Posted by isntshelovlei on October 7, 2010
When (medical-ly) things go wrong in my own house, right under my own nose, it really makes me start to question how good a nurse I can/will be. If I don’t even notice when one of my own kids is in respiratory distress then how in the world am I supposed to be able to assess multiple patients?
One of my daughters—the “small girl” as she calls herself, not the much taller one from my strong therapy post—was admitted to the hospital this week (hence very few tweets and status updates from yours truly). I was at work, actually in the middle of taping another Insights in Nursing podcast episode over my lunch break, when I got a call from the daycare saying that she was breathing pretty hard. Of course I hightailed it over there, stopping by the house to grab her barely-used inhaler. Until this admission, the docs refused to label what she had as “asthma.” They said she was too young and her symptoms were just a bad reaction to a virus, so up to this point she had not been on any type of maintenance therapy. Nevertheless, I did still have that trusty rescue inhaler (which had probably not been used for close to a year). I get to the daycare and she looks absolutely horrible. I could see her working to breath through her hoodie. I gave her her “puffs” and put her in the car. By the time we got to the hospital she was tachypneic, with intercostal and suprasternal retractions. How could I have not noticed any of that this morning? Surely, she did not go that downhill that fast and without showing some preliminary signs/symptoms; she didn’t look like that when I dropped her off that morning.
Thinking back, there had been signs—just none that I had readily accepted. She’d been coughing recently. It started out as a dry cough; I now noticed that it had become junky. Just that morning, she complained that her throat hurt, and she looked tired as all hell. I sort of brushed it off thinking (or hoping) she was “just” coming down with a cold and even told her that she’d “be alright.” And of course she was tired. Our lives are hectic as a side effect of all of our various responsibilities; we get up at the crack of dawn after staying up late nights most of the time. I’m sure our entire household could benefit from a few more hours of sleep.
But this was bad. She’d had a similar “episode” (since we weren’t calling it asthma) sometime in 2009, but it wasn’t like this. It took her a lot longer to come around this time. The albuterol and prednisone weren’t even touching her wheeze (which sounded more like an expiratory snore). I felt horrible. I am under such tremendous pressure and stress—between home, work, studying and keeping my grades up in school, trying to stay “involved,” community service, networking…all on very little sleep. But at what cost? I already know I’m stretching myself thin. But everyone keeps telling me that it’ll all be worth it in the end…
I think my overpacked schedule and subsequent need to have things proceed in an orderly, organized fashion (such as not having kids get sick when I already feel like I’m being pulled in a million different directions) has led me to develop “hyper“chondriasis (sort of the “opposite” of hypochondriasis). Yep, that’s what this was—a case of hyperchondriasis by proxy. My kid was really sick, but I was in some type of manic denial.
Through it all, I did learn something new…retractions seem to work their way UP. As in the patient usually has subcostal retractions first, then intracostal, then supraclavicular or suprasternal ones. My daughter’d had retractions before, but never up at her collarbone area.
In any event, she’s home now, doing much better, and back to jumping off the walls and eating us out of house and home. 🙂
Posted in Family, Nursing school | Tagged: asthma, kids, nursing student, respiratory, retractions | 2 Comments »
Posted by isntshelovlei on September 28, 2010
You know you’re into the meat of your nursing program when the concepts start to creep into your everyday life. You assess friends and familys’ vital signs…you are now a germaphobe and engage in scrupulous handwashing (and encourage others to do the same)…you might even use medical terminology in every day conversations (I’ve been known to say things like, “Well I do XYZ prn…” or complain that my son is “noncompliant” with some rule). One could imagine it would only be a matter of time (especially now that I am taking mental health/psych) before the therapeutic communication would begin to kick into auto-pilot.
I have three kids. It was the weekend and I was trying to study (of course) so I let them go outside so that I could have a smidgen of peace. My daughter comes back in the house huffing and puffing, eyebrows knitted. I sighed and put my books down. The conversation went a little like this…
ME: “What is the problem now?” (giving broad openings/open-ended question)
HER: “He thinks he’s the boss of me!!”
ME: “He thinks he’s the boss of you?” (reflecting/restating)
ME: “He is only 11. Do you think he’s old enough to be anyone’s boss?” (voicing doubt)
She thinks it over for a minute (silence), then makes a face.
ME: “Well? Go on…” (general leads)
HER: “No…but he still acts like he is…” she grumbles.
ME: “I know, sometimes big brothers are just difficult like that. But if you ignore him when he acts like that he won’t do it as much (supportive confrontation). Please stop fighting with your brother. If the two of you can’t get along, you will have to come back in the house (limit setting)…
Sufficiently unruffled, she goes back outside and all is well with the world.
Until next weekend…
Posted in Family, Nursing school | Tagged: kids, nursing student, therapeutic communication | 4 Comments »
Posted by isntshelovlei on December 18, 2009
So it’s a wrap! At times I wasn’t sure that I would be able to do it (or that I even wanted to anymore), but I made it through my first semester of nursing school! I also got my first B in about eight years—damn philosophy/ethics! It was a high B at that—like an 88.5—so close and yet not close enough. But I’m actually okay with it. My primary focus was on nursing and I did extremely well. Finals were not as bad as I expected them to be; neither was the dreaded HESI. For anyone planning/needing to take it, what I found to be really helpful were the case studies and practice quizzes/tests on Evolve. I also liked that they gave you the rationales for the correct and incorrect answers—it really helps you learn to critically think through the scenarios. I’m not saying the HESI was a breeze because it wasn’t, but it was manageable. Some of my classmates may not agree with me seeing as though the class average on the exam was a 613. But I got a 1033—not too shabby. So I’m feeling pretty good—and it was comforting to know that all of the stress, the meltdowns, and the hair loss were actually turning out to be worth it.
But now when I get home from work I find myself totally stupefied. No chapters to read, no care plans or concept maps to develop, no exams to study for—what in the world am I supposed to do with myself for an entire month? And has cable always been this crappy?—there isn’t anything good to watch that I haven’t seen enough times to be able to recite the script on my own. I will get to spend more quality time with my family though. It gets so hectic during the semester that sometimes I feel like I’m just a family member visiting from out of town. Even my son has said a couple times—“it seems like I haven’t seen you for three days!” Between getting up at the butt crack of dawn to go to work, not getting home from class until after they’re asleep, and then tiptoeing out to clinical like a thief in the night on the weekends—sadly, sometimes that’s almost true. In order to pull this off everyone is making a few sacrifices—not just me.
During the break I’ll also have a little time to work on a few scholarship applications (times is hard, lol)—I know for one the deadline for the FNSNA scholarship is coming up in mid-January. Join me for a little friendly competition?
But before I know it I’ll be bored out of my mind and ready to go back to school (and back to bedlam). Spring semester I’ll be taking Health Assessment and Maternity—maybe I’ll get to catch a baby or something 🙂
Happy Holidays and New Year to all—I’ll see you in 2010!
Posted in Family, Nursing school | Tagged: care plan, clinical, clinicals, education, Elsevier, Evolve, Family, FNSNA, health assessment, HESI, kids, maternity, NSNA, nurse, Nursing, Nursing school, nursing student, scholarship | 4 Comments »