#10 Technology

When I first thought about what I might blog in regards to technology in nursing I was, in a way, a bit overwhelmed! I could think of so many ways technology is vital to nursing today. I thought about electronic charting at clinicals, which makes so much information available at the click of a mouse. I thought about the BiPoc scanners for med administration and how they can reduce med errors and be an extra safeguard for our patients, even if the bipocs are annoying sometimes. We have monitors that tell heart rate, rhythem, etc, machienes that take blood pressure, and pumps that can deliver IV fluids at precise rates. We really cannot separate nursing from technology and much of the technology we have available is a tremendous help in providing the best patient care possible. However, I think it is important that we don't loose our fundamental nursing skills and attitudes that the profession was built on. We cannot allow ourselves to loose our competency or compassion in the face of all the "new-fangled" bells and whistles.

Later, in thinking about how this blog has affected my nursing journey this semester, I wasn't sure how to respond. I liked keeping a blog accessible to the entire cohort much more than a private journal on discovery because I think that it's a platform for us to share our experiences with each other and learn together through those experiences. However, a blog is not something I'd be likely to keep up if it wasn't a class assignment. I have enjoyed writing blogs for class, but outside of assignments I prefer sitting down with a friend and a cup of coffee to talk about our experiences. I think maybe I'm a little old fashioned that way.

#8 Thanksgiving!!!

Today being Thanksgiving, I though it appropriate to post something I am thankful for. I am thankful for a clinical group (I'm sure the other 2 groups do this as well) that starts and ends every single clinical day with prayer. The other day I was realizing how lucky we are. If we were students at UW or another school, I'm sure we would begin and end with our own prayers said silently in our heads, but how cool is it that corporately our group pulls together each morning and afternoon, thanks God for the oppertunities He's given us, asks for His hand to be on us through the day, and recognizes Him working in our daily interactions with our patients. This is something I'm very thankful for!

#7 Advocate!

Now that we're well into acute care rotation I thought maybe I should make a post.
So far I feel like acute care is far more exhausting than long term care. However, I feel more sure of my role as a student nurse in acute care than I did in LTC and I'm learning lots!

Today I was taking care of a lady with small bowel obstruction and post-op paralytic ileus. She felt nauseated much of the day and the nurse gave her IV antiemetics several times. However, around 11 the patient asked for help to the commode. I gave her privacy and when I came back to check on her she just said in a sad and frustrated voice "I smell." There was a very foul odor coming from the commode, and it turned out that she had been able to pass a very loose bowel movement. I have encountered many GI bleeds in my job as a patient transporter and am familiar with their distinct odor. However, this odor was different but just as strong. When I checked the stool it did appear to have blood in it but the blood was bright red indicating it was from the lower intestinal tract, or maybe even from a hemorrhoid. The blood also looked almost clotted or congealed. I told the patient's RN and she looked and agreed, but asked another nurse to take a look just to be sure. The second nurse also agreed that it looked bloody and we called the doctor. The doctor came by and took a look. She felt it did not look bloody but rather like something the patient had eaten. I thought this was odd because she was on clear liquids yesterday and full liquids today. The doc also asked a colleague, another doc, to take a look and the second doc agreed with the first. At this point it's nurses: bloody, docs: not bloody. But the doc did seemingly hesitantly decide to order a stool sample which came back positive for blood. I was glad I had followed my instinct and gotten the nurse involved because my initial assessment was confirmed by the lab test even though the doc had disagreed. This showed my the importance of following instinct (when it comes from experience like the two nurses' instincts had) and advocating for the patient above all else.

#6 Don't be surprised

I can't believe LTC rotation has already come and gone. It went FAST!
This rotation was my first experience regularly interacting with someone with dementia. It really challenged my thinking, and sometimes my patience when my resident repeated each story over and over again. But as the weeks went by I definitely got little glimpses of hear heart and her deep faith in the Lord.
Saying goodbye yesterday was also unique. I knew that she probably wouldn't remember me, and would just go on with her life as she did before I came to Cascade Vista. This didn't really bother me though, because I knew that I had made her feel special and valuable during the moments I spent with her during LTC rotation. When I found her in the dining room to say goodbye I told her I enjoyed spending time with her as her student nurse over the past weeks and gave her a card. The card that I'd bummed from Alex (who remembered to bring some cards while I forgot) had a pretty picture of some blue glass jars with seashells in them on the front. When my resident opened it she remarked sweetly, "ah, that looks like my life." I stifled a giggle, knowing that she grew up and lived the majority of her life on the plains of Nebraska, far from the beach. It was a classic example of her dementia. But, she obviously like the card and enjoyed the simple message I had written inside. After she'd read it I asked her if I could pray with her. She got so excited and said, "Oh! Please do!" I prayed for her and then she surprised me by having a totally lucid moment and praying for me! It was a short prayer, about one sentence, but she obviously understood who I was and why I was there, even if only for that moment. I suppose I shouldn't be surprised though... sometimes God works and connects people in ways we don't expect.

#5 Perspectives

Today while I was walking down the hall at work a lady who works on one of the floors (I think she's a unit secretary) happened by and asked me about my shoes. Random conversation starter, I know. Anyway, as we were talking I mentioned that I was in nursing school. She caught me totally off guard when her response was, "Oh, I'm sorry to hear that." I still don't have any idea what she meant. I had never met her or talked with her before that I know of, and usually everyone at the hospital that knows I'm a nursing student is extremely supportive and encouraging. I'm not sure if this lady had a 'bad taste in her mouth' about nurses recently, or if she was referring to the load of homework she knew nursing school carried, or if she meant something else all together.
In any event, her comment made me think about perspectives. Sometimes I feel like I have so many irons in the fire with all the different projects and exams on top of trying to keep up with my reading. I also have a great boyfriend of almost 3 years who is very understanding but does take up some of my time. I spend a bare minimum of 2 hours a day in the car driving to and from school, and I'm really struggling to fit in the 4 shifts a month required to keep my job. Nursing school and all it's demands are really, really hard. But I think I have a choice. I can dwell on the feeling of being stretched too thin and woe-is-me because school is hard, or I can ask God for strength and enjoy how far He's brought me already. If I shift my perspective and consider my goal of becoming a nurse, I will also be able to enjoy the blessing of the journey rather than just struggle to get to the end. Nothing worthwhile comes easy and I can honestly say I am happy exactly where I'm at, sleep deprivation, homework stress, and all!

#4 Clinical Reflection

I can't believe 3 weeks of clinicals is already over and we have just 2 more days in LTC. It has flown by! Taking care of my resident has been such an interesting exprerience for me. My resident has a significant ammount of cognative impairment due to dementia. This really puts a different spin on our interactions. I'd never spent much time with anyone with dementia before now, and at first I didn't realize how little she remembers. The first couple days she seemed depressed and kept saying "I don't know what's wrong with me. What's wrong with me?" She was so frustrated that her mind didn't work the way she wanted. As I had more interactions with her I began to try some new things. For example, I began to introduce myself each time I entered her room. I'd tell her my name and that I'm the student nurse working with her that day. I probably introduce myself 10 times a day at least. Just a simple thing like introducing myself each time I enter her room really helps the rest of my interactions with her. If Introduce myself to her each time as if it is the first time I have met her it puts her at ease and she doesn't feel like she should know who I am so she doesn't get frustrated with herself. It makes her smile and seems like she feels like someone really cares about her and what is important to her when I do something simple like tell her my name. It has brought me a lot of joy as I have interacted with her because many days she is pleasant and grateful for the time that I spend with her. This is extra gratifying because her husband has been deceased for many years and she has no children. Her only family is a sister who is also in her eighties. I'm glad to know that my interactions with her leave her feeling loved and special.

#3 Tonight I'm thankful for those before me

It's 10:20 pm and tomorrow I have to get up for clinicals at 4:30am. I really should be sleeping but here I find myself, still checking off my to do list. I would have been in bed by now, or at least I'd like to hope so, but tonight God had other plans.
I've been really stressing about my Christian Nurse interview. A couple weeks ago I'd asked a lady I work with if I could interview her about how she integrates her Christian faith into her nursing practice. I felt like I was taking her time and inconveniencing her, but she assured me she was honored by my request. Still, as I prepared tonight to call her for our scheduled phone interview I couldn't help but feel butterflies. I couldn't shake feeling bad over taking up her evening off work and was worried (for no good reason, mind you) that it would be awkward. So I found myself asking "Lord, give me peace. Direct this interview and do with it what you want." I followed my gut (something that turned out to be a key point in my interview with Jo) to pick up my Bible and flip to Psalm 29. Immediately my eyes fell to the last verse, "The Lord will give strength to His people; The Lord will bless His people with peace." So, grasping on to the promise of God's blessing of peace, I dialed the phone expecting a half hour Q & A. Instead, for the next hour and 45 minutes Jo shared with me her heart for people and for the profession of nursing. She encouraged me in traits she has seen in me at work and gave me advice for my own career and, she told me stories that made me cry. I hung up the phone feeling like I had gotten a glimpse of the heart of God.
I'm not meaning this post to be redundant since I will be writing about this in my paper anyway, but I do mean to remind myself and the rest of us of God's faithfulness in providing answers to prayer. I asked for peace, and He provided scripture. I asked Him do direct my conversation with Jo and boy did He ever! I thought I was going to ask a few questions and get a few short answers, but instead He provided me with an opportunity to learn from someone I deeply respect who has a heart of gold. How cool is that!