Open Book Test You Say?!

One of my favorite classes this quarter has been synthesis.  I think I've mentioned it before, but every week we get case studies and have to make connections with disease processes, symptoms, risk factors, medications etc. The class really makes you put together everything we've learned in a realistic cases.  Just to think in a few weeks I'll be doing that with a real person! There is little leg work that goes into this class, you show up each week work through the case and that's pretty much it.  The best part is even the tests are open note because the purpose of this class is to make sense of the information, not just memorize it.  People literally rolled into class with carry-on suitcases filled with books.  I put my books on a scale just for curiosity when I got home and they weighed in at a whopping 31.8 pounds!  I swear I'm going to need a chiropractor after nursing school.

Everything I carried around for the exam

I really rocked it on the midterm, but that didn't matter much because the final case was worth 50% of my grade anyways.  Our teacher surprised us by assigning us to groups of 3 or 4 for the final.  I was on the fence about it though.  I was barely able to finish the three hour exam by myself and if you add the element of discussion with teammates... I was afraid time would be our enemy.  My group worked like a well oiled machine and we were able to finish with 20 minutes to spare.  I know this class is only worth 1 credit hour, but 1 hour was all it took to put me on academic probation last quarter.  Im hoping to pull out an A on this one!    

Mother's Day

For mother's and father's day, Chelsey and I like to do something fun with our parents rather than just give them a gift and card.  I think all parents can agree that there is no greater gift than the presence of your children.      We decided to make the entire day a surprise for my mom.  We started with a mani/pedi and made sure we had a bottle of champagne for mimosas on hand.  Then we were going to go to bingo at the VFW since last time Chels and my mom went she had a blast.  While they state that they have bingo every Sunday, apparently mother's day was an exception. The parking lot was empty.  Soooo, we went back to my mom's house opened a bottle of moscato and devised plan B....

I probably haven't been there since grade school.  I remembered it being so much bigger than what it was, but it was fun to take a trip down memory lane.  We all had our favorites, my mom loved, loved, loved this goat and wouldn't stop petting it to the point that my sister and I just walked out of the barn.  Chelsey was entertained by the llama who was gnawing on the fence post and had to take a video of it.  I was interested in the pigs and all the products they make out of pig parts like chewing gum and insulin injections to name a few. 

After Cosley we got back on our plan for the day and went to Pepper Jack's for some dinner and a margarita or two.  I was enlightened by the concept of the Coronarita which is a beer flipped over in a margarita.  My mom wasn't the biggest fan, but did her best to get it down.  Also, I discovered for the first time my sisters extensive widows peak.  Being that it's a inherited dominant trait and no one else in the family has one, I think she's adopted.  All in all it was a great day and my mom had an awesome time.  Now the planning for father's day is in the works!  

Eddie Munster

Widow Peakless

Mother-daughter bonding at its finest

More than a university

As I continue my journey through nursing school, each day affirms that I made the right choice in picking Rush.  Not because it's one of the top graduate nursing colleges in the nation but because there is a genuineness in the community that beyond any other university I've attended.  Yes, my heart will always bleed orange and blue for the Illini, but I never was able to build a rapport with my professors in the four years that I've attended U of I like I've been able to build in the short 20 weeks I've been at Rush.  Everyone here wants you to succeed, they kick your ass, but they want you to be the best nurse you can be.

I recently took my first ATI exam.  ATI is a series of standardized tests we need to take throughout the program which are suppose to help us perform well on our boards come graduation.  Our first test was on nursing fundamentals and pretty much anything related to the topic was fair game for the test.  Our "study book" was over 700 pages.  The test is scored 1, 2, or 3.  To pass we need to get a 2 (above the national average) or we have to retake it in two weeks.  I passed by the skin of my teeth.  I'm pretty sure if I got one more question wrong I'd have to retake it.  My instructor came around, saw that I passed and said good job.  I gave her a look like really,  you think that score is a good job?  She replied therapeutically, "I know you're not happy with your score, especially since you had the highest synthesis midterm but a pass is a pass."  I later went up to her office to reflect on the quarter and we had an hour long chit-chat.  I've never had an instructor do that.

Rush Football Team, 1900.

Another reason Rush is great, is all the activities they plan.  While we no longer have a football team to cheer on together (picture is proof), there is always something going on on campus to bring the student body together.  They have the student-faculty tea every month, they had a student-faculty music recital, they do lectures and workshops all the time (most with lunch included) and have social events.  The most recent and exciting event was the 40th Anniversary Garage Bash!

Mary was on the planning committee (I think that was her way of trying to convince herself that shes "in it").  Honestly, I thought it was going to be a bust and super lame but since we're such good friends we went to support the event she helped plan.  It ended up being a lot of fun.  They had it on the roof of the parking garage and it was a beautiful day.  There was a buffet of typical party foods and round tables set up for people to sit and eat.  They had some bags sets and other lawn games for people to play.  There was a line up of bands playing great music.  All of which had at least one Rush student in it.  There was a photo booth.  There was a Good Humor ice cream truck and there was a trivia table.  Pretty awesome right?!

The photo booth was a first for me.  Believe it or not, I've never been in a photo booth before.  You can probably tell by some of the pictures that I had no idea what I was doing.  That first picture I was like whaaaat. It was good fun
though and I can't wait to do it again at Carla's wedding next summer.  Before the photo booth I wanted to try trivia.  I LOVE triva nights at bars in Chicago but nursing school has been cramping my social calendar.  I was excited to get some random Rush knowledge in my noggin.  Vivien jumped at the opportunity to go with me.  You might remember her from one of my first posts, the "Vivien peace!" girl.  Well, she's an interesting character, but growing tolerable.  We ended up getting our questions right so we got a prize.  I took a bookstore gift card she took one from dunkin donuts.  Then she had the nerve to ask for the bookstore one and never put back the first prize she picked up.  People never fail to amaze me.  Anyways, the point of this post was even though I have cried over classes and tests, am super stressed 95% of the time and am barely holding on to what I use to know of as a life, I love Rush.  It is a great school and a wonderful community to be a part of.  I know I will proudly wear my alumni gear come next year.

Tea for two... or maybe forty-two

Rush really strives to foster the student teacher relationship.  Every month they have a student-faculty tea at the "Rush House" a few blocks from campus.  It's a great opportunity to mingle with faculty on a casual basis and with students in other disciplines.  I've always been curious about the event, but never brave enough to approach it solo.  My friend Mary has been on the fence about nursing since she started the program.  Why would a person who freaks out about germs and disease and hates hospitals be a nurse she wondered.  She confided into her adviser and the prognosis was good.  Mary is staying.... for now.  Her adviser also invited her to join in the tea party so I jumped on that bandwagon too.  Actually her adviser was the same woman who interviewed me and as we were talking she actually remembered who I was, I was impressed!

The house was really nice inside (Im sure someone's tuition money went toward building and furnishing this house for the president).  They had a team of chefs come in and make mini appetizers and deserts and they have tea, coffee and punch.  Then a faculty member gives a brief 15 min presentation about their career or what-have-you.  The speaker this time talked about her long journey to get where she was.  It started with her wanting to be a bedside nurse because she loved General Hospital.  She actually loved the show so much that her mom would take notes while she was at school and tell her all it when she got home.  Much to her surprise she realized actual bedside nursing was not like it was depicted in General Hospital.  She dabbled in a few areas of nursing, got her Masters, taught, got her PhD and now is doing some amazing research with AIDs patients.  The moral of her story was don't try to write your career path, just let it unfold and it's okay if getting from point A to point B is not a straight line.  In fact, that's perfectly normal.  What's important is that you just love what you're doing.  

Cinco de Mayo Study Party!

Sorry for the long delay in a blog update.  This quarter has been a bit overwhelming.  Week 7 was dubbed the hell week.  We pretty much had a test in every class and it was conveniently scheduled right after the Cinco de Mayo/Kentucky derby.  I was a bit bummed because how often do two great events happen to fall on the same day?!  I knew forgoing a study group was not an option so we decided to spice it up a bit and make it a cinco de mayo themed study group.  I headed to Trader Joe's that morning to pick up some taquitos to snack on that night and the fixins for real margaritas.  One friend was going to bring Tequilla and another some chips and salsa, we were set!

This was one of the longest study groups we've had.  I think everyone came over around 3 and didn't leave until at least 10 or 11 that night.  We started by getting down to business with cardiovascular and muskuloskeletal systems.  After getting a good handle on the material, the drinks came out.  We decided it would fun and productive to turn our review questions into a drinking game.  You get the answer right, you are rewarded with a sip from your drink.  I think everyone had a good night and I wasn't bitter that I missed out on a great night out in the city.  While you might think this wasn't the best method for studying, but I ended up getting one of my best scores in that class and was 7% above the class average.  Ah, the secret to success.... Tequila!  

Health Assessment Clinicals

Next quarter I will have my medical/surgical quarter where we have clinicals twice a week and class once a week (plus a bunch of other stuff), but this quarter for my health assessment class I am on a med/surg floor so I get a taste of what's in store this summer.  The patients on the unit I'm on are very sick people.  I realized I haven't talked about my patients at all so here is what I've experienced so far...

Thumbprint left in the foot from excess fluid
(4+ pitting edema) 

My first day I had a patient who was probably 150 pounds but because his abdomen was so distended with fluid he looked like he weighted 400 pounds.  He had 4+ pitting edema all the way up his legs and was so swollen with fluid that he could not even get out of bed to go to the bathroom (4+ pitting edema is when you push your finger on the foot and it leaves a deep pit where your finger was) He was bruised all over, had a blood clot "the size of a sewer cap" according to the patient, removed from his abdomen and had the fluid drained twice but it just seemed to come back.  He also suffered from acute renal failure and was getting dialysis every other day.  I went to visit him a two weeks later when we were on the floor and he looked a lot better despite to toll being in the hospital for a month plus has taken on him.  All he wanted to do was get well to go home and see his 3 year old son.

My second day on the floor we had to do a musculoskeletal assessment on a patient.  We get paired up with a nurse and then have to pick one of their patients to do our write up on.  My instructor told me that Mr. M would be an interesting candidate since he probably had a lot of limited range of motion.  Mr. M was a 380 pound man who came in because of dizziness.  He use to be 500, dropped to 340 when he was in physical therapy for a month, but now is back up to 380.  He had wounds all over his legs and goes to Cook County hospital to get the bandaged changed every week.  Likely cause of the pressure ulcers is inactivity, poor nutrition and not being able to reach his legs and feet to wash himself.  When I first walked into his room and introduced myself he said between you and me I know I died and Jesus brought me back this morning.  I knew it was going to be an interesting day.

lymphedema, this is good compared to
what my patient looked like.

This patient had an ongoing condition called lymphedema, a condition of fluid retention and tissue swelling due to a compromised lymphatic system.  This patient had it primarily in his right leg.  It took us 7 minutes to just get him to sit on the edge of his bed and I had to help him move his leg.  He also had a dislocated right shoulder and very little mobility with that arm.  We assessed what we could with his mobility and then we helped the PCT with am care aka give him a bed bath and change his sheets.  Now I always prided myself on having a strong stomach, but when we had to start cleaning under the skin fold of his leg and stomach I thought I was going to lose my oatmeal.  Dead skin was just sloughing off and the odor was pungent beyond explanation.  The patient was appreciative that we cleaned him up, lord knows the last time he had a thorough cleaning and the PCT was thankful that we had helped.  The best I can describe it was giving a bath to an elephant.  The skin was callused and rough, he was very large and you could not escape the smell in that room.  Despite my lack of enjoyment I was glad I could bring him some comfort and encourage him to get back on his weight loss journey.  He was talking about how his one cousin goes to the gym and lifts all these weights so I told him, "Mr. M your body is like a built in gym.  Not many people can lift as much weight as you do every time you get up and walk across the room.  You're burning as many calories as they are when you do that."  Start small, work your way up and don't get discouraged.  He was in dire need of a pep talk, whether or not he follows through is up to him, but I can say that I tried.

This past Friday was probably my favorite day of clinical.  We had two patients and had to do a cardiac health assessment.  Both were older women.  One suffered from congestive heart failure, Diabetes, Hypertension and was a breast cancer survivor.  She was diagnosed with CHF three years ago and it came out of the blue.  One day she just couldn't breath so her husband called 911.  She use to be her husbands care giver and had no health problems until that day.  Her husband was a double amputee and just passed away two years ago.  Since that day three years ago, her shortness of breath has been becoming increasingly worse.  She is admitted to the hospital about once a month now.  She uses a chair walker when she goes out but gets short of breath walking as little as a half a block.  She was in high spirit and would let us do any assessment we asked with complete compliance.  I told her if I had stickers she'd get on for being patient of the day.  She is a very much a proactive patient and  follows her doctors advise to a T at home.  She recently has had some rapid weight gain (1 lb/day) from fluid retention which is due to the heart failure.  She is already on a diuretic and has cut back on drinking water.  The big concern was whether or not to increase her diuretic medication because she also has chronic kidney failure with about 40% of the kidneys working.  Upping the diuretic will put more strain on the kidneys.

The other patient we had on Friday was in for a lead revision on her pacemaker which she got back in 2000.  However her chest x-ray showed a small pneumothorax in her left lung (an abnormal pocket of air) so they admitted her for 24 hour observation.  She seemed bothersome at first, but warmed up to us quickly.  Oral histories are my favorite part of assessments because you get to learn so much about the patient.  She had a houseful but was one of the loneliest women I've met.  Her parents, all siblings and Im pretty sure husband have all passed away and she talked about how much she missed them all.  All she had where her children, but they were all too busy with their own lives to pay much attention to her.  Some even lived with her, but despite their physical presence I don't think they were really there.  "It's just me and them four walls all day and them walls don't talk back to you," she told us.  Completing our physical assessment was no longer our top priority, providing her company was our new goal.  We talked and squeezed in a few health assessment questions here and there.  We learned she was a woman living in constant pain, but would never tell anyone because she didn't want to be a hassle (sound familiar miss nani poo).  But everyone can see it on her face, even her 3 year old granddaughter has learned to ask if she's feeling okay.  She constantly refused morphine in the hospital for fear of being addicted.  However, when we were in her room she had an episode where the pain took her breath away and she had tears dripping down her cheek.  I told her I was going to get the nurse and give her some pain medication.  She told me she just wanted to go home.  I explained to her that taking morphine did not mean she would have to go home later and that no one needs to be in pain like that.  When the nurse came in with the vile of morphine she asked if it was "dope."  One of her sons use to be a drug addict which only heightened her caution of medications.  I assured her that a dose of morphine would not make her an addict and that I know plenty of people who have taken morphine before with no repercussions.  She accepted the shot and we let her rest.  My heart goes out to that woman and I hope her family appreciates her for what she is.          

Perseverance

Persevenance is commitment, hard work, patience and endurance.  Perseverance is being able to bear difficulties calmly and without complaint.  Perseverance is trying again and again.  Perseverance is what will get me through nursing school....

First quarter was no easy feat, and we had a day off!  This quarter is far more challenging than last. I've finally caught on to Rush's strategy.  They push you to the max and wait for you to acclimate to the stress, pressure and work load of the program.  Once you get use to the routine, they take it to the next level again.  Quarter 2 is no joke and each class expects a lot out of you with no regard for the work load in your other classes.  Last quarter it seemed like the classes took turns proctoring a test each week.  This quarter it's no holds barred.  I usually have 2 and sometimes 3 tests in a week back to back.  Trying to juggle it all is still a challenge.  In addition we have another test, ATI, which is a computerized test that will help us prep for our boards come a year and a half from now.  We need to take and pass the ATI in order to move on in the program.  It is completely independent work and trying to fit it in is near impossible.

Being half way done with Q2 is bittersweet.  Im excited that the program is moving along and Im that much closer to my professional career, but with that I realize how little time I have to get everything done before the quarter is over.  I have three exams next week, two monday and one tuesday.  While my performance in classes has improved since last quarter, I still am not up to my own standards and expectations.  I constantly feel like I'm treading water and my only arm floaties is knowing that in four weeks I'll be done with this quarter.  There is a lot to do till then though.  If I had a genie in a bottle, my second wish would be for an 8 day week...