Learning

"I don't know how you're always calm and collected, always in control..." -frazzled family member of a 1-month-LOS patient.

I learned a few things about myself today at work- I learned that I work better/efficiently when calm and relaxed. My patients see the difference and use the call-bell less. Two families and patients realized this and complimented me on it today; not to mention these families are difficult to deal with, as one of them is thinking of suing the hospital. Usually, the call bell is going off all the time for these families, but I tried to anticipate their needs and quell it asap.

I notice if you make an effort to know your patients, the days get better and they tend to work with you more. Being social helps. Laughing, making jokes helps, too. Depends on the patient, but the effort should be made.

I also brought in a book for a patient from my bookshelf at home...her case really touched my heart and she really grew to like me as her nurse and would request to see me sometimes if I wasn't her nurse. I gave her the book i read enroute to the Philippines February 2009- "Eat, Pray, Love." She was really grateful and the look on her face was priceless.. she showed me the picture of her 4 month old son Michael and I told her to hang on and to read.. then left for the night.

I can't imagine sitting in a room- all white walls, day in and day out, makes you go crazy..

I also transferred a patient to CCU because he went into rapid Afib. HR 220s. Adenosine x2, amio, adenosine x2 given and he converted back to afib low 100s. I made sure to xfer him out right away and give report, unlike last time when I should have given report a long time ago and my patient went back into vtach.
Acting calm and collected in this "code-like" situation helped too. Just thinking about what u need and communication are key.

BSN RN :D

So, it has been quite a while since I've posted and I definitely have good reasons for this.

Feb 8- my grandma, who was in the Philippines at the time, passed away suddenly

Feb 12- I took the NCLEX in 2 hours with 75 questions. I left the test feeling good about it. Later that day, I immediately booked my flight to the Philippines...

Feb 13- Hopped on a plane solo to the Philippines to meet the rest of my family (they all flew there a couple of days before me--I had to stay because of the board) and say my final goodbyes to my grandma. It was a long 18 hour flight (well 2 flights--16 hours to Hong Kong and 2 to Manila, Philippines)

Feb 14- 10PM Philippine time/10 AM EST (US) I landed in Manila and as soon as I got on a computer, I found out I passed and was an official Registered Nurse!

I spent a week in the Philippines for my grandma's funeral, humanitarian work (my family has a foundation to support local children/schools with feeding programs and scholarships), and also enjoyed the gorgeous islands/beaches.

Feb 21 I came back to the US and was definitely in for a temperature shock! I went from being in 90 degree, humid as anything weather, to 25-30 degree temps. Definitely not a pleasant surprise.

I got over jetlag after a couple of days and saw some friends and did some errands. Lately I've been cleaning my room out because I haven't really had enough time or patience to just sort things out/throw old and unnecessary things away. Also, I think it will be easier later on (prob May/June) when I move out to an apartment in the city.

On that note, I am happy to say I had some job offers before the board and I chose where I did my summer internship. I will be on a telemetry/vascular unit and I start Monday, March 9!

I just had a TDAP vaccine (apparently the most recent tetanus shot avail) and handed in all my paperwork today. My final interview with a unit manager (it had to be post-board--they wouldn't hire without a license) was this past Friday and so I was in HR and Employee Health all day getting processed.

It feels so great to finally have achieved the RN license and just be able to relax from all the pressures of actually attaining the degree and license. Of course, the journey isn't over. It just seems that the basic academic part* has ended and a new chapter of my life is beginning...

* not to say that working on the floor won't be as much as "academic" as college and the nursing program

Stressed out

This studying business is getting super old. I can't wait to take it already! I caught myself in a depressed state earlier because
a.) it's freezing cold outside
b.) i'm always home or indoors somewhere studying
c.) no change in routine
d.) studying all the time (I feel guilty if I don't)

Tomorrow night, one of my nursing friends agreed to go out to a bar to just chill out. The exam is next week and I'm feelin pretty good about it. I finished all the Kaplan questions on the online QBank and just doin the incorrect ones and answering other questions from different books/ERI website. For the most part, I just gotta review the drugs a bit more....

I've also decided to BAN myself from facebook as it is inundated with negativism and other new grads freaking out about the exam. I can't deal with the negativity anymore; I'm being as trying to be as positive as possible... Falling apart and stressing out just isn't doin it for me anymore.



Enough babbling...back to drinkin some wine and relaxin.

Just sweet...

Just as a treat and a break for myself, I went with my friend to the nail salon for a mani/pedi. The last time I went was like 6 months ago! (In nursing school, they'd chastise us if we had our nails done and plus, I barely had time for it.) It was really relaxing and I'm glad I just took some time off to get pampered. When I was leaving the salon, the owners asked how I was doing and such (I've known them since I was in grade school) and they asked what I graduated as. When they heard I became a nurse, the customer sitting in front of the owner was just so pleased! She was glad I was going into the city to work because hospitals around here aren't as great anymore. She also told me "Don't allow yourself to be eaten alive by the older nurses...they need to learn to accomodate you and you need to learn...I'm just so happy to see younger people going into the profession. It always warms my heart. Best of luck and God bless you..." I thought that was so sweet. It made me feel really great about the profession--she made it seem more like a calling than just "work" (as a few jaded people in nursing see it these days, unfortunately).

I figured I wouldn't get any studying done immediately after as I had just taken a 3 hour/180 question Kaplan NCLEX Readyness Test this morning. This time, I was able to sit there without fidgeting or getting bleary eyed for the entire 3 hours. Mind you, the NCLEX is a max of 6 hours, but at least I can sit for 3 so far. I still have to work my way up. I've been practicing questions everyday since I started Kaplan last week and my endurance has definitely gone up. The price you pay is still a rip-off, but I just wanted the extra confidence boost that I knew the course would offer me. The test is a month away (Feb 19) but I'm still a tad nervous! I think it's because of all that passing can do for me--I can finally work in a hospital as a nurse (can't work as a GN without a license here), I won't have to pay a ridiculous amount every month for insurance (cause I'm on Cobra right now since I graduated), and I can just stop stressing out about this test and do things without worrying about studying. (I.E.: I go to a movie or out for dinner with some people and I stilll have the test on the back of my mind.) It's been driving me insane! My fiance knows and unfortunately, I took out some of the stress on him earlier this week. But, he gets why I'm so crazed. I did find out that working out more often definitely helps me cope with stress

Boards Drama

Soooo today, after the Kaplan class, a couple of people from my school showed up at the center to take the diagnostic test. I found out from them that they received their ATT (Authorization To Test) from the State this morning at like 9 AM. When I heard that, I was so eager to just go home and check my email, but I first had lunch with some of my nursing girls then sped home and checked...

of course there was NOTHING about ATT in my inbox...and that really threw me off!


I immediately sent text messages to friends asking if they had gotten their ATTs and some had and some hadn't. I just found it odd because I had sent in my paperwork last month, well in advance in order to be on top of things.

I called Pearson Vue (the test people) asking if they got anything from the state board, but they didn't, so the lady was kind enough to give me NYS Board's number and extension. I called NYS Board and the lady almost made my heart stop beating. She said that she only had received my college's verification that I graduated from the nursing program, but not the payment or application. So, I explained how I mailed it in last month with a certified receipt and this information made her check again. Fortunately, she found it and explained that they had mixed up my files and separated them, so she put me on hold while she combined the files. Then, she told me she would email the Pearson people so that I had an ATT in 24-48 hours.

All I can say is, WHEWWWW. THANK GOD I CLEARED THAT UP!

I sent in my paperwork a month ago, hoping to be ahead and have my stuff processed fast, but that totally did not happen!

I'm already stressed with studying for this board and to have someone say they have none of your payment/application (which was notarized and has a picture of me for ID purposes) would just not help things...

Anyway, back to studying...

Last day of clinicals

Today was my very last day of my 185 hours of preceptorship and marks the end to nursing school!

It's interesting because I started off my rotation with my preceptor being floated to a stepdown unit and today, I ended the rotation being floated to an oncology medsurg floor. I'm definitely going to miss a lot of people...I used to walk into the lounge to grab a bite to eat and I'd talk to the aides or environmental lady. Some of the nurses were just a pleasure to work with and some I definitely will not miss. It wasn't the best rotation I have ever been through, but I still got something out of it.

I feel like without the Mt Sinai internship I would not want to go into critical care so much because I just saw a gazillion things there that I did not experience at this hospital. The staff there worked SO WELL together and they were COMPETENT as hell. I am still amazed by the intelligence and expertise I saw over the summer internship. Bedside procedures, cool stuff like marsupialization, hardcore coding, trauma wounds and the NYPD being involved, ENT, vascular cases...just a whole slew of things. I dunno, I guess as a student it's really intriguing. There definitely was a cultural variety, a lot of the physicians/nurses/staff could speak Spanish, and many other languages, fluently. Here, at this hospital, the medical staff weren't very welcoming to other cultures and if a patient spoke Spanish, forget it. The staff wouldn't be happy at all.

Something interesting did happen yesterday- a family member of a patient who was slowly but surely recovering in ICU came out frustrated and fed up and said to the doctor "Get off your ass and do the job you get paid to do. Stop bullshittin!" Meanwhile, this doctor wasn't even working on his relative's case yet. WTF. We all just ignored it because we were so shocked. This relative usually abuses hospital visiting hours and so the nurse (it was my patient, so my preceptor really) went into the room and asked him to please leave the unit and that it was past visiting hours and the guy just said "you're fucking full of shit, bullshit, i can do what i want" and my nurse got so angry, she was just yelling at him "You don't talk to a doctor like that! That was very rude and unprofessional. It's past visiting hours and you rarely leave when we ask politely." The guy started to leave, cursing out the place, and shoving chairs into the nurses station, and we threatened to call security. He went downstairs and tried to complain and another doctor who was in the unit when he had his tantrum called him out as disrespectful and to never talk to another physician like that again. Turns out,both doctors he yelled at dropped his relative's case. Oh well. What can ya do.

I'll be working in a hospital still as a patient care associate/nursing assistant up until I take the boards, so it won't be the last time I step into the hospital before becoming an RN. I only have one more day, which is Nursing Pinning, when I have to wear my all white nursing uniform. Exciting!

I am just so excited that I've completed my preceptorship hours and took my two finals earlier this week. I had to present on bloodless medicine Monday night at like 8 pm and of the whole group, I definitely rocked it. I was planning on having my index cards, but those just went out the window when I went up because I had researched the topic enough. I was nervous about the professor asking questions, which he did, but it wasn't really in depth. The pens we gave out were needle syringe pens and the class loved it!

Friday, I have my nursing seminar ethical paper due; I focused my topic on DNR orders, healthcare proxy vs. legal will. I had a patient who was coding overnight and the proxy wanted everything done whereas the patient's legal will stated not to do anything that would support life by artificial means. Fortunately, the issue was cleared up the next day when a DNR order was consented to by the proxy (not so pretty overnight when everyone was like wtf do we do since they followed the proxy over the legal will).

I'm loving life right now and definitely just wanna step back and enjoy everything before I start working as a PCA back at the hospital...but yeah, I'm still in a daze and can't believe it..

It's been a MONTH!

Wow, it's been a while since I've posted. I've been absolutely busy with applying for jobs/nursing fellowships, classes, work, and my preceptorship that this has just been nonexistent on the to-do list as of late.

I had two interviews today for the same health system--one was with corporate then a second was for the manager of the NSICU. The questions were all behavioral and the recruiter asked me to walk her through a complete assessment and then give report on a difficult patient I have had. She also asked a difficult decision I have made in practice and how I have gone above and beyond for a patient. Fortunately, from my summer internship I had a plethora of answers to give her! It was great and she was impressed. Thank god. My last interview was okay, but they didn't want me because I had no experience yet. That one was somethin else--gettin thrown to the staff nurses for a group interview (5 staff nurses, care coordinator, manager vs. me!) after interviewing with the manager. I just wanna graduate, take the boards, PASS, and then deal with jobs.

I have so much to do still before graduation in 14 days!!
-Final Presentation in Med Ethics Mon night- presenting on Jehovah's Witnesses and Bloodless Care
-Final Exam in Weightlifting/Gym class (go figure, it's dumb...)
-3 days of 12.5 hour shifts for preceptorship
-1 journal entry for preceptorship + Clinical Ethical Paper
-Cor (American Dream class) presentation
-End of Preceptorship Seminar

Once I'm done with all this, I have to finally set a schedule to work at the hospital again and study for boards...on that note, I just dropped $335 registering to take the NCLEX. =) Sweet stuff, huh. and I'll be paying $500 monthly for insurance to be covered until I get a job, so yeah...no pressure to pass, huh. Love it.

I have day shift tomorrow in the ICU, so time for bed and hopefully a more interesting, well thought-out update next time. After tomorrow, 2 more days in ICU...how sad.