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.
Tuesday, October 19, 2010
Sunday, October 10, 2010
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.
Sunday, October 3, 2010
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.