Spring Redux

The interesting thing about journeying to the Frozen Northlands (currently not frozen, at least during the day) is that spring resets itself. You go from irritatingly summer-like conditions in April, and suddenly find that you've jumped backward about three weeks as judged by plants. Its rather fun, since you get to see some of the prettiest foliage TWICE.

On the nursing front, filling out applications, more applications, still MORE applications, including to a freestanding Dialysis clinic, the Big Spiffy Academic Hospital (ee!) the Smaller Local Hospital, and, of course, the Public Health Service. That's the one I REALLY want to come through. The best POSSIBLE outcome would be to go with them for the summer. I just called the recruiter, to ask if they need anything else from me, and am waiting for her to call me back. Fingers, toes, and all other appendages crossed!

In the meantime, I will be helping serve at the festivities marking Commencement at the Law School where my mother works. Good food, and they pay. Could be worse!

Also, recertifying my EMT on May 30! Then I'll be able to get some decent trauma!

Wrap Up: 2008-2009 School Year

Well! It's actually that time already! I'm spending the entire day packing all my things that I might conceivably need for the next three months or so, returning books/DVDs to the library, emptying out the freezer (taking the food to the volunteer EMTS, who WILL eat just about anything) returning the school-sponsored laptop to tech support, hopefully hitting the gym one last time, putting everything in the civic.
Tomorrow morning throw the sheets into the laundry bag, make the bed, close all the windows, unplug EVERYTHING, get IN the civic, and head North. North, where the leaves are just beginning to THINK of coming out, where the grass may or may not be green yet. You know, like early May is SUPPOSED to be...if you live in the Frozen Northlands.

On the way home I'm making one more attempt to have lunch with one of my oldest and best friends on earth. He helped me through a nasty depression, through high school, and he himself survived 4 deployments to Parts Classified. For the last couple of years EVERY ONE of our plans has fallen through due to circumstances beyond our control. Still trying to break the trend, this time with a picnic.

Then, because the universe is funny like that, I get to meet up with the Former-Fiance, to hand off a textbook that he's buying from me. Its funny to think of him getting his EMT license, since he used to put his hands over his ears and hum to himself when I described trauma. Who knows, maybe (if fate is feeling especially nasty) I'll be working with him a lot in the future. I'll deal the way I always have- crack a few jokes, and pull faces when he's not looking. Its Terribly Mature.

Armed Forces Physical on friday for the public health service. Cross your fingers and hope they take me!!!! If they do, i'm strongly considering accepting a commission after graduation.

Finals

One more test, one more paper to go. Needless to say, i'm SWAMPED with work. Also managing to fit in some time at the gym. I'm really stepping it up! Hopefully by summer in the Frozen Northlands, I'll actually be in good enough shape to wear a bathing suit in public.

2 grades in so far, both A. I'll take it!

In Which I Do NOT Have Swine Flu

Ok people. I know you've heard on the news about the Impending Piggy Doom that hovers over us, the "Swine Flu Possible Pandemic". But really, there is something very important that needs to be said:

OH MY GOD, STOP PANICKING!!!!

It's the flu. For the GREAT majority of people, even if you DO get it, you'll feel under the weather for a few days. Maybe a fever, chills, cough, muscle aches. You've had it before. Seriously, you have. This time it just has a scary name. Unless you like pigs. Mostly you can avoid getting it by WASHING YOUR HANDS, and not letting people cough in your face. Really. Not only am I NOT worried about this, but I'm actually planning on calling the Public Health Department first thing tomorrow to ask if they can put me on the front lines with the Epidemic Intelligence Service for the summer. That's how not worried I am, and I'm an asthmatic. Yes, one of the people who qualifies for "special circumstances that would warrent prophylaxis". Which I'm not going to take. EVEN if you get the nasty form, which is cytokine storm, where your immune system overheats a bit and makes your organs shut down, we can treat that before it gets you killed in the vast majority of cases.

In other words: YOU WILL BE OK. STOP WORRYING!!!

In Which I am almost Half Done

I can hardly believe I've been a nursing student for almost a full year. Looking back I feel so DIFFERENT. Even though I had four years of EMT experience before heading to nursing school, it still feels like I started out as a civilian, and have started to think as a Nurse sometime during this semester. I look at people on the street, and I've started to see CHF, fluid overload, cor pulmonale, various genetic defects. I look at the man next to me on the train, and my first thought isn't "oh I wonder where he works" but "oh I wonder if he knows he needs a little Lasix!"

It's so much nursing condensed into such a short period of time that I wonder how I've suddenly become an impending medical professional. Next week I'll be HALF DONE. Hopefully I'll be sub-letting the apartment for the summer, and either serving as an Ensign in the Public Health Corps, or teching at some hospital Up North.

Tomorrow: THE CATH LAB!

In Which The Universe Evens Out

The last two days almost made up for Monday's wretchedness. On Tuesday I recieved news that I, so far, am at the top of my class, and my research professor wants me to go to grad school ASAP. I was flattered, but will be much calmer once I pass all my finals. And get a summer job. Still no word on that.
Wednesday was even BETTER: I went to Interventional Radiology, where they let me put in my very first IV on a real person. And it went PERFECTLY- no bruising, slid right in, LOVELY. It was fun. I think i'd like to do it again. One of the patients was a lovely spry 80 year old, in for placement of a chemo port, for her SECOND type of cancer. She was able to hop right up onto the stretcher in a way that I seldom see my 55 year old patients manage. She pulled me over, and whispered "I'm only doing this for my son. He's too scared of cancer to let me die like a normal old lady". I was saddened for her, but the twinkle in her eyes gave me hope- I feel fairly confident that she's got a fighting chance to see 90. I just hope it isn't too painful for her.

Once I got home, I found out that my pathophysiology professor had nominated me for an award as the one student of the semester who displayed "aptitude and love for the subject". I regressed to a mental age of 6, and did a little happy-dance around my apartment. At least the universe is evened out a bit...

Tomorrow is the Relative Invasion- my mother and two aunts are coming to stay with me. In a studio apartment. I have no idea how we will fit.

In Which I Am Reduced to Tears

They say that every nursing student encounters something that makes them question their motivation to be a nurse. Mine came today.
At first he seemed like any other patient- a little younger than some, in his mid-50s, with no acute cardiac problems, or anything critical. A few days ago he suffered a dizzy spell and collapsed on the toilet, after seeing blood in it. So he went to the ER at Spiffy Teaching Hospital. They, being reasonable people, decided that while they were transfusing him, they should probably see WHERE the blood was coming from. So they CT scanned him and found...Cancer. LOTS of cancer. Somewhere upward of 15 distinct metastases, on at least 4 organs, including BOTH lungs, the liver, one kidney, and a mass in the bowels. Some of the metastases were bigger than a fist.

So, because he had a prior cardiac history of some sort (HTN, high cholesterol, cocaine abuse) they sent him up to telemetry. Then a Gastroenterologist got involved. You see, he decided that it was important that this patient be given a colonoscopy. After all, the medical team wanted to see what KIND of cancer was in the bowel (even though, by his own admission, the patient was almost certainly inoperable, and with all the metasteses there would be no way of ridding him of ALL the tumors without a minor miracle). So they ordered a gallon of Go-Lytely.

And that is where I came in, at 7 in the morning. He didn't want to be assessed, only "left ALONE". The nurse overheard this, and my quick check of his bodily systems (lungs, bowels, neuovascular, vitals) and told me to "just come back around 10 to finish up with him after giving his meds". So I gave the meds, left the Go-Lytely in reach, and went to go keep an eye on my OTHER patient, a 90-something, delightfully confused gentleman who kept trying to sneak off the floor, because his dead wife was telling him to come home. After all, Cancer Patient was fully self-care, not even on fall precautions.

So, around 10, I came back into the room. After all, I'm a student, and I have to get my assessing done. The Worst Smell In The World greeted me. I gloved up, and lifted the blankets to find a SEA of feces, from his chest to his knees. "What HAPPENED????" I was devastated- had I left the call-bell out of reach? Was he conscious?

Oh yes. He was fully A+O. He "just hadn't WANTED to get out of bed. It had "Seemed pointless, since I'd be sitting there for so long". Why no call bell? "Didn't feel like it" Why keep telling me NOT to come in? "Didn't want people around". So, frantic, I ran and fetched the nurse to help me clean him up. It was NOT a one-person job. So we double-gloved, gowned, and masked, and went in to clean him. I was apprehensive (ok, terrified) but determined to prove I could handle this. After all, I want to work in Emergency medicine. And then the smell, coupled with the patients flat refusal to help us in any way (including refusing to turn to his side) hit me, and the sound of it, and the sight, and I started gagging as I tried to contain it all. Fortunately I made it out of the room, to an unoccupied one across the hall, where I was violently ill, and promptly started to cry.

But I couldn't leave the poor nurse alone in there with all that...so I wiped my eyes, rinsed my mouth out at the sink, regloved, and went back in. Where it took the next half hour to get all the feces up, and off the patient, and sanitize everything afterwards.

I felt like a failure- after all, nursing school taught us that we MUST simply "get over it" and do the job at hand, that "maybe you aren't cut out for nursing if this bothers you", and that "you can NEVER show disgust, because the patient will feel worse", and "this is just part of the job". All of it implying that we have to somehow be super-nurse from the very first day of clinical.

And that, after removing gloves, masks, and gowns, and washing our hands up to the SHOULDERS, is when the nurse hugged me. "THAT," she said, "is as bad as it can get in my opinion...and you came back in. You'll do fine".

I still want to be a nurse...but maybe not on a GI floor.

Update: The patient was sent up to the GI floor, and did eventually get his colonoscopy. I have no idea what they found.