Thursday, February 28, 2013

Labor & Delivery!!

Yesterday I spent my entire morning with 2 adorable little 1-day-old babies. One was 8 lbs, the other only 4. I got to assess them and hold them and just get wrapped up in their cuteness. Am I baby hungry now? Heck no! Do I want to go back and hold a few newborns? Yes please!

Today I was with the labor nurse, Carla, who was super fantastic and taught me so much. There was one girl in a labor room when I got there at 6 AM, and she was dilating one cm every hour. I was so worried that she wouldn't give birth until after my shift ended at 1, especially because births don't happen every day in a small hospital. Carla and I spent the morning monitoring her contractions and the baby's heart rate, and popped in on the mom to check dilation and to see if she needed anything throughout the morning. Carla showed me how to feel the stomach for the fundus (top) of the uterus, and I got to feel how hard the stomach gets during a contraction. Carla really was fantastic in teaching me things, and she promised me I would get to see and assist in the birth before I had to leave for work.

Noon rolls around, and I'm supposed to meet up for lunch with all the nursing students. Carla promises me I won't miss anything while I run to grab lunch, so I head to the cafeteria. When we get our food and sit down, our clinical teacher, Gina, rushes in and says we have to go to post conference (a meeting where we discuss what we did that day and ask questions) right away because an RN student had shown up to do his teaching assignment. So I go to the break room pretty convinced I'm going to miss the birth. I'm eating and learning about wound care (thank heavens for my strong stomach) when I hear over the hospital intercom "Courtney Brown please return to OB, Courtney Brown to OB"

I jump up and practically run back to OB. I rush in the room and get there at the same time as the doctor. Carla and I set up the bed and supplies, and the mom is ready to push. The dad and I help hold up her legs, and the doctor says to push. One nice long push later... voila! Cone-head little boy! The nursery nurse takes the baby after a few minutes to do her assessment, and Carla and I start caring for the mom. A few minutes later the placenta is delivered, and the doctor lets me put on gloves and touch it. He was great to show me the anatomy of it, and the dad was so grossed out he couldn't look away. The baby was doing just fine, and so was the mom, so we started cleaning up.Carla cut the cord into a few sections to be kept for a few days in case it was needed for testing (Did you know the umbilical cord will test positive for ALL substances the mother may have taken during the entire span of the pregnancy?) and we did a sponge count to make sure everything was accounted for.

She told me that the afternoon students had been trying to convince her not to find me, and to let them in to the delivery instead of me! Thankfully Carla responded that I had been there all morning long helping to care for the mother, and that if any student was going to see the birth, it would be me. Thank you, Carla!!! I so appreciated her when she told me that! Quality nurse right there.

The best part about watching the birth (aside from the amazing child comes out of a tiny orifice thing) was watching the mom and dad interact with each other. Such a beautiful, loving couple. Kinda made me all sniffly and wistful for the day when I have a husband as loving as he was.

Really cool rotations in L&D, but I'm pretty sure I'm not heading in that direction professionally. Only time will tell I suppose!

~Courtney

Wednesday, February 27, 2013

Pondering My Future

I've decided that every month I'm going to answer the same questions for the 2 years i'm earning my R.N. I thought this would be a fun way to get me through nursing school. So here goes!

1. What are you scared of right now?

          Not really scared of anything at the present moment! Yay!
2. What have you thought about most today?
          Relationships
3. What did you learn about today in class?
          The endocrine system
4. What was your most recent test on?
          Pregnancy complications
5. What is your next test on?
         Endocrine, on Friday
6. What was the best part of today?
          Playing with little newborns in my clinical today!
7. What are you stressed about?
          My medications test in 2 weeks. 
8. What/ who do you miss right now?
         Disney World
9. What did you have for dinner?
          Spaghetti and lima beans
10. What field do you want to work in?
            The operating room!  

Tuesday, February 26, 2013

Lifted Up

Today in Institute we talked about the people who will be "caught up together... in the clouds, to meet the Lord in the air" from 1 Thessalonians 4:17. 

My Institute teacher shared a dream his father had years ago, we will call him Adam to keep the story clear. Adam is standing in a large field, and he looks around to see hundreds of people in the field with him. Suddenly the skies burst open, and the Lord descends from the clouds. Adam notices the people around him start being lifted up off the ground. He realizes the significance of this, and immediately starts worrying that he's not being lifted. So he starts jumping up and down, hoping that will help him get lifted up. He realizes that no amount of jumping will help him, and he stops in despair. The feeling of guilt and shame overwhelms him, and he starts crying. Then, just as the dream ends, his feet lift off the floor.

After sharing that story, Brother Olsen shares what he learned from Adam's story. His dad told him about that dream a few weeks after he had it... which was, of course, years ago, and Bro. Olsen dwelled on it for a while. He decided he never wanted to do anything that endangered his ability to be lifted up at the last day.

I cried, let me tell you. It hit my heart so hard, and spoke to me so strongly. Am I doing anything that is endangering my ability to be lifted up? Are my friends and family doing anything to endanger their eligibility? 

Unfortunately, I know of a few people who are taking steps off the straight and narrow path, and it hurts my heart. I want them to know how special they are to our Father in Heaven, and that He is mindful of them. I wish I could make these people realize that they can turn to Him in their times of need or trial, and that He listens. 

I hope that I will always have the courage to speak to Heavenly Father when I need him, and that I will be strong enough to make the right decisions when trials are placed before me. I know that God lives, and that He knows who I am. I know he follows me and sees my future. I know He listens when I pray, and I can not wait for the day that I fall at His feet and worship Him.

I love the gospel of the Church of Jesus Christ of Latter Day Saints with all my heart and soul. It keeps me grounded and on the right path. I love the people in my single's ward here in Price, especially the women. They are wonderful women, and I know they care for me. I hope over time I will be able to express to them how much their concern and compassion has made an influence in my life.

Hold to the rod, I love you all.
~Courtney 

Sunday, February 17, 2013

Operating Room Clinicals

Dear readers,
I am almost 100% sure I have found my calling in life. (a very large emphasis on almost) That calling, you may ask? It's the operating room. Oh baby, is it the operating room! Which comes as a slight surprise to me, because I was almost 100% sure I was going to pass out, or get sick to my stomach, or actually vomit during this clinical rotation. None of that happened! 
In fact, I was moving all around the room, both days, to get better looks! On Wednesday I got to see a wide variety of surgeries. I saw 3 ear tube placements, which wasn't new to me, but I got to hang out with the nurse anesthetist (CRNA) while he kept the little kids under, and ask him questions about his schooling, and the medications he used. Then I saw 2 nerve block procedures, which were less thrilling, but involved a machine that looked a lot like an MRI, which was cool to watch. Last I watched a colonoscopy with multiple biopsies. That was the first day, which was cool, but not screaming to me "This is where you're meant to be!"  Though the nice cozy blue scrubs were definitely a big plus.



Day two: a whole different experience. Oh man, I got to see a hysterectomy, and an attempt at laser prostate resection. Both were cool, but the hysterectomy wins for most awesome thing I've ever seen. WARNING: this blog post is gonna get graphic, if you are squeamish, stop reading. 
The hysterectomy was done vaginally, so this poor female's legs were suspended way up in the air. She was covered up, so the only thing showing was the vaginal area. The doctor was so wonderful to let me see what was happening, and he told me what he was doing the entire surgery. It was fun to listen to him chat with his nurses, and it was so impressive to see the camaraderie between them. It made me look forward to the time when I will have work friends to chat with, too. He showed me the Fallopian tubes and ovaries while he was doing the surgery, and after the uterus was removed, he sewed shut the opening. Then he told me to put some gloves on, which was unexpected and weird, so I do, and he proceeds to turn around and HAND ME THE UTERUS. Which was awesome, by the way, freaking awesome. Then he hands me scissors and tells me to cut the uterus open. 
I've done dissections in anatomy lab, and in high school, but to have a fresh human organ in my hands... it was incredible. Seriously ya'll, I'm meant to be in the medical field. So I cut it open, felt the tissues and whatnot, then sent it off to patho for testing.


The next surgery was a laser prostate resection on an elderly guy who's prostate was so enlarged that he had to use an indwelling catheter to urinate. The plan was to thread a laser tipped catheter up into the prostate area, then turn the laser on and pretty much disintegrate the tissue. we all had these green goggles on to protetc our eyes (which I found slightly odd because the entire procedure was completely internal), and there was the laser technician in the room, who had brought the machine from Salt Lake.
It took the surgeon almost 10 minutes to get the laser catheter up to the prostate, because the skin was completely shredded all the way up the urethra, which the surgeon assumed was from months of catheter use. The tissues were spouting blood everywhere you looked; I felt so bad for the poor guy. The catheter finally reached the prostate, and the surgeon tells the tech guy to start up the laser. He does, we all fasten our goggles on securely, and... nothing.
Yeah, after 10 minutes of work threading that laser up there... the thing doesn't work. Turns out the wire to the foot pedal had a cut in it, and during the 10 minutes of catheter threading, urine and blood had been dripping down on to the foot pedal wire... ruining the entire system and bringing the surgery to a halt. You should have seen that tech guy. He didn't bring a replacement foot pedal, and he hadn't thought to check wiring before the surgery started. He was stammering and apologizing to the surgeon, when really, he should have stuck around and apologized to the patient. The surgeon put in a new catheter so it would be easier for him to get to the prostate on the second try in a few weeks. After the laser catheter was removed, the tech guy left pretty much immediately, and left the circulating nurse to explain to the patient what had happened, and that he would have to wait another few weeks for the surgery.
While it was disappointing to not get to watch a laser disintegrate tissue, it was a great lesson for me on the importance of double checking your equipment before surgeries, and for Heaven's sake  have a replacement or two waiting in the wings!

So those were the surgeries I got to watch, and really, all of them were pretty dang cool. So we will see if operating room nursing is what ends up being my calling in life.
~Courtney

Tuesday, February 12, 2013

Dear Naomi,

     If my dad hadn't overnighted my Social Security card to me the first day of my program... I may have never met you. And it makes me so grateful he was willing to do that for me, because I can't imagine not having you in my life! I am so grateful that you left Australia, and I left Utah, and we both got put together in the same character training group. Everything was working in our favor, and this friendship that has come from it... really, I cherish our friendship so much.

     I remember meeting you that first day of character training, well, really all you Australians. I just sat there listening to you guys talk with those beautiful accents. Riding in those vans with all you guys, I was so anxious to be friends with you, because you seemed so cool.

     Training week was a good time to chat with you during lunch breaks, but it wasn't until that first 'Character Dinner' that we all got to know each other. Then you and Connor came to visit me while I was hanging out with Donald Duck one day, and you guys asked me what I would do to get revenge on Chip and Dale. I was so flustered! I think I shrugged at you guys, creativity at it's finest.

     Then we made plans to see The Hunger Games, and man, that was so much fun! It amazes me that you remember such little details, like how I said "suck it, Gale!" under my breath, or how I raved about Wetzel's Pretzels, and a few months later you finally tried one because of it.


     Although I hate how I look in this picture,  I love that it represents us perfectly. We had so much fun, all the time, no matter where we were. A late night run to get Ben and Jerry's ice cream, cause it's on sale? Okay! Let's go! I loved that we were spontaneous with stuff like that.

Walmart at 11 PM


     Remember the day I tried Vegemite? And Crystal had you thinking biscuits and gravy were cookies in gravy... oh man. The foods we tried in Florida... good times. Vomit dip, J Dawgs banana boats, s'mores, Cafe Rio, the China pavilion. Geeze, we ate a lot together.


     You know, it was at the China pavilion that I realized how good of a friend you were. We talked about religion, do you remember that? It was really the first time I had ever talked about my religious views with someone who wasn't Mormon, and I remember being so impressed with how accepting and kind you were! No snide comments or rude statements, you asked me honest and sincere questions, which is a perfect reflection on your character. You, Naomi, are the most accepting and generous person I know.


     I remember the day I suggested you should come to Utah after the program ended. When you said you were going to come, I was shocked! Like... Utah. No tourist goes to Utah... but you did! I was so excited to take you out camping, and hiking, and seeing the mountains of Utah. I was so jealous of your hiking ability on the Mt. Timpanogos hike, while I'm huffing and puffing my way up the mountain.

Mt. Timpanogos hike


     We watched Captain America in our tent, and made the traditional camping foods. I had such a good time showing you Utah, and I can't wait for the day that you can show me Australia!



It was Flag Day, so we took a picture


     I love being your pen pall!!! Oh man, every time I get a letter from you, I practically skip to my apartment to open it right away. Seeing that Air Mail sticker on the envelope makes me so stinking giddy. I also love that we have been writing Disney quotes on the back of our envelopes.



     It's good to know that we will forever be Disney friends. I'm so glad I can talk to you about being stuck in the Disney past, and having a hard time moving forward in life.


     I'm sorry this gratitude letter has turned out to be more reminiscent than grateful... gah. When I think about you, I immediately think of all the awesome stuff we did in Florida. Overall, Naomi, I am so stinking grateful to have met you. You have been the one to encourage me to chase after my Disney dreams, and I will never be able to thank you enough.

I love being your friend, and I am so grateful we became so close.

~Courtney

Sunday, February 10, 2013

A Letter

I teach relief society every 2nd Sunday. Some weeks I'm good at it. Other weeks I'm relying entirely on Heavenly Father's help to teach my sisters. As you've figured out already, it's the 2nd Sunday, which means I taught. I was a crying mess. I really was. Pair that with the cold I'm still getting over... it was bad. But it was bad for good reasons. The Spirit was so strong in that room, I wasn't the only one crying. The lesson itself went well, but I found a 'letter from Heavenly Father' a few days ago, and chose to include it in the lesson. I cut it into 7 pieces and had girls read it out loud. Girls that weren't crying already started crying though this. After it ended, I gave paper and pens to everyone and encouraged them to write a letter back to Him, so they could express their love and testimonies to Him.

Here's the letter. I really encourage you to read it, and take a few minutes of your day to realize how incredibly special and loved you are.

Dear Daughter,

I remember well the day you left my side, wandered through the veil and ventured forth to fulfill your earthly mission. I had a tear in my eye as I clothed your spirit in a cloak of love and sent you off to learn. Be assured that my thoughts are with you now, as always. 

I love you with all of my heart. I know your life, the good, the bad, your grief, your disappointments, your unrewarded efforts, your frustrations. But always remember-- all that I have is yours if you will only come home again.

Daughter, realize that in you I have placed a bit of heaven. no one was exempt. I love all of my children. You have some blessed gift, some talent, some little part of me in you. Search for it, develop it, use it, and most importantly, share it with others. If you really love me, then help others find themselves and lead them to me. Show your love by serving others.

Repent of your failings and humble yourself. Make yourself ever teachable and continually strive to improve. I gave you weaknesses to help you be humble. Don't condemn me for that. I did it because I love you. Be full of hope. Don't let discouragement engulf you. I'll come if you need me. 

Daughter, cease your idle contentions. Be a peacemaker, for it breaks my heart to see so many of my children fighting. If they could only see what I have hoped, planned and desired for them. My heart breaks as I watch them. But you, faithful daughter, are my hope. It is through you that my work must proceed. You haven't much time and there is so much work to be done. I beg you to get started. Accomplish the mission I gave to you before you left me. I'll help you. I'll never be too busy or too far away to come to you. I'm nearer to you always than you might suspect. I have so much I would like to tell you, but I can't if you don't pray.

Come to me often in prayer. I love to talk to you, my beloved daughter. Be diligent in my work and my kingdom shall be yours. I'd love to take you in my arms, but I too, must wait patiently: that time will come. Till then I leave you my peace, my blessing, my love, and never forget I am nearby whenever you need me. 

I love you and miss you so very much and, oh, how I am looking forward to your return to me and your Mother.

All my love,

Your Heavenly Father



I know I am a child of God. I know that He knows me, my trials, my troubles, and my worries. He rejoices with me in my successes, and He comforts me when I fail and falter. I love Him with all my heart, and I know He loves me.

~Courtney

Thursday, February 7, 2013

Clinical Photo Dump

I've got a nasty sore throat, so to protect the residents
of the nursing home, I wore a mask all day long

Jen and Maddi

Stephanie, AKA The Roommate

Just ordering some medication refills

Celessta and Janelle, our instructor

Stephanie and me up top,
Celessta and Brooke on bottom
Brooke passing meds

I look so cute in a surgical mask, don't I

Discussing something important it seems.
I don't know. I was taking pictures

Stephanie's turn passing meds

Counting narcotics at the end of the shift.
There were 88 pills in that bottle

We were talking about hand washing and the spread of germs.
Janelle's face says it all.
Clinical was good today, pretty average experience, until I got picked to assist a resident with a phone call. Pretty much I sat and held a phone up to her ear so she could talk to her brother in England. But as I sat there, with burning arms hanging in mid air, and a stuffy mask on my face, all I could think about was how that moment right there is the epitome of being a nurse. Putting others ahead of you, so they can heal in whatever way possible. It was a gratifying feeling. Not to mention as she chatted with her brother, she said "this sweet young lady is holding the phone to my ear for me". That's all it took to make all that pain and stuffiness worth it. Made my day, actually.

Over and out
~Courtney

Wednesday, February 6, 2013

{the weirdest things make me happy}

I've had this mental 'to accomplish in nursing school' list. It's not numbered or anything, and things get added and taken off all the time.

Today, I catheterized a patient.

Check that right off the list!

I was standing in the nurses station when Celessta walked by and mentioned she was going to do a straight cath, so I immediately asked if I could watch. It's stuff like this that's going to give me vital knowledge, so I jumped at the chance to watch an actual catheterization. The nurse walks by and asks which student nurse is doing the cath, and I look at Celessta expectantly. She doesn't say anything, so I shoot my hand in the air.
"Me! I'm doing it!"
So I did.

And I got it on the first try.

Oh, and BTW, the urine was the most concentrated, sediment-filled stuff I've ever seen. It. Was. Awesome.

Sorry guys. This is a medical blog after all.

~Courtney

Saturday, February 2, 2013

The Nursing Home

Last semester, I spent about 10 hours spread out over at least 6 weeks with a resident at the nursing home I do my clinicals at. I did my NANDA and care plans on her, and got to know her pretty well.

This semester I have been at the same nursing home, but I hadn't noticed her scooting around the facility in her wheelchair. Granted, I was busy talking to other residents or following around the director of nursing. But this week was my 'med pass' week, where I handed out medications to the residents all day long. The 200 hall at this nursing home is called The Unit, and the Alzheimer, dementia and high-skilled nursing patients live there, behind a locked door. So I'm beginning my morning at 6:waytooearly A.M and I hear the characteristic nasally deep breathing M.C. has. So I flip to the room the breathing is coming from and I see her picture tucked into the folder. I started pulling out her medications, and noticed a lot more dementia medications than the previous semester, but didn't think much of it. I walked in to her room and cheerily said "Good morning!". I pretty much stopped dead in my tracks as I stared, horrified, at this... body, that resembled the M.C. I knew and loved.

She had that characteristic look of someone who's here, but not really 'here'. Her eyes were unfocused, and she Made no sense when speaking. I watched her choke down her pills and walked out of the room feeling stunned and a little empty.

I can't work in nursing homes. I can't watch patients deteriorate. I can't do that. Obviously patients deteriorate in hospitals, I'm not naive, but patients at nursing homes... you learn so much about them: their quirks, dislikes, funny habits, their sense of humor. And then you watch them completely change. And it kills me.

So nope. Nursing homes are definitely not the place for me.

~Courtney