Wednesday, January 27, 2010

Right there beside you

The design, core, and purpose of the OR is to perform surgical procedures in a sterile manner. I had the opportunity again this past week to observe and occasionally participate in these procedures. I was amazed again to see patient after patient be rolled in and out of a room with great care and efficiency by all the staff. What struck me most however, were those of a very gentle demeanor in the OR. They were those who treated the patients with the utmost respect and were able to speak very calmly to them as well. They treated the whole situation seriously and were not distracted by their outside lives but concentrated fully on patient care.
Located slightly on the outskirts of the OR core is the PACU. This is where patients are monitored and cared for as they emerge from the effects of anesthesia. This is where I discovered something about myself as a future nurse. As each patient was rolled in for care I was drawn to them and their status. I was intrigued by how the nurse was going to assess and care for them. I enjoyed talking to them and helping provide for their comfort. I found myself getting excited about their vitals returning to normal levels and them being able to be admitted to their rooms. I discovered that I really do enjoy one on one patient care.
In my experiences in the OR and PACU I discovered different ways to provide patient care. What I truly learned though was about how I want to be more involved in patient care. It is a small acquisition but it has helped me realize, even in the slightest, what direction I would like my nursing career to go.
I hope to treat all my patients with care and concern for their entire body as I witnessed in the OR. I also hope to maintain the same level of a reverence almost to sterility in the procedures I will have to perform, such as placing a catheter. I also hope to treat my patients in a calm, respectful manner and have my central focus be on them while I am at work. In learning more about what kind of nurse I hope to be, I am grateful for this experience to now know that I really do want to be by the patient’s bedside caring for them one on one.

Saturday, January 16, 2010

"Snap- SHOTS" of last semester

Placing a "Bleb" Giving Em an IM injection, she looks a little scared! This is also where I hit this skinny girl's bone! No worries you cannot feel that when it happens to you!

Standing Strong

 8 This book of the law shall not depart out of thy mouth; but thou shalt meditate therein day and night, that thou mayest observe to do according to all that is written therein: for then thou shalt make thy way prosperous, and then thou shalt have good success.
  9 Have not I commanded thee? Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee whithersoever thou goest.
 Joshua 1:8-9
I happened upon this scripture as I was preparing for my efy(especially for youth, counselor position) interview since it is this year’s new theme. It struck a very strong chord with me and was what I needed to hear desperately at that time.  As I write this post I will tweak its meaning for it to more accurately apply to my nursing life.
Only two weeks down in school and I am drastically behind in my reading. I feel completely lost in my classes as they review over pathology with terms that sound so familiar but fail to fall into congruence of what they all really mean. Part of me feels so overwhelmed, with the 3 chapters of reading for one class, four for another, or two and lots of videos to watch somewhere in between, making the climb of K2 seem not as daunting! In wanting to give up and hopefully survive through the bare minimum, that is where the encouragement of verse number 8 comes in. My book(s) of law are now my very heavy new set of Pharmacology, Medical-surgical, Nursing-research, and so on. Right now nothing I read out of them is quite making sense or sticking but I guess it is not suppose to yet. Eventually I hope after doing my reading I will have success in finally at least understanding what my teacher is talking about in my three hour class on Tuesday. It may sound like I am complaining and maybe I am but then I have my experiences in the hospital where it all comes together and makes sense. It gives reason to all the studying and reminds of what I am really doing, learning the healer’s art.
OR:  Operating Room = Real life Grey’s Anatomy
I am not an advocate of that show , although I do watch it on occasion, for one it does not have a single nurse in it and if it did half of the problems they run into would not have happened! I do not watch it for the drama and the incredibly annoying characters but I watch it for its back drop, the OR. So for those of you who watch it you have an idea of where I spent an entire day this past week. This year my clinical are in IMC, Murray UT, which has been so nicely nicknamed the Death Star! Do not be alarmed this is not because of very poor statistical ratings discovered by JAHCO but because this hospital is a monstrosity and very confusing to navigate through!
IMC patient tower, a very small portion of the entire hospital!

A sample OR

In my first day in the OR I was able to follow a patient from preparing for surgery till right up after she would be admitted to the hospital. We will call her Elle Woods for HIPPA purposes. I was not very warmly greeted by my first RN of the day and felt quite uneasy about how the rest of the day might go. I met my patient Elle who was to have an ORIF of her left distal humerus translation being that she had a fracture in her bone above her elbow that needed to be closed by placing plates and screws into her bone. As the RN started to put in the IV in her arm for surgery trying to find her vein and causing great discomfort in Elle! In seeing her pain sympathy struck too strong with me and I thought I was going to pass out right then and there! I thought how in the heck am I going to make it through an entire surgery if I cannot even watch an IV being put in! As embarrassing as it was I sat down until I started to feel more stable and had said about a dozen prayers to get me through the day, since the banana I had eaten  at 5:30 was not cutting it!
As we made our way up into the OR we were greeted by our friendly OR circulating RN who flight attendant like directed us into the room. I had never imagined to meet such professional, yet relaxed, intelligent, cool people ever in my life in the OR. Yes these RNs and DR. were listening to 80’s rock while they were doing this surgery and cracking jokes to one another the whole time while still being very focused on the patient. They even asked me about who I was, I could tell that they really care about everyone that comes into their OR. It was amazing to see the care they went into to protect the patient who would not be moving for four hours during the surgery. They made went to great efforts to provide lots of padding everywhere, warmth( because it is absolutely FREEZING in the OR!), and the sterility of the procedure. I was able to move around a lot during the surgery and watch all of it! I was right by the anesthesiologist for a while and was able to watch him intubate her (put a tube down her throat so she could breathe) and could see her vocal chords! The Surgeon was amazing he told me everything he was doing and all the anatomy that went along with it. It was incredible! I even was able to see the fracture in the bone that he was trying to fix! After the surgery I followed Elle into the PACU (Post Anesthesia Care Unit) This is where they monitor patients coming out from anesthesia and start controlling their pain level. Elle was in a ton of pain when she woke up and reasonable so, after just having seen her entire upper arm cut open! The RN there was great in explaining all her monitoring and what meds she was giving to help relief any pain. Unfortunately for Elle nothing was working! So then this other MD came in and preformed a nerve block by finding her nerve with an ultrasound machine(compliments of GE) and then injecting around it to help block the pain radiating down her arm through her nerve plexus. The pain was finally relieved and Elle was able to be admitted to an official room to see her Mom again. By this time it was almost three o’clock and I had yet to eat anything and I successfully had not passed out yet either! I then went to see if I could catch anymore surgeries before I went home. I entered in where they were doing thyroidectomy. The RN there was also amazing and really funny. He made sure I could see everything going on and showed me everything possible of interest and all of it was! I also saw a 10 lbs goiter removed, adrenal glands the size of a football (which are normal the size of a small rubber ball), and how the pathology lab diagnosis different tissues that come to their lab! Overall it was an amazing day. When I came it was dark and when I left this other world(very much like Star Wars where their technology is astounding, and their light sabers are bovies that electrically severe tissue, which smells like burnt hair!) it was dark again but I will never be the same because of it! I have a huge appreciation for what surgeons know and do, orthopedics being my favorite ones so far. I am so thankful for all those who taught me so much on my first day and for how much I was able to see. I was able to stand strong the entire day and knew that God was with me the entire time pulling me through, along with all the patients in the 60 some surgeries that happened that day.

Accomplishments this week
1.      Placed a couple of IVs successfully
2.      Learned how to start an IV pump
3.      Did NOT pass out in the OR despite the empty stomach and quivering nerves!
4.      Somehow managed to get the efy position even though I showed up thirty minutes late to my interview because I had the wrong room and I had a dryer sheet stuck to my skirt!
5.      Finished Anderson Cooper’s book, very interesting and great perspective on fairly recent historical events.
6.      Was fortunate enough to be the confidant of several confidential reports and kept them
7. Learned that you have to park the direction  of traffic to avoid a parking ticket :(
Pictures to come soon!

Sunday, January 3, 2010

Patience is a Virtue

 Mosiah 3:19 "For the natural man is an enemy to God, and has been from the fall of Adam, and will be, forever and ever, unless he yields to the enticings of the Holy Spirit, and putteth off the natural man and becometh a saint through the atonement of Christ the Lord, and becometh as a child, submissive, meek, humble, patient, full of love, willing to submit to all things which the Lord seeth fit to inflict upon him, even as a child doth submit to his father."

We had a Relief Society lesson  on this scripture a couple weeks ago, entitled "Stick it to the natural man!" The challenge from this lesson was to further one of the characteristics mentioned in this scripture. I decided that I needed to work on patience. Obviously, I did need to work on this because it was found to be tested not too much later. I also had the feeling of needing to contact an old friend I kept on putting it off and saying I would do so over the break.

Well my little tale began on a snowy cold morning in SLC airport. Made it there due to a good friend who was willing to drive the distance in exchange for some fudge. I then made it to Dallas, TX airport to wait for my connecting flight to Greenville, SC. It was a long layover so I was prepared to wait but then I found my flight not appearing on the screen, I continued to wait anxiously to see it appear. Alas it appeared on the screen with a flashing red update next to it CANCELED. Of course that happened right after I had told my Mom that there was nothing to worry about me flying in there despite the blizzard that was forming in that area. How was I to know that there would be a massive storm where I live when it never snows there! I even thought this as I was packing and left behind my serious snow Ugg boots. So then after waiting for four hours as my layover and getting my flight changed for the next day into Charlotte, I got my luggage and headed out of the DFW airport to where. Then I made the effort of calling every person I knew from Texas, unfortunately Texas is a pretty big state and even those who were in Texas would have to make a long trek to come rescue me. There was one dear friend that I knew that lived not too far away from the airport. This was the same friend that I wanted to call earlier but neglected to do so. Well unfortunately she was out of state with her family for Christmas, but it was good to talk to her and I am thankful I was finally able to do so. It is funny how God can intervene in our lives to help us achieve things and bless us by having us do it!
Me and my king size bed!
 The festive geese at the GSP airport.
Just thought it was a cool shot. What can I say I was bored.

After  the disappointment in not being able to see my friend and much phone calling back & forth between my parents and I, we acquired a lovely King size bed at a Fairfield nearby! The patience testing however was not quite complete. I then was dropped off at a restaurant to pick up some much needed sustenance and waited a good hour for my food then another good hour to be picked up again and finally taken back to the hotel. Of course during that time I had left my cell phone in the shuttle that had picked me up and was unable to contact my worried parents. At last though I made it to the hotel. It was a fun, grown-up sort of experience but also strange staying there all by myself. Luckily the next day I was able to switch my flight to Greenville again and flew in no problem. Then I just had to wait another hour or so before my family could come pick me. Thankfully some good friends of ours were kind enough to lend us their four wheel drive so my family could even get out of the driveway to come pick me up. Oh yes there was lots and lots of snow everywhere too, they were not kidding!
Puppy Prints!All the beautiful snow!

   All in all what I hope I learned from all this was a bit of patience can go a long way. I learned that sometimes we cannot do anything about our circumstances but to make the most of the opportunity of having to wait, to face the challenge head on. Being impatient does not help get it there any faster, actually slower. No one is perfect, neither is technology or the weather when you want it to be. It was also said in our RS lesson to remember when your patience is being tested how many times someone has had to wait on you to get something done they needed. So remember the next time you are at the grocery store and the line you have chosen(and are now stuck in) is backed up for some reason to be patient. It could be karma or it could be your opportunity to be kind anyways despite the circumstances or the urge to get upset.