Day 5/36

Today was a bit of a change from the usual. Instead of getting up at 5am, I was able to sleep in. My shift didn’t start till 1500 (3pm) so, I was in no rush to get out the door. As the morning slipped away - at a pace much quicker than I expected, I was out the door - trying to beat the traffic. I somehow ended up at my preceptorship 1.5 hrs early, thank goodness I brought my book.

When I started, things were somewhat busy on the unit, but nothing I couldn’t manage (haha yah right). As the afternoon flew by, dinner approached and then bed time. Some of the kids were exhausted by that point and were ready for bed, while others kicked and screamed the whole way! Before I knew it, you could actually hear the humming of the lights (not like those creepy flickering noises you hear and see in the scary movies, but the quiet as in silence). It was nice for a change. Because of this down time, I was able to get my hands on some chart and do some more digging around - find out more of these kids histories - reason why they were admitted. As some of these stories unraveled, I once again.... was hit in the face with a whirlwind of emotions. I asked my RN, K, how she is able to separate her work from her actual life. I have often gone home at the end of my shift and struggle with leaving my kids at work. I think about them often. She gave me some fantastic advice - which I know will help me down the road. Some ways are:

• Having good nursing friends that you can talk with on a regular basis. Sometimes being a nurse, you see things that not many people would understand. To have those that can relate and give you advice about certain things (such as this), is always good to have.  
• When you get home, change immediately out of your scrubs. This is saying that you no longer are Nurse K, but you are just K for tonight.
• While driving home from work, take time to pray and reflect. 
• When you get home, have a cup of tea, think about the day for x amount of time (15 minutes) but then go and do something else (watch TV, read, hang with friend etc). 

Aside from her wise words, I got to rock little babies as the night progressed! This day was great - different, but nice to not feel so fast paced as I usually would during the morning/early afternoon! Driving home at 2300 (11pm) was great - no traffic! Ahh, I look forward to many more of these days!

Day 4/36

What a DAY! It wasn’t as busy as yesterday, but it kept me on the tips of my toes. After gathering all my tools (stethoscope, pens, paper, lunch, name tag), I headed out my front door ..... I saw that my car had been sprinkled with snow. To much of my delight, I skipped on down the drive way (exaggeration!). Luckily my mitts were in the car - so scraping my windshield wasn’t that tedious for my phalanges (fingers) were nice and warm. As I headed off on HWY 91, I had the opportunity to watch the sunrise. Can I just say it’s FLIPPING GORGEOUS! 

I arrived to the unit a half hour early - like usual. Got myself all settled in and listened to morning report. I love the fact I am starting to become more familiarized with the unit, staff and patients. I feel as though I’m actually apart of the team! I had the same patient as the day before, which helped - for I knew when his medications, feeds, glucose checks were. This was the first day I was paired up with my other old friend K, who graduated last year from Trinity. I enjoyed following her around, seeing her ways of staying organized and how she interacted with the patients and families. 

There was a point in the day where I began to get overwhelmed at something so simple. These nurses did their jobs with such ease. They didn’t have to look up every medication, they talked to doctors as if they were friends, they took telephone orders, did EVERYTHING as if they were experts. Being a student is stressful, especially working along side someone who has it all together. I often find myself allowing that “negative” voice inside tell me that I’m not smart or good enough for this job. As the day went on, K realized something was up. She took me aside and had an amazing heart to heart talk with me. K shared with me that for lent, she decided to give up “I can’t” for a specific reason. As we talked about the stresses of being a nurse and how over time, it’ll get better, I was comforted by this. There are still moments when I doubt, but it’s evident that this is where I am meant to be. Nursing hasn’t been easy for me - I’m a few fries short of a happy meal at times, but I know that I wouldn’t be where I’m at if this wasn’t God’s plan for my life.

I need to change the way I think, changing “I can’t” into “I can.”

It’s my challenge, for this preceptorship to remind myself that when I get to those places of wanting to give up, that with God’s strength and perseverance, I can do this! No matter who you are, or what you do..... I challenge you to do the same. Think positive, remind yourself, that: 

“When the world says, ‘Give up,’ Hope whispers, ‘Try it one more time.” - Unknown 

Day 3/36

Why does everyone dislike Monday’s? I've heard from many individuals that it's the "WORST DAY of the week." I am on the fence with this one. There are days I don't mind them and other days where I dread them! But this Monday, besides putting myself to bed at an unearthly hour Sunday night, I was eager and pumped with excitement. 

It took me the usual - 40-45 minutes to get to my preceptorship placement. One thing that I love about my commute is the sun rise! SOOO exciting! Can someone say SUMMER? Not only that, but the sky was clear blue - all day! I enjoyed it from inside! 

Once I arrived to work, I was assigned two patients. This was the first I was juggling two in this setting. One was a total care, which took up the majority of my day, and the other was a child who was cared for by his mom. On my total care patient, I had to do blood glucose checks on him every 4 hours (before feeds), NG tube feeds at 0800, 1200, and 1600, pH level checks (from the NG tube), charting, vitals, etc. It was overwhelming, but a great learning experience. Let’s just say the day FLEW by. It was so busy, I could hardly catch a breath. Little gaffers were crying, babies fussing, children needing to be turned and changed, oh the list goes on. 

I get a kick out of the little children (ages 2-4) who are pushed around the ward by the nurses in their strollers because they can’t be left alone (or else they SCREAM at the top of their lungs), trust me, it's LOUD! So at times, we have a traffic jam in our nursing station, for we’ll have up to 3 strollers surrounding the tables as we all do our charting.

During the day, my other patient (8 yrs), had a rough afternoon. Because he wasn’t eating much - from chemo and radiation treatments, the doctor ordered an NG tube. I was given the privilege to do this. My nurse, E explained everything to the mom and patient, regarding why he needed to have one. Unable to communicate (verbally), he did a great job during the insertion. Just as we got the tube in, but before we had it taped to his cheek, he had a nauseous episode (to put it nicely). We were all a bit bummed when the tube came out with everything else. Because this kid was on chemo, we had to be careful with his bodily fluids. We quickly grabbed some extra gloves and cleaned everything up. My heart was saddened for this guy. He was so tough, so brave... you could tell he was poor in spirits after it came out. We gave him 40 minutes to re-group, relax and just have some private time. After that, we came back and gave it another go. Second time was the charm. As we put it in the second time, you could see his eyes start to well up with tears. We did everything we could to encourage him. I wish you could all see how brave he was. 

All in all, today was a great day. As busy as it was, we survived! It was nice to have the day fly by though! One thing I learned from it all was that I need to stay organized - write everything down, for it’ll help me when it comes time to charting! I know with time, things will get easier on me. I can say that I finally feel apart of the team. The staff are incredibly friendly and inviting. I had no trouble going to them, asking questions. I look forward to the remainder of this week. 

"They may forget your name, but they will never forget how you made them feel." Maya Angelou

Day 2/36

Today was an emotionally draining day. I think the proper definition would be something like “compassion fatigue.” I’ve heard my share of lectures that talk about “burn outs” and how nurses need to “detach themselves” from their patients. What I struggle with is, how can nurses care for their patients when they remove themselves?  Nursing isn’t a glamourous job, trust me! Just the other day, a nurse on my unit had her scrubs soiled from one of the kids. Aside from the initial laughing, our jobs aren’t always fun and enjoyable. But.... no matter what, I believe compassion is an important part of nursing. 

[What is better?] Having a nurse cuddle a child who is crying and fussing, or a nurse who closes the door to drown out the noise - so she can have some peace and quiet? I believe that there is an important balance when it comes to caring for our patients, because we are all susceptible to experiencing a burn out in our careers at one point or another.  

Burn outs can be due to many reasons. It occurs when someone endures major/continual stress (emotional or physical) and has difficulty coping. This could be seen from:

• providing care around the clock 
• patients becoming vulnerable and too needy
• health care constantly changing
• development of new technologies
• constant noise & business
• critical ill patients
• crisis of patients and family’s
• work environment - work overload (limited time, resources, staff)
• demographics - young age, early in career, high level of education
• personality - low self esteem, need for approval, perfectionism, impatience 

Whatever the reason may be, it’s important to be aware of these and know our limits. If burn outs aren’t treated, one can become ill, exhausted, have a mental break down, go through extreme depersonalization and have an extinction of passion. YIKES! I tell you, I’ve worked with many burnt out nurses; they are miserable, cranky people. During this 12 hr shift, I had many opportunities to think about burnouts, and how they could affect me - or how I might be heading down that path.  

Working with children is rewarding. They are full of life; their smiles warm your heart. BUT..... on the flip side, working with children can be extremely challenging; especially sick children. For those who read my previous post, I had the chance to work with the 2.5 month old baby; aka... my little Prince Charming. When I first came onto the ward, I went into his dark room to check up on him. As I approached his crib, I peeked through the individual bars that surrounded his tiny body. I noticed immediately that his NG (nasogastric tube) had come out of his nose. Ever since he was admitted to the unit, he was put on a continuous feed (the tube goes into his stomach - making feeds much easier on him). So because of his tube being pulled out, his bed and clothes were wet from the formula. 

After morning report, I hustled back to his room where I scooped him up into my arms and headed down the hall into the bathing room. I filled up his baby bath and got everything ready. He loved his bath, which made it easier for me. After his bath, I got some new clothes for him and rocked him back to sleep. After his little cat nap, E (my RN) and I re-inserted his NG tube. That was one of the hardest things to do. His fought with every muscle - squirming and arching his back, how he usually does when he’s upset. I hated the fact I made him cry, it broke my heart. To make a long story short, the shift was a great learning experience. The majority of my day was spent in his room, cuddling him with every opportunity that I could. Because of the neurological damage, I was scared to leave him when he got upset/started to fuss. He’d arch his back so much that he’d burry his face into the blankets we have in his crib to keep him from rolling over.  I was worried for his safety, so of course, I’d come to his rescue and pick him up - cuddle him and put him back into his crib. 

There were times during the day where I was late - getting to my break because I wanted to calm him down before I would leave his room. It wasn’t until later on in my day that I realized how exhausted I was. As I was rocking my little man, I could feel my eyes growing heavy, wanting to close. I felt spent. It is evident how exhausting nursing can be. For example, a clock fell down in the hall way and made a loud crash! All the rooms that were close by heard this. Of course, the children/babies were scared. It was like an orchestra of screaming and crying that echoed the hallways. The majority of the nurses would try and calm/sooth these children down -lemme tell you...it’s hard work! 

The biggest thing that I learned from today was as much as you want to take care of all these little kiddies, you got to take care of yourself. In doing so, we can prevent ourselves from becoming physically and emotionally exhausted. In order to avoid burnouts, we must set boundaries, keep balance in our lives, be involved in friendships (which are giving and taking of equal amounts), get a significant amount of sleep, participate in self-renewal activities, be more organized, and seek love and support from others. 

Overall, the day was great! This is definitely something that will be on my mind for quiet sometime. I may choose to not “disconnect” myself from my patients, but I do need to look after myself as well! Once again, I need to trust God, know that He'll fill my "compassion tank" when it's running low. I believe He put me in this place - to be a nurse- for these specific reasons. I will continue to love on my patients and be a shining light for them! 


"I can do all things through him who strengthens me." Philippians 4:13

Day 1/36

So........... I just finished my FIRST shift! Can I just say..... WOW! 

I went into the day with an open heart, not sure what to see or expect. My morning started off with the rude awakening of my alarm clock at 5am. Of course I didn’t sleep a wink the night before. For those who know me..... I stress out before clinical (especially the first day). I always have that underlying fear that I’ll sleep through my alarm and be LATE! Eek! Needless to say, between my cat naps, I managed to drag my tired butt outta bed. 

I got to my placement around 6:30am, with the help of my dad’s expert navigational skills. For those who don’t know me, my sense of direction is HORRIBLE! As I waited in my car, my mind was going a million miles a minute. 

[What was I going to see? What would my day look like? Who was I paired up with? What kind of patients will I encounter? What if I mess up? What if I don’t know the answer..... what if... what if..... what if?] 

I took a couple deep breaths, said a quick prayer, and was on my way up to the unit! I was greeted by friendly staff members (two of which were New Grads from Trinity which are old friends of mine!). Unfortunately, my preceptor lady wasn’t able to come for the day, so I was paired up with my good friend E - I can’t express to you the feeling of relief that washed over me! 

As the morning started, I got an opportunity to listen to report - seeing which patients were on the floor etc. For those who don’t know, I am working at a Health Centre for Children with Disabilities.  I will be working with children as young as birth, to age 19. For those who don’t know, I LOVE CHILDREN! Ever since I wanted to become a nurse, pediatrics has become my biggest passion. At this placement, I will be working with children who have conditions that affect their physical, motor or sensory development or have acquired brain injury, prenatal exposure to alcohol or other drugs, cerebral palsy, or autism. Not only will this be a challenge for me (learning about these conditions), but also learning how to deal, support and encourage families who live with this on a daily basis. 

For the course of my day, the patients I helped with ranged from 2.5 months - 16 years of age. One was in respite, two were brain injuries and the other was in for otho.

The 2.5 month old was one of which suffered from a brain injury. My heart broke when I found out this had been caused by subdural hematoma, retinal hemorrhage, and brain swelling. For those who know what SBS (shaken baby syndrome) is, you’ll understand a bit more. When I picked that little boy up from his crib, my heart melted instantaneously. How could something so precious, be mistreated? Emotions flooded my heart as the day progressed. Whenever I had a spare minute, you could find me in his room.  There were multiple times he’d begin to cry, and I’d rush to his side, pick him up and hold him tightly against my chest. I would stare into his blood shot eyes and tell him how much he is loved; especially by our heavenly father who created his inmost being. I prayed for him, over and over again. As I stood there, he looked up into my eyes, reached for the side of my arm and dug in with his little finger tips.... grasping whatever physical touch he could get. If I could, I would have walked out of that unit with him that evening. As the lump formed in my throat, I held back the tears ... knowing that God’s hand was in all of this. I had to trust Him - knowing that whatever happened with this boy (foster care) etc... that God would continue to love him and watch over him. 

Another patient that touched my life was the little 6 week old girl who shared the same room as the little guy above. Her story gave me chills. This little beauty wasn’t my patient, but I was informed by K (my other nursing friend) that I had to read her charts. When I had a spare moment, I sat down and was blown away by the events that took place in the previous week. The mother woke up one morning to find her little girl unresponsive. She called 911. When they arrived, the little girl wasn’t breathing and didn’t have a pulse. They began CPR on her as rushed her off to the hospital. After 30 minutes of CPR, they announced her time of death. They swaddled the baby and let the mom have some “private” time with her. An hour and a half later, the nurse went back into the room to find the baby........ wait for this............ PINK, and BREATHING! Can someone say miracle? This gives me chills just thinking about it. To this day, the little girl is doing good, gaining weight etc, but is suffering with brain injury. I can't help but look at this story and wonder why people don't believe in God. For something like this to occur, it isn't by chance. God was watching out for this baby all along! 

These are only two of the many stories I could share with you. The staff that work along side these families are incredible, I am so lucky to have this experience. I am excited for the many more opportunities where I can love on these children in ways that may brighten up their days etc. I definitely look forward to my next shift!!! 

I can’t wait! Counting down the days! :) 

For you created my inmost being; you knit me together in my mother’s womb. I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well. My frame was not hidden from you when I was made in the secret place. When I was woven together in the depths of the earth, your eyes saw my unformed body. All the days ordained for me were written in your book before one of them came to be.

—Psalm 139:13-16