Swans in Trashbags

Well, I've survived my first semester of nursing school. :) Well, I still have 2 cumulative finals and a proctor test over the next 2 days, but after going through the last 4 months this just seems like a hiccup. I have learned the most extraordinary amount of information, which I guess is a good thing since as of this moment I am 1/4 of a nurse. I am 12 months away from holding fragile sickly lives in my hands. Terrifying! But we're all terrified so I'm in good company. We learn a lot, but its taught in a totally different way. Instead of rote memorization, they teach us concepts. So acing a test really isn't about memorizing lots of trivia long enough to regurgitate it for the exam, but really understanding how things work and why you need to do what you do. Which is good, because my brain refuses to retain what it deems as useless knowledge. Every question on the exam starts with, You have a 48 year old female patient with.... then gives you a scenario and they ask any number of things. So if you really know how the body works you can generally reason your way through to the right answer. That being said, its still an unholy amount of stuff you just have to know, and I've never been so happy with 3 A's and a B before in my life. I will never understand how I got an A in the class who's teacher's name has become my class's unofficial swear word, but I'll take it!

I started the downhill slide to Christmas break by having my final evaluations with my clinical instructor at the VA. Let me just mention that she is one of the BEST teachers we could have asked for. She is unfailingly patient, kind, and protective of us. We follow her from floor to floor like she's our mama hen and we are her chicks, only she lovingly refers to us as her "swans." Quite a stretch for anyone who has seen us in in what we nostalgically refer to as our "button down trashbags" (white nursing uniforms...nobody, let me repeat NOBODY looks good in these things!). In my evaluation she said she wishes she would have taken a video of us huddled around the nurse's station our first day looking terrified and green around the gills. I will admit, she kept telling us it gets better but none of us actually believed her. Just as we got comfortable with the staff, the floor, and the basic concept of manhandling old men, the semester is over and they kick us out. She did say something to me, though, that absolutely made my day/week/month/semester. She said that I have one of her top 3 all-time favorite bedside manners. That she loves the way I deal with patients and how I come across as friendly, genuine, and confident and that it makes the patients feel safe. This meant so much to me, especially since I actively dreaded every Wednesday clinical at the VA for the first 7 weeks or so, thats how far outside my comfort zone I was. Then I had this really great 83 year old guy, a stroke patient who could barely walk and only had use of one arm. For some reason I just turned a corner with him, and saw that even though most of what I had to do horrified me, he really needed my help and it felt REALLY good to help him. As he sat on the toilet in nothing but his birthday suit I washed his back for him and put lotion on and he told me how great that felt. Something so simple. Granted, at that point I was blissfully unaware that in a minute's time he would provide me with what has come to be my classmate's favorite story for me to retell over and over, complete with hand motions. They encourage us to have the patients do as much for themselves as possible because its good exercise and keeps them moving their joints. So when he was done on the toilet I handed him a warm washcloth and instructed him to go ahead and clean his "bits" while he was standing there. He was hardly stable, so I held him securely by one elbow while he did so. As you can imagine, his face was only about 12 inches from mine and he proceeded to vigorously wash himself for 3 minutes straight... looking me straight in the eye for the duration. *here you must picture me doing an impersonation of him, beady-eyed, breathing heavily, whole body shaking from the exertion* It didn't get weird until about the 1 minute mark, then I was like, uhhhhhhhhhh..... is this OK?! Just then my instructor, Nicole, popped her head in the door and said, "Kayte, you doing ok in here?" I said a perky "Yep!" with only a slight note of hysteria in my voice. After working with these old guys all semester you see that very few nice feeling things happen to them and I'm much more understanding of an extended tryst with a warm washcloth.

My next fun patient was, I kid you not, the cutest old man any of us had ever seen. Even my instructor said so! He was 85 with Alzheimer's, but just the most pleasantly demented person you ever could meet. When we got to the floor and were waiting to get our nurse assignments, a nurse standing next to an old man strapped into a walker-slash-chair contraption said, "This one belong to any of you?" Sure enough, there's my patient, placed in front of the nurse's station so they can keep an eye on him. She said, "Good luck with that!" when I claimed him. A moment later one of my classmates tapped me on the shoulder and informed me he was trying to escape. I looked over and he was working at his seat belt with his breakfast fork. Yup, it was gonna be that kind of day. Within minutes he was out of his belt, had figured out how to open the walker's gate, and was headed down the hall. It took 3 of us to get him headed to his own room, but he was laughing and giggling the entire time so that makes up for part of it. I ended up dragging a computer station into his room so I could do my charting at his bedside because he was a 90 lb. version of Ayden when he was 1, constantly on the go. At one point I was unable to persuade him to stay in his own room and we ended up in another patient's room, where my patient proceeded to climb in this poor guy's vacated bed. The whole time I'm pleading with him and trying to convince him this is not his bed, he's looking at me with what my father would have perfectly described as a "shit-eating grin" on his face, and told me, "Now THIS one is comfy!" as he gently bounced his bottom on the mattress. I actually had to go get my instructor and tell her my patient was in somebody else's bed and I can't get him out (I may never live this down). When I got him back to his room I handed him a newspaper and put his reading glasses on his face in hopes it would keep him entertained for a minute, which lasted all of about 5. After that I asked his roommate if we could use his playing cards and proceeded to play poker with my patient, who kept hinting that he knew how to play strip poker then would collapse in a fit of giggles and snorts. After about 30 minutes of this, his roommate's wife came in and I overheard her complaining that she couldn't find her husband's reading glasses anywhere. Panicking, I took the glasses off my senile patient's face and sneakily slipped them onto the bedside table behind me, only to hear her 10 seconds later turn toward me and say, "Oh, here they are!" OMG. I had my patient wearing another man's glasses while he didn't even own any glasses himself.

Here is a picture of my clinical group and instructor on our very first day at the VA, trying not to look as terrified as we felt. Nicole, my instructor, is the pretty blonde on the left.

Musings From A Necromaniac

Well, I'm home sick from class today which affords me a rare moment to do something unrelated to class, homework, sleeping, eating, or panicking. I'm pretty much taking 7 classes, with absolutely mind-boggling amounts of homework and reading due for each one. I was feeling pretty cocky after getting a 100% on my first test, 98.5% on my second, then yesterday BAM! My first 81% test score of my entire life. I shake my fist at Health Assessment and Ms. Spain's arbitrary choosing of random and obscure test questions. On the bright side, I came home sick, disgruntled, and disgusted with myself and decided to take a nap. When I awoke, 7 of my nursing school friends had been writing me nonstop on Facebook telling me to wake up and look at my test grade because "the grades are rising like the flood waters downtown Charleston!" Her tests might be ridiculous but her grading technique is out of this world, seeing as how I ended up with a final grade of 89%. I'm not happy with it but I can live with myself.

So far I have to say I LOVE MUSC. It might very well be the death of me, but if I can make it 15 more months I'll be golden. I have already made some really great friends and Facebook has absolutely changed my life as far as providing a support network where we can vent and commiserate. I was just totally unprepared for how much work it would be... I don't even recognize this girl who studies and does homework literally ever spare moment of every day. Dustin and I occassionally catch each others eyes over the computer screen and think to ourselves, "Don't I know you?" I don't even read any more (gasp!!). Instead I read my textbooks before bed each night then dream of gaping black pressure ulcers sporting exposed vertebrae. Or palpating somebodys thyroid gland (horror!!).

The craziest part of all this school nonsense is that my lab group of 10 students learns a new skill on Fridays then does it to real people the next Wednesday at the hospital. There they break us down into groups of 5 per clinical instructor, who is literally at our beck and call every minute. Which is good, as it affords us bumbling idiots less opportunity to kill somebody. :) Last Wednesday she asked me if I wanted to learn how to flush and remove and IV, even though we haven't learned how to do that in class yet. She's all about exposing us to anything that comes along, even if it means asking the one student whos phobic about IV's and veins to do it. It actually turned out to be really easy and pretty awesome, too. I felt very nursey. This week we are learning how to give injections since my class will be giving all the flu shots to MUSC employees here in a couple of weeks. Our instructor keeps trying to ease our nerves by saying, "They even know you guys are students and are STILL letting you do it!" Not sure that helps, though.

As far as interesting things I've done so far, I'd say the bed-bath takes the cake. I have conquered the all-feared cleaning of a strange old man's penis and I doubt I will ever be the same. It really was not so bad, though, and by the end I actually felt like I had done a good thing leaving an invalid, delerious, unresponsive old man fresh as a daisy with clean sheets and Wheel of Fortune screaming at him from the corner. Last week I learned wound dressing, so God only knows what I'll get myself into this week at clinicals at the VA. I keep thinking that Jacqui would so appreciate the art of packing sterile wet gauze into all the nooks and crannies under somebody's shin bone with a 10" sterile Q-tip. Speaking of which, it has been eye-opening to immerse myself in fellow students who LOVE the gross/disturbing things in life. I'm so used to living with Dustin who unintentionally makes me feel like a living breathing necromaniac because I like this stuff. Now I'm in a class with 59 other people who when the instructor shows a picture of a 250 lb. man that flesh-eating bacteria has devoured most of his torso and thighs, leaving his exposed "bits" wrapped in gauze, there is a collective sigh of "Cooooooooooooooool!" I feel like I've come home. ;)

Orientation

Well, I've survived my first two days of orientation which I guess is something. Adjusting to early mornings has probably been the toughest thing so far. Yesterday Ayden and I got up at the crack of 6:20, which is no small feat for us. Then this morning at about 5 a.m. I woke up with a raging allergy attack and a cold kitty literally draping himself across my face so I'd steaming up his belly with my breath. I was so out of it that I was tossing and turning, fretting in my half-conscioius state about a Swine Flu Authorization Form on Google documents that I needed to download and fill out and take with me to my VA orientation today. As if this isn't irritating enough, the stupid form does not even exist, so at this point my frazzled brain is actually creating imaginary paperwork for me. Considering the VA is a Federal agency, you can imagine the volume of REAL paperwork I've already had to wade through. So anyway, as I lay drowning in my own snot and now with cat hair papier-mached to my face and stressed about a phantom VA form, I finally just got out of bed. At 5:15 a.m. Help me Lord. On the plus side, I was up in time to take a shower and wash my hair (gasp!) and I had no less than 3 people tell me today that I have beautiful hair. :)

So far I've been photographed, badged, fingerprinted, stood in line for 40 minutes at 7 a.m. this morning for a coveted library locker assignment, ridden the MUSC shuttle bus all over downtown Charleston, and have been educated on all statistics regarding MRSA and suicide (did you know the majority of suicides are men over the age of 40? Men have no sticking power). But more importantly, I have been inspired. I had no idea I'd be this excited about what I'm going to be learning over the next 16 months! My teachers are going to be out of this world, which is something I'd been a bit concerned about after reading all the nursing school horror stories online. Yesterday one of the first things our instructor told us is that at MUSC they do not "eat their own young" like other schools, but that they hand picked us to be in their program and they are determined that we all graduate with honors. They have a 98% pass rate, while the national average is somewhere closer to 70%. And MUSC students have an average grade on their board exams in the high 90's, while the national average is an 80%. Which means that most of the nurses taking care of you in the hospital barely passed their state exams. Hmmm.

I got the impression that the instructors will actually be an asset to us, not something we have to survive. *whew* Speaking of which, I had to go to Trident today to request my final transcript and I literally had a full body shiver walking those halls. It seems so... dirty and sad after spending just two days at MUSC, with its library full of flashy new iMac computers and student fitness center complete with olympic pool. I looked around and felt so sorry for those poor bastards still plugging away at their pre-requisites like I have been for the past 8 years. I've gotten my first itty bitty taste of being in school for something I actually find interesting, and its positively intoxicating. And to think that tomorrow we get to find blood in fecal matter!!!!!

This Is Really About To Happen!

I start MUSC on Monday... ahhhhh! This week I've been trying to master dosage calculations (anybody ever even HEARD of dimensional anaylysis mathematics? Me either). Apparently MUSC cannot be bothered to teach it to us, so they said to know it before we start and we'll have a test on it in Week 3, which if we don't pass we can't continue the program. No pressure or anything. I'm pretty good at math, but this stuff is... greek. I've been alternately frustrated and panicked for going on 8 days now. But after parking my behind in Barnes & Noble for 5 hours while Ayden was in school yesterday and reading their dosage books cover to cover, I'm beginning to get a handle on it. I honestly almost wept with joy when I took a practice test online today and found myself getting about 80% of them right. And all I can think is, if this stuff is too easy for them to teach us, WHAT AM I GETTING MYSELF INTO? Then I get an email from MUSC today saying they are holding a lottery for the coveted study spots at the library, but you have to commit to use it 20+ hours/week, with at least 2 hours between 8pm-midnight four days a week. Who are these people??? Robots?

I've discovered a new passion: buying oober decadent school supplies with other people's money (birthday money is awesome). I never knew the joy of buying a ridiculously overpriced $12 leather bound notebook with pretty pink flower watermarks on every page... or the seriously sweet $10 dragon embroidered pencil pouch... or a $15 box of that best pens known to mankind that I keep sneaking into work with me just for the joy of writing with them. I'm thinking that these little creature comforts might help to make up for the fact that I will be forced to be one of the tattoo-less, jewelry-less un-special nursing student sheep for the next 16 months.

Beating the Odds

While volunteering at St. Francis Hospital in preparation for applying to MUSC, I bumped into some Trident Tech nursing students. I wound up going to lunch with them and when they found out I was getting volunteer hours to apply for nursing school, they were all very interested. My original plan was to attend nursing school at Trident Technical college where I had taken all my prerequisite classes, but by the time I finished all my classes they had a 2 year waiting list for their Associates degree nursing program and I was informed that all my math and science classes would expire before I could start. Which would mean I'd have to take them AGAIN. I was visibly horrified, so the nursing adviser took a look at my file and said that with my grades I should go to MUSC that had no waiting list and gave a Bachelors of Science in nursing, but that instead of going to nursing school for free on my federal pell grant which was the plan, it'd cost me about $25k tuition. Having never needed student loans, I was reluctant to go into debt but that was still a better option than re-taking classes that took me 8 years to accomplish the first time, in addition to waiting another 2 years to even get started with a single nursing class. Which is why I then spent the next 3 weeks in a mad dash to get my application in order, as discussed in my previous post.

Anyway, as I ate lunch with these Trident nursing students I was very excited to be seeing first-hand what hospital clinicals would be like. One girl asked me where I was planning to go to school and when I told her I was applying to MUSC, they literally all snickered. Then she said, "Well, you might want to have a back-up plan because NOBODY gets into MUSC. I was on the Dean's List at Clemson and my boyfriend's mom works in the MUSC admissions department and told me not to even bother applying because I wouldn't get in. So you might want to also plan on going to Trident." Not wanting to go into detail about my (of course) supreme qualifications and all the reasons I'm an inherently more qualified applicant than this high-faluting student nurse to begin with, I just didn't say anything at all. And went home much more worried about my prospects than when I started my shift.

Today I received my letter of acceptance to MUSC and would like nothing more than to waltz in and waive it under that girl's nose. Because I'm apparently petty like that. When I called the admissions office the woman told me that they received 366 applications for 60 openings, which means that only 16% of us got in. I'm really glad I didn't know my odds before or I would have been a nervous wreck. I start nursing school August 17th. I'm thrilled, scared s***less, and overwhelmed at the prospect of juggling 32 hours a week of school, plus a reported 15-20 hours of study time each week, a husband and a kindergartener all at once. Thank goodness the program is only 16 months, so I'll be graduating with a Bachelors Degree next Christmas (2010). The plan is to get my Masters in Midwifery.

Yes, I've gone completely to the dark side and covered my upper back in tattoo ink, dyed my hair an unnatural shade of red, and even got my lip pierced. Blame city livin'! Or finally being old enough to do the things I've always wanted to do and a boss who will let me. (I'm currently working part time as a bookkeeper/assistant to a woman who arranged continuing education for teachers.)

Toot, Toot!

I worked on my prerequisites for nursing school for (drum roll)..... EIGHT years. I am the only person who managed to draw out an two-year Associate's degree comparable to med school, but the fact that I did not get serious about school until after having a baby could have something to do with it. I juggled school and being a stay-at-home-mom, plugging away at my classes part time, doing homework and online tests during nap times and running off to night classes when Dustin got home from work. I'd meet him at the door with my backpack on, take the keys to our only car from him, and dash off to class where I'd often be till 11 o'clock at night. Looking back on that time I honestly do not know how we did it. But eventually the day came when I was ready to apply to nursing school and the nightmare that embodied that experience. True to form, I would find out about the Medical University of South Carolina's nursing program less than a month before the application deadline. In addition to the application fee that we could not afford, I needed volunteer experience, letters of reference, to take the ACT standardized test, and an essay to make them fall in love with me. I was able to take the ACT test the following day on a stand-by basis, which pretty much meant I had to pay for it and show up at 6 a.m. and wait while a hundred or so teenagers filed in and if there was a spot left they would allow me to take a test I should have taken 15 years ago when high school material was still fresh in my mind. Thankfully, I was able to squeeze in and did surprisingly well with a 28 which put me in the preferred category of applicants to MUSC. I volunteered at a local hospital, managing to wrack up 40 hours in under 3 weeks which was just enough to get my volunteer certificate of completion the day before my application deadline. The stress of all this combined with having to write a stellar essay surely took years off my life.

The question we had to answer was, "If accepted to nursing school, what unique perspectives or talents do you bring to the profession of nursing?" Keep in mind, this essay is all about making them believe that you are something special, and is one of the few opportunities one is encouraged to toot their own horn. This is what I said:

Everybody has a story. Some people's are predictable and lucky to be born knowing what their calling in life is, but for others, it takes navigating life's twists and turns to flush out such an important truth. The only early truth about me is that I love people, as evidenced by my kindergarten teacher's comment on my first report card that "Kayte is an excellent student but has great difficulty not turning around in her seat to chat with her peers." I am also nothing if not eclectic in nature, with so many passions and interests that the thought of settling down to just one never felt right to me. Nursing called to me quietly, in a subtle way, with circumstances coming into my life to show me glimpses of myself that I never knew existed.

When I was 17, my father was given one year to live by his doctors, and it was uncertain which would kill him first, prostate cancer or heart failure. We said our goodbyes many times over the next six years as he bounced in and out of the hospital. Eventually my family grew comfortable with death, seeing it not as a tragedy to be lamented, but a natural part of life. I saw how a person can die with dignity and peace, and realized that all the rest of us can do is help the ending to their story be a good one.

As a massage therapist I have enjoyed working with people in pain and having the satisfaction of seeing them improve under my hands over time, but one of the greatest gifts I was given came when I was hired to give a gentle massage to a hospitalized woman in the end stages of brain cancer. I enjoyed that massage more than any other I have ever given, watching her revel in the pleasurable sensations I was able to bring to her life of mostly pain and confusion. She died a week later, but I knew then that if I could find a way to truly help people through painful circumstances, I would be living the life I am destined for.

Over the years my greatest enjoyment has been acting as a labor coach for women in labor, freely giving my time all hours of the day and night for the honor of helping women naturally face and conquer what has always proven to be one of the greatest stories they will ever tell. At first I thought I was in it for the babies, but have discovered that the mother's experience through pregnancy and childbirth fascinates me much more. I long to someday play a part in helping women become more educated about and empowered by the birthing process.

Looking back on my life, I can see now that all the choices I have made have not been random after all, but have pointed toward my eventually becoming a nurse. I do not see nursing as a smart career move, but as a calling in life that I cannot afford to ignore. I think the greatest thing I can offer as a nurse is seeing everybody as an individual and being conscious of the role I play in their life, to see their story as it unfolds before me and ensure that it is told with dignity and compassion. I have the life experience of dealing with people in medical crisis, not to mention the passion, drive, grades and intelligence that your nursing program requires. All I am lacking is the knowledge and superior training MUSC can provide me, granting me the opportunity to realize my dream of one day being a great nurse.

Second Semester

Well, school started again 4 weeks ago and I am constantly amazed at how different this semester is from my first. One thing that remains eerily the same is that I should be studying for my Psych test tomorrow and instead I'm goofing around on the internet, but that's neither here nor there. Last semester was a non-stop frenzy as they tried to turn us "lay people" into some semblance of a healthcare professional, and this semester is quite a bit more relaxed and now we're learning how to talk to the crazies and do research papers. Its surreal. I do have two hard courses, though, my med-surgical class and my Pharmacology class *full body shiver.* I'm doing my clinicals at MUSC for my med-surg and I guess this semester we don't do bed baths or vital signs because there are paid nurse-techs for that (yay!). Thats mostly what we did last semester and only a few of us got to do anything impressive like bandage changing or injections. On my friend Elizabeth's first day of clinical this semester she got to insert two foley catheters and suction a tracheostomy. Whoa! I guess the catheters went smoothly but her instructor told her after her first one on a man she needs to "grab it like she means it." Haha! Caitlyn got to change an ostomy bag (bag that catches poop as it seeps out of an artificial bowel opening in the abdomen). The man's wife was there as she did it and told Caitlyn that her favorite thing is when it shoots poop in your face as you're changing the bag. When she later asked her instructor Nicole (same one we had last semester), Nicole said what has since become my class's unofficial motto, "Sure, you can shart through and ostomy."
By sheer chance I am in my 4th week and have yet to have a med-surg clinical (first one is tomorrow at the crack of 6:45) and now I'm a bit terrified. Who knows what trouble I'll get myself into. Our new skill so far is IV insertion which I've always been horribly phobic about it, but when we practiced it on the rubber arm with veins and blood I was the only one in my class who did it correctly. Maybe there's something to be said for facing your worst fears and plunging blindly ahead in a silent panic!
My favorite class so far is Psych, and we do our clinicals for that class at the Institute of Psychiatry and work one-on-one with the inpatient crazies. FYI- if you ever bump into a person wearing paper clothes who you suspect could have possibly just escaped from the IOP, walk briskly in the opposite direction without making eye contact. Trust me on this one.
I was able to get into a Woman's Special Interest group, and we get to do about half of our clinicals working with women around Charleston at such places as the Florence Crittendon House (pregnant teenage runaways), Charleston Center (working with pregnant women with alcohol and drug addiction), Magdalene House (recently incarcerated women), and My Sister's House (women's shelter).
Yesterday we attended a seminar presented by People Against Rape and it was my absolute favorite day of nursing school thus far. They have a huge volunteer network of women who man the crisis hotline after hours and even meet women at the emergency room who are there to have rape kits done. We heard from the woman who runs the support groups, and one of our clinical assignments is to attend the monday night Adult Survivors of Childhood Sexual Abuse support group and act as her co-facilitator. This is one of the coolest things I've ever been involved in and I think I'm going to go through their 25 hour training on February 19th to become one of their volunteers. I can't believe this has been in Charleston for the last 20+ years and I didn't know about it!
We also heard from a Forensic Nurse Examiner who is the one who performs rape kits in the ER. I didn't even know this job existed, and it was fascinating to hear about what she does. Apparently women used to be made to wait in the waiting room for hours only to have whatever medical intern who happened to be rotating through the ER do the rape examination while a male detective stood in the room, which as you can imagine sufficed to totally re-traumatize victims. A nurse in 1973 identified this problem and single-handedly changed the way these situations are handled and now there are Forensic Nurses who are legally trained to collect evidence that will stand up in a court of law and who even testify as expert witnesses for the prosecution. She said that its important you be a confident and professional person since survey after survey shows nurse's to be the #1 most trusted profession (second only to fire fighters for 2 years after 9/11) and their testimonies in court account for a 98% conviction rate. How awesome is that?! This is something I could be trained to do in a few months after I graduate in December. Who knows?
Speaking of which, I graduate in 10 short months. Ahhh! I've decided to go straight on through and pursue either my Master's or Doctorate degree in midwifery. Its currently phasing from a Master's to a Doctorate in Nurse Practitioner degree, so things are very fuzzy about it right now. I do know that it will be another 2-3 years of education, but its mostly online so I will be able to work as an RN as I do it, thank goodness. I had originally though that I'd work a few years, pay off my substantial student loans, then go back and finish my education. But I've realized that I'm 28 (again) and do not want to wait till I'm 40 to be doing what I want to do. I want to work hard now and have as long a career in midwifery as possible so that I have time to accomplish all the things I want to do. Its a long list. :)