So I survived the child unit.

It really wasn't as horrible as I thought it would be, but I will say this, some parents are seriously, extremely fucked up. My instructor says that with the kids who keep coming back to the hospital, you eventually have to look at the family unit. I think she is spot on, and it's just really sad.

I got my first grade lower than a B on a test. I don't know how I feel about that. When I took the test I was rushed, not in a quiet area, and I didn't use my normal scrap paper system. I think that may be what my problem was. Anyway, I learned that I was studying the wrong kinds of things. We studied differently for the next test, which we took on Thursday. I will know the results sometime next week.

I got through a period around the end of October when it was time to either withdraw from the course, or keep going (last withdraw date). I was seriously freaking out. It was a week when my academic concerns were completely brushed off by the instructors I tried to contact, a week when they changed so many things about our test taking and academic experience and basically said they didn't think we should be concerned about it. It was a horrible week for last withdraw date to fall on. I decided not to withdraw. We'll see how that works out.

I met with my advisor. She insisted it was time to apply for graduation, which felt ridiculous. I mean, we're way far from that right? I guess we're only 6 months out. I don't know how that is going to work. I feel so unqualified and stupid a lot of the time.

I applied for my preceptorship. My first choice is a ped oncology unit in a research hospital nearby. It's probably one of the places I want to work when I graduate. My second choice was adult oncology in the same hospital, and my backup is oncology in a local hospital where they don't have a child unit. My desire is to go into peds hem/onc when I graduate so I would love to have a preceptorship there, but at the same time it would be very intimidating, because if I really screw something up, that is the place I was hoping to work. So really, whatever happens I will probably have mixed feelings about. My Assistant Dean told me that whether they accept preceptors at my first choice hospital really depends on the unit - that some do and some don't. So we'll see. The only thing we find out in the next couple of weeks is whether we got placed in the first rotation or second rotation. She said you don't know what hospital or unit you get placed in until at least December, maybe even January.

So I will keep on chugging, and maybe even still get an A. It's still within reach even with my 84 on one test.

Let me count the ways....

That I seriously hate psych clinical.

So I've been kind of avoiding writing about it because I've been really enjoying getting out of there each week, and I just have no desire to further think about it once I'm gone.

I think it's impacting my grades, my attitudes about school, and overall I have begun to question whether I want to actually finish nursing school. I've been on the adolescent unit, and so many peoples' parents are beyond fucked up, their mothers sleep with loser after loser who then abuse the kids, etc.

I have 7 days left - 3 1/2 weeks. Two of those days are in the child unit (a place even more fucked up and sad than the adult unit, I am anticipating), and then 4 1/2 days in the adult unit, where I am hoping to at least actively hate it less.

I got an 84 on my last test, after getting a 96 on my midterm. An 84 is hands down the worst grade I have gotten in nursing school. I just have no motivation left. Hell, at least it's passing, right?

Clinical

I have been assigned to the inpatient adolescent unit. All in all, not bad. For the most part I can already see that in many cases these kids are getting actual help and they are learning coping skills there. Part of my frustration is that I feel because of my experience so many cases of childhood psychiatric disorders are greatly influenced by the home environment - if it had been up to my mother I probably would have been placed in an institution indefinitely and permanently put on antipsychotic drugs. What would a place like this have done for me? I guess they'd medicate me and have sent me right back, because what else can they do if there is no outward easily diagnosable abuse or neglect? And so often the parent gives the "psychiatric history" in pediatric cases.

I don't honestly know what "should" happen in cases like this, as opposed to what currently happens. I recognize the system is set up for functioning families and that in healthy families where the parents are not trying to be martyred or trying to scapegoat the children there is nothing to fear from such an arrangement, and that the worst that can happen is that someone is medicated for a condition they may not have, and this is probably better than not medicating the people who ARE sick.

I just really dislike this clinical. It's been one day and I am already counting down. I suppose I have been lucky to have mostly had clinical rotations I like so far, but this one is going to be really hard for me. To top it off, I don't understand what I am supposed to be learning here. I don't understand the role of the nurse there.

Another one I worry about, now that I've had a few days away

This guy was in the hospital with a pulmonary embolism and was diagnosed with diabetes really recently, so he was having a lot of sudden health issues. He was one of the youngest people I've seen on the cardiac/telemetry unit so far, and his teenage daughter was in the room hanging out with him. She was quiet and shy and told me she wanted to be a nurse.

The guy was so sweet, told me that he couldn't even feel it when I injected his insulin (I didn't tell him it was the first time I had ever done a subcutaneous injection outside the sim lab, so it made me so confident). He helped me stick him again when the first time I did so, I didn't get any blood for the blood glucose reading. He was so good natured about it and had the best sense of humor. He was to be discharged during my clinical shift, so I think he was excited and ready to go.

I went to get his insulin and headed back to his room, and he was in there with the other nurse, practically writhing in chest pain. They think he may have thrown another pulmonary embolism. He was in such intense pain and it was really the first time I have had such a dramatic case of a patient's condition changing during my shift. I really hope I did all right in handling it and didn't look too stupid. I had to run and get the vitals machine and help hook him up to his monitors again while my instructor went and got some tubing and a couple of other things and the other nurse gave him pain meds within seconds of all this happening. I feel like I must have looked shellshocked and stupid. His daughter looked so scared, she was the one who went to the nurses' station freaking out when he started having pain again.

Needless to say, they decided not to discharge him that night. They were going to do some scans and see what happened.

I hope he is home feeling a thousand times better by now, but I will probably never know.

I also wanted the chance to tell his daughter that she did the right thing and that she was taking good care of him, but by the time I got back there while it was on my mind, she was gone for the evening. I hope that she knows that and isn't too scared of all the stuff that was happening to her dad.

Busy couple of days

So tuesday I had 4 patients, and was way too busy to have any sort of emotional reaction to any of the patients I had. I was glad to be busy, I still had not had four patients in this clinical and I was kind of frustrated about that. So I did good with it.

Yesterday I only had 3 but we had a lot to do like our evaluation with the teacher and such, which went well.

So I am done with this clinical rotation. I am so freaked about starting the psych clinical though. I don't know what I am going to do, because a lot of the patients there are kids and I am going to want to adopt them all or something.

Clinical this week

I was told by two of my patients that they were glad I was going into nursing and that I am really good at it. I have never gotten such a compliment and I felt like I was on top of the world for the rest of that shift.

One of the patients I had is in his 80s and really anxious to get back to work so he could pay his rent. I hope he got to go home like he was supposed to in the next day or two.

There was a patient who wasn't mine that I keep thinking about. He was in his bed and couldn't talk understandably. I took his vital signs to do someone else a favor and he kept gesturing with his hands and talking in words I could not understand. He seemed to really urgently want to tell me something. I finally realized he was rubbing his face and saying "shave". He did have hair growth on his face. One of the techs was in with me and she told him he couldn't get shaved until the morning. She was being really firm and kind of assholish with him. When we left the room I told her I would have shaved him but I didn't know how. She said that he was being combative with someone and had hit a nurse the night before.

It was the end of my shift so I just went home. Now I can't stop thinking about that poor guy who just wanted a shave and couldn't even communicate. One of my worst fears is to be trying so hard to talk to someone and not have them listen. I feel like a failure for not understanding what he was saying to us. He seemed so desperate for someone to hear him. I wish I was a better person and had decided to shave him myself, or told the assistant that she should just do it herself.

I think I need to find a therapist, because I was actually crying about this in the car yesterday.

This week

Tuesday, September 23 I had an 18 page care plan due at clinical. She gave them back with corrections and wanted it returned on Tuesday, September 30.

Thursday, September 25 I had to go take a test on campus for nursing management.

Sunday, September 28 I had a 5 page paper due for nursing management.

Wednesday, October 1, I had to go to lab to test out on tracheostomy care, tracheostomy suctioning, and chest tube care. Before going to do this, I had to go to the computer lab and complete 2 3-hour (approximately) modules. I had to make sure to get to the lab to practice the tracheostomy care and chest tube care, so that I wouldn't fail and need to do it over again.

Thursday, October 2, I had a test on 3 weeks of material for psych nursing.

The care plan was accepted with minimal revisions required. It took maybe half an hour to complete the things she suggested.

I took the nursing management test and got an 80. I was OK with that, even though it's the lowest grade I have gotten so far in nursing school, because I've been doing what I can this week and am not going to beat myself up.

The 5 page paper - I turned it in at 11:59 (it was due at midnight). I still have not gotten my grade for that.

I passed lab skills testing.

I just finished the psych nursing test a few minutes ago. I got a 92. And seriously, the only studying I did for this was some time after clinical in the hospital cafeteria going over sample questions from an NCLEX book. I have spent less than 2 hours studying for this.

I feel like I just escaped from a burning building. I am disheveled, sleep deprived, have bloodshot eyes, and when someone asks me how I am I want to burst into tears. But I somehow survived. It's really been making me think about how much I really want to do this nursing thing, that is for sure.

Oh, and in the middle of all this I had a major project release at work, which (someone someplace decided) required daily conference calls. I don't even get paid to work every day. I was calling in from the car on my way to lab some days. It was ridiculous. I was getting emails first thing in the morning asking if things had been fixed overnight. It was really enough to make me do a double take.

I got an employee review this week and was told I am doing well. I am not even sure how that worked out, sort of like I am not sure how any of this worked out, including my test grade.