I'll never be a nurse now!

I had an experience today that made me wonder if I will ever make it through nursing school. We had an opportunity to see/do a dressing change on a patient with a PEG tube (percutaneous endoscopic gastrostomy aka a feeding tube). The patient is not responsive, so this was the perfect opportunity for us. Well...all of us except me. I had to leave the room because I almost passed out. How embarrassing. I don't know what happened because there was no blood or anything, just a hole with a tube in it. Hopefully repeated exposure to such situations will cause this phenomenon to subside. Otherwise, I might have to consider a career change.

Self diagnosis

Today in class our professor walked in and told us to take out a sheet of paper (a statement which usually causes extreme panic). She told us to write out a nursing diagnosis for ourselves this morning. Nursing diagnoses are designed to address human responses to disease processes. There is a standardized list of diagnoses and they follow a specific format. There is the diagnosis, the etiology, and the signs and symptoms. Here's what I came up with

"Ineffective coping related to being in class on Friday when there is fresh snow to be skied in, as manifested by increased blood pressure, extreme agitation, and a lack of interest in the present class."

I volunteered to read my diagnosis out loud in class. Luckily our professor is one of those people that not only understands, but also appreciates sarcasm.

Let the clinicals begin!

On Tuesday we had our first clinical day at the Anchorage Pioneer's Home. Luckily, it wasn't nearly as scary as I thought it would be. In class our professor made it sound like they were just going to turn us loose on our elders (that's what they call the residents of the Pioneer Home) for seven hours. Good thing that wasn't really the case! Our clinical instructor (whose name is also Martha) gave us a tour of the facility and then introduced each of us to our elder. We ended up spending most of the day going through their charts to get some information for the paperwork that we have to fill out. We will be doing a complete "mini" assessment of our elder (assessing the major functional areas of their life: activity/exercise, mental status, nutrition, health maintenance, cognition, self-perception, role/relationship, values/beliefs, as well as their medications) and creating an individualized care plan for them.

The facility was very nice and most of the elders seemed to enjoy living there. My elder said that they do a good job of providing a variety of activities and that the staff is all great. The one thing that I found somewhat amusing was the area for those who tend to wander off (I believe it is the acute Alzheimer's unit). There is a set of locked double doors and the side facing the unit is wall papered to look like a brick wall, which keeps them from trying to leave. I just find it amazing that it works!

Dummies

So this week in our skills lab we learned about changing dressings on wounds and catheterization. Here's the problem with putting in a catheter on a dummy...dummies are not exactly anatomically correct. The male and female anatomy on a dummy is somewhat out of proportion (i.e. the target is MUCH larger than it would be in real life). I have a feeling when any of us get the opportunity to actually put in a catheter, we will all be slightly surprised at how much more difficult it is in real life (at least I realize the hole it goes in really isn't a 1/2 inch in diameter, right?).

Nurse...or mom?

After class yesterday I was thinking about all that I have learned in the last week or so. I have acquired all kinds of useful skills such as hand washing, feeding others, moving people in bed, bathing people in bed, providing assistance with various aspects of personal hygiene (hair care, mouth care, etc.) and changing linens while someone is in the bed. Am I going to school to learn how to be a nurse, or a mom? I'll have to get back to you on that one...

Also I learned that I'm not going to the Mary Conrad Center next week, I'll be going to the Anchorage Pioneers Home (http://www.hss.state.ak.us/dalp/anchorage/default.htm) instead.

What a week!

Last semester, students from the semester ahead of us warned us that we would feel overwhelmed and confused at the beginning our next semester, but by the third week it would all make sense. Even after being warned about it, I was still thoroughly overwhelmed and confused. Having one class with four parts that all relate to each other makes for a lot of confusion. Not to mention the fact that in every part of that one class they talk about "in clinical you will be doing this" and "in clinical you will be doing that"...well, clinical starts in a week and there is no way I'm going to know all that before I go! On top of the feeling that I have no idea what I am doing, I also have no idea what I am supposed to read or turn in when or who I am supposed to turn things in to. Why? The calendar is broken down by week and assignments that are due are listed on the week, but with no specific date, who you turn things in to depends on which part of the class it is for and what day it is due and readings vary depending on where you look. Confusing! I hope the "more seasoned" students were right and it will all make sense in a few weeks.

Despite feeling lost and overwhelmed, I do feel like I actually accomplished something. Here's what I learned this week:

• When taking a history you actually have to ask, "with what gender do you identify?"
• Having your finger poked to check your blood sugar hurts more than you think it might
• Feeding fellow students pudding is hard to do without laughing
• People actually agree to be filmed receiving enemas so students like us can learn proper technique (I'm not kidding, I saw the video)
• I'm not as good at washing my hands as I thought
  
• Talking to dummies (the inanimate kind) is also hard to do without laughing
• When inserting an NG (naso-gastric) tube into a dummy, it is not ok to stick your finger in their mouth to check whether it has reached the esophagus...you have to use a tongue depressor (something about pretending to be in a clinical setting...)
• It is also not ok to accidentally stab them with a safety pin when attaching the NG tube to their gown
  
• People do not volunteer to be filmed while having an NG tube inserted

Back to school

The last three weeks off from school were much needed. I was able to catch up with a few friends who were in town for the holidays, work a little (but not too much of course), and play outside in the much anticipated snow!

Yesterday it was back to school. My feelings are a little mixed. I am glad to have something to focus on and to be on a schedule again, but I am not excited for all the work! This semester we only have two classes, but one of them has four parts. It's going to be a challenge just to figure out where I am supposed to be each day. In addition to Pharmacology, I am taking Foundations of Nursing II: Therapeutics. Foundations consists of four parts: theory, clinical, assessment lab, and skills lab. For the first two weeks we don't have clinical because apparently we need to learn skills in the lab before we can go into a clinical setting and practice. After the first two weeks we will spend three weeks in long-term care facility. I will be going to the Mary Conrad Center, a 24-hour nursing care and rehabilitation facility (http://www.providence.org/alaska/facilities/mary_conrad/default.htm). In the long-term care facility I will have one patient for three weeks. I will do a complete health assessment of my patient and complete a set of nursing related tasks (analyze the information, identify nursing diagnoses, and write a care plan). After completing three weeks in long-term care, I will spend the remaining nine weeks of the semester in acute care at the Alaska Native Medical Center. I will complete many of the same activities in acute care as I did in long-term care, but with more patients.

Today instead of having clinical (being the first week) we had a lab. We spent seven hours watching videos about patient confidentiality, hand washing, fire safety, and moving/positioning patients. Not the most mentally stimulating day. Tomorrow I have assessment lab where we will practice the art of interviewing patients and taking histories. The most exciting part is that I get to break in my new stethoscope!

One down...four to go...

I am officially done with my first semester of nursing school! My grades were decent...depending on who you ask (two A's and two B's). And now I have three weeks to let my brain rot before I need to use it again (just kidding dad, I'm not really going to let that happen).

In addition to finals, I spent this past week collecting on a number of birthday dinners...I'm up to five, and I still have a few more to go. One of them is waiting for me in California (thanks Lisa!)...now I just have to find a way to get down there!

How did this happen?

I can't believe that today I am a quarter of a century old! What happened to the last 25 years? Surely I'm only 18 or 19...right? Unfortunately I will not be having a huge celebration today. Instead, I will be studying for my Pathophysiology final. I am pretty sure that this is birthday #5 that I will spend studying not celebrating. Thanks mom and dad for having me in the middle of finals week!

Speaking of school, I am almost done with my first semester. Tomorrow will be my last final and then I will be free for three and a half weeks! Next semester I will be starting clinicals. The first three weeks we will spend in a long-term care facility, where we will only have one patient. Then for the rest of the semester, we will be in acute care (I'm not sure exactly where yet).

Let's see...other than that, not much is new. The weather here sucks. It is currently 33 degrees and pouring rain, so I probably won't be skiing any time soon. There has been snow in the forecast for at least 4 out of the last 5 days, but we have yet to see any of that...

Klondike Pictures

Here are some pictures from my crazy overnight

Pre race drinksOnly 4 miles left...RUN

After being awake for 24 hours and running 11 miles...that is a look of relief!

Post Race

Halfway done (with one semester)!

I have officially passed the halfway mark for this semester! I feel like I've learned very little for having been in school for eight weeks, but I think that is mostly due to the fact that I have nothing to apply it to yet. Next semester I will be in the hospital for one day a week actually applying my knowledge. I'm sure I will lose track of how much time has passed and this will all be over before I know it...but for now, halfway through one semester is a big deal!

No news is good news...right?

Well, I wish I had something exciting to report, but I don't. School has been keeping me fairly busy, but not with anything worth mentioning.

The weather also leaves something to be desired. It's chilly, but there isn't any snow. It snowed one night (less than 1/2 an inch), but then it warmed up and poured rain all last weekend. There's nothing like 33 degrees and rainy to motivate you to do nothing and stay in bed all day.

Call me Student Nurse Rosenstein

Today in school, I learned my first "real" nursing skill. We learned how to prime IVs AND we got to take our IV bag and tubing home to play with (apparently this is a huge responsibility as these are prescription only items). Priming an IV is the process of attaching the tubing and getting all the air bubbles out of the tube so that it can be hooked up to a patient.


This is me after priming my very first IV (now, you realize that I can't actually do anything with it yet...I can just get it ready for someone else to do something with).And here is my IV, ready for administration...maybe

After we learned about priming, we learned how to manually set rates on IVs. Definitely not an exact science. You open the stopcock (the light blue piece has a little rolly thing that opens or closes the tubing) a little and you count the drips from the bottom of the bag into the fluid chamber (the tan thing to the left of the light blue thing) for one minute. 31 drips/min is not an easy thing to accomplish. There is a lot of trial and error involved. I think the electronic IV pump might become my new best friend!

My first test

Today I had a test. It was the first test I've taken in approximately 5 years, and the first test in my nursing school program. Good news...I passed. I got a B, which my dad was not very excited about (he thinks I should get nothing but A's), but for the amount of effort I put it, I would say that is acceptable. C's still get degrees, right?

What? Snow?

There was snow on the mountains yesterday...and that can only mean one thing, winter. Don't get me wrong, I'm ready for winter. I'm just not THAT ready for winter.

Update...again?

It seems like I do more updating that keeping people up to date here...here's what I've been doing for the past few weeks:
Lost Lake Run 8.25.07 (www.lostlakerun.org)
The Lost Lake run is a 16 mile run from Kenai Lake (near Seward, AK) to the Seward Fire Station. It is an amazing trail! You gain about 2200 feet in less than 6 miles and the view from the top is gorgeous. So, after running uphill for 6 miles, you get a little break, then you run uphill for about 1.5 more miles, then you run downhill for 7 more miles. All I have to say about that is OUCH! My time was 3:24:54, which is great considering I was going for four hours! I was sore for about 3 days after...more sore than I have ever been in my entire life!

Me running somewhere around mile 9...don't I look like I'm having a blast?Nursing School 9.4.07
On Sept. 4 I started nursing school. After waiting for almost two years to start...it finally happened. Fairly anticlimactically if you ask me. There are about 40 people in my class, and so far I am not overly annoyed by any of them (that's a HUGE thing for me)! I am taking four classes: Nursing Informatics & Technology (don't ask me what that means because I don't know, it's the class where they put everything that they don't want to make a whole class for), Fundamentals of Nursing, Pathophysiology, and Biomedical Ethics. None of these are very exciting. In fact, the other day I was sitting in class thinking "is this really what I want to do?" and "why am I here?" at which point I almost decided to quit. But, as I am almost 25 and have not yet "done" anything with my life, I figured dropping out after five days really was not the best choice. Besides, when I told my dad I had thought about quitting, he told me he would kill me if I did. If that's not enough motivation to stay in school, I don't know what is! I have discovered that being out of school for two years and then going back is a lot harder than I thought it would be. I am very out of practice doing basic school-related things such as reading and taking notes and studying. I'm sure I'll remember those skills very quickly...I have a test next week and I'm hoping I remember how to study before then!

I would like to take a moment to thank my elementary school education for giving me a skill that one of my professors deemed "essential for being a nurse." Thank you Chugach Optional for making me a full-time learner!

Yukon Road Relay 9.7.07 (sportyukon.com)
Last week I did something crazy (even crazier than running 16 miles for fun). I piled into an RV with 9 people I don't know very well and drove to Skagway, AK to run a 113 mile relay race to Whitehorse (in case you didn't know, that's in Canada). Now, all the things that make up this trip sound like they would be painful and not fun at all (riding in an RV for almost 4 days straight, running a race that goes overnight, camping in the freezing cold, etc.). However, this was possibly one of the best experiences of my life! One of the guys that I work with at my summer job asked me if I wanted to run on their team...they needed a 10th person. The first time he asked, my response was "no way! That sounds terrible." Then after thinking about it for a week or so...I decided that I really had no good reason not to do it. When would I ever have this opportunity again? At the very least, it would make a good story. So I went. We left Thursday morning...drove to Destruction Bay in the Yukon, camped in the freezing cold, got up at 7am, drove to Whitehorse, had lunch, and drove to Skagway. I think we arrived in Skagway around 2pm on Friday. Our first runner started running at 7:30pm Yukon time (now that's a tough concept when you've crossed into and out of a time zone in less than 24 hours...and you are supposed to adhere to a different time zone than the one you are in). I ran leg 9, so I wasn't running until sometime the next morning. Now, that is another aspect that makes this race difficult, not only do you have to run overnight, but after your first runner, you don' t really know when you are going to be running. You can guess...but that's about it. Due to nerves and anticipation, I was unable to sleep all night! I ran at about 9am on Saturday morning (after being up for 24 hours...running is hard!). 11.1 miles late (1hr 53 mins) I was done...and exhausted...and sore. As soon as our leg 10 runner finished, we crammed ourselves back into the trusty RV and headed back towards home. We camped again on Saturday night...I'm not sure where, about 150 miles from the Canada-Alaska border I think. And headed for home Sunday morning.

That was the most unexpected fun that I have had in a long time. I was the newcomer to the team, yet they treated me like I had been around forever, which is a great feeling. Hopefully I made the cut for the team next year!!

Yet another update

So apparently I'm not very good at keeping this updated. I guess I'm just too busy and important for menial things like blogging.

I'm now working at a new job. Yes, that's right, I am no longer a professional tourist wrangler (that also means less amusing stories about old people on vacation). Now I'm working at North Star Hospital (an acute care psychiatric hospital for kids 3-17) as the Administrative Assistant to the Nursing Department. Right up my alley. Currently my job involves me following around the Director of Nursing and doing whatever she tells me to do. She's awesome though, so it's not as bad as it sounds. Soon I will be doing her bidding in the mornings and then answering phones on the Children and Pre-teen units in the evening.

In non-work related business, I just returned to the great frigid state of Alaska from a fantastic vacation. I went to Portland, OR to visit a friend from college and then we drove down to Santa Barbara, CA for my dad and Paula's non-Alaska Wedding Bash. We left Portland at about 12:30pm on Oct 24, stopped in Eugene, OR to have coffee with a friend and then continued on south for another 8 hours. That got us to Sacramento where we thought we would spend the night. We decided we would drive past downtown to try and find a hotel in the interest of possibly saving money. That was a bad assumption. Apparently every hotel in Sacramento is just North of downtown. So we drove South for another 45 minutes until we arrived in Lodi, CA. We stayed the night listening to the trucks parked at the truck stop next door idle their engines and honk their horns with a little bit of ambient highway noise in the background. The next day we were on the road before 9am. We ate lunch at In-n-Out burger in Gilroy and then met my dad and Paula in San Luis Obispo for coffee before we all headed to Santa Barbara. We then spent four absolutly fantastic days in Santa Barbara shopping, going to the beach and working on our tans, hanging out with my family, partying it up, and eating too much. We both enjoyed Santa Barbara so much that we stayed until the last possible minute. Thus, we got up at 4:30 am on Monday Oct. 30 and drove for 16 hours straight to get back to Portland in time for Margaret to go to work at 9am on Tuesday morning and for me to fly home on Tuesday night.



The sight of our future beach shack












The result of this vacation is that Margaret and I are going to move to California and live in a shack on the beach.

That's the update.

The flood of 2006

August 19, 2006 was almost the end of the world...ok, not the end of the world, but Alaska almost disappeared underwater. Either that or it was time to start building an ark and collecting animals. I knew it was going to be quite a day when I walked upstairs that morning and heard my boss on the phone saying "well, what kind of whale was it?" Yeah, the ship hit a whale and it was STUCK to the front of the boat.

I was spending my usual Saturday at the airport getting crabby old people on buses to Seward, while the state was flooding. I thought I had it bad when 50 people were going to show up at 5:00pm (we have to send the last bus to Seward by then or they will miss the ship). My boss informed me we would be holding the bus for them as well as the ship. One disaster after another led to the last bus leaving at 6:50pm. When I got back to the office, I realized that was the least of our problems. The road from Talkeetna to Denali was closed because Troublesome Creek flooded and washed out the bridge (go figure that Troublesome Creek would be the "troubled" area). We had guests from Alyeska to Talkeetna that were going to need places to stay and new tour patterns. 40 hours in three days and we got everyone where they needed to go. We ended up sending 4 tours worth of people on the Richardson Highway to Fairbanks, turning a six hour drive into 14+ hours of driving. We put 112 people on a train that only holds 65, and we made 380 turkey sandwiches to send with people on their excessively long coach ride. Not to mention the fact that on Sunday night the phones went out in Talkeetna and we had no way of telling the drivers and tour directors what odd route they would be taking the next day. Luckily one of our employees was at her mom's cabin out in that direction and had cell service, so she called the office and then drove to Talkeetna to relay our messages. It was an interesting few days...but we all came out of it alive, and a little wet.

TV Material

So I've decided that our office should be the subject of a new TV show, it will be called "As the Ship Turns." If "Airline" is a relatively successful TV show, then why not have a show about the cruise ship industry? Who wouldn't find things like guests yelling and screaming about having to wait 30 minutes for a $74 bus ride to Seward which is three hours away (a taxi costs upwards of $300)? What about sending a one-armed man from Tennessee, who has only been west of the Mississippi once in his life (and he was pushing 70), on a charter flight to Seward, only to have the plane turn around due to bad weather and a mechanical failure. Or how about when you go to talk to your boss at the end of the day and his office phone rings, he answers, then his cell phone rings and he tosses it to you to answer, he gets off the phone, your cell phone rings, you toss it to him to answer, you get off the phone, his office line rings again, you answer it, and so on. Really, it would be funny in a tv show...I promise.

How I spent my Saturday

I spent this Saturday as I have spent every Saturday since May 27, and will spend every Saturday until Sept. 9, at the Airport, working. On Saturdays we turn our ship, which means a mass influx of people through the airport. Both people coming off the ship and going to the ship (which leaves from Seward) come through the airport.
Here is what happened:

*I got yelled at by a man and his wife who booked their cruise through AAA and their flight home had somehow gotten cancelled. However, when guests don't book directly through the company there is nothing we can do for them regarding their air travel. So I told them this, gave them a phone number, and smiled. It wasn't very effective.

*We recieved a bag from the ship that had been urinated on. We did not know this until the guests picked the bag up around 1pm and brought it to our attention. The guests were very good natured about this and were content when we provided them a replacement bag and a phone number for Customer Service. It is suspected that an intoxicated ship employee committed this act when the bags were collected on Friday night on the ship.

*I had a couple of guests who arrived too late for a bus transfer (they arrived at 5:45pm and the last bus transfer is at 4:30pm because it's a 3 hour drive to Seward and guests need to be onboard the ship no later than 8:00pm). We got them a charter flight to Seward. While I was waiting with the one-armed man and his wife from Tennesee I learned that this was only the second time the man had ever been West of the Mississippi. So we put them on a small plane to Seward where their friends were waiting, only to have a mechanical issue with the plane and have the plane have to return to Anchorage. The couple will miss 1.5 days of their curise as they can't meet up with the ship until Monday when it docks in Skagway.

*We had six bags found at the Hospitality Center at 6:00pm that were supposed to have already gone to the ship as the guests we onboard waiting for them. We put these bags on the charter flight with the late guests...the bags are now sitting in our office waiting to go to Skagway on Monday.

Overall it was a productive 15 hour day. That's how I spent my Saturday and how I will spent the next 8 Saturdays.