me know where I'll be this summer. It all depends on what the other applicants look like on paper, or whether they were previously employed by the NICU.

I'm okay with wherever I end up, as long as it's at Hopkins. I'll put my time in anywhere in the hospital, then work my way to where I want to be once I graduate.

I've nothing to say, except:

APRIL FOOLS!!!!!! HAAAA HA HA!

It's so literal! Has it ever been so literal?

Was that mean? I didn't mean for it to be mean. Matt once told me it was snowing outside on April 1st when I was little. Then he laughed at me. THAT was mean. But this?

The Lake House

2009-03-31T13:21:00.000-04:00

Next year, 6 of us will be living in this house:

It's 10 minutes closer to campus than I am now! This is the living room, unfortunately the fire place doesn't work.

Here's the kitchen:

This is the hallway off the living room that leads down to three bedrooms and a bathroom. My bedroom is the door straight ahead, just slightly to the left.

It's pretty tiny, and I'm going to try to pull the carpet up and see if I can't store it downstairs, then put it back before we move out. It's really gross. But hey, it's my own room, right?

Here's the sunroom and the deck:

We will have access to the tennis court, "beach" area, and lake!

Here's the backyard and lake, just over the fence:

There are lots of gnats outside. I guess we'll need a couple of those blue light zapper thingys.

Here't the basement where we'll put the TV and games. This is where we'll all hang out.

And the laundry room/storage room:

That's it! It's pretty spacious, and I think it will look a little more "alive" once we all start to decorate it. It's hard to believe this will be the last place I stay in Lynchburg. I'll graduate from here!

My House, Part II

2009-03-30T13:42:00.000-04:00

Welcome! I'd like to show you around more of my house! I pulled up to my house today, and it was such a nice day out after having a few days of rain and clouds....
This is the main enterance which heads in to the kitchen. This is not the door to the outside that I will mention later in the post. That door is around the house to the left. See the enterance down to the left? That's the boy's enterance.

It's really starting to look and feel like Spring! Which makes me think of Willy Wonka, when he's on that bike in the Inventing Room, singing about Spring time... I always have movies on my mind. All the windows on this side of the house look into the rooms we will be touring today! Starting from the back of the house, it's the master bedroom windows, the guest room windows, the living room windows, and the kitchen (which are the windows that stick out in a circle).

"Spring time, the only pretty ring time, birds sing-a-ding"

So if you'll remember: from the doorway to my room, looking out, you can go next-door to the left and go into my roommates room. The door you can see to the left in this picture is the door to my bathroom.

EUREKA!

No, I haven't gone all this time without toilet paper. But as you can see now, I have plenty. If you walk straight out of my room, you'll see my roommates bathroom there on the right, or you can walk straight forward into the master bedroom. But we'll pass that by, because it's locked. The hallway moves to the right....

... and you come to an area full of options.

You get to choose from 5 doors. The first on on the right will take you outside, which means you are going to get the mail, which means you are about to walk a really long way. No thanks. The double doors straight ahead will take you into the craft room, formerly known as the music room, until all the instrumets were taken out. This room will also connect you to the kitchen, but we'll get into that later.

As you keep turning to the left, there is a doorway that takes you to the living room. (See the other door through the craft room? Go through it and immediately on your left is another doorway to the living room. Immediately to your right is a bathroom. Straight ahead is the kitchen.)

Still moving to the left, there is a door to the guest room, then finally, a door to the downstairs (not pictured here). This door leads to the apartment downstairs which houses 3 other people. They're boys. We don't go down there. And they don't come up here! Except to do laundry. They have thir own kitchen, door to the outside, etc.

Ok. First, we'll see the guest room. This is where Matt and Ian stayed and giggled all night long.

Now here's walking into the living room. The door there on the right is the kitchen.

Walking further (farther? further?) into the room, you can see the doorway on the right is the one I mentioned before. If you walk through it and turn right, you'll head into the craft room. Walk through it and go straight, the bathroom. Turn left? The kitchen! (Are you completely confused?) And there's the kitchen to the left.

Here's another view: We just came from over there on the right.

Now I'm standing in the kitchen, looking towards the guest room and the downstairs door.

Closer up:

The first door on the right? Guest room.

Second door on the right? Downstairs.

Hallway to the right? Heading back to my room.

Door straight ahead is a closet, and the open door goes to the outside.

Do you feel dizzy? Hope I didn't confuse you.

Until next time!

It's Been A Long, Long Wait

2009-03-27T19:14:00.000-04:00

But I have finally heard from, what Matt and I lovingly call, the Number One Hospital In The World.

That's right, Johns Hopkins!

I interviewed way back and forever ago on Tuesday March 10th. Actually, that wasn't too long ago, was it? It sure feels like it was. Anyway, yesterday afternoon I got a call from a 410 number... a 410-955 number, which I know to be the first 3 digits and area code of Hopkins, my heart be still. So I took a second to gather myself before answering "hello?", in as much of a mature, professional manner as one could express through a phone.

"Hello, is this April?"
"Yes it is"... (kinda like, "Oh hello, who is this?" Except I KNOW!)

It was the guy that interviewed me, a nurse manager in the NICU.

"First of all, thank you for the thank you card you sent, that was nice."
"You're welcome! I had a great time visiting the floor." (Major bonus points to my Career Coach for making sure I sent that letter out! Props, bro.)

"We would like to hire you, if you are still interested."
"Oh, yes I am, thank you."
"Ok, great. And how many hours would you like to work? Were you thinking full time? Or part time?"
"Full time, if that would work for you."

YES! 40 hours a week of feeding, burping, and caring for neonates! I'll get to do "cares" on them, which is taking their vital signs and listening to their heart, lungs, and belly, suction them when they spit up, change their diapers, take them to get procedures done, and go see some C-Sections and high-risk deliveries! I'll also re-stock supplies, prepare beds for admissions, and re-stock the bag/kit that the delivery team takes with them to every high-risk case; it's full of medications and anything that would be needed for any situation that could possibly happen. My heart is beating faster just thinking about it.

And get this, 30 minutes after this phone call, I get a text from my friend informing me that we had been accepted to rent a house! And the house is right on a lake! For a while, these two situations were in the "I have no idea what is going to happen, but they both will shape my future plans" category, but giving things like that over to God and trusting in Him to take care of them makes it all so peaceful, and handle-able (if that's a even a word). And they were both handed to me in one small moment. God cares about the little things, and I'm so glad He does!

I've also been seriously thinking about getting "My House, Part II" up. I know you just can't wait to see my bathroom. I may just throw in the hallway too. I'll also be sure to take my camera to the Lake House when we sign the lease.

Go Low, Go Slow, Go Like You Know!

2009-03-20T16:52:00.000-04:00

Today, my clinical group learned how to start an IV!

Types of IV's:
1) Peripheral: the ones that go in your hand, arm, elbow... these can stay in for only 3 days.
2) PICC (Peripherally Inserted Central Catheter): these go on your arm as well, but the catheter travels all the way up to the heart. Like what Aunt Pam, Dad, and Matt had for Lyme.
3) Central Line: the one that goes in the jugular (IJ) or on the chest (subclavicular). These go straight to the heart too. Lines that go to the heart can stay in for up to a month or so.
4) Port a caths: these are surgically implanted under the skin in the chest and are accessed by a 90 degree (looks like an up-side down L)needle when the patient needs medicine or treatment. These can stay in for a year or longer.

There are so many rules to dealing with different IV lines; what you can give through them, what you can't. How you can administer the medicine, how you can't. How often you need to change the bandage, etc.

This guy has all the types of IV's, and we use him to practice IV dressing changes on. And see that box? Those are the needles we used to practice with!

An Angiocath is the basic IV line. It has the flixible catheter with a needle inside, after inserting the needle, you pull it out, leaving the catheter in the vein. The newer models of needles have a small white button that pulls the needle into itself when pushed after you have placed the IV. It's a safety feature: with this, there won't be an open needle on your field when you pull the needle out of the catheter. Here's how it works, watch for the uptake of the needle, it's fast!

Before we stuck eachother, we practiced our critical thinking skills with patient scenarios. We were each a "patient", and we went around the room figuring out what size needle was best to use (gauge 14,16,18,20, or 22?) for each condition, and where to put it (hand, forearm, or antecubital/elbow?).

This is Melissa! She's one girl in my clinical group. She's playing a 15 year old athlete, who, based on her age and physicality, should have good veins. Because of this, you can think of using a larger size needle (the lower the gauge number, the bigger the needle/larger diameter needle). But, the patient is going to the OR, so you need to put at least a size 18. We chose a size 18 gauge on the right hand, this way the anesthesiologist can be on the one side while the OR surgeons, etc. are on the left side dealing with the leg.

Here was my scenario:

EEK! Sickle Cell is painful! So first, you need to ask where the patient is having pain, because that is where the sickle cell crisis is, and what if they are having their crisis in their arm?? You would definitely want to avoid putting a needle where someone is having a crisis! Plus, she is getting PRBC (Packed Red Blood Cells) which means you would need a big lumen so the Red Blood Cells can pass through without being broken up.

Other scenarios also included a diabetic with dizziness and fainting (Her veins would be less-than-ideal because of the diabetes, but... what's the worse case scenario? Dizziness in a diabetic is from low blood sugar, and if it gets low enough she would need to be given Dextrose, which is really thick. So she needs a big lumen, 'round a 16 or 18). Also, a 50 year old with chest pain and nausea (heart attack! This requires TWO IV lines because he could code.) It was fun!

Next, we watched our teacher place an IV line so we could see how it's done.

Here's the whole process, in three parts (you can pause the music above so you can hear what the teacher is saying):

Don't you just wanna grab a 22 gauge, find a forearm, and go nuts?!

Well if you do, here's what you'll need:

A tourniquet, alcohol preps, a needle (pink is size 20, a smaller needle), tegaderm (a clear "plastic bandage" that will cover the IV site, keep it stable, but still let you assess it every 2 hours without having to take the bandage off), some tape, some gauze, and a saline flush (the outside tube with a blue end, where the saline flushes or medicine is pushed into). Don't forget the gloves! All the needles are color-coded depending on their size. We usually see blue (22), pink (20), and green (18).

Here's a vein we can practice on first. You can see if you go straight through the vein with this device, and it helps you visualize what is happening under the skin.

In this picture, the pliable catheter is in the vein, and the needle is coming out.

Now we can move onto the practice arms. These are pretty realistic. They actually BLEED!! And there are many veins to choose from, so whichever one you stick, be sure to go low, go slow, and go like you know ;)

Here's Maya.

Here's a hand you can practice on too. Looks like Thing from the Adam's Family. This is my site that I put in. Look at all the blood (but that's not all from me, just the fresh-looking drip on the white board). See the blue tip? That's the "saline flush". You can hook up IV tubing and syringes there. Without it, the blood would just backflow out of the IV line and the patient would bleed all over the place. This would be terrible if the blue tip came off of a central line because it would be like the heart was spilling out on the floor.

Here I am having a go at the practice arm.

And finally, a real victim! I got it on the first try, no problems! It was an awesome feeling, I wasn't nervous or shaky while I was doing it.... but the second I was done inserting the line, my hands started to shake! I was so excited I had just done that!

Here's the whole clinical group! We've been together since day one of Junior year.

Don't worry about our arms, this was our "funny picture", so it's all fake blood.

We're nuts.

(Congratulations on getting to the end of the post! It was a doozie.)

Tuesday

2009-03-17T22:01:00.000-04:00

We have ants invading the kitchen. I sprayed them with Clorox. The ants are now 99.9% germ free.

I still don't have toilet paper. I drove past Wal-Mart today.

It's dark outside. My room is dark because it is dark outside.

I bought a book today. It will tell me what to expect when I'm expecting. The book is "What to Expect When You're Expecting". I'm expecting to get extra credit in OB class for reading it. There was a cute boy behind me when I bought it. I expect he thinks I'm expecting. Oh well.

I take over 46 pills and supplements, three times a day. I swallow most of them with one gulp. Mandy thinks that makes me a superhero. I want to know why she didn't think I was a superhero before she saw me take the pills.

I wish there were more hours between when I go to bed and when I have to wake up. Of course, I could make this happen by going to bed earlier, but that's not what I mean.

I am learning how to start an IV line this Friday. I plan to have my camera to document.

The Dark-en-ess

2009-03-16T18:46:00.000-04:00

All my lights are burning out. My overhead light in my room is blown, and you can just forget about this 5'3'' girl trying to fix that thing. It's like, all the way up there on the ceiling, and, there's this, thingy, that is under the bulb so I can't get to the bulb to unscrew it. I feel like Aunt Becki; "The doo-hicky under the thingy is too far up and I don't have a thingamagigg to fix it."

How many nursing students does it take to change a light bulb?

Where's Dad and his superman belt? I think he has a step-ladder on that thing.

2 of the 3 light bulbs in my bathroom are out, too. But I figure I can just deal with the less-than-ideal lighting because I actually looked for replacement light bulbs, but you can't replace one bulb with another that is a different wattage, can you? The whole house would blow up if I did that!

I realize that may not be entirely accurate.

I am also out of toilet paper, and I am wondering how I forgot to snag a roll or two while I was at home. I was only reminded of my need about five times a day as I used the bathroom (how many times are you supposed to go to the bathroom in a day? Should I know that? I know it's 30 cc's per hour... I wonder if this will be on my next test...).

But my pantry and fridge are stocked with yummy organic food :) And my room is slowly getting darker and darker as the sun goes down.

Study Break

2009-03-03T14:15:00.001-05:00

I was reading a chapter of "A Long Obedience in the Same Direction" the other night on how Psalm 124 is a magnification of the items of life that are thought to be unpleasant. Peterson was using an example of a friend of his who took magnifed pictures of ordinary, every day things. The results were "artful", giving a new perspective on the things that you would normally view as insignificant, such as a Brillo pad.

""God's strong name is our help, the same God who made heaven and earth,"... It takes the majesty of the One who pulled a universe into order and beauty, and finds this same God involved in the local troubles of a quite ordinary person.""

So I decided to play around, have some fun, and see what I could come up with. Can you tell what the following images are?

Here they are together:

My roommate guessed "sunglasses".... wrong!

The other roommate just said "Hmmmm....".... wrong again!

These are everyday, ordinary,.... utensils. A fork, knife, and spoon.

So tell me your thoughts:

Did the cutlery become "artful"?

Will you ever stab, cut, and scoop your food the same way again?

I need to go do some nursing stuff, for crying out loud! Next test is tomorrow on geriatrics and orthopedics.

My House, Part I

2009-03-02T11:25:00.000-05:00

Here's my room! My roommate from last semester graduated in December, so I am all alone! I really enjoy it, and it's nice because I came back this semester with lots of pills and jars for germinating and sprouting nuts. It would have been "fun" to explain all the crazy stuff I need to do sometimes to someone I didn't know.

Here's walking through the door, then moving around to the left:

My clinical schedules: the top is Med/Surg clinicals: I'm on the Oncology floor now. The bottom is for OB class: I have a Baby Massage class coming up on Wednesday, and my Mother/Baby clinicals in April.

On my dresser, I keep my printer and my class books. Those are ALL nursing books, plus 2 that you can't see in the picture :) I use them when I write my weekly profiles for clinical.

What desk would be complete without a Dwight Schrute Bobblehead??

My window. All my medicines are in the drawers.

These are over-the-door hooks that I put on the walls using "Command Strips" as curtain holders. I still need one more for the other side.

The view from the window this morning: SNOW! 8 inches last night.

This was my roommate's dresser, but now I use it to put make-up on, because it has a mirror.

I get to see these girls every morning!

And these girls too! Elizabeth, Mandy, and Laura

These are two pictures of Kek-Chi kids from Guatemala. The "frame" is actually a shoe box lid.

My closets:

My reminder for clinical: If you are missing your med cards or profile, you go home. Scarry!

Coming up: the bathroom :)

Ignorance is Bliss!

2009-02-23T21:39:00.000-05:00

This has never seemed so true, because as a nursing student, you know what can GO WRONG!

I spent a few hours today in our Nursing Lab. We learned about caring for a Mother and Baby during and after labor. And you know what? I think I want to adopt...

Just kidding, I think.

Obstretics is an interesting field, and I'm intrigued. I enjoyed my 12 hour clinical rotation on Labor and Delivery last week and am looking forward to my 3 clinicals in April on the Mother/Baby floor. I now know how to read a fetal heart and maternal contraction monitor and what to do if there is something wrong. It's lots of fun when all those squiggly lines make sense!

Did you know that if a baby has an abnormal drop in heart rate, from compression of the cord, you can try re-positioning the Mom?
(Hey, that happened to me when I was being born...)

Did you know that there are 2 arteries and 1 vein in the umbilical cord, and that missing one of these could mean a congenital abnormality?
(Hey, I only had 2 vessels in my umbilical cord...)

EEK! Not to worry, turns out I am one of the 75% that turn out okay, heh heh.

Our lab is fully equipped. We even have a dummy that gives birth and can go into distress, but she wasn't working today - but I did get to palpate her tummy for the baby's head, back, and hiney!

Labor and Delivery nurses spend a lot of time with their patients (2 patients during the shift, not 5 or 6 like other floors!) and have a lot of autonomy, meaning they provide a lot of care. I could see myself doing this one day. But that is the problem, because every time I go to a floor that has anything to do with children or babies, "I can see myself working on that floor".

Time Flies When You're Having Fun!

2009-02-17T15:39:00.000-05:00

This past weekend was a BLAST!!!!

Matt and his college roomie Ian Prince came down to visit me at school and take me out to celebrate my 21st. They brought a little surprise with them.... Mandy Jean! As I walked out of my house to greet Matt and Ian, this little blonde thing jumped up from behind the car like a jack-in-the-box. It took me a while to register who it was, but I screamed with delight once it dawned on me, haha. They played it well over the few weeks leading up to this special visit. I even asked Mandy if she could come down but "she had to work", or something-or-other, and I texted Mandy while waiting for Matt and Ian to arrive to ask her if she had Skype (a live video chat on the computer [thanks Aunt Candy! I love it :)]) so I could talk to her that night. Meanwhile, she was secretly on her way to my house!

We had fun hanging out over the weekend, going out to eat with my school friends (who enjoyed being able to meet the people I talk so much about!), and laughing as we all watched our favorite childhood movie, Pee Wee's Big Adventure. Matt and Ian spent the night in "Room 318", which was our guest room with a sign they made so they felt like they were in their old college room again..... they were giggling all night. Mandy slept in my top bunk as we wished it could be like this every night.

But, the weekend was over too soon, and now I get to look forward to coming home this weekend for a quick visit!

But now I have to study for my first OB test tomorrow. I didn't study this past weekend, of corse, so it's crunch time.

UPDATE: Hopkins has my application and I have submitted by top 3 requests for which department I want to work in this summer:
1. Pediatrics/NICU (Neonatal ICU or Pediatrics ICU)
2. OB/GYN (Labor and Delivery)
3. Critical Care (the sickest of the sick; this was an interesting decision for me, but I think it would be very interesting to work on a CCU floor. I would see and learn a lot....)

It's That Time Again!

2009-02-12T19:30:00.000-05:00

After about the first two weeks of the semester are done-and-over with, the "real life" of a nursing student begins. This means tests - and lots of 'em. We will have one test a week for the rest of the semester; it's a cruel cycle. First is Med-Surg (in this class we learn the basics; what's wrong with your patient? How would they present? What do you do?), then comes Pharmacology, and the third week in this terrible rotation means OB (or Peds, for those who took OB last semester). At present, we are in week two of the cycle, and I have just finished my first Pharmacology test with an 86%. Yes, Mom, that is good news! I also got an 88% on my first Med-Surg test last week - also good, Mom ;) Those are both solid grades to start on, and I hope to build up from there.

And now, because I can hear your thoughts at night, right before you go to sleep:

"Ok, that's M.O.M. in the A.M.... no, in the P.M., for a B.M. in the A.M. Yeah, that's it..."

I have decided to share with you all the contents, the "bulk" if you will, of my first Pharm test.... which included "Bulk-Forming Laxatives" - get it? ... Nursing humor.

Anti-Seizure drugs: Now there's an interesting field of nursing: THE BRAIN! We had an award-winning Liberty grad neuro nurse teach us this in Med-Surg, which made it just a little bit easier to learn about in in Pharm.I use stories to remember things about drugs. Like for instance, Carbamazepine. "Carbs are only a small part of your diet, so Carbamazepine is the drug of choice for partial seizures."

We also learned about GI drugs: medicine to help with peptic ulcers.

Another interesting disease that affects the brain is Parkinson's. I would like you to travel with me, we're going to my brain. What's it like in there while I'm studying?

1. Parkinson's is an imbalance between Dopamine and Acetylcholine.

2. Parkinson's has two basic classes of drugs: Dopaminergic and Anticholinergic.

The Dopaminergic drugs are as follows: Levodopa/Carbidopa, Tolcapone, Entacapone, Selegeline, Bromocriptine, and Amantadine.

I read it over like this: "Let Tol Enter the Sale gate on his Broom with Amanda." Boom, got it. And you know what? Poor Amanda has had the flu for a while so she's been in her room where there is little sunlight so her skin is getting spotty. (Amantadine is also used for the flu, and a side effect of the drug is mottled discoloration of the skin).

Here's my favorite: Tolcapone: Al Capone drank a lot of alcohol and Took ('t' for 'took' and 't' for 'Tolcapone') money. Tolcapone causes liver damage and death. Alcohol and the liver don't mix.

I'm telling you, the brain is awesome. I can go through drugs pretending it's one big story and I remember it way faster than if I read and re-read facts.

Let's end this post with some Q&A:

Question:

Answer: Immodium

3 Years at Liberty

2009-02-09T22:38:00.000-05:00

February 9, 2007

February 9, 2008

February 9, 2009

Whelp... I'm 21

2009-02-09T14:31:00.001-05:00

It's crazy to think of it, but another year has passed. I'm excited to come home next weekend for Leah's baptism, and for a get-together with the family!

Here's a little peek at our outside. I'll be putting up pictures to give you all a tour of our house soon.

This past Satruday, my friends and I (a total of almost 20 of us :)) had a great party to celebrate the big 2-1. The weather was a beautiful 60 degrees. We had a bon-fire with hotdogs, curly fries, and s'mores (I had a couple of nice, organic hotdogs and organic sweet potato fries), then we all went inside and played card games and "Running Cherades": a game where there are two teams in two locations in the house, and one person from each team runs to a central location where there is someone waiting to tell them a noun. Then, the players run back to their teams and cherade the word; whoever guesses correctly is the next team member to run to the word-giver to get the next word.... etc etc etc. There are a total of 5 words, and whichever team guesses them all first wins. It is fast, frantic, and fun! It was fun hanging out with all my friends, which are all nursing students, because that's pretty much all I know here at Liberty.

And the BEST THING IS: Matt's coming down to visit me and take me out this Saturday! He's staying for church on Sunday then heading home. It should be a lot of fun!

UPDATE: I called Hopkins and will be putting in an application to work there this summer!

Do You Want the Good News First?... Or the Bad News?

2009-02-02T17:44:00.000-05:00

How about the bad news? It's really more along the lines of sad news that I will not be going to Guatemala again this summer, as I was hoping. I once heard we shouldn't say "I'm going to stay home until God tells me to 'go'", but instead, "I'm going to go until God tells us me to 'stay home.'" It would have been the first time that I had returned to the same mission field, but, due to a series of unfortunate events, I will most likely be home this summer. And really, I had been preparing myself for a while that I wouldn't be going back just yet; I had "that feeling". And looking back on everything that happened, I can see how God just wants me to be home. At the beginning of this semester, the person who would have been the leader of the trip lost his job. It was really "unfair" (for lack of a better word) that he lost his job, and no matter how cliche it sounds, he didn't deserve it. But, apart from that, he also hasn't been home for one month out of the summer for many, many years, and with six young children at home, his wife would like for hime to stay this time 'round. And that's okay, really, I think it may be best. Furthermore, with it being this far into the semester, I begin to feel exhaused at the thought of trying to find another trip to go on, and I almost feel like maybe I shouldn't be "trying to find a place to go on a missions trip". My heart was in Guatemala, and hopefully I will be able to go back summer of 2010. I do wish I could see these faces again!

And of corse, with everything that is going on with me health wise, being home this summer means that I can easily stick to my organic/raw diet and I won't have to worry about running out of medicine in the middle of a jungle.

On to the good news! Tomorrow, my plan is to call Nurse Recruitment at Johns Hopkins to see about being a CNA again this summer! I would have planned to possibly leave Guatemala early so I could be back in time for orientation, but that is no longer a concern! I am starting to get excited knowing that I could soon be walking through these doors again:

This is what I would see every work day at 6:30 am! Hopefully I will be in the Neonatal ICU this time. I was able to shadow there last summer and meet the Nurse Manager of the floor; she sounded like she would like to have me work as a CNA, so we'll see where it goes. But truth of the matter is: I'll go wherever Hopkins tells me to go. It's Hopkins!

God is Good!

2009-01-29T20:05:00.000-05:00

So here's one way God has continued to show me just how much He cares... about the little things!

If there's one thing (haha) about nursing school that makes me nervous to... well, uhhh... be a nurse, it's the fact that one tiny mistake can cost someone their life. It's a fact that I have been really thinking about and a fact that I just need to put in God's hands, while taking measures to prevent something bad from happening. Here at Liberty we learn how to treat and care for patients in a way that would make giving someone the wrong treatment difficult: for example, checking THREE TIMES that medications are given in the right dose, at the right time, for the right patient, via the correct route, etc. etc. etc. But there are so many medications, and so many routes of administration, and so many side effects... how could I learn all of this????

Anyway, last weekend, at the Nursing Convention, I won a prize from a raffle. Out of a viariety of prizes, ranging from Starbucks gift certificates to personal review sessions with NCLEX tutors, this is what I got handed to me:

YAY! This little stack of note cards is amazing, and makes me feel a little more relaxed about the whole drug thing. And here's why: they're fun!

They give mnemonics and use other creative ways to help you remember everything about drugs.

Here's a drug that I am learning about now. And what's funny is that my teacher used this example as something you would not want to remember. Versed is best for causing amnesia during procedures. You won't remember or care about a thing while this drug is in your system.

One thing that I had trouble remembering was with which drugs you should avoid Grapefruit Juice. I randomly flipped to this card today...

...and it told me exactly which drugs to avoid drinking Grapefruit juice with, and there were less drugs to remember than I thought!

Besides fun pictures, the cards also have imortant information on the back... Here's an example: Lidocaine (front)
And Lidocaine (back) with important things highlighted in different colors, depending on what you need to be thinking about and looking for.

Wow. God is so good!

Nursing Convention

2009-01-27T18:05:00.000-05:00

SWAAAGGG! Stuff We All Get! (Michael Scott)

Last weekent a few Virginia Nursing Schools gathered in Virginia Beach for a Nursing Student Conference at the Founder's Inn resort and Spa! A bunch of us from Liberty went along and had a great time!

We were able to meet representatives from different Virginia health systems. There were also different "Breakout Sessions" where we could learn about different fields of nursing. I went to the ER, Operating Room, and Pediatric Sessions, as well as a Fluid and Electrolyte review session - because fluids and electrolytes, apart from being hard to understand and remember, are very important for your NCLEX test. But what we all really enjoyed was getting FREE STUFF! Pens, highlighters, pen lights, frisbees, tee-shirts...

For lunch we enjoyed catered fish, salad, veggies, and iced tea. It was delicious. It looked like a wedding.

Liberty won a few prizes for our community work and our school spirit! These girls are our Liberty Student Nursing Association leaders.

Of corse, it seems that wherever we go, there is some sort of adventure in store. It never fails. This weekend we had a rough first night and ended up switching hotels. Let's start from the very beginning, a very good place to start. When you read you begin with?

Okay, that was for Matt.

We arrived our first night (Friday) and checked into our beachside (across the street from the beach) hotel. Of corse, online, it looked decent enough. There were pictures of a chandelier (which was overtop the clerks desk), a grand staircase (which led to... the ceiling), and a nice, safe-looking parking lot (kind of an alley way). Our first room smelled like cigarettes, so we went back to the office and requested the room we ordered, a non-smoking room. We were "up-graded" to a room with a stove! Yay! The front desk guy told us we could invite him up for dinner. EEEK! So we ran away, back upstairs, and moved one room to the left. We were greeted by mold and bugs. We thought we'd just stick it out, "it's no worse that what I had to deal with in Guatemala".

We decided to go check out where the convention would be the following morning. MapQuest told me it was half a mile away, but 20 minutes later, we were still driving down the highway. After seeing the Convention's beautiful Resort and Spa location, we headed back to, what my friend Lindsay lovingly called, "the place that looks like a CSI investigation site". We were soon smashing more bugs that were crawling out of their cozy little home from inside our clock. "Okay, time to get out of here"

We got a refund and moved across the street to the Best Western, Oceanfront. Hotels.com is very sorry for any inconvienence.

Here's the view outside of our room.

We really had a great time the next day (Saturday) at the Conference. We learned a lot and enjoyed not doing any work. A few of us stayed an extra night to enjoy the beach even though it was 30-some degrees!

Next I'll show you something I won at the conference.... something that reminded me that day how awesome God is!

Tuesday Evening

2009-01-27T17:42:00.000-05:00

I figured that I would start a blog because they are really a lot of fun! I spend most of my time on my computer making the rounds, jumping from one blog to another, to see if anything new has been posted. "Does Heather have a new pic up?" "Has Leah had a second attempt at rice cereal?". I must visit thedeterdingfamily 5 times a day. Then I go to The Pioneer Woman, Stacy Richardson, even Mandy's DR blog, though she's home now :)
I think it is an excuse not to study.

Anyway, I figured this blog could give me an outlet to all my family and friends back home. So here is my chance to try to keep you all up-to-date on what Liberty Life is like, and what Nursing School entails. I'll try to be a consistent blogger. I'm already having some fun!