A chronicle of a brand new Nurse Practitioner, fresh out of school, about to embark on her first job. I'm happy to share my ups, downs, my victories, and my, um, *learning opportunities*. Hopefully this will be helpful to some of you pout there who are on a similar journey!
Friday, June 22, 2007
Dogs will be Dogs
I do have to write about a little occurrence this week.
It involved mud via the rain and an increase in my blood pressure.
The rain has been incessant for a while now and thus, the one spot the dogs have previously dug around in is muddy. All along I thought the majority of the digging (they have escaped twice, once they were retrieved, this last time, they were promptly put back in the yard even though I was in the shower).
Wrong-O.
Gabe, the older Lab and one I had blamed the majority of the digging on was in the kitchen happily chewing on his rawhide. I was sorting mail, paying bills, all that jazz, also in the kitchen.
Then, suddenly, my brain says, "Hey what is that on the floor over there-wriggling?"
I looked over only to find a small mud-slicked statue that vaguely resembled the miniature pinschure I was also looking after. After screaming "OUTSIDE" the statue deftly got up from rolling all over the carpet and bolted outside.
Little monster.
Little mud-slathered mud statue.
Oh, half mud-slathered statue since the other half was now all over the carpet!!
After two doggy baths, and a fun toweling off (I forgot how fun that is!) for the dogs that is, the house is back to normal.
And the carpet is too!
Dogs are so doggy!!
Saturday, June 16, 2007
Advice of the day:
You have done all you can do.
No sense in abusing yourself because you can’t do anything more.
Just move forward.Be the best you can be and know that you have done the best you can.
Who's your Momma??
- I know where I get my wriggles from. She could not sit still the entire trip. Up/down/up/down/up/down with the window seat window.
- Rearranging the blanket and bumping me: I was so glad she was not riding next to a stranger.
- “What was that??!!” At every new noise that happened on the airline. And because has Alzheimer’s, none of this knowledge stayed in her memory, so it was repeated ad nauseum.
- Questions like, “Can we go to the bathroom while the plane is moving,” I learned to accept. If you don’t know, you gotta ask. Another quality she and I share.
- OCD cleaning. Yes, she and I clean obsessively at the same rate. She regularly “swiffered” my brother’s house ( 5 cats and one dog = lots of hair).
- My love of sleeping in regardless of the previous night's festivities....yep, got that from her too.
I am my mother’s daughter.
If I can PLEASE just avoid that loosing your mind thing....
Our partners in crime
If you look at life, generally most people have three stages of life: young adulthood- making your way, discovering who you are; Middle adulthood- finding a mate, raising children, and finally, Late adulthood- retiring and enjoying a life of looking back and looking forward to enjoying that which you have planned for.
So, how do you pick a mate? I think this is one of the most difficult things to do. I think, it is very difficult to pick one person whom you can grown thru all three (if not more) stages of life with.
I thoroughly believe it is possible to do: pick someone who can grow with you and you with them. Yet, it requires the person and you obviously, to be brutally honest with one’s goals and aspirations. It requires a level of self-awareness that a great many people are not capable of until much later. Hence the divorce rate we see.
Finding one’s identity is very difficult and very time consuming; especially if you have not had a very good example as a child.
By the time you figure it out, say around 28-35 years of age, you have already gotten married. Maybe you wake up and think, “Wow, what the hell have I married?” Or maybe you get to late adulthood and think, “I don’t want to spend 24/7 with this person.”
It is really very difficult. Yet, the most important things do seem to be very difficult to get correct. Trial and error…
I guess that is why they say, “Why is divorce so expensive?” “Because it is SO worth it!!”
Being able to retain who you are and what you are is priceless. Finding someone who is interested in nurturing that in you and you are interested in nurturing that in them is the key. This takes a great level of self confidence and that in and of itself is hard to come by. Growth and change is scary. Harder still, taking that good, long, hard look in the mirror and asking, “What can I do better with me?”
Growth, personal growth through the lifetime, is where the real challenge lies. Picking someone who really wants to grow at the same level and life-time rate is where the challenge lies.
It requires that everyone involved by honest. Brutally honest at a level that most find distasteful or uncomfortable. But this level is necessary for long term happiness.
Wednesday, May 30, 2007
The Adult Card.
This is so hard on so many levels. There are many activities she still does and she needs to keep attending them. My siblings and I are trying to work it out so we can get her to some of her events. But, it looks impossible to do everything.
Decompensation in Real Time
My mom’s nouns are gone. Apparently, when you begin to decompensate neurologically certain sets of neurons hold up their little axons and dendrites and say, “Oh, we are nouns, we will just blink off now.”
And that’s it, all the nouns go away.
Ever try to communicate without nouns? Or, have you ever tried to understand someone who is trying to tell you a story without nouns?
Impossible.
My mom stopped recently and asked point blank, “Where have all my words gone?”
I wish to hell I knew. I’d go get the little devils and put them back in her brain. The emotional pain of watching this happen in real time is a fate I would not wish on my worst enemy. And yet, it is amazing, really, how and in what order the brain falls apart. How is it that the nouns are affected? Why not random words? Or words from all parts of grammar? How did the brain know all these were nouns?
The cognition is starting to go as well. That’s why I know she won’t pass her driving test…
At first, I wanted to believe it was attention seeking behavior. But no, her inability to understand and integrate new processes is real.
It kills me, inside and out.
And yet, there is still something interesting going on.
Such conflict…Latest on the Nomadic Life…
My goodness I live almost in Louisiana….
I had forgotten how far away from everything you are when you are out that way.
It’s only till August, but still.
Next, a search for my own residence…..
Yeah…!
What's on for this Summer!
Back at UT
One of the summer jobs I have is working part time for the lab I worked for at UTSW. I have returned to the pathology lab to do brain genotyping and synaptophysin protein assays on post mortem samples. Basically, it consists of finding out what genetic makeup a person had for the genes involved in neural degeneration that we associate with dementia and Alzheimer’s. The protein assay is just that; looking at the quantity of synaptophysin in different regions of the brain. Synaptophysin is associated with synaptic health. As the synapses in the brain breakdown, so declines the quantity of synaptophysin. I am getting my science fix this summer!
Two Down, Two to GO!!!!
Well my second semester is down for the count! Great grades and I am so happy summer is here! I have decided to take no classes this summer and just work…work on that being broke thing! But, man I am happy I am doing what I am doing.
Next semester is OBGYN and Peds as in Pediatrics. I would love to just skip the OBGYN section, but I am very much looking forward to the Peds rotation. I adore kids even though I don’t want any of my own. They are great! I'll see if I take to the sick kid / stressed parent thing or not. Who knows? The possibilities abound.
This is the most convincing reason I decided to take the plunge and get my RN: choices.
With an RN I can do anything. I am already thinking about an advanced degree after I work for a bit. First of all, where I work with pay for it. Bonus! Maybe a nurse practitioner or OR first assistant, I just have to see.
I can also foresee doing something else I truly love once I am at a later date of my career; teach. I think teaching nursing and nursing related classes when I am tired of everything else would be “just what the Dr ordered!” I already love to teach and nursing is so hands on and quite mechanical in a lot of ways. I could teach it, I’m sure.
Another facet of nursing that calls to me is being the organizer of academic research and its application to patient care or medical uses. I can speak the different languages necessary to communicate with the doctors, the scientist (I do speak geek!), and organize the data. The down side with this avenue is that it leads out of Dallas. The cutting edge science that is being applied to medicine is not in the southern part of the US. Lots to think about….
I have time. Why hurry? Life is too short.
Life is too short to be miserable, to hurry or to be in the wrong place.
I know my path is right.
It’s a great place.
The Best Line So Far…
So, um…..Can I waste drugs with you??
This STILL cracks me up! All narcotic medications have to be disposed of with supervision for obvious reasons. The above line is the usual line I heard while doing my OR rotation. It always made me giggle!
Wednesday, May 09, 2007
Two Down Two to Go!!
Finals were not so bad. I did well in th skills and clinicals. I did passable in lecture as did the vast majority of the class. The bottom line, is, I am still in the program. Sadly, not everyone can say that.
At happy hour, we all discussed how well our class has meshed. We have a great class of a wonderful mix of people. We all work together, party together and generally have great time. A rare thing I believe.
Nursing school is just a blast for me. I love the people, the patients, the learning and the unknown. Fear is really such a hindrance. I don't look at things as fearful, just the next adventure.
What does the next semester hold??
I will let you know.
Just a Body Part…
Namely, once you are anesthetized, you are, in fact, just a body part. You are draped and covered so that nothing appears except the offending region of your person that needs to be operated on. This made me both comfortable and slightly uneasy. Of course, this allows the surgeons to do what they need to do, operate without any distractions. However, if does remove the fact that there is a whole person under all those drapes. So, it is good and bad in numerous ways. The anesthesiologist keeps tract of the whole person, i.e., is that person under all that still breathing and is the person still asleep! Out cold is very important!
I did really love OR. I liked the teamwork: everyone has a job and everyone does it. I liked knowing that all the instruments had to be arranged and accounted for. Yes, I am an organizational nerd. I liked the music too, surgery is a great place for good tunes. I was able to get past the cold. The room is 60 degrees F. So, yes, you freeze your ass off if you are not careful.
But I did really enjoy my OR rotation. OR ranks high on the list of possible avenues of nursing once I graduate.
Yeah, gotta graduate fist!!
Two semesters down, 2 to go!!
Monday, April 30, 2007
My Nomadic Life
I really believe that when you are on the right path in life, a way makes itself available to you. This is a good example of that. I had to move very unexpectedly from where I was ( the house I was renting sold) and was kinda stuck as to where to go. So this has worked out for both me and my fellow student. He knows his home and 2 dogs will be loved and well cared for and I can stay somewhere and take my time as to where to live next.
I hope to stay for a bit where ever I land this time around. At least for a while…
My one desire when I finally land in my own place this fall is a cat.
I want a cat.
So I am torturing myself looking on Petfinder.com!!
Home again, home again, jiggidy-jig…
Tuesday, April 10, 2007
Almost Done with Number Two!
I cannot wait to be done with this semester. So far, the grades are great, and I am having a blast. I have work lined up for the summer to keep me busy and to keep me funded. So far, I am keeping my head above water.
All of this still includes martial arts and some tiny bit of personal life.
However, between now and finals, I have to pack, move, somehow gently sell my mom's car as she is having her license revoked (how does one do that gently??), figure out how to get her around and re-schedule her life, plan to attend my brother's wedding in June (lives in New Jersey) and organize three part-time work schedules.
Oh and taxes.....crap. Can anyone say extension??
Thank the gods for my palm pilot.
I seem sorta busy, but I am having a great deal of fun. I kinda like the challenge of keeping it all going. I am really looking forward to getting away this summer somewhere and somehow. That is in the beginning stages of planning.
I really miss diving. But it will have to wait for a bit.
It is really quite busy but I like it.
I am still the one driving the car of life.
More Analogies to the Animal World
Considering what normally happens in spring...
Male posturing and competition.
Courtship.
Breeding.
Babies.
That is very obvious in the animal world. How does it relate in the human world?
Human beings are one of the few species where the females can be more flambouyant than the males. Typically it is the males that have the colorful plumage, large, fluffy coats, or horns with which to compete for females with. Generally, this makes the males more visible and thus, more susceptible to being eaten.
However in the human world, both genders are generally more visible with the females being more visible than some of us would wish at times. This is one difference.
I have also come to understand that after battle, often times men have a major increase in libido. Why is that? I think it may have to do with the age old fact that males at battle usually battled for breeding rights. At the end of the battle the victorious have rights to breed.
Our civilation, our culture has leaped ahead of our evolution through our technology, food production and the like. Our biology has yet to catch up with our society's evolution. Biology just does not move that fast.
Maybe males going through battle still have that biological memory if you will, that the reward for battle involves rights to females. Just a thought. Maybe this also has something to do with why in raging battles, the raping of women also happens. A horrible thing, but similar behaviors can be seen in numerous animal specieswhen taking over other groups' females.
I also have known of women who are very taken with men who fight over them. Some of these women often encourage such situations. Not healthy, but a fact.
So the idea of battle being a prelude to rights to females and the right to propogate genes may not be so removed from our species.
Just some random thoughts.....
Update after Terrell
I have finished with Terrell! I cannot communicate how happy I am to have that all done. I never thought the words, “I can’t wait to get back to med-surg,” would ever cross my lips but they have with relief. Terrell was not somewhere I ever want to return to. I did live through the experience. I will say in the defense of Terrell, the staff were very interested in caring for the patients. Most of these people did really need to be there. It was unusual that a patient at Terrell did not need to be there. I ran across one, but it was unusual.
Monday, April 02, 2007
New Job!
This is really a great deal of fun. Mostly the babies are adorable and the people there are happy; new baby and all. I have only wanted to run from the room with two children so far. I feel badly for some of these babies and what they are obviously born into.
I do really believe we should have requirements for child bearing. By and large, the job is great and the hourse very flexible.
Yeah!
Reasons for comfort:
Why is that? I have come to the cursory decision that it is acceptance, a lack of judgment, love; that defines this comfort. Those people you can be around, those who will not judge you, those who will trust you beyond doubt believing you will make decisions that are good and that you have the strength to make those good decisions regardless of the situation- these are the people that we find comfort in being around. There are no “uncomfortable silences” b/c they know you just need time to think and be quite. They let you come to the time to talk in your own time.
These things sound so small and so easy. But these are very difficult things to do: not judge people, be patient, trust them, have faith and love unconditionally. So very hard to do.
When you find such people hold gently and nurture them. You should be able to be the same person no matter who you are around. This I think is the best goal. It is such comfort to just be who and what you are no matter.
Thursday, March 01, 2007
Purtis Creek
All things were packed into the car and off we went. Of course, there is always one thing forgotten and this trip was no exception. The infamous green bucket of cooking utensils, headlamp, and camp soap was left behind. Alas, the best laid plans....
Since it was the last weekend in February, the trees were not yet green with foliage. However, there was the cutest of light green "fluff" to them as they were just beginning to sprout forth new leaves. Everything had the appearance of fuzz. As night fell, the stark, leave-less trees silently stated one word to me: patience.
Simple because they were waiting.
I liked the stark contrast of naked branches against the waning sunlight. We saw birds galore and we still have several to identify.
The Saturday dust/wind storm was something else. The morning began with, "Wow, it is all hazy outside." Walking throughout the day proved to have grit attached to it but you didn't notice until you got back to camp because you were so distracted with trying not to take flight in the high winds. When we did get back to camp, several tree branches had landed very near the tent. We decided that since Mother Nature had provided firewood in such an obvious fashion, gathering and burning it all would be just fine. We had a grand fire.
Purtis Creek is a small camp ground but we had practically the whole camp ground to ourselves. We camped in spot #60, on the other side of the dam and there was not a soul around us. Perfect.
We have another trip scheduled for Dinosaur Valley. Who's in??
One Down, 5 to go…Psych!
The first day has come and gone, and really it was not that bad. Granted, I have not been to Terrell yet, that is next week, but so far, it’s ok. We sat in on group therapy today. This entails the patients all coming together to discuss what they are feeling, fears and other thoughts. The vast majority of people were there because of severe depression and/or having attempted suicide.
The real theme I heard in this group of sad, depressed people was a lack of connection to other human beings. “I am just so lonely since my husband died,” or “I just feel the loneliness come over me,” were both common statements.
What I heard from these people is this: they don’t feel like people care about them. What’s more, they don’t know how to go about changing that feeling. Many of the people there had been abused or taken advantage of in terrible ways. Honestly, I could relate on some level to how some of the patients were feeling.
Why is it that we can be so mean to each other? Are our lives so busy that we forget to care about our friends or about our families? The therapist said something sadly very funny: “Yeah, any major family holiday can make anyone want to starting using [drugs/alcohol] again.”
So very sad, and yet so very true.
I think the part I have the hardest time with is the simple fact I identify with some of these people. I know how they are feeling and what they are going through because I have walked their path.
Of course, it begs the question, why am I not also in their shoes? Why am I not also sitting here on the other side of the table? Why is it that I have not been on that other side of the table at least once before?
To me, there is only one obvious answer to that: Friends
A gift I seem to have in abundance.
Ya’ll, I am thankful for every one of you.
Yes, you too…