Putting It All Together (or Holy Carp, It All Makes Sense!)

I’m studying for my MedSurg final and I remembered this incident that happened last week during clinicals.

My patient was very stable and compliant that day, so after doing my assessment and morning care I went to check with my assigned nurse to see how else I could help her. We saw all her other patients and then I tagged along while she gave meds, which gave me a chance to review desired and side effects as we went along.

One of her patients was a middle-aged man with severe wrist swelling. As she prepped his meds, I would tell him what he was taking and some side effects to watch out for. For one of the meds we had to check his sodium level, which at the time of his last labs was 131, slightly under normal (135-145 mEq/L). As I applied a topical gel to his wrists to help with the pain, he asked us if he was scheduled for a brain scan that day. The nurse and I looked at each other, a bit confused by his question. She said that there was nothing in his chart about a brain scan. I asked him why would he have a brain scan and he said he’d been having extremely vivid dreams for a while, the type where you don’t know if you’re awake or asleep. The nurse said she’d check again to be sure and I filed away this information.

As I went on about my duties, I kept thinking about this patient and his question. Something in his case was triggering memories in my head but I quite couldn’t put my finger on it. It hit me about an hour later, while I was helping my patient back to bed after she had eaten her breakfast and I saw the slip on her tray that said “Cardiac Diet” (which means no more than 2g of sodium a day).

Car-Free in 2012 (It Seems)

Back in 2010 I had this idea to go car-lite, then eventually car-free. I had a tag for it on my blog, I was taking notes on expenditures to validate my findings, and I was generally pumped up to do it. Then my bike got stolen, my class schedule changed, I lost impetus and it all fell by the wayside. Fast forward two years.

Much like in 2010, right at the start of classes in January my car was put out of commission, this time with the brakes ceasing to work instead of me getting my license suspended. My school is just on the other side of the bay from Miami Beach; it took me 6-7 minutes to get there by car, and being right next to the hospitals, it gets excellent public transportation coverage. So the next day I took the bus, decided it was doable on a regular basis, and after purchasing the reduced-cost bus pass for students, I made the switch entirely to public transportation.

I have not regretted it at all. Even though there are mornings when I arrive a few minutes late because of missing the bus, I still take it over the hassle and costs of driving.

In February, when my clinical rotations started, I happened to have my wife’s car available those two weeks, and when I didn’t, I car-pooled with a classmate. My next clinical rotation was at a hospital that is only 3.1 miles from my house, so now I get to commute by bicycle twice a week.

And I absolutely love it. I wake up early, yes, but then I ride for about 20 minutes around Miami Beach as the sun is rising. I get to take pictures in dramatic light. I get to arrive fully awake and ready to rock, whereas my classmates all arrive sleepy and groggy. Then in the afternoon I get to ride at a leisurely pace, stop along the way (maybe for a beer, maybe for a donut) and get home still with ample time in the day and some 7+ miles bicycled in m pocket. Seriously, what is not to love?

My car has been parked for two months and I have had absolutely no need for it. I have learned to live with the extra time public transportation/bike commuting requires and decided that the savings in cash and driving aggravations more than make up for it. I get in incidental exercise twice a week and help the environment just a little bit.

At this point I am considering selling my car and using that money for bus passes during the year. That means I’ll save the money I’d spend on repairs, parking permit, insurance and tag renewal. Even with a possible clinical rotation during the summer some 30 miles south (and an accompanying 3-hour public transportation ride starting at 3 AM), I am sure that it is the right thing to do now.

And how does this tie in with nursing, aside from the obvious connection with going to school and clinicals? This is role-modeling at its best. Although I have yet to take my Community Nursing class, I know it is an area with appeal to me, and one where I will seek to integrate my love of bicycles as much as possible. What I’m doing now can be considered research; it’s walking-the-walk so that I can talk-the-talk in the near future.

So, two years later, but look at that, I have achieved my goal of being car-lite, and eventually car-free!

End of First Semester

Just so you get an idea of the speed at which my program moves: I am writing this on March 11, a Sunday, and already I am one week into the second semester and one week away from my first exam. No time to breathe!

Anyway, on Friday, March 2, I finished my first semester of Nursing School and I did really well!

• Nursing Fundamentals: A
• Adult Health Assessment: B
• Introduction to Pharmacology (Math): A
• Nursing Fundamentals Skills: A
• Nursing Fundamentals Clinical: Pass

It feels like I’ve been in school forever, but it’s only been two months. Two really hard, challenging months. I’ve gone from being a naive enthusiastic student with absolutely no practical knowledge of nursing, to an apprentice, enthusiastic student with the fundamental skills and knowledge of nursing. I’ve already helped patients on the floor at a nursing home and at the hospital, not to mention at an accident and during a potential emergency. I’ve given medications, I’ve redressed wounds, given bed baths, changed beds, cleaned whatever needs to be cleaned, been yelled at by a hooped-up-on-narcotics patient, gotten to know patients well enough for their families to recognize me out on the street and for me to wonder about them and their status in the days in between clinical rotations.

I’ve already studied far more than I ever thought I would, and realized it’s not enough; I’ve already felt like I have learned nothing and I’ve wasted time and money because I’ll never be able to do this right; I’ve already cried for no particular reason simply because of stress; I’ve lost so many hours of sleep that I simply don’t think I will ever catch up. And I’m only two months into my education.

And I friggin love it.

I had one weekend of freedom, and already the second semester has started. I am now taking Medical-Surgical (Med-Surg for short) Nursing Lecture, Skills and Clinicals, and Pharmacology. Bring it on.