Go big or go home.

I have been a poor updater, but that's because life is so great!! :) I LOVE acute care and I have had the best patients I could've ever dreamed of. I've gotten to do a lot of things that I thought I could never do, including (today!) a rectal suppository. I started giving shots yesterday, a current total of 2 have been done, and have been able to tube feed, do trach care (dressing changes and that type of stuff) and I've really improved on therapeutic communication. Part of my improvement with TC is that I have felt a genuine connection with my patients - it was something I had to learn how to separate from any other tie I have forged with another person. To me, it's so COOL that they're letting me help them get to a better place in life. Obviously that doesn't always happen, but that's always the intent and I think I've gotten good at communicating that. I used a trick that my mom got from my great aunt that she used on me when I had a tummy ache when I was little. My patient seemed to appreciate that I was always in her room and that she finally had some human contact that wasn't just about poking and prodding her.

I find what I am doing in clinical is really rewarding. At some point I'll have a bad day, but one of our nurses told us that the important part is that you did the best you could that day for that patient - that's all they really expect of you. Sometimes their families want more, but sometimes their families are more than happy to share their own stories with you. We had a group of 3 sisters this week on the floor - 2 were always with the third one, our patient. One was a retired nurse from the Navy, another was a pharmacist and the third was a bookkeeper. They were more than happy to explain all the things they brought for their sister to have in her room, tell us about the drugs that their sister was taking and how their family is full of doctors and nurses. The patient (the nurse) even called all of us into her room so we could listen to her heart and lungs. They really were the living Golden Girls! I am sure than when I am old and batty (probably with a UTI), Stace-face will be perched near my bed with some ridiculous picture of us, probably the one where she has a pot belly since that is my favorite :)

One of my goals today was to get the nasal feeding tube out of my patient. It had been discontinued since the feeding tube through her belly was approved yesterday, but she hadn't let anyone take it out. She had told me it was irritating to her, so I kind of made it my crusade for the day (especially since I wasn't sure if I could get her constipation cleared up by the end of my shift). I felt like I was pestering my nurse and my instructor to get this thing out, but eventually I pestered enough to get it done before I left. Even though my patient had finally relaxed a little and gotten to sleep before, it was my little victory knowing that I had advocated for her like our instructors keep telling us to do. All I hear is "As a nurse, you are a patient advocate". Well, duh, listen to your student nurse because this is what the patient AND the orders are saying to do! Just because she didn't let someone take it out yesterday at 3 pm doesn't mean that 16 hours later she will still refuse! I am hoping my ability to not blindly follow directions will never leave me - I should just quit nursing if that ever does happen - because if I don't take the time to listen to a patient before I "give up" on them, what's the point of trying to help? It's tough to take the time to get to know every patient you have when you are taking care of 5, but I think that if I know at least 5 things about each patient it would help me in my own practice to keep them human. Some of the charts are unbelievably thick. This person, on paper, is 300 orders deep because of their length of stay within the hospital. If all they are to you is Room 12345, bed A, I don't think you're doing it right. It could just be me. I mean, that's why I chose to do nursing - getting to know and assist a patient in a way that is far beyon medication is what I want to do. They only other way I could see this happening is through counseling or spiritual life, neither of which I am called for (I'm already crazy and I'm a mostly delinquent Catholic).

So that's my soapbox speech about patient care and the essence of nursing. Suuure, I've had a month in the clinical setting. Go ahead and discount my opinion. That is my own moral code that I choose to base my practice off of. I happen to think it's fabulous. Besides, if I just wrote all of that out and didn't believe in it, that'd be kind of silly.

I'm not totally sure how that tangent started, but anyway...

I have some pretty great friends here :) Clearly I can't pick favorites, but my "twin" and the rest of my clinical group are pretty amazing. I like that we all get along well in and outside of clinical, plus we are all trying to support one another. 3 out of 8 played basketball with our resident baller plus about 10 others from our program (!!!!!!!!) on Tuesday, and it was really fun! (I made one basket... pretty sure I am still not a baller. Sorry, Dana.) Kathleen and I hit up the public market Tuesday morning and I picked up some plants to transport home. One is a pink gerenium (however you spell it) and the other one's a daredevil I think. Either way, I feel like a pretty decent granddaughter at this point.

I'm trying really hard not to get my hopes up, but I am pushing for a kitten for my parents. A horrible gift choice? Yes. A rewarding gift choice? YEEEES! I am hoping it's a go, pretty much because I love those little balls of fluff, but we will have to see. I may have won over my mom, but my dad will be a tougher sell I think. It depends on how he is feeling on the day whether or not her really misses our cat. A puppy would be a tougher sell to my mom though. I'll stick with the smaller animal...

Yes, I have an exam tomorrow morning at 8 am. No, I have not studied for it yet. I'm sure it will all be fine in the end.