I love you, a bushel and a peck!

A shout out to my beautiful and talented roommate, Jessica:

Congratulations on winning the Mrs. T. M. (Kathryn) Hodge Scholarship and for being an honor medal recipient! Nursing school wouldn't be the same without you.

You are going to be the most beautiful bride and I cannot wait to stand beside you on your wedding day. June 23rd cannot get here soon enough!

The Valley of Vision

Since it's been about a year since my last post, I figure I'm long overdue for a new one! There's so much that has happened this past year, and as I look back to my first day of clinicals last October I can see how much I've grown as a nurse-in-training.


Walking into that first patient's room was such a terrifying experience. I had a simple task: give this elderly woman (who was very resistant to this) a bed bath. A bath sounds so simple (and there really isn't much to it), but my inexperienced hands were probably trembling as I filled the basin with warm water. The thought of giving a complete stranger a bath was very intimidating and awkward to me. Do I try to start a conversation with her or do I wait for her to start talking? If she does want to talk to me what do I say to her? What do I have in common with this sick, elderly woman who is very resistant to having me in her room? Does she resent me? I distinctly remember pleading silently, "Please, please, leave the TV on so there will at least be some background noise!" I can only laugh now looking back at all these thoughts running through my head.


Needless to say, she and I both survived the experience! It's quite humorous to me to look back on what I was most concerned about on my first day and compare that to what concerns me now. Now I'm more concerned about things like blowing a vein while trying to start an IV, pushing an IV drug like Lasix too quickly (it can cause permanent hearing loss if administered too quickly), knowing the actions, indications, contraindications, and side effects of every drug I give, catching all the abnormal physical assessment findings on my patients, and dropping a gallbladder on the OR floor, just to name a few. (Yes, that last thought actually ran through my mind! I got to spend a day in the OR and the surgeon handed me a gallbladder straight from the patient after a cholecystectomy. Right before he handed it off, visions of me tripping on my own clumsy feet and a gallbladder flying through the air flashed through my mind.)


I have seen human nature at its best and worst. I have also seen human suffering and joy at the two extremes. Nothing could have prepared me for the emotional turmoil of walking into a room and seeing a man with aggressive, end-stage pancreatic cancer in so much pain that the only way to relieve it was to give him so much Dilaudid (an opioid narcotic) that he was completely out of it. Before we gave him the medication, he reached out to me, moaning, and grasped my hand; his suffering was almost palpable through that touch and it broke my heart to see a person in so much pain, wasted away from illness. My first instinct was to run from the room in tears, but I stayed there, holding his hand, until I felt him relax as the drug started coursing through his veins, taking effect. Although it wasn't much, holding his hand was the only way I knew to share the love of Christ with him and let him know that through his suffering he was not alone. He did not live much longer after that day. That night was the first (and definitely not the last) I spent in tears over nursing school.


However, as surely as there are bad days in nursing, there are good days as well! I cannot think of a more joyful moment than watching new life come into this world and from that seeing a mother's unconditional love as she meets her new son or daughter. I will never forget seeing that first delivery. I will also never forget cradling the head of a premature baby girl born at 24 weeks gestation, being in awe of having intimate knowledge of just how perfect, wonderful, and human unborn babies are. I've always been pro-life and have felt that life begins at conception, but there's nothing like seeing a one-and-a-half pound baby that should still be in the womb to confirm those feelings.


Nursing continues to fascinate me. I can't think of a more unique profession that is so full of opportunities, diversity, and dichotomy. I have yet to encounter another experience that is both rewarding and trying, joyful and heartbreaking, fun and frustrating, rejuvenating and wearying. I have developed a new love for people that I didn't have before, but I have also developed an intolerance toward lifestyle choices that unfortunately do not seem too terrible until it culminates into a disease process or condition like cancer or a heart attack. I have discovered that one of my greatest passions related to nursing is patient education, and I love health promotion and the teaching that goes along with it. 


As I was writing this very unorganized and scatterbrained post, one of my favorite Puritan prayers, "The Valley of Vision," kept weaving through my thoughts. These beautiful words are so applicable to my life right now. My favorite line -- "Thou hast brought me to the valley of vision, where I live in the depths but see Thee in the heights..." -- helps get me through those tough and trying days when I feel as though I am hemmed in by mountains of pain, suffering, and death around me. Knowing that there is more after this life for these patients -- an unfathomable lifetime of joy and peace surrounded by the love of our Heavenly Father -- pushes me forward and gives me a sustenance that comes not from my own strength but from the Lord.


It is my hope that this humble prayer blesses you today as it has blessed me.


The Valley of Vision


Lord, high and holy, meek and lowly,
Thou has brought me to the valley of vision,
    where I live in the depths but see thee in the heights;

   hemmed in by mountains of sin I behold

   thy glory.

Let me learn by paradox

   that the way down is the way up,

   that to be low is to be high,

   that the broken heart is the healed heart,

   that the contrite spirit is the rejoicing spirit,

   that the repenting soul is the victorious soul,

   that to have nothing is to possess all,

   that to bear the cross is to wear the crown,

   that to give is to receive,

   that the valley is the place of vision.

Lord, in the daytime stars can be seen from deepest wells,

   and the deeper the wells the brighter

   thy stars shine;

Let me find thy light in my darkness,

   Thy life in my death,

   that every good work or thought found in me

   thy joy in my sorrow,

   thy grace in my sin,

   thy riches in my poverty

   thy glory in my valley.

What I've Learned

Out of my four semesters in college so far, I've definitely learned the most from this one. I can perform a full head-to-toe physical assessment in 30 minutes or less, take vitals, calculate a medication dosage, and tell you more than you would ever want to know about AIDS, heart attacks, diabetes, the immune response, the dangers of a sedentary lifestyle, and over a hundred other disease processes.

So here are some of the things I've learned after one semester of nursing school:
1. Hypoxia will rule the world! Pretty much every disease process results in an oxygen deficiency.
2. Kidneys are extremely important. So take care of the one (or hopefully two) that you've got! Kidneys filter approximately 200 liters of blood per day, plus they control blood volume and blood pressure.
3. You can't memorize everything. It's impossible. There's just too much information out there. It's extremely important to understand concepts.
4. Think critically. As one professor told me: "Nursing is 95% common sense."
5. Take control of your heart health. Heart disease has several unmodifiable risk factors (age, gender, family history), but the factors I can control are diet and exercise.
6. Read the textbook. It actually helps boost your test grade.
7. Don't use medical jargon in front of a patient. He or she is probably already scared or apprehensive, and hearing a bunch of words that don't make sense doesn't help the patient feel in control. I learned this lesson personally: I was so frazzled during our first lab simulation that I wasn't thinking from the patient's perspective and I informed him I was about to auscultate for a carotid bruit. I proceeded to do so without thinking about what I'd done, and I didn't realize my mistake until my instructor gently pointed it out after the simulation was over.
8. As a nursing student, never say, "That's not my job!" I haven't experienced this personally yet, but I've been forewarned. Always follow instructions in the clincal setting, even if it means you have to "go fishing."
And that brings me to...
9. "Going fishing" does not mean a fun day at the lake. I'll let you try to decide for yourself what that could mean...
10. Good nursing care includes patient-centered care! It is the nurse who is the patient's advocate.

Even though I've learned so much, there's still so much that I don't know yet... but I'm so excited for next fall. Clinicals, here I come!

Worries and Cares

I can’t believe I’m typing this right now, but I’ve broken down and done something I’ve always said I’d never do:

I’ve created a blog.

I told myself that if I passed my validation today, I’d create a blog about nursing school. I’m not actually narcissistic enough to think that tons of people are deeply interested in my day-to-day life, and I’m not expecting many, if any, to actually read this (Hey, Phebe!). I just can't believe that two years of college are almost gone, and that's slightly terrifying. What's even worse is that I feel like I've already forgotten a lot about it! So this is more for me – a way to gather my thoughts, reflect, and look back on “the best time of my life” (So they say).

Today marks a milestone in my career as a student nurse. I, along with 50-something other classmates, had my first validation: we had to take vital signs. I can’t even think of a way to cohesively explain validations. It’s kind of like a hands-on test (you don’t get a number grade on it – it’s graded on a pass/fail scale) where you have to perform tasks you’ve learned relating to nursing. Later in the semester we’ll have a hand-washing validation (I know, it sounds pretty basic; however, it’s extremely important!!! Hand-washing is one of the most effective ways to prevent the spread of infection in a clinical setting) and a head-to-toe physical assessment validation (which will be part of our final). You have to pass each validation in order successfully pass the class; however, you can still fail the class even if you pass every validation. But if you don’t pass the validation on the first try, it’s not the end of the world – for this validation, we had three chances to pass. Nevertheless, today was a rather stressful since it was our very first one!

I think I felt stressed because I just didn’t know what to expect. Last night I felt kind of jittery and couldn’t get my mind off validations, so I decided to watch a couple of episodes of M*A*S*H. It was the right choice. :) This morning, Jessica (my roommate and validations partner) and I were really nervous! I could tell she was nervous because when I took her pulse she was tachycardic (her heart rate was over 100 beats per minute) and I’m pretty sure I would have been, as well, if I hadn’t taken my atenolol (which is a beta-blocker; it slows down the heart rate) the night before. 

However, there was no need for us to be concerned! We paid attention in class, went to a practice lab last week, and practiced on each other all week; I feel that we were adequately prepared. I think because it was just our first validation, especially over something extremely fundamental to nursing, we psyched ourselves out. The faculty member who validated us was one of our instructors, and she is such a sweet lady! As soon as she gave us a warm smile as we entered the room, she made us (I’m pretty sure I can speak for Jessica as well) feel at ease and I had a certain peace about it. Jessica went first; she accurately took my temperature, pulse, respiratory rate, and blood pressure. After she passed, I felt more confident about the situation. I took her vital signs, and after I finished taking her blood pressure (which can sometimes be a little tricky to hear, depending on the stethoscope you use), I felt so relieved when I saw the instructor check “Pass” on the validations sheet! 

After today, things are finally starting to feel more real. I actually feel like a nursing student now – not just a little kid playing dress-up with a stethoscope hanging around my neck. Facing the future head on, I’m a little scared, a little nervous, but mostly excited. There’s so much to learn – so much knowledge out there – and I just want to dive right in and soak it all up!


“Give all your worries and cares to God, for he cares about you.”
-1 Peter 5:7