Help! I Have Akathisia!!

So my first final is tomorrow at 8am and i'm so frickin wired, it's not even funny. i knew i shouldn't have had that double americano at 5pm... i know it was dumb- but i didn't even drink half of it! Seriously though- my hands are all shaky and i can't hardly sit still. i'm going to jump out of my skin. Uh oh, maybe adam put me on a typical (conventional) antipsychotic like Chlorpromazine, Thioridazine, Fluphenazine, Thiothixene or, my favorite, haloperidol. and now i'm having an extrapyramidal symptom (EPS) - namely Akathisia, characterized by rocking, pacing or the inability to stand or sit still. Why, Adam, why?? okay, so i'm officially entered the pre-finals psychosis... where are those antipsychotics when you need them?

"Look-- it's an Eeyore!"

Okay, well finals are at the end of this next week, so let me take a moment to talk about my life outside of nursing. This morning I got up a little early and drove down south to my friend, Judith's house to go for our first of several training bike rides. We decided we are going to sign up for the AIDS hill country ride in April (she's trying to convince me that a century (100 mi) is reasonable- still working on that one...). Along with her partner, Alicia, we headed out for a 25 mile ride.

They live pretty close to the start of the ride we looked at (they printed it off of ACA's website), so we decided to ride to Austin High School and then catch up with the route. It turns out that it's the same place where the Tour De Cure ended last May. Unfortunately, it was a little further than we thought (and with some killer hills that had me sucking for air). But when we did finally get out on the Old San Antonio Hwy, it was great riding. There were still some hills, but the scenery was much preferred to being stuck behind a bus breathing in fumes.

We turned around at about 13 miles out to make the ride a total of 26 miles. On the way back we saw probably a dozen deer just sitting in a field, and then a little ways down we saw a bunch of different animals. The funny thing is that as we were going by, i completely spaced and just pointed and yelled, "Look, it's an Eeyore!". I'm sure at some point I must have seen a donkey in real life, but it was still pretty neat and they were only about 20 feet off the road. Alicia, who was leading the way, did her best donkey noise. And that was when I knew I had found my perfect riding buddies.

It was a long, hard ride, but pretty decent for our first ride back in the saddle. We averaged about 13mph with plenty of hills, and that's not a bad place to start. Near the end we were going up a particularly rough hill and I started to stand up to pound up the last few feet, but my legs wobbled and i quickly sat back down. Even though I nearly bonked, I was still happy at the end of the ride. I'm really looking forward to many more rides, and excited to have a couple of stronger riders to train with.

A gosh darn really good day!

Wow, I am just floating on air right now. I just got back from my clinical at the hospital and I just had such a fantastic day! I swear part of it was due to my determination to have a great day- even my cranky patient this morning wasn't going to ruin it (I killed her with kindness- don't worry she's still alive!).

So my morning started out well because i was so well prepared and organized. I found this "jot sheet" that another student (from the year ahead of us) had given me this summer- and it is perfect! It has spaces for everything you need to write down throughout morning report as well as keeping track of things to do throughout your shift. At the bottom it even has spaces for each hour we're on the floor so we can keep track of med times and other activities like linen change and hygiene. It's funny because I was so excited about it and then our meds assistant was like- hey my friend made that (she's finishing her masters this semester). I think she was proud to see it handed down- I'm just bummed i forgot about it until this late in the semester!

The other critical aspect of my perfect day was being paired with one of the best nurses on the unit. I had never worked with her before, but i had only heard great things. (she has this awesome fanny-pack thing that has nearly every little piece of equipment from scissors and gauze to luhr lock needless IV connectors!) Anyways, early in the morning i told her i was an eager beaver, so if any of her other patients needed something that i could learn from- i was all for it! She was so awesome, and it was a huge change from the last few nurses I've worked with who may be competent, but they certainly aren't helpful or friendly. I did my first real venipuncture today (and on a dark skinned gentleman that was hard to see the veins!) and drew blood for labs, and then my nurse let me give a couple IV push meds- it was just great! I was busy all morning, but in such a good way- not ever overwhelmed but also never standing around with nothing to do- the perfect combination!

When i was giving my end of shift report to my nurse, she complimented me on how organized and adept i was- which after last week's crappy day was really nice to hear. I joked about how she should casually drop that in conversation with my instructor, and she smiled and said, actually i already did! What a fantastic way to leave for thanksgiving vacation! We only have one clinical day left, and our instructor already said we would be leaving early to go out to lunch! Okay, enough with the excessive explanation points- sorry, I'm just in the best mood I've had for awhile. It feels great! (sorry i had to get one more in there)

Goodbye, my dear Sam.

I just got a call from my friend Bethany in San Antonio. She gently told me that our friend Sam passed away today. After a few minutes i was in tears. He was only 24, but had suffered from spina bifida and various other complications his whole life. But damn, if he wasn't the sweetest guy with a fantastic smile. Last spring he gave a sermon at church about Gratitude. He had been close to death many times before, and he really wanted to tell the world how grateful he was and remind us to all do the same. I am grateful that I went to church last weekend and got to see his bright shining eyes and big smile. He told me he was having surgery on Wednesday for yet another infection from the rod in his back. Apparently after surgery he slipped into a coma. Bethany said the rest of his family was able to fly out, but he passed on this morning. I will always remember him, and forever be grateful for having him in my life. My heart goes out to his mom, Karen, who lived for Sam- and kept his life full of fun and adventure.
Blessed Be.
Namaste.
Be in Peace.

free from restraints of this paper

Whew. I think, is it possible?, that i am finished with my 13 page paper on restraints. The research was actually really interesting, albeit some of it was really hard to read. The use of restraints in psychiatric settings is waning, but still not completely eradicated. I don't know if I've blogged about this, but my very first day at ASH (Austin State Hospital) I saw two take-downs in the first 3 hours. The worst one was a physical restraint of a girl (she was only 18 years old) who was screaming that she was pregnant, so they couldn't put a strap around her stomach. Maybe the first one is always the hardest to watch, but she was bucking at the straps and bashing her head against the padded restraint chair as she was wheeled into the "reflection room". Times have changed since they locked people in padded rooms, so she was kept in the restraint chair in the room with an open door and a staff member sitting in the hallway. Another staff member made a flippant remark about the future of the baby that i found distasteful, and it contributed to my negative feelings about the whole thing. One of the PNAs (psychiatric nursing assistant) was really good with her, though. He was very calm in talking to her and kept repeating that this was a hospital, and that they were there to help her. He's really good, and in the weeks that followed, I saw him as a really positive force in the unit.

Anyways, i might do some more editing or additions later, but as for today, i am finished. finito. Oh, this morning, i helped humanity. yes, all of humanity. okay I'm being a little dramatic, but i did contribute to helping some of the less fortunate here in Austin. The UT School of Nursing helped staff the "Stand Down for the Homeless" event at a Rec center in East Austin. Basically they opened the doors and provided the homeless with showers, food, health checks, haircuts, and many more services that i didn't get a chance to check out. I was really looking forward to helping with some basic assessments, checking blood pressure and doing some patient education. But... instead i spent three hours checking for lice. I was stationed before the haircuts (next to the very funny Terrell who looked a lot like Jamie Foxx -and knew it- so he entertained us with some great Ray Charles impressions) and was responsible for making sure they had showered today and then checking their head for lice. Didn't find any, thank goodness, but i did see a lot of dandruff. But so many of the people were really grateful for the free haircut. As Jessica and I were walking to the car, a guy in army fatigues rode by on a bike with three bags on his back and said, "i know probably no one told you this, but we really appreciate you coming out." So that definitely made it all worth it- even if i was on lice duty. (btw- not going into elementary school nursing, thank you very much)

late night ramblings

Woo hoo! i got my ticket to visit my parents for Christmas! I haven't seen them since June, (okay, i did see my mom for a day in October) and I'm going to spend nearly two weeks (of my six week vacation) in wintry Ohio (it better frickin snow this year- or old man winter is going to pay). I'm bummed that Adam can't come up with me, I really want to be with him for Christmas, but unfortunately he doesn't have the vacay time (nor would we let him leave his mom all alone- love ya Joyce!) I'm really looking forward to spending some quality relaxation time up at my parents' house- i never actually lived there, but it still feels like home. Besides, nothing can beat hot chocolate with marshmallows while cozied up next to Oreo, knitting by the fireplace. (to be clear, I'm the one knitting, not Oreo). Alright well this tired girl needs to go to bed, she still has one more day before the weekend can begin (and six more pages of paper to write before she can fully enjoy her weekend, but who's counting).

skipping class to go to a lecture- bad, nerdy girl.

Today, after taking my last patho exam (excited bragging moment- 4th 95 in a row!!) i hopped on the FA (forty acres) bus that takes a big loop around campus to attend a lecture in the Pharmacy building. The lecture was entitled, "Connective Tissue, A Dynamic Mechanically Responsive Network: Implications for Acupuncture," presented by Helene Langevin, MD. Basically it was a presentation of her research showing how connective tissue is more interconnected than previously thought, and that acupuncture actually can change the shape of the connective tissue much in the same way that stretch can change it. It was really interesting, and makes me want to blow off my assigned research paper on restraints and start ravenously consuming information about acupuncture.

The other cool thing about this lecture was that it was actually the first of a series of lectures in Integrative Medicine being spearheaded by a professor in the Pharmacy school who is also a licensed acupuncturist. I'm on the email list now, so hopefully I'll have plenty of opportunities to learn more about this fascinating subject. It's part of the reason i applied to this program - the "holistic health" masters track, but it turns out i have to put in some extra effort if i want to really incorporate a multitude of alternative and complementary health practices in with traditional nursing.