Breaking point

It happened.

Grad school pushed me to my breaking point.

I’m talking full on emotional breakdown, anxiety attacks, re-emergence of repetitive behaviors…

It got bad.

For some reason I hit a wall and could not move past it.

I went to work and functioned as if I was ok, however mentally I was losing it!

It all started with one class… Pathopharmacology. Now let’s remember, I’m in school for my masters in nursing education. I was not prepared to cross paths with this class. It hit me like a ton of bricks. The grading rubric was 5 pages long with part “A” consisting of like, 3 of those pages. I hated it. It’s not a class I have ever wanted to take. It did not interest me. I couldn’t retain the information. The paper I turned in was basically a pompous regurgitation of information that no one wants to read.

It sucked.

The sheer weight of the paper that was due gave me anxiety so I procrastinated. The procrastination made me anxious. The anxiety made me procrastinate more. The procrastination gave me anxiety.

It was the feedback loop from Hell.

I almost broke. Quitting actually started to look like a viable option. I was literally in tears thinking about the paper.

It was the beast I could not defeat… or so I thought.

I had to have friends and family really rally around me and offer support to help pull me back from the edge. They managed to get me to take a step back, breathe, and break the monster down into manageable pieces.

I have a great support system, something I don’t acknowledge enough.

After hours of research, coming up with an outline of what was needed, and taking the paper in small chunks, I completed it. I turned in 36 pages of absolutely glorious regurgitated information. It’s what they wanted, so it’s what they got.

I passed the paper and the class.

It was if a 10-ton Boulder was removed from my shoulders. I could finally breathe. I celebrated by drinking wine and playing Final Fantasy Online with my cousin. It was amazing.

I’m now in Health Assessments. It’s at least something I have some familiarity with. I know the advanced practitioner health assessment is far more involved but it’s something I can learn and retain. It’s useful information, I mean I’ll have to teach that to nursing students one day (hopefully). So, I’m nervous about the assessment I have to record. I’m nervous but not panicking. I’m learning to breathe and take things one step at a time. I finally have a plan to move forward. It’s doable.

One down

So, term one is done.

One down, three terms to go to finally get my master’s.

I’m proud of myself. When I started school I really thought I might have been making a mistake. I didn’t think I was ready. I thought I was in over my head. My first paper got sent back and recommended for the writing center because it was so bad.

I had forgotten everything about APA formatting! I felt like an idiot. I took the recommendation and used the writing center for help. My papers are much better now. I feel more like a student, like I kind of know what I’m doing.

I still second guess myself. That’s just me. However, I feel more at ease. It’s tough, papers suck, I’m tired all the time, but I see that I can do it.

I know that it will get harder from here. More 14 page papers, projects to do, and soon, clinicals. I’m going to gripe, moan, groan, curse, and complain. I’m also going to get sh*t done.

I can do this. I’m ready…

Does nursing education need an update?

I am going to share my thought on nursing education:

The way nursing teaches feels like it’s 20 years behind.

There, I said it.

What we are teaching our students and how we are teaching them is outdated.

I graduated with my Associates in nursing almost 10 years ago. Why in God’s name did I have to calculate drip rates? Not once in my almost decade of being a nurse have I EVER had to calculate a drip rate! In fact, most hospitals prefer meds to be given through the IV pump to help avoid mistakes in how fast an IV medication is given. Another thing I learned in school that is absolutely obsolete is how to give the “perfect” nursing bath. Let me just tell you that the bath you are taught and the bath you will be given are not the same. No one has the time to give this elaborate bath and many facilities are moving away from basin baths and moving towards the chlorohexidine wipes. However, those are mminor things that need to be updated.

What I really am appalled by is how nursing school made me feel like I would be all on my own. I spent so long trying to memorize every medication my poor brain could store because I was made to feel like I had to know them all. I tried to memorize all the side effects. I wanted to know contraindications, interactions, dosages…

I needed to know it all because I alone am responsible.

Yeah, no.

I have always had a wonderful relationship with pharmacy. I have no problem with calling pharmacy and asking about a dosage, an interaction, how often it can be given, etc. As a nurse you are actually not alone. If all else fails, there are several apps that can be downloaded to your phone that can provide a wealth of medication information (think Epocrates, Medscape, and so on).

And that is my next gripe, technology.

Why are nursing programs not incorporating the wealth of technology into their nursing programs? Just about eveyone has a phone now with access to Google. This idea that we have to memorize everything because we have no one to turn to is very obsolete. There is literally a wealth of information at our fingertips. We are in the information age and it’s time nursing realizes that.

But nothing, and I mean nothing, is probably more obsolete than those damn careplans! Hours and hours spent writing thorough nursing plans, while thumbing through the nursing diagnosis books and for what? Most careplans are now documented in the online charting systems (Epic, Cerner and such). Furthermore, NO ONE looks at them but the TJC when they come to visit!

Something is wrong with nursing education. Many Associates prepared nurses are coming out of school with plenty of knowledge on how to complete tasks. A lot of ADN programs teach tasks with no real time spent going over critical thinking. There are Bachelors prepared nurses have all the knowledge of theory and delegation but no real idea on how to apply that knowledge in the real world.

This is a problem. We are hammering nurses with knowledge and theory but not showing nurses how to apply what they have learned with REAL patients. Don’t get me wrong, as individuals providing health care we need the knowledge we are given. However, we need to learn how to teach nurses to apply what they have learned. We need to learn how to teach nurses how to reflect and resolve when problems do arise. This idea that nurses have to do it all and be perfect needs to die. Quickly.

Our future nurses deserve better.

April 1st

It’s coming.

April 1st.

No, I am not worried about April Fools Day.

I start graduate school. I make that first step towards my Master’s degree. I take that big leap back into school.

I. Am. Terrified. I don’t know why. I feel like I’m not ready. I feel like I have gotten myself in over my head. I feel like I am not good enough for this. I know this is my anxiety talking. This isn’t my first time dealing with the panic and self doubt that comes with anxiety. Anxiety stopped me from going back to school before now. Anxiety almost stopped me from taking the job I have now. Anxiety has awoken me from my sleep with my heart racing for absolutely no reason. True anxiety is no joke. It’s not easy for me to admit that I deal with depression and anxiety. I am the nurse that has it all together. I am the nurse that other nurses vent to. I am the nurse running a blog giving advise to other nurses. I am the nurse that has mental health issues.

I am not going to let anxiety win though. Yeah, I am scared sh*tless, I won’t lie. I feel like I might have made a mistake. However, I am still going to log into my student portal on April 1st and begin looking over my first assignment. I am the nurse that is going to have her Master’s in two years because I am the nurse that refuses to give up.

Unprepared

What’s the one thing you wish they would have taught you in nursing school?

For me, it’s definitely time management. I feel like nursing school and the NCLEX gave me this belief that I would have all the time in the world to do everything I needed to do for each of my patients. WRONG! I have 12 hours to provide my patient(s) with the best care possible. That’s it. 12 hours. It sounds like such a long time but sick ICU patient or 5 med/surg patients can take that whole 12 hours and then some. 

It was a big reality check for me when I first hit the floor after graduating. My first nursing job was in a very busy med/surg unit at a level one trauma center. I rarely had less than five patients. I went out on the floor with the idea that I could spend ample time with each patient and still get all my charting done and have my meds passed on time. LIES! ALL LIES! WEB OF LIES! I was one of the ones left behind charting long after my shift was done because I just didn’t have the time management thing down. It took me a little while to understand that I needed to learn to prioritize what was important. Before I could stop and chat with one patient, I needed to have seen all of my patients. I needed to learn how to delegate to my care tech some of the small things so I could do the big things. 

I just wasn’t prepared for nursing in the real world. I was lucky that I had an amazing set of preceptors to teach me how to actually be a nurse. 



Dear medical student…

Dear med student,

Hi. I’m the nurse that had been taking care of this patient for the last 12 hours. I am the nurse that charted every med given or not given over this shift. I’m the nurse that verified all those vital signs. I’m the nurse that put in that progress note last night. I drew the labs this morning. Yes, I know my patient.

You do not. That’s ok.

While I do not mind you asking me about my assessment, I will not do your assessment for you. You need to check the pupils. You need to check a neuro status. You need to check the lab results. You need to look over the vital signs. You need to look at the meds. You need to know this patient so that you can give your information during rounds.

Walk in. Introduce yourself to the patient and I, the nurse. Put on your gloves and get hands on. Ask questions, we don’t mind. We nurses understand that you are still trying to get your footing. We were there at one time as well.

Understand that ultimately, you still have to assess your patient yourself. Take these moments to build your communication and assessment skills. Each moment of patient contact is a potential moment for learning. Get all up in there!