An Unnecessary Thank You

In my last post I mentioned I had received a letter from a family member of a cancer patient thanking me for my "help." As I also mentioned I don't feel I did anything extraordinary, but I did what I do, and will ALWAYS do for my patients. This is why I chose oncology and why I can be an oncology nurse.

Yes, it tears me apart when a patient and his wife get discharged after just being told to go to the beach, spend time with your loved ones because all avenues of treatment have been exhausted and goodbyes are less than a year away, like I did on Friday last week. I shed a few tears of my own with them and hugged them goodbye, really pissed off there wasn't anything else I could do for him, angry that this stupd disease existed.

This stupid disease can scare even the strongest and bravest at any moment, even those with very promising outcomes, like my other patient. He needed 3 cycles of chemo and had tolerated the first cycle just fine, but this second round he was hit with chemo-induced nausea and vomiting (CINV), and it scared him so badly he wanted me to stop his infusion pumps and discharge him at that instant. We talked (and I don't consider myself funny, but for some reason others do and my sense of humor has become an asset in oncology) and laughed, even left the building for a little bit. In the end, he survived his second round of chemotherapy and gave me a huge bear hug before he left the unit to go home upon discharge.

I am always touched by the large and small gestures of cancer patients and their families. It reminds me even for those who I can't help save, perhaps the support and care I gave them helped ease their mind and pain for just one second.

Anyway, here are the letters I received from the family...

"I would like to acknowledge Beth for being such a kind,compassionate and informative nurse. She has provided patient X, who has cancer and is struggling with this, has renewed my hope in our profession. The time, care and true understanding of a pt's needs made me proud to have met her."

and (same family, different person)

"I wanted to thank you for going above and beyond, showing sincere compassion for patient X when he needed it. You are an incredible nurse, and my family is thankful he was in your hands."

and the letter they wrote to my boss...

"Dear (ElizaBeth's Boss),

I wanted to thank you for being kind to patient X, although I know you treat everyone like that-I would just like to recognize your thoughtfulness.

Also your nurse Elizabeth Hxxxx, (I hope I spelled it correctly), showed patient X empathy, warmth, and understanding during a difficult time. Despite having other work to attend to, she took time to destress patient X by walking him outside, which made all the difference. She had to stay late to chart and never complained about it, instead she held patient X's hand and talked with my family. She admitted she is a newer nurse, but one would not be able to tell. Her thoroughness, motivation and skills preceded her. She is your best asset and thought you should know how wonderful one of your own has done.

On behalf of patient X, my family and myself-thank you!"

It was extremely kind of this family and unnecessary for them to recognize me like this and I appreciate their kind words more than they will ever know.

Round 5....

was in my opinion a fail!  Monday started off well with the race and some additional running, but then Tuesday I was asked to work over, Wednesday I was scheduled 12, Thursday I tried to get back on the horse, but by Friday I got bucked off.  Friday I had my first float shift to a leukemia floor (and no it's not the same stuff as on my floor) for 8 hours only to have the boss call and ask if I could stay over for a total of 12 and then with the full moon Saturday and Sunday the patient's went crazy!!  When it was all said and done I worked 63 hours.

Although, running was not the focus of my time for the week I feel the work I put in with my patients was well worth the trade (I'll even share a letter I got from a patient's family in another post).  I don't feel I went above and beyond or did anything I wouldn't normally do. 

Mon AM: 12.3 (0.73 mile warm-up, 5k race, 3.42 mile cool-down)
Mon PM: 5.05 (8:33/mile a little bit harder than an easy run)
Tues: OFF
Wed: OFF
Thur: 11.62 (8:40/mile - long run)
Fri: OFF
Sat: OFF
Sun: OFF (very glad, but tired this work marathon was over for 2 days)

Total: 23.92 miles

Round 4

I have been following this SmartCoach training plan from Runner's World.  It has me running 3 times a week (one long run and one tempo or speedwork and then an easy 3-6 miler). I have been able to run those workouts and then squeeze in easy miles around the two (hard) workouts the best I can. I have managed to cover about 10-15 miles more than this plan calls for which makes me feel a lot better than picking a more intense, harder program would have.  I believe the latter would just frustate me because of my ever changing work schedule.  The additional mileage has come by doing doubles on my days off and on days when it seems pretty much silly to suit up to run but I have jumped on the treadmill to get in a mere 2 miles at a poker's pace, just to say ... "I ran."

Mon: OFF
Tues: 2 miles (treadmill easy - 10:00/mile)
Wed: OFF
Thur: 15.25 miles (roads - 8:34/mile - skies opened up and lightening tried to strike this turtle down!!)
Fri:
Sat: 4.1 miles (roads easy - 9:00/mile)
Sun: 11.1 (SERC run - 8:29 - quads felt beat-up)

Total: 32.45 miles

Each week there are days I really just don't want to do the mileage to break 30 or even 10 miles, but when I type this up I'm glad I did.  I think this running is also really helping keep my head about me at work.  I had my second code blue (in retrospect, the patient never truly lost a pulse ) at work yesterday and was the second responder, never left the room and took it all in stride.  Also, had a patient who wanted to stop treatment in the middle of his chemo bags and leave due to severe chemotherapy induced nausea vomiting and a PCNA that was to say the least not very helpful yesterday.  I think I punched out at 9:30ish last night for another 14 hour day and I'm ready to go at it all over again -- after I enjoy my day off today ;o)

Mad At The World

Sometimes being an oncology nurse sucks -- a lot!

When I first started on my floor a few moths ago, one of my first patients was a young man (a baby in my eyes, significantly younger than me who was definitely in my opinion, just starting out in life) who had a wife and a 17 month old baby.  I had had patients near my age before, but never this young.  As the weeks went by I got to know him, his wife, his parents, his in-laws and his siblings.  They became part of our unit almost.  They slept on floors, cots, chairs, anything they could find to just get a few more moments with him.  He had beaten cancer once at 19, but it had come back and it was moving faster than I had ever seen cancer move before.  He spent a month with us, before I discharged him the week before Easter and told him "I hoped I'd never see him again." 

He came back in less than a week to my dismay and he was worse than ever.  The doctors told him it looked bad and they didn't think he could handle another round of chemo, unless things changed.  I watched him fade away before my eyes, until God finally took him earlier this week.  It was a blessing.  He had held on for so long, fighting for his family and for the long life he should have had, but he couldn't do it any longer and with just a few gasps for air he passed and was gone. 

I had a wave of nausea pass over me and I almost broke down in the medication room, but I managed to close my eyes and take a few deep breathes.  I reminded myself "I had to keep going."  I had patients to take care of.  I was calm on the outside but a turmoil of emotions on the inside as I tended to my patients and helped the family through the aftermath, as best I could. 

The night took forever and when daylight crept through the hospital windows signaling my shift was nearly over, I felt so relieved.  I had to get the hell out of there.  I stopped at the store at 8:30-9:00am and bought a six-pack of beer, under the circumstances beer for breakfast seemed the way to go.  I made it through one before I fell asleep exhausted. 

I woke up angry that a child so young had to grow up without knowing what an amazing father he had, a man who apologized to his mother about a week before he passed saying "I'm sorry, I didn't do more mom." 

I couldn't email anybody or call them that day.  I hid from the world.  I wasn't up for talking or sharing.  I never am when things like this happen.  My anger was of course, full throttle, not that he died when he did, but that it had to happen to him at all.  I spent most of my time wondering what the hell God was thinking and what more I could have done to help him. 

I finally, dragged myself out of my hole on Tuesday to go to the track, not to do the workout, but to go back and face the world.  Seeing my friends was really nice, a few knew something was wrong almost right away and when I told them they hugged me and told me they were sorry.  It was a short conversation, without a lot of dwelling or details.  I couldn't deal with a heart to heart, but just the short talk took a load off.  I ran absolutely terrible.  I was too hot, I couldn't breathe, I felt sluggish and completely blew the workout.  All those awful feelings though meant I was still alive.

Even in the moments of road rage, the crappy track workouts, the pain in my feet, the cotton mouth, the tears and the unimaginable sorrow that accompanies loss I'm not dead and I still have a lot to do with my life yet.

Forced

That is the theme as of late for me, force myself to get up, force myself to go run, force myself to fall asleep, but it's very exciting nevertheless to be out in the big bad nursing world.

I received my first paycheck -- finally, after not having any income since January 26th.  It was a very welcome blessing.  I can't say how much it makes me happy to know that every two weeks I will get one of those puppies direct deposited into my account (heck yeah!!). 

I finally, started with one of my two regular preceptors this week and I felt much more comfortable and a lot less lost.  Medication administration makes me extremely nervous and it is taught to check the patient, dose, drug, route, time etc... three times before giving it to the patient.  I check about seven.  The idea of a medication error scares that crap out of me.  Last night, I worked a twelve (ended up a thirteen) and by the end of the night I was passing meds alone, no supervision or help.  I felt so insecure about giving insulin subcutaneously and pushing dilaudid into IVs I would swing by the nursing station and have another nurse confirm the right dose for me.  It's still my butt, if I give the wrong med and I can lose my license, so a million checks it is.  I ended up with about two hours of OT this week, which will only make my next check a little fatter (Woot!!)

On the running front, I am struggling with motivational issues right now.  I have had to force myself to go running as soon as I get home when I work an eight or I will just go into couch potato mode.  Thursday, I got home a little after 4:30p, changed and head out for an hour and a half only to come home, do laundry, eat dinner and have about 45 minutes before I had to go back to bed (very exciting life).  The days I work my twelves, I have yet to run.  It baffles me how to find the time to get a run in thus far.  I have yet to make it home on time and by the time I get home, I am freakin' exhausted.  I've gotten up at 4:30am a few times in an attempt to go out before I leave, but I just end up seeing the low temps and saying to hell with that and doing some yoga and stretching or going back to bed for another 30 minutes.  I had a good 11 mile run the other day with 5 miles at tempo pace, but I was really flat and felt horrible at the track Tuesday night.  The 'guestimated' paces for me were just too much and after only 1800 meters, I was suffering, by  2400, it was over and I ended up just jogging around the track for the remainder of the workout.  It was a little disheartening, but not the end of the world.  I haven't ran farther than 13.1 miles since the 1/2 marathon earlier in the month and with Boston only 3 weeks away, I really need to get in at least one more 18+ miler. 

I am hoping I can force myself to go here in a little bit.

The First Day

After nearly two full weeks of training and orientation I was finally scheduled to work on my unit.  It was a 12 hour shift (7a-7:30p), so when I got up at 5:00 am, I knew by the time I got home around 8:30 pm I was gonna be wiped.  It was so great to be back and see so many familiar faces.  It was a whirlwind of a day and of course, problems arose all at once rather than consecutively.  I spent a large part of the date observing IV drug administration and getting all my passwords set-up for the time clock, the computer, the pyxis machine (it's like a pop machine, but it dispenses drugs at no charge). 

I had my first up close and personal experience with an Indiana pouch.  I think those things are so cool!  Patients that have an ostomy bag on the outside of their body that can smell and must be emptied often suffer from self-image issues, but this internal pouch is pretty sweet for those who need new bladders.  The stoma itself just looked like a second belly button off to the left of my patient's abdomen.  The patient said catheterizing himself at regular intervals was pretty painless too.

We've added tele to our floor since I was there as an undergrad and reading EKG's has become more common.  I didn't care for them in my first undergrad and I still don't much enjoy counting the little boxes and trying not to go blind as I measure the PR interval or the QRS complex, but I am definitely better at it after spending two full eight hour days reviewing the material earlier in the week. 

Anyway, I was sitting at the nurse's station with about 45 minutes left of my day when I heard this strange noise that kind of sounded familiar to me, but I couldn't place it.  Out of the corner of my eye, around me, I saw a few nurses jump up quickly and call out a room number as they headed down the hall.  It registered at that point what it was.  "Oh sh*t!!"  A code blue really?  On my first freakin' day back, just when I was almost done!!!"  I jumped up and hauled ass down the hall to the patient's room.  It had been the tele monitor alarm indicating the patient's heart rythm was a flat line.  I was thinking two things, man I am not ready for this and if I was going to be in on this code, I definitely wanted to do compressions or bag the guy.  No way was I gonna put the central line in, if needed or push atropine, epinephrine, etc into said line. 

Luckily, when I got to the room, it turned out the patient was trying to get up to go the bathroom and had pulled a wire.  CHEESE AND RICE PEOPLE!!!  I was relieved, no code today for me.  I went back to my desk and prayed I would make it to 7:30 pm without any more codes or craziness.  The full moon was Saturday, not today.  I had a chance at normalcy and freedom still. 

Exhausted at 7:45pm I dropped off my time sheet and headed for the elevators.  I made it down to ground floor and had to get through the J building to get out by my car, but before I escaped I could see a couple looking a little confused.  I knew they were lost and I debated stopping.  I stopped.  They were lost and I ended up taking a ten minute detour into another building and up the elevators to escort them to the appropriate floor.  They told me their daughter was extremely sick and while I was exhausted, I wasn't sick and no one I loved was either.  The extra few minutes it took to help them were well spent. I left them in the waiting room of the unit their daughter was being transferred into and headed back out.  Finally, made it to my car a few minutes after 8:00 pm.  I was ready to head home.

Day 1: DONE

The Initiative

I had to backoff the blogging for a minute there, because I have found additional things to occupy all this free time I have so excitedly stumbled upon.  I also discovered I am not alone in my "what to do? what to do?" state.  Many of my classmates who have passed the boards are now searching for projects.  I spent over a year of my life living a fire drill, trying not to panic and get everything done and study enough (I realized I could never study enough) to arrive at this...

The ability to wake-up, stretch and just breathe.  I then plan out my day however I see fit for the most part.  If I wanna run, run, if I wanna watch TV I can do it, drink coffee and hang out on FB for half the morining, well go right ahead.  I even get to bed between 10pm and 11pm most nights and rise between 7am and 8:30am most days.  Never had a regular sleep schedule before, wasn't even sure if I could do it.  This nearly stress free zone I have been living in is fantastic and I know completely and whole heartedly that I earned it! 

It's only been a little over a week and I find myself excited for the next adventure!  Work starts on the 7th of March, and I have been going over new hire paperwork and scheduling appointments for exams and check-ups.  I have also started reading books again -- for fun!  No more text books addressing lab values and abnormalities of the human body.

I even started a private group on facebook for me and my classmates to share our knowledge about new nursing information, such as SB5 and collective bargaining (and to plan reunions, of course).  I have also reached out to a former professor of mine at school and have been mapping out some professional meetings and lunchs with some "superstars" in my profession.  I don't want to say too much yet, until it's set in stone, but there are about 3 million nurses in the US, however only about 20%  of them belong to a professional organization and are proponents of active nurse advocacy.  It is my hope to help that number increase in my own small and special way.  My last semester I made a promise to myself.  I wouldn't be that nurse that punched a clock and went home.  I would be professionally vested in my career, supportive of my colleagues and job, taking initiative to improve nursing care and patient outcomes. 

This is a really "BIG" step for me and I worry a bit I may have bitten off more than I can chew, but hey I wanna die trying..so I say "bring it on!!!" 

Results are in...

By 3:00 pm on Friday, the Ohio Board of Nursing still had the words "pending" by my name.  I was dying a slow death inside.  Most of my friends had found out by noon the day after their exams and I knew if mine weren't up by 5:00 pm I would have to wait until Monday!!!  I wouldn't survive that long with my anxiety.  I needed a straight jacket.  I needed Ativan.  I needed results.

I finally threw my running clothes on and texted A I was going out and gave him the information to check my status on-line if he wanted to while I was gone.  I swore to myself I would not return until after 5 pm.  The run turned out to be the best thing for me.  Mile by mile I slowly lost focus on the boards and just looked at the road ahead.  My IPOD wa turned up full volume, drowining out all my thoughts.  Peace of mind was filtering in and taking over, ahhhh thank goodness.

Eventually, I had no choice but to return to reality and at 5:05 pm I arrived back at my drive way.  I ran upstairs to see I had missed (2) phone calls, (2) text messages and (2) emails.  Oh man, something was going on, could it be, it had to be...my results were posted.

Sure enough, I went to the website and pulled up my name and there it was plain as day, my name with an active status and an RN number!!  It was over.  I had passed!!  I was officially an RN.

Hell Yeah!!!

Testing? Testing?

**This is the wall in front of my bed**

As I continue to sift through my stack of nursing notes in preparation for the NCLEX, my fears eb and flow like the sea.  At times I feel completely prepared, if not over prepared and at other times I don't think any amount of studying will ever truly prepare me for this f*ckin' thing! 

The test is based on what a new nurse knows.  Who is this person?  I don't know half the stuff she knows.  She had to be the chic that ruined the curve in school and had no life -- b#tch probably never bonged a beer in her life or trained for a marathon.

The test is computer adaptive, so depending on how I answer the first question will determine my next question and so forth.  The idea is to get a bunch of the easy ones right (about 15-20) and get up above the competency line then if I miss a few I am still above the competency line. 

The minimum I can take is 75 and the max is 265 questions.  I have 6 hours, which is way too long.  If I am not out in less than two hours it's probably not a good sign.  Shutting off at 75 doesn't tell me if I passed or failed.  If I make it past 75 questions that means I am still competent and the computer has not yet gauged my knowledge base (it's not that big--snicker, snicker).  If the test shuts off at 76+ questions and I got the last one right, I passed, if it shuts off on one I missed, I failed.  No pressure. 

The minimum also includes 15 questions that don't count for or against my score, of course I don't know which ones they are.  The state boards are trying to determine if the information is being taught in nursing schools yet and it should be a valid question they can utilize on future NCLEX exams (like we don't already have to know too much information). 

There are also these questions called "Multiple Multiples."  They suck!!!  The question will be something like ...

A client takes HCTZ for treatment of essential hypertension.  The nurse should instruct the client to report which of the folloing.  Select ALL that apply.

a. muscle twitching
b. abdominal cramping
c. diarrhea
d. confusion
e. lethargy
f. muscle weakness

You don't know how many you need to pick, you just know if you don't pick all the right answers -- it's wrong and if you pick all the right answers + a wrong answer -- it's wrong.  The good thing is these questions indicate high competency and if I get them I way above the competency line and I will pass.

UPDATE: There were 30 of us in my cohort in the fall of 2009.  One quit after 8 weeks, one failed out the 3rd semester and one dropped down to the traditional program after the third semester.  Twenty-seven of us made it through the acclerated program and of those twenty-seven, five of us have taken the test and passed.  Here's hoping I join those ranks shortly!!

Resignation

I did it!!  After a little more than 6 years at the restaurant I wrote up my resignation two weeks ago notifying them of my last day.  I am a little sad, but extremely excited.  Some things that I just wont miss...

Crappy tippers -- I have never really discussed tipping on my blog, but before I stop serving here is my $0.02.  I approve of most of my friends tipping, but some are completely awful!  The going rate for good service is at least 18%.  If you can't tip don't go out to eat.  Servers make $3.50/hour + tips and then tip-out 2.25% at our restaurant, so if some table comes in has a $100 check and leaves $5.00, I just made $2.75 after tip-out.  If you stiff me, I am in the hole $2.25 and it costs me to come to work!!  I have people tell me all the time they are crappy tippers and I tell them that's fine because I give crappy service.  Ask yourself: How would you feel if someone was messing with your money?  Would you laugh at the funny joke?  No, so don't expect me to either. 

Unprofessionalism -- All the servers, that yell at each other, refuse to help out and do their assigned work, well I say be gone, bye bye, I wont miss you!  I often think that if I was too lazy to change IV tubing or an IV itself in the hospital, I would hands down lose my job.  That's how it is at work.  I wont miss how the bartender is married with 2 kids and sleeping with a server who has her own kid or all the people that have DUIs and have no money for rent because they spent it at the bar! 

Improperly cooked food -- I wont miss how ticket times get up to 25-30 minutes when we are busy and guests want us to give them a free meal.  "Jesus people!  We are busy!!  We can only fit so many steaks on the grill."  Also, when we tell you the steak will be a warm-red, HELLO, there will be blood.  A sirloin "well done, not burnt" will not be juicy.  You got the cheapest steak, because it is the cow's ass, of course it will be tough.

Some of the things I will miss are...

My girls (RG, DVL & TI).   They have such great work ethic and if we hadn't stuck together during the many moments of insanity, we may have all walked out and quit.  I told them I would come in next Christmas and tip them all $100.  All too often people under tip than over tip. 

My awesome regulars, who came in religiously over the years to keep me up to date on their adventures while enjoying some unhealthy, but tasty food.  I genuinely enjoyed getting to know all these wonderful people and share many laughs.  I have been saying my good-byes and introducing them to the other 3 awesome ladies I worked with so that they can continue to come in and have an a good experience at the restaurant. 

I am even gonna miss my GM, who is so much like my dad.  He is impossible to talk to when the restaurant is on fire and yells in a time of crisis (kinda like Chef Ramsey), but in the end he means well and loves you with all his heart, like you're one of the family.  Deep down, he is a big softy.  Sometimes, I think too much.  He needs to expect more out of his staff and put down the law, stop this letting them slide on their work. 

Alas, I am going to an hourly wage, with full benefits, paid time off and full-time hours in 4 days with the opportunity for overtime!!  I am so happy to know my paycheck will no longer depend on how well I can kiss ass or how educated or uneducated a customer is :) 

As of February 23, 2011, I am officially no longer a server.

The Next Chapter: See You Soon

When I last left my blog I was at the pinnacle of my stress level.  However, a canceled final with the option to take the average of your test scores and a few weeks of working like 35-40 hours after finals and I managed to

a) Graduate
b) Make the $450 (cash or money order only) for my review class

I felt it necessary to "get away" from the books and blogging to allow myself a re-load of some sorts before starting this promising new phase of my life.  I am still thinking "next semester" thoughts, only to remind myself a minute later -- there is no next semester, you are done, but that will fade. It seems so strange that I have been going to school since 2005 and in that time gotten (2) bachelors degrees and (1) masters and now that chapter has ended. 

I promised myself, I would study diligently for my state boards and build up my mileage again in preparation for my 5th marathon, but both are not quite where I had planned them to be.  Although, I told my employer I would be leaving him here in the next few weeks, he seems to have decided to get as many hours out of me as possible, thwarting my efforts to study and run in favor of asking how a guest would like their steak cooked and refraining from walking out because as a whole our restaurant lacks accountability from the management on down (which completely frustrates and annoys me, as a person with a self-diagnosed obsessive-compulsive personality disorder). My sanity clings to the thought of, "a few more weeks and then I am done with this."

As for my review class it is exceptionally informative and funny.  My instructor is 110% NO BS.  She tells the most ridiculous stories to help us remember drugs, diseases and treatments we will need to not necessarily be a good nurse, but to pass the NCLEX exam.  My homework includes 530 questions every week with stacks of handouts, which will put me pretty near the recommended 3,000 that should be done before taking the boards. 

As for my board exam, well of course KSU's administration who set unrealistic goals and deadlines for us dragged their feet "because of snow days" and submitted our graduation work to the state late (Uuggghh, one last thing to add to the pile of things KSU did to piss us off).  I am very excited to be done with that place.  If and when I go back for my masters in nursing, it certainly will not be there.  I did however, sign up for my test and am keeping it a secret from the world, so don't ask. 
 

Running has been slow, but progressive and my weight has come down about 3lbs.  My aunt even came out on New Years and was able to run 8 miles with me and my running club, followed by some mimosas and a kick ass runner's breakfast at FDs.  The weekly mileage is only hanging in the 30s, but on a positive note I have found new uses for a golf ball that has minimized the discomfort in my left hamstring, calf and foot.  Mornings are always a test the first few steps as I walk gingerly until I can assess the damage from the day before. 

Boston is less than 100 days away and I very excited to go with the e-speed, BB and JP.  My team (mom and aunt) will be traveling separately, but will be there nonetheless.  My mom has been at the starting line of every one of my marathons.  The first one (Akron) she was not quite at the level of a hot mess, but she was a bit teary eyed and emotional, right before I left.  I told her I would "see her soon" to try and calm her down and although she is much more composed and focused on getting me focused now-a-days, I still always say it before I cross the starting line. It's funny how I used to give her a 20 minute window of when and where I would be at a certain mile and she would just watch expectantly.  Now, she gets updates on her cell and knows my splits almost better than me.  It's my hope one day that I am the one standing with the cell phone watching her splits and trying to not to pull my hair out as she leaves the starting line and tells me "I will see you soon."

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.

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.

Just Around the Corner

This semester, I have 6 weeks of community nursing and gerontology for rehab and it is intense.  I finally broke down and bought some Unisom to help me sleep and it's working, but the problem now is it is lingering and I am exhausted 24/7.  I fell asleep at the my gerontology clincial watching a video on dementia and alzheimers the first day and have been napping in my car on my lunch breaks.  I am so over the top intense and stressed all the time through nursing school I don't know what to do, except keep going until December when it's over.  If I take the pills I am tired.  If I don't take them I am tired.  If I quit the program, well that is not an option.  It is worse than it's ever been.  I have 35.5 hours of clinical and class time, combined with 12-15 hours of work and 14 hours of drive time, putting me at 60+  hours not counting all the time I need for projects and studying for tests. 

I feel tightness in my chest and my throat all the time. I don't feel like I am learning the material because it is so fast and I am just guessing at everything I do in class.  I am not doing anything I don't already know how to do at clinicals.  I am just killing time.  I am completing my degree to be an RN, not an LPN or an aide, yet at my gero clinical I spend my time bathing my patient, teaching her how to wipe herself correctly and washing her hair, because that is what my patient needs the most. 

I can't stand the smell of old people, but the thing is old people only smell because the people that are supposed to be taking care of them are doing a half ass job!!  Old people get fucked up feet to if you don't apply lotion and wash them appropriately they smell!  I don't want to change bedpans or wipe asses, but I absolutely refuse to have a stinky patient.  Needless to say, it seems healthcare professionals get lazy or burnt out and become a little calloused to caring for patients and when I gave my patient a foot bath and massage she ended up crying and telling me no one cares enough to do that for her and she was glad someone still did.  I left the room and told my instructor I couldn't deal with that and needed this rotation over.  She was proud of me, but I just felt sick.  I vowed that day I would take time off work to care for a family member before I let some half-ass healthcare people do it.  I guess what I am saying is there are shitty people working everywhere.  It's not the first rotation where I saw a lazy healthcare worker.

Community is overwhelming with the amount of paperwork.  I have a midterm on Tuesday and haven't studied yet, because I had to prepare for a population teaching project.  ML and I were told we had to each do an hour presentation on puberty to about a hundred 4th graders.  The words "oh shit!!" were flashing through my mind.  I hated going through puberty.  I hate my breasts.  I hate menstruating.  I hate having to shave.  I hate not being 50 lbs and being able to do an unlimited amount of pull-ups.  How am I suppose to explain to all these girls that becoming a woman isn't too bad?  Oh, and not cover the topic of sex, fertilization, STDs or pregnancy?  We were told the kids were too young and to tell them to defer to their parents with questions in those areas.

I am not a presenter.  I get nervous and shaky.  I would rather write a 50 page report.  We over prepped with our outline, transparencies of female anatomy, a powerpoint with topics to cover and I re-read all the basics of puberty just to make sure I hadn't miss anything in my three degrees.  It was definitely overkill, but I was armed.  I started off by asking the girls if they knew what puberty was.  I got some really strange answers like "red" and "hair" and "your hands and feet get bigger."  All of them were in a sense right, but they were avoiding the BIG answers, so I said "Come on guys.  What's the difference between you and me?" To which I got the response "you're old!" WTF!!!!  Ahhh, I should have known that would happen.  It did lead into breasts and growth eventually, but damn really, old? 

I introduced a video called "Just Around the Corner" which covered the growth changes, menstruation, ovulation and the importance of good hygeine.  I had two choices when the video was over.  I could re-lecture on the topics or I could do a more interactive Q & A.  I wanted to do the Q & A because the girls were nervous and had not been excited about this lecture today.  My outline had my objectives for my instructor to grade me on such as know the definition of puberty, identify the changes, understand the process of menstruation, understand what things good hygeine involves etc... But I had my own underlying objects to make the girls more comfortable with what was to come so they would make the best choices or at least be able to identify a trusted adult in their lives they could go to in the future for questions.  The only problem was if I did the Q & A I might lose control of the group, or miss covering an objective both which would lower my presentation grade.  I ended up choosing the Q & A.  I couldn't give the talk based on my grade.  I want to be a nurse.  I want to help people, even if my grades suck.  The girls started off asking about tampons.  I was told to cover pads and pass some around but to avoid tampons, because of toxic shock syndrome and that they had to discuss that with their parents.  I tried but their were too many questions...

"How do you know you put it in the right hole?"
"What if it goes to far in and gets lost?"
"How do you get it out?"
"Can you feel it and does it hurt?"

I finally gave in and pulled out a transparency of the female anatomy and explained how a tampon works.  They were way too curious to not cover the topic.  We had a few good laughs and I got more and more questions.  I would see 5 hands up and answer 1 and then 4 more would go up.  It was crazy.  I had won them group over and they were interested in my lecture!!  I had to defer a few questions regarding sex to the parents, but for the most part I was able to explain a lot and I concluded the conversation by explaining it was okay not to be embarassed and no one should make fun of someone regarding puberty.  When I was done I asked "how many of you feel much better now about puberty than you did when we started this?"  Every single hand went up!!!!  It was a victory.  I had done it.  I was super nervous and a hot mess by the end, but my instructor said I was getting no less than a  98%.   YES!!!!!!!!!!!!!  Perhaps, I would survive this semester afterall.  Four more weeks is just around the corner.

What to do? What to do?

It's over.  It's really over!  I am half way done with this accelerated nursing program.  I finished my last final at midnight last night for genetics.  My grades have gone in the crapper, but I am passing. 

Pediatrics - C (teachers thought maybe I had a learning disability and suggested it had to be my fault my grades along with many had severely truncated from medical-surgery in the previous semester)
OB - B (although it was really fun and I learned a lot, there were only 2 exams and only 2 got an A on the first exam and no one, I repeat no one got an A on the second exam). 
Pharmacology - B (never showed up to class except for a test after the first two weeks; I got a 91/105 on the final and only studied for 3 hours because all my time went into my OB exam - plus I know my drugs, so studying was minimal)
Genetics - B (I didn't learn much as the class seemed too disorganized and answers with rationals were never posted, so I have no idea what I missed!)

My GPA has dropped to 3.15 (ewwww!).  That is the lowest it's ever been (sigh).  I am hoping things will turn around this summer for me, but I am extremely fearful as I have 17 credits!!  It is going to be intense! 

I have all but resolved myself to put running and triathlons out of my mind after this weekend.  I thought I could do it, but I am so broke and the idea of trying to train and work with my schedule is impossible.  I am going to get my few races in to make the quota for SBR, but that's it.  I can't force myself to spend money on races I am going to suck at.  I just want to train as a break from school work, not as a necessity for a race. 

I need to get my GPA back up (or at least try).  I applied for a tuition assistance program with a possible employer for my last semester at KSU.  The employer gives you $5k each semester and then every year you work for them it forgives the $5k, plus you have a job.  It may not be exactly where I want to start, but in this economy it is a job and I will take it!

I think ultimately, I am going to try and get into OB in a hospital or even a place like Plan Parenthood.  Although, I thought this would be the end of my scholarly years, I think I will continue my education after a year or two of working as an RN and going to school for my master's as a nurse practitioner or a certified nurse midwife.  I am certain if either of my parents read this they will be groaning and thinking "not another degree!"  -- But I can't help myself!  I am an addict, I guess.

Off My Chest

I entered the healthcare field because I loved the life sciences and was fascinated by the human body's physiology.  Helping people was initially, secondary, but as I did my first internship, my field experience and now my clinicals, it has become my main purpose.  I always viewed the healthcare field as "good and true."

Not so much anymore.

As I complete more and more clinicals, I see and hear things that should never occur.  Things that should be seen only on "Law and Order," but not in reality.  I feel it has no place in my life, or anyone elses, and it really upsets me!

I think about my brother, who has just had his first baby and all my friends having babies and the idea that this could happen to someone I know and care about is quite disturbing. 

As a nurse, I am taught to be a patient advocate, to promote patient education, to utilize therapeutic communication and not be judgemental in anyway no matter what the patient decides.  But here on my blog, I refuse to hold my tongue! 

I have encountered two mother's now, who had to have their newborns taken to the treatment room for blood draws, who refused because "they couldn't bear to hear their baby scream in pain."  Well screw them!!  They are the parent.  How do you think the child feels.  Their baby is alone and suffering without their mother in the room who could provide some sort of comfort and familiarity.  Get off your ass and go support your baby!!  As painful as it is for the mother to hear it, it IS worse for the baby. 

As much as a parent wants to trust a healthcare professioinal with the best care for their baby, they do not all do the right thing, ALL the right time.  It is your job as the parent to ALWAYS protect your child. 

I heard a very true and horrible story that happened in a hospital the other day.  It makes me so angry and tearful to think this can happen, but it can and don't think it can't be your baby.

A newborn came in with possible meningitis and was on prophylacitc antibiotics already, but needed a lumbar puncture to confirm.  The lumbar puncture would provide cerebral spinal fluid, which would be tested for the presence of the bacteria.  The first day they attemped seven times!!!  Seven times to get the sample unsuccessfully, before giving up for the day.  It gets worse.  The next day they decided to try again.  The father had gone home to shower after a day in the hospital with his baby and wife.  The wife was asleep.  Healthcare staff did not wake the mother to the treatment or tell the father to be back and be present for the test.  They just whisked the baby to the treatment room and started poking away.  Again and again they tried, but were unsuccessful.  Nurses protested and said enough was enough, but doctors kept trying.  The baby screamed and screamed until it passed out from pain, but they kept going.  There was no parent in the room to fight for the baby, to stop the unethical behavior.  Finally, after eight tries the doctors gave up. 

15!  15 Fucking Times these doctors poked a little baby!!!  And no one stopped them!!!!!!!!!!!!!

If there is anything to gain from my post it is this....

As much as you want to trust the healthcare professionals alone with your baby, you should always be a part of all your childs procedures, no matter how upset it makes you.  Ask questions, ask a lot of questions.  The baby can't speak for itself, so you must!!! 

NICU

Our pediatrics rotation involves our choice of two "alternative experiences" as they call it. We could choose from NICU, PICU, ED, Psych and I think one other (obviously I didn't pick the one I can't remember).

Please understand because I must follow HIPPA guidelines and privacy of the families I utilize "preemies, babies and it's" throughout my post instead of referring to the gender.

I chose NICU for my first choice and ED for my second. Anyway, yesterday when I got up to my floor, I was instructed to report to the NICU for the duration of my shift to learn as much as possible. I was super excited. My exposure to newborns was very, very limited and my experience with preemies was non-existant. I walked over to the sink and scrubbed in next to a somewhat large woman who had been brought in by transport. She seemed very agitated and I tried to stay out of her way as we entered at nearly the same time.

I reported in at the desk and was surprised to see over 30 babies!!! Most were 30-35 weeks. One preemie was soooo little, only weighing in at 2.5lbs and entering the NICU around 1.8lbs. That baby was less than 25 weeks at birth.

I met another preemie who , a real fighter. The baby was being weaned off morphine and going to be extubated in the next day or so. It sounded like a hopeful scenario as I spoke with the mother who was unmarried and looked less than 20 years old. This was her second preemie!! Her first had also been born a preemie died at birth.

After I left that mother to spend some time with her preemie alone, I noticed the woman that I had entered the NICU with sitting in her wheelchair with her hands in an incubator stroking her preemie! The baby was on an oscillatory ventilator. I didn't stop and observe or speak with the mother as it seemed inappropriate. In some ways, I felt like I was at the zoo, walking by each cage and observing the animals, only these were preemies, fighting for their lives in the NICU.

The next room had this phenomenal nurse with 30 years of NICU experience who was unbelievably kind and began explaining many of the conditions and interventions used and seen in the NICU. It was no surprise that the majority of the preemies came from families who were ignorant of good prenatal care and health habits, abused some type of drugs and/or alcohol or were themselves babies having babies. It really pissed me off and made me sick to think, even if these kids make it out of the NICU, they may never have an good childhood or healthy life.

As the day wore on we saw a preemie with it's belly button in the left rib cage, a rather large forehead and what looked like a permanent "elvis sneer." There were a few babies with MRSA too and one preemie who was born with it's intestines on the outside of the body! After touring the NICU and learning a bit about many of the preemies and their conditions we headed back to our awesome nurse to get some more in depth information on some of the preemies conditions.

We were observing and learning how to care for a preemie who had developed Necrotizing Enterocolitis (NEC) and lost what I believe to be about 60-70% of it's colon and had a stoma. I felt I could spend days and days in here and never learn or see enough.

****WARNING THIS PART OF THE POST CAN BE VERY SHOCKING AND I DO GO INTO SOME DETAILS****

Another nurse came into the room at that time and asked us point blank "Do you guys want to watch a baby die?" My stomach dropped and started doing flip flops. Was she serious? Who says "yes" to that? She informed us that the baby we had seen on the oscillator, with the mother I had entered the NICU with had an oxygen saturation level of 7%! A normal human is at 98%-100%, a person with a respiratory disorder (e.g. COPD) is usually put on supplemental O2 when their saturation level is 88% or less, so 7% is just unfathomable. KT, who was in my class was also with me and looked over at me with that look "yeah, that would be a great experience to watch and we want to, but it is someone's baby!!" There were about 4 or 5 nurses in the room with the family as the baby took its last few breaths. It is a terrible site to watch people struggle for air for a few breaths, then nothing, and then they manage another breathe or two before it's all over. It is not a peaceful breathing. It looks like torture! When the preemie died it was wrapped in a blanket and removed from the NICU, to a private room so the family could say good-bye.

After, we took the body to the treatment room and did post-mortem care on the preemie. The IVs had to remain until the coroner had a chance to examine the baby and make a final diagnosis. Molds or the baby's hand and foot were taken along with a little bit of hair and made into a keepsake for the family when and if they were ever ready to have it. I thought it was morbid, but maybe after time the family would be glad they had that to remember the baby by. I just wanted to nudge the preemi and say "hi baby." The preemie looked like it was sleeping, but you could see the physical changes occuring, blood was flowing to the lowest points, the heels and the backside as the preemie became very pale on the frontside, this is known as livor mortis. The preemie was definitely not as warm as it should have been either, indicating algor mortis too. The last step after washing and changing the diaper was to wrap the preemie up. We then headed to the morgue. I had never been in a morgue. It was on the bottom floor, but it is not marked easily and we had to call security to let them know we were coming. I was very unattached at this point. The transfer paperwork was completed and we left. It was also time for me to report back to my floor for a post conference, so I thanked the NICU nurses and headed back up.

This one day has completely opened me up to working in the NICU. I thought I would detest Peds and OB, because parents aren't supposed to out live their kids, but maybe, just maybe I can do my best to help those preemies have a fighting chance at a long healthy life.

A Sigh of Relief

It seems so long ago I graduated from high school and started my first year at Kent State pre-med, but then after only a few weeks of chemistry I realized I was in trouble and dropped out. I changed schools and my major to criminal law and realized after 2 years I missed science and sport so much I compromised and went to school for exercise physiology. I have had a passion for the cardiovascular system since I was 11, memorizing the anatomy of the heart and the path of blood through the body. I had lots of road blocks to finish my bachelor's degree and after 10 long years I did it. I thought it was over and I would finally begin my career. I was so excited to get away from serving and all the complaining about shitty tippers (Yea!! 10% is NOT appropriate!!! Average tipping is 18% and up!!) who want free meals, the lazy servers who do half-ass work, the tipping out to everyone and their mother in the restaurant, the health code violations employees commit and the high stress of having managers constantly yelling during the rush. I was relieved I was going to find a job in cardiac and pulmonary rehab and help people to a better life, to a second chance. I was done consoling people who wanted the most tender steak "well-done but not burnt" who didn't get it just the way they liked it and thought the world was ending. I sent out my resume, excited about my future, about having a salaried income, a 401k, maybe even my own home someday soon, but it didn't happen.

My lack of experience, no ACSM certification and no master's degree = "thanks for your applicantion but NO!!" I spent a many nights stressed and panicked over my future and made the decision to continue my education and complete my master's degree and work for free at a hospital in my field. Thankfully, I finished that one in 2 years, but the job market plummeted and hours were being cut everywhere. I was beyond frustrated. I was just down right pissed off!! What the fuck was it going to take to get a job! I was a server with 2 degrees, both with honors (what a waste). I didn't want to take a job outside my field because I worked so hard for it and I really truly enjoy the people and the clinical environment.

I felt like my future was a big black hole with no direction and then a friend at work said I should apply for the accelerated nursing program at Kent State. It would be 4 semesters of my life. I am already 31, but what is 2 more years? It goes by so fast and there would almost always be jobs available. I would NEVER EVER have to worry again. I applied in April. I was really nervous. They only take 30 people! I even know a girl that has applied for the program 2 times and been rejected and was also applying again for the 3rd time. They grade you based on your 2 letters of recommendation (I had one from my advisor and my boss at the hospital), your essay on why you want to be in the field, pre-requisites (I had all A's, except A&P II, got a B!), cumulative GPA for degrees (undergrad 3.5, grad 3.8) and prior experience in the medical field (I had 2 years working in cardiac and pulmonary rehab, along with Basic Life Support Training). It seemed I was a shoe-in, but for the last 2 months I have beeen stressing and stressing about my future and my finances. Let's face it working as a server is NOT a steady income and with the new tip-out system our company implemented I will make $2000 less this year!!!

I even applied for tuition assistance through the Cleveland Clinic, but because their deadline for acceptance was last week and Kent State does not begin accepting applications until this week I had to contact the Clinic and apologize for wasting their time and withdraw my applicaiton. After I hung up the phone, I'll admit I broke down and cried. Why is this so hard for me to grow-up and have a career, a family, a home? What was I doing wrong? I felt it was a bad sign of things to come. Now, I was even more nervous about my future. Had I signed up for this summer chemistry class only to have my application rejected by Kent State? "Sorry, you are not a winner, please try again."

Last night, I arrived home about 11:30pm from work and I received an email from the accelerated nursing department.

Congratulations! It is an honor to inform you of your provisional acceptance into the College of Nursing’s Accelerated Baccalaureate Degree Program for fall 2009. Official acceptance is only valid with a response to the attached Electronic Statement of Intent indicating you will accept or decline your seat by June 30, 2009.

Instructions for submitting your Statement of Intent:
ELECTRONICALLY: (Preferred method)
Open the attachment in Microsoft Word
If accepting your seat for fall 2009; Click on the box for Accept; TAB to fill in the information below.
If declining your seat for fall 2009; Click on the box for Decline; TAB to Reason, We appreciate a reason for you decline.
TAB to the bottom of the page and complete the date and electronic signature.
Click on FILE, SAVE (we suggest saving to your desktop).
Open the original email and click on REPLY.
ATTACH the Statement of Intent you saved to your desktop.
SEND

BY FAX:
Open the attachment in Microsoft Word.
Print document & complete
Fax to: 330-672-2061
Keep in mind the June 30th deadline.

You will be receiving a packet with additional acceptance requirements by e-mail on July 1, 2009. Please watch closely for it. All requirements are due July 24, 2009.

Student Services
Kent State University College of Nursing

I let out a really quiet "Hooray!!!" as my roommates were asleep and breathed a sigh of relief.