HESI.

The HESI is this Monday, March 30, 2009 at 8 am. 160 questions of everything we have covered in nursing school. 6 hours allotted to complete it. A score of 850 needed to pass. Some schools require their students to pass the HESI in order to graduate, some don't. My school believes in the former.

A score below 850 means we take the second attempt in a month, and if we still don't pass, we don't graduate in May. We'll take independent study next semester and take the third and final attempt, a failure on that means we're out of nursing school.

You may think, "Hey, you have a second chance next month," but really, no one wants to take that chance. We all want to graduate and we all want to pass it on the first try. I don't think no one truly understands this pressure we're under except, well, us, and those who have had to take it. We have people, left and right, telling us that we will be fine, that we know these materials, that we will pass. As much as we appreciate the encouragement, and want to sit back and tell ourselves the same thing, we...find it hard to do so.

There are moments where I can tell myself that yes, I can do this, I'll pass. Then, there are moments where I am absolutely frustrated and scared out of my mind. As one of my friend put it, all our years of college come down to this exam on Monday. Everything we have worked for to get to this point come down to these 160 questions that will determine our fate. It's even more nerve-wracking than taking the NCLEX. At least, by the time you're ready to take the NCLEX, you have already graduated from school. For us, without passing the HESI, there will be no NCLEX.

So it's the Saturday before the HESI. Almost every one of my friends' Facebook status has conveyed these two words: anxiety and HESI. Our anxiety is in overdrive. We are freaking out. We are trying to de-stress from the pressure and at the same time staying focused. It is so. damn. hard.

We took a mini HESI last semester, and I scored over 1000, way better than expected. However, it was so...traumatizing, I guess, that I do not remember anything about it except for the anxiety I felt and when I got my score at the end. I don't remember any of the questions and whether I thought it was hard or not, which is odd because I usually have some kind of a semblance of the exams I've taken. Now, the anxiety I have is probably ten times that or worse. I just hope I don't go blank on Monday from it.

I'm praying for myself and everyone in my class to pass. We're on the same boat, all of us. In the last two years, we have kept each other going and inspired each other to be a better nurse, and there is nothing I want more than to see all of us succeed this Monday.

I'm just a human being overwhelmed by this mammoth of an exam, but my God is far greater than the HESI. When I start that exam at 8 am Monday, I know I'm not doing it by my own might for He is with me. If you believe in prayers, please pray for all of us in the Senior II class to do well on this HESI on Monday. If you don't believe in prayers, please send us good thoughts. We need it.

Jumping Hoops.

Today, I had two doors of job opportunities shut in front of me. Two disappointments and one dream job crushed in a matter of minutes.

I've been jumping hoops ever since I set foot in the States due to my international student status. As an international student, I have limitations such as not being able to work outside of school and not being able to receive most scholarships. Then, there is also the mountainous paper works and rules to follow to make sure you're not out of status. One step outside the line, and you're out of the country. I'm used to this. I'm used to the paper works, to not being able to have a part time job if there's not one at school, to not being able to get scholarship to pay for tuition. For years, I've adapted to this and I've sucked it up and gone on with it.

But I have never felt such anger in me until today when things were held against me just because of my status. It felt like everything I've been working hard for means nothing, because I didn't even have a chance to prove myself before I was told I cannot go further. It is unfair.

The hospital I interned at, the one I invested last summer, the one I counted on so much, told me they can't hire me because they don't sponsor immigrant visa. Even though I'll be on OPT (allows international students to look for a job and receive work training for a year after graduation), they won't hire because I'll only be working for them for less than a year, a year max. They knew when they hired me last summer that I was an international student, yet they never once mentioned the fact that they won't be able to sponsor me. Instead, I got encouragement to apply for their scholarship and employment, only to have both of those doors slammed in my face. I'm going to stop talking about them here, otherwise, it's going to turn into a hate mail.

Then the other hospital I had really wanted to work for--the one with the 3.5 GPA and no C's in nursing school requirements--scheduled an interview with me--whose GPA is lower than that 3.5, only to had to cancel it because they don't hire non-permanent resident workers. It was as if I had the dream not only within reach, but actually in my hands, then to watch it disappears in a second before I can start on making it happen.

After talking to several people, I realized that, with the current economy status, it is even harder for international workers to get a company that will hire them. The hospitals in the medical center here are on a hiring freeze, the numbers of employee they're hiring now is considerably lower than last year. I've heard stories of people accepting job offers, only to have HR called them and canceled on them. I've heard hospitals starting to close their doors on people like me, the ones without a permanent residency.

I'm not giving up on New York just yet. I'm still trying and I'll keep looking. Although, I have to start entertaining the idea of staying in Texas, I'm not quite ready to let go of my dream. Maybe, something good come out of this and I'll be able to move to NY as planned. Maybe, NY won't work and I'll have to stay in Texas. Either way, for now, I'm still fighting.

I have HESI in a week, and I need to focus on passing that instead of letting this lost get into me. I'm moving on. I have my faith, and I believe my future is in His hands. Whichever way it goes, there's always hope. Hope of better things, brighter future, and less hoops to jump. There's gotta be something better than this.

Special thanks and loves to my friends who have comforted me today as I cried, listened patiently as I ranted, and encouraged me to not give up on NY just yet. They are already the better things in my life.

Grateful and Humbled.

When I say right now, that I am grateful for my life and have been humbled to not take it for granted, it's not a cliche. That is truly my sentiment after hearing a news story in the recent days.

If you haven't heard, actress Natasha Richardson had a ski accident a few days ago, in which she fell and hit her head on the ground. She was fine immediately after, and it was not until an hour later that she started complaining of a headache and was taken to the hospital. Before that day ended, she was unconscious, suffering from swelling of the brain. The news are filled with conflicting reports, some say she's brain dead, some say she has not reached that state yet. Nevertheless, she has suffered from a hematoma, and now in critical condition.

I cannot get this news out of my head because I realized this could've been me when I fainted, fell down, and hit the back my head--hard--on the bathroom floor 3 weeks ago when I had a 103F fever. I didn't just fainted and fell once, but twice, although I didn't hit my head the second time. I remember the fear I had when I woke up seconds later to feel my head pounding and find myself lying flat on the bathroom floor. My immediate thought was not of why I fainted, but what can result from this within the next few hours or days.

The knowledge I have gained from nursing school told me that I could either get up, walk back to my bed, and have no effect from the fall, or I could get up, have headaches, and start projectile vomiting within an hour to a day or to a week time frame. When I got up from the floor, I had a gut feeling that I would be okay, that this wasn't going to turn ugly, but I very well knew I wasn't going to be out of the wood for at least a week. That day I wasn't praying for my fever to go down, instead I was fervently praying for no hematoma formation. I am not exaggerating when I say that I was praying for my life the rest of that day--or week for that matter.

When I told my preceptor of my fainting episodes, she immediately replied, "Oh my God, thank God you're okay. That's how people die! They faint, hit their head somewhere, and they think it's nothing. But then it turns ugly and they die." That pretty much confirmed that I wasn't being dramatic to be worried and afraid of the fall I had. What my preceptor said was exactly what I was thinking, and that was exactly what happened to the actress. She thought it was a minor fall, she talked and walked back to her hotel room, and then she went into a coma within short hours. Just like that.

My heart and prayers go to the actress and her family. I don't know them, but it's a very sad and unfortunate situation, and I cannot stop thinking that it could've been my family and I in the very same situation.

It's another reminder that anything can happen, to you and the ones you love, that life can be too short and unpredictable. So use the time you have now to love, to bless, to care, to be kind, to appreciate, to fulfill, and to be thankful of. Don't waste it, don't take it for granted. Do what you need to do, and say what you need to say before life takes an unexpected turn and you find yourself wishing you've done or said some things sooner or differently.

I am truly grateful that I am still alive today, and humbled that I was still given a chance to live.

ETA:
An official statement just came out from the family stating that she has passed away. I can't fathom what her family is going through. It's another odd feeling to realize what I had worried could happen after I fell 3 weeks ago actually happened, but to another person. And it's also a little eerie to think of what my preceptor had said after I told her the bathroom incident. I just had a different ending, a healthier and living ending.

What is this feeling?

As much as I'm at peace with my granmpa's death last summer, today I realized that I don't know if I'll ever be "okay" when I have patients in the similar situation my family and I went through that fateful July.

The first one happened last semester, and I wrote about it. At the time, I thought it was just a one time thing. It was my first and of course I was bound to feel...something. I thought it'd go away and but it didn't. Yesterday, I started to realize that one of my patients is dying and the family was finally able to made that difficult decision to let go of treatment and do palliative care instead. Today, everything is more...official, I guess. All PO meds are on hold, and the Morphine Sulfate surfaced in the order. Again, I got that uneasy feeling I did last semester.

I think what did it for me is seeing the Morphine PRN dose on the MAR first thing in the morning, just because that is the staple drug for end of life patients to keep them comfortable. It's become some kind of a sign for me that, yes, the time is near for that person. We were given doses of that, too, from the hospice care for Grampa when he went home from the hospital. I had to give him that, and so did my cousins.

Then my chest got thighter as I walked in the room. The patient is much like my Grampa was before he died. Eyes opened but no one is there. They can't talk and you wonder if they knew who you were, and you wish they remember who you were. They're just lying there, waiting for their time to come, and it's an excruciating wait for the family members.

It's a weird weird thing to experience, I can't say enough how uncanny it is to watch a dying person, especially when you've watched a family member went through it. I wasn't exactly sad or upset, I didn't feel like crying or breaking down. There is just...an uneasiness to it. There is a voice screaming in my head that this is the same thing as Grampa: the Morphine, the inability to talk, the waiting, the what happens when we bring him home, the ever present wondering of when he'd actually die. It keeps screaming I have been here before and I should never be reminded of it again.

But it's life. People die everyday, and unfortunately, you will witness that more times than you'd like. Heck, I'm only a student nurse and it already happened twice. My career awaits many a future experience of taking care and witnessing dying patients. After the first time, I thought I had to find a way to be okay with this, to erase that feeling out of me. But after today, I realized I can never make that feeling go away, and I'm accepting that I will forever be taken back to Grampa when that happens again. I will always take a sharp breath, my chest will always feel thight, and I'll always get this inexplicable feeling when I have a dying patient.

As if one dying patient isn't enough, the universe, of course, just has to mess around with me some more. Another patient on the floor, although wasn't mine, vomitted, had a seizure, and went into a code. (This was also a second code, the first one I saw was also last semester) Oh, the brouhaha of a code, there's nothing like it. It seems like, in a code, no matter how fast you're moving to get things, you are never fast enough. How many times did I hear that doctor yelled out "I NEED PROPOFOL 10 cc FAST!!! WHERE IS THE PROPOFOL?! GIMME THE PROPOFOL!!!" in the 10-15 seconds it took the other doctor to get the Propofol and have it drawn up in syringe? You're trying to bring someone back to life, get that heart beating again, breathe air into the lungs. It's a person's life literally in the hands of the many medical staff who rush into that room, and I don't think you'll ever be fast enough. No matter how experience and collected these people are, it's still a total and utter chaos.

Now, the code didn't do anything to me. It was actually exciting, to be honest. This patient was actually in a much somber situation than my dying patient, but I was fine. I've never had to watch a family member going through a code, having tube inserted down their throat, surrounded by doctors and nurses doing everything to revive them. After 30 minutes--that seemed like hours--the patient was stabilized and transfered to an ICU unit.

And then I knew there is a difference. In some cases, I'll be fine. In some others, I'll just have to deal with that weird feeling. That's just the way it goes now, and perhaps for the rest of my career. All in all, for me, it's still an other wordly experience to witness births and deaths. They make me appreciate and respect life more.

T-I-to the R-the E-the D.

Okay seriously, somehow, I must have managed to permanently implant this exhausted look on my face because the nurse director of the floor I'm doing my clinical at said to me today as I was leaving, "Wow, you look tired." And I thought, well, I am tired, but not nearly as I usually would after a 12 hour shift. I only pulled an 8 hours shift today, this is nothing! How tired do I look?!

Last Monday, the student life lady, whom I know fairly well, came up to me as she passed me in the school cafe and said, "Are you okay?" I, perplexed at the question, replied, "Well...I have been sick for the last 2 weeks. But I'm alright now."

"Ah, I can tell." Then I coughed and she shook her head, "Wow, you sound rough." And I thought, lady, you should've heard me last week. That was rough.

Now I'm wondering, goodness gracious, what is this haggard look I have plastered on my face?! I'm not feeling that bad.... Has the stress of nursing school finally managed to age me into looking like a 30 something stay at home mom with 4 kids under the age of 5?! Maybe I should do some Botox or plastic surgeries done like that octomom and look like Angelina Jolie. Ya know, 14 kids and little money but damn, I look like a supahstah!

And I'd be like, I have HESI at the end of the month and I'm studying my ass off, but damn, I look like I get 8 hours of sleep every night and not under any stress whatsoever! Take that, nursing school! Heh. I'm kidding, I'll never get anything done on my face. I'd like my forehead to have the ability to move and look...ya know...normal.

Next time you see me, just tell me I look great and glowing like the rays of sun on a cheerful Sunday morning. You tell me I look tired, I'm sending Cookie my ADD dog to maul you.