Hopping through the year...

I can't believe it is already going to be April tomorrow.  It seems like it was 2012 just yesterday and we're already a quarter of the way through 2013!  Since I am going to be in Charlotte from Tuesday to Saturday and I have to work my 20 hour a week minimum, I had no other choice but to switch to work a 12 hour shift on Easter.  That meant I had cram all the family time in before that between all my other obligations.

The festivities started on Thursday when I met my Aunt Julie, Chaz and Drew at Lutheran General Hospital to dye eggs.  It's been a tradition for a while and we weren't going to let a little spinal surgery get in the way.  Plus Drew had been dancing with his cane during therapy.  Now I know I don't have my RN licence yet, but I think that is a tell tale sign that he's recovering quickly.  My aunt was able to reserve a room and brought all the fixins for egg dying.  You would never have known we were in a hospital.

 There are always a few traditional ones like the cow and the flower eggs but then we try to get a little creative and think of some themes.  Chaz did a really cool skyline one and I made a Drew egg complete with the neck brace and head strap.  I think he liked it.  We also got to facetime with Aunt Dawn, Corrinne and Thomas which was fun too.  From there I met Chelsey and my mom at Friday's for $3 cocktails and apps.  After my dad was done bowling he swung by to make it a family night.

Friday morning I headed to nani's for lunch and pick up some calzone before the rest of the family demolished it on Easter.  It is a traditional dish that I look forward to every Easter.  Only once did Nani make it for me when not in season.  That just shows how special I am!  If you know my family you know nothing is secret so this little lunch turned into a party with Aunt Nee, Aunt Brina, my mom, Beth and the girls all in attendance.  After stuffing myself to the gills I went to my mom's for a mini nap because "family night" ran a little late and I was low on sleep.  Of course the second I get reclined and comfy with a blanket, the doorbell rings and my mom has a showing.  With much dismay I got up and hid in the garage while they took a gander.  Fingers crossed that she gets a bite soon!

Friday night I had all intentions of meeting up with Angie in Dekalb, but then the night just slipped away.  I was just going to stop by my aunt and uncles for a quick chat.  That turned into me going to Bobby and Beth's, which turned into dinner, which turned into wine drinking, which turned into horseradish making, which turned into a sleepover...  Saturday I was volunteering to draw blood for Hep B screenings in Elgin so I just got ready at their place.  There were two little munchkins knocking and trying to get in so I let them hang out when I got ready.  Abigail kept telling me my hair was really long.  She also told me it was like Rapunzel when her and Caitlin were taking turns playing beauty shop and brushing my hair.  Abigail asked when I was going to cut it and when I said maybe in a month or so she was wide-eyed and said, "your hair will be on the floor by then."  Think it's time for a haircut...  I also got some quality time with Libby when she was not being fussy.  I just can't get enough of that face!

All the fun had to end though and I went out to do my good deed for the day.  When I got there we went over how things were going to flow because we had a full house.  There were 80 who showed up to get the screening.  At first I got a little nervous, this will be the first time I would be drawing blood from a human and not fruit punch from a manikin arm.  The supervisor walked me through the first blood draw and verified the site where I wanted to put the needle in.  It was a bit tense for me and then I saw the flash of blood.  Woohoo, I was in the vein!  With each stick my confidence grew.  There were only two that I had to call in for back up and one of those the nurse couldn't even get a good stick.  This whole volunteer system is actually pretty great if you think about it.  It gives students a chance to practice their skills on real people and it gives these healthcare events the free labor to provide services.  I mean you can't complain too much if we don't get you on the first try since you're not paying for the service in the first place.  It's a win-win in my eye.

From there I drove back home to the city and was able to change real quick before babysitting.  While I know CT is fond of me, when he sees me come in he knows mom and dad are leaving so he throws a little tantrum.  This night he heard voices so he ran down the hall to see who it was, saw it was me and then instantly turned around and started crying.  When they actually leave he calms down in a few minutes and we are best buds again.  I just had to send Nicole proof with a picture because I feel like they're going to start thinking I beat him with the way he freaks out every time I come over.  I can't believe I was watching this boy when he was an itty-bitty newborn.

So Friday and Saturday were my "days off."  Sunday I headed to work and it was crazy on the floor.  I was kept real busy with a lot of babies.  There was no Easter egg hunt, but all the kids got Easter baskets from the hospital.  Some families brought the party to the hospital.  Some families couldn't have their other children come visit because patients on contact precautions can't have visitors under 12yo.  I can't even imagine what it's like to leave your baby at the hospital to go spend time with your other children who have been neglected since the admission.  There really isn't a win in that situation.  However, most made the best of it and had other family members stay while they ran home real quick.  One parent was really cute and brought the Easter dress, cardigan and baby doll shoes to dress up her 6 month old in the hospital.  No PICC line or G-tube can stop a girl from getting her pink on on Easter Sunday!  Some parents were less extreme and just had cute Easter onesies, but nevertheless there was holiday spirit all around the hospital.  It wasn't a bad day at work and it went by fast because I was so busy, but I would have much rather been with my own family.  There's always next year...

Angels with Tails

Throughout my nursing school journey I've learned that sometime you have to do something that is not nursing related whatsoever.  We have recently elected two volunteer coordinator positions for SNA's exec board and while we are a professional student nursing organization our first event was at PAWS Chicago.  We put a nursing twist on it that this event would create comradery among the cohorts, it would be a great way to destress from school and that it is proven that animals lower peoples blood pressure, but our adviser still wasn't seeing the connection.  We decided to go as a small group anyways, unaffiliated with Rush.  

Chapitas with a cuddle buddy (both 10 wk old)

It was a great experience.  While I am not a crazy animal person I do have a soft spot for some of those big fur balls.  We started off with an informational video about PAWS mission and values.  They are a no kill shelter striving to decrease the population of homeless animals through education and practice.  In just one year, one unspayed cat can lead to 420,000 kittens born!  In an effort to decrease the overpopulation of animals, PAWS spay/neutered 18,000 animals in 2012 for free or low-costs.  Chicago is also one of the most cooperative cities that allows feral (wild domestic) cats to be caught, fixed and returned to their environment.  Allowing PAWS to pursue this mission has actually saved the city money because it is cheaper than euthanasia.  In 1997 over 42,000 pets were euthanized in Chicago alone.  Today, with much help from PAWS and other shelters no kill effort, that number is less than half of what it was.

Brandon

After the info session we were put to work assembling cat and dog cones for post surgery recovery.  I was relieved because I was under the impression that they would have us cleaning up poop or something along those lines. After making a bunch of cones it was time for some socializing in Dog Town and Kitty City.  The gentleman who was orienting us asked if we had a preference or wanted to go to both.  I had no shame in saying I only wanted to play with the dogs, preferably big ones.  I asked if they ever get Bernese Mountain dogs and he said not really.  Once they got a St. Bernard puppy, but he was gone in a day.  Last year PAWS found 5,606 animals a home, which is 1,338 more that in 2011!  PAWS is also unique because their animals are not kept in cages, instead they have little rooms with a couple dogs in each.  Of course the one donated by Oprah Winfrey had a little dog house in it too.  

Little Boy Blue

I know I don't have a lot of time on my hands now, but come August when I graduate, this is an organization that I would really like to devote time to.  They do wonderful things.  For example this now three legged friend was picked up from county shelter before they could euthanize him.  They had to amputate his front leg, but you would never know it with the way he was hopping around today.  He was such a happy little dog.         

         

Not quite a vacation...

but I'll take it!  As a board member of the Rush chapter of the National Student Nursing Association I was given the opportunity to attend the annual convention in Charlotte, NC and represent Rush as a delegate.  I was really excited because my friend Mary was also invited to go too.  On top of all the tests, papers, work etc I had to get all the paperwork for the trip in within a week so our travels can be approved and funded.  Rush's SNA is going to pay for the entire trip: airfare, ground transportation, hotel stay for 4 nights, our registration fee, an NCLEX review course, all our food, everything!

It's going to be a really great opportunity to learn, network and be a part of the voting process of policies and procedures.  Rush is definitely not flipping the bill on this for me to have a vacation.  I was looking at the convention schedule and most of the days are 14 hours long.  We also have to do a presentation on the conference when we return.  I'm just hoping there is some time to get out and explore the city even just a little bit.  

stress and de-stress

On top of a crazy week at work I had two tests on Thursday and a paper due on Friday, none of which I felt very prepared for.  After Tuesday's crazy day I did not have the capacity to start writing a paper or indulge in intense studying so I made the executive decision to make it an early night and cram it all in after clinical on Wednesday.  After clinical and a quick nap I hit up the arrhythmia strips which was one of my tests.

There were 19 different heart rhythms that we needed to be able to identify on an EKG strip plus causes and treatments for them.  This was one of the only tests that I studied for weekly.  One week I focused on sinus rhythms, one week junctional rhythms, one week ventricular rhythms and so on.  I was getting frustrated because I knew the rules for all the rhythms but the strips are not always that straight forward and obvious.  Which I guess is the point of higher level thinking and applying your knowledge rather than just spitting it back out.  Is that a p-wave or is it undiscernible or is it just artifact?  Should I start measuring the PRI and QRS interval here or here?  It is frustrating.  By the time I figure our the arrhythmia the patient would probably be dead!  Our book literally has hundreds of strips to practice on and my confidence was decreasing as the night went on. I studied arrhythmias for a good 6 or 7 hours that night.  We needed to get a B or better on the test or we had to retake it and I was not going to add another test to take on my list of things to do.  With my primary focus on arrhythmias I chalked up my public health test as a common sense test and most of the content seemed like a review of my health promotion class so that wasn't high on my priority list.  And I wasn't going to increase my stress by thinking about the quality improvement paper that was due the next day.  That would have to wait until after the tests.

I finished the public health exam and of course everyone was complaining about how ridiculous the questions were.  I personally walk away from those crowds and don't like to talk about the test after the test.  It only makes you more nervous when people are like what did you put for this one, oh I put this... yada, yada, yada.  I chose to go to the computer lab and print off stuff for my trip to Charlotte (that will be the next post) and ignore all the buzz after the test.  There was a quick study session reviewing strips after lunch and then we had a lecture on OB emergencies before the arrhythmia test.  Did you know that even with a very low incident rate, 10% of maternal deaths are due to as little as 1cc of amniotic fluid getting into the pulmonary vasculature?!  They think the fetal cells and hair cause an anaphylactic reaction and the airway closes.  They are now changing the name from amniotic fluid embolism to anaphylactoid syndrome of pregnancy.

Anyways it was hard to completely focus in lecture, because all I was thinking about were EKG strips.  Then it was test time.  Lynn, our instructor, was like guys this isn't suppose to be that stressful and I replied, "Lynn have you met our cohort before?" to which she just laughed.  She was kind enough to grade our tests right then and there so we knew if we passed or had to retake it.  That was the most nerve-racking part.  Just sitting in line waiting your fate.  When she graded mine I was able to identify all the strips correctly, I just got one silly multiple choice question wrong which I should have known in the first place (pts in v fib don't have a weak pulse, they have no pulse!).  I will take the A though.  Since we had two tests that day, Lynn was kind enough to push back our due date for the paper from friday to sunday so that meant I could go home and enjoy a bottle of wine with the company of my roommate. And that is exactly what I did!        

I cant make this up folks!

So work is a little crazy lately and I have come to terms that nothing fails to amaze me.  The other day I had to sit for an autistic 14 year old kids who was admitted her hyponatremia (a fluid imbalance with sodium).  Why does he need a sitter I asked.  Oh he was chasing his mom around the house and very aggressive lately so the doctors want a sitter in the room.  I was like okay and went about my day with him.  I asked what toys he liked and got similar ones from our closet, I ordered a breakfast that he loved, we watched the Muppet Movie with a lot of songs.  The day was going good.  Then he decided he wanted to go home.

I tried all I could to keep him calm.  If he wanted to put his pants on that was no problem .  All he wore was camo and if that made him feel more at home I was okay with it.  If he wanted to have another apple juice that was no problem.  But when he wanted to leave, that was a problem.  The nurse, mom and I were all in the room when he got irate.  We tried our best to contain him in the room, but then he started swinging and we couldn't stop him from getting out the door.  He darted down the hall with the nurse and I chasing after him.  The nurses at the nurses station called security because there was no way we were going to contain this 250 lb. boy.  He had the mental status of a three year old but the body of a grown man.  We were able to distract him with the doll houses, but it wasn't long before he re-realize his mission to go home and went for the elevator.  I was trying to give him space yet block him from running off. All I was thinking was what if a visitor comes up in the elevator.  They have no idea what they are walking into.  There were about 10 people around to contain the situation from RNs to charge nurses to unit directors to doctors to security.  It took 3 6 foot security guards to contain this child.  He pulled the buttons off one guards uniform, broke the walkie-talkie.  He was out of control and then all of a sudden he just started crying.  We were able to get him back to his room and sit down and he sobbed for at least a half an hour.  He said he wanted a hug and when he called his dad at home all he could say was he got upset.  He kept telling us he got upset and just cried.  finally exhaustion got the best of him and he just crashed.  We didn't have to restrain him physically or medically.  There was an instant psych consult, the chaplin was in the room talking with the mom and my resource unit director even came down to see that I was okay and if I needed anything.  While an unfortunate event, the rapid response from everyone made me love the hospital even more.

I stayed in the room and talked with mom until I got pulled to another floor.  What I love about pediatrics is so much of nursing care is directed to the families and not just the patients.  One would think perhaps this is a bad mother for not knowing how to control her son, but then I find out she was a foster mother of 12 and has adopted this and another son through the process.  Her eldest son is even more of a handful than this one with homicidal thoughts who just got out of the hospital for chasing them with a knife.  While not probing, the mother opened up about her home situation.  Her other son had been writing manifestos about how he was going to kill her and his siblings since he was 7!  She told me how he writes detailed plans on how he can do it and not get caught and then makes her read them.  Inside Im like holy shit! but on the outside I'm calmly like that must be very hard for you as if this a something I hear all the time.  This it's time for me to more to another floor so I let mom know what the plan is and point out that the giant security guard that is now stationed in their room is probably going to be more effective than I.  She simply said, Christina, you're done more than you give yourself credit for...

Then I go upstairs and this kid needs his new toy that he won from bingo opened.  After reading the instructions I was like sorry bud, but you need a screwdriver to get the batteries in and all of a sudden he whips out a mini screwdriver from his pocket.  I was flabbergasted and like ugh why do you have this?!  He was like so I can fix stuff, very nonchalantly.  At this point in the day I was like whatever, and set up his travel size bop it!

I couldn't wait to go home 12 hours is long, but 12 eventful hours like I've had is very draining let me tell ya!  It was almost time to go and a nurse texted me asking me to bring clean sheets to a child's room.  She was one of the cutest little 4 year olds I've ever seen (aside from my own family of course) and just not feeling that well.  She had a ng tube in and mom was holding her while I changed the sheets and got everything all nice and tidy.  The second she put the child back in the bed she projectile vomited all over the clean sheets.  I just calmly was like well I guess Ill be back with a clean set, is there anything else you need?!  Mom jokingly was like apparently she likes you and wants you stick around for a while.  While adorable, I was not having it after the day I had, but I put on that happy face and re-changed her bed.  The funny thing about this whole day was I didn't hate it at all.  It tested my patience and I might have complained, but I never was like I need to call in sick or complain to anyone.  I never questioned if this was what I wanted to do for the rest of my life.  I just took each event in stride and chalked it up as an "experience." :o)

Suicide Watch

Sad but true.  We had three attempted suicides on the floor today.  Any kid that comes in from a suicide attempt or expresses suicidal thoughts is automatically given a sitter for the rest of their stay.  I always like to read the charts, but then pretend like I know nothing when talking to the kids.  This girl was a 16 year old freshman who could not take her parents drinking and fighting any more.  She came home to her mom and uncle arguing so she wrote a note to her mommy and daddy saying she was sorry, but she couldn't take it any more and then took 30 pills and chased it with alcohol.  She had talked to her boyfriend earlier and when she didn't answer the phone he got worried and called 911.  She was rushed to a local hospital in her town before being transferred to Lurie's.

When I got there she was still sleeping.  I might be a creep, but there is something I find so precious about a sleeping child.  They look so calm, relaxed and comfortable and have a chance to escape their reality if just for a nap.  I let her wake up slow and didn't say much aside from an introduction.  I helped her order breakfast and go to the bathroom, checked her vitals and even then just initiated a little small talk.  She was a girl of few words.  In true American teenager fashion first thing she did was hop on facebook and updated her status about being at the hospital and feeling horrible for what she did, of course probing people to ask "what happened?!"  (I was shocked by how many teens were up and on facebook at 9 in the morning on a sunday).  I was curious how she was going to respond in her fb chat and she just openly said it... I tried to kill myself.  I took a lot of pills. etc.  I felt like she was crying out, but I really didn't know how to initiate the conversation and interrupt her facebook tell all.

When her breakfast came and she was pulled away from her key board I asked if she wanted to talk about what happened last night.  She said she didn't care.  I whipped out my therapeutic communication with a "Well this must be a really difficult time for you right now and if you want to talk about it I would be more than happy to lend an ear, but that is up to you.  Now you have the opportunity to figure things out while you're here free of all the stresses you have at home.  She told me she felt bad for what she did.  I asked what part do you feel bad about.  She said adding stress to her family and ruining her relationship with her mom because she means everything to her.  The fact that she almost took her own life was not even a thought in her mind made my heart crush.  She was so worried about everyone else that she didn't think of her own needs.

She started to tear up and open up a little more.  She was concerned that what she did would affect her relationship with her mom who she thought very highly of (I begged to differ, but wouldn't show it).  Her mom actually got kicked out of the hospital she was initially taken to because she was arguing with the police, yelling and told her daughter (who just tried to kill herself mind you) to pack her bags and move out.  She talked about how her parents drank a lot and that her dad use to be abusive but now is better.  She has three younger brothers at home that she really worries about.  While she's in the ROTC program at school and wants to join the navy to be a medic, her grades are dropping because she's worried about everything else going on.  At this point all I could do was boost what little she had left.  I kept telling her how strong she was and what a promising future she had and that most teenagers her age were nowhere near her level.  What else could I do!?  We talked about some off topic stuff like Hunger Games and such and then she hopped back on facebook.  To give her her privacy I started to read my kindle, but then I realized she hopped back on facebook to show me pictures.  She was like this is my sister, this is my godson, this is me in my ROTC uniform etc.  It warmed me inside to know that I'd created this bond with her.  Then I was pulled from the room to work the floor because they were so short staffed.  I made sure I checked on her often though.  I hope she can find the strength to get through high school and out of her house where I know she will flourish with her drive and determination.  No child should have to deal with the misshappenings of their elders but I see it happen all to often and if I could I would take them all in.  

A sweet family

First, can I mention that it is already March.  Where the heck did February go!  That means I only have 6 months left of school.  It's both exciting and nerve racking at the same time.

So every third weekend I have to work and it happens that this past weekend was my weekend.  I finally was put on the floor on Saturday, which doesn't happen as often as I'd like.  Most of the time I have to fulfill sitter needs and get stuck in one kids room all day.  Being on the floor, I get to interact with more patients and families and it feels like more nursing than babysitting.  I had seven patients, but there was one family that just warmed my heart.  First thing in the morning, they accidentally had their call light on so I went to check in on the room.  I gave gentle knocks and walked in to find the parents of a 4 month old standing next to the crib comforting one another with a long embrace.  It was sweet, but I felt a little awkward barging into the room and being like, "ugh did you need something because your light was on?"  They were a middle-aged, spanish-speaking family with a their first baby who was vomiting regularly.  They were so nervous and worried and I was glad to be there to support them.  The dad spoke a little english and I was able to get out a few sentences in spanish so we hit it off right away.  They would call me to help put the baby back in bed or swaddle him because they were nervous about all the monitoring wires and IV.  After a short, non-invasive procedure the baby was cleared to start eating.  They asked me to stay and help burp him and watch to see if they're doing it right.  With pleasure and in very broken spanish I taught them the proper way to bottle feed and the best way to burp the baby as well as why it's important to do things that way.  I would talk to the dad and then he'd translate in just english to mom.  They were very appreciative.  At the end of my shift he asked if I'd be back tomorrow and were a little disappointed when I said I wasn't sure what floor I'd be on.  

While childless, I was able to learn a lot from shadowing a lactation consultant in mother/baby and was glad to pass along the information.  But what about all those new mothers out there?  I had my clinical at Northshore hospital in Evanston where there are a ton of resources, but what about those less leisurely hospitals?  I'm sure they don't have consultants as readily available or counseling/coaching for new families.  While I know some mothers could give two hoots, I know this mother would take advantage of every opportunity to learn the best care of her son if given.  You could see her heart ache with each whimper and while they were so compassionate, they were a little overwhelmed.  As much as I am annoyed by my Public health class, it's moments like these that I appreciate what public health nurses stand for.  They reach out into the community to promote preventative care and health awareness.  This was a prime situation where both parent and child could benefit from a few parenting classes.  Now will a little air in the nipple of a bottle kill the baby?  No, but it the options are available and the family is willing why not take a class or two?!  When I left for the night the family was super thankful and I am confident that he will be okay.  He has a home full of love, and that is more than a lot of the kids I see everyday at work.