Friday, March 25, 2005

Back again, couldn't resist!

I decided to come back and blog a little. This is avoidance behavior. I am supposed to be cleaning the house. A few days ago, my son got the brilliant idea to tell the people at his elementary school that I beat him. Before you start thinking I am a horrible mother, let me explain what happened.

My son is a sweet child. He never really adjusted to being a big brother, and since the birth of my daughter, he has felt like an outsider. I noticed that he is gradually pulling away from the family and retreating to his room. He has always been a little spoiled. I had him when I was 22, and I was 27 when I had my daughter. I thought that it would always be me and him against the world. We have made it through a lot of tough times together. Maybe I didn't wait enough time between my kids.

Anyway, it is spring and I decided to let him wear a short sleeve shirt. His father has been getting on me about his arms. He scratches them constantly and as a result, he has little scabs and spots with varying degrees of healing. I guess his counselor at school thought there was need for concern, so she called child protective services. The child protective service comes to the school and pulled both of my children out of class. They asked them questions and made them get undressed. They took pictures of any suspicious marks and sent them back to class. What makes things worse is that my son told the people that I beat him. I can't believe that. Why he did it, I have no idea, but now the CPS wants to come and do a walk through of my house.

I am a full-time single mom student. What that means in layman's terms? The house is a wreck! During the semester, I have no time for housework, I catch everything up on break. This time while I was on break, I had to do community service for school which meant I didn't get to clean my house. I don't even know where to start. Maybe I will have to take the advice of hiring someone to come and clean once in a while. My mother thinks that is ridiculous. She seems to think that I should be able to make it happen. Too late now, gotta start hiding stuff.

I am very tired. I want to strangle my son. My advisor talks to me like a puppy. I have a Spanish test on Tuesday, and as I said before clinicals all day Saturday and Sunday. I had better get started on this house. It can't be that bad. At least there is no cat poop between my sheets. I better be idle threats could be considered endangering. I really didn't beat him...I swear!

Today I heard a lecture about poverty. It was pretty interesting. Our speaker talked about a little girl who was murdered a while ago. He said that the identification of her body was delayed because she had never been to a dentist. No dental records, no identity...well there's always DNA. Anywho, this whole thing got me thinking. Where do we begin to address the problem of poverty? It seems like an onion with layer after layer of issues. To provide work, you have to train people in a trade, or help them to develop a skill, then there has to be inexpensive day care for those who need it. Then there has to be jobs available. Then the schools need funding for education. Then some families need medical assistance. And public assistance is a complete waste. With the energy that our government spends to keep certain groups from taking advantage of public assistance, they are overlooking the people who really need the help and can't get it. I was thinking about it. People have to complete a maze to get to assistance. Here's an example:

When I first graduated from high school years and years ago, I tried to go to college. I applied for student aid and I was being considered under my parents income even though I didn't live with them. My parents didn't feel comfortable releasing their personal information and so the whole school thing got put on hold. A few years passed. I decided to go back to school after I had my son. The doors of education swung wide open. I got a pell grant, and a perkins loan and I could have gotten a stafford. Having a baby made me independent.

The point I am trying to make is that once you have a child and you are not really making any money, then you can get the help you need. But not many people know that. The government offers daycare assistance, but there are income guidelines associated with that assistance. If you make too much money, you have bigger co-pays and you can eventually lose the assistance. If people work too much, they can't afford daycare. If they work not enough, they can afford daycare, but not rent and food. He also talked about the deserving and the undeserving poor. The purpose of the lecture was to get us to remember that poor people are people too. They have feelings. I know all to well how it is to be less fortunate, but some of the younger students really needed to hear this lecture. It was a very interesting.

Okay, okay, okay! I am going to get started on this housework.

Thursday, March 24, 2005

Critical care is going well

This past week was my first in an ICU. ICU has always been a little bit intimidating for me because I was once told that patients are generally sent to the ICU when death is imminent. I know that the patients are generally more sick that those who are on a general med-surg floor but they can survive, my mother has been in an ICU before and she is alive and well even though she manages various chronic illnesses. And then there have been people who were sick and placed on a general med-surg floor that have expired somewhat unexpectedly. Medicine is a mixed bag, you never know what you're going to get.

In the short time that I have been in the ICU, I have already had a patient die. She was a 60 year old female with a variety of chronic illnesses. She was on a ventilator and dialysis and she had a below the knee amputation. She was unable to speak, and I was trying to communicate with her by watching her eyes, reading her expressions and making suggestions. Her family wanted her to be a full code, which means that if she were to arrest, they wanted us to try and bring her back to life. Anyway, she went into respiratory failure and despite our best efforts, she passed away.

I have been spending quite a bit if time lately thinking about quality of life, especially with the whole Terri Schiavo stuff going on. When Terri had her first collapse she was about my age. I couldn't even begin to imagine spending the next 8-10 years of my life attached to a feeding tube, stuck in bed. My motivation for living would be my children, but would I really want them to see me like that? I wonder what Terri would say if she could momentarily come to and know that her picture has been splattered all over TV with her in a persistent vegitative state. I'm only a little chubby and I don't even want my family to take pictures of me!

This is going to be a rotation that is eye-opening. It is going to be a learning experience that I will never forget. I am not able to write the post that I want to right now because I have to get to Spanish class pretty soon, but I plan on working this Saturday and Sunday. (Yes, I have to work Easter. 12 hours!) After that, I will have some time to share.

Tuesday, March 15, 2005

I wish it was 2006

If it were 2006, I would be preparing for graduation. I would be done with all of my clinicals. Don't get me wrong, I LOVE nursing. I HATE being a student sometimes. I am so tired of the bureaucracy of school, I would QUIT if I didn't owe thousands of dollars in loans and could find a job where I could make enough money to pay back the money I borrowed.

Many people wonder why students decide to go to a community college to get their RN. I can tell you why. First of all, community colleges respect non-traditional students. Really, they do. They respect the fact that we are serious about our educational endeavors. They help us when we need help and encourage us to ask questions. They do whatever they can to be sure that we make it. Colleges and universities are so quick to say that they want the non traditional students. (I will be fair, not all colleges and universities are this way.)

But when we (the non-traditionals) come there do they make their programs accomodate us? No. There are no evening or weekend programs for those of us who need to work. I have even heard that certain directors of nursing say do you want to be a nurse, or mother? If you want to be a mother, best of luck, but if you want to be a nurse you better do those hours. But we are not here to help you with your kids. Be late paying tuition. We know how to find you then.

Money is the root of all evil. But you know what the saddest thing is about all of this? Most of these administrators that I speak of....ARE NURSES! Registered, BSN, MSN, PhD nurses! What the hell kind of example are you setting here? They have degrees in psychology, pediatrics, etc. and they could care less what toll this experience has on us emotionally or psychologically.

Advice for those who are shopping nursing schools? Know what you are getting yourself into. Check out the curriculum. Find out what is required of you in advance. Don't let the niceness of the people fool you. They will be nice because they want the school to look inticing. They will be VERY nice in order to lure you in. Find someone who is currently in the program. Talk to them when there is no one else around (faculty/or recruiter). Meet them for coffee. Ask them how stressful it was and if they felt that they received good support.

Thursday, March 03, 2005

Remembering where I have been....(smile)

I was asked to do a presentation in honor of black history month. I wasn't able to do it at school. So I guess I'll do it here, in my blog.

It was my sophomore year of nursing school, spring semester. We had been in clinical for a few weeks now, and I kinda felt like I knew which end was up. Even though, I knew that I had a lot to learn about becoming a nurse. At this time of my educational career, we started our day at 7am on the floor to get report. (My day started at 5:30, but that is a different story.) Our beloved clinical instructor allowed us to choose our patients and she had a list that she was reading from. I can still remember the smell of warm coffee and banana from the random students having breakfast during report. She read about a patient, and she said that it would be a good opportunity to see a patient with end-stage syphilis. Here's his story:

Past Medical & Surgical History:
COPD, seizures/epilepsy, smoking, angina, HTN, DVT, MRSA, syphilis, hepatitis A, hepatitis C, gastric polyps, ESRD, peritoneal dialysis, MVA 1982 with head injuries, diabetes, IV heroin use, ETOH

Admission diagnosis:
Mental status change, hypoxia, end stage syphilis

History of Present Illness:
The patient was brought to the emergency room from the nursing home with mental status changes. He was hypoxic and hypotensive without his tracheostomy oxygen mask. Although the patient's condition improved with oxygen therapy, he was still admitted for further observation.

I wanted to take care of him, but I didn't want to step on anyone's toes. So I thought I'd wait for someone else to chime in. It was quiet. I looked around the room. No one wanted to take care of this guy. So I asked for him. She said okay. I could tell by the way she said okay, this was going to be an interesting day. I always start my day by introducing myself to my preceptor and reading my chart. I read my chart first, and I didn't know what to expect. I expected an old Caucasian man with soft, swollen, pink skin. I imagined that he would be soft spoken and shameful.

I finally found my preceptor and she said, "I have had to take care of this man everyday this week and it's not fair. These other little nurses should have to be responsible for him. He is mean. He will yell at you. He bites, scratches and spits and oh did forget to tell you he is extremely contagious? Welcome to nursing!" At that moment I turned the corner and went in to see my patient for the first time.

He was a long, thin, mahogany-colored man. He had a moustache and beard mixed with salt and pepper gray hair. He had large droopy brown eyes. He had a tracheostomy so his voice was kinda raspy. His body was covered in crusting sores that had concentric rings. There were a group of doctors standing his bed around admiring his penis, that was covered in golden crusted ulcers/sores that oozed a serous drainage all over the white sheets. It can't be fun feeling like a class assignment, so he was understandably in a bad mood. But as the day passed on, his mood gradually changed from bad to good. At times he became tearful because he wished that he had made some better life choices.

As the day progressed, I found that this man was not really mean (on this particular day), he was misunderstood and he needed someone to listen to him, and have some control over his environment. Then I thought of Nurse Eunice Evers who took care of the young men who were subjects of the Tuskegee experiment. She was a saint. She had patience and understanding. She loved those men. And because of her work, and the sacrifice of the lives of many young men, scientists have been able to study the course of the illness and discover treatment modalities.

The patient had a great sense of humor, he was polite and courteous, and he loved to teach me the different aspects of his care. I hated to see the end of the day. I think he did too. Before I left him, I said my goodbyes, and he said don't care about a dead man. From time to time I wonder how he is doing and if he is still alive. If I had the chance, I would thank him for the honor of being his nurse.