Sunday, August 30, 2009

Pas de deux

With finals, ATI, vacation and other things looming over me, I never really posted the secondary part to my last entry regarding a professor's hurtful (and in my opinion, quite ignorant) words.

Nursing school offers a banquet of stress to feast upon in as many helpings as you can handle. It's a day-to-day of self-esteem bashing at the hands of instructors, preceptors, doctors and whoever else just happens to fall a little higher on the hierarchy than yourself. You either learn quickly that most of it is minutiae that shouldn't even register on your radar or, you spend a lot of time crying in bathroom stalls, your car, hell, maybe even in front of the offender in the wide, jarring space of public. There is a middle ground and I like to think that those are the people that end up as excellent nurses. Come in too hardened and you're already jaded in a profession that, far as I can tell, chews up even the best and brightest at some point. Start too soft and even the easy punches will leave dents that leave minimal chance of recovery. The days can be long, tiring, frustrating with only occasional small victories. Those small bites of why you've chosen nursing have to sustain the overeager appetite each student has. We all long to help people, but like anything else, it's the little dance of balance to get it right. There are some things that simply can't be taught.

I think Not Nurse Ratched said it best here about developing a thick skin as a nurse and the worry that writing about the absolute sucktastic days of nursing school & beyond possibly dissauding someone from choosing nursing as a career. I'm glad that I read nursing blogs voraciously before starting school; there were some things I was prepared for and others that I never could have expected. In my regular life, I'm a confident, assertive person. I have healthcare experience so it wasn't a total foreign land I was entering. And for the most part, I've done well in my classes and clinical with positive feedback. Even with all that, I almost folded in half in the aftermath of my last entry.

Thankfully, two days later, I received a clinical evaluation from an instructor that cemented my feet clearly back into nursing ground and gave me some reassurance that I wasn't a total failure who'd been falsely building up my own hopes. It was so good that I took a picture of the best comment and looked at it before my last exam. Because it was one of my little victories.

In my school, when given any oral (informal) or written (formal) dressing down, we are given an opportunity to write a rebuttal that is part of our nursing file. Since I felt this particular incident of ridicule was completely baseless and uncalled for when addressed to a mass audience, I opted to write the rebuttal along with several other students. I mainly wrote how I felt that the dismal grades of one test does not measure my worth as a future nurse; rather that my compassion, competent care and technical skill in the clinical setting reflect my ability. Of course, didactic material is important, but, again, it goes to the balance above, because I am that one in the middle, trying to find my way and make sense of it all. I haven't heard any comments so far over my break and hope it quietly dies down. My rebuttal wasn't an attempt to fan the flames, but to give myself the voice that is stifled a good majority of the time just by the virtue of being a student nurse.

How very Breakfast Club of me.

Posted via web from somnambulant's posterous

Tuesday, August 18, 2009


Do what you feel in your heart to be right - for you'll be criticized anyway. You'll be damned if you do, damned if you don't. - Eleanor Roosevelt


Ordinarily, I stray from bleeding my heart and feelings out in public. I'm ultra-careful because if my identity were uncovered, it would likely bring about unpleasant ramifications at school. Plus, I consider myself a bit of a stoic and really don't enjoy my more vulnerable moments on display. If I'm honest, that holds me back quite a bit in blog writing. In my world, there is a fine line between a brave show of human emotion vs. oversharing.

But I digress.

The above quote ran through my head all through today. I'm an Eleanor Roosevelt fan; I'd totally be her BFF any day. Again with the digression. Though I can't go into specifics, today was wicked from the start. And as a nursing student really starting to feel my transition into a nurse, I handle it because nursing school has been good for my inner control freak. Before the end of my day spent embracing the semper gumby motto, myself and a few classmates were told a great deal of hurtful, damaging things by one of our more respected professors. It was one of those moments where the words are said, they hang in the air for a moment and settle with a thud. The bell has been rung and it can never be taken back.

I will always ask for constructive criticism because I want to learn the correct way of doing things while a student, while it's proper to ask questions. But, if there is every any question of my professionalism, integrity or compassion as a nurse-to-be, we definitely have a problem. I believe that people often say things in haste, under pressure and when emotions are running high. We've all been there and it's human, There is a point where I can brush it off, because somewhere at some point, someone has been gracious enough to offer me the same courtesy.

Even so, I have been dreading school each day for a solid month and it just became exponentially worse.

Posted via web from somnambulant's posterous

Tuesday, July 28, 2009


It's a blurry picture, but it's moments like this that make it worth getting up so early to get to clinicals. I love my city.

Sent from zee iPhone

Posted via email from somnambulant's posterous

Ah, life.

I've been spending the last few months trying to wrap my head around the speed at which my nursing program moves as well as trying to properly write how I feel. This has had me peering into this little white box often. Sometimes I'm overwhelmed, others I'm exhausted. Sometimes I just have no clue what to say. It's daunting to be an ex-wannabe writer struggling to find the proper words.

Then, like an amazing little beacon on the horizon, came all these microblogging/social media/whatever sites where I can post a picture or a few words more frequently and not feel like I''m dragging my feet.

Having my shiny new iPhone helps a lot too. I'm in love.

So, stayed tuned for more some point I will write something longer about some experiences I've had. Suffice to say, I'm still here and feeling more like a real nurse everyday.

Wednesday, February 11, 2009

Getting by

Dear Student Nurses of the World,

Settle around while Momma Somnambulant tells you a little story.

If you haven't heard the phrase already, one day, someone will tell you that nurses "eat their young". And then you'll think about it for a minute or awhile and decide either: 1) Bring it on, betch or 2) Oh, dear [deity of your choice], please please PLEASE let that never happen to me. But somehow, you will prepare yourself (you think) and almost absolutely at some point, it will happen.

Now that you know, allow me to paint a picture: you've been working with some really receptive and amazing nurses And then, one day, it happens. Some burned out, condescending mega-snatch who realized somewhere along the way that she hates her work and maybe even her life is informed she's having a student for the day and only sees an indentured servant/dumping ground for all her angst. You're treated badly and not in the "wahhhhh I'm going to stomp my feet because my nurse didn't give me warm fuzzies" kind of way. More like the nurse making fun of you in front of patients kind of way. Or giving you her grunt work and chuckling with the staff about it at the nurses' station kind of way.

And, if you're like a certain smart-mouthed student nurse who blogs, you'll momentarily go to a happy place where you lay into this douchecake with hurricane-force f-bombs and excellently timed insults. Then she cries. It's awesome and beautiful. Eventually, you have to come back to reality and go to the next ri-damn-diculous thing you're asked to do.

But, sadly, such is the way of nursing school (unless someone gets really out of line, of course). So, you get through the day (or days, in this storyteller's case), talk shit with your classmates over a drink or four, and hopefully come home to someone who loves you (and who has had the foresight to get ice cream after reading your enraged and expletive-filled texts).

Most importantly, you tuck it into the back of your head for some horrible and hectic shift years from now when you're handed a student nurse. You remember being there and try to be the nurse you wish you'd had on a day that it would have meant so much.

There's your lesson for the day. Use it as you will.


P.S. One side effect of this whole ordeal is a greater appreciation for my friends who are nurses, both in my daily life and who blog as well as those nurses at clinicals who have patiently sacrificed a lot of their time to let me learn and try new things.

Monday, February 2, 2009

Ah, and so it goes

I'm sucking at updating due to some medical junk (I'm fine, thanks) and school (I'm fine, thanks).

But, I can tell you 2 things:

  1. I am now of firm belief that when student nurses study fluids, electrolytes and acid-base balance, we should not be held liable for any fits of lunacy unleashed on each other, our families, friends or the community at large. I have one hell of an exam coming my way tomorrow and I've got to be honest: I've had a lack of sleep, a lot of coffee, about 100 pages of reading on this material and I'm feeling kind of dangerous, ya'll.
  2. I drew the lucky stick today and had a chronic paineur (abdominal pain) as my patient. 34yo w/some ridiculous meds and a nasty smoking habit that had him wandering the (nonsmoking) campus. His already too-lenient pain management doctor was debating giving him the boot for leaving AMA. He thought calling me sweetie would win the "gimme some meds" game. I just couldn't keep myself away from his room from all that charm just oozing down the hall, calling my name.
I have some catching up to do - don't worry, kittens. It's coming soon.

Thursday, December 4, 2008

death/dying and the nursing student

Finally, a new post!!

I've had a lot of good things to write about, but I seem to be more prolific when I've got an axe to grind, sorrow to nurse or just general blahs hanging over my head.

I've got an axe to grind.

Every class has a know-it-all don't they? The perennial teacher's pet who will polish every apple, dislocate her shoulder raising her hand repeatedly and elucidates neckbreaking eyerolls when she threatens another anecdote. My cohort's know-it-all is about ten of these biznatches rolled into one grating package. Ordinarily, I ignore her save for my sarcastic comments under breath (because, hey, my powers of restraint are only so much). We actually used to be friends, but above know-it-allness (this is tiring; now known as KIA) combined with a deep need to cut others off at the knees with horrible rumormongering just left a bad taste in my mouth, so I separated from her with a clean break shortly before the term started. As exasperating as she is, there's really not much I can do about her. I try to ignore her when she speaks to me, but am civil when necessary. I don't like her in the least, but we can get along for the next year, right?

Not so much.

The scene: clinicals last week. I have a resident with Alzheimer's that I have worked extensively with. I really enjoy her and am currently working on a careplan about her. She's been under hospice care for close to 2 years now and from all appearances will most likely die soon. I've gotten attached to her, but used to work with hospice patients, and have learned how to deal with death in a way that I actually consider healthy while at the same time preserving my own self. Not to mention that as nurses, quality of life is important, no? How much quality of life can a person with Alzheimer's so severe have that they cannot communicate basic things like being in pain, hungry or just wanting to watch TV? If I think too hard about it, yes, it will make me horribly saddened. But, as people like me like to so enigmatically say, it is what it is.

Here is where Kia comes in. At our postconference in clinicals, she had the sweetness and light in her to say that I was cold and unfeeling toward my patient.

Let's pause, for a minute and think about that. I've spent a lot of hours with this patient, do any small interventions that I can. And to have someone tell me that I'm cold because I don't dissolve over the possibility that my patient's death is imminent? Oh hell nah.

We all handle this grief and heavy burden differently. Even though my stating that I dislike her is lightyears away from my actual disdain, I didn't crack a sarcastic joke as per my usual way when her patient that she'd only spent 1 hour with died suddenly between clinical days. I know she doesn't have much medical experience and it would hit her hard.

What is the point of this, you ask? I don't know. A little kvetching maybe. Or, to kind of set the record straight on death and how we each accept it in a different manner. There is no wrong way and it doesn't make someone cold and uncaring to understand the nature of life in a way different than your own.

We can have petty differences that we commonly snark one another about - this doesn't have to be a part of that.

Wednesday, November 5, 2008

Yes I can.

I should be working on an outline for Pharmacology to study in downtime at clinicals tomorrow, but I can't seem to get started. All I want to do is take a bath (thank you, Lush addiction) and hang with the hubs for awhile.

Re: my last entry about how I had a feeling I wasn't going to like the SNF-life? Yeah, I don't. A lot of my classmates think that it's a downer, but that's not my problem. I guess in some ways it is, but I'm of the mind that my feelings aren't necessarily congruent to the patient's feelings/needs, so my downer could be much more positive in their eyes. I am catching on to that whole ideal that the patient's view of the situation supersedes my own. Novel, huh? I am actually assigned to a very nice facility that has its own beauty parlor, movie night and lounge to play Wii (loved the residents playing Wii bowling!). I think being in a place with elders of differing states of ability, memory capacity and other things reminds even the whippersnappiest among us that one day, we could be in the same position. And no one wants to think about that.

My problem is that I'm bored. I know, I know. While I realize that this is prime time for understanding and applying some of the art of nursing aspects we've discussed in class, my science of nursing side can't help but want something clinically interesting to come along. I'm going to spend my time this rotation working on it.

Tomorrow, ahoy.

Wednesday, October 29, 2008

How to complete care plans and influence people

Books, books, books!
Originally uploaded by somnambulantsn
It's a tearful little milestone at Chez Somnambulant today.

I handed in my first extended care plan this morning!! At my school, we do something called comprehensive care plans that include extensive med logs, assessment data and some other stuff. I don't know if any other students out there have these. I think the final product was ~ 20 pages or so. From what I hear from the other university and CC in my area (we sorta chat at clinical sites), their plans are much more abbreviated. I think some of my profs feel like we have extra to prove since some hospitals think less of the BSN SN's because they think we're all theory. Not true, at least in my program.

So, to make this awesomness happen, I ended up editing and consequentially redoing part of my care plan yesterday afternoon after school. Nevermind the gorgeous cool weather and clear sky; I will GET careplanning, damnit! I'd been about 90% done and just wanted to put some final touches on, but then I started picking at it and made the mistake of working from 1400-0100 with brief breaks to eat, pee and other essentials. By the time I was done, my eyes were blurred and I was on a very short fuse. Right before bed, I told my husband to shut up and I loved him, so nursing school is bringing out this really charming part of me. I was a little too hardcore for myself yesterday.

Tomorrow, I start clinicals at a new site. I'll be at an ALF until the end of the semester. The last six weeks I was in a community hospital and though it was rife with problems, it was still a hospital. I know I shouldn't be picky so early on, but I know what we'll see and I'm just not feeling jazzed about it at all. I know someone knows what I mean.

Good news: I made the highest grade in my class on my last test! Bad news: It was an 83! Still, I know I'm doing well. I think my overall average is somewhere around 87 and considering that about 1/2 my cohort just received midterm warnings to shape up or ship out, I do find some solace in this.

Overall, I just need an attitude adjustment. I am cranky (crankier?), impatient with others and just painfully tired. My fuse is pretty short lately. This is my first day in two weeks not working on a care plan or studying for a test/quiz of some kind and since I have no lecture tomorrow, I'm going to 1. take a sweet nap and 2. read some of the third book in the Twilight series. Ahhhh. That makes it a little better.

Sunday, October 26, 2008

I come here often to at least make an attempt at blogging. Twice I've fallen asleep and more than a few times I've started for a minute and lost the mojo. Working on that.

For all of my unusual (for my cynical self) hopefulness in the last entry, I'm much more worn now. And it's okay; I'm expecting this as the ebb-and-flow of things. Things are really starting to click and that's what matters. And hey, we've finally gotten some fall weather here in the warm & humid state. That alone perks my mood a bit.

It's been a hard couple of weeks though. My first care plan deadline looms a few days away. I have a quiz tomorrow on lab values, a Fundamentals theory test on Tuesday , care plan Wednesday, clinicals Thursday and a Pharm test Friday. So, I knew this was coming, but I was still ill-prepared. It's also been a tough week emotionally. One of my classmates' parents died suddenly, so most of my class skipped a clinical day to be at the funeral and give her some support. She's just had a rough time for the past year or so and needed to know she has an extended family.

I worked out the study issues from the last entry and thankfully enough, amicably parted from one person in my group, sat another down and gave her a reality check and added a couple of low-maintenance people. I really don't mind helping people as long as they want help and don't elicit the do-it-for-me vibe of desperation. I realize that people have to do what it takes to get by in school, but have a little bit of class and integrity. As I was writing this, I started receiving a litany of texts. Phone is now off as I'm doing my own work and getting some downtime at some point. I want to help, but I also want to set boundaries on the smattering of private time I occasionally get.

Clinicals have been going well. Classes for the most part are going well, except for the shareaholics that just won't shut up. I know that people get excited when they hear something familiar, but it's gotten out of hand. No. More. Stories. And and and, just for extra giggles, stop giving your rationale on every test question you get wrong. It takes up so much class time and you've still gotten it wrong.

I'm getting drowsy as I type. Maybe a short nap before getting back to the care plan.

Tuesday, September 30, 2008

Livin' the somnambulant life

I've been trying more valiantly than you might think to get myself here and update to no avail. Until today!

School is awesome. And scary. And exhausting, boring, amazing, strange and at times, disgusting as hell. In the last 5 weeks, I've surprised myself with how strong I am and thank my mom every morning for ingraining in me so hard the ability to face the hardest of situations with humor. I also love the camaraderie we've been building up. It helps to start reaching that comfort zone with people you see all the effing time.

I had a rough start, due in part to my stubborn insistence that I could help myself study as well as drain my own small pool of stores trying to help everyone around me that was helplessly drowning instead of treading water as I was. Last week, I had to have a self-intervention and let my friends know that while I would do everything I could to help them, we all had to figure out a different methodology. I was the only one prepping outlines, doing flash cards, the whole nine. Essentially, I was killing myself and not having any time to study on my own. I'm all for the group dynamic, but it wasn't working. So, I ease up a bit and bam! 95% on both my Pharmacology and Fundamentals tests! I feel like I've finally hit my stride now.

I started clinicals about two weeks ago. It's in a medium-sized hospital known in my city for not exactly being...the best in a lot of areas. Still, it's exciting to actually apply things we're talking about in class. I'm always especially exhausted after clinicals (our day lasts 9-10 hours), but am so awed by all that I've already seen. Last week, we talked about bruits/thrills in class; a couple of days later, my friend was assigned a patient with an A-V graft. The poor man had everyone from my class shuffling into his room, but he said he liked the attention. I tied my first restraints, did a very elementary assessment and have learned a lot about classroom training to real world doing. It's really neat. And luckily, I've worked with very patient and helpful nurses. One had graduated about a year ago and was giving me some excellent advice.

So, it's really worth the lack of time and the realization that I've no clue what day it is or the near-constant fatigue. Or that I'm verging on irritation or tears at least a couple times a day. I'm such a nerd right now. So, give me some caffeine and I'll go. : )

Wednesday, September 10, 2008


I am excited. I am scared. I am, however, not taking drugs. But really, was she taking caffeine pills or actual speed? Because if it's caffeine, I miiiiiiiiiight have a problem.

Actually, at this particular moment, I'm physically tired, mentally alert and superficially sleepy, if that makes any sense at all. I made the mistake of letting myself take a nap this afternoon and woke up later in a panic that I have 2 chapters of Pharmacology and 5 chapters of Fundamentals to cover for tests Friday and Monday. Add to that a dash of BLS today, Skills Lab tomorrow (vitals, fun!) and orientation at my clinical site on Friday (along with that Pharm test I just mentioned), and well, I'm kind of overwhelmed. Not as overwhelmed as a lot of my classmates, but yeah, that doesn't help.

We also just got our first tests back. No one was expecting the questions to be so NCLEX-esque (why, I've no clue -- we'd been properly forwarned). I did not make a grade befitting my usual performance, but I also did better than about 2/3 of the class (we're talking tears in some cases), so I'm not complaining. I think now I get the idea of how we need to think for tests, not to mention that our professor said this was our "wake-up call". So, wake-up. I looked at my test, saw that I effed myself up on 90% of what I missed by judgment error. Yay for critical thinking!

I've just been texting/talking with someone from my study group about the possibility of finding places to study late/early (I'm talking after midnight and open by 4:00 for early). I don't want to make a habit of it, but I know there will be nights like this that we need to. In Pharmacology, we're working on routes, prep, admin, sites and etc. In Fundamentals, it's care plans, care plans, care plans. The way we've divided the work is that every person is responsible for reading all material alone, then each person takes a chapter to dissect and create scenario-based questions from. The study materials are individual choice. I'm partial to typed outlines and flash cards. It's worked for me so far. My chapter happens to be planning. Trying to pare down the material is tricky for me, but I'm managing. When I get overwhelmed, I walk away (which is why I'm blogging right now).

And, just for the sake of my own sanity, there are things other than nursing school that I love and remind myself of for about 0.5 seconds of the day:

- My husband is the best, most supportive, wonderful person ever. BFFF.
- If I didn't have an iPod right now, I would probably go insane. Really.
- It's September and that means Pumpkin Spice at Starbucks for Fall. (!!!!)

Okay. Me + fork = done.