Adventures in Nursing

I passed!!!!

2007-06-19T08:21:00.000-07:00

I just found out that I passed the NCLEX! Thanks to all you who were praying for me. Now little Michael will be able to go to college. This is super-exciting for me. The test that I dreaded for so long I passed with flying colors! 75 questions and the test was complete and I passed! Praise God! He led me to trust in Him and He was faithful. "Not might, not by strength, but by my Spirit, sayeth the Lord." Amen.

Free at Last!

2007-06-14T21:52:00.000-07:00

Thank God Almighty, I've taken the NCLEX and am free from it's horrible tortuous grip at last! Wow, what a horrible test. (For those who aren't keeping up, the NCLEX is the national board certification test for nursing) The test gauges how you perform as you take it and responds with increasingly difficult or decreasingly easy questions. I didn't feel like I knew the answer to a single question on that test, so I'm assuming that I passed. hehe... The test shuts off when it determines what level of competency you're at. 75 is the minimum amount of questions you can have; 265 is the maximum amount. I had 75 questions. So I either really blew it or I blew it out of the water.

I had a lot of anxiety about it yesterday when I woke up. So I prayed to God about it. I was reminded about a passage in Philippians about giving up your anxieties to God and His peace guarding my heart or something like that... So I started reading at Chapter 3 (I couldn't remember that it was in chapter 4). Immediately I was convicted that I was relying on my own strength to pass this test. God calls us to rely on His strength in everything. He gets the glory, not me. Yes, we need to study, practice, etc... but in the end, it's God that builds the house (a reference to a psalm... 122?). After prayer I felt a lot of peace. This morning as I took the test, even when I didn't know any of the answers, I felt a huge amount of peace. Praise God!

I'll keep you posted on the outcome. But I think I passed.

Working again

2007-06-08T05:49:00.000-07:00

Well, I finished my 2nd day at Alvarado as an "RN" yesterday. It's not actually different from two weeks ago except that I get to pull medications out of the pyxis machines (that's our local drug dispenser on the floor, kind of a like a vending machine ;). I've had 2 interesting patients to take care of as well. I can see myself growing as a nurse in areas of compassion and assessment as well as prioritization. This is very good, because these are all critical for me to have in my repertoire if I'm ever going to be a proficient nurse. Alvarado is treating me well. God has blessed my family immensely with this job.

In other health-related news, Shannon's contractions are 7-10 minutes apart!

Waiting game...

2007-05-30T16:36:00.000-07:00

- _______ Hospital, how may I help you?
- May I please speak to the director of critical care?
- Just one moment
------
ring.... ring.... ring.... ring....
- Hello, you've reached the director of critical care. I'm not able to answer the phone right now, but if you will leave your name, phone # and reason for calling, I will return your call at my earliest convenience. If this call is an emergency, you can page me at ###-###-####. Thank you.

grumble grumble grumble....

This is what I've listened to for the past 3 days trying to get my job back in the ICU... sigh. I think my director is on vacation. Waiting sucks.... Studying while you wait is even worse. Studying for a test that will determine if your baby ever gets into a decent pre-school while waiting for a job? Hell. Having a supportive wife through it all to keep you from going insane? Grace.

Mission Accomplished: Graduated

2007-05-27T17:28:00.001-07:00

Before getting to the main story, my arm is still attached and functioning (see prior post). I was kind of worried for a few days there. I was experiencing nerve pain, parts of the arm were bluish-black, and the surrounding areas were yellow. All that remains now is a small yellow patch on the ventral side of my middle forearm. Creepy!

I graduated from USD's Master's Entry Program for Nursing this Friday, the 25th. It was a very nice ceremony and I made out with a lot of money from the relatives! ;) But seriously, I enjoyed having my family with me as I celebrated with friends on finally finishing this program (I took an extra year to complete it compared with the rest of my colleagues). Some of the speakers offered some very encouraging and inspiring words. I'm actually starting to believe that nurses really are special and a very great asset to the community both locally and abroad. The ceremony made me feel honored... very odd for me to feel that. (Photo: Shannon, me, Mom, Dad)

Now all I have left is to take the NCLEX and I can just work for the rest of the summer... and take care of our new baby!!!! Not here yet, but check back for pictures in a couple weeks. I'll be working at Alvarado in the ICU as my permanent job. I'm very excited and can't wait to learn more.

Infiltration

2007-04-26T11:20:00.000-07:00

Ouch! I gave blood today (or tried to) when the needle infiltrated through my vein. That sounds painful, but really, veins don't hurt to be stuck with needles. What hurt was all the blood that filled up the non-vacant space between my skin and muscle. It swelled to about 1/2" high and 1 1/2 " wide! I cussed too, under my breath of course. I totally freaked out, tried to loosen the blood pressure cuff while the nurse was turning off the hemaphoresis machine.

What a reminder of the sheer terror that I can strike in the hearts of my patients...

In other news, 2 1/2 weeks left of school and I'm currently working in the ICU at Alvarado, endeavoring to take care of 2 patients simultaneously; it ain't easy. Shannon is 34 weeks pregnant today. The nursery is complete, only awaiting our friends artwork on the walls and a new occupant. :D

Rest

2007-03-07T10:03:00.000-08:00

Wow, what a difference the Holy Spirit makes. Last week was so rough on Shannon and me. I felt overwhelmed by work and study and I just felt unable to rest and enjoy myself, ever. At home group on Sunday, I asked for prayer for us. I know God is totally helping us: this week was been a lot easier to handle. I'm actually gonna do an extra clinical day this week because I feel like I can handle it. wow!

One of the things I was convicted of while praying at home group was how poor of a 'spirit' I seem to have (translation: I never feel like I'll have enough of whatever it is I need). This it totally contrary to everything in the Bible. Isaiah 55 addresses the best; it calls out the poverty and dissatisfaction of God's people and tells them to go directly to the source, God Himself, and receive abundance. I'm still mulling over these thoughts, but I feel so much more satisfied and excited about life. I have less fear and anxiety about nursing (well, a little bit less).

Subsequently, my rest this week has been great! I've actually woken up about an hour before my alarm the last three days and felt pretty refreshed. I still took the extra hour for sleep, but the difference is still noticeable. Time with Shannon is less rushed as well; we can really enjoy the time we have together.

So now... I'm waiting at school for my class which begins in about 2 hours. Then it's off to the grocery store and home.

Yes, Really THAT Busy! & Creative Patients

2007-03-02T15:28:00.000-08:00

I can't count the times that I've wanted to sit down and update this blog (mainly because I can't remember), but I just haven't had the time. Average schedule now:
Monday: 12 hour shift
Tuesday: 12 hour shift
Wednesday: School and study
Thursday: 12 hour shift
Friday: 7 hour clinical round and a little bit of rest
Saturday: upkeep my life and marriage
Sunday: church, home group biweekly and time with Shannon

But not this weekend! Oh no! This Saturday, it's Legoland and Outback Steakhouse, all the way! Yeah baby!

Ok, serious stuff now:

This Wednesday our Leadership class was requested (read: required) to attend the Janet Rogers Lectureship series at USD. I was interested, but probably would have stayed home and slept a little more if I'd had the choice. However, I was actually blessed by attending. I don't know what I think of the guest speaker after talking to her in person, but her work spoke volumes into my own understanding of God. She did her dissertation on art intervention for suicidal teenagers. She also described the effect that art had on cancer patients in her hospital in Florida. The patients were formerly resigned to death and depression. But, after making some form of art piece, they experienced a renewed sense of purpose. That just blew open the windows, swung wide the door and basically tore the roof off the house of my theology and understanding of God's will for our lives.

The past years have been hard for me in relating to God. I just felt so much pressure to perform, for Him, for Christians, for my family, for nurses and teachers. I just couldn't grasp the truth that God genuinely loved me, liked me and desired my best, and all this not against some greater desire to punish me. The last few months, largely attributed to the cessation of media in our house, I've begun to draw nearer to God. As this has happened, I've begun to see afresh the love and grace that continually flows from God, from the cross. I still don't spend a lot of time praying and reading the Bible, but I at least don't beat myself up everyday for not being a "good enough" Christian, like such a thing were ever meant to exist. (What an insult to the cross that idea is!)

Now to the point: God's been showing me that He has never meant for us to be depressed. He doesn't want us to dump on ourselves all our failures and sins. He commands us to be joyful and to receive His love. As I've pressed into this anthem of love, I've seen that God actually has a purpose for us, and it's not to be a perfect little person who dresses, talks or acts a certain way. No, God wants us to grow in faith and love and progress to our pre-fall nature. He desires our joy, love and general stress-free character to be developed via the Holy Spirit's influence. And what this lecture taught me is that God wants us to be little gods, just like Him. We're made in His image. When I heard that patients who had no purpose and were resigned to death found joy and purpose in making art, it made so much sense. Our God is a creative God. Ergo, we have a desire to create, to be productive, to work the ground and make wonderful things. That's what He did. The end result and the affection which we give our creation must be of a different design than God's, but the function of creating is still the same.

And so I thought to myself, "It makes sense that people would feel more healthy and 'better' when they are doing something they are meant to do." That's why worshipping God gives Christians so much joy. That's why children and artists alike love to draw and paint, why builders love to build. It's when we live unproductive lives that our level of satisfaction and joy decreases and death begins to settle inside of us. A heart and soul that is alive will cause a life to be productive and creative, whether the medium be art or science. I think that's why I've begun to journal more recently. I have a need to put down my thoughts and create... something!

So, in summary, God loves us and wants us to be who we were meant to be: beloved creations who create and love and find joy in God.

Journey's End

2007-02-09T17:39:00.000-08:00

My first patient passed away on me this past Thursday, February 8th, 2007. It was an event that I hoped might never come. I don't mean to say that I'm afraid of death, but more that I knew it wouldn't be easy for me nor the patient's loved ones.

I was honored to care for someone who was well-loved and, from what I hear, was a very nice man. By the time we received the patient, at the beginning of the shift, plans were under way for him to moved home in hospice care. Hospice care is basically end-of-life care. No curative measures or life-prolonging treatments are given.

Around 3pm, the patient's heart began to slow down to 42 bpm. We went into the room to see the patient. He had been unresponsive for the majority of the day, partially due to the pain medicine we gave and partially due to his multi-system organ failure. The wife was there and my nurse told her that she might want to stay; she was planning on leaving. About fifteen minutes later the heart rate was down into the 20s. Fifteen more minutes and he passed away, his hand being held by his wife of almost 60 years with her telling him how much she loved him. It was really hard to watch, but at the same time I had so much joy because he was loved and didn't die alone.

Later that night when I got home I told Shannon all about it. As I was trying to process the death, I realized how much I fear dying alone. I was so happy to see that he wasn't alone in some hospital room with a million tubes coming from his body. Shannon and just held each other for while, silent. We thanked God for the relationship that He's given us and the new life growing inside Shannon's belly.

When the patient passed two other nurses had to come into the room to pronounce death. Then the physician was notified, orders were received and paperwork was filled out. The family came to see their patriarch. And I continued caring for my other two patients. It was probably the most difficult day I ever experienced. I longed so much to be in the room with them. I didn't want to go back to work and let such an important moment go by. I wanted to honor this man who I'd heard only seven words from my entire life. I'd only known of him for eight hours, but he was still a creation of God, subject to the curse of death. I wanted to mourn his passing. Yet I did my job. I knew it was what I had to do and what was best. The other patients needed medications and I had to finish writing notes.

I don't know why, but I felt like that was one of the times I'd been closest to God, both physically and spiritually. As he died his soul left his body was either bid welcome or denied entrance to Heaven. God was in that room in a different way than in our every day to day life. It was an honor to be there as one more soul came to its journey's end.

The New Job

2007-02-06T09:48:00.000-08:00

It seems like the last month was full of new things. And this month is shaping up in quite the same manner. I began my new job at Alvarado this past Saturday and worked again yesterday, Monday. I'm a Nurse Extern in the DOU; it's basically a step-down unit from the ICU. The nursing ratio is 3 patients per nurse. ICU is a 2:1 ratio. Med-Surg floors (the basic nursing floor of all hospitals) is 5:1 in most San Diego hospitals, but I think the California regulation might be 6:1. Back east the ratios are as high as 8:1, but since California is more litigious than any other place in the world!!!! we have to take more time out to chart so that we don't get sued if something wrong happens ( incidentally takes more time away from patient care, go figure). But, I digress...

The DOU is fun. I like all the nurses I get to work with. I'm following Linda and Joe, two exceptional nurses who have a good head for taking care of their patients while keeping everyone involved in their patients' care well-informed of their current status (this is very important usually and more so in the DOU). I had a patient who was on a ventilator yesterday. He had a mass removed from his lungs which was exacerbated by COPD (emphysema in his case). I really enjoyed taking care of this patient because I saw him progress throughout the day. I think he surprised himself in how far he was able to walk. We put him on a less invasive ventilation setting in the morning, which he tolerated well, and then put him on a Trach Collar, which means their is no longer any machine operating, only oxygen being blown near his trach. The machine helps the patient breath by creating a positive air pressure. We normally breath by negative air pressure (we create a vacuum in our chest when we breathe, which sucks air in). So what he did yesterday was a vast improvement for him. AND considering how small the trach tube is to begin with also emphasizes this point. My nurse compared it to trying to breathe through a straw. Well, maybe an over-sized slurpee straw (see above pic)!

I tried to choose tame, non-gross pictures this time, so hopefully they're more interesting than overwhelming. Above is a ventilator (not the same model we use, this is more bulky), top right is a drawing of what someone looks like with just a trach tube in, bottom left is a trach tube, and bottom right is a drawing of where the trach tube goes. The hole where the tube enters is called the tracheostomy (stoma = "hole" and trach refers to the windpipe). Click on the images to make them bigger.

I'm really looking forward to learning more. I feel slightly overwhelmed by all the new info and the huge responsibility of keeping someone alive, but I feel like I'm able to bear it. But, yes, I need God's help so much. I can't do this without him. I don't want this to just be a job. I want this to be worship. Come Lord Jesus.

Hell-week

2007-01-25T11:29:00.000-08:00

I'm in the last class of my pre-semester week at USD. We're studying EKGs today. On Monday, we reviewed skills and on Tuesday, we had the orientation for Maternal Child.

I'm understanding the EKG stuff pretty well. I think I'm very logical when it comes to things like this. It's kind of like geometry with all of its theoroms and postulates. With EKGs though, it's all about the regularity of the beat, the length of P-waves and QRS complexes and some other things which I don't quite comprend well enough to explain without being able to draw it for you. Suffice it to say, I feel a lot more prepared for my ICU externship.

Speaking of which, my first day in the DOU (I'll be there about 2 months before I actually go to the ICU) will be next Saturday, the 3rd. This should be pretty fun. I was going to work tomorrow, but the nurse I'll be following isn't working tomorrow, soooo I have a day off. Yah!!!! Now I'll actually have time to study and learn.

Well, class is starting again. Only 2 1/2 hours left til my weekend. Oh, and we're moving to a 2-bedroom apartment this Saturday! Yah!

Child Birth

2007-01-23T14:10:00.000-08:00

As most of my readers know, Shannon, my wife, is pregnant. Today I just had an orientation class for the Maternal-Child nursing class for this semester. I learned a lot of stuff about the actual delivery, breast-feeding/lactation, and assessment of the baby after birth. I felt like a sponge.

Obviously, the information was very relevant to me right now. So I payed attention. But I also felt very overwhelmed. I'm sure all the other students felt inundated with new information, but they don't have a wife who is about to actually go through delivery. Some of the info was intimidating. Some info was funny. I don't know what really to make of some of the information presented, but I do know that this class will be my "Respect of Your Wife 101" for me this semester.

I've recently noticed how difficult women seem to have it without childbirth. They have the monthly cycle, an extra article of underwear (which isn't very comfortable from what I'm being told), societal pressure to shave their legs and pits, and pressure to look "pretty" which means lots of upkeep both on hair and the face. Then there's the optional tanning which some girls value. All their clothing is more expensive. It costs more to clean than men's clothing. There's a million and one special things they have for the bathroom (which I'm most would like to do without if didn't seem so necessary to have). And then, of course, there's the weight/exercise/comparison cycle which drives many women to eating disorders and loads of stress. Let's face it, men don't have as much of a problem. Some of us really put effort into our looks and some of us care about having power. But our toys are optional whereas most of theirs are a necessity in the current cultural climate.

So all this said, pregnancy, while a blessing, seems to be another burden to dump on an already insurmountable mountain of stress. There's the back pain, difficulty sleeping, UTIs, soar nipples from breast-feeding, lack of sleep, frequent feedings.... the list goes on. I probably am over dramatizing all this, but the way I see it, I have no worries or stress in comparison with the average woman.

Anyway, what I learn from this is that my wife is amazing. I'm in awe of her, her body and her ability to love me when I forget how difficult her burden is bear at times. I praise God for sustaining her and giving her patience for me, slow as I am. And she's so cute right now as she sleeps next to me as I finish this sentence.

14 Shifts in 3 weeks

2007-01-20T14:36:00.000-08:00

14 shifts! That comes out to 168 hours! (12 hour shifts, remember?) In only 3 weeks. That's like 4 weeks of work in 3 weeks. Wow! I feel more important or responsible or something like that... And I'm not that tired today either, but my mood has been a bit labile (up and down)... but that could be the mocha I had from Starbucks.

So, great news! I just officially signed up for my nurse externship class with Alvarado Hospital in the DOU/ICU. I'll have 2 months in the DOU and 2 months in the ICU. When I finish with this, I'll go into a New Grad nursing program in the ICU for about 3 months or less and then start a full-time job in the ICU on night shifts. I'm totally excited. A little scared too, but excited. I know it's a lot of experience for only a year's worth of nursing experience, but I feel like I'll be ready.

So far I've done 6 days on the telemetry floor in Sharp Grossmont. Telemetry means that the patients are on heart monitors because they either have rhythm irregularities or came into the hospital with chest pain. I've learned a lot about this stuff too. For example, any patient who experiences A-fib (atria of the heart don't beat in a regular pattern) will have to be on anti-coagulant therapy, Wafarin (Coumadin). I've also learned some more medications and the parameters under which to give them. I feel so smart! Yah me!... ahem. I mean, Praise God! :D

I started another successful IV also. And I've taken out 2 foley catheters.... from women! :
Monday begins our re-entry into school for this last semester. We'll have some skill reviews, orientation for maternal-child and a review on EKGs, for the Telemetry floors that we're on. I hope to learn a lot from that day because I only understand the basics right now. (If there's no P-wave, then the patient is in A-fib/A-flutter; if there's more than 10 normal QRS complexes with P and T waves, then it's Sinus Tachycardia, etc.) I still don't understand PVCs very well or what V-Tach looks like on the monitor (but I do know that V-Tach is when the ventricles are beating independent of the Sinoatrial node, which is fairly dangerous).

Monday also is Shannon's next scheduled appointment for an ultrasound. Yah! I'm so excited to see my unborn child. It's been awesome to see Shannon's belly grow. She just started to feel it kick this last week. By now it's practically fully developed. All the organs exist and most of the neural connections are complete. Everything just needs to mature and the bones need to develop from the existing cartilage (pre-bone) I think.

Now... add all of what I said to the fact that we're moving this next weekend and, hopefully, you'll feel so compassionate that you'll volunteer to help us move. We're planning on Saturday, but might do it on Sunday if our friends move on Saturday also. So please, come help. New address: 4496 1/2 48th St. Yah!!!!! a 2 Bedroom, just for baby McMahon. Thank you Jesus!

I'm Back!

2007-01-01T19:43:00.000-08:00

I just finished my first day back at Nursing since Shannon and I left for Christmas vacation. It was quite a hectic day. One of my patients was a borderline code for most of the day (more about her later), another patient who was status post-hip surgery kept trying to go to the bathroom because he didn't believe me when I explained the purpose of his foley catheter, and another patient I had was perhaps the saddest-looking person I've ever seen. She could barely talk, had an NG tube for suction, and was very weak. To make matters worse, I attempted to untangle her long and dirty hair but probably only made things worse and caused her unnecessary pain... sigh.

I think I saw a parable in the first patient I mentioned, so I'll tell the story and then you can compare it with what I got out of the experience:

One day in the hospital I had a patient who had a history of drug abuse and was found to be positive for barbiturates and methamphetamines in her urine. Her eyes were puffy to the point that she could barely open her eyes and whenever I tried to assist her or obtain vital signs, she would yell at me and complain about the poor nursing care she felt she was receiving. Eventually, about 2/3 through my shift, we found that she was desaturating (she had a low O2 reading). We put her on oxygen therapy and continuously monitored her O2 Sat. However, whenever her O2 sat got to a high enough level she would regain consciousness, take off the oxygen mask and desaturate again. I would then wait until she was asleep again and unable to fight me so that I could reapply the oxygen mask. This continued over and over again until the end of shift when I left.

So what did you get out of it? The woman is us! When we're lost in sin, God comes to our rescue, but as soon as we regain control and healing, we turn right back to our ways. We reject the assistance God offers. To put it another way, God is offering us medicine. We can choose to take it of our own free will or wait till things are so bad that we have no choice.

Ironically, the only way that I could have maintained her O2 sat would be to restrain her arms and legs, which would practically take away any choice of hers to work with us. In spiritual terms, God would essentially be removing our free will from us which would take away all purpose in living. But in real life, this happens in the hospital from time to time and, hopefully, the patient no longer needs the restraints by the time they leave the hospital and can once again make good decisions for themselves.

I think the deeper meaning of all this for me is that nursing ceases to be just a job when I choose to love this person and not give up on her. God has never given up on me even when I have given up on Him and myself. I think this can be seen in Matt 25. It's a great verse and speaks volumes to the life of a servant.

Nerves

2006-12-04T11:49:00.000-08:00

Contrary to what the title might lead you to believe, I didn't see a neuro surgery. Quite the contrary, this post is in relation to my nerves (which are shot!).

I've been having a lot of anxiety and depression lately. School is almost over for the semester (which is a good thing, right?), but the work that's due, which isn't really a lot to do, is adding to my stress. Add that to doctor's bills for Shannon (she's pregnant, surprise!) and an interview tomorrow at Sharp for an externship in the surgical ICU and I feel like a total mess. There are so many odds and ends on top of that which I find myself unable to get to until school is finished also.

But most immediately, I'm going to the Neonatal ICU today for my pediatric rotation. I'm dreading this because I just don't feel like my heart can handle it. I want to cry just thinking about it.

However, there's a silver lining. Shannon and I have been getting closer I think, closer than we've ever been. And she's been super supportive of me through this time of sadness. Friends from church are walking alongside me as well. Add that to a good dose of the Bible in life daily (Proverbs among others) and I am better equipped to hope.

We watched It's a Wonderful Life last night. I found myself identifying with George Bailey to a tee. I have such a wonderful life. I've blessed so many people and I have a life full of blessings, yet I feel unable to appreciate it, or rather, receive of it and be joyful. I feel unworthy of it all. But what a cool ending to the movie. Everyone that George worked so hard to help returned the favor and he found himself the richest man among them all. What a wonderful life! With that in mind, I think I might be able to make it through today at the least.

It's the latest rage. The ladies love it.

2006-11-21T10:44:00.000-08:00

For any Mel Brooks fans out there, the title is a quote from Robin Hood: Men in Tights. Now, if the title doesn't tell you what I saw in the OR, then the picture of Mel as a Rabbi should. Yup, that's right. I saw a circumcision. I've seen an open heart surgery, total hip replacement, endoscopies, but none of them made me cringe. There's just something about being a man that makes you have you compassion on another guy when something traumatic happens to that area of the body.

The patient I saw was a young guy who wasn't content being uncircumcised. It's understandable. But I don't know if I'd be willing to go through something that traumatic during my teenage years. The surgeon said that some guys think they won't get a girl or that she won't like "it" if it's not circumcised. That reminded me of conversations I've had with Shannon in the past related to completely different topics.

Warning: Social Commentary!!!!
Men in America (and I think, in general) are pretty clueless when it comes to women. Most of us think that because we've seen a movie, have talked to a married man or seen a woman naked, we understand women. It's not true. My advice to men: just give up. You'll never understand them. That's not meant to a be an insult to women. Women are meant to be loved, not figured out like some puzzle. "Husbands love your wives." And while you're at it men, drop all the myths that say that women are supposed to look a specific way. They are all different, but they all need love. Over the past couple weeks I've had to come to terms with the fact that I assume so much about women, and I get most of my information from questionable sources to begin with. Humility is probably the only place to begin if you want to understand/love your wife/girlfriend.

That said, I feel really bad for the guy that had the circumcision. Maybe he was getting peer pressure from his friends. That would be sad as well. His body is a gift from God. To modify it solely to please someone else (who is unworthy of such an action, only God is) is a tragedy to me. I think it says a lot about our culture and how far we are from God when not only will someone consider it, but also that friends will support such a decision. How little we fear God and much we fear man.

We Have Contact

2006-11-16T18:29:00.000-08:00

Yes! I did my first IV in the hospital today! Yah! I'm so much more of a nurse today than I've ever been. :D

I was in the ER today. It was almost boring actually. I spent a large chunk of time cleaning up a patient who had a case of diarrhea. I also unsuccessfully attempted to insert a foley catheter on a female client twice. But I don't feel too bad about it because the nurse tried it after me and even she couldn't get it. There was a cute baby in the ER too, but don't worry, it was his mom that was being treated: post-partum depression. That's right Tom, it really happens. sigh...

Well, I have a quiz to take sometime tonight I think... I'm waiting for a call because we're supposed to do it pairs. Then I have an online exam tomorrow. I just have to concentrate on breathing and I'll be ok.... (I stress way too much about this stuff... I need to remember that nursing is fun and life-giving, not cold and exacting like our tests which try to suck the very life from our bones... Ok, I'm getting way too goofy and this parentheses is starting to get stretch-marks. Bye.)

Wound Care

2006-11-09T18:09:00.000-08:00

Don't worry: I'm not going to tell you about the horrible wounds I saw. I'm more mature now and don't find it humorous to make my friends squirm by telling them about "gross" things I see at the hospital. Ok, I'm lying. I do enjoy making Terrence squirm. hehe.

I followed the wound team today at clinical. It was pretty chill. I got to sleep in this morning, which was by far the best part of the day. So I arrived a little before 9am and went listened to report. There was a picture of a diabetic ulcer on the table. We didn't get to see that patient because they had been visited the day before. It's probably a good thing too. That was probably too much, even for me. Parts of the muscle seemed to be missing.

I accompanied the wound nurse through various floors. Mainly, she just reassessed patients she had seen early this week. So, while it wasn't boring, it was a bit monotonous. One guy had necrotizing fasciitis (flesh-eating bacteria). It's caused by Group Beta-Hemolytic Streptococcus. Not very pretty. But he seemed to be healing pretty well. He was missing a lot of skin and the fascia (the cellophane-like connective tissue which covers our muscles) and had a deep hole in his neck, which the nurse packed. While his wound was pretty nasty, what really surprised me was that everyone seemed calm about it. I thought that once this bacteria started, there was no stopping it. Apparently vancomycin does wonders :D

Two patients incurred gangrene in lower extremities due to the use of vasopressors. Vasopressors block off or limit blood flow to unnecessary systems which increases blood flow to necessary ones, like the brain, kidneys and GI system. One patient had blisters all over his feet with purple toes. I won't tell you where the other patient's gangrene was, but you could probably make a pretty good guess if the re-read the first sentence of this paragraph. Moving on...

Tonight I'm home alone. Shannon is going to dinner with girls from work. I'm happy for her. She needs that time with women. And me? I'm working on a case study which I might talk about later in a later post and studying for a quiz I'll take later tonight I think.

Update regarding my job at Alvarado

2006-11-05T08:42:00.000-08:00

Just wanted to apologize. I misinterpreted the letter that Alvarado sent me. They are letting me go, but that's just a letter that everyone got apparently. So... I guess I'm still working, but I don't know what that means for my contract. It'll probably be the same which means that I'll have to work the day after our Anniversary. Which means that our Anniversary will have to be postponed until a few days later... sigh. OR..... I can just quit. I like that idea better :D

Learning the Ropes

2006-11-03T16:17:00.000-08:00

I just finished a Kardex for my medical-surgical clinical class. A Kardex is basically a quick reference of what the patient's medical orders are, like diet, activity, if you resuscitate them just in case they die (trust me, you hope that certain patients are a "DNR:" Do Not Resuscitate), and any other information. Our Kardex contains a lot more than that. Info from the body assessment we do as nurses is on there along with medication info and lab results. But probably the more difficult part to put together is the Care Plan. All nurses are supposed to address care plans. It's basically how nurses form a plan to assess, treat and evaluate the patient. They aren't the most comprehensive approach to caring for someone, but they do a very good job nonetheless. I think this week was the first time I've turned in my Kardex and felt good about every part of it. I'm sure my instructor will find something to criticize (for my own good mind you), but I think it will pass. So that's good news.

Tonight Shannon and I are hanging out with some friends. I'm very much looking forward to this. Yah friends!

My Hospital Sells, I Lose My Job

2006-11-02T21:05:00.000-08:00

Sigh... Yes, it's true. Alvarado is being sold to Plymouth Health. They're planning on keeping the majority of the staff and will continue to be an acute-care hospital. However, I appear to be in the minority. Alvarado said that I will be terminated as of Dec. 31st, 2006 (or when the hospital sells). Funny. That's my anniversary. And funny. My work contract says I have to work either Christmas Day (going to be in El Centro that morning and Las Vegas that night) or New Years Day (let's just say I'm planning on staying up a little too late the night before if you catch my drift). So guess what Alvarado? Not gonna happen. You can have my job. I'm gonna celebrate with the most important person to me in the world besides my God, my wife.

(This actually couldn't have happened in a more favorable way if I'd planned it. I was actually planning on sucking it up and working on New Years Day, then leaving the next day for vacation. Instead Shannon and I can have an extended celebration in the mid-California area after our trip to Nevada with Shannon's family. Yah!)

AIDS Meets My Reality

2006-10-30T11:24:00.000-08:00

I had my first AIDS patient on Thursday during my clinical round. I don't really know what I expected before meeting my patient, but I think that what I experienced really helped blow all expectations out of the water.

When thinking of AIDS, I think of 1) homosexuals, 2) someone who seems really bitter, and 3) someone who is very sick. At least externally, my patient did not fit these stereotypes. He may have been gay, and that would be fine, but I think the fact that he didn't line up with this stereotype was a very big help to me for my first experience with this disease. I'm not the most biased person in the world, but I can still recognize that I have my fair share of bias towards certain lifestyles, especially those that I disagree with. (In case you're wondering, yes, I'm a Christian, and no, I don't think that just because someone is gay means they're going to hell. Homosexuality as a practice, according to the Bible, God's word, is sinful. It may not seem fair and it's far too easy for me, a heterosexual, to make such a claim when I have nothing to lose, but it's not my word, it's God's. But at the same time, homosexuality is not the primary defining characteristic of a person. I recognize that it is only one small aspect, just as me being white or American is a small part of my own personality. That said...) I found it a joy to take care of this man. He was very kind, polite and he made good conversation. I felt bad that I had to ask him so many questions and continually interrupt him to give him meds, take vitals and give instruction regarding healthcare practice. This patient put a new face on AIDS for me.

I think I have only begun to understand how horrible this disease is. His meds, I believe, have given him chemical pancreatitis. This is life-threatening and, I suspect, can be very painful. Because of this, he stopped taking his medications 6 months ago and now has a CD4 count of 1. That's bad, just in case you weren't sure. He had a couple different infections going at the same time too. I couldn't help but have compassion on the man. According to my instructor, he's looking a lot better since he arrived at the hospital some weeks prior. But I know that he doesn't want to be discharged. There's too much responsibility to carry by yourself with this disease. Too many do's and do not's. Too many pills to swallow. People with this disease need our help. They need our compassion, not our admonishment (assuming they got the HIV infection through risky sexual practices). Though the drugs may help them live much longer than 15 years ago, there still isn't a cure (and I suspect some people, many who call themselves "Christian," hope there never will be one since some feel this is "God's curse to fags"). I for one hope a cure will be found. I hope that I can find some way to be more caring towards the AIDS community both here in the states and world-wide.

With Great Blood Type Comes Great Responisibility

2006-10-30T11:06:00.000-08:00

Yup. I donated blood today. I remember being too scared to donate when I was a senior in high school. I really hated needles then. But on Urban Project, an inner-city mission in San Diego, I decided to be brave. And it wasn't that bad. So I think today was probably the 6th or 7th time I've donated. Working at a hospital I see how great the need is for blood donation. I've probably had 20 patients get a blood transfusion since I started working as a CNA and having clinical rounds. And supposedly the blood levels are very low currently. That's really bad. They're the lowest for O+ and O-. And I just happen to be O+. That means that when I give blood I'm very generous because my blood can be received by about half the world: anyone who has the Rh antigen on their blood cells. But I'm also very sacrificial, because I can only receive blood from O+ and O- donors. I would have a hemolytic reaction (kill the new blood cells) to A, B or AB and that might send me into anaphylactic shock! Just a little 411 on blood chemistry for ya'll.

Well, today I did a new procedure. I gave 2 units of packed red blood cells. This is a little more extreme than your average blood donation, which is whole blood (serum and RBCs). In this procedure, they take out your blood and then reinfuse most of your serum; this contains H2O, platelets (things that help you clot if you bleed), and white blood cells (WBCs, these fight against of variety of infections). The procdure takes about 3 times as long as a normal donation, but worse than that, when they reinfuse you with your serum, it's really cold. My arm was still cold 5-10 minutes after the infusion stopped. I was shiverring all over and needed a blanket. I felt like such a wimp. But my wife assures me that I'm brave for even going in the building. Thanks honey. :)

TV totally adds 10 pounds...

2006-10-19T19:28:00.000-07:00

Before I talk about today's experience, here's how I did on the test. 85%. 34/40. Not what I was hoping for, but all I need to do is pass, right? Oh well...

Today I went to Endoscopy. That's where they stick a camera down your mouth or up your..... Anyway, it was pretty cool, but not something I want to do as a nurse. It's the same thing really. You help the doctor out where necessary, teach the patient and help them get dressed once the Versed (sedative) wears off. Eh...

I'll spare you the details, but I will say that TV does actually add 10 lbs to your colon. It was pretty cool to get to see the doctor guide the tube into the bowels. It looked really easy until a doctor who was learning gave it a try. It definitely takes some finess. Oh yeah, this isn't so much gross as just kind of funny. On the first endoscopy I saw, once the tube passed the gastroesophageal sphincter, I thought I was looking at the brain. The stomach is really wrinkly inside, but very pink if you haven't eaten for about 9 hours. Most the bowels I saw were very clean. ;) Some weren't though :(

Oh, and I've decided to get TED hose. I'm getting varicose veins and I figure I don't want to risk getting a venous stasis ulcer, really ugly legs and more pain (it actually hurts even before they get bad). Sigh... Thanks Dad!!!! (these things are hereditary).

Since I'm posting pictures, I'll explain why varicose veins occur. First of all, it's a genetic defect in the veins. Leg veins have valves, much like the Aortic and Pulmonic valves in the heart: they all blood to flow only in one direction. In dysfunctional venous valves, they don't keep blood from back flowing. That can cause blood to stay in the interstitial space. When pressure gets too high in the legs it can keep nutrients from circulating to the skin. This can lead to skin breakdown and lack of upkeep in the cells. That's when venous stasis ulcers can occur. The way to both treat and prevent this from happening is by applying pressure, thus my decision to get TED hose. If I can save myself some pain and my family some money, then I think the inconvenience of wearing them might be worth it. We'll see...

Anticipation

2006-10-17T15:30:00.000-07:00

Arrrgggghhh!!! I took an exam online 6 days ago now and my score still isn't posted. This is giving me so much anxiety. The test covered nursing care for patients with fluid/electrolyte/pH imbalances, respiratory problems, and cardiac problems/dysrhythmias. It was only 40 questions. I know I got at least a C, but I'm not quite sure beyond that... I don't know why I'm letting this get to me, but eh...

On another note, I do sincerely apologize for being somewhat grotesque with my last two postings. I do thing both because I want you to continue to read my blog and also because I don't like making people feel unwelcome/uncomfortable. I can't promise I won't leave a few details out in the future, but I'll keep it a minimum. Besides, I have find some way to deal with the psychological trauma I experience when I see a human body in a near death state.

And on another note. God is good. He has given me hunger for knowledge and I have studied at least 3 hours today with 2 more hours til Shannon comes home. Yah!

The Foley

2006-10-12T17:59:00.000-07:00

It's eluded me for over a year now. But finally, today of all days, minutes before my clinical round was to come to its end, I inserted my first foley catheter. Yes! This was the moment I was waiting for. This was the moment that I will look back on and say, "That's when I made it. That was my homecoming. That... was the day I became a nurse." Ok, maybe not. Actually, that day will come when I prove a doctor wrong. hehe

So I inserted my foley. It wasn't so bad and not too difficult. But it wasn't fun for my patient. He was about 84 and already in some pain, so I just made a bad day worse coming from his perspective. Anyway, the procedure is sterile, meaning that you have to open everything in a certain way, put on sterile gloves at a specific time, and make sure you don't touch anything that is non-sterile until you're ready to do so (like the sexual organ of your patient). You clean the area with idodine. Make sure your foley catheter is working properly (a balloon inflates with water at the tip once it's inserted; this prevents it from dislodging or moving back and forth which can lead to infection).

Then you lubricate your foley. Um... actually... I lubricated the inside of his urethral meatus. Yeah. I actually injected his member with lubricant. I was told to do this by my instructor. I thought she was crazy, it makes sense. It probably was a lot less irritating when I shoved inside past the prostate, which was probably a little larger than normal due to his age. Not much urine came out though; he's in end-stage renal failure.

Well, that was today's highlight. I also gave my first nicotine patch today and gave two injections (insulin and lovenox, an anticoagulant). Life is changing so quickly. Last year I was scared to be in the hospital. Now I feel like it's my home away from home. God has really done a big work in me to get me this far. But I digress. I'm gonna have some pizza now and do some work so I have the weekend off. Shan and I are driving to El Centro to hang out with my parents on Saturday. Yah!

The OR

2006-10-08T18:45:00.000-07:00

Open Heart Surgery. Need I say more?

Well, probably, because you really have no idea what is involved until you hear all the procedures involved.

The patient I saw was getting an aortic valve replacement (bovine aortic valve). First you get the patient ready, give them an IV and then knock her out. Next, insert a foley catheter (muscle reflexes are down to minimum, you wouldn't want your patient waking up in a pool of urine.)

Then insert a SWAN catheter. This is a form of a central line catheter, but after entering through the sub-clavian vein a blood-pressure sensor is sent through it into the pulmonary arteries (that inside the lungs) to assess the BP in the right ventricle and pulmonary arteries. It also has two lines that can be used to send drugs straight into the heart.

Next, completely cover the patient with iodine and a celephan-like substance to ensure asepsis. Then you're ready to start cutting! Cut through the skin directly over the mid-sternal line over the heart. Then pull out your Mikita buzz-saw and go right through the sternum (I'm not kidding). Then start cauterizing the lining protecting the heart, the pericardium. Then, there she is, the most amazing muscle of the human body, the heart. You might get to see the lungs also.

Now comes the tricky part. You have to cannulate the Aorta. This involves sticking a plastic tube inside it just after it leaves the heart. Then you stop the heart by shooting it up with large amounts of potassium, which you hopefully can flush out when all is said and done. Then you cannulate the Vena Cava and turn on your blood fusion machine: In the Aorta, out the Vena Cava, through the machine and back in the Aorta. It's pretty cool.

Finally, you can cut the bad-boy open and cut out the stenotic (tight) aortic valve. Then it's a long process of sewing the cow aortic valve in. Then you stitch it all back up, de-cannulate, and shock the heart back into motion. Last of all, you sew the patient up, using stainless steel to bring the sternum back together, making sure to turn the stitches down so they don't go through the skin. Also, you might want to cauterize any bleeding vessels as that might present a problem when the patient is trying to heal. Then send your patient to the Surgical ICU. You're done.

PS - I hope you didn't mind the smell of burning flesh.

Coffee and a Good Book

2006-10-04T06:43:00.000-07:00

I went to Starbuck's yesterday near Shannon's work to study. It's amazing how concentrated on study I was. I usually am extremely distracted at home. Maybe I'll make this a normal study habit... It may be a bit costly though: $3.50 for my mocha, but you know, it kind of tasted like dirt and wasn't very enjoyable since I only had my books to share it with. But I didn't let them have any (Thank God! I hate when my books try to drink my beverages).

I worked on a kardex and plan of care for a patient I had last week. Although it is a lot of work, I found myself enjoying it. I didn't feel rushed, which is a nice feeling. And I enjoyed learning about lab values and attaining more of a nursing perspective when developing a plan of care for my patient.

the PICU

2006-10-02T21:21:00.000-07:00

PICU stands for pediatric intensive care unit. It was pretty intense. I saw 2 month old girl that had been physically abused. A 5-year old boy was there for suffering a brain aneurysm; they actually went into his brain to drain cerebral spinal fluid from the ventricles (that's like dead center of the brain) in order to relieve intracranial pressure.

The patient I had is comatose and they really aren't sure why. He had some seizures, so he might have suffered some brain trauma, but they don't know why he had the seizures to begin with. They think it might be Acute Disseminated Encephalomyelenitis (ADEM), but they really aren't sure. Some doctors think it could be a "metabolic problem" which really just means they've eliminated all other possibilities and are ruling out a mitochondrial disorder. The ADEM is supported by a CT scan (computerized tomography), which shows what think is a distruction of the myelin sheath in the brain. Myelin is a coating that many neurons in the brain possess which increases the nerve impulse speed.

Currently, my patient doesn't have deep tendon reflexes. Like when you swipe the bottom of his feet (Babynski reflex), he doesn't respond to that. His pupils are round and reactive to light, but they don't react very quickly. I felt so bad for the patient's family too. I'd hate to be in their situation. But there was one patient who was a happy case and I didn't realize it. She was a 2 month old who was born with a congenital defect in her heart. She had a perforated septum between her ventricles. This actually not rare and is easily remedied. She is recovering nicely, will probably be off the the ventilator tomorrow and will be in mommy's arms in two days. If there are cases like this to look forward to, I just might be able to hang in there with the kids. If not, I don't know what I'll do, cuz they break my heart when I see them in those beds with all those tubes coming out of them.

After Week 3

2006-09-24T21:11:00.000-07:00

Well, we had our first clinical day on Monday at Children's Hospital and our 2nd day at Sharp Memorial. Children's was really slow. We don't get to pass meds, just do assessments and vital signs. At Memorial though, I got to pass pills (nutrient supplements and pepcid), give a shot (lovenox, an anticoagulant) and three IV piggybacks (like flagyl IV, levaquin and magnesium sulfate). I had two patients, which is the first time I've had 2 patients. I think I got everything done that needed to be done, but boy(!), I really have some time management skills to learn. I felt like all I did was give medications and write notes. Oh, and I took some glucose levels on one of my patients.

I met with the director of the MEPN program on Friday to discuss my path in the master's portion of nursing school. I'm currently on the Family Nurse Practioner (FNP) track, but am considering the Pediatric Nurse Practioner (PNP) or Master Nurse Clinician. The PNP is just an idea right now. It will depend how much I like taking care of children. I'm planning on doing an externship next year to get a better idea. If I don't though, I might just do the Master's degree. This will give me a MSN after my name (the FNP and PNP are just certificates), which will give me the ability to teach in nursing programs later in life. Also, I'll only have to take 27 more units to graduate with that after I get my RN. With the current inflation rate on campus, that will be about $30,000. It will be at least $60,000 for the FNP... sigh. Now some of you know why I get a funny look on my face when talking about the future of the program.

Tomorrow is the beginning of another week. My thoughts... study more Michael. I've procrastinated a lot so far. So hopefully I'll be able to hunker down this week. I think I found a study partner in one of my fellow classmates though. That's a definite answer to prayer. There's banana bread in the oven right now. It'll be edible in 40 minutes. Can't wait. You know you're jealous.

Why I'm a Nurse

2006-09-18T08:43:00.000-07:00

Yesterday was Sabbath for Shannon and me. That was really nice. We went to church, watched the football game (Chargers v. Titans, 47-7) and then rested at home and watched Stargate and prayed. It was a restful day. Something that had been emerging in my heart for the past two days finally came out during prayer though. It was something deep that really has to do with a large part of me.

I've collected comics, read fantasy books, watched fantasy movies and sci-fi movies through the years. When I first picked up X-Men, I wanted to be a mutant so much. When I read the Chronicles of Narnia I wished that I would go to sleep one night and wake up in Cair Paravel or on board the Dawn Treader. I found that what I was doing was feeding my hunger for the spectacular and heroic. When I was at UCSD I was part of a Christian group called InterVarsity. There was always a sense of urgency regarding our ministry on campus. It was always vital that what we did was important. I think that somehow, I've made most of my decisions since college for a similar reason, being a part of something important. Nursing is without a doubt meant to accomplish that end in my life.

When I first thought of nursing it seemed like the perfect answer to my questions about the future. I wanted to do something "spiritual" as in service to someone else. But I also wanted to be heroic and save people's lives either physically or spiritually. It's always with the sick and dying and the drastic changes in lives occur. And I wanted to be there to be a part of it.

During prayer last night I finally realized that. All the questioning that I've done for the past couple months has, I hope, come to an end. What I want is only found in God. I already knew that, but I had to discover it anew I guess. Only in Him do I find the urgency I crave. Only in Him will I find the direction from a leader to whom I actually want to submit. And He will give me missions that are fit especially for me. I guess I'm really just craving a rush, and I know that a life of worship is the only way for me to get that. So, just in case anyone was wondering, that's why I'm in nursing.

Clinical Orientations Begin

2006-09-11T16:46:00.000-07:00

I just had my 2nd clinical orientation today. My first orientation was at Sharp Memorial. To get there I will have to park at Qualcomm stadium and then be shuttled to the hospital. This is very aggrivating for me since I live closer to the hospital than I do to the stadium. The second orientation is at Children's Hospital, which is physically connected to Sharp Memorial. To get there I park at the National Guard Armory off of Mesa College Dr. (Let's here it for the military offering us healthcare workers some space!) (Ok, Qualcomm is nice, too.)

I think I'm going to like both clinical sites. They both seem very professional, as hospitals usually do. But Children's seems like it might be a lot of fun! I'm excited to see how my experience there goes because I'm very hopeful that I could go into pediatric nursing. (But, just to give you background, after I had a day in the OR, I thought I'd be an OR nurse; then after my psych clinical, I was thinking of being a psych nurse; with my luck I'll just be a regular Med-Surg nurse, which is nothing to be ashamed of.)

Well, I have a seminar to attend up in RB, so I have to leave in a few minutes so I can make it through traffic in time. Then it's back home for dinner, my wife and bed: I'm working tomorrow.

Studies Begin!

2006-09-09T12:01:00.000-07:00

Well, it's my first Saturday since beginning afresh and I've already studied for 3 hours! Way to go me! I think that just about matches how much I studied during last Fall semester.

I just finished going over fluid, electrolyte and pH imbalances. It's amazing how complex our bodies are. God put into place so many different counter measures just in case one compensatory action fails us. For example(!): someone who is in the state of acidosis (blood serum level < 7.35pH) who suffers from COPD (emphysema, chronic brochitis) will be unable to expel enough CO2 to decrease blood acidity. So the kidneys will hault the excretion of bicarbonate (HCO3) in order to maintain pH balance.

This is pretty much the story of the entire body. It's pretty cool, no? Well, my parents are here and we're heading down to the Coronado Brewing Co. for lunch. Yah (real) Beer! (Boo Red Stripe) hehe.

God administered a gut-check...

2006-09-06T16:05:00.000-07:00

Last week I had an experience with a patient that started a wake-up call for me as nurse. I was working at Alvarado. One patient who is well-advanced in years told me at noon when I brought her lunch tray that she expected more service of me. I hadn't had the chance to get her to take her shower yet because I'd been working with other patients. She basically used a lot of rhetoric, pulled the age card, and talked with my Charge Nurse. I talked with the charge nurse later and apologized for my lack of service and the words I used when communicating with this difficult patient. Looking back, I still think I had some validity for what I said to the patient, but I also know that God was being gracious with me.

The charge nurse told me what the expectations of patient care were for my position. It was clear that I was not meeting the mark. However, I wasn't completely missing it either, this at least didn't break me, but I did feel crushed. It's difficult for me when I fail in my job or studies. I take it very personally and assume it reflects on my self-worth. What she said though, helped me to take inventory of what I really believed about my job and nursing in general. I will outline the main points that I felt God speak to me through her.

1. Nursing is a job: Simply put, someone is paying me to do a service for them. Whether it be the patient or the hospital, I've been entrusted with an important task and I am asked to deliver those services in a specific fashion. I often forget that nursing isn't only a compassionate service, but an actual job. I need to respect my employer and do the best job for them that I can. And the plus to this is that if I do this, following their rules, I know I will be worshipping God because it would only mean better patient care.

2. Being in a Hospital sucks: Patients never ask to spend time in a hospital. It's scary, lonely and often noisy or uncomfortable. Patients are woken up every 4 hours for vital signs. There's no way to get good sleep at that rate. Looking back on my patient interactions, I see that I really could have afforded my patients more grace and sympathy. I've never been in there place and no matter how much I think I know what they're experiencing, I don't.

3. Follow God, not the nurses: I often find myself sucking up to nurses by joining in conversation about the patients in hopes of making friends. This is actually illegal due to privacy policy. But more than that, it is unkind. I think that most nurses really care for their patients, but it is difficult for any of them to be gracious to the "needy patient" all the time. Some patients end up being stereotyped, such as a "psych case" or "drug seeker" or "needy patient." This isn't just unkind; it's unfair. As I already said, the patients here didn't ask to be in this position. Some may not have control over their own thought patterns, may genuinely be in pain or may be scared out of their mind which causes them to ask a lot of things of the nurse. Everytime I think about what God has called me to I remember Matt 25. He simply said, "I was sick and you cared for me." Nothing more. He didn't say that we helped the person get over their addiction, withheld medications they had a dependency on, reprimanded them because they were acting like a frightened child or anything else. He commends the sheep in that passage because they had compassion on God's people, just as Jesus did when He walked the earth. I want that heart to reside in me.

The culture of nursing is often two-faced. Everyone wants to be a compassionate healer. But deep down, we also want to have an easier job. Why should we have to expend emotional energy on someone we blame for their own physical ailments? We'll reserve that energy for the ones who really deserve it. But Jesus came for the sick, not those without need of a physician. I want to follow Jesus in this. And it seems apparent to me that He wants me to follow Him also.

First Post

2006-09-04T14:15:00.000-07:00

Well, school begins this week. So I figured that in honor of my 2nd year of what is sure to be filled with anxiety, failure, sucess and lots of poop, I should start a blog that will communicate all the joys and frustrations of nursing to my very squemish friends (like Terrence).

Currently I'm working as a CNA (that's a nurse's assistant) at Alvarado Hospital. I've worked there for about 7 months so far. So I feel like I'm ready to get back in the swing of things. My clinical rotations will be at Children's Hospital and Sharp Memorial, both of which are very close to my residence. Very convenient.

Expect a couple rants about quality of care, hospital policy and my growth pains as I become accustomed to my new calling as a servant to the sick and dying. I hope that what I learn and have to say will somehow reflect God's good news for the world. I have hope for this because the blog will be really sad if doesn't and because I need to be met by Him every day if I'm going to be in the field of healthcare at all.