Two Words

One word for 2010: Metamorphosis

In 2010 I truly changed from the inside out. I started out as a shell of a person, beaten down and bitter, with no real niche to call my own.

Somewhere along the way I changed from a second chance nursing student to a new, but quickly growing nurse. I went from a me too tag along to a full fledged leader amongst my peers in my own right.

Even in my personal life huge changes took place. I lost over 50 pounds. My marriage solidified. I admitted to and faced my depression.

It was a long hard year, but I've changed for the better.

One word for 2011: Fulfillment

It's time to put my money where my mouth is. It's time to stretch these wings and take flight. It's time to start contributing instead of just consuming. It's time to create a means to engage all these dreams I've been chasing for so long.

So, two words.

Metamorphosis and Fulfillment

Happy New Year!

Down For The Count

My family and I have had what I can only assume is the flu for the past 9 days.

It started with my oldest daughter bringing it from her mother's house and infecting us one by one. It generally started with horrendous diarrhea, moving to chills, fever, body aches, and in the kids, vomiting.

I haven't run in a week. We haven't had a full night's sleep since a week ago Tuesday. I haven't eaten more than a few crackers since Sunday. I can't stand up without graying out, and I'm in the best shape of any of us.

Right now my son is worst off--instantaneously puking up anything that touches his lips. His poor perianal area is completely excoriated from the diarrhea.

Right now we're just surviving.

We leave for our cruise Monday morning.

Maybe.

Thoughts From The Treadmill IV

I am relatively certain that the flu and other assorted viri were bio-engineered by laundry detergent manufacturers. The amount of laundry generated by these viri in soiled bedclothes and pajamas is staggering.

Christmas 2010

Christmas Eve was a flurry of activity. I started the day with a 6 am grocery run, and it worked out perfectly. Not only did I beat the rain (we had a 100% chance forecast), but I also beat the feeding frenzy that usually happens the day before holidays at the grocery stores around here. I took a short nap after I got home from the grocery store, and then got in a good run at the gym before they closed at 3. Somewhere in there it started a cold, cold rain outside. We had planned on going to Christmas Eve services at our church, but my younger daughter had a stomach virus that moved south, further along in her GI track that made close proximity to a private bathroom a necessity--poor thing! So we stayed home and made cookies for Santa and watched Polar Express instead. The kids left a plate out on the mantle for Santa with cookies, and a few carrots for his reindeer. After the kids were finally down for the count in their beds, it was darn near 11 pm. My wife and I started wrapping presents at that point, and munching on Santa's cookies so the kids would think he had dropped in, while the rain continued to pour down outside.

Christmas morning dawned clear and windy, and chilly. The kids actually let us sleep until about 8 am, with my younger daughter up first. She came busting into our bedroom, "Santa came! There's presents under the tree!" Then she went sprinting back out into the living room to check on the cookies and stockings, only to come running back into our bedroom. "Santa came! He really, really came!!" She was so excited--completely heartwarming to see her joy. It wasn't long after that that we let her get the other two kids up. Once everyone was assembled in the living room, we read the Christmas story from the Bible, to help keep things in perspective. And then it was present time. As you can see, opening presents is a very serious business around here.

My son received his first wooden train set, which he played with for a good hour after getting it set up--pretty focused for a 2 year old who won't sit through 30 minute TV show.

My younger daughter received Disney Fairy goods--both the Fairies themselves, and their animal sidekicks. She was completely over the moon with them.

My oldest daughter only received a very small package from Santa. But she was OK with that when she discovered it contained a pink iPod Shuffle--her first mp3 player.

The kids got my wife a cute little ring from James Avery, and I got a Kelty internal frame backpack for my trip to the Grand Canyon in a couple weeks.

Once presents were opened, I started in on our Christmas meal. I didn't do much, because it was just our small family this year. Usually I'm cooking for 18-20 with my wife's family who live near us. However, her family was traveling to Wisconsin this year to attend a wedding, and spent Christmas up there instead. It was kind of nice to have our little family all to ourselves this year. I served Earl Campbell sausages (haha!), cornbread stuffing, rosemary potatoes, tropical & citrus fruit salad, and green romaine salad. We had sweet potato pie for dessert.

After lunch, I helped my daughter sync her iPod, and then helped my wife create a new workout playlist. Then it was time to get the kids down for naps, and my wife rested a little bit since she was going to work. She was scheduled to work Christmas Eve, and Christmas Day, but their census was low enough that she got canceled for Christmas Eve, and split a shift for Christmas Day night. It was really nice having the whole family together for the holiday.

What did you do? What did Santa bring you?

Happy Christmas All!

Pinning Ceremony

Next up in the Graduation-Season-Gala-Extravaganza-Event was our pinning ceremony. As you can tell from the left there, I finally made it to the big screen. The 100" plasma screens at my church that is. Our pinning event was held in my church building, mostly because I was able to negotiate an amazing deal on the cost, and as a venue it was pretty much perfect. It was a big point of contention that the school itself (because pinning is not a school supported event) was going to charge us out the ass to use their facilities. On top of that, if we held it at the school, on top of the rental fees, the audio-visual department within the nursing school would have to provide their services for a mandatory fat payment suggested donation of $1000. Given their track record, I we didn't want them to have any part of our ceremony. Not to mention the principle of paying to use facilities at an institution we'd just paid $40,000+ to, to earn the degree in the first place. Thankfully because I'm good friends with the facilities manager at our church, we got an amazing buddy deal. Full venue with professional audio-visual for a mere pittance over what just the audio-visual would have cost us at the school.

I gave my speech pretty much verbatim as posted here, save for a few added inside jokes (thanks for the suggestion Will). I also took the opportunity (and advantage of having a microphone) to tell my wife that I loved her when I made the point that we needed to tell those we love that we love them. I have it on good word from those that she was seated next to that it brought some tears to her eyes (mission accomplished). The speech went over well, and I received many compliments from families of classmates--complete strangers--as well as classmates and faculty. I enjoyed being up in front of so many people, and mercifully I wasn't the least bit nervous.

Here is my lovely wife pinning me on stage to the tune of Coldplay's Life in Technicolor. I really was privileged to be pinned by someone I love so much, who also happens to be an RN and working member of the profession. I even caught her getting a little teary eyed as she pinned me.

My service to the pinning committee was providing the venue, the heavy lifting, and the occasional reality check to the estrogen infused pinning committee meetings. There were essentially two other people that bore the brunt of the rest of the organizational duties, and they did an amazing job. The faculty present gave several comments to how nice our ceremony was, and how much they enjoyed it. The entire ceremony went off with only a minor hitch or two, which was gratifying considering the amount of work involved.

Overall I'm glad I was involved as I was in the planning and execution of this event. In the past I wouldn't have bothered with something so inane and peckish. I hope that's a sign that I'm really going to take to this nursing thing.

Sigma Theta Tau Induction

The whole Graduation-Season-Gala-Extravaganza-Event was kicked off on Wednesday evening with my Sigma Theta Tau Induction ceremony. Yet again a masterpiece of misinformation and lack of communication. We were told the event started at 1630, only to arrive and discover it actually started at 1700 and was running behind, so more like 1730. We had left the kids unfed at home with my parents and sister (who had just arrived in town a couple hours before), because we were sure we'd be home by 1800 or 1830 in time to get them their dinner. Some hurried instructions by text and the kids were provided for so my parents and sister didn't have to deal with hungry-cranky kids.

The ceremony was nice. It was even more nice to see my friends from school that I hadn't seen in awhile because of Capstone. And especially nice to hear that one of my best friends and study partners got a job on the same unit as me at Gargantuan Hospital. I'm so very grateful to be going through the critical care internship and orientation with an already established friend and study partner. I have to say I'm much more confident going into this with my tried and true study crew. (She's the one standing next to me in the picture there on the right.)

When it came time to be "corded" various members of the faculty were rotating through, cording each of us after we were handed our membership packet. When it was my turn, who should be the next faculty in line? The only faculty member I've gone to the Dean about because she physically threatened me when I questioned a quiz question in class, and then later kicked me out of her office when I tried to reconcile the situation during office hours.

Nice.

She just hung back, refusing to cord me. So a really awkward situation resulted, and I ended up being corded by someone I've never taken a class from.

Whatever.

Interesting to note, my wife immediately recognized this faculty member from her own days as a student at our CON. My wife received clinical excellence awards for every clinical she was a part of...except for the one led by this faculty member. She was the only faculty member that my wife (the most ultimate get-alonger ever!) had an issue with her entire nursing school experience. So it runs in the family apparently. Her class called this faculty member "The Wicked Witch of the __________" (Fill in whatever direction you're facing at the time).

It was a very nice ceremony though, and I appreciate the honor.

(Although the keynote speaker mentioned that Sigma Theta Tau was like the Ya-Ya Sisterhood of nursing--yay me!)

Prayers for a Sweet, Sweet Friend

Many of you that read this blog also read Running Wildly. She is absolutely one of my very favorite bloggers that I've had the pleasure to read.

Her quiet encouragement at just the right times--a small comment on a post of mine, or a timely post of her own on a very pertinent subject--have helped sustain me, lift me, and carry me through nursing school.

The amazing weight-loss journey I've been on? Inspired by her as she coached and coaxed friends of hers to run a 10K with her. Then she stayed involved even after a training-ending injury, even showing up on race day to cheer on her friends. She is the reason I stepped onto the treadmill that first time however many hundreds of miles ago now.

I love her for the way she lives with wild abandon, Running Wildly through life as a child of God. I love her because of the way she loves her husband and her gorgeous children. I love the way she fairly radiates pure, unadulterated "nurseness". She is all that is right about the nursing profession. She is one of the good guys.

But now she is facing excruciatingly scary news. And in the face of horridly fearful news she speaks of God's glory, and God's plan, and her faith.

Please, if can spare even a small quiet moment, send a prayer up for RW. I would appreciate it, and I know that she would as well.

RW, even though we've never met, please know that you've been an integral part of my nursing school experience. Thank you so very much for everything. I think you're an amazing person!

Captcha Ninjas

So, a word or two about comments.

First of all, I'm extremely grateful to all of you who take the time to read my blog. It really makes my day when I get comments, and it makes me feel good that people care about what I say and write.

On the other hand, as much as I love getting and reading comments, I'm just as terrible about responding to them. Please know that your comments are valued much more than my lack of responses indicate. I will try to do better. Hmm a New Years resolution maybe?

While we're on the subject, I have some comment commentary: Don't you just hate Captcha? I mean I get why it exists, and I don't fault those who use it, but man it can be annoying. Sometimes they spell words that are funny or a little dirty, but mostly they're just annoying.

The worst of the lot are the Captcha Ninjas. You know them, they are the comment forms that allow you to type in your comment, hit submit, and then.... Wham! Out of nowhere the Captcha Ninja pops up and strikes.

I much prefer the comment forms that let you know up front they're packin' a Captcha. It's nice to know what you're getting yourself into from the start. This way you can gauge if what you've got to say is really important enough to deal with a Captcha form.

So I don't use Captcha on my blog. It's not like I'm so overrun with spam that I can't handle things with comment moderation. NurseXY is a proudly Captcha free zone, so comment away.

But don't let down your guard...you never know when those infernal Captcha Ninjas might attack.

Numbers

1--One week until graduation.

3--Three weeks until we leave for our cruise.

4--The number of children 5 and under currently terrorizing our house right now. We're watching some friends' children while they attend parenting classes in the process of adopting a 3rd child.

17--As in January 17th. My official start date for my new job.

19.4--Miles to hike in and out of the Grand Canyon the week between the cruise and starting work.

27--The number of pounds left to lose before the USAF will pay for CRNA school and pay me a salary while I'm in school, in exchange for 3 years of service.

49--The number of pounds I've lost to date.

235--Current weight, after ballooning up to 241 from 237, and then back down.

Two Years Ago Today...

...the heavens opened and sent us a little devil of an angel. (Probably they were relieved to get him out of the big house before anything else got broken.)

I remember that my wife started contracting about 11 am, but we thought she was just having Braxton-Hicks-ish contractions. They kept up all afternoon, and by the time we headed to Target that evening around 6, she was having to concentrate on them as they passed. At that point we realized probably this was for real, but thought we had hours and hours to go. She sent me off to Baby's-R-Us to buy a piece of furniture with a 20% off coupon that was about to expire, and when I got home at 8:30, she let me know she just couldn't take it anymore. The contractions were becoming painful.

Reluctantly we decided we'd head to the hospital after calling some friends over to watch the other kids. We were both sure that the longer we were at the hospital before delivery, the more likely we'd end up with an intervention filled birth--exactly what we didn't want. We left about 9:30 pm, and when we got to the L&D unit about 10, it was a madhouse. I don't remember if there was a full moon, but that's the type of night they were having. When someone finally triaged us, I'm sure it was probably the 8 or 10th person she'd assessed, and she was a little bit cranky.

When the nurse assessed my wife's cervix, we were sure she'd be dilated to a 2 or so, and we'd have hours of waiting. Surprise, she was a 6 on the conservative side, probably further along than that judging from the look on the nurse's face and the speed with which we got a room. She got a line in (second try after blowing the garden hose in my wife's hand--sucks to put IV's in on a nurse, haha!) and started LR. The nurse trundled off to call our midwife. My wife was starting to panic, completely sure she wouldn't be able to bear the pain, and requested an epidural. Of course until the liter of LR bolused in, there would be no epidural.

And then her water broke.

Not that it mattered, there was no CRNA or anesthesiologist anywhere to be found--they were just as far in the weeds as the nurses.

It was less than an hour later that my wife told the nurse it was time to start pushing. The nurse asked that she wait for the midwife, to which my wife sweetly and politely replied that it was time to push, NOW.

The nurse checked her, and judging from the way she bolted to the door and bellowed for the midwife, my son must have been at about a +4 station. The midwife showed up within minutes and asked my wife to take a test push. Since he was crowning, they decided she was ready to push after all.

One push, and his head was delivered.

One more push, and his long body came splooshing after.

And in that moment, 11:20 pm, the world beyond the walls of that room ceased to exist. His small squishy, wrinkly form, that I had longed to see for 38 long weeks was right before me. That tiny little heart beating as fast as it could just to pump my overwhelming love through his veins pulsed under my fingertips as I touched his chest for the first time. The roaring in my ears had to have been the sound of my soul stretching and expanding exponentially to accommodate another being for which my love is boundless.

My beautiful wife was exhausted and had pretty extensive tearing from delivering him so quickly. The midwife was repairing her perineum, so I was standing guard over my son at the warmer while they assessed him.

8 lbs 13 oz, 21.5" long. And all boy.

Counting toes:


Three months:


Six months:


One year:


20 months:


The family:


Happy birthday son.

I love you.

Pinning Speech (or, All I Really Need to Know, I Learned in Nursing School)

Remember my Sally Fields moment? Well here is the bulk of the text of my planned pinning ceremony speech. I'd love to hear what you all think. (Unless you think it sucks, in which case don't tell me it sucks, just tell me I might consider going back to the drawing board...). My pinning ceremony is the morning of December 16, just a week away. Graduation is that night.


As we draw close to the end of nursing school I find myself looking back over our time here. Now granted we’ve all lived from test to test, from memorizing each drug to the next, and from one disease to yet another pathology. Nursing school is clearly about taking care of patients and helping people get better, or not get better with dignity. But somehow I can’t shake the feeling that nursing school is about so much more than that. If we boil it down to the very simplest terms, some sort of academic red wine reduction sauce, nursing school is about, well, life.

Now that thought immediately brought to my mind the famous poem by Robert Fulghum, “All I Really Need to Know I Learned in Kindergarten”, which is of course, pure genius. I rather like the view from the shoulders of giants, so I give you, “All I Really Need to Know I Learned in Nursing School.”

1. A bath and a tidy bed will make anyone feel better. I’ve seen it time and again, simply straightening a patient’s bed invariably elicits the comment from a family member, “Oh, they look so much better today.” This isn’t any less true in the rest of life. Stressed out? Overwhelmed? So much to do that you just don’t know where to even begin? Make your bed. Bad day? Overworked? Stretched to your absolute breaking point? Take a bath. You’ll feel better on both accounts, I guarantee it.

2. There are few things better in life than a good nap, a good meal, and a good poop. As nurses, if our patients are eating, sleeping, and pooping, their prognosis is pretty good. In the larger picture, when we came into this life, eating, sleeping, and pooping were first three things we did, and I’m pretty sure we got it right.

3. Speaking of poop…it happens. Ignoring it doesn’t make it go away. Or smell better. It’s best to simply clean it up and move on. Remember, very few people aren’t completely mortified when their own poop comes to light—always, always do your best preserve their dignity. Apply that to the poopy things that come your way in life, and it still rings true.

4. Always keep careful track of what goes in, and what comes out. Balance is a good thing. We all had I&Os for our patients drilled into our heads in class and clinicals, but this applies to so many things: bank accounts, raising kids, our minds and our mouths. Think about it. Don’t spend more than you have. Fill your children with the good things in life and you’ll never worry about what will become of them. Fill your own minds with truth and knowledge, and the words that you speak will never embarrass you.

5. Assess the patient, not the monitor. How many of us have gone sprinting into a patient room because the monitor was showing a lethal rhythm or an ugly 02 sat, only to discover the patient sitting up and laughing in bed? In real life, people may have impressive resumes—a litany of accomplishments and achievements, but that should never substitute for your own assessment of their character. Listen to your gut, it’s almost always right.

6. Details matter. Write things down. Time and again I hear people say how much it’s the little things that make a difference. Remembering the small things will make you a hero to most people. Keep a journal, and occasionally read over it. A little self-clarity can never be a bad thing. Every major change begins with one tiny detail that’s altered.

7. You don’t always have to wear gloves when you touch people. We talked about this in class—that human touch means so much to patients. We’ve learned the value of therapeutic touch, but again, this applies to even more so to real life. When we open ourselves up to people, we truly begin to experience the beauty of human relationships. When we leave our protective barriers behind and take off our gloves, we are truly able to receive—and give—love.

8. Sometimes it’s just time to let go. Who hasn’t taken care of a patient who we all know will never get better. The patient suffers, and the end result is the same. In life how many times do we go down the same road, making the same decisions, expecting a different result? Sometimes it’s just time to let go.

9. Always ask for help when you need it. As we transition from nursing school to real life practice, most of us will feel like we have so much to learn yet. Something I’ve learned in my short years on this earth is this: When we get right down to it, people love to help each other. Helping one another makes us feel good. Allowing someone to help is often just as beneficial for the helper. Again this goes back to allowing ourselves to be vulnerable, and admitting that maybe we could make it on our own, but it would be so much easier if we just allow someone to help us.

10. Tell the people you love that you love them. I know that in clinical at some point during nursing school we’ve been party to a patient dying unexpectedly. Gone before their time, or passing on before family can make it to the bedside. As nurses we have the privilege of being present for births, and for deaths, and nearly every kind of moment in between. We should take the lessons we learn from our experiences with others lives. Be sure that you tell the people you love that you love them.

And so here we stand at the close of one journey, and on the verge of another. Through the years, each of the 4 semesters, the 6 am clinicals, the exams, the OSCE’s, Assignments 1, 2, and 3, we’ve grown together to be a family. Oh sure, we each have some of us that we can’t hardly stand to be around, but we are family nonetheless. I want to thank each of you for the privilege of making this journey with you.

Well done Class of December 2010, and best of luck with the future.

The Great Laude Wars

One of the things I've been looking forward to the most about graduation has been Latin honors. I've always been more than capable of excelling academically, I just never really cared to. The effort required to track every grade percentage point just hasn't seemed worth it to me in the past.

For example, of my high school class of more than 800 students I graduated only at #24, all the while tutoring both the valedictorian and salutatorian in math and physics. If I'd only taken the trouble to turn everything in, I'd have easily challenged them both for their positions.

To me though, it was much easier to rock the evaluation exams than to do the day to day drudgery of homework and coursework. Hence my 36/36 perfect score on the ACT when I took it my senior year in high school. The trend continued when I got into college. The exams that blew everyone else away, I was that person that blew the curve for everyone. I consistently performed at high B/low A level, regardless of the difficulty of the exam. I lost points not for lack of knowledge or understanding of concepts, but rather for housekeeping details that I just didn't bother to read or attend class to hear. This style of ill-preparation and poor class attendance earned me a stellar 3.2 GPA in my first undergraduate degree.

When I graduated with my BS in Biology, I decided I wanted to go to medical school. Clearly a 3.2 GPA wasn't going to get me noticed by any medical school in the continental US, so I knew I'd have to rock the MCAT to even have a chance. That was probably the most legit exam I've ever taken, and I only scored a 29 the first time out. A decent score, but hardly earth-shattering especially combined with my crappy GPA. I buckled down, actually studied, and scored a 38. That score generated some interest from the schools, but I ultimately decided against going to medical school.

So when I came to nursing school, I made a decision from the outset that I was going to do the work. If I was going to take this second chance, I was going to do it right.

And so I did.

I kept track of every little percentage point. I obsessed over assignments. I studied for exams I knew I could pass without trying in search of those extra 8-10 points. I had a few bumps in the road, like when my son was born at 11:20 pm the night before my pharmacology final, and I got less than 2 hours of sleep. The final dropped most people a letter grade it was so ridiculously hard, and I was no exception. I ended up with a B. Then there was the research teacher that decided I was Satan's spawn and through the subjective grading of research analysis papers, orchestrated me receiving a B by less that 0.02 points. I talked it over with my wife, and we decided I wouldn't grant the instructor the satisfaction of seeing me worked up over it, so I let it go without challenging it. In the end I have a 3.88 GPA for nursing school, and achievement I'm quite proud of.

Imagine my surprise when I found out I would not be graduating with Latin honors. You see, when I entered nursing school, they automatically upgraded the catalog under which I would be taking classes, regardless of the catalog under which I first entered the university. They also updated the requirements for Latin honors. Previously it had been either an overall GPA over 3.5, or the last 45 hours over a 3.5. The new requirements require both an overall GPA greater than 3.5, and the last 45 hours over a 3.5. Not only that, they would calculate overall GPA from every hour ever taken at the university, not just the hours applied toward the current degree.

And so that 3.2 overall came back around to haunt me. Clearly my own fault, but people change. And I have dramatically.

If only the hours being used for the current degree were calculated, I easily had the >3.5 overall required. And my last 45 were way above requirement. Additionally, if I had transferred in to attend nursing school from an outside university, all that GPA would be wiped clean--lost in transfer credit hours. So because I chose to be loyal to university, I get penalized.

I decided that being a nurse was all about being an advocate, and I was going to start by advocating for myself. I made an appointment with the assistant registrar/graduation counselor. She refused to consider my points, and was actually quite rude. So I made an appointment with her boss, and in the meantime wrote the following email to the deans of my nursing school:

Dear Dean HeadHoncho & Dean FirstAssistant:

When I first came to ### in the Fall of 1998 in pursuit of my first Bachelor's degree, I was young and unfocused. It showed in my grades--yet still I managed to eke out a 3.2 overall GPA when I graduated with a BS in Biology in 2001. Nine years later as I am about to graduate ###CON's BSN program, I am older, more mature, and much more focused. As a result, at the end of this semester I will have over a 3.8 over the last 45 hours--the criteria used to award Latin honors. Mind you, I did this with a job, 3 children, no daycare and wife that works full time nights as a nurse.

Unfortunately due to arbitrarily having my catalog year reassigned when I entered the nursing program, my overall GPA doesn't qualify me for Latin honors. However, if I had done my prior coursework at another college, those hours would not count toward my overall GPA, and I would easily qualify for Latin honors. This seems a bit unfair to me, and rather unfortunate. Because I chose to stay loyal to ###, I am being penalized by not receiving Latin honors.

I came to nursing school for the sole purpose of gaining my BSN so I could continue on to grad school. I would love to stay in the ###CON program, however since my undergraduate overall GPA will continue to haunt me, I just don't see that as a possibility any longer. I refuse to patronize a learning institution that endorses a double standard for its students, refuses to reward students for institutional loyalty, and arbitrarily changes the rules as it deems convenient.

I know that you have no direct control over who receives Latin honors, but I thought you should be aware of the fact that you will be losing at least one well-qualified student from the pool of potential graduate students. NP? DNP? PhD? Who knows how far I would have gone. I feel you also should be aware that people like me, loyal to ###, are being treated differently than someone who hasn't worked any harder than me, but will be rewarded for disguising their overall GPA in transfer classes.

I'd be happy to entertain your thoughts on the situation. I am currently working the chain of command to try and resolve the issue on my own--now making an appointment with HeadHoncho Registrar.

Regards,

NurseXY

Something I said must have lit a fire somewhere, because by the time I attended my appointment with the registrar the next morning, the Dean had already written an email forwarding my email on to him. Oddly enough, they found it appropriate to return me to my original catalog year (which never should have been changed), and suddenly I qualify for Latin honors. Magna cum laude in fact.

However, as the assistant registrar/graduation counselor rather gleefully told me, it doesn't matter because the programs have already gone to print so it can't be changed to reflect my honors.

But it matters to me.

And it will matter on my CRNA school applications.

I had purchased honors cords when I bought my cap & gown a couple of months ago. And you can bet your tassel I'm going to wear them during graduation.

I Think I'm Addicted...

...to running that is.

This past Saturday I ran my second 5k, nine days after my first 5k ever. I was a little worried about the weather because a cold front was pushing through. I don't really care about the temperature, but cold fronts around here bring wind, and lots of it. When you're my size and have roughly the aerodynamics of a barn, wind can be a race killer. But a little before race time not only was the temperature in the balmy 50s, there was no wind.

I got in line to pick up my race packet an hour before the starting horn and the line was seriously long, but the people around me were friendly. The time passed quickly and I soon had my race packet in hand. I then headed to the port-a-john. And that's where things went bad.

The grass was wet from the morning mist, and so the floor of the port-a-john was a sloppy toxic mess. There was nowhere to set my race packet while I took care of business. In a flash of brilliance, I opened the door and set my packet down on the ground just outside the door. When I was done, I re-emerged to find someone had stolen my packet.

It was now less than 5 minutes from start time. By the time I found a race official, I barely had time to pin on a non-numbered bib and scribble down my name and address for them to send me an extra shirt if they have any extras. I was seriously pissed, but the starter horn was going off, so I tried to put it all out of my mind and started running.

I started near the back of the pack, and as a result I had my work cut out for me dodging strollers and gaggles of walkers. Before I realized it, I was passing the 1 mile marker. I tried settling into a rhythm but the pace that felt comfortable was way too fast, and I knew I wouldn't be able to maintain it--I was running about an 8 minute mile pace!

The 2 mile marker I was really hurting, and so I made the decision to walk a minute or two, knowing I have a real problem getting started again after walking. I walked for 2 minutes and forced myself to start running again. I pushed onward and finished in 28:44.4 according to RunKeeper on my phone. Since my race timer was in my race packet. That's the real bummer, no official time.

It's almost a 5 minute improvement over previous race. I had a coughing attack after finishing, so I'm not entirely convinced I'm 100% yet.

All in all, I'm happy. I'll take it.

Professional Distance

One of my favorite bloggers, New nurse, in the hood (NNITH) has a really touching post, Haunted up over at her blog. I immediately wanted to comment, but as I started composing my thoughts I realized there was so much more to be said than should be left in a comment box.

I'm coming up on a year of work experience in an ICU, and I've made my way through all the clinicals associated with nursing school. All of that, though hard-won experience, isn't terribly impressive, and really I'm still just a baby as far as my nursing career goes. But, I have been around long enough to know that sometimes, certain patients just stick with you long after shift's end.

In school we were counseled on getting too close to our patients. We were told to maintain a professional demeanor, a professional distance, a certain detachment from our patients. This was necessary to protect the patients, and to protect ourselves. You see, we need to remain objective so as not to miss some critical sign or symptom. So as not to be blinded as to what is truly best for the patient. So that we can continue to function in highly stressful situations, and deliver the same standard of care to all whether through good news or bad.

Admirable advice really.

And I think it's a load of crap.

I work in an ICU. People come through our unit on a regular basis, and when you're a patient in the ICU it's generally for a reason. We don't typically see a lot of stubbed toes or sunburns--our patients are sick. Nearly all of them. Some are sicker than others, but everyone has the potential to backslide right down to death's door. Others claw their way back towards health, and I think it's our job to give them a hand up. Or sometimes let them know it's ok to just let go. I see so many gravely ill people that their faces and cases have already started to blend together a bit. The rooms in an ICU are witness to life-altering scenes, and when the patients are gone, the room gets cleaned--a set of fresh linens, and a liberal dose of CHG to wash away the tears and pain. Then, a new patient arrives, and we begin it all again.

I treat every patient with the same standard of care. I am equally conscientious, engaged, and caring, regardless. But the memory of some of them slips away to join my collective experience of the unit. Not individual anymore to me, but part of the background ambiance, or aura, if you will.

But others remain with me, their faces clear as day, dancing just at the edge of my vision in that moment between sleep and wakefulness. Their whispers still echo in my ears in the quiet moments, and I've come to realize their stories are firmly entwined in my heart--a part of my life experience.

I believe that patients like these are put in our path to teach us lessons. Sure, we may be the one to provide the patient care, to serve them, to fight for their well-being on their behalf when they simply cannot. But the true service comes from the lessons we learn about ourselves from them.

The emotions from losing the older gentleman patient that NNITH has written about haunt her in a very real, very painful way. But I guarantee she went home and told the people she cares for that she loves them.

It seems a terrible price to pay for life's lessons; to be haunted in a such a way. But are any of life's lessons worth knowing any less expensive?

We risk being hurt when we care. It's the price of admission of letting yourself be vulnerable. Opening ourselves to experience joy and love leaves us unguarded to pain and suffering as well.

As nurses we routinely intersect people's lives at times when they are in full-on crisis. They are frightened and angry. When we put ourselves in the path of these times and places, it's not unforeseen that they will begin to affect us.

So NNITH, please don't stop caring. I respect you because of the compassion you show for your patients. I respect you for your intolerance to bullshit when people come into your ED to waste everyone's time, and to steal attention and resources away from those that actually need it. I respect you for being affected when life happens in front of you, and you allow yourself to be a part of it, and to ultimately allow your soul to be touched.

I think you're an amazing nurse.

Humbled

As I mentioned in previous posts, I have been offered an amazing job. I have been accepted into the critical care internship at Gargantuan Hospital. Gargantuan is a Level I trauma center with over 1000 beds. My home unit will be the coveted CVICU. This is THE job I said I would turn down any other offer for.

Looking back over the journey I've taken to get here--from the depths of despair as a chiropractor unable to even provide for his family to a new grad nurse intern on one of the top units in one of the best hospitals in the country--I am struck by how visible the hand of God is in all this to me.

I know several of my readers are atheist or polytheist, so I hope this post doesn't come across as too preachy. That isn't the intent at all but my Christian faith is a very important aspect of who I am, so I feel I need to record this experience as I've lived it.

It's been no secret that I've schemed and planned to get this job for months--actually over a year and a half now. From the moment I heard about my externship in my Jr. I semester, I coveted it. I sought out the manager after spending the day on the unit as an "off unit experience" for my Jr. I clinical. I made my case for wanting the externship, and he told me to email him the following October when the position was posted.

I cultivated a friendship with a student a year ahead of me who was currently in the externship. Granted we have much in common, and he truly is a good friend now, but my purpose in the beginning was to open doors for me.

When the time came, the extern position was posted for only 2 days, and I was offered the position even before the end of the interview. I had secured the job before anyone else in my class at school even knew the position existed. I vowed to keep an open mind and considered staying on at that unit after graduation, but really the whole reason to work there was to gain valuable experience on an ICU so I could move on to a bigger hospital and a bigger unit. I wanted all this within the educational confines of an externship rather than working entirely as a grunt tech. The experience I gained was invaluable. I learned and did things that many working RN's don't know how to do.

I schemed and pleaded my case to get into the clinicals that would pave the way to such a desired position after graduation. I suffered through Med Surg clinicals at a large county hospital to be able to put the name on my resume. Before Sr. I semester even started, I uncovered who my clinical instructor for critical care would be and I wrote emails to her to ensure I got placed in the CVICU at Level II hospital, again for the name drop on the resume, and to build relationships to possible secure a position after graduation. For Sr. II, I again scrambled and plead my case and managed to get into management and Capstone clinicals at the only large hospital on the clinical list for that semester (Gargantuan Hospital). Only 10 of us out of 110 students got into that clinical group--but it was a must-have because Gargantuan Hospital has a reputation for hiring out of Capstone.

I worked my ass off to keep a high GPA in classes that I could have simply passed without studying at all, with no work at all. I joined professional organizations and attended meetings. I spent time doing community service through volunteer work. I volunteered to work as a standardized patient for an ACLS class, missing a baseball game with my family, because the class was sponsored by Gargantuan Hospital and I would have the chance to interact with the education department.

Only God knows how many prayers went his way regarding my employment.

And through it all, God has simply directed things and made it all fall into place in an eerie sequence of events. Happenings that don't seem to make sense at all, and lead me to believe that someone has been watching over me with a greater purpose for my life.

For example--remember Amazing Children's Medical Center? I applied for their summer externship position. The person I interviewed with all but handed me the position during interview, saying, "If any other hospital offers you a position, be sure you call me first." I canceled a family vacation and didn't sign up for summer classes because I firmly believed I would be getting an offer from them. You may remember that no job offer came. Others in my class were selected instead. And I was devastated. That program was supposed to lead to a job for me after graduation.

And you remember me applying for Level II's critical care internship a month ago? One of the panel members I interviewed with was actually the manager of the unit where I did my critical care clinical--one who approached me at that time to find out my plans post graduation. I rubbed elbows with the ICU managers during a recruiting event, and I had an awesome interview. I fully expected a job offer. And I did not get one, while others in my class did. People that I couldn't understand why would be selected above me.

But God knew just what he was doing.

Amazing Children's Medical Center? They still haven't interviewed for their critical care internship. In fact I've heard through the grapevine that they haven't even nailed down a budget for their interns yet, so they don't even know if they are hiring anyone. The people hired into their externship are still waiting to know if they'll have jobs or not. Meanwhile other hospitals are hiring and filling their positions. They'll be sifting through leftovers if they aren't offered the jobs they were all but promised.

And the Level II internship? The people they've chosen to fill the positions speaks poorly of the entire hospital. Certainly not people I would trust to work near, let alone depend on to have my back in tough situations. That's not even mentioning whether I'd allow them anywhere near a loved one in a health crisis.

In fact, I was recently rejected even by the large county hospital. A hospital that's so desperate for nurses they are giving out sign on bonuses in this economy. And they didn't even bother to interview me.

And so God has orchestrated my hiring into an amazing hospital, onto a prestigious unit. A place with an amazing culture where it seems every time you turn around, you meet an employee who has been there for 20+ years. A hospital with such a great reputation in the community that I have never heard anything but good things about it.

More importantly, God allowed me to scheme and plan. He allowed me to beat my head against the wall. And then, when there was nothing left for me to do--when I had exhausted all my human antics and vain attempts--he simply put me where he'd planned for me to be all along.

A week before I interviewed for my new job, the manager wasn't planning on hiring anyone--their census had been too low. But when the numbers for the last quarter came through, their census had picked up so much there was room for not only me, but another new grad as well. If that isn't a sign of God's abundance and provision, I don't know what is--he provided twice what was needed.

And so I here I am. Broken and humbled. And well cared for.

My grades, my work experience, my resume, and my networking may be the justification for my hiring, but I know quite deeply that they are not the reasons why.

Content

I've been whittling away at my 8 12-hour Capstone night shifts on the Transplant ICU at Gargantuan hospital. As of this morning I've done 5 of the 8. I'm back again for the next 2 nights, and then a chaser shift on the 7th. At that point I will have completed all the requirements of my nursing school for graduation.

Transplant ICU has been interesting. I have a really great preceptor--so laid back--we fit perfectly. I've felt good about my contributions to the unit, and it's been great learning another aspect of ICU nursing.

In fact, this morning as I was leaving from shift #5, I found myself reflecting on the state of my life at this point, and a sense of well-being washed over me. The air was chilly, and the sun was just coming up. I was snuggled inside my college of nursing hoodie, and walking to the remote parking felt good.

I suddenly realized, I love my little ICU world. I love micro-managing my patient's care, and controlling every vital parameter. I love that the difference between doing well and crumping can be just a few mg/dL, or a few mmols. I love things as simple as writing vitals every hour, putting my mark on the chart stating, "I assessed this patient this hour, and things were good," or "things weren't so good so I..." I love that when patients go bad on the floor, they come down to me. I love the look of relief on the floor nurse's face when I take over responsibility for the patient's care. I love that docs ask me what I think the patient needs, and 9 times out of 10 they're on board with me. I love these things.

I love that I'm almost done with school. I love that the school and professors have thrown their worst at me, and I've met every challenge head on and succeeded. I love that I've excelled not only in classes, but in clinicals even more so.

I love that I have a job waiting for me. That I beat out 758 applicants that had been screened over the phone. I love the tone of respect in other people's voices when they hear which hospital I've been hired into, because it is truly a fantastic organization. I love the tone of respect in other nurse's voices when they talk about my home unit. I heard a Transplant ICU nurse say that on my home unit, "All the nurses are oddly intense."

I love that my wife truly gets what I'll be doing for a living. I love that I can complain about docs or nurses or lab or RTs and she understands why I'm frustrated. I love that I can throw out a set of vitals or lab values and she's appropriately shocked or mystified without me having to explain it.

Most of all, I love that my little, beautiful family is still gathered tightly around me despite the journey I've been on. I love that the kids still scream "DADDY!!!!" when I come home. I love that my wife kisses me and says, "Good job."

Life is good.