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Nursing Boards

Brian has been laying hardwood in the bedrooms. He has finished Kayla’s and Allyson’s room and is currently working on ours. This requires everything to be moved out and going through everything. I refuse to discuss how much stuff I have either given or thrown away. I still have more than enough junk and I can’t help but wonder where it comes from.

Yesterday I was cleaning out my night stand when I found this gem.

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It has been in the same place well protected for THIRTY years now. I still remember this like it was yesterday. Back in the day, NCLEX was a class you could take to help you study for boards. I am thinking it was a couple of hundred bucks to which Gena and I said nope not taking it. It was optional and the acutal test was just called  boards. Now the test is called NCLEX which is very confusing for me.

Back in 1988 it was a two-day test given in Springfield Missouri, The test was in four parts, two each morning and two in the afternoon. Gena, Katie and I all drove down together. I borrowed my moms car because it had air conditioning and my personalized plates had already arrived RACH-RN. I figured it would be bad karma to drive mine to the test as if I had already passed. We shared a hotel room as well. I can’t remember which night we went to the mall and had this done but we each received a copy.

The test was awful. For starters people walked around the entire time staring at you making sure you didn’t cheat. If you had to use the restroom, you had to raise your hand and be escorted to the bathroom like a three-year old. I remember the room was filled with long cafeteria like tables. It seems like we had two hours for each portion. This led to once everyone was finished, we would all start comparing answers and be convinced we had all failed. I had smoked during nursing school but quit when I graduated. Over those two days I easily smoked over a pack of cigs by myself. I remember throwing what I had left out the window on the way home.

I think it was a good six weeks before our results arrived in the mail. I was so thankful to see a small envelope because that meant I had passed. I swore if I failed, I was working at Hardees for the rest of my life because I wasn’t going through that again in December. Boards were only offered twice a year back then. Gena and Katie also passed as well, although by the time we had arrived home we just knew we had failed. Katie and I worked together at Deaconess until I left for St. Johns burn unit. I must really be getting old because all of these memories just keep flooding back and I am starting to feel like an old person with all my “back in my day” stories!

 

Mole Moral ~ You never know what I am going to find in my house when I actually go through stuff. This was a true gem and put back where it has always been kept!

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Own it, don’t dismiss it.

A few weeks back my music switched to cycling through everything on iTunes, instead of just my play list. I usually tolerate this until one of the kids nasty worded rap songs comes on and I switch it back to my Christian music. After I saw Rob Bell two years ago I downloaded some of his first pod casts and it so happened number seven popped on. I had heard it before but I had a feeling I should listen again. I believe he called it the tapes in your head. The word tape kind of shows our age since I’m pretty sure they no longer exist.

He was talking about the way you talk about yourself in your head. So he launches into a scenario where he is playing kickball with you and you catch his ball but you trip and fall and run a spike through your chest. So he cuts the spike loose and halls you to ER. I had a hard time getting past playing kickball with Rob and not calling 911. Anyway you arrive to ER and they stat page a doctor to your room. Do you want your doctor to play this in her head? I’m not really sure about this. I graduated last in my class. There are so many doctors that are better than me. Or would you want her tape to say I’ve got this. I know exactly what needs to be done. I have the skills and the team to accomplish this. Another thing he spoke about is not owning compliments but rather dismissing them or downplaying them.
Three hours after I listened to this I walked into work and my boss was talking with another gal I had never met. The unknown called me high energy and my first thought was no I’m not. And then it was if my head shook and cleared my brain and I was like I think she’s right. So I’ve been thinking about how my life does indeed reflect high energy.
For starters my job reflects this. I am scheduled eleven am until seven-thirty pm to come in and take all the new admits. They include surgeries, direct admits (straight from home or doctors office) ER patients and moms who just had a baby that ends up in NICU. This shift originally started because for a few years the hospital did away with having people on call and we were not allowed to staff for patients who weren’t there at the start of the day. On big surgery days (10 or more) this could be a nightmare with every nurse being at max capacity and yet more surgeries needing to come. I worked three to eleven back then so a lot of times they would call me to work early. So anyway I now come in at whatever time they need me. This may be as early as eight thirty or as late as three. I sometimes have all five patients within three hours. The recovery room loves me because I almost always take report when they call and have taken back to back and say send at same time I’ll make it work. The only time this is a nightmare for me is when the patients were not given adequate pain medicine during surgery and are out of control upon arrival. This keeps me running for the first few hours. Our unit is huge and really spread out so on a crazy day I can easily hit ten thousand steps in eight hours. And to think my husband likes to harass me and say all nurses do is sit around and eat chips and dip.
My activity level screams high energy too. I walk almost three miles every day for my coffee and then around the back neighborhood. It’s also my time to play Pokémon. I’m still running and always training for something. Last years fifty mile runalone says either high energy or belongs in an insane asylum.
At the end of the same day I had a patient and her husband thank me for being the kindest nurse and person they ever met. My first reaction was to dismiss the entire compliment and then Rob popped into my head and the love dare. I remembered one of the three things Brian said he admired about me was my willingness to do whatever I could to help others. And I must admit they were right. They were of a different culture and I respected that and incorporated it into my plan of care. Plus they were Heartprint patients which will always have a special place in my heart.
So over the past three weeks I’ve been trying to own it, instead of dismissing it. I must say this is a lot harder than I thought it would be. My head tape likes to go immediately to the negative and the worst case scenario. I guess I have something to work on.
Mole Moral ~ If the tape is negative, eject it, and replace with a positive one, you deserve it!
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CPR can KMA

This May I will have been a nurse for thirty years. I can still remember taking CPR for my first job. That year they had these fancy mannequins that recorded rate and depth on a strip. You had to get so many right to pass. I managed to pass it just fine, but many others did not. They didn’t have to retake it or anything either. Two years later when it was time to recertify they had changed it and no longer required a passing strip. So it was much easier and way less stressful. Two years ago I took one of the last old style classes in which there were instructors and real live people who checked you off. This year it was online with learning modules and then you go into a room and perform on a mannequin that is hooked to a computer that will only pass you if you do it perfectly.

Please keep in mind that I am old school. When I went to nursing school, computers did not exist. I mean there were some a frame type computers but personal computers were not around and everything was typed on a typewriter. I went to class every day and listened to lectures and took notes. So this online stuff is not really my way of learning. I have had numerous people ask me why I don’t go back to school and become a nurse practitioner. One, I have no interest in leaving bedside nursing and two, I do not want to write papers and do group projects to earn a degree. So back to CPR. I did the online stuff without any issues. It only took about two hours to get through all the modules and the simulation stuff. I managed to forget to turn the AED on every single time before applying the pads. Yesterday I went to the lab for the manequin portion.

I did just fine on ventilating the adult and the baby. I also had no issues with the check off for the chest compressions on both. CPR on the baby was ridiculous. I had to push so hard I swore I was going to break both of my fingers. Then the adult came and no matter what I did, I could not pass the three cycles. In the middle of my attempts I posted on Facebook and someone asked if I was having trouble with the ventilation. My response was “I can blow like a porn star!”, it’s the chest compressions I cannot manage to do effectively. Someone else said you have to do it hard, fast, and deep. My first thought was do I look like a dude? Maybe my husband could give me some pointers! I finally asked for help and the gal came over and gave me pointers but by this time I was so exhausted I was told I had to come back the next day or day after depending on how sore I am. She also gave me the you need to work on upper body strength to which I replied I am a runner and that’s what I enjoyed. When she continued to annoy me about upper body strength until I threw out there that I just ran fifty miles. That pretty much shut her up. Yes lady I am in the best physical shape of my life, this computerized mannequin is stupid.

On the way home I started thinking about one of my many bus rides to Big Stuf camp. Jack Riley was on my bus for my very first camp and he was a freshman that year. Fast forward to the year he was an Obtern and an EMT. We were talking about CPR across the aisle from each other. I said to him “the person is dead so if you screw it up, it’s not like you killed the person.” He started cracking up and knew what I said was true. However the other kids sitting around us about lost it. But I speak the truth, if your heart isn’t beating, you are dead and your chances of CPR working is not the greatest. Now if you heart is in an arrhythmia and you have an AED available then your odds have greatly increased. So here I am all worked up over ineffective CPR on a plastic mannequin. I went up to the floor afterwards and burst into tears. My good friend Amy said what is really going on, there is no way you are crying over CPR. I was like seriously my life is cool for a change. It was only this morning I realized what the issue is. I had forgotten to take my crazy pills for over a week, so I took two right away.

I cannot even think about attempting it today. I forgot to take my Fitbit watch off and it put a nice red mark and bruise on the top of my wrist. My arms are killing me and the palms of my hands are bruised as well. Hopefully I can perform tomorrow or I won’t be working until I can pass. Once you expire, Mercy will not let you work. Now had I been taking my medication properly I would look at it like this “I can’t pass, cool I get a day off work.” But since I am unmedicated I look at like this “Oh look Rachel is such a loser and horrible nurse she can’t even pass CPR.” The second statement is beyond false but the voices in my head like to shout at me and without Zoloft they are louder than my God voice that tells me I am a treasured child and a really cool person. Work has just called me to come in so I will sign off.

 

Mole Moral ~ If you are CR, never attempt CPR unmedicated!

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Suburban Junky:From Honor Roll to Heroin Addict

A few a weeks after my five week headache, my niece Sierra told me she was reading this book about a kid from Chesterfield that becomes a heroin addict. She said it was really good and since she never reads, I decided to buy it on kindle. I read it in three days which was really fast considering I was still recovering from the headache and my concentration had not fully returned. Here is what amazon says the book is about because I do not want to give too much away:

Jude Hassan came from an upper-middle class household in suburban St. Louis. For most of his life, he was an all-around normal kid. He excelled in sports and academics, and cherished his time at home with his family. It wasn’t until he turned fifteen that things went seriously wrong. While attending his first high school party, he was introduced to pot and alcohol. Needless to say, he gave in to the pressure. A month after that, he discovered heroin. The drug had just made its way into the suburban party scene, and Jude was sure that he could get away with doing it only once. He was sadly mistaken. Within a few short months, his entire life was in shambles. His fate appeared certain, but it was just the beginning.

​In a series of events that leaves you grasping for the next page, Jude spares no amount of detail in his account of his near-decade long struggle with drug addiction, and the horrors he witnessed along the way.

The book is well written and I felt like I was in the middle of the story the entire time. Maybe partly because when my headache was at its worst I would have shot up heroin if that would have gotten rid of it, partly because I have always heard one try and you are addicted, and this kid lived in Chesterfield which is a short drive from where I live.

This is a mole blog so you know this is just the beginning of the story. Last night I was scrolling through Facebook which I haven’t done much of with all the stuff going on lately.  I came across a post that said Suburban Junky made the top 500 books on Amazon, I am so proud of my husband. (Now in the book he had a friend named Rachel from high school, who after he got clean they spoke, he told her everything and they eventually married.) So I looked to see who posted this and I froze because I was so blown away. I work with this Rachel as she is a tech on women’s health who is going to nursing school. She is an amazing tech and I know she will be an amazing nurse. I will be real honest here when she was first hired I was jealous and upset. First of all, I have always been the only Rachel wherever I worked. Heck in high school of 2000 kids there was only one other Rachel so I considered myself special. Rachel also looks like a supermodel. So not only is she super nice, and smart, she’s beautiful. So after a month or so I decided yes I like her and yes I can share my name without being a green eyed idiot. I also feel like I now know a famous person as well. Who would have guessed that she was the Rachel in the book. God is always showing me his ways are better than mine.

Anyway I just want to encourage everyone to read the book and if you have middle school or high school kids, they should read it as well. One stupid decision can change your entire life and lead you down a road no one should ever have to travel.

 

Mole Moral~ Women’s Health now has a third Rachel who is an RN. (Can you believe it? We only have about 50 employees and there are three Rachel’s!) The newest Rachel received the Five Star Nurse award this quarter so she is cool to share my name as well! The other two work nights so it’s really fun when I hand my team off to nurse Rachel and then tech Rachel is the patients tech as well. Rachel’s rule the world!!

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Physical Therapy VS Nursing

 

This past Friday was Emily’s white coat ceremony for Physical Therapy School.

“This is a ritual in physical therapy school that marks the student’s transition for the study of preclinical to clinical health sciences. this landmark ceremony involves a formal ‘robing’ or ‘cloaking’ of second year students in white coats, signifying their transition for the basic science and academic portion of their education to their clinical studies. Students receiving white coats in today’s ceremony have successfully completed foundational coursework, lab practical examinations and comprehensive examinations covering basic sciences, physical therapy management, research, and professionalism in anticipation of their upcoming clinical experiences in physical therapy practice settings across the nation. Every student in todays ceremony strives to embody the core values of Rockhurst University and the physical teary profession, including altruism, compassion and caring, integrity, excellence, professional duty, social responsibility, and active acceptance of responsibility for the diverse roles of a physical therapist (accountability).” Rockhurst University

I am not sure what I expected at the ceremony but it certainly wasn’t to be a blubbering mess. I found myself tearful on several occasions. Firstly, it reminded me of all those years ago (1986) when I received my cap from Debbie Dutton (a third year Deaconess student). I didn’t know any nurses who could have capped me but I picked her because I admired her so much and I could barely speak to her. I was very shy back then. This was a huge deal as well and after that we had to wear these crazy caps to clinical’s.

They had a speaker who had graduated from the physical therapy program twenty years ago. She was fantastic and when she spoke about how nervous she was when she first started clinical’s because she was going to be in charge of real patients and what if she missed something or killed someone. And it was at the moment i realized two things. Firstly, physical therapy is way more closely to nursing than I ever realized and secondly, new nurses also feel this way. Here lately at work we have had a fair amount of new nurses start on our floor. This caused me to remember my very first day of orientation which I have shared with some of the girls over the years. Anyway I was working at Deaconess on the renal, ENT, and GU floor. We walked into our patients room who had a laryngectomy and had a laryngectomy tube. This is similar to a trach but bigger. He happened to cough right as we walked in and out flew his tube and landed on the floor. I was thinking what the hell had I gotten myself into but my preceptor walked over and picked it up off the floor, rinsed it, stuck the obdurator back in and shoved it back in his neck as if it happened all the time. Later I would realize that was the only time that ever happened in the two years I worked there. Had my preceptor flipped out, I might have ended up a totally different nurse. So clinical instructors and preceptors are very important in shaping a future nurse or physical therapist. I do not precept new nurses because it makes me nervous and I do things my way which isn’t the best way to instruct new people. I am however a resource and will answer any question or show anyone how to do anything.

Next they did the blessing of the hands which I thought was wonderful and really wished nurses did this. Each student took oil and wrote the letters P on the palm of one hand and T on the other hand. It must have been super oily because the look on their faces was hysterical.

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And after it was over I began to reflect on physical therapy because as a nurse they have always been a pain in our neck. They always call “can I work with your patient in room x”. I want to say don’t call me just do it but I am sure they are taught this way. They always seem to get the biggest patients up all by themselves and then they leave. It always takes five nurses to get them back to bed. If you don’t believe me and need a good laugh please click to view this PT vs Nursing. Emily and I watched it together a year or so ago and were laughing so hard we could barely breath. I really never recognized that they  also have a healing touch. That they can seriously injure a patient just like a nurse. That they have to be mental therapists just like nurses because you just can’t teach a patient to walk again without learning a whole lot about his background and what kind of environment he comes from.

 

Mole moral ~ Perhaps those physical therapists with their gait belts permanently attached to them aren’t so bad after all. If they would only put the patients back to bed, life would be well PERFECT!

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A life changing event

232323232fp93232>ydnjthgqubwsnrcgu8243>nu=3235>844>978>WSNRCG=3-94445564324nu0mrjIt’s hard to believe that ten years ago today the RN strike started against St. Johns Mercy Medical Center. In some ways it seems like just yesterday, and others many lifetimes ago. It was certainly a life changing event for me. I was picket site #6 (why do I remember this stuff?) and met a lot of new people over the almost six weeks we were out in the freezing cold. I remember Christmas Day being extremely cold and since I would have worked 3-11, I did four hours on the picket line. Then on New Years Eve it was so warm we didn’t even have the fire barrels fired up. We certainly turned the medical center into shanty town. I remember that some people who lived there complaining about it. It really was monumental. I do believe we were the first nurses union in the state of Missouri and certainly the first to strike.

During this time, we created an email chain and would send out emails for support and to let each other know what was going on. Well since I love to write, you can see that I became heavily involved. It is how I became fairly well-known all over the hospital. Now this totally cracked me up because you see ever since I was a little kid, I would hide out in the corner hoping no one would notice me. I am still that way most of the time. My sister-in-law worked at Dierbergs and people would come through her line and say I know your sister-in-law Rachel. It was crazy.

The emails were turned over to management upon return to work. We eventually found out who did it and although it was infuriating at the time, as time as passed it really no longer matter. Everyone that was out on strike had to go to meetings before they could return to work. I am not sure if they thought all the people who stayed out the entire time were going to break the legs of people who worked during that time. I certainly had no intention of it. However, I was not allowed to attend one of those meetings but had a special one on one meeting with HR and my nurse manager. They had to access my level of anger to see if I was safe to return to work. I remember talking to my father after the meeting and he said he would have walked in there and told them to F off. I however played the game because I really just wanted to come back to work and resume taking care of the heart print patients. (moms who lost a baby). And so I promised to be good and stay out of trouble. And that lasted about two shifts at work. Management put a note on the dry erase board stating we could no longer chart at the main nurses station but had to chart at the pods. So what did I do? I wrote spare me next to it. The next shift I worked I got called into the office and talked to by HR like I had just sold heroin to kids on the school playground. I was informed I would be formally counseled for this to which my smart reply was great I will bring a union rep. Our secretary was a union person and she honored the picket line and never returned to work. So Holly was our new secretary. I walked up to her and said do you smoke and she said yes. I said I’m Rachel and we are going to go smoke a cigarette. So after not smoking for six weeks while out on strike I was back at it. I also made a great friend in Holly that day!

The nurses union would be voted out three years later and not return. I became involved with CNA (California Nurses Association) now called NNOC (national nurses organizing committee.) until the union was voted out. I was then finished with it and ready just to focus on nursing.  I became good friends with those representatives as well who also constantly told me I was a leader. I still don’t see myself as a leader but since everyone else seems to, I try to behave these days.

After the strike was over Laura talked me into signing up to do a 1/2 marathon with Team in Training. She ended up becoming pregnant and did not do the marathon but I did. I smoked all during the training and would actually smoke to and from the way to the track. It would be another 4 years before Erin would talk Jennifer and I into doing a 1/2 marathon. It was the Lewis and Clark half and my number was 2319. (Yep the monsters inc code which i was totally excited). Erin ended up not being able to do it because that is when our computer documentation started but it triggered my walking and then running obsession.

A lot of good things came out of the strike. I made some great friends especially Kathy, Jean, Carol, and Jane from the surgery center. I found out I am seen as a leader of sorts, no matter how scary that might be. I eventually started running and got into the best shape of my life. And I still work at Mercy despite my constant paranoia that I will be fired at anytime.