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!

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.

First.

AB was my first patient to die. Since the moment I came on that morning, we knew that it was going to happen soon because AB was in grave condition post cardiac arrest. What I didn't knew was whether AB was going to pass on my shift or not. Doctors, palliative care, and chaplain have been filtering in and out of the room that morning to inform the family of AB's prognosis and what can be done should they decide to go for aggressive treatments or what will be done should they decide to end all life support measures.

The family needed more time to decide, and all day my preceptor and I took care of her while waiting for the family to decide. It was obvious to me that AB was very loved, it was evident by the numerous members of family who came by, and how distraught they were of the possibility that that day was the day AB could pass away. My heart went to them.

It hit a little too close to home. My family and I were in their shoes a little over 3 months ago when we have to decide what we wanted to do for Grampa. I knew of that anger of wanting to do more, just to have them with us one day more. I knew of that hope of a miracle, that by the grace of God they'd come back. I knew of that love that allowed us to see and choose what was best for them and not us, the love that allowed us to let them go.

I never thought my first patient death could come this soon. I knew that I will encounter it in my career, but I've had it in my mind that it'd happen when I'm already a nurse, not a student. I'm okay with it though, it didn't make me emotional like I thought I could be because of Grampa. I'm glad I wasn't emotional, it wasn't me place to be because at a time like that, it should be about the family and how I can be a help for them.

Toward the end of the shift, AB's sister came out of the room and asked me who she could talk to "to take the machine off." I informed my preceptor, and the arrangement was being made. I was in the room when the doctor informed the family of the event that will follow, and that brought me back to when the nurse handed me a brown bag of meds that we could give to my Grampa to keep him comfortable and when the home health nurse told us that his time was near. That morning I've thought about what this meant for me, seeing this all too familiar scenario played in front of me soon after my own loss. I didn't know how I would feel if I had the chance to witness this, I only knew how to be there for the family and care for AB the best I knew how.

Sometimes during that shift, I had the chance to talk to AB's sister. At one point, she asked me about nursing school and the hardship that comes with it. I told her that it is indeed not easy, but it comes with having experience to know what to do in caring for someone in her sister's situation. She said, "I'm sure you'd have your (off) time here and there, but you will get there." I chuckled, "Oh I'm sure I've had plenty of my (off) times just in today alone." She smiled, "And that's okay, but you keep telling yourself you'll be good. It'll come to you." "I hope so," I told her.

AB passed away an hour before the shift ended. I wasn't in the room then, I was at the nurses station watching the monitor (the monitor in AB's room had been turned off) and chronicling the vital signs as AB left this world. The doctor asked what time it was when the flat line appeared. "1804," I told him, looking at the strip print out. "1804," he repeated as he looked at the strip, then he went to AB's room to tell the family.

I'd remember always remember sitting at the nurses station and looking up to see AB sister rounding that corner of the nurses station toward the exit door about 45 minutes after AB's death, and as she waved goodbye to my preceptor sitting a couple feet away from me, she also waved and pointed at me to make sure I knew she meant me when she said, "And you. You will be good."

And now, when there's a thousand things running in my mind due to a recent school related conflict that make me doubt myself, when I keep asking myself if I had what it takes to be a good nurse, I'll remember that kind lady, who, in the midst of her sorrow, still took time to be an encourager and told me that I will be good. And I'll always remember what I told her as she left, not only that I hope so, but I will. I will be good.

Reflecting.

The internship, I miss it. As I started my Child Health (Peds) class this semester, I realized just how much I'd learned over the summer. Even when, at the time, I complained that it was unfortunate that we as interns were limited in what we were allowed to do. Now, I saw just how much knowledge I've gained by doing what were seemingly trivial tasks over this summer.

Those urines I dip and how to get them out of diapers, keeping track of I&O's and the importance behind it, checking on IV's every hour and keeping track of those numbers, monitoring those vitals during conscious sedation, the little tricks you use with children to get them to cooperate with you, getting blood from those central lines. They all came rushing back to me, and when my instructors lecture or showing us things in the lab, they make an absolutely perfect sense. And once again, I am humbled to be where I was this summer.

The floor I interned at receives Hematology/Oncology patients, so a lot of the children that I've taken care of are frequent fliers or regular costumers, which means they stay on the unit for a long period of time and/or frequently return for treatment. As a result, the staff get to know them and their family pretty well and vice versa. There is not a day that has gone by since I ended my internship that I don't think about those "regular costumers".

How are they responding to their treatment? Have N & M lost their hair? Is P still scared when it's time to change his port-a-cath needle? Is G still refusing his meds? Has R finished her round of chemo? How are they and their family coping? Is Y home by now? I hope her count stays up. I hope C's bone marrow transplant goes well. I hope none of them relapses....

My heart breaks for them, for what they have to go through. I used to read their charts in the lounge, then I'd watch from the window in the corner, out to the green of Central Park across the street. A playground was there, swings, slides, monkey bars, you name it, and everyday I watched as kids filter through that playground throughout all hours of the morning and afternoon, wishing the kids I had on the unit could do the same. I'd take a long sigh and get back to work, saying a little prayer as I pass each room for them to get better a little sooner.

Yet in all of this, I've found great courage. Cliche to say that, but it couldn't be more true. For two days I watched as one family broke down as their 3 year old was diagnosed with Leukemia, but in the days afterward I watched them gathered every strength they had to pull through. They took in every ounce of information the doctors tell them--treatments, procedures, side effects, risks, prognosis, asked questions, and clang to every hope. They braved procedures that they have never heard before--lumbar puncture, bone marrow aspirate, port-a-cath insertion--and one they've heard but never thought would exist in their family--chemotherapy--being done on their tiny child. They held their child's hands and soothed their child through every vitals, labs, and meds with "It's okay, it's okay. It's gonna be okay." Sometimes, I even think they said those words to assure themselves too.

Those children, they're bravery and courage personified. As angry as they might have been, as scared as they might been, as rebellious as they might have been against all of these diseases, they manage. They just do. Somehow, along the way, they find a way to cope, to accept, to fight, and a reason to live. Every so often I'd come across charts so thick with health history, full of conditions so foreign to me, I had to google as I read those charts, and every so often afterward, I've found myself dumbfounded as to how they find the strength to go through all of that for years and years. My hat is off to them.

I really do miss those kids. Baby D, unaware of the how sick he really is, moving his head happily when you play his music toys as you take his vitals. Little N, the little tod, screaming bloody murder at everything and anything done to him, but once in a while when you're just checking on him throughout the day, he'd show you what game he's playing, he'd smile and you'd forget an hour ago he was kicking all four limbs as you and your nurse restrain him down for an oral med. R, in her early teen, as sweet as she can be, letting me draw my first central line blood from her even though she's very particular about her line. S, who came in for a sickle cell crisis, was quiet as a rock, but once she talked 50 mph with her 5 year old imagination, you knew she was no longer in pain and she was going home soon.

With this experience, I look forward to my Peds clinical this semester. I love working with children, they are a source of inspiration.

Productive

Oh, look who's being productive today:

1. Loan application - check. Okay, almost check because the stupid security system locked me out when I was thisclose to finishing. Bah! Now I have to call them on Monday....

2. Preliminary online applications two 2 internship programs - check.

3. Letters of recommendation request to two faculties - check.

4. Look up required textbooks - check.

5. Order required textbooks - check. I cringed at the cost....

6. Find out my schedule - check.

7. Choose 1st, 2nd, and 3rd choices for clinical days - check.

I still have agibizziliion things to do this coming week in preparation for the upcoming semester. I am excited and nervous at the same time, though it's a different kind of excitement and fear than that when I was about to start my first semester. This time, it's more...excited for what is more and scared because I know it will be harder and busier and more than likely more chaotic. Oh, and getting back to the swing of things after a month of vacation isn't exactly easy. A month of time off have rendered me quite lazy and useless, hah! Not complaining though, it was good to relax and veg, vegging is necessary every once in a while, I promote the vegging.

Now it's time to get this ride back on the road again, and as a result I have signed up to volunteer at the new students orientations. Yes, i know I've mentioned I did that already, but my school holds this series of orientations every semester, it's a bit too much but hey, anything to help out the new kids, right?

So that's that. New year is here and I'm gearing up for the new semester. There is a lot of exciting things that I'm working on happening this year, so I'm hopeful. For now, I'm going to rummage to the fridge for food. Food is good.

World Spins Madly On

…and it spins fast too.

Is this what it means when they talk about objective vertigo in that Assessment textbook? The person feels as if everything around them is spinning?

At least that’s how I feel. My world is not spinning out of control per se, it just spins…faster, way faster than it used to be. I’ve been trying my best to get a hang of it, alas, no such luck yet. Things come my way in bulks and they swoosh away before I get to the bottom of it most of the time, and I’m left exhausted at the end. I wonder if I’ll ever catch up or find my footing soon…or ever again.

The wind is blowing harsher, too. My hairs are strewn all over my face, covering my eyes. Sometimes, I can barely see what is before me. I reach one hand to hold my hair back so I can see the road ahead while the other one gripped my pole of faith, bringing it close to my heart as I try to take a step forward. My feet start to tremble as the wind blows hard against me, lifting and swirling particles of the earth and blocking my vision. I struggle to set my feet firmly on the ground, “If I fall then so be it,” I thought, “I have my source of strength here with me.” And I do fall, but not for long. It’s not always easy getting up, but it always worthy of trying. I use my ever presence pole of faith to pull myself up, slowly but surely, until I regain my balance and stand up straight once again. Then I dust the dirt of my knees and continue on the journey.

I do wonder, sometimes, if I’ve made the right decision or where this particular road leads to or what the other roads are like. Does the wind there blow as stormy as it does here? Do things churn heavily and quickly as they do here? Does it take this long to get to the end? But there is this little voice I can hear clearly amidst the chaos that is my surrounding. His voice tells me to keep going and trying, to keep my chin up and my eyes straight ahead, to keep moving forward on this path I’ve chosen, and most importantly, to keep that pole of faith in my hands.

Then there things along this road that don’t go as fast as the others do. The people who have been in my life are still around me, I don’t see them as often as I would love to, but I know they’re cheering for me as I go on. They might be somewhere else in this big world and I can’t see them within my field of vision, but I believe technology will keep them in my world always. Perhaps, the most exciting are the new people I’ve met along the way, those whose worlds are spinning as madly and as vastly as is mine. In the short time I’ve come to know them, we have laughed and whined together, and we have made each other smile. They push me forward when I stop on the same spot too long and I them.

In all of this madness, the one thing that keeps me hanging on is hope. The hope of a new strength for each day. The hope that the heavy wind will turn into a gentle breeze. The hope of the ability to regain my footing. The hope that I will find what and who I am looking for. The hope of where this road could branch to. The hope of what I will be. The hope of the rain He will send now that I have prepared—and am continuing to prepare for—the field.

So throw me a rope to hold me in place. Show me a clock for counting my days down….