Ice Road Trucker

It seems my third degree is gonna take a little longer than I had hoped (bummer).  It would figure that of the three final exams I have scheduled this week they would be at the beginning of the week when all snow, had broken loose!  I prayed they wouldn't be canceled since KSU's contingency plan was to reschedule them for the week of Christmas -- What kind of present is that??!! 

I left for my first final around 9:00 am and drove at most 30 mph, since the "snow governor" on my truck wouldn't go any faster. Oh and did I tell you the doors were all frozen shut and my dad  had to jimmy the door open with a crow bar.  It wasn't too bad, except when I would try to get going from a dead stop, then the back end would just fish tail left and right with only a little forward momentum, until I gassed it a bit.  Kent was a disaster.  The snow was coming down so hard it looked like white rain and two of the main roads onto campus were closed.  I detoured over to the northeast end of campus only to find a car in the ditch and myself going down a hilll in the middle of a traffic jam.  Impatient, young and not so bright college students were pulling into a nearby parking lot to turn around.  I left space in front of my truck so they could pull back out, but cars started going around me thinking they were just gonna cut in front of me and wait in traffic.  I was completely irritated and ready to get out of my truck and hit the a-holes in the face with a snowball or take my truck and tap their back ends into the ditch, but people are idiots and even worse in bad weather, so I just honked hoping they would realize they had cut me off and blocked people from being able to pull out.  Thankfully, they all got the picture and pulled into the parking lot themselves so cars could get out.  It took me about 15 minutes to go 1 stupid mile, but I made it for my first final -- Whew!! 

My final went off without a hitch and as I was leaving I got an email stating all classes were canceled for the remainder of the day.  I hurried to my truck thinking..."I gotta get the hell out of here!!"  I took the main roads home (i.e. 261N and 43N), but when I got into Streetsboro I could see a line of cars slowly going up a hill.  Great, my truck doesn't do slow uphills in the snow.  I slowed as much as I could at the base of the hill before trying to rush up it, but no dice.  My truck was succumbing to the snowy kryptonite.  As I slowed, my back end started sliding toward the ditch and no matter what I did it just kept going the wrong way.  Arrrrggghhh!!!!  This was the most frustrating drive in all the years I have had my truck. Usually, I can handle my truck in the snow, but I was losing ground -- literally.  I hit the brakes and stopped trying to fight the slide for a second when this crazy broad in a van decided while I was trying to avoid and accident and getting stuck she would go around me.  Enter full on slaught of Road Rage:  I yelled "WTF are you doing, you dumb broad?"  She of course couldn't hear me, but she did smile and wave as she passed.  All I could do was mutter the words "complete idiot" under my breathe. 

I pulled my foot off the brake and hammered the gas.  It went straight, but I was diagonal and went toward oncoming traffic. I managed to get the truck back in the appropriate direction after a second and minus having to pull over to clean the ice off my windshield at the next gas station, I made it home without further mishap. 

I had a final tomorrow, but thankfully KSU smartened up and canceled it, until either Thursday or Tuesday of next week.  While I am not happy my last day at Henderson Hall wont be this Wednesday, I am quite glad I wont have to drive in this snow tomorrow.  The bright side of this extended, unfinished business is I get at least one extra day to study for psych.

The Big News

Well, if you haven't guessed my beyond exciting news from my other post by now, you obviously don't care about my life in any way, but I got a job!!!!

If you read through my prior posts this fall, you will see I worked in oncology, solid tumor to be exact and I can't express enough how much I loved the work and the team of healthcare professionals I worked with, nurses, doctors, physicians assistants, case managers and PCNAs.  My preceptors had asked me what I thought of the unit while I was there and I of course told her it was really well run and such a great atmosphere.  She then asked me "would you wanna work here?"  I thought "HELL YEAH," but responded with "absolutely, this is a great place." 

I was fortunate enough to spend a shift shadowing the nurse manager (the boss) and getting to know her (she is very direct, no non-sense and super cool).  I went to a staff meeting and they covered important topics that I can't disuss here, but they also covered small things too.  I remember her asking where was the coffee machine for her staff?  Although, silly and miniscual she cared about here staff and wanted her staff's needs met big and small.  This woman was my kind of boss!!  As my practicum progressed, I had short encounters with her and she even asked for help with drip calculations on the new pumps and what I thought of her unit as a nursing student.  I told her I loved it and if a position ever opened, I would be more than excited to work for her. 

Fast forward to about three weeks ago: My semester was coming to a close and I was excited to be done with step 1: get the degree.  Step 2 & Step 3 would commence at the same time, i.e. pass boards, get licensed and find a job.  I had applied for  position in leukemia, bone marrow transplant and cardiovascular units, but got the response "thanks, but no thanks."  It appeared nobody wanted to hire an ulicensed nurse with no experience, but then I got an email from my old nurse manager that a positioin had opened up and I should post for it.  Immediately I did and I got a call for a phone interview a few days later.  I was excited and nervous.  I went through questions on the internet on how to best answers questions about your weaknesses, why you feel you are qualified and why you want to work on a unit and had nearly two pages of single spaced 11 inch font answers all ready for the the phone interview and no, I am not a worrier, or neurotic, or a perfectionist ;)

I got the call and it took all of ten minutes.  I breezed through it and felt really good about my answers.  I was told I would get a call back in about a week if they were interested.  Okay, here we go witht the waiting game.  I thanked HR and hung up, but then my phone rang not an hour later and I was shaking -- CRAP!!  They had forgotten to ask me something or I was that bad they knew immediately how much I sucked.  I answer (Gulp) "Hello." 

"Hi, E, We have your results and you did really well and we are calling to set up a two hour working interview with the nurse manager."  Oh my God, you are, I thought!!  "Oh that's awesome!" I said.  We discussed times scheduled it at 9:00 am on the following Wednesday.  I would then have to haul ass down to KSU by 1:00pm, since Psych class takes attendance -- blah!!

December 1st, I dressed in my scrubs and headed down to my old stomping ground (or to what felt like it anyway).  I got there about 15 minutes early and ended up hugging lots of nurses and saying "hi." Everybody seemed pretty glad to see me.  My preceptor was there and I got a huge hug from her, have I mentioned how great she is?  I waited until about 8:55 am to head down to KD's (the nurse manager) office.  We chatted for not even an hour about everything.  We were then supposed to commence with the shadowing but the resonse I received was "you already know the floor, the nurses and how the unit works.  I am not going to make you shadow.  You can leave or you can go visit with the nurses, or just hang out, whatever you like, just don't pass any medications."  I laughed, this was so awesome, even a little fun.  She told me she would know within a week, who she would be hiring, but HR is slow so if I didn't get a call in a week, then don't to panic.  I left her office and helped my preceptor care for a patient who was vomiting, changed some sheets, helped a guy arrange for his dinner and said my good-byes, hopefully not for the last time. 

One week later, I had received no phone call and I was devastated.  I had sent a thank you letter and worried and worried and -- nothing.  Some of my classmatesknew about the interview and would ask me everyday "did you get the call yet?" "No, they don't want me.  I am not gonna get it"  I said.  "Yes, you will!  They love you" they said.  I hadn't really told anybody for fear of cursing myself, but maybe the few who did know were enough to curse me anyway.

This Thursday, I had stayed up until about 2:00 am working on my last project and so I heard my phone at 9:30 am on Friday morning I was a little groggy, until I saw the number. It was THEM!!!  I sat up quickiy and had a huge head rush.  My heart was pounding in my chest.  I felt like I was under water.  I was losing my hearing.  Oh, Sh*t!!!!  I am gonna pass out.

Me: (heart rate is well above 100 bpm) "Hello."
Them: "Hi is E. there."
Me: (Of course, it's me!!  This is my cell, who else would it be?) "Yes, this is she."
Them: "This is so and so from the so and so."
Me: (I know who it is!!  I have been waiting for you to call all freakin' week!!) "Yes, hi, how are you?"
Them: "Oh, great.  Thank you. And yourself"
Me: (my heart is about to explode and I am ready to puke, how do you think I am feeling) "I am doing really well. Thanks."
Them: "Well, I am calling on behalf of KD, about the RN position on such and such a unit."
Me: (of course, I know what you are calling on behalf of!!) "Oh yes?!?!"
Them: "Well we would like to offer you the position (goes over shift, pay, details etc...)  "Would you like to accept?  Oh wait do you have any questions?"
Me: (Yeah, why did you wait so long to call and Hell No, go back to your question!!!!) "No, I have no questions."
Them: "Well, would you like to accept the offer or would you like time to think about it?"
Me:  (that's all I have thought about for a week and a half, how much more time do I need?!?!?!) "Um, no I don't need time to think about it.  I WOULD LOVE TO ACCEPT THE POSITION." 
Them: "Great!"  then she goes over more details and requirements for start date and hangs up.

I sat there for a good two minutes just staring at my door and smiling and then I jumped off my bed and yelled "I DID IT!!! I GOT A JOB!!!!!"  I am an idiot, but an excited one nonetheless.  I found a job in nursing before graduation and on the unit I wanted to boot.  I had heard horror stories about kids who had graduated in August still looking for jobs, but not me.  I was on top of the world, now to pass my finals and my boards.  (HELL YEAH!!!!!!!!!!!!!!!!!!!!!)

Last Days

It hasn't set in at all that today was my last clinical ever, before I become an RN, barring failing any exams (actually I could fail and still pass, unless it was an extremely low grade).  Every patinet I had in critical care with the exception of one was intubated and none had made it off the vents when I cared for them.  I had a patient a few weeks ago that respiratory therapy attempted a wean test with (usually lasts about 30 minutes), but she failed within 10 minutes.  Today, my patient for the first time in my critical care history ... PASSED!  I took that as a good sign for not only him, but for me. too.  He had been taking quite a bit of the Michael Jackson juice (Propafol/Dipravan) as I have so fondly been calling it and when I stopped the pump, called out his name and gave him a firm sternal rub he could barely open his eyes.  However, when I reported off a little before 1pm he was extubated, had a venti mask on and was turning his head to the left and right.  What a fighter!!!  Hell Yeah!!

Tomorrow, I have my very last class from 9-1p and testing from 1-3p, but you can bet your candy canes I wont be going down until noon or so.  I have one final project due by midnight tomorrow that's pretty much all wrapped up.  I look back now at all I have learned and I still feel like I don't know anything.  It's rumored it can take up to 2 years to feel  comfortable on the floor -- yikes! 

In other related news, I nominated my precpetor for an excellence award as a leader in nursing and lo' and behold I received an email stating ..... "thanks for nominating so and so.  Your nominnee passed all the necessary criteria and will be honored at a semiformal dinner celebration."  She hands-down deserved the award and so much more in my opinion.  I don't think I could ever thank my preceptor enough for all she did to guide me as a soon-to-be new nurse. 

The entire nursing school experience was much more difficult than I had ever thought it would have been.  I generally am not an overconfident person, and when it came to academics I never worried.  This program has really knocked me down a notch or ten, but it's also opened my eyes to critical thinking and application on a whole new level. 

This program has afforded me the opportunity to meet twenty-nine peopleI will never forget and miss dearly.  We have worked together, studied together, and even cried together, but all those times don't even come close to how much we have laughed together.  I know they will all be very successful in their nursing careers.

 On Wednesday, if I haven't said it before I am scheduled for my last exam.  It ends at 12:30pm and when I walk out of Henderson Hall it will be for the last time. 

I will have victoriously crossed another finish line.

Holy Hibernation Batman!

It looks like winter has hit.  I am usually not excited for the snow, but I had such a great winter of running last year with the snow falling, the slush slushing my shoes and lets not forget the cold butt cheeks that I can't be anything but excited for this year!  Except for one problem, I can't stop sleeping!!!  I have been so drowsy since last Thursday.  I still have 6 days left of school too before running season can commence. Everyday I have been getting a little bit more pumped about the nice quiet days that lay ahead for me.  The days that will only require me getting out of bed and lacing up my shoes for the next few weeks and coming home to a nice hot cup off coffee with Baileys in it...mmmmmmmmm!

I just need to stay awake long enough to wrap up two more projects and four exams!!  I did my professional issue yesterday and it got a few laughs and an A....WOOT!!  I am learning to become googledocs savier-ish.  I like powerpoint and attaching documents to emails, but KSU is so up to date on technological advances it was unavoidable and I had to submit to there "linky" ways. 

I am hoping to have some beyond exciting news here in the next few days (or some super sucking news), but I don't deal in patience.  I deal in patients :)  I have noticed I have acquired this urge to make up new words or transform them from verbs to nouns or adjectives too (weird, I know). 

Running has been about 3 times a week.  This week I have 0 in and probably wont do any, just not in the cards, nor do I want to.  It's gonna be a long road back, but no sense worrying about that now -- at least my weight isn't going up, so maybe I am not really ready to hibernate yet.

"Hey Man, Nice Shot"

Is just not an acceptable thought in my head right now as I have 11 measly days of school left until graduation!!!  The long road within the never ending tunnel of darkness has come to an end.  I can see the light. 

I finally got out for a few runs to counteract my sluggish, defeatest attitude the last few weeks.  I am moving at the speed of a true turtle, especially with the additional poundage nursing school afforded me, but it's better than sitting on my bed with my laptop for countless hours trying to do, well you know, all that stuff that has kept me from triathlon and running and stressed me the heck out for the last 15 months!!

I feel very removed from my friends and the endurance world right now.  Everyone is talking of big dreams and goals for the upcoming year.  I am starting to enjoy my runs here and there again, but the idea of racing and "training" is so much for me.  I feel like Maverick from "Top Gun" right now.  I have lost the edge.  My motivation to run is there, but to compete and all that jazz, yuck!  I just pushed myself through nursing school and realized I am ready to decompress not re-compress with a new stressors.  Hopefully, my racing motivation will return by April 18, 2011.

Over the last few weeks, I have really cut back on my studying, tried to go to bed earlier and myabe even sneak in a few extra minutes of fun.  I have slowly started to realize somethings in my life must change.  I am so excited to become a nurse and get a job, hopefully in oncology.  I still have my work cut out for me with finals in 2 weeks and the infamous NCLEX exam for licensure, before it's official but I am definitely ready for this challenge!!  I just can't see myself failing, so I say bring it!!  I worked too hard for this one and I know I can do this :)

Results are in -- It's da' bomb

I pulled out all B's on my exams.  The first line defense was SSRIs, but because they take 4-6 weeks to work benzodiazepines are given immediately.  I got it right, but personally I think that question is bull.  What am I saying, I think they are all bull.  The question about the patient having the acute myocardial infarction, should not try to pull himself up in bed.  It could make his heart explode.  He should just lay there and wait for help.  Finally, the math answer is 8.4 or rounded is 8 ml/hr.  Thankfully, I have not missed any of the math.

However, this week included another critical care exam that I nearly failed.  I have been so tired and unmotivated to do anything the past two weeks.  I came home from clinicals and finally got in a run, only to fall asleep and get in no studying for the exam.  I also received my paper grade that my instructor had said not to put too much effort into with a really terrible grade on it.  I was mad at myself for putting so little effort into it, but I was a little pissed at him to for saying not to worry about it!  What the heck does he want?  I am just so frustrated and tired of nursing school.  I am contemplating quitting every other minute.  I am burned out and after the last test, which hopefully I didn't miss any math on, I am done.  It's like the last few miles of the marathon for me.  I just want it over.  I don't care anymore.  I hate worrying that every time I have a test I will ruin my grade and fail.  December 15th can't come soon enough.

Trailin'

I barely have time to keep the last breath of life into this blog and wrtie about things I am doing and I find of interest.  That said there is just no way I am going to write a paper on the roles of the certified nurse midwife pretty much from start to finish in less than 8 hours.  I got nothing.  After, last weeks life sucking saga, I just had the wind knocked out of me.  It's like running a marathon on Sunday and then taking no time off to recover. 

Speaking of running, even with last weeks craziness, I managed to get out for 3 runs/week for the last 3 weeks.  Shocking, I know.  I have slowly been morphing into what feels like a large mass of blob.  I can literally feel my love handles, pulling on my skin as they hang off me, likethe way the last drop of maple syrup hangs on the bottle before you re-cap it.  Anyway, graduation is only 26 light-at-the-end-of-the-tunnel days away and then bring on normalcy. 

I had been part of the CRTR running group on FB for about 2 years now and never found the time or cared to check it out, but after digging myself out of the hell hole that is nursing research, I committed myself to meeting Solar Squirrel at lock 29 last night -- no backing out now. Studying had taken such a precedent and time-consuming necessity this last semester, that I started to look forward to urges to go pee, just to have a good reason to break away from it, if only for a few minutes. 

I had run the day before and hard, for me anyway and I had taken a 2.3 (per Garmin) trot around the neighbor hood earlier in the day with Bailey.  As you can see, this is how he spends the majority of the day guarding the house.

 I figured 5 easy miles on the trail with some good running people would be just what I needed to recharge for my research paper and nursing process recording.  It was completely dark, but with over 30 people, there were plenty of lights.  I was nervous about the pace, but JC, said even out of shape I wouldn't have any trouble with this group, but I found out the route was more like 8ish miles and that is almost a long run for me these days.  Solar and I started running together with Spiderman (her beau) and about 8-10 others ahead of us.  We did about 1.5 miles on the towpath and road before we started the ascent.  We had been chit-chatting and catching-up, but I could feel myself getting tired on the hill and made mention I was probably gonna have to slow.  Surprisingly, SS said "me too" (truthfully, I think she was just keeping me company).  The front of the group broke away and we couldn't see them and there was the majority behind us, so we ended up running in a group of about 8.  We never got lost for more than a 100 meters or so and I only fell once.  We ended up rolling through 8+ miles in no time and I was bummed it was over so soon, but excited to continue my fun night out at the Winking Lizard with old friends and new ones. 

I really want to try and attend this group again soon, but with another exam next Friday morning in critical care and Thanksgiving the following Thursday, it looks like I will have to wait a few weeks.

Hell Week

It's over.  I had known this week was coming for 10 weeks, but couldn't even think about it for fear I might break down crying, quit or just start screaming and pulling at my hair.  I know it seems like it's just school and school is easy right, but nursing school is unlike any other.  You can study, study, study and still NOT get it.  It is absolutely imperative you train your brain to think in a critical manner, based on the over abundant information they try to smash into your brain.  An example of a critical thinking question that I missed on my last exam was ...

The patient is having an acute myocardial infarction, which of the following would be the worst thing for him to be doing...

a. Sitting in a chair for 30 minutes
b. Getting up out of Bed
c. Eating
d. Bathing

Go ahead, post your answers (heck include your ratioionale for why if you like) and I will let ya know in my next post, or post nothing and just wait for the answer. 

Monday I had my first exam in Leadership which was fairly easy to pass.  It's not a matter of understanding the material, it's a matter of finding time to look it over.  Tuesday, I spent the morning with the crazies at Metro on the 6th floor dealing with a patient who tried to kill himself by swallowing a bottle of seroquil and a fifth of vodka because he felt he was useless and couldn't do anything right (had to laugh at the thought that he couldn't even kill himself right -- I know terrible thought, but I had it nonetheless).  Wednesday, I took my second exam in psych, which I studied the hardest for and did the worst on.  I think the class has too many instructors with different points of view and criteria and we are all just a little lost.  A prime example is a powerpoint slide in our notes looks like this...

BIOLOGICAL INTERVENTIONS FOR ANXIETY

SSRIs (Selective Serotonin Reuptake Inhibitors)
- produce anxiolytic effects by increasing the transmission of serotonin by blocking serotonin reuptake at the presynaptic cleft; take about 2-4 weeks to work
Benzodiazepines
-the most commonly used medications for panic disorder even though SSRIs are recommended for first-line treatment; they are fast acting and usually given first

THE QUESTION
Which of the following drugs is used as a first line intervention for anxiety?
a. Benzodiazepines
b. SNRIs
c. SSRIs
d. Alcohol

We find out the answer on Wednesday, and I picked SSRI's, but half the people picked Benzos because that is what is given right away and most often.  So, the real question is what the heck does "first line intervention mean?"

Thursday, I had to get to Marymount for critical care by 6:45am, so I was exhausted from only 4 hours of sleep and I had to do six medicaiton sheets on drugs and their effects and things the nurse needs to watch so she doesn't kill her patient like labs for blood, liver and kidney toxicity, urine output.  An example, lopressor is a beta-blocker, usually given to patients who have hypertension, but if at 0900 you are scheduled to give the guy his meds and his heartrate is less than 55 beats per minute and his BP is 120/80, if you give it you will probably just put the poor guy into cardiogenic shock or damn near close, so as a nurse pay attention!!  My first week my patient had coded twice, once less than 24 hours before I was assigned to her and had a transvenous pacer and a transcutaneous pacer keeping her going along with a nice little endotracheal tube and a ventilator to help her breathe with vasopressors and propafol.  The code cart was in front of my door and I can't say I wasn't scared shitless my patient was gonna punch her ticket on my shift and freak me the hell out.  Thankfully, she made it through and so did I.  This week my patient was cake compared to her.  He was even awake and could talk to me a little, so I was able to take some time to actually learn how to do central venous monitoring, using the phlebostatic axis.  The poor guy had some bad scrotal edema (BEWARE!) and kept telling me "my balls hurt!" so every 2 hours I was pushing 3 mg of morpine in  his IV and telling him to "stop touching your balls then."  He was too funny.  We managed to get out on time at 5:30 pm on the dot.  I hurried home, already exhausted and managed to force myself to listen to audio lectures and cram for my critical care exam until 2:00 am before I couldn't keep my eyes open.  I set my alarm for 6:30 am and managed to drag myself out of bed for another hour and a half of studying before heading out for the last of my three exams.  I wasn't even panicked at this point.  I was just exhasuted and knew by 10:30 am, pass or fail it would be over.  The last test I took this week consisted of 50 questions 5 med math that you must work out yourself with no choices.  There are 5 on each of the 3 exams and you can only miss 2 or you fail and you have to take the "Save My Ass Exam" immediately after the final exam which is 15 quesitons that you get 30 minutes to do.  If you fail again, you fail the class.  Two weeks ago my classmate told me how she had to take it and another girl in the traditional program sitting next to her had failed for the second time.  She just broke down crying in class, knowing she had just failed the class and would have to take it all over again because of 15 math questions.  An example question looks like this...

Your patient is in CHF (congestive heart failure) and is place on a nesiritide (Natrecor) drip.  Nesiritude 1.5 mg is mixed in 250 ml of normal saline.  A continuous infusion is ordered to run at 0.01 mcg/kg/min.  The patient weighs 185 lbs.  At what infusion rate should you set the IV pump?  Answer will be in ml/hr. 

Now, these are really just means extremes problems once you get everything into kg. or mcg. or mg. what ever you are using, but all the stress of failing builds up on you.  I never did the math to figure out how many I needed right to maintain a passing grade in a class until nursing school.  Needless to say, I passed and by 1:00 pm me and 10 of my classmates trekked to the bar to celebrate living through hell week.  I have no more exams until finals now, one big paper and about 8 small ones and then it's done.  It's really done.  I will be through the hardest academic challenge of my life.  I don't really believe graduation is only 5 weeks away, but it is.  It was way harder than any marathon I ever had to do and at times felt quite comparable to a some distorted version of hell, but my classmates and I (most of us anyway) survived it.

We did as Winston Churchill had advised..."When you are going through hell, keep going!!!"

Exit Externship :(

Well, it's over and it hasn't even been a week and I miss it already. I feel like I learned more in 120 hours of my externship than I did in all of nursing school. I am sure the truth is it just all finally started to come together for me.

I feel my preceptors were wonderful. They always provided feedback good and bad, but never in a condescending way and kept pushing me to take on more patients and nursing skills, even though at times I felt unprepared. I enjoyed the one on one experience much more with my nurse as she was there initially to guide me and help me get into good habits.

This rotation finally removed some of the doubts I had about my abilities as a competent nurse and replaced it with some confidence. I learned even if I don't know something, I have become independent enough to find the solution. My last 40 hours I was pretty much on my own, unless I needed medications out of the pixis or chemotherapy or blood were needed. My preceptor had thought I was proficient enough at pushing Zofran in an IV and I felt confident too. My last day I went to push some in a patient's IV and noticed it was D5 and not normal saline. I was quite unsure of the compatibility and did as I was instructed since day one. I was honest. I told the patient I was unsure of the compatibility and I wanted to check before I killed him. He laughed and thanked me for thinking of him. I left and checked -- they were not compatible. I was so glad I had trusted myself and admitted I didn't know! I went back stopped the pump, clamped the line flushed it with normal saline, pushed the Zofran and flushed it again with normal saline before starting the pump back up. I was so elated, I had not hurt my patient, maybe I could do this.

My second to last day had been very hectic. I got behind on my medications and my documenting, even one of my assessments wasn't done until 11:00am because the patient had been off the unit for a few hours. I tried to manage my time wisely, but every time I went to document, someone needed a medication or an IV was beeping or people wanted discharge. I didn't get frazzled, just realized I couldn't keep up. My two main priorities became getting a patient discharged and getting a sent tray for a patient that had one meal in two days due to NPO status that had been waiting for it for 4 hours! Needless to say the secretary had put in the tray for dinner and although we had ordered it at 2:30 pm and called four times it didn't arrive until I finally went upstairs to the pantry to personally pick it up. I left wondering why I had such a hard time taking care of my three patients. My only plan was, if I was waiting for chemo to be checked or hung or something else I couldn't participate in, I would be documenting, instead of standing and watching.

Friday, my last day, I went in and had two of the same patients and one new admit. It was by far, undoubtedly my best day of time management ever. I had everything done and nearly all my documenting with the exception of one patient note before noon. I couldn't believe it! I stayed past my 120th hour. I wanted to discharge a 57 year old woman with brain cancer and metastasis to the liver that had just signed a DNR the night before and was going home to brother-in-laws and sister's house with hospice care. The doctors explained to her that because her radiation was so recent another dose. It would undoubtedly cause necrosis of her brain tissue and the treatment would be as disabling as the disease. She and her sister gave me and my preceptor so many hugs as they left. They thanked us for all the wonderful care and support and all I could think was "that's it, that's all I can do and it's not enough." It was very hard to watch her get on the elevator and leave knowing that she was not going to beat her cancer.

My drive home was full of reflection about how much I had enjoyed the patient's, the nurses, everything about G-70, about how much I had learned and how much better I felt about maybe calling myself a nurse soon. I had had an awesome experience and could only hope to be lucky enough to go back as an employee after graduation.

Bowman Cup 5k - A Race Report???

Running had been a little bit better than non-existant for me the last few weeks, which was definitely helping me manage my anxiety over school.  I felt pretty slow and not at all light on my feet, course I am carrying around an extra 10lbs. right now. 

A few of my classmates were planning to run the Bowman Cup 5k this year and although I wanted to run it I was hesitant because I have absolutely no money and my leg and foot are so sketchy.  I was surpised when I received a confirmation email that said I was running a few days earlier.  One of my friends had secretly tried to sign me up -- he is too nice!  So a racin' I would go!!

The race had record numbers and it started later than scheduled.  I had to stand in line for about 10 minutes and ended up getting in absolutely no warm-up. 

My classmates and I all stood together at the start, but when the gun went off KS shot out so fast I lost her right away and MV was somewhere behind me.  I made it about a quarter mile out and realized I was way too fast.  I pulled up and did my best to stop pushing.  I regained my breathing and watched a lot of people run ahead of me.  I knew I wouldn't run anywhere close to my time last year.  I looked over to see MV had actually caught and passed me just a tad at the .5 mile mark.  Wow, had I slowed down that much? I caught him and we ran together to the first mile marker.  The timer shouted 7:26, 7:27, :28, I sighed because I was about where I thought I would be and also because last year I ran that first mile in 6:45. 

MV continued to stay with me to the 1.5 mile marker and I couldn't help but be so impressed by his performance.  He usually runs in the 8:20 range or higher, but then it happened, he started to fade.  I made a decision right then to stop running my race.  I wasn't gonna PR, but MV had a great shot at it!  I also felt flat and was nervous about my leg.  I started talking to him about relaxing his form and joking that KS was only a little ahead of us and she was hurting and we could keep the gap to a minimum.  Initially, he tried to wave me off to go on without him, but my mind was made up.  I wasn't going without him.  We hit mile 2 at 8:06. 

The next mile wound up the bike and hike path back onto campus.  I remembered last year that I had been so shocked at how much harder the course had gotten for me at that point.  MV definitely, felt the inclines.  I told him to run the tangents and started swearing at him that for 8:00 measly minutes of his life all he had to do was run and then it would be over.  He was pushing himself so hard to get that PR.  We made back onto the road and I kept trying to pull him along, saying "4:00 minutes MV, 4:00 more f*ckin' minutes! Come on!!!"  We made the last climb and he hit his next gear.  I was yelling at him "Yeah, hell yeah, you got this, just get to the intersection."  The intersection was about 150 meters from the finish.  I kept thinking if he can just get to tthe intersection he'll be golden. 

We crossed the intersection and could see the finish balloons.  There was a young girl just ahead of us coming up on the finish.  I yelled at MV "come on you can get her!!"  He found his next gear, the girl ahead heard me and turned to look back at us.  We caught her, but she wasn't giving up, she hit her next gear too.  She pushed forward and I yelled "yeah, come with us, don't let him have it!!"  It was a great battle to the finish.  I was so pumped to see two people pushing themselves to the finish.  The girl ended up getting MV by one step.  His last 1.1 was 9:37.  He had fought so hard and he was rewarded with a new PR!!  I was so proud of him.  He finished in 25:17.  I crossed right behind him in 25:18. 

KS had won her age group with a 22:08 averaging 6 miles a week and also being 5lbs heavier -- the girl has so much potential! 

I finished feeling really good.  I didn't get a great gauge of my fitness, but the 8:09 pace definitely, didn't hurt me.  I never felt anywhere near tempo effort, so that was a good sign.  I went home and ran another 4 miles just to stretch out my legs after breakfast, since my feet and my hamstring were naggingly tight.  I am limping today thought (Maybe, it's time I go to the doctor). 

I know I was supposed to race, but sometimes being a member of a race team isn't always about racing for me.  Sometimes I feel it's about inspiring and swearing at someone, witnessing a new runner's PR and that is worth so much more than an age group/overall win or my own PR.

Electrified Mania

My favorite time of year has come, fall, when the leaves are so colorful, the temperature is perfect and I can eat lots of candy leading up to and after Halloween. The only problem is the pain in my left heel, just wont heal and the nagging pain that gets very sharp and painful if I overdue it in my hamstring, still lingers. Not being able to run anymore would probably cause me to commit a felony of some kind, so the last 3 weeks I have been gingerly trudging around my neighborhood for a half hour most days of the week with my favorite 7.5 mile jaunt on Sunday. I am completely avoiding hills since it aggravates the heel, but a few false flats here and there seem to be doable.

Today I started out extremely tentative and careful on what I hoped would be my longest run since Muncie. I made it out about 3 miles before that electrified feeling hit me. I was overjoyed as I had missed that second wind, tingling, ready to go get 'em sensation, I so often felt on my runs last year. I opened it up a little and felt awesome, a big smile on my face as I pressed on down Pettibone Road. I started thinking about psych class and how people with bipolar disorder loved their manic states because it was such a high and they felt so strong, even at times invincible -- that was how I felt in those next 5 miles today. My runner's high was my manic state and I loved every second of it. I made it home rolling though 9 gloriously kick ass mile, feeling great with only minor and completely manageable pain in my feet and no biting pain in the hamstring.

The Blog Is NOT Dead

Good grief where have the last few weeks of my life gone?  Every semester, I had hoped it would get easier and every semester it gets crazier.  The tests are the same, but now we have so many self-reflection projects to incorporate into our analysis of the nursing process and research articles utilizing evidence based practice, not to mention trying to remember how long I can leave a peripheral line in a patients arm, all the while hoping for an order to extend and STOP!!  JUST STOP, I keep telling myself, but I can't.  Every time I turn around it is another new assignment. 

School has now incorporated mandatory attendance for classes that talk about the most exciting things like malpractice and managment theories.  It is like being at the superbowl.  Very exciting!!  NOT!! 

My psych rotation completely blows ass!  I feel most of the patient's are a bunch of sissy bitches that just want to utilize the fact that they drink or beat their families because they can't HTFU and make the necessary choices not to be an asshole.  We have a ton of patients who are "suicidal," but yet they are full codes.  Really?  Do you wanna die or not?  I had one patient who has tried to kill himself more than ten times, yet he refuses to take depacot because his lab results have shown liver toxicity in the past.  Again really?  You can't live without a liver, you wanna die, so why do you care?  In my non-psychiatric opinion, I feel he just wants attention.  I bet if someone were to stick him in the electric chair and threaten to throw the switch he would change his mind about dying.  Needless to say I have little tolerance for this rotation as we don't actually cure or fix these patients.  We take care of them for a few days and try to get them to at least pretend they are sane and then send them back out there until they come back again in a few months.  We also had a disgruntled HIV black male patient who was racist and they wanted one of us to take him.  Hell No!!  All that guy has to do is get pissed off and bite me and then I have HIV too.  As a lowly nursing student, I definitely have the right to refuse to provide care to some people -- him being one of them!

On the flip side oncology is just beyond rockin' right now for me.  I don't care for the 4:50 am wake up calls 2-3 days a week, but the work itself is very rewarding.  My preceptor is awesome.  At first she gave me the most difficult patient (the one with the most problems or needed the most care), but now I am up to two paitents, so she lets me pick which cases I want to deal with.  I usually take the hardest patient and an easy one.  I have definitely had to learn to manage my care on the floor or I would never be able to care for more than one patient at a time.  I felt strange being only a nursing student and delegating to a paid patient care nursing assistant things such as vital signs, intakes and outputs, mobility and feeding instructions, but that is supposedly one of the pitfalls of a new grad -- trying to do everything themselves and not knowing how to delegate, thus resulting in less quality care for the patient, so bossy it is :)  While I feel it is not my job to do those things, it is my responsibility to make sure they are done.  I had a hard time trying to figure out how to tie in all this leadership and management with my patients at first because I was so busy worrying about tasks, such as a head-to-toe assessment and what to look for (e.g. edematous patient, check for crackles in lungs, JVD, capillary refill, tingling or numbness in extremities or immobile, does he have DVT's, is he on heparin, does he use incentive spirometry is he using the deep breath and cough method...oh the list goes on and yet there are probably tons of things I am missing), grabbing a refill of water for a patient, or just plain old utilizing my therapeutic communication skills to listen to the patient's concerns, I had no time to reflect of even sit down to eat lunch on the first two shifts. 

The chemotherapy regiments are about 4-5 days with bags being hung consecutively every 12 hours.  Some require two IV lines such as, Fluoracil and CISplatin because they are incompatible while others need administration of a rescue after, such as Leucovoren, which acts as a toxicity prophylaxis for those given methotrexate.  Cancer is not just cancer on this floor.  It is accompanied by complications such as neutropenic fever, imbalanced nutrition, especially if the cancer is esophageal.  Some of the patients have a corpak because they have dyspahgia and are at a high risk for aspiration.  One patient had radiation on his throat and had very visible blue radiation marks along with what looked like the worst sun burn ever.  He was prescribed aquaphor for his neck and a warm soak to maintain the skin integrity and minimize discomfort. 

My second week we moved from one unit to another.  The nurse manager on our floor is no doubt a leader in a management position.  I was able to observe her interactions with directors, nurses and construction workers as to what the most effective and time saving way to safely move patients who could walk, needed a wheelchair or were completely bedridden.  The nursing managner and the assistant nurse manager spent about thirty minutes developing a floor plan on which patients to move first and which room to assign them to. They split the nursing staff up into teams of those who would be sending the patients and those who would be receiving patients.  I was on the receiving end.  I escorted patients to their new room and plugged in their IVs, put the bed in lowest position and made sure some, but not all the side rails were up, as that is a restraint, unless they do it.  As time wore on our nurse manager felt it wise to take a "time out" and confirm all patients were safe and in their assigned rooms and continuity of care was being maintained.  It was very organized. 

Unfortunately, with all this nursing there is just not enough time to jump on the "train" wagon.  Hopefully, once I get some of these crazy projects off my plate and meetings out of the way I will be able to do a few things in the upcoming weeks.  Either way this is all gonna end in 12 weeks.  I can't believe it.  It seemed just yesterday I started this and to think it's almost over, at least the school part will be.  It looks like I wont be able to take my boards until late January or early February and then I can get a big person job!!!!!!!!!!!!  Holy cow, I am so close I can taste it....mmmmmmmmmm, mmmmmmm, mmmmmmmm :)

The Heroic Comeback of a Lame Duck!!

Well, it's been 5 months since my feet and my left hamstring started bugging me and they STILL do.  I am just beside myself with this one.  I stopped running, did nothing, switched to cycling for exercise and added more strength training than ever in the last 4 weeks and no changes. 

I dread going to the doctor and having them say I need physical therapy that will probably cost me $50 a visit out of pocket even with my insurance.  Not to mention I don't even have time for it with my schedule or even worse they will tell me my hamstring has just been beaten up so badly I am looking at a walker in a few years (LOL). 

Anyway, after studying pretty much all day yesterday and following some stellar performances at Rev3 I feel renewed with hope.  Hope that by next spring I can either run the Boston Marathon or team up with Daisy for what promises to be the most painful experience yet!!  What to do...What to do.....???

Either way this lame duck has gotta try and fly again soon.

Riding Dirty soon to be White and Nerdy

It's hard to believe my 3 weeks hiatus from hell, errr I mean KSU is nearly at an end.  It went by so much faster than I would have imagined (DRAT!!). 

After the last race I ran, I had resolved to taking some time off in hopes my hamstring and foot would heal up and feel better.  It's definitely improved, but it's only been 2 weeks so I am still anti-running at least through September.  However, I committed myself to at least cycle as much as my butt would tolerate. 

Last week I spent 4 days riding 88 hot, sweaty, spandexy miles mostly through Aurora and Shalersville.  AH even came out one night and dragged me through a hard 24.5 miles.  I normally ride this route between 17.5-19.5 mph, but his easy cadence of 80ish made me feel slow and I desperately tried to hang on his wheel saying to myself "No chain motherf*cker, No chain" just like Lance Armstrong does.  I was rewarded with my fastest time ever 20.5 mph...WOOT!!!

I was hoping to break 100 miles for the week but really who makes plans and sticks to them when you are on vacation???  Instead of a nice 2 hour ride on Sunday AH and I ate wings and cheese fries, watched Avatar and Terminator Salvation and pretty much spent the day laying around.  It helped that my "brittany" as some call it was super sore and chafed from all the miles of riding. 

This week I managed to get out for my loop on Monday at a hard effort and rolled through at 19.4 mph all by myself.  My butt was still sore, so I started applying Neosporin to the area as the chafing resulted in some unspeakable nastiness.  The good news is the lymph nodes down there that usually swell were NOT swollen.  Yes, I know perhaps this is a gross and dirty conversation, but I can't be the only girl that this has ever happened to! 

Tuesday, I chose a nice hilly route that had some nice climbs in Bentlyville and I switch backed a couple roads up and out of Chagrin River Road.  I only managed 17.8 mph, but I just wanted to make all the climbs, while preventing my heart from exploding out of my chest.  The Neosporin had definitely helped, but the bumps on the way home up Liberty were certainly a bitch!!

Wednesday I rested and yesterday, while I was hoping AH wanted to come over and ride again, he texted me saying he was feeling fluish.  Great!  I was on my own until I remember BH led a ride out of LifeTime.  They were planning to ride 25 miles, so I told him I would pick them up at Hawthorne and Sulpher Springs.  I got there in about 28 minutes and kind of rode around in a small loop waiting for them.  It was less than 10 minutes before him DM and 3 other guys came flying by!  I told him I could ride almost 18 mph through the hills and he said I would be fine, but as they flew by I hammered to try and catch them.  There was no pace line and it seemed every man for himself.  I guess some etiquette rules were being broken and some "man" stuff was going on as we raced up Chagrin River Road.  It was okay BH helped me out by letting me act like a leach and stick to his wheel.  I had picked them up at about 8.5 miles into the ride around 7pm, so I knew I would have to ride HARD to beat the darkness home.  We rode up to Berkshire where the ride was meant to go but DM basically called BH out to ride up Old Mill and since I was the only girl, well I wasn't taking the easy way out and hung on BH's wheel until the climb started.  DM is way too fast for me and he suggested we take it in our easiest gear and ride it like a hill should be ridden.  That sounded like a great plan.  I got dropped by the 3 guys, but that was by far the best I had ever climbed Old Mill.  I wasn't hurting or out of breathe.  It was about 7:40pm.  We were running out of time.  I figured I had until 8:30pm to make it home.  We rode down Gates Mills to Brainard and then to Harvard where they split off.  DM and BH were worried offering me a ride home in a car, but come on!!  I knew what I was getting into.  I checked my computer.  I was at 25 miles in 1:29:xx.  It was time to GO!!  I turned my ipod back on and just started jamming on the bike.  It is completely flat or downhill with the exception of one climb up Miles Road.  I just kept pushing and thinking "Go you p*ssy!!, Go!!"  It was nearly dark I had to take off my sunglasses, not to mention I could feel the air temperature dropping.  I hammered away until I pulled in the drive in less than 35 minutes.  I checked my computer...38.1 miles total.  Holy cow!!  That was a race pace for me (and yes it felt like it too).

Hopefully, I will be able to get in a few more rides this weekend, along with working Friday, Saturday and Sunday (LAME!!). 

And then Monday, it starts again.  I can't believe it's been a year already and I am in my last semester.  I miss my classmates and without them I would not have made it this far, but the amount of studying and research, not too mention test after test after test...yuck!!  It will certainly be the hardest semester thus far, but this time off has really de-stressed me and I know I can hang in there for 16 weeks...or there is always the alternative

Either way I am gonna have to HTFU!!!

Twilight Trail Run by Team HTFU!

I don't know why I do this race.  It is always very humid and hot and I always struggle to the point wear I have puked during the race and after through the years.  It always seems like most of my girlfriends do it and it's a nice chance to see them (especially after being so off the radar with school for a year) so I just get sucked in.

I really wanted to do this race with JP and the girls.  Although, not being the fastest team out there the bandanas, sunglasses and pink HTFU t-shirts would undoubtedly get a few questions and some laughs.  It had been about 2-3 weeks since I had done anything. I hadn't swam or biked since Muncie and after one good week of 38 miles my left hamstring and heel were just destroyed. However,I had made my decision, I would run the race with JP and then call it quits until October or November on the running front. 

I got to the race super early and although I didn't need a warm-up I was talked into 2 super hot and sweaty miles.  My HTFU t-shirt was soaked with sweat by the time I was done and the bugs were already coming after me.  Two of my classmates running under the team name "Kenny Rogers Chickeneers" had come out, so I was excited to see them and thankful they had bug spray. 

Our wave started at 9:00 minutes in and I had every intention of taking it out slow until about 1.5 miles and just running smoothly from that point on.  My effort felt okay all the way to the hill and then I ran as much as I could before power walking the second half to the top.  When I reached the top I walked a bit longer as it is a false flat before re-grouping and picking it back up.  Mile 1 was so incredibly long, I thought for sure it hadn't been marked, but then at 10:24 I saw it.  OUCH!!

My achilles and my hamstring were just screaming at me from all the uphill and I felt hot and nauseated.  Wow, was I paying for it.  I started smiling though, thinking this half of Team HTFU needs to harden up a little for sure.  I had lost sight of all my friends and just kept plodding along thinking I really should not have run those 2 miles for a warm-up. 

Each mile took forever and I never got that feeling of am I gonna vomit or not to go away.  I just kept thinking 49 minutes max it would be over...keep going.  It seemed after the first mile I ran between 9:00-10:00 pace.  As I was running down the big down hill I passed a woman who was walking and she slipped and scared the crap out of me.  I asked her if she was okay and she responded with "yep, that's why I walk this down hill." 

I was almost done and when I saw mile 4 just passed the castle I was relieved, less than a mile to go.  I had nothing in my tank, but I had nothing from the start, so what did it matter?  SL ran me down and we exchanged words of encouragement with each other before he broke away.  I couldn't wait to stop and catch my breath and have this feeling of puking everywhere pass!  When we popped out of the woods I forgot we had to run a zig-zag back to the finish and I was definitely thinking "F*CK!!"  But I did it of course, and as I ran across the field to the finish I heard my friends cheering for me.  I crossed the finish in 48:41 and walked right over to the woods where I dry heaved for a few minutes before heading back down to join my friends.  The feeling of puking subsided as I recovered, but it never totally went away that night.  My leg was completely trashed though and it hurt like a mother.

It seemed most of my friends had done really well.  E-speed and NC winning 1st in the female team division with Daisy and ET 2nd, BS had of course won the 1st place male.  My teammate, who was running a good hard pace still finished really well (not a shocker - GO JP!!!) and although "2 Slow 4 Elizabeth" didn't place as a team I think they might have quite possibly come up with the BEST team name EVER....hahahaha!

Therapy in Mamby Pamby Land

Anybody need someone to talk to or a shoulder to cry on?  This guy reminds me of my mom.

Blood Work

I had quite a headache all day at clinicals, but managed to not let it distract me from one of the most hands-on clinicals I have had thus far.  It started off rough with my grandma dying in the first week and having 3 case studies, a nursing profile for a client having a pulmonary embolism and a concept map on a patient with lymphangitis cellulitis and 2 quizzes to make-up, but it all worked out. 

Our rotation was only 6 weeks.  I missed week one, but week two had my first patient refuse medication and got to pull out a central line.  The central line is just insane.  Its basically an IV that runs directly into your subclavian vein, which feeds directly into the vena cave, which feeds into the right atrium of the heart!  Crazy to be that clos to it! The patient had been unable to eat due to stomach cancer and we were running total parenteral nutrition (TPN) right into his blood vessels.  Removing it is quite simple, the patient turns his ahead away from the line, he holds his breath and you just pull it out -- it's a rush for a nursing student.

**This is not my patient, just a pic I found**

Week 2, they sent me off to "convenient care" which is like outpatient oncology, but that day all my patients were anything but.  My first two patients had kidney failure and needed bi-weekly injections of procrit or aricept, which is just two different brands of erythropoetin.  The kidney also have the responsibility of making RBCs and obviously when they quit working RBC production becomes inhibited.  I was able to give both shots in the deltoid -- thankfully, most IM's are given in the deltoid or the vastus lateralis.  The butt is usually a last resort (whewww!).  Then I had 2 patients with peripherally inserted central lines (PICC), which start somewhere in the upper arm and are threaded up and through to the subclavian again and into the heart.

These people had IV antibiotics for a few months, so they needed to be cleaned and have a dressing change.  A peripheral IV is only good for 72 hours and having to be re-stuck every couple days would just suck.  These were much more realistic.  A patient with an insanely low blood count came in for 2 units of PRBC and so I watched a blood draw (or 3 for that matter as this patient's veins just ran away from the needle every time it seemed).  We finally got it and it was cross-typed and matched and for the next couple hours I monitored her VS (specifically for hypertension) as that is a common side effect of the transfusions, not to mention she was hypertensive anyway.  After that, a patient managed to rip a saline locked IV out of his upper arm while eating and got blood everywhere before we finally managed to re-dressed and cleaned it up. 

Week 3, was dealing with all the other bodily fluids as my patient was end-stage alzheimer's and had lost the ability to swallow.  Eating had become impossible and with a hiatal hernia, successful placement of a g-tube or peg tube was impossible, so she ended up with a j-tube, which I found out you do NOT check the residual on.  I was worried about running too much isosource as the pump was 35ml/hour continuous, but was told I would know if it wasn't being tolerated because, well everyone knows what happens when you eat too many oreos or corn right? 

Needless to say, I will never be a GI nurse of any kind.  I spend half my time trying not to vomit and the other half of the time holding my breath when dealing with patients who are inconinent, but I know I am a super hero because I willingly do that stuff!!  I had also willingly volunteered to take on a second patient that was MRDD and had to take about 8 oral meds.  I ended up doing one at a time hidden in small bites of his breakfast tray, starting with the smallest and working my way up to the horse pill sized ones.  My instructor actually gave me 4's for the day, which is above satisfactory, so YEAH!!!  She even stated she only gives \3's (satisfactory) unless something very exceptional occurs, so BOOOOYAAAHHHH for me!! 

Today, was my last day there on the floor and we were told it was exceptionally, slow and there weren't enough patients for all of us.  I volunteered to go back to convenient care and work and as a result she told me since I worked with two patients last week to go on down to the heart failure clinic.  SWEET!!!  I hate standing around at clinicals, even if there is absolutely nothing to do, I still feel guilty.  Heart failure was definitely different.  My first patient needed Lasix IV push (4ml over 2 minutes) and then 2ml and hour for 4 hours on an IV pump.  It was nothing knew, but each pump is different and it's always nice to brush up on skills to clear the lines and access the ports correctly.  They were having a slow day too, but it was still more action packed than upstairs as I had 4 patients coming in needing blood draws for BMPs, PTs, BNPs you name it.  I had only started an IV and accessed a med-port one time, so using a butterfly needle and finding veins, followed by doing a blood draw was exciting and new!  It may not seem like it, but sticking a needle in a teeny-tiny vein, without missing and miniminzing the discomfort of the patient is very nerve racking for me.  Not to mention when every patient you have says "I have really hard veins to get blood out of" it definitely makes me a little doubtful of my skills.  My first patient I was told to go for a little vein on the dorsal side of the hand.  I know I hit the damn thing, but it ran away from me and I got no flash.  I was disappointed, but my instructor told me not to worry that patient was indeed a hard stick.  None of my patients had pretty veins just popping up in there antecubes for me, but I successfully nailed the rest on the first try.  My confidence with blood and needles was definitely boosted after today's handy work. 

Now, I have 4 more days of school and the "Dog Days" of summer finally begin for me after 7 long, intense months of school.  I only need a 59 on my final exam to pass, so you can only imagine how confident I am.  I feel like a senior in high school again, just itching for the end of school.  Although, it's only 3 weeks off.  I plan on enjoying every minute before I start my last semester of school.  It's so crazy I am almost 3/4 done.  It seemed like just yesterday, I was sitting in orientation wondering what I was getting myself into.  I know the hardest is yet to come, but hopefully, these few weeks off will allow me to re-charge and hang in there until December 17th.

Johnny Cake 5 mile

This is the 4th time I have run this race (I think).  I ran my 2nd fastest time unintentionally on the course, which sounds good but the truth is the other times were when my anemia was in full effect.

It had only been one week since the half ironman and my workouts consisted of 6 miles of running in 2 days.  I was super excited and stoked I would undoubtedly PR (NOT!).  I had worked late like usual Friday and Saturday night, so draggin my ass out of bed at 6:30am to drive to Mentor/Painesville was almost as hard as the 5th mile of the race that day, but this was a big race for my team and I felt obligated to participate.  I love Achilles, the owners are personal friends and wonderful runners themselves. 

I arrived at 8:00am with only 30 minutes to grab my packet and go to the bathroom (OF COURSE!), but the line was huge.  I was out and on my way to the start line by about 8:25.  The weather was way too hot for me.  I had no intention of doing a warm-up.  Five miles would be plenty for me.  I felt run down and knew I had a fun, fun day of studying ahead of me.  I did see BD and E-speed right before the start and got to wish them both luck.  It seemed we all new the weather was going to make this race a little more miserable than usual. 

When the race started, everyone took off...FAST!  I got passed and passed.  My main goal was to negative split every mile (except for 2, which has the hill).  I figured starting off at a slower than normal effort would ensure my plan. 

Mile 1 was tight with all the construction barrels and I heard the timer yell out "8:12!!"  Eeeeekkkk!!!  I could only laugh at my suckiness.  Between the heat, my lack of training and my poopedness -- I was literally a "hot mess."

Mile 2 has the only climb in the race and I took it nice and easy.  Some people around me charged up the hill like angry bulls and others were breathing like they were in labor.  I wasn't doing either so I took that as a sign that I was right where I needed to be.  The timer called out "16:30"  Sweet 8:18 for that mile.  I was only 6 seconds slower with the hill, but wait no, no, no that split sucks too. 

I kept thinking I did 20 milers at these paces in the spring (course it was in the 30s and 40s and I was 8 lbs lighter and I was running 50 mpw -- excuses, excuses, excuses).

Mile 3 was flat and slightly downhill with some shade (two of my favorite things).  I saw some of the Mentor cross country girls and one of the parents and I waved and yelled "You guys should be running and suffering too!!"  They replied with lots of cheers and smiles for me.  Mile 3 I think was 24:35, so my split was 8:05, the time was coming down just as planned. 

Mile 4 was forgetable and in the sun and where you begin the long deadly, hot run down Mentor Avenue to the finish and can only think "one more to go after this."  Timer number 4 shouts "32:33", doing the math in my head I realized that was a 7:58.  Finally a sub-8:00.  I was wondering if there were any in my legs today. 

The last mile was the least painful 5th mile I have ever run on this course.  I was running people down one at a time and using that to help stay focused.  I forgot to mention how I had poured water on myself twice during the race to keep cool.  My mom was out of town and not home to remind me that morning to put body glide along my chest where my sports bra rubs and I could feel a burning pain where I had already chafed that morning.  I could see the banner in the distance and passed the 880 marker and then the 440 marker.  I was almost done when a kid next to me started dry heaving.  It was absolutely repulsive and after dealing with vomit, urine and feces at clinicals I wasn't up for it today, so I picked up the pace and purposefully pulled away from the pukemeister. I saw the clock going just passed 40 minutes as I was closing in and I saw 40:20 when I crossed but official time showed 40:24, so that makes my last mile 7:51.  Not to mention, if you look back up at the picture at the top I am CLEARLY way past the finish clock and it only reads 40:22, so how I got moved to 40:24 I don't have a clue, but a crappy time is a crappy time right?

I hung out for about 40 minutes catching up with lots of running buddies and was really happy to hear most of my girlfriends JO, Campy, E-speed and BB had all but cleaned up.  Congrats to all my Female Fasties.  That took a lot of pressure off me to have to win the race that day knowing they had been there ;-)  HA!  I managed to snag some pizza and was on my way back home for a fun filled day of renal diseases.

Mucnie Endurathon

JP and I woke up at 4:00am on race morning and were loaded up and on the way to the race site by 5:15am. This would be my first HIM, but I wasn't nervous and I really wasn't too excited. I knew I would more than likely finish, but my time wasn't going to put me in a good overall position at the finish.

I went to the bathroom about 5 times before the race, like usual and thought I was in the clear and might only have to go once after the swim, maybe twice at most.

JP and I lined up for the wave 6 start. BH had gone off in the wave before us and EG, AH and BS would be coming right behind us in wave 7. My goal was to not drown. The water temperature was over 78 degrees and going sans wetsuit was not the option I had hoped for. This was only my 5th swim this year and I had only swam one time with my wetsuit off all year for 25 minutes. JP and I wished each other luck and the horn sounded. I walked deeper into the water and just started stroking away, like I was out for a nice easy swim. Swimming is so intense. You always have to check to make sure your hips are up, your feet aren't dragging, your entering the water with your hand straight and not crossing over, your not dropping your shoulder, your head is in a neutral position and then you have to make sure you swim in a straight line and avoid as much body contact with other swimmers as possible. It is always something, much more technical than running. I tried to get into a rhythm and relax. I used the swimmers around me to sight and after finally checking my position to the far buoy discovered I had swam far on the inside. Damn!! It seemed so had a bunch of other people. Perhaps the buoy's initial position was an optical illusion. I wanted to get out of the water in under 45 minutes and I didn't want to put myself in oxygen debt, however, when I made it to the far buoy to swim the backside my watch said about 18:xx minutes (UGLY). It was going to be close. The backside was easy and I was on my way back a lot quicker than I had thought. I finally settled in, but my hip flexors and my back started aching from holding my legs and body up in the water. I was fatiguing already and I still had over 69 miles to go today. When I was almost out of the water, I stopped kicking to allow myself to pee one more time. I was happy to have gotten it out of the way so I wouldn't have to pee in T1 and could just go straight out on the bike course.

I hit the shore in 43:xx and hit T1 at 44:43. No wetsuit and no drowning, I'll take it.

T1 was slow for me, but uneventful in 2:10.

The bike started off on the greenway, which was sick fast. I could coast at 20mph easily. I spent the first 15-20 minutes spinning easy to get my heart rate down and figure out where the heck my body was at with all this. My lower back and my hip flexors were pretty tight from the swim and my neck and shoulders were a little achy. A little over 10 miles in I felt the urge to pee and by mile 15 it was unbearable. I debated trying to pee while cycling because there wasn't a porta-john anywhere. I couldn't do it, to uptight I guess. Indiana is all fields and no forests, so when I finally found a wooded spot I jumped off my bike and ran into the woods. I tried to hurry, but my bladder was full and I wanted to get it all out, so I wouldn't have to pee again, or so I thought. I jumped back onto my bike feeling so much better and started making up ground, but another 15 miles later and it happened again! Again, I jumped off and ran for cover. I wasn't too frustrated, just a little annoyed. I was trying to stay focused catching people that had passed me while I was peeing. I would check behind me pull out to the left and pass then check again to make sure I was a few bike lengths in front of the biker before pulling back to the right side. I was following my routine and as I pulled left and checked behind me I saw a guy coming so I made sure to pull back right as soon as possible to get out of his way. Now, when I pulled right, I pulled far right, just to give him extra clearance, but this asshole and I mean asshole pulled far right, right behind me. I veered back left thinking he was going to pass me on the right, but when I checked he had pulled back left on my wheel. I completely lost my cool and yelled "get the fuck off my wheel!!" The guy gave me a nasty look and yelled "I was just using your slipstream for a minute!" To which I replied "That's illegal!!" He mumbled something I couldn't quite hear and pulled away. I was so pissed. I hate cheaters. I tried to focus on my pedal stroke, but I had to pee again...damn!! I pulled over for the 3rd time and jumped off, but this time my foot slipped on the gravel and I went down on my right knee. I managed to rip the skin off and blood started trickling down my shin. I just kept running for the woods. As I was peeing I noticed some plants that perhaps could have been poison ivy and as I tried to move away I almost fell back in it. Thankfully, I grapped a tree and kept my balance. Jumped back on my bike and with about 12 miles to go, but one more mishap awaited me. I was less than 7 miles away and I heard a soft humming. People were flying by me. I looked down and my speed had gone from 20+mph to 14mph and I was working HARD. Great! My front brake was rubbing. I reached down and tried to pull on the calipers, but that didn't work. I began pumping the brakes trying to get them to open up a little bit. Finally, after about 2 miles I got my bike working again. I had had enough I wanted to get off the bike before I flatted or wrecked. My luck was running out. All the mishaps put me at 2:56:43 for the bike.

T2 was a blessing. I was so glad to be off the bike, but as I ran into the fenced area I felt the urge to pee again. Uuuuugggghhhh!!! I transitioned like the flash and ran to the porta-john, let loose like the Hoover Dam and got out in 2:01. Had I not had to pee, I would have been out in under a minute darn it!!!

The run started off fine for the first 2 miles. My legs felt really good, which surprised me because my longest work out had been just shy of 3.5 hours and I was beyond that by this point. I was not running hard and I was passing person after person from the get-go. They had aid stations every mile, which I thought was a bit much, but as I got to the first one I greatfully accepted ice and gatorade. The temperature had been fine for the bike but by mile 2 I was warmer than I would have like and there was no shade. I took more gatorade and water at mile 2 and by mile 3 I realized I was not going to make it the 13.1 miles unless, I could cool myself off. I was overheating so fast. I started to see more and more of the leaders coming back and some were running, some were hobbling and some were walking. This was a bad sign. I had to cool my core. I grabbed to cups of ice and jammed them down in my sports bra. Almost immediately, I felt a little better. I continued to stuff ice down my top, grab fluid and then added an ice water soaked towel to my neck. Every aid station became like a buffet table. Ice for the sports bra, get a new cold towel, or re-soak the one I had, grab some flat coke. I couldn't do all that on the run so I had to stop at the table for a few seconds. I hated to lose the time, but it was the smartest move I could make. After mile 4, runners were everywhere walking and hobbling. I was still passing a lot of people. I don't think one person passed me the entire race and I knew I was running the worst half marathon time I had run in 3 years! I made it to mile 10 and my body finally gave out on me. My legs became extremely heavy and it felt like my throat was the size of a straw. I was really glad my body had held up this long, but I knew with an average of 40 miles a week biking and 15 miles of week running I'd be lucky to finish. I started thinking about my grandma a lot at that moment and how she was the one who had died and I was the one who was still alive, about how this past year has been about doing a lot of things that I didn't think I could do. I started to get a little emotional and I did what I ALWAYS do... I just kept going.... one foot in front of the other, thinking about her and how I was doing this for her. About how even if this is my only half ironman ever, at least I did one.

I made the final turn at the church knowing I had a little less than 2.5 miles to go and I started to cry a little because I knew I wouldn't give up. I knew I was gonna finish and I was gonna finish in plenty of time to break 6 hours. The last 2 miles were all uphill and a few people were just too beaten to run, but I kept going. I could see the finish tents at the top of the last hill and people were on both sides of the streets clapping and cheering. I was almost done. I was smiling and tearing up at the same time as I ran up the last hill and as I crossed the finish line I threw up my fists in victory. I had done it. I had gotten in enough training to do swim 1.2 miles, bike 56 and run 10. My determination and my grandma had brought me the last 3.1 miles in 5:47:37.

It was a great day and I loved the race, the course, the volunteers, everything. If things work out I definitely want to go back next year and crush my time.

Still Standing

I am still here. Spending a lot of time trying to gather my thoughts and keep my head above water. I can't bring myself to talk/blog about things yet. It is just too much for me right now. I know I have a lot on my mind, but I have put myself on autopilot for the next 5 weeks. The idea of throwing in the towel and giving up has been coming at me full force this past week, but I just keep thinking "hang in there" and "don't be a pussy" but sometimes it just fucking sucks right now and I can't help but hang my head and let a few tears go....

but as of right now... I am still standing...

Baby Steps and Strokes

So, I took my final today in Gerontology and had to get 55/90 to pass, as always I am worried I will fail and am out of the program. I have another final tomorrow I have yet started studying for in Community Health and a 20 page research paper due by midnight on Wednesday of which I have 2 pages done. I didn't procrastinate. I literally ran out of time and after 40+ hours of nursing, nursing, nursing it is useless anyway to try and do anything.

I tried to study all day yesterday, but after 4 hours I needed a break so I got in a little run(2 miles)- ride(16 miles) - run(2 miles). It helped refresh me and I managed another 5 hours before falling asleep listening to my teacher drone on and on about gastritis, cirrohsis, Crohns, yadda, yadda...zzzzzzzzzzz...

I swam for the first time since January or December. I managed a little over 20 minutes in the lake and avoided any snapper attacks. I was really pumped I was able to maintain my breathing the entire time. I was expecting to be out of breath about 5 minutes in, but pacing was right on, course I don't know what the distance was. My arms paid the price though as they are still sore today. Reminds me of a workout I did with Daisy once where my arms hurt for almost a week! I think I doubled the size of my traps with one swim. My core was tight too from trying to hold my body in good alignment (like I am a car or something). Hopefully, I am not way far off from my swim times last year and it will come back to me quickly with more open water time.

The volume and the intensity are lacking in my workouts, but they are "workouts" and I am not completely sedentary yet!

Last week I was so swamped with school and work while doing an intervention on childhood obesity at Ravenna City Park I took it upon myself to play a pick-up game of full court basketball with 3 boys about 10-12 years of age, just to get in some exercise that week. I got the chubby kid, but we crushed the other two! HA!!! This old lady has still got some skillz and I even made it a point to pass on shots, so the chubby kid could shoot. I did need an "old persons" time-out though. I was sucking air like a MO-FO' sprinting up and down the court, so different than endurance sports.

A few more days and the workouts should pick back up as I only have to go to campus and clinicals 3 days a week!!!

I really hope this is the worst week (last week) of training I have for the rest of the summer.

Swim - 20 mins (1 swim hopefully 1000 yds???)
Bike - 16 miles (only 1 bike)
Run - 10 miles

Itis so PATHETIC!!! It makes me wanna do something gung-ho and bold, errr, I mean stupid.

My Sunday "Fringe" Ride

It is admittedly true that I have been living for my Sundays and sunny skies, just so I can get out for my weekly bike ride (I usually run too, so I guess it's really a brick). Either way the amount of exhaustion or pain I feel during the workout is a far cry from that of the pain my school work brings me. I am elated too that I can endure a 3-4 hour workout still. This week the ride was just a tad shy of 2 hours with about an hour running.

I headed out east on Pettibone Road and ended up in some podunky area and came upon this!!!

What in the heck was it? Had someone genetically crossed a zebra and a bull?

Then right after I saw that,I saw this ...

I felt like it had turned it's head to look right at me. I gulped and pedaled on hoping I was not going to be unknowingly completing the trilogy series for the "Wrong Turn" movies. What was wrong with a normal scarecrow's head?

As I quickly pedaled away I could only wonder, did Northeast Ohio have it's own Walter Bishop?

Bleeding Hearts

Boy did I hit a nerve today at clinicals. 

It is inevitable that working in the healthcare field is going to bring up the problem of healthcare reform.  While I usually try to play devil's advocate or take an opposing side just for the sake of argument, today it happened because I can't stand the sympathetic, pity party for sooooooo  many who don't deserve it. 

It seems the majority of my classmates believe that ALL people in the United States should get equal healthcare.  I don't quite feel that way.  I believe that since healthcare is tied to income, those who have jobs and pay for it should be allotted healthcare and those who are unemployed, having unprotected sex and having unplanned pregnancies are shit out of luck.  I am a firm believer in Darwinism.  If it comes down to providing food clothing and money for my kid or giving it to someone else's kid because they can't too freakin' bad.  If all these bleeding hearts want to adopt a person without healthcare or a family fine, but don't force me to follow the rules, pay for my healthcare and then charge me money for those who don't. 

I would be all for healthcare for all people if it wasn't a "throw money at the problem" solution.  I believe education, health promotion and disease prevention are key, but not an allowance. (hence my decision to work in the field of nursing -- perhaps I will move to Oregon and do assisted suicide --LOL) 

I see healthcare as a priviledge, not a right.  Why should a smoker or a person that goes to McDonald's everyday and makes poor food choices be given the same healthcare as me?  Both are risk factors for higher inicidences of many diseases.  Why should some homeless bum who spends her life doing drugs and drinking receive healthcare when she gets pregnant?  It is her mistake hence, her problem!  Abortion is a couple hundred bucks.  I would much rather give her the money for the abortion, than pay for her and her kid.  Lets face it, the kid will probably not be that special one that does anything with his or her life anyway (Birds of a Feather...).  And don't give me that "the Lord wanted me to have a baby" garbage, because I didn't get the message from Him that said I had to pay for it!!  Survival of the fittest, if you can't protect yourself and your young...SEE YOU! 

If two kids were dying and both needed a heart transplant, but there was only one heart and you paid into the healthcare system for you and your child all your life and some ghetto-ass, drug addicted mom brought in her baby for the same heart, do you really think that is fair?  I know it's not the child's fault but I refuse to allow the government to make me responsible for a mistake (having unprotected sex), that was followed by another mistake (having the baby) because these people don't believe in birth control or abortion. 

Our society is irresponsible and indulgent.  Americans, can't control money, can't control their diet and they can't control their sexual urges it seems.  We need to teach people discipline, refrain and control while educating them and empowering them to take responsibility for their lives and the lives of their children, not say "oh, it's okay, somebody out there worked really hard and can throw money at the problem for you!  Don't worry, you can continue to be a total fucking loser and never be held accountable.  It's not your fault." 
(I know there are a exceptions to the rule and some people who lose their jobs and are trying.  A system that helps them would be awesome to be in place, but these other people = Be Gone!

Cardiac rehab showed me the unwillingness of so many to change their diet (high fat, high salt, obesity) and lifestyle habits (stress, smoking, inactivity).  I work with a bunch of single moms who worry more about where they are going out after work ends then getting home to their kids.  They all know better, but they don't care and I am suppose to care?

Give me a fucking break!!  Take some responsibility!! Grow up!! 

Our healthcare system is the Titanic. We are sinking and we do not have enough life boats. We are not all gonna make it.