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.         

Love takes many forms

I hate that Valentine's day is dubbed a "couples holiday."  In my opinion, the day should simply be shared with those you love, no matter what form your relationship takes.  I was thankful that I could spend the evening with my roommates who have become an integral part of my urban family and I love them very much.

Last years v-day celebration was a blast and we wanted to keep up the tradition of having a solid, home cooked, soul food meal.  Everyone contributed to the cooking and the special guest this year was Tyler's friend our friend David.  He made green bean casserole and mashed potatoes and surprised us all with valentines personally selected based on our celebrity/tv show obsessions.  We still have them proudly hung on the fridge.  Super cute and very thoughtful.


While Tyler was finishing up frying the chicken in peanut oil, Matt and I busted open the wine and had a mini dance party to pass the time.  He might have been upset that he couldn't make a "cooking contribution" to the meal, but the wine was an integral part and the floral centerpiece and table sets were a special addition.  We sat and had a delicious meal that even beat the one from last year (didn't think that was possible).  It was so good that the boys gorged themselves and left no room for the ice cream dessert I made.  I on the other hand knew better and only succumbed to seconds on the mac and cheese.  All in all it was a great day and a tradition has definitely been born.  Valentines day = soul food and I joked that even if there is a special someone in the picture down the road, we are heading over to spend the night eating fried chicken and drinking wine with Matt and Tyler or vise versa.

Sulky Sunday

Just having one of those days today.  Maybe its because I had such an awesome weekend spending time with all those that I love so much and it's back to reality tomorrow.  Maybe its because I'm hitting week 7 in the quarter and burnt out a little.  Maybe its because while the end is near, it still feels so far away.  Maybe its because I tend to stretch myself thin every once in a while.  Maybe its because I feel like everyone is hitting their next milestone and my personal life has been stagnant for years.  Maybe its because I can no longer ignore that my pants are too tight.  Maybe its because Im dreading the reality of my financial situation and having a student loan payment the size of a mortgage as soon as I graduate.  Maybe its because I'm overwhelming my mind with thinking about what maybe it's because....

Whatever it is, I just haven't felt right.  I've been mopey, emotional, forcing smiles and haven't really wanted to talk to anyone today.  I have a career plan paper due tomorrow at noon and have been staring at the screen for the past three hours with only a few sentences to show for it.  It's hard to write your "self-assessment" when you feel like an emotional wreck.  I'm hoping I can sleep off this slump and attack it with a fresh mind in the morning before I volunteer at the vaccine clinic at U of C again.  Blah.  Well this post was somewhat therapeutic.  Just glad I have an alternative avenue to get it out.  

1st Annual Cider Summit

Whenever I catch up with my grandparents on the phone, both my nani and grandma always ask, "So what are you doing for fun and to relax?"  Well this past weekend I knew exactly what I was going to do for fun.... the Cider Summit at Navy Pier.  I don't remember how I came across the event info, but I knew I had a few cider lovin' friends that would for sure go with me.  One thing I like about living in the city is there are always different things to do.  It unfortunately was my weekend to work, so I planned ahead, packed my backpack with clothes and walked over the Navy Pier after work to meet up with Molly.  Tyler was a little hung over from the night before, but he made it eventually(there's your blog shout out).

There were 26 booths set up with multiple ciders at each booth ranging from 5.5- 16% alcohol.  With our admission we were given 10 tickets to pick and choose our ciders.  Now Molly, bless her honest heart, would walk up to the booth and ask how many tickets each tasting costed.  I on the other hand would only hand over the tickets if they asked for them.  I probably got twice the money's worth in cider that day.  The place was packed, but we would sip our cider as we waited in line at the next booth.  Some were too sweet, some were amazing and some just tasted like feet, but overall it was a great event.  The event originated in Portland, OR and they have expanded for the first time to Chicago underestimating what a drunk city we were.  We met and talked to one of the organizers and he said they had to go out and buy cups twice.  Since we came later, we got stuck with the Dixie cups and not the cute logo ones with stems.  They will definitely be back next year, bigger and better with a band and more spacious room and a store to buy the product.  It was loads of fun and I'm already looking forward to it.  As you can see in the pictures we didn't want it to end and were some of the last ones to leave the event.

Yep, by the look of those eyes you can tell
I've had a few samples by then...

Tyler was obsessed with this cider poster.  At the end of the
summit they gave it to him for free since it was all dripped on 

After the summit we I was a little toasty and had a good buzz going on.  We headed to Hubbard Inn to meet some more friends for food and drinks.  I passed on the drinks since I had to be at work the next morning at 7 (The nice thing about drinking early is you have time to sober up and be in tip top shape the next day).  The food was amazing and I gorged on a plethora of small plates.  So many in fact I had to unbutton my pants as soon as we got up to leave because I was convinced they were creating a bowel obstruction.  Im thinking this is a sign and since I have signed up for my first 5K in May.  Ill keep you posted when I start training for it...

Off to a good start

I am about 1/3 of the way done with my last quarter of classes (not that I'm counting or anything).  This quarter seems to be a good test of time management and organization.  While we are only in the classroom for 2 classes, we also have two classes online that we can't forget about.  Let's just say I'd be a nervous wreck without my planner.  While other quarters seemed to be very test heavy, this quarter seems to have a lot more writing and reflection assignments which can be a bit time consuming.  Not to mention that online assignments are easy to push to the side until last minute.  I've learned that to get through this program I need to focus on one thing at a time.  I look at my week and prioritize everything I need to do and when I can do it.  Then I just slowly check things off my list.

I have clinical Monday nights, and while I thought I would use the day to get some work done, I have the tendency to just do some mindless tasks and ease into the week.  Plus, it's nice to not have to set an alarm at least once a week.  After clinical I head to the grocery store and get food for my lunches.  I've found that packing lunches for the entire week at the same time is a time and money saver.  Tuesday I usually work 12 hours so I call that a wash as far school work is concerned.  Sometimes, if I'm sitting with a kid, I can get a little studying in, but it's usually not very productive.  Wednesday I have clinical at 6:45-3:30 and while they're usually exhausting I am getting into a new routine of going over notes and studying with Nadine afterwards.  Thursday is a day of class and Friday is a day of work unless it's my rotation to work weekends.  I like to pile on the work and responsibilities on my busy days so I can completely veg out and reboot on my days off without worrying about doing anything.  It might sound backwards to some, but it's what works for me.

I feel like Im managing fairly well.  I know I'm not as stressed out as I was this time last year, but that doesn't mean I have my moments.  This week was my first test in comprehensive management of health through transitions of care.  This is what I'd like to call my "hard class."  I didn't get much time to study on Tuesday so I crammed on Wednesday after clinical.  I was so beat that when I stopped to pick up a burrito salad for dinner the guy at Chipolte was like, "looks like you've had a long day."  All I could respond was, "yeah, something like that..."  It all paid off though.  I ended up getting an A on my test.  I think this only the second or third A I've gotten in my "hard classes" so I was really pumped.  I'm hoping to keep this up and not have a freak out session at the end of the quarter where whether I pass or not depends on my final exam grade.

"The Most Beautifulest Campus on Earth"

The mission behind public health is to promote physical and mental health to prevent disease, injury and disabilities in a population.  The idea is to fix it before it's broken.  Public health enthusiasts live by the motto prevent, promote and protect to foster healthy communities.  With that being said, we've all been placed in clinical locations where we need to promote health to a specific population.  I have been placed at Misericordia.  For those of you that are unfamiliar, it is a predominately privately funded organization that strives to bring normalcy and maximize the potential of people with developmental disabilities.  It is a campus that accommodates 600 residents in small houses and apartments.  This place is so great that there is a waiting list that is 600 people long to get in.

Now those who know me, know this is not a population I am super comfortable with, but I'm embracing the experience.  I tend to dread the drive up Lakeshore to clinical, but find myself laughing all the way home because of something that happened that night.  We work with the higher functioning residents who live independently is a 60 person apartment complex.  The first couple of times we visited we just hung out and got to know the residents.  They are SOOOO excited to have visitors and very eager to introduce themselves and shake our hands.  It was quite cute how polite they were.  One woman always greats us very enthusiastically saying, "Welcome to Misericordia, the most beautifulest campus on earth!" every single week we come.  One day we made valentines.  I was lucky enough to get one from a resident and then another resident wanted to make one for the children at the hospital I work at.  She thought it was very sad that children have to be at a hospital.

L:  I was asked to write but did the hearts all herself
R: my personal valentine from a special friend 

After hanging out we get to eat dinner with them in the dining room.  It is sometimes hard to hold long conversations with the residents because in orientation we were told to help promote normalcy by talking about things they can relate to.  One of the guys asked what I was doing tomorrow and I said I had to work.  He asked for how long and I said for 12 hours and then he shouted Oh wow! 12 hours! at dinner.  Then a few minutes later, out of nowhere he said it again, it was quite hilarious.  Everyone at Misericordia has a "job" and they take them very seriously.  Some work in the restaurant on campus that raises money for the organization, some cut brownies in the bakery, some work in a grocery store.

After building rapport with the residents we have begun health club where we pair up with another student and prepare a health promotion lesson for all the residents.  Stephanie and I had portion control. We get there at 3 and have been paired up to do a health promotion lesson.  We took feedback from the previous pair that presented and were really excited to present.  We have a lot of props and visuals.  One of the activities was to have them pretend they were at dinner and draw the size their chicken would be on their plate and how much pasta they usually put on their plate.  After explaining instructions step by step his is what they drew...

Very few actually drew the food.  Needless to say it was a liiiiittle too abstract and we wrapped that activity up pretty quick.  I wasn't really sure how well they picked up the concept but then we were in line to get dinner and the resident who asked me to sit with her was like, look at this portion.  The pasta covered up much more of the plate than it should have.  Clearly she wasn't the one when drew the cat...

Purple Affair for the Bear!

It has been a hectic couple of days and school was kinda been put on the side this past weekend.  The Bear Necessities auxiliary board just had our big event of the year, Purple Affair for the Bear.  We had been planning this event for months so everyone was so excited that it was finally here.  On Thursday I went to the  office to help assemble silent auction baskets, do inventory on all our donated alcohol, cups etc, but together VIP bags and work on some decorations.  I was there until midnight when they kinda kicked me out because they knew I worked at 7 the next morning.  There were still a few people that ended up staying until 3am.  Friday I went to work and then straight to babysit because it was Nicole's birthday.

Saturday was the big day and it started at 9 am when a group of us met back at the office to bring all the decor, silent auction items and alcohol over to the River East Art Center.  After several trips up and down the elevator, my car was packed and ready to go... and then my car didn't start.  The past few days it was starting funny, but I just thought that was because it was so cold outside.  Luckily one of the guys that was still at the BN office had jumper cables.  

A work in progress

As we discussed what to do, a man waiting in a car right in front of me, conveniently with his window cracked came out to help.  He was a mechanic, talk about luck!  Turns out it wasn't a dead battery as most would think, it was corrosion that was preventing the positive connection.  He got out a few wrenches, went to work and half an hour later we were back on track.  Of course we treated the man to some starbucks for being such a good Samaritan.  Then I headed off to the venue to unload and help set up.  There was a lot of stringing of lights around the railings and confetti bears for the tables, setting up all the silent auction stuff etc.  Needless to say there was a lot to do.  I left around 3:30 so I had plenty of time to get ready but there were still a bunch of people working and some even brought their dresses so they could just change there.

It was nice walking into the River East Art Center all dressed up and seeing the fruits of our labor.  All the board members got together to take a group picture and then we hung out waiting for our guests to arrive.  We sold 450 tickets, which is about 100 more than we sold last year.  We had some fun entertainment with jugglers and acrobats that put a show on for us in the middle of the evening.  We had Miss Illinois USA as our MC for the evening.  While I didn't get a chance to talk to her, I heard she was very friendly and down to earth.

Miss Illinois with President and VP of Bear Necessities

Everyone seemed to have a blast and the night flew by way too fast.  Before I knew it they were calling last call on the silent auction, which my blanket ended up selling for $250.  The couple who bought it were taking pictures with it so I went to go introduce myself.  They insisted that I jump in on the pictures.  Then I took the time to tell them about all the drawings the kids made.  They were so appreciative and said the stories made the quilt that much more valuable.  I felt really good that I could make something so special and help raise money for pediatric cancer.

Amazing Future Nurses

I wish I had more time to enjoy the company of my friends, but I was spread thin with various jobs and visiting with different groups.  Three of my lovely nursing friends from Rush came out to support me and this wonderful cause I care so much about.  I am so appreciative to have made these great friends.  Alexis came with her husband as a special surprise for his birthday, Nadine came and and extended the invite to her entire family who all were in attendance as well and Mary, after some contemplation about the tickets, decided to join the festivities after all.  It kinda felt like Christmas day where you plan and plan and plan and just like that it is over and you just don't want it to end.  When all was said and done, we ended up raising $58,500 for the foundation.  It's the highest we've ever made and only after talking to a few guests did I realize how phenomenal this auxiliary board really is.  I am privileged to be able to work with such wonderful and mindful people for this amazing cause.  I can't wait to see what next year's event will have in store.

Older Sick People...

... are not my favorite.  I didn't realize how much I enjoyed peds until I had to switch back to the older crowd.  This quarter we have two clinical classes, public health (post coming soon) and continuum of care.  Continuum of care makes you look at the bigger picture and not just what needs to be done right now.  It makes you think about discharge and the patient's living situation/amenities.  For example, you can't just discharge someone to go home who lives on the second floor, but can't walk up stairs.  This class is suppose to make us think of more individualized care.

This quarter I am commuting to Rush Oak Park Hospital, which is nice because, again I am getting a brand new hospital experience.  Oak Park is more of a community hospital and services the surrounding area.  Recently one nearby medical center shut down and another is converting to strictly a psych facility, so Rush Oak Park has become the main hospital in the area and is packed.

I am on a general med/surg unit where the population tends to be more geriatric.  We will see anything from transplant patients, to heart disease, to poor diabetes management etc.  These patients are usually more tricky because of all the co-morbidities they have.  It's not just I have heart disease, but I have heart disease, diabetes, hypertension and dementia.

My clinical instructor is pretty relaxed.  She doesn't believe in unnecessary homework and encourages us to get paperwork complete while at the hospital.  She is actually a graduate from the first cohort of the program Im in right now.  It's nice to have someone who knows exactly what you're going through.  Our first day we just oriented to the hospital, went over expectations and then she released us to any patient's room.  We had to go in completely blind and find out as much as we could about the patient just by what was in the room and what we asked them.  My patient was a 57 yo woman who was sent to the hospital for hyperglycemia.  Her blood sugar was in the 700s!  When I asked her about home management she really didn't know much.  Her daughter does all the cooking and says its a diabetic friendly diet, but I beg to differ if her glucose was that high.  Now, I don't think she was being non-compliant, as many jump to assume, but rather she just doesn't know how to manage her illness.  When I asked her about medications, she didn't know what she took.  It took a lot of probing just for me to figure out she takes insulin and "pressure pills."  Education is going to have to be a huge part of her care so she and her family can manage her care at home.
 

The next week my instructor gave me one of the heaviest patients on the floor.  He was a total care, meaning I needed to feed him, turn him, bath him, everything.  He came from a nearby nursing home with a fever, dehydration and mental status changes.  He also had dementia and while he would tell you "watch my knee" or "I don't want anymore" he couldn't answer any questions.  Not even can you tell me your name.  He also had severe hip and knee contractures, likely due to neglect from the nursing home.  The muscle naturally wants to be in a contracted state and if you don't exercise your muscles they will permanently become contracted.  Now he just lays in bed (like the position in the picture) unable to straighten his legs.  He had 14 different medications, which again is a little change coming from pediatrics, and they were for several different routes.  Some were PO but since he can't swallow them we'd crush them into apple sauce and cross our fingers that he ate it.  He also had a subcutaneous injection and a suppository.  Yes, this was my first suppository and it didn't bother me at all.  What did bother me was knowing what that suppository was going to do and the fact that I'd have to clean it all up because he's incontinent.  This is what we like to call the "ick factor."  You can be the most caring and compassionate person in the world, but if you can't handle the ick factor, you just aren't going to cut it as a nurse.  Thankfully I was able to use my delegation skills to pull someone in the room to help me, but it still was an hour long process.

Later my clinical instructor commented that she hadn't seen me all day, to which I replied, I have a heavy patient today and gave her a quick report.  While I feel I am enhancing my skills and critical thinking as a nurse, I realize there is still a long road ahead.  It is hard to believe I am almost done with school but feel I don't know anything.  This one patient was exhausting, I can't imagine have to take care of two to three other patients on top of that.  I suppose I should add time management on top of everything else that still needs fine-tuning.  

Creative Collaborations

My favorite part about being on Bear Necessities Auxiliary Board is working with the kids.  Our winter event is called creative collaborations where the kids and families come to our office to do a bunch of craft projects and have a nice lunch.  This year we were spoiled because Sable was very generous in donating the food for us. Kids are busy working while parents sit back and relax.  One mom was telling me at the end of the day that she felt bad because she spent the whole day talking to people and didn't even know what all her kids did.  I told her that's the point, we hang out with the kids and she gets her me time.  I think it's very therapeutic for the parents to talk to other parents that have gone through the same thing.  Most parents talk about activities their kids are involved in and when they lost their first tooth, I heard these parents talking about the number of chemo treatments and when their kid's hair started growing back

While this day is all about the kids and families having a nice Saturday afternoon, our other mission of the day is getting auction items for our events.  We make thousands of dollars off of their artwork.  It's pretty amazing actually.  The parents are cute because some are like, is this going to be an auction item because we'll make sure its a really good one.  The older kids also understand that their artwork will make money to help other kids that have cancer too.

The kids loved our crafts this year and they are all easy do it yourself projects that can be done at home.  But first we needed their hand prints.  Each VIP goodie bag is personalized with hand prints from one of our kids.  We needed 200 and while some kids wanted no part in it, there were a few that wanted to do them all.

 

One of my favorites.  He's such a typical 8yo
boy and was feeling very patriotic this day.
All his crafts were red, white and blue.

Bubble Painting:  mix paint with water and dish soap in a cup.  The kids blow bubbles like in a glass of milk and then pop the bubbles by placing a piece of paper on top.  The popped paint bubbles leave a cool design on the paper.

Marble painting:  take a piece of paper in a cake pan.  Dip marbles in paint and then roll them around.  Fun and simple!  Sorry I don't have pictures of the paint projects, but they looked really cool.

Quilt Squares:  taken from the concept of t-shirt quilts, each kids got a square of flannel material and fabric markers to draw whatever they want.  Some are so adorable and a picture doesn't really capture how great the blanket turned out (not to toot my own horn or anything).  I just loved the stories each square had.  I already had the back complete and couldn't wait to get home and finish the front with all the kids pictures.

cutting the squares is the hardest part 

Sewing is a cinch.  It's just all straight lines.

I wanted to direct one girl away from a rainbow because there were like 3 rainbow bears already.  And our conversation went a little like this... So I said lets have your bear do something, like build a snowman or swim on the beach.  Whats your favorite season?  Spring.  What types of things can we do in spring?  Maybe pick flowers.  It rains in spring.  Right so should we draw an umbrella in your bear's hand?  Well after it rains there is a rainbow.  You're so smart, I guess we can draw a rainbow...  The other square is by an 8 year old boy.  He originally wanted to write Cubs Suck, we settled for Cubs are bad!  There is discussion on whether this will "depreciate" the value of the quilt.

This 6 year old boy was obsessed with penguins so it was only fitting that he drew himself walking a penguin.  When I looked at the final product I asked Whats that pointing to the jockstrap looking detail?  To which he replied, that's my underwear.  I was like good call, you don't want to walk your penguin without underwear! The other square was by a 10 year old girl who loved to draw.  She did a square earlier with a really good sun and bee.  I told her I knew how to draw a cow and she wanted to learn so I showed her step by step how to make it.  After lunch she went back to the quilting station and drew a cow on another square.  I must say she did an awesome job and she was excited to go to school and show her art teacher her new talent of cow drawing.

This little 4 year old was so adorable.  he was just drawing away and when mom realized it was going to be sewn into a quilt she asked for another one.  We were like, No! we love what he's doing!  There was a lot of concentration going on (those are super heros, by the way).  The other square was the one that preceded the cow drawing.

The final product.

The star of the show was the crayon melting project.  You hot glue crayons to a canvas and then melt them with a hair dryer.  It takes some time to get the crayons going, but once they do the kids get excited.  Oh, and I think Crayola works best.  Some turned out really artsie!

Back to the Grind

It's crazy to think that I am in my last didactic quarter of nursing school!  Come April all I'll have left is immersion and my capstone project.  People in my cohort have changed their tone and we've all talking about NCLEX reviews, portfolios, immersion placements, graduation, where we want to work and weekly countdowns.  It definitely doesn't get any easier.  We still only have one day of class, but we have two days of clinical and assignments for two additional online classes.  It's a heavy load and I'm trying to manage working 20-24 hours a week on top of it.  We also will be required to start collecting 132 "indirect hours"  which is volunteer work in a non-clinical setting that is nursing/health care related.  Monday through Friday is a drain and all I want to do when I get home from work on friday is lay on the couch and watch some mindless tv.  Days where I get to sleep in past 5:45 are far and few between, but I guess that is the life of a nurse.

• Mondays:  Public Health Clinical at Misericordia 3-9
• Tuesdays:  Work at Lurie's 7-3:30 or 7:30
• Wednesdays: Comprehensive Care Clinical at Rush Oak Park Hospital 6:45-3:30
• Thursday:  Class 9-4
• Friday: Work at Lurie's 7-3:30 or 7:30
• (every 3rd weekend I work so I get either Tuesday or Friday off) 

I'm half way through my second week of the quarter and still haven't gotten into "school mode" per say.   I've put all assignments, tests and other important dates/meetings in my planner and color coded them, but that's pretty much it as far as prep work for the quarter is concerned.  I know I can't get the ball rolling until I'm completely organized otherwise I'm a scatter brain and constantly wondering what I need to do when.  So I guess that's a start and now I just have to look at my assignments and what they actually are.  For my first assignment of the quarter I had to post this leadership discussion by Monday at 9 am.  I posted it at 12:30 am.  I promised myself that I'll get more on top of things come Saturday morning...

All about the kids

...kidneys that is.  When you think of end stage renal disease (ESRD) and kidney failure you usually don't associate it with adolescents, but through my clinical and work experiences I have come to know a few children with this unfortunate disease.  Here are some interesting characteristics about the adolescent kidney, as they are not just "mini kidneys."

• adolescent kidney function can decrease just from stress 
• infants cannot concentrate urine so specific gravity is irrelevant
• complete bladder control is not obtained until age 4-5 (Potty training too early will just frustrate you if the body isn't physically ready for this task.)
• Most children can regenerate and regain full function in Acute Renal Failure if caught early
• Heart disease and Renal issues usually go hand in hand because the systems develop during same gestational period.

hemodialysis catheter going straight to
the heart.  Not a good idea to pull on it.

Chronic renal failure in children is usually caused by structural abnormalities or specific renal diseases.  Only when 5-10% of function remains, will the medical team initiate aggressive treatments such dialysis or transplant.  The first patient I had with ESRD was an 18 year old non-verbal autistic boy.  He was put on the transplant list, but due to the dire need for a kidney, they started testing family members for a match.   His stepfather was the best match and was going to donate his kidney after the work up was complete.  Until then he was receiving hemodialysis every other day of the week.  Imagine asking a non-verbal autistic child who doesn't understand what's going on to sit in a bed with PICC lines filtering his blood for four hours.  My job was to make sure he stayed in bed and didn't pull on the lines or anything.  Each time he was mildly sedated with Ativan, but never really fell asleep.  Because of the Ativan dose, he was admitted each time rather than simply going to an out patient clinic like most kidney patients.  That meant admit and discharge papers had to be signed and completed every other day for this family.  It was an all day process.

I watched the boy on 3-4 occasions during his hemodialysis treatments and got to know the family pretty well.  Mom had 4 kids: the patient, an older daughter in college and 10 year old twins.  I got to know the boy a little better too, which helped when trying to distract him during his treatments.  He understood simple commands like "throw this away" and "wipe your mouth" and liked to pick things up.  We would literally spend an hour with me putting five straws on the table and he'd put them in a cup, then I'd take them out and we'd do it all over again.  He liked to go on walks down the hall and wander around his room when not hooked up to the dialysis machine.  One overnight shift I couldn't get him in bed and then I had a light bulb go off.  I tossed a couple of his straws in the bed and voila he went to the bed to pick them up.  Worked like a charm.

So many people ask if it's sad to see all these sick kids every day and to be honest, I feel the parents and families feel the effects of a child's illness more than the child themselves.  One of the days the mom asked if they could change one of the dialysis dates because she had an event to attend for her daughter who had been neglected during this whole process.  Doctors tried to be as flexible as possible, but there was no way they could skip.  Mom just needed to figure out how to be in two places at once.  Another time, everything was done and mom was just waiting for discharge papers.  Why they were taking so long was beyond me, but after two hours of waiting she just left.  I tried to stall her and see what the deal was, but bottom line she needed to pick the twins up from school.  To be honest I kinda agreed with her decision.  They are in the hospital every other day, there is no reason why there should be any delay in the discharge process.  To top it off, while I was trying to stall her in the hall and sign all the papers she could, I didn't realize the resident was sitting right there in the office.  Only after they left did she come out and ask where they went and why.

With kidney transplants, they usually
don't remove the failing kidney.
They just add the new one. 

Another patient I had was during clinical at U of C.  He was a 16 year old boy who appeared much younger than stated age.  Decreased renal functioning and the anti-rejection medications can drastically stunt growth and development.  He had a kidney transplant from a living donor, his third grade teacher, a few years back.  When I took care of him he had just had his second transplant, this time kidney and liver from a nonliving donor.  He was readmitted because his electrolyte levels weren't being controlled by PO meds.  A couple weeks later he was still there with suspected rejection from the recent transplant.  He took his illness in stride and had enough pills to take each day to fill up a fun size bag of M&M's.  There are 4,600 children on the donor transplant list in Illinois with 2/3 waiting for a kidney.  The average length to wait is 4-6 years.  Children get priority on non-living donors under a certain age.  Don't remember the number, it's either mid-twenties or early thirties.

My clinical instructor was a PA who works very closely with transplant patients.  When we had orientation at U of C, she mentioned a lot about international patients coming in for transplants.  I inquired about how international patients work into the national transplant donation list and was a bit stunned at what I found out.  The government of some countries that do not do transplants will pay for families to come to America for the procedure.  When the family comes over for the work up, they just hop onto the donor list wherever they fall.  The sicker you are the higher up on the list you go.  That means someone can fly over from any country and hop ahead of hundreds of kids who have been waiting on the list if sick enough.  Don't know if I necessarily agree with this system, but money talks in a capitalist society and if the country is going to flip the bill, why can't the kid get on the list.  It is also a huge commitment on the families part as well.  As long as the family is on the list they need to stay in the US.  Sometimes families are split for years waiting for an organ and there is no guarantee that they'll even get one before time runs out.

Moral of this post... register to be a organ donor if not already.  It's as simple as a clicking here and registering with your state.  It's not just donating an organ, it's donating a life.