Glitter in the air

Have you ever fed a lover with just your hands?
Closed your eyes and trusted, just trusted?
Have you ever thrown a fist full of glitter in the air?
Have you ever looked fear in the face and said, I just don't care?

It's only half past the point of no return
The tip of the iceberg
The sun before the burn
The thunder before the lightning
The breath before the phrase
Have you ever felt this way?

Have you ever hated yourself for staring at the phone?
You're whole life waiting on the ring to prove you're not alone
Have you ever been touched so gently you had to cry?
Have you ever invited a stranger to come inside?

It's only half past the point of oblivion
The hourglass on the table
The walk before the run
The breath before the kiss
And the fear before the flames
Have you ever felt this way?

There you are, sitting in the garden
Clutching my coffee,
Calling me sugar
You called me sugar

Have you ever wished for an endless night?
Lassoed the moon and the stars and pulled that rope tight?
Have you ever held your breath and asked yourself will it ever get better than tonight?
Tonight

- Pink

Here we go again :: N30040 :: Clinical Journal Entry #26

The Clinical Journal Entries started as a clinical assignment but then turned into tradition.  Unfortunately, we are back into the assignment mode, and that takes all of the fun out of it.  It will start out as a copy-paste from Word (the doc I emailed my professor) and now I get to tell you how the day really happened (or at least my uncensored and way-more-fun version of it)

This is our geriatric/rehabilitation rotation.  I signed up for the section closest to my home.  A solid 30 minute drive at 6:20am for an instructor who wants us there prior to 7am because "these patients are already awake anyways!"  Right.

Now, I love old people.  I'm a sucker for grandparents, and I even enjoyed working on the Acute Care of the Elderly unit for my first-ever clinical rotation.  Old people, the elderly, seniors... however it's politically correct to call them these days, are full of stories and have such varying personalities.  They're just like us twenty-somethings, only a whole lot smarter with many more lessons learned.  They're so easily stereotyped, while to them, we're probably just as easily stereotyped.  The more you're around the people who hit their '80s, '90s, or even 100s (101 - like one of our residents!) the more you realize that they're just people like you or me, only their bodies sometimes get worn out from this life and they need extra help.  That's all.  Alzheimer's and incontinence aside, forget about the hearing aids and teeth sitting on the counter...  Each and every old person in the world has a personality, interests, dislikes, memories, habits, values, and fears.  And, like everyone else, they just want to love and be loved.

Studying the process of what can go wrong in old age, however, is a different case.  We have clients, not patients.  They're here because they, the government, or their families are paying for their stay.  They're here to get better so they can go be good Grandmas again.  They're here to play games and sing songs until they go across the river.  They're here because they are a little forgetful and someone needs to help them know to take their medicine.  They might be here because their spouse died, their family couldn't take them, yet they couldn't quite live on their own.  And then some have colorful rooms filled with photos and banners and flowers and things from the home they will soon return to.  See, it's a different kind of place.  It has a distinct smell and sound, and yes, there are medicines and health problems, but it doesn't feel like a hospital.  Instead, nursing homes seem like big dorms for old people.  And I'm a nurse, just not that kind of nurse.   Just when I was getting proficient with tubes, needles, systems, IV pumps, intricate computer charts... I get dropped off on the doorstep of an old people dorm and am told to make myself useful and take assessments and give meds, charting it all in 4" 3-ring binders . Hand-charting aside, those things really don't take long.  But this does - this takes 10 hours on our feet, looking busy, and some weeks we will have alert patients, while some weeks we may not even have a patient who can talk back.  I'm the busy-busy-busy nurse, the one in the group who just doesn't slow down, so this might be a problem.  I foresee a lot of craft events and afternoons spent at the group "Dining Room Movie."  If I have to feed a few people or clean up after them, that's okay, too.  If I have to smile at a mean old lady or help him clean his dentures, that's okay, too.  And if I get to do a dressing change on a stage 3 pressure ulcer or get to go with a patient to see how dialysis works in our (rare in-nursing-home kidney dialysis) center, then it'll definitely be a good day!  I just don't like the smell of that place, especially at 7am, and I really, really, really don't like being bored.

Today was just orientation, see the unit, meet the staff, here's-all-the-assignments-and-final-paper-i-want-to-kill-you-with kind of day.  So next week, maybe something will change or I'll have some sort of different opinion.  Probably, yes, most likely.  :)

Oh yes, and because this is an assignment, I must state 3 personal goals, one with a clinical focus, one with a gerontological focus, and one with a rehabilitation focus.

Clinical: To increase my patient assessment skills (...Seeing how one of the only things we are doing here is, well, patient assessments, lol)

Gero: To be comfortable with dementia patients (Because let's face it - they're scary.  I had one when I student tech'ed at General and it was a BAD experience)

Rehab: To help a patient work on skills so he/she can return to home (Because we do have a few "acute" older people, and we all know that homes are soooo much better than nursing homes!)

My next journals will be on activities I did with residents or random things the syllabus wants us to do ("Make a list of stereotypes of older people"), citing a website that taught me more about my patient's condition, citing a journal regarding one of my patients... ya' know.... just the normal fabulous stuff the professors sit at home and make lists of because they have nothing better to do.  All while reading about 4-8 (50 page-ish) chapters of 2 textbooks a week.  (Well, technically 3 textbooks. The one was so big they had to make Vol. 1 and Vol. 2.  Not. even. kidding.)  Whoooo!!!

And I need to rant just a little more to get "today" out of my system, because I'm tired and was up too early and am crabby from being bored and so stressed... I would have guessed a nursing home would be on the warm side, but this place was HOT.  We toured all 4 (or 5?) "units" and went on two different floors, all the different wings, and there was not one single cool spot beyond opening-wide a window or a door.  So next week, other than coming in swim-scrubs, I have no idea what I'm supposed to do.  I figured it would be rude to steal an "out of it" patient and turn on their room A/C.  Definitely rude.  And mean.  Neither of which I'm into being.  But it's like, we can put nice warm blankets and Snuggies and jackets on them, yet we are not allowed to take off any more clothing without violating some kind of rule or law.  Yes I have a tank top under my scrubs, but will they let me walk around in that?  No, because how un-professional!  Yeah, well then get a thermostat that works, set it where normal people set it, and try that for professional!

And to think if this was any other day, I'd have my reason for doing this, the hope of the ONLY one thing that I fought through this much school for already.  But it's funny... we humans are odd creatures.  I'm still fighting and even the faintest hope of my reason is gone.  So am I fighting for nothing?  Probably.  Uh-oh, I can't let my mind go that way.  K, turn this way...

5. More. Weeks. Of. This...  And I wish I could say I'm getting the summer off, but I'm NOT.  I will be spending 6 weeks taking what I should have taken January through last week but nervous breakdown'ed my way out of.

If I can keep going at this insane pace, I'll be done in 1 year, 1 1/2 months, making my grand total... 6 painful years.

And then what?  A nanny who just happens to have a nursing degree?  God help me!  All I wanted was a part-time job that I loved (which could be nursing, yes, could be this....) and to work because of want and not need, with the ultimate goal of staying home with my children.  Somehow all of my dreams got really mixed up into the life I have now.  Add a degree and a part time RN job, keep the nannying, and I have everything in the dream except the kids... The kids I pour so much into are kind of other people's kids.  Oh, and a husband... I think somewhere in there the dream was being married first.  Yeah, and that's a sore subject right now.  But yes, he would be present because I would be working because I want to, not because I have to, right?  Remember that part?   Not sure how this knot of "dreams" came to be, or how to untangle it, but we'll get there... look around, assess, reassess... intervene when necessary.   Follow the plan of the Divine, foremost.  Stay on for the ride, because it's sure going to be interesting how this one plays out!

(Sidenote - Nurses, did you know that after 2015, the MSN is no more?  The next step is the doctorate of nursing practice I think.  I'm not sure if they're moving CNS NP CRNA, etc. up to PhD level or what, but the masters will cease to exist.  The nursing board smartypants are doing the physical therapist thing where all existing MSNs will be "grandfathered in" but anyone wanting to be a grad student has to work to PhD.  So my plan is, you guessed it, to start my masters the latest day in my life possible before I can no longer get "grandfathered" in for my MSN.)