To be honest, I have enjoyed something about each of these experiences. I liked the environment of the OR and the idea of being a part of such a significant event such as surgery. Granted I was part of an aortic valve replacement so my experience was rather profound,  I think it would be rewarding to participate in surgeries like that day after day. In the PACU I like how it was fast paced and very focused on airway and getting the patients awake and out the door. In the cath lab I was really amazed by the technology, but the negatives of that experiences stuck out to me most at the conclusion of that experience. I liked the patient interaction in the short procedure unit. It was also fast paced and was fun to meet a lot of different patients and hear a lot of different patient scenarios. That unit seemed more "low-stress" and seemed like somewhere I might want to work when I have a family. 

Following the wound care nurse was probably my favorite experience. It was very dynamic in that we learned about everything from ostomy care to stage four pressure ulcers. I think the experience also had an impact on me because it was clear that this nurse knew what she was doing. One of the patients we saw was in particularly bad shape.  We checked through his records with her to see where he had come from, to establish at what point he had developed all of these different wounds and then tried to figure out why the progression of his wounds was so rapid. I was impressed by how tactful and thorough she was as well as by her bed side manner which was very impressive.

It's through these opportunities that you not only learn what you want to be but also who you want to be like and I think they are equally important.

Nurses have the special ability to form a connection and establish a trusting relationship with a patient regardless of either the patient's or the nurse's personal background. Though it is probably obvious to most people that if I am a student at Villanova, regardless of loans/scholarships, I am not on welfare, but this does not matter to patients.  From what I have witnessed, these patients instill trust if you take the time with them, talk to them, listen to them-nothing else matters. It doesn't matter to the patient that I am Caucasian, it doesn't matter that I am a female, it doesn't matter that I am a Villanova student. All that matters is that I am doing my absolute best to care for this patient carefully, intelligently and promptly.

Nursing truly bridges the gap between communities, socioeconomics, race...the American people as a whole. This alone makes nursing a truly special profession that I am blessed to be a part of.

My experiences shadowing in urgent care this summer have been so valuable. I underestimated how much I would learn by shawdowing and not actually "doing" as much as I would be if I were in clinical.

Recently I encountered and therefore learned how to handle a situation in which I knew the patient that had come in. In my case it was a high school teacher of mine and this teacher's complaint was a sex-specific issue so it was certainly not something that this teacher would have mentioned in class when I was a student such as a broken arm or laceration. 

At first I was apprehensive and did not know if I should go in with the doctor as he had asked that I do, so I let him know that I thought I knew the patient.  The doctor's response was that it was up to me whether I felt comfortable or not, which left me feeling a bit unsettled.  This feeling dissipated as soon as I saw the patient come into the unit, in a wheelchair, in complete agony I realized that the fact that I knew this patient was irrelevant. It was not about me, at all. This patient was in pain and if I could learn something from the patient's condition and ultimately the manner by which the doctor and nurse helped to ease the patient's pain, that was what mattered.

This was a profound experience for me both in witnessing someone I knew in such pain and learning how to handle that feeling while in a professional setting.

Ophthalmology had seemed, well, boring as far as I knew about it but I discovered how often patients come in with an issue that turns out to be caused by a serious underlying condition such as high blood pressure or MS.  I could go on and explain some of the intricate details I have learned about the anatomy of the eye as well as the different imaging methods I have observed but overall the most important thing I learned or rather came to realize was how connected every aspect of the human body truly is. This in turn has only exacerbated, in my eyes, the importance of critical thinking and the ability to put the puzzle pieces together because everything is connected. 

I have so much more textbook information to learn before I will be able to apply my critical thinking skills and look at patients more abstractly.  This experience has also taught me to always be open minded about new avenues within my upcoming career.

Bad luck in California has struck me again. I thought I would be able to get a job as a student nurse but none of the hospitals in San Diego had spots for me again since I do not go to a San Diego school.

On Sharp hospital's employment listing they literally have two open spots for RN's, a list that is typically a page long, so I am not entirely surprised that they wouldn't have a menial student nurse position available.

I am lucky that this summer was not an essential or even necessary time to gain employment in a hospital as I have only had 28 hours of clinical and am a rising junior. I feel really bad for some of the graduating seniors who for their entire four years in the program had seen their upperclassmen nurses all easily finding not only employment, but high paying employment. Instead, the class of 2009 was faced with difficulty even in what people view as the profession with the greatest "shortage."

It appears the long talked about "shortage" has dissipated (though I'm sure this varies by location in the country). I hope and pray that the current economic situation will change over the next two years and that I will gain an externship next summer that will propel me into a job the following year.

For now, it's the usual-babysitting and fulfilling odd jobs for family friends. I will try my best to enjoy my last real summer before almost real life and then real life smacks me in the face.

1. You discuss a sore in your mouth with your fellow nursing student friends and they proceed to get up, surround you, and inspect the inner workings of your mouth
2. It's Thursday night and although you don't have classes on Friday you are stuck staying in studying for your anatomy and physiology test the following Tuesday
3. You can tell time using a real ticking watch AND you can decipher military time (one would be surprised at how many young people have trouble telling time with out their cell phones)
4. You go to bed at 9:30 PM on Sunday and Tuesday nights because you have to wake up for clinical at 5:15 AM...a time that many of your peers were out until the previous night
5. You discuss your patient's elimination patterns over dinner in the dining hall
6. You have the privilege of wearing the Villanova blue and white pinstriped nursing uniform with the pants that hike to your belly button causing an artificial poof in your lower abdominal region
7. You can no longer walk by without offering help to a person in the bathroom who is intoxicated and vomiting, regardless of whether you know the person
8. You use hand sanitizer like it's your job
9. You see a man walking with an abnormal gait and automatically begin thinking of probable causes in your head
10. You advise your giant offensive lineman friend from the football team to thoroughly clean his turf burn so that he doesn't contract staph

Well I have officially completed 28 hours of clinical—a smallglimpse into my life as a nurse. After my experience on this particular floor(rehab) I’m rather certain that is not the floor I would choose to be on. (Isay “choose to be on” because if the economy does not shape up I might not havethe luxury of choosing exactly the floor that suits me, but hopefully I will!) I can't quite pin point why I did not care for the floor, it just didn't quite click with me.

Despite my few dislikes of my experience on this rehabfloor, I am very grateful for the experience and certainly learned a lot fromit. Working on this floor, I could see how as the nurse, you would definitely establish relationships with many of the patients since their stays were typically more than a week and some more than a month, which is definitely something I liked. I learned, as I mentioned in my previous blog, the importance of findingthe joy in what you do as well as the fact that patients have immenseconfidence in student nurses. Perhaps they were pretending but it always seemedas though their trust in my peers and I was unwavering. This surprise was oneof the experiences I most enjoyed throughout my first clinical experience. Evenwhen I did not have confidence in myself, the patient seemed to have confidencenonetheless. I think maybe the patients have this confidence because they knowthey need the care, regardless of who it’s from. They were so appreciative ofus especially when we cleaned them or helped them to clean themselves. 

This experience was very valuable and hopefully built thefoundation for my skills as a nurse. It also helped to build my confidence and hasprepared me for the next round of rotations in med/surg. 

To have a bad day and be in a bad mood for one day is acceptable to me. It happens to the best of us regardless of profession, role in life and age. But to both act and appear unhappy for multiple days, especially as a nurse--one who is supposed to take care of others--is unacceptable to me.

I have seen this manifest not only in interaction with the nursing students (which I could maybe understand since we are fresh and need extra assistance), but also with fellow nursing colleagues and even patients. From what I saw of the interaction with the patient, it was not so much rudeness or attitude, but the manner by which this particular nurse cared for the patient. The nurse was not gentle in cleaning the patient or moving the patient and was not very responsive to the patient's desires. 

 From the knowledge I have gained from both my own mother and professors, I understand that you get busy and have moments of impatience, etc. but I simply can not accept that it's okay for a nurse to be rude to colleagues, future nurses and lack patience with patients. If you are that unhappy perhaps you need to reconsider what you are doing. Everyone has stress in his or her life, no one's life is perfect and as a nurse I think it is so important to be able to step back and realize that in order to give patients the proper care and in order to help them heal you yourself have to be in somewhat of a good place. 

 I'm sure this will probably prompt the thought in many that this is all easy for me to say because I am not working full time yet and am still a college student, but I figure maybe by realizing this early on, I can avoid this sort of sentiment. 

After having my first clinical rotation rather thenproviding a play by play of how AWESOME it was and telling you how my nervesare at rest, I’m going to instead elaborate on something I learned.

I learned the importance of listening to the patient. When Isay listening I do not mean simply responding to what the patient says whileperforming various tasks, but actually internalizing the words that leave thepatient’s mouth.  

While I was helping my patient with a bed bath my patientexpressed concern over an itch/rash that had developed in the patient’s perinealarea. Now, I could have simply brushed this off as a normal itch in a sensitivearea, but the fact that the patient was at high risk for pressure ulcers andinfection, I thought it to be important to let the nurse know. I have heardthat nurses are not always able to take the time to help the patient with hisor her hygiene so this was probably a unique opportunity for the patient toexpress concern over something that he would have otherwise forgotten to tellsomeone about.

Not only did I learn the importance of listening forpotential risks for the patient, but also just plain listening to what mypatient had to say. I learned a LOT about mypatient’s life which was, for lack of a better word, really cool! I trulyenjoyed listening and learning and hope that my patient enjoyed having someonelisten as well.

Today was our final lab session (excluding skills-testing next week) before our first clinical rotation! I have been assigned to a rehab floor at a hospital about thirty minutes away. For our first day we have to meet at 6 AM in the main lobby of thehospital. Luckily, the near-dawn hour wasn’t a huge surprise as I had already heard that, that would most likely be the case. Sunday nights will certainly be “Mom nights” as I like to call them—in bed by 9.

I have to be honest, I am sincerely nervous. I know it will take time in order for me to feel comfortable but I have this fear of walking into the patient’s room and being at a complete loss as to what I should do. Ifeel like the patient is going to look at me and think in his or her mind, “what is this child doing here and how can she possibly know how to help me?” 

In order to avoid this overwhelming feeling I figure I need to maintain a bit of confidence. Confidence in knowing that I have learned many of the basic skillsI will be implementing with these patients and confidence in knowing that if I need help my professor willbe present. However, there in lies my next predicament. I feel that if I were apatient with a student nurse taking care of me and she had to go ask her professor a question, wouldn’t I feel a little worried about the quality of care I would be receiving from her? I know the obvious answer is probably something along the lines of, “well she is seeking help from someone who definitely knows what to do”, but I still keep thinking the patient is not goingto be confident in me at all.

Aside from the various fears, I truly am excited. I am excited to finally be working with patients which is what I have been lookingforward to ever since I decided I wanted to be a nurse. Even if my patient turns out to be cranky and difficult, hopefully I will be the type of nurse that can dig beyond that and maybe make that person smile just once in my four days spent on the floor.

We completed the baths behind closed curtains with our partners so it was private and it was essentially honor code that as a student nurse you would indeed put yourself in the vulnerable position that a patient would be in. (Our professor used those exact words when describing why we needed to ditch the bras.)

When all was said and done it turned out to be a really good and naturally a fun experience. There were various joking remarks about whether or not we would also be performing peri care, which OBVIOUSLY we were not. Though it can be perceived as distasteful, the humor was all in good fun and as with the breast exams, our professors had fun with us while maintaining a mature learning environment.

As far as I'm concerned I think it's important to be relaxed when giving someone a bed bath. Most likely the patient is going to be slightly uncomfortable with the situation as is so at least in conversing with the patient, you as the nurse can lighten the mood while maintaining a professional, appropriate demeanor.

I want to be prepared for this as it is prevalent in more places than simply San Diego or California in general. My current thoughts of my future lend me to the possibility of working in New York City where I know Spanish would also come in handy rather frequently.

So far in this course we are learning (or re-learning) simple greetings and body parts, but will soon be delving into potential dialogue between a nurse and a patient. Even though I am taking this as an elective, I have a feeling this class is going to be more beneficial then I could have imagined.

This semester is, for lack of a better phrase, going to be "the real deal." We begin clinicals at the end of March therefore my nursing lab is going to be much more hands on in preparation for clinicals.

Already we have practiced using restraints (though we were informed they are not widely used anymore) and within the next few weeks we will be practicing giving injections and administering oxygen.

With clinicals approaching I feel the need to really focus on my nursing course and lab. Not that I did not pay ample attention to it in the past, but more difficult and time consuming classes such as anatomy and physiology often took precedent. Not this semester. Soon enough I will be working with real patients and therefore I feel the need to keep up with ALL of my reading for nursing and to pay close attention to everything going on in lab and lecture.

Time to watch a nursing module on administering medications!

Nonetheless finals are my focus. The most difficult aspect of studying is dividing my time up efficiently so that I devote enough time to each subject. Right now my main focus is A&P because it is my first final, but I figure by Friday I should know the material well enough to begin studying for cell bio. Sunday I plan to begin studying for and prepare my page of notes for Criminal Justice. Monday more of the same and Wednesday I plan to relax a bit in addition to the minimal studying necessary for my open book/open note stat final on Thursday. Yippee!

Luckily, through the grueling studying required this year I have discovered that I learn material, such as A&P and cell bio, best by going through the power points with some of my best friends (that also happen to be my classmates)  reading them aloud, explaining and asking questions. It helps SO much. The three of us have come to really understand how we each learn, therefore we are the best possible teachers for one another. And, of course, we end up having a lot of fun while studying.

Well enough with the procrastination, I should probably sleep or study or... deep breath!

My professor set up the room so that we were all facing one another and left the discussion open ended by beginning with the quote "once you learn how to die, you learn how to live" from Tuesday's with Morrie. From there my peers began sharing their own various experiences with death. As the discussion progressed, more and more people felt moved to share and as more people did, the tissue box began a whirlwind tour. What I discovered about my fellow classmates in this class session was truly a revelation. More than one of my classmates had lost a parent, and one had lost both parents. Other classmates had lost best friends, aunts, cousins and siblings. The fact that these classmates of mine felt comfortable enough to share this with our group of thirty or so young women was profound and solidified for me why we had a unit on this in the first place. If we can feel comfortable sharing with each other-our peers and soon our colleagues-such emotional experiences and be able to discuss and decipher exactly that which hurt so badly or was so frustrating, then I truly think we will be able to more effectively handle death in our profession.

As human beings we are inevitably going to encounter death, but as nurses we have a responsibility to be able to cope with the entire process of death as effectively and professionally as possible. This is certainly not going to be easy, but I think that if we can speak to each other about it, grieve together and ultimately accept death we will be better at helping our patients or the family and friends of a patient, when we encounter it. My fears of encountering death in my profession are by no means quelled, but this discussion helped me to see that emotion is inevitable and that with time I will (hopefully) be able to handle my emotions appropriately in the work setting.

Though I definitely gained from this what I gather I was supposed to from a professional standpoint, I also walked away from it thinking how thankful I am for what I have. I am so thankful that I have two healthy parents and a healthy sister. I am thankful for their love. I am so thankful that they have allowed me to be here at Villanova and have encouraged and supported me in my desire to be a nurse. I am so thankful that I can go to bed at night and not worry about my safety or if I'm going to survive another day. I am so thankful for the troops abroad. I am so thankful for all of my friends. And I am so thankful to live in a country driven by freedom. Happy Thanksgiving!