The Cheering Section in the OR

So this week's clinical day ended with nearly everyone in tears because we were laughing so hard. One of the women in my clinical group (all of whom are fantastic) is hilariously dramatic. She is always so perky and funny about things. Normally i think it would bug me, but you can't help but love her! So she got to go down to watch a surgery on one of the patients on our floor. There was a bit of a hold up because the nasty plastic surgeon was a real bear and said absolutely no students. Somehow, Robin totally won him over. So she comes up from the surgery all flushed and glowing and immediately spilled the story of her fantastic stint in the OR. I don't think i'll be able to describe it well enough to really get across the true brilliance of it, but i still crack up just thinking about it.

So the doctor was all angry and cursing all over the operating room, all, "F this and F that", so after he yelled at a couple of people he got his way and started doing something (i can't remember exactly what happened), but Robin decided that his gruff nature would really need a little cheer- that would stroke his ego just enough. So in her cute little high pitched voice she claps her hands and says, "Yay Dr. Thompson!!". He turned around and took notice of her but kept acting all nasty to the other people in the room. I think something was going on and they were trying to figure out what to do with a wound on the leg, and she shouts "just close that sucker up Dr. Thompson, you can do it!". I think this is where she totally won him over. He laughed and went ahead with what he was doing. He even answered some of her questions when she asked what he was doing. Everyone else in the operating room was just looking at each other, like who is this girl? She kept it up through the end of the surgery, and as she was walking out someone, i guess, commented on how she was the only one able to deal with him. To which she flippantly replies with a little wrist flip, "he's a gentle boy, he needs a soft touch." and sashayed out of the OR. It was fantastic!! She is so cute and dramatic, i just wish i could do her justice. She totally won him over, and apparently he's a total ass to both his patients and other staff, so it's even funnier that a second semester nursing student was able to have such an impact!

A Brilliant Turning Point

I've done it. I have separated my feelings from my test scores. Okay, so let me explain. We have pathophysiology tests every wednesday morning. Generally my scores have been okay, some up and some down, but nearly every week, i let that grade dictate my mood for the day. Early in the semester when i was figuring out the test style and format, i was in tears some days (over a frickin B i might add! how ridiculous is that?). That is no way to participate in life. It reminds me of something one of my wise classmates said early this summer, "This is grad school- everyone is brilliant and school is really hard. If you only get your self worth from your grades, i'd be really concerned about it." Okay so even though i used quotes, i am paraphrasing, and she was refering to a friend of hers from college who got all of her pride from working hard and getting A's in school. While it is a positive trait to get pride from working hard, it can be detrimental to one's mental health to get so much self-worth from an arbitrary grade. When i first heard Bev talk about that, i was like, oh yeah, that's no way to get through life. But these last few months i've let myself sink into that downward and sometimes upward spiral of mood swings based on grade fluctuations. (and i'm pretty sure adam is not appreciating it! but he's a trooper and he loves me, neuroses and all)

I read a book called the four agreements or something and it talked about how you shouldn't take things personally. Good or bad things. I wanted to cringe, because i was just working on not taking negative things personally, but i was really holding on to those positive compliments i received. I still have not mastered it, and i fully admit it makes me happy when someone tells me i helped them or when i do well, i feel pride. So here's where patho comes in. I chose today to not let my test score dictate my mood. It's just a grade, and a mere 7% of my final grade at that (thanks mindy for calculating out every assignment's worth).

I mostly think of this because I see a good friend of mine, who is so brilliant and hard working, get so caught up in grades, and letting them equal her worth. And i think the reason i see it so clearly is because I see myself in her. Each week, i see her either giddy and excited or really depressed and mopey. And up until today, i was the same way- i just didn't recognize it because i had done well on recent tests, and was in great moods on wednesdays. But the truth is that I know that i am a smart, capable and caring person who is going to make a great nurse. I may not know everything i need to know now, but i am putting my best effort into this very intensive program, and that is what i take pride in. I need to start pulling my happiness out from within, because i'm not going to make it through this program if i let a grade on an exam tell me how i feel and who i am. I am not my grade on a twenty question patho exam.

This is officially "not good."

Man, i am exhausted. I am just now sitting down at about five pm for the first time since six this morning. So I prop my throbbing feet up on the ottoman and sit down to reflect on my day. Today is my clinical shift at the hospital on an IMC/Telemetry floor. (for you lay people, that means that half the people are intermediate care (IMC) or on cardiac monitoring (telemetry) although mostly they're both. My patient that i cared for today was not doing well. As my professor put it, this is officially (with air quotes) "not good". He came into the hospital for a GI bleed, and most likely will not be getting out. He is one of those people that lived his whole life eating whatever he chose and sitting on the couch. One nurse description was, "he's been a non-compliant patient his whole life". While i think she was a bit of a grouch and left some things to be desired in her nursing care, it's true. Most likely people have been trying to tell him for the last thirty years (he's only in his early seventies) to take better care of himself and eat well or exercise at least a little bit. But, as one of my classmates reminded me, there is something to be said for living on your own terms but dying a little sooner.

When i checked his labs this morning, his BUN and creatinine had shot up to 60 and 2.5, and one of the first things we learned this summer was that when BUN and creatinine rise together, it signals renal failure. I just wish that were his only problem. I don't want to violate any patient privacy issues, but just to make a long sad story short, he ended up with multiple organ system failures. The treatment for one caused the other, but when they stop that treatment, the first gets worse... it was all one big mess. So all day i just tried to keep him as comfortable as possible. But I don't think I will ever get the look on his face out of my mind. His eyes got really big when we had to move him because of how much pain he was in, and all day he just kept repeating, "oh my God". By the end of my shift with him, the doctor came to evaluate him and sent him to get a CT scan done to, as he put it- "I'm not ruling out retroperitoneal hemorrhage- I'm confirming it". After that, he was moved down to ICU where hopefully he'll make a recovery, but the way his bloodwork looked and what the Doctor and my professor said, it did not look good.

When i first realized how bad off he was I had to choke back some tears because he reminded me of my dad. No, let me rephrase that- he was my biggest fear of how my dad would end up. Severely obese with multiple organ system health problems. But my dad has impressed me so much with his progress. He has lost over forty pounds, and is on his way to taking back his life and his body. (although apparently he'd prefer to have cartilage in his hips, so that needs to be fixed, but other than that he is doing wonderfully). So i just choked back those tears and silently thanked my God (and my dad) for listening to my pleas. I just wish him and his family peace and strength to endure what has got to be a really hard couple of days ahead. Blessed Be.

My new work area!!

Yay Ikea! I finally have a study area set up in my bedroom. I don't know why it took so long, but i have a wonderful little area now that i can escape to (and letting Adam watch tv or listen to music occasionally). Furthermore, it means that my ten billion textbooks aren't just scattered around the living room all willy nilly. sorry, but i've always wanted to use the expression willy nilly, and it finally seems appropriate.

As you see here, (besides the fact that, yes, i do need to vacuum) i've got a big giant bookcase which can be accessed from both sides. So on the other side is my bed, and i have my alarm clock and some nighttime reading and knitting supplies facing that side, and all my books and study supplies facing towards the desk.

Sadly, i did have to move Max's window perch/scratch tower because it didn't fit. But not to fear, i moved it to Adam's window area and plan on getting one of those small little window shelfs for cats so Max (or Nigel) can hang out while i'm working.

This past week was still very hectic, as all weeks are in grad school apparently. However, i got A's on both of my exams that we had on wednesday (and i might add, only an hour appart). I know i need to work on getting too much satisfaction and/or personal worth from my grades, but i'm really excited about doing well. I had been struggling in the begining of the year, and i was worried i might
actually make (gasp) a B. That will not, hopefully, be the case. Especially now that i'm super productive Katie with her super studious space!

ps. please ignore the unmade bed on the left (the maid hasn't come in yet this week) lol.