time passed…

March 11, 2008

so with the plethora of websites devoted to re=connecting friends, it’s actually quite amazing that i have not found each and every person i’ve ever met…

the thing that really surprises me is where everyone is now… i guess it shows me how wrong i was at graduation – high school & college. i was leaving a group of friends convinced that i would maintain contact with them. i don’t have contact with anyone from high school and, despite these websites, i still don’t. (maybe that will change.) i’m definitely still in touch with many people from college, but these websites have helped me find so many of the more casual acquaintainces i had.

it’s remarkable to find out where life has taken them over the past decade. some people are where i thought they’d be and others could not be further from where i had anticipated where they’d be… well, i hope they are all smiling and enjoying their days. and for the ones i haven’t found.. they can hurry up and find me. 😉


randy moss didn’t win a superbowl! randy moss didn’t win a superbowl!!

February 4, 2008

remind me to send kyle orton a box of chocolates for christmas!

December 18, 2007

Ron & Ann Williams

December 15, 2007

have become the coolest people ever in my world.

after forcing myself to open yet another letter from UCSF, which was going to tell me how much $ i owed them this week… i find out that the lovely Ron & Ann are giving me a chunk of change that is roughly 60% of my class fees. not to mention that i am one of 3 recipients. oh my gosh… i am not really breathing right now.

i cannot begin to express my gratitude and exhilaration


JUNO

December 15, 2007

not only is this movie entertaining, in that “little miss sunshine” kind of funny, but it’s set in MN. everyone needs to see it. ok, not everyone. i’m not sure my parents would really find it as funny as i did. but c’mon, when else will you hear a fantastic line like “doctors are sadistic people who like to play God while the little people cry” ???

 is it any wonder i didn’t got to Med School?


Second quarter

October 1, 2007

has come and I guess I finally dove into it.

Diving, it’s not really my thing. I remember learning it and being scared out of my mind. Actually, before diving, I was afraid of entering the deep end of the pool. I could swim to, in, and out of the deep end, but there was NO WAY I would jump in the deep end of the pool. And, then one day, out of nowhere, I decided that I was going to jump in to the deep end of the pool at the Gaylord Municipal pool. It was evening open swim. I have no idea what happened in me. Suddenly, no one was watching me. For the first time, the deep end wasn’t scary. It was just another part of the pool – another area in which to play. And, I was jumping into the deep end of the pool over and over and over again. It was so much fun.

But, I had it wrong… there were so many people around me watching out for me. I was at a pool. I had 3 lifeguards, whom I had known my entire life, who could not believe I had finally jumped in the deep end. Lifeguards. Funny, it was so obvious and yet so hard to believe.

Later, I experienced the same freak-out feelings when I was required to dive off the low diving board. It was horrid. I am pretty sure it was more of a belly-flop than a dive. I didn’t enjoy it a bit. I hated it. And, I made sure to not try it again – until I was required to do it again. (Weird, here was the same thing as the deep end, but I was taking a drastically different stance) A few years later, I was required to dive off the high diving board. I wanted to quit. This was one of the most scary things I was going to face in high school. It lasted a second and then it was over. I had completed one of the required tasks for Junior Lifesaving. At that point, I wanted to save lives.

So then I got side-tracked. I found things that didn’t scare me. I found things that I could do. And I found things that didn’t make me happy, but my diligence and patience kept me there.

Here I am, again looking at the deep end of the pool. I know that I have studied diligently. I know that my new lifeguards will keep me afloat. I can’t do it all on my own. And, sometimes, I am incredibly frustrated that I haven’t learned the right stroke to handle the waves. But, between my many lifeguards, my own patience and my own drive, I know I can do this.

So, this week I took care of this adorable older man, who had so many complications. I had learned a bit of what I should be thinking about for him last week in class. It was one of those things, a bit of knowledge is a DANGEROUS thing. So, here I am being so concerned about the health of my patient that I just want to protect him. And, now I have basically no experience and a little bit of knowledge and I cannot express enough knowledge and explanation why I need the doctors to pay more attention to my patient.

ok, so now I get the whole concept of you caring about your patient, but not caring about the patient. I have met several parts of his family. I have spent 24 hours with this man. I have fed him. I have made him thickened water and made sure that he is swallowing adequately enough. What if this man’s kidneys are taking an acute hit? What if he is in the beginning stages of renal disease? WHY AREN’T WE TRYING TO PREVENT PROGRESSION OF KIDNEY PROBLEMS??

Now, I just need to learn more about everything in the health world and go through a lot of experiences so that I can handle myself and successfully convince every resident that I am incredibly competent and intelligent – and that they really should consider my thoughts and respond with an equally intelligent thought.

So, now I have returned to my goal of saving and protecting lives. It’s scary and sometimes I hate it. Sometimes, however, it is amazing and more fun than anything else. I have returned to the feelings I had sitting on the edge of the pool: scared that I am in too deep, I forgot about my lifeguards. I think that I should be able to do it alone, but it’s not about doing it alone. Lifeguards are there to guard lives. If I want to be one, then I need to let others guard my life. 


weeks 7&8

August 19, 2007

Weeks 7 & 8.

I realize it’s been a while… and I’m even starting to wonder what happened over the past two weeks… I believe the patient I cared for last week was another “no right bone flap,” which means that the neurosurgery team has taken off the right half of his skull so that his brain can swell and have more space to swell… this allows for better healing. He was a very passive patient, but I realized that family can be both a blessing and a nightmare. The family is able to notice little changes in personality that we, as nurses, do not detect. However, they also detect little changes that we do not detect…  

It was amazing that my patient was just regaining his ability to speech as he was experiencing pain, which made our job a lot easier… he could indicate exactly what he needed/wanted. That was pretty cool. However, the thing that I struggled with the most was putting his “helmet” on when he was being discharged. Patients without bone flaps wear these padded helmets to protect them from any falls, etc. they are close fitting… and just a reminder, when they don’t have a bone flap, the skull is the ONLY thing protecting their brain. I was now putting this big padded, tightly-fitting skull-cap on him. All worked out well, but I didn’t enjoy the increased level of stress…

We also had a very scary incident involving a patient, who went downstairs/outside with an attendant, striking a match while he was receiving oxygen through his nose… Needless to say it caused an incredible stir and I took one major lesson from it. EXPLAIN WHAT THE REAL CONSECUENCES ARE… “Patient X, You are on oxygen, so you can’t smoke or light a match because the oxygen will ignite and cause ……” not just the “patient x, you can’t smoke or light a match.” The full explanation, if the patient is not struggling with altered mental status, might make a lot of difference.

Last week, I also had two exams in Clinical Skills and Pharmacology. They went ok. Nothing too big.

This week, I took care of a patient, who had aortic dissection & mitral valve regurgitation.

http://en.wikipedia.org/wiki/Aortic_dissection

http://en.wikipedia.org/wiki/Mitral_regurgitation

Listening to his heart beat was incredible… He was a really wonderful, patient, good patient, but that almost made it harder. His prognosis is not great. As a relatively young man – 42, the prognosis for the aortic dissection is pretty grim and that is before considering that he blew his mitral valve. (Side note: the patient had had a previous aortic dissection when he was 39. I’m not sure if this was the same injury or if it was a new dissection.)

I also completed two tasks that had been plaguing me.. I completed the last of my assessments and, for the first time, Jane, my clinical instructor, showed me how she does it. The rest of the assessment she had just let me do my thing. She explained that she did that so that I would develop my own style. This time, she showed me another way of doing things, that would give me more information and allow me to do multiple assessments simultaneously – without letting the patient know that I’m doing anything… So, I’d be able to minimize the time I interrupt the patient’s day.

And, the second task that I crossed off was that I GAVE MEDICINE! I gave 6 medications at one time – PO and IV push. PO is Latin for by mouth and IV push is just what it says. I take a syringe and push the drug directly into a patient’s IV access point. Giving PO medications is not a difficult process as it’s really just getting medications out of a machine and then giving it to the patient. However, before we are allowed to do this, we have to understand how the drugs work and how they will work within our patient. As a result, we need to know the adverse affects that might develop so that we can watch for them and respond quickly if we note any of these affects. After I have explained these things to Jane, I then need to be able to explain it to my patient. And, no, we don’t usually speak with the patient the way we speak to Jane. We prefer to use terminology that makes sense to the patient. So, instead of explaining that the drug is an Angiotensin Converting Enzyme Inhibitor (ACE-I), we would say that the drug will reduce blood pressure, which will reduce the workload of the heart. Depending on the patient, we may also continue to explain some of the things we are looking for – the dehydration, the potential that the patient might get dizzy if they get up too quickly, etc. Teaching is a HUGE part of my role and by teaching the patients about their care, this can also help when/if they are discharged and are responsible for their care at home.

This week we had our last exam before our finals week. Shockingly, I have one week without any exams… it’s a bizarre feeling. Hopefully, the study group that I have found will be able to do a lot of review this week after lectures so that next week will be a bit less stressful.

And, my exciting plans for break… I will be going home to see mom & dad for several days at the beginning of September. And almost immediately after my trip home, I head south to visit Matt & Shaari. I’m very excited to see Mom & Dad and maybe enjoy some nice weather. We have had beautiful weather in SF lately, as it’s sunny and clear, but it’s not warm. It feels like early fall, but without the bite in the air… “Bite in the air” is saved for later in the year or it is “fog” and it smacks you upside the head. Anyway, I’m also looking forward to seeing Matt & Shaari’s new home and meeting the kitties!