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.

Sickity SICK.

I was going to write about how awful I have been feeling for the past week and a half. I mean, I was ready to go all out on this, because, dang it, I have never been this miserable from an illness in my entire adult life. The last time I was even remotely close to being like this was 3 or 4 years ago.

I’ve been MISERABLE. And I want to WHINE. Because that’s what sick people do, they whine. But then I thought, wait, I don’t want to do that. I am a better person than that, so I’m going to do the opposite. Because that’s what a mature adult would do, they’d look at the bright side and be grateful instead. So here it is

I’m grateful:

• That I am still alive and I’ll recover alright. I mean, a fever that broke only to come back less than a week later, plus the discovery of a palpable lump in your armpit, hacking coughs and congested nose that last more than a week? It’s no wonder that my mind started to wander to things I know could go wrong. The downfall of working in the medical field is that you see what can go wrong and you know very well it can happen to just anyone, including you, and that is the elephant in the room whenever something abnormal happens to you and your loved ones. To find out that this was an upper respiratory tract infection with early stage bronchitis and that lump was nothing more than an enlarged lymph node due to said infection? It was a big relief.

• That hey, I have one heck of a story to tell now! I mean, I fainted TWICE in the BATHROOM as I got up from the toilet seat. I fell back and hit my head on the bathroom floor the first time, I fell forward to the wall the second time, which was about 6 hours after the first one.
  
• That, as a student nurse, I have the skill and knowledge to know what caused those fainting episodes. High fever (Tmax 103) + period + getting up too fast = orthostatic hypotension. BP 108/72 lying down, and 88/50’s standing up? Not fun.

• That I was okay after I hit my head on the floor. That was a scary moment, finding yourself flat on your back, head pounding, and realizing you just hit that head on the tile, but you had no idea how hard you hit it. Again, as a student nurse, you know of all the things that can go wrong, but as you did neuro check on yourself to make sure you were indeed okay, there was a sense of calmness telling you that you were okay and no, you weren’t not going to have a hematoma.

• That, although I missed two weeks of clinical, I will still be able to make it up. I’m bummed that, while my friends are nearing to complete (or already have) their 100^th hour of the 170 clinical hours we have to complete this semester in order to graduate, I have only raked in a measly 44 hours. I will be the snail that finishes last at the end of April, but screw that, I’ve made peace with it and I’m okay with being the snail as long as I cross that 170^th hour mark before this semester ends.
  

• For my friends and family, who have taken care of me when I didn’t have the energy to get out of bed, sent me well wishes, prayed for me, and made me laugh through all this. They’ve made my miserable days somewhat bearable.

• For my immune system. As much as I’d like to beg to differ, come think of it, God has given me a pretty darn good immune system. I rarely get sick, probably a couple minimal colds here and there per year, but nothing that would hold me down to bedrest like this. I even noted to myself last year that I was surprised I didn’t get sick a whole lot ever since I started nursing school. I thought with that high pressure cooker of a stress, I’d be crawling in and out of bed being sick as a dog several times a year. But I haven’t until now.
  
  
• For losing weight! I’M KIDDING! I’m not shallow like that. I actually hate losing my appetite, because my tummy hurts but I have no desire to eat. Plus, the Nurse Practitioner put limitations on my diet: no dairy and nothing complex, just broth with rice or noodle. Basically, my tummy can only handle soups for the time being. Blech. Now all I want is a tall cold glass of chocolate milk, which, obviously, I can’t have. Human being, always want what they cannot have. Ya don’t say!

So that’s it. I’m coughing less and blowing my nose less, which are good things. I still get tired easily, so I’m pretty much spending my days vegging on the couch on my computer or watching TV when I’m not napping. Yeah, isn’t that the life of a millionaire? Wake up, check emails, watch TV, nap, wake up, maybe try to eat, some more TV or computer, nap, try to write papers, more TV, bedtime (oh, and insert copious amount of coughing and blowing out nose in between).

My goodness, I am a BUM for sitting on my ass all. day. long!!!

But I’m a grateful bum, though…. Just sayin’….

Avaiable for hire.

I think I'm more productive when on bedrest than not.

I mean, I submitted job applications to 2 different hospitals already, and the only reason I didn't apply to the third one was becasue I'm too sick to get one document scanned.

Anyway.

Raise your hand if you think applying for a real job is scary? *raises hand*

Goodness gracious, I didn't know it could be that scary. I don't know, maybe it was the fear of rejection or something, but I was reading whatever it is over and over before I finally clicked submit. It's your life you're putting on the frontline. All your education and accomplishments that you hope are good enough to get you hired to do what you want to do for the rest of your life. I'm not one to beg, but after every job application I'm all, "Please, love me, want me, HIRE ME!" Okay, not a good idea to say that to the recuiter, that has crazy not mentally healthy written all over it....

So application to hospital A was submitted yesterday. I seriously wasn't expecting much of it because it was a very competitive hospital and my friend, who I think has better qualifications than me, had applied there before and received a rejection email. Sure enough, I got the rejection email on the same day I applied, which made me wonder if they sent out that email automatically. You know how you get an automated email after you applied saying your application has been successful? Well, with this hospital, you also get an automated rejection email. Because seriously, I think both of us are pretty darn good candidates. Heck, I even had letter of recommendation to boot. It really made me wonder what kind of super applicant they say yes to. Robot applicant maybe....

Application to hospital B was submitted today. This is the hospital I interned at last summer, so you can say I do have inside connection. I knew the recruiter, I have met briefly with the manager of the unit I want to work at, so I've given them head ups that I've applied. However, this doesn't make it less nerve wracking though. They did say that they have never turned away an intern, and my friend did assure me that we are already in, but still, it's a freaking real job on the line here! I have higher hope on this one than hospital A, of course. So we shall wait for a call back.

Hospital C, I'll hopefully apply tomorrow. I think I'll feel good enough tomorrow to go somewhere with a scanner for one more document and then I'm ready to submit. It's another competitive hospital--heck, all three of these are--but I somehow have hope too on this one, unlike hospital A, to which I felt rather indifference about. Out of the three, this one has the toughest criterie, I actually don't fit one of them but screw that, I'm still apllying. My GPA is thisclose to their 3.5 requirement and I just got invited to the nursing honor society. That should count for something, right? I have nothing to lose, I'm applying anyway.

So that is the tale of my job applying process. Less than a year ago, I did the same thing for an externship job and I got what I wanted. So here's to getting the nursing job I want (and need) this year!

Scary.

I had the scariest thing happened to me last night and this morning.

I had two syncope episodes in the bathroom, once at midnight and once around 6 am, and both after I got up from the toilet seat. It must be fever induced orthostatic hypotension, which is a conisderable drop in blood pressure when a person moves from a sitting/lying down position to a standing position.

I started running a fever yesterday, so my blood vessels are already dilated from the fever (Tmax 103 this am), and it's not helping either that I'm on my period. You add these together and you'd think, "Hmm no wonder this happened." I did remember I got up rather quickly from my bed to the bathroom, which just aggravated it. Still scary when it happened, nonetheless, especially when I had neevr fainted in my life before.

And yay for being a student nurse and having assessment skills. I can't imagine how freaked out I'd be if I had not been able to draw conclusion on what may have cause this, and had not known how to do neuro check on myself to determine if I had hit my head too hard on the floor when I fainted.

I don't remember anything from the first one, I got up and the next thing I knew I was on the floor. With the second one, I remembered more. I was feeling dizzy and seeing dark, which got me to think "Didn't I turn the light on already? How come it's so dark?" Then I fell forward and passed out. Ion ly fainted for a a couple seconds, and after the second one I called my aunt to get over here and bring me her blood pressure machine.

Sure enough, when lying down my BP was 108/72, and when standing up, it was 88/60. My aunt wanted to wait to see how I'd feel before we decide going to the doctor or not. I'm feeling much better now. No dizziness when I stand up, and I have gone to the bathroom twice since the second episode and didn't faint. I still have a 101.3 at the moment, but I'm gaining my appetite and energy back as we speak. So here's to hoping that the orthostatic hypotension is just a fever induced episode and nothing serious, and that I'll get better sooon.

I called in sick for clinical this morning, and definitely not doing any this week. I still have to study for Leadership/Management exam on Monday and finished my part in our group Community paper though.

That's all the update I have. I haven't had a chance to write on anything else, so this will do for now. If you believe in prayers, keep me in yours! :)

5.16.2009.

I just applied for graduation.

I will be walking in that cap and gown across the stage on May 16, 2009.

Wow, I, and the other 64 people in my class, finally get to say that. I don't know how they feel, but I'm pretty stoked about it.

But scared too, because ohmahgaah this is it I'm going to be a real nurse and how the heck am I going to do that when I feel so inadequate and incompetence and I don't know anything and jebus am I going to make it am I going to be a good nurse there are patients' lives on the line here!!!

Yeah, it freaks me out, sometimes a little and sometimes a lot.

School does its best to teach and provide us with experience, but it's nothing like the real thing. How many times have I gone to clinicals and come across drugs that I never heard before in class? How many of the machines I saw, when I had clinical at the Cardiac Recovery Unit that one time, can I name and tell you what they're for? Heck, I'm a senior II and how many IV have I put in? None. And how many venipuncture have I done? Only one, and that wasn't even on a patient, it was on my internship friend for a check off (and yes, my friend did one on me too).

But then, it always surprises me at how much I know that I didn't know I know before. I know, I just lost you right there. Do you know what I mean? Okay, okay, I'll stop.

What I mean is that, the general feeling among the seniors is that we don't know anything. It's like, wait-how many conditions does this patient have? How do you pronounce this drug?! What is that futuristic looking machine is for? They did what on that patient?! Is he gonna cra--holy sh*** BP's dropping--fast--he is crashing! Will we know how to think and act critically? My own immediate answer to that question used to be "No.... I don't know...maybe?" But now I'm starting to think differently, in that I think I know more than I thought I do.

Today is an example, we had a 50 questions pharmacology exam that wasn't counted for a grade, just to see what we know so far; students usually don't do so hot on this impromptu exam. During the review, the instructor asked, "Once you start Iron therapy in an anemic person, how many days will it take until you see some improvement?" There was a lot of answer thrown out, "a month" being the most common I heard, but "120 days" just rolled off my tongue. I wasn't shouting it out to be heard to the class, more like saying it to myself, and I didn't hear if anyone else has shouted "120 days" also. I was just thinking, "120 days, that's the lifespan of adult Red Blood Cells, you have to wait 120 days for the new RBC's to see some result from that Iron."

And I was right.

My exact thought at that moment was, "Huh. Where did that come from?! How did I come up with that?!" While the grade of that exam is a failing one by the school's standard, it's still better than what I expected and it's higher than the class average. I've been surprised at myself a lot--especially in the last semester, perhaps it's time for me to start setting higher expectations of myself.

I guess what I need to keep telling myself from now until that May graduation day is that I am more competent than I thought I am, and I am more than I give myself credit for. I have been pushing myself to trust my gut and go for it for the past year, and I've found out that--actually--more often than not, I was doing and/or saying the right thing. It's like this whole nursing thing has finally been coming together in my head, unbeknown to me, and I am now starting to realize it. Although, I still have to admit that believeing in yourself is sometimes easier said than done in this world.

There is still much learning to be done and confidence to be built in on my part.

But you better your bottom dollar I'll be as ready as I can be when 5.16.2009 comes along.

Huh. That's weird....

You know what I've been noticing?

I cannot recite my cell phone number in my native tongue.

No, I am not kidding.

Everytime someone--who speaks my first language--asks, I'd start telling them in said language but when I get to the last 4 digits I have to stop and cannot, for the life of me, remember it in that language. I have to repeat the number again in my head in English and resort to saying the rest of the numbers in English.

This happens every.single.time. Am I weird or what?!

Do you also wanna know what else I've known all along but has just been confirmed now?

I am slightly deaf. Or even mildly deaf.

I've known this. I find myself asking for a repeat whenever someone speaks really soft or whisper. Last year when we practice for head to toe assessment check off, I sometimes couldn't pass the whisper hearing test, to a point where my partner and I promised on what words she was going to say (Wednesday to the left ear, Saturday to the right ear) so I would be able to say those for sure instead of keep asking "what?!" and end up distracting her assessment routine (we were already a nervous wreck doing a 30-40 minutes routine under the watchful eyes of our instructor). Then last Wednesday as we practice hearing and vision screening for a check off, we did the Sweep hearing test on each other with the machine and I couldn't hear the last 4000 Hz on a 25 decibel. Forgot how far my friend went up on the decibel before I can finally hear all three of the 1000 Hz, 2000 Hz, and 4000 Hz. Or maybe it was so bad and embarrassing that I am in denial and choose to forget it.

My vision is already not perfect--although, it was a relief that I still have 20/20 on this prescription, which hasn't gone up in two years based on my early exam. Then I have this memory confusion thing. And now I have hearing problem, too? Will a hearing aid be in a near future? Gah, I am such an old person!

They better give me senior discounts for this crap.

For serious!

Ready to launch.

I have been thinking.

A lot.

I have put in so much into this decision and I'm going to commit to it and do my parts to go through with it.

I'm moving to New York City in June 2009.

For some people, this isn't a surprise, even for you (I have no idea how many--if there is any) if you've been following my blog because I've talked many times about my amazing summer there. But now, now I'm saying it out loud and putting it out there. I didn't just make this decision in the time following my summer stint there. Although it sealed the deal, my journey to have come to this point began more than 3 years ago.

I visited NYC for the first time in 2005, and I fell in love. There is just something about it that charmed its way into my life and managed to stay since then. For a while I thought I'd move a year or two after graduation, but for the last year or so I knew if I'm ever going to make this dream of mine come true, I have to move right after graduation. Then the internship fell into my lap, an offer I couldn't refuse, and the 3 months I spent there confirmed every reason I have for moving and drove away every doubt I had about making the move--okay, maybe not entirely drove away the doubts, but those doubts were greatly minimized to a point where I am not afraid of them anymore.

A lot of people want to move to NYC, it has a lot to offer: the fun, the lifestyle, the people; it's the best City in the world, they say. I have many reasons too. Out of the places I have traveled to in the U.S., NYC is on top of the "Yeah, I can see living here..." list. I just feel like I fit there, and I am not alone in thinking this way. My family and friends are very supportive and encouraging, telling me that they, too, can see me living there and making it.

I've been where I live now ever since I moved to this country, that is 9 years ago, and by now, I'm getting restless. I want to go to the next level of my life, where I'm out of my comfort zone, where I can grow as a person, where I can open my eyes and see more of what this world can offer, where I can meet new people, where I can make a difference. I'm young and this is my time to spread my wings, if we want to be cliche here.

Having said all of this, I do think that I'm not going to live there forever. I do feel very strongly that once I'm settling down, I'll move somewhere calmer, even come back to this Texan city that has been my second home. In my 23 year old mind, there is no way that I see myself raising a family in the jungle that is New York City, but this will be another decision I will have to make when I get to this bridge years from now. For now, let's just deal with actually moving there first before any thoughts of moving away from there.

This decision has been more than 3 years in the making and you have no idea how much I am relieved and excited to be able to say it out loud that yes, I am moving to New York City in June 2009. Yes, I am and will be making arrangements from now till then. Yes, if God's willing, I'm going to start my nursing career and a new life there.

With my last semester of nursing school--oh man, I can't believe I get to finally say that, my.last.semester. Wow, where has time gone?--starting next week, I'm excited and nervous all mushed into one. A lot will happen within the next 5 months let alone in the rest of the 12 months of this year, in a life changing way at that--applying for jobs in the City, job interviews, HESI, graduation, moving, NCLEX. It's overwhelming I can barely keep my head from exploding.

But I'm ready. I'm ready to launch this year. I'm ready for what may come. I have my faith, I have my family and my friends, I have myself to carry me through. Intermission is almost over, let's get Act II of the Senior Year rollin'!

Silenced.

Today was supposed to be an exciting day. My bestfriend is getting married tomorrow, and today is the wedding rehearsal, and we're all getting so pumped up already.

But this morning I woke up with a call, informing me that one of our friends at church has died this morning at the hospital. I knew she has been in the hospital for 3 weeks already, admitted from bouts of stomach ache and throwing up to a diagnosis of pancreatic cancer stage 3, but I still didn't see this news coming. I saw her last on New YearIt's Eve, she was weak but in good spirit. She was only 28 years old.

I'm saddened, for her family and for all of us who have lost such a sweet and kind friend. She is loved by many and will be missed. I'm asking everyone to send her family good thoughts and prayers, even if you don't know them.

It's just a reminded, once again, that life is simply too short and we will never know where it's going to take us. Here we are, ready to celebrate this wedding tomorrow, almost everyone at church is involved or at least will be at the wedding, yet today, we received this horrible news. It's ironic. She was going to be an usher at the wedding, but I believe this morning the angels has ushered her into the gates he heaven.

I will miss you, L.