Nurse Sean (dot) com

I dreamt of a Spirit bear again last night (A black bear with a specific set of recessive genes that causes its fur to be white). This is something I do a lot!

Richard and I were driving a rented Dodge Caravan. We were distracted by a black bear off to the side of the road. This caused us to accidentally leave the road, plowing toward the black bear. We ended up stuck in a forest between some trees.

The black bear had run away from us, but as we got out of our van to survey the damage, we saw it charging towards us, seeking revenge. I was incredibly calm. I knew it was either a bluff charge or an attack. I knew that either way there was nothing I could do about it (but hope for the best).

All of a sudden, the black bear stopped in its tracks, with a scared look on its face, and quickly walked away. I hadn’t noticed at first, but a Spirit bear had come up behind me, scaring away the black bear, perhaps saving my life. The spirit bear nuzzled its head against me as a large dog would. I pet it and spoke to it, saying “thank you sweety.’

Help arrived to get us unstuck. We got in our van and drove away.

This is one of countless dreams I have had regarding spirit bears. Every dream starts with black bears, and somehow ends with Spirit Bears. For more info on this amazing animal, go here

I wanted to spread the word to nursing students, nurses, and health professionals alike. google video offers an entire year’s worth of anatomy lectures from Berkley!!!

Here is the first video in which I went from initial skepticism, to awe. While the lecturer doesn’t immediately look like she’d be enjoyable, once you start listening to her you get sucked right into her personality. She is energetic and unique. I found myself wishing that she had been my anatomy instructor. But, from now on, she can be whenever I would like!

I just finished watching the lecture on the urinary system (below). I learned a lot! She is thorough, consice, and interesting.

This is free education people! I am totally blown away that google and Berkley have made this available. I thank them profusely! Click here and search for “Biology 131″ for the rest of the anatomy lectures.

I woke up at 5:30am today for no particular reason. I looked at my clock in shock and dragged my butt out of bed. Getting out of bed at that time is a bit of a shock at first, but I love having a quiet morning with a cup of tea and breakfast television. It makes the day feel longer when you get that chunk of time in before the sun comes up.

I decided first thing to search for “erasure” on youtube.com. What ensued was about two hours of watching video after video of their’s. We don’t get to see much of them here in Canada, so it was pretty much my first time watching many of their videos. An even harder chore was trying to pick a video to share with everyone. In the end, I desided on this one, simply because it’s one of my all time favorites. It is called “Fingers and Thumbs (Cold Summer’s Day).”

My only plan for today is to write a clinical reflection on ethics. I need to research the specific rules around performing procedures against a patient’s will. This is a pretty big topic, so it should really be no big deal. This all stems from an incident where we put an NG tube in a man that was begging us to stop. He didn’t speak english, so we struggled to communicate the reason for the procedure. In the end, after his extremely distended abdomen was drained, he was VERY happy we did the procedure and thanked me profusely. Still, there was something about inserting the tube while he was yellling “no, no, no, no!” That didn’t sit well with me. The other option was to clean emesis off him and his bed every fifteen minutes.

Other than that, I have a lot of tea drinking and blog reading planned. I have decided that people just don’t update their blogs enough to entertain me on these long days away from clinical practice! Get to it!

I hope everybody is having a wonderful day!

When I was deciding what I wanted to do with my life, I had to pick between two desires. The first desire was something medical. After awhile, this was narrowed down to nursing, which was ultimately chosen. The second option was journalism. I wanted to become a television critic. I wanted to watch television and write about my thoughts regarding old and new shows.

So, I have decided to use this forum to occasionally review television shows. Nursing has become my career, but television criticism can be my hobby! So, if you’re here to hear about my life as a nurse and couldn’t care less about television, just bear with me. My next post is never too far away.

Obviously, there are too many shows to review all at one time, so I will base my criticisms on one or two shows I have viewed recently. Today, I would like to review “America’s Next Top Model” and “Jericho.”

I have to admit that “America’s Next Top Model” (ANTM) becomes more and more addictive every season. This show, hosted by supermodel Tyra Banks, premiered in 2003 and is already on its seventh season!

Every year, it seems more competitive, and more dramatic. It is insanely, deliciously “bad.” The show is certainly about modeling and transforming pretty girls into beautiful centerfolds. However, the real show occurs between shoots in the giant mansion in which all 13 finalists are sent to live. There is fighting, backstabbing, yelling, crying, and drunken silliness.

Lasts night’s episode was my perennial favorite of every season. In this episode, every girl is given a dramatic makeover. Some girls are given extensions, others are dyed and bleached, and others have their hair cut down to almost nothing. Two things are certain to always come from this episode. There will be a lot of crying like babies, and the makeovers will leave each girl absolutely stunning!

The problem with ANTM is that it seems to be increasingly focused on the emotional dynamics of the household. Sure, it’s fun to see the girls fight and create drama, but this should first and foremost be a show about discovering the next great model. All too often it feels as though they keep the girls that create the most entertainment and drama, while getting rid of those who are boring–regardless of talent or potential.

I’m no modeling expert, but I’m under the impression that to be a super model, you need to be unique and refreshing. The other problem with the show is that they keep finding girls that in my opinion will just blend in with the other million girls trying to become a model. The ones they choose just don’t seem unique enough.

My favorite this season is Anchal (Bottom Right). She truly does represent that uniqueness and beauty that I feel embodies supermodels. At first look, you don’t instantly think “Wow, she’s beautiful,” but you soon realize that you can’t take your eyes off her. You become sucked into her exotic spell. And the more you look at her, the more you realize she really IS beautiful.

My other favorites are the identical twins (second row from top, last two on the right). I dread the day one of them will have to be eliminated, leaving the other. I hope they can truly be happy for each other’s success.

Overall, this show continues to be an addiction of mine that will not go away soon!

Jericho premiered last week, with the second show of the season showing last night. In the first episode, we are introduced to the town of Jericho which is only a short distance from Denver, Colorado. Jake Green (Played by Skeet Ulrich) arrives mysteriously in town to get money from his Dad for mysterious reasons. Other peripheral characters are also introduced, including: Jake’s family, a visiting IRS agent, and a few cops here and there.

All of a sudden, in the distance, the town sees a mushroom cloud coming from Denver. Panic ensues and then increases when all power and communication is completely disabled.

The second episode takes this idea further as town folks hide underground to protect themselves from the radioactive fallout that is coming their way. More characters are introduced, and already introduced characters are explored further. On top of this, sub plots and mysteries are created. For example, there is a former cop from St. Louis that knows just a little too much about nuclear warfare. There’s also a subplot about two prisoners disguised as cops that take a women hostage.

The problem with this show is that they don’t realize the potential of their main story. A nuclear bomb was dropped on Denver, and radioactive fallout is on its way. This should be enough plot to keep us fascinated and glued to our TVs. The race to find out what happened and hide could be a fast paced and powerful storyline on its own.

So why then are they so focused on small little side stories that take away from what is truly interesting? I don’t need exciting hostage takings or mysterious characters to like this show! A nuclear bomb just destroyed Denver! And as we discover, more bombs have destroyed several other cities.

I would like this show better if it focused on the “here and now.” A real time, real emotion enactment of what this town would be going through in the event of a nuclear bomb over Denver

I have seen this problem a lot lately, which I am going to dub “The Lost Factor.” In the show “Lost,” A plane crashing, and several survivors having to live on an island, is enough plot to create many seasons of interesting story lines. Do they really need all the strange subplots and mysteries?

But what do I know? Lost is one of the most popular shows of all time. And to be honest, I really like Jericho. I am hooked and will be watching to find out what happens next.

I feel bored…

In reality, I have a lot of work to do but I would rather sit here agitated and restless than pick up a text book, or start writing a paper. There are so many projects I am supposed to be working on that I can barely wrap my mind around the amount of work involved. I just wish nursing school was easy.

*laugh*

I really need to buckle down though! I don’t have any clinical days until Tuesday, so I have no excuse not to work on the academic side of school. Our clinical days are matched up with our preceptor, so my schedule is completely dependent on her shifts. After working nights, she gets six days off, which she says she needs to “recover” from night shifts. So, right now, I am in the middle of those six shifts. You should have seen the look she gave me when I said I wouldn’t mind working a day shift two days after a nights shift. You would have thought she was looking through translucent skin and seeing wires and flashing lights underneath!

To be honest, I’m completely a night person. I had to flip my brain around to understand what she was thinking. I reminded myself of what I feel like after working two weeks of day shifts, and suddenly realized that I could really use six days to recover! I immediately understood.

I wish 100% night shift positions were available more often. If I see one, I think I will snatch it up! The reason they stopped offering them was because it’s rare for someone to like night shifts. Management found that if someone left that position, it was very difficult to find a replacement.

Anyway, here’s my agenda for today:

1.) Watch the View

2.) Play World of Warcraft

3.) Watch Beverly Hills 90210…increasingly aware of my procrastination

4.) Fiddle with my website–I’m in love with it! My thoughts will be similar to “Oh GOD why do I keep procrastinating?!?!?”

5.) More procrastinating.

6.) Accept that I need to get my ass in gear and start working on my learning contract. This includes learning and implementing a nursing framework (anyone know a good website on Parse’s “Human becoming theory?”), creating a library of journal articles on urology…among many other things.

7.) Rewrite my posts to our online seminar. Topics include interprofessional (non)cooperation, and patient independence. I spent hours doing this last night only to have what I wrote wiped off of cyberspace.

8.) Beg Richard to make me dinner while I watch TV from the new fall line up!

9.) Desperately create a topic and research it for my next clinical reflection. Perhaps this will be on the NG tube we inserted on a man who couldn’t speak english, but CLEARLY didn’t want the procedure. We inserted it anyway. The results were instant and drastic. The patient was overjoyed that he was feeling 100% better. But should we have inserted it when he kept shaking his head yelling “no, no, no, no!” I’m on the fence. Any thoughts?

10.) Play World of Warcraft and fiddle with my website before going to bed

I love the quiet solitude of the world that welcomes me as I take the bus to work at 10:30pm for night shifts. Wrapped in my favorite fuzzy jacket, backpack beside me, iPod soothing me, and Tetley tea in hand, I watch the dark world zoom by. The hospital rises above its citadel overlooking the blackened lake as I get closer, the empty scaffolding from the half done expansion is lit only by the bright sign that advertises, “Emergency.”

The unit is dim as I arrive; someone has turned off most of the lights to help patients sleep. Peace, and an obvious lack of chaos greet me. I begin focusing on tasks. As I approach the end of my degree, I have noticed just how much nursing is about tasks. The main concern as I start my shift is what I will be doing, when I will be doing it, and how I will be doing it. I have a peace of paper on a clipboard that I diligently fill out with patient information. I make lists on it of what I need to do overnight–little crooked boxes are drawn beside each task, waiting for my checkmark that signifies it has been done.

But I know my task list is a little more flexible at night. During day/evening shift, time is an extremely hot commodity, and everything must be carefully timed and prioritized to ensure that nothing is missed. Something is always missed. Time always seems to run out. You always feel as though you have twelve hours of work to fit into an eight-hour shift.

I think prioritizing is one of the hardest skills to learn as you transition from student nurse to RN. As a student we have such different expectations. We have no “wiggle room” for prioritization; we are expected to do everything by the book, no omissions, and no short cuts. We miss breaks because we have four bed baths to do when most nurses would delegate to nursing attendants, we stay late because our charting needs to be four times more detailed than an RN’s. Every moment of our shift is scrutinized and judged, every action is expected to be perfect beyond imagination.

But on night shifts, I feel free of these pressures. I feel that I can be creative in how I go about my duties. I can bathe patients, take them for walks, get them food, but none are expected of me. I need to do vital signs and assessments, but I can judge when is the most appropriate time–before bed, or in the mornings. There is freedom, and within this freedom is power. There is nursing as I pictured it before I began my degree, because for some reason I did not foresee nurses as slaves to clocks, schedules, and routines.

I suppose I am saying that during the days and evenings nursing feels like a job while during the night nursing feels much more like an art.

I always like to do an assessment and a set of vital signs when I start my night shift, particularly if this is my first time caring for a patient assignment. This first round of checks is slower on nights. I take my time to check all the IV bags and lines, I restock, clean, and organize.

As I went about my duties this particular night, I was stopped in my tracks by a patient after finishing my assessment and vitals. He simply stated that he was glad that the doctors had finally planned a procedure for him. I hadn’t mentioned the doctor’s decision to perform a certain procedure because I wasn’t sure that the doctors had discussed it with him at this point. So, I probed further, asking him to tell me about the procedure. I was interested in knowing how well he understood the process so I would know what I could help him with in terms of teaching and preparation.

But as he began to talk, I realized that he wasn’t talking of facts or treatments, but of emotions and feelings. He described the events that began his time in hospital and how it progressed. He described his family’s reactions and his own. He told me how his wife was coping, and how she helped him during the ups and downs of the process.

After about fifteen minutes, I began thinking about my other patients and tried to break away from the conversation. It wasn’t easy to put closure on our conversation since every time I thought I was free to leave he would begin talking again. I began getting increasingly frustrated.

At this point he started talking about how scared he was and about his wife’s fears regarding his long-term prognosis. My thinking and feelings were changed entirely. I remembered that it was a night shift, and thankfully it offered me the chance to be creative—to practice the “art” or nursing. My frustrations melted away as I began to understand my true priorities better.

I grabbed a chair and sat down. The unit was dark and quiet except for a soft light above his bed and the sound of his voice as he told me his “story.” I stopped thinking about my other patients, knowing they would be fine if I took half an hour to listen. I knew that my schedule and list of tasks wouldn’t be jeopardized. I knew that by sitting and listening I was doing something that was potentially more important than making sure there was an extra bag of IV fluids in the room.

In nursing we are so incredibly focused on tasks that we forget that nursing is NOT a job. It is a career, and it is (I truly believe) an art form. Night shifts remind me of what I want nursing to be. I feel so strongly that day and evening shifts should have the same feeling of freedom and creativity. I have yet to finish nursing school and I feel burnt out by the regimented style of most shifts. I am crushed by overwhelming expectations to complete tasks that seem to take priority over taking true time to “be with” patients.

My feeling toward nursing is that each patient does not have a diagnosis or a treatment. Instead, they have a story (or what I have heard called an “illness narrative”). The patient’s story must be put at the centre of our practice with effort put toward discovering how the patient perceives the story’s characters (nurses, doctors, family) and events. Being able to understand the differences between each patient’s experiences, and knowing how to treat each patient differently as a result really is the art (and the heart and soul) of nursing.

The challenge is learning how to let go of the details and “busy work” that fills the day, reprioritizing, while still living up to our expectations as members of our team. An even bigger challenge is leaving the hospital proud of the work we did on a shift, knowing we made a true and positive difference in a patient’s story, and letting go of our need to feel validated by compliments from other nurses. If I did not have time to restock towels and IV bags in the patient’s room, and the oncoming nurse is upset, but the patient had time to talk through his hopes and fears regarding his upcoming surgery—I will make no apologies.

On this particular night shift, I left feeling incredibly proud of my work, and my new understanding of nursing.

I’m not sure when the transition happened, but I have realized over the last few days that when someone asks what I do for work, I no longer say I’m a “Student Nurse.” Instead, I tell people I’m a nurse. I feel comfortable in my skills and knowledge that I make no apologies identifying myself as such. It will be nice when I can call myself Nurse Sean RN.

I’m 99.9% positive that this confidence and comfort comes from working as an undergrad nurse during the summer (they’re so desperate for nurses here they created a job for almost graduated nurses). I was on the most intensely busy, complex, and scary unit I have seen (both patients and nurses), and I am realizing now what a positive effect this has had on me.

In three months, I feel like I learned what could take years to learn on any other unit. So, while it was torture to work there, and I found myself hating everyday, there was a positive outcome.

I remember describing my summer job as being akin to the movie “The Devil Wears Prada” in which the main character works a horrible job for a year. Her job is torture, but she knows that if she just hangs in there she will learn a lot and be able to get any job she wants.

And yes…some of the nurses on the unit were as crazy and mean as her boss! It’s an awesome movie, I recommend it with all my heart. I actually enjoyed the movie more than the book, but do whatever makes you happier!

So, I’m on nights again this weekend. night shifts make me very happy. There is a definite calm in the air. Things are peaceful as the patients sleep. I love that it’s slow enough that I have time to really look over patient’s charts and get to know them. I also love watching the unit dive into instant chaos at 7:00am when doctors and nurses start arriving, and patients start waking up and needing help.

The unit I am on is a urology unit, which I’m truly enjoying. It’s giving me a set of procedures/surgeries/conditions that I can research and learn. There’s enough for me to sink my teeth into, but not so much (like a general surgery or medical unit) that I barely have a hope of getting a handle on my patient population. I also like that the patients tend to be a bit younger.

As for the school aspect of this practicum. I have been working on putting together a list of journal articles and professional websites on urology. I have also been doing a lot of reading on leadership. This will be a busy busy busy three months, but it will help time fly by until graduation. I can’t wait!

I sat reading the email over and over again. It was time to renew my .mac account. This was going to cost me about $170 dollars. I reviewed all the reasons why I should or shouldn’t renew my membership. The only reason I could come up with is that I love having a blog that is separate from livejournal or xanga or blogger etc. It was on my own webpage that felt like my own little “Third Space.” But unfortunately, I was paying all that money and was barely using any of the features of the .mac account.

I realized that for the price I would pay for a .mac account, I could have my own domain name, even MORE creative freedom (not that I really have the technical ability), and much more space for audio and video blogging. Not to mention $170 would buy me much more than one year!

So, I took the plunge and registered my own website!

I am here to introduce NurseSean.com!!!!!

Feel free to check it out. Don’t expect to be wowed thought. It really isn’t different from anything you have seen so far. Over the next couple weeks I will be playing with it to get a look I really like, so expect it to change a billion times.

I found a program that will automatically cross post all my entries to livejournal, so you’ll still be able to read what I’m writing for a short time. However, I do plan to shut down all my sites in a couple months so I can say goodbye to all the cross posting and confusion.

once again, that’s http://nursesean.com

See you there!

Another summer has faded into fall, and while others complain about the weather, I am once again joyous as the crispness in the air grows sharper. I am reveling in the cloudy, rainy, cool weather. I have had the opportunity to wear my favorite jackets, and I no longer sweat instantly just by thinking of going outdoors. Fall, to me is truly bliss. It is comfortable and calming. It is powerful and intensely spiritual. Why people prefer summer is outside of my imaginative abilities…it is like trying to figure out what the fifth dimension looks like.

Like most Autumns, I have a million projects on the go, Each one sparked by my renewed sense of energy and vitality. Most of these project are, of course, a direct result of being in my last year of my bachelor’s degree in nursing. In my senior seminar, we need to write weekly reflective journals (I wouldn’t mind this if it were more like blogging, but in reality, it’s more like a research paper), create a case study presentation, and develop a professional portfolio (I’m still unclear what that means). In My nursing leadership class, we are doing a group case study, and a couple other projects.

On top of all this, we have to work nearly full time as nurses (for free of course), including evening and night shifts. This of course includes papers, presentations, research and much more. This will make for an absolutely exhausting semester as I try to fit everything in. Sometimes I wish we could just go to clinical, learn hands on skills, and leave. However, they need to find every opportunity to squeeze in the “fluffier” side of nursing.

So far I enjoy my unit, but my opinion of my preceptor is still up in the air. She is a very blunt, opinionated, black & white, assertive (bordering on aggressive) type person. I have always thrived around, laid back, calm, positive instructors. We’ll see. It will depends on how much freedom and space she allows me. The more the better!

I have started a timer. As of now, I have 80 days, 8 hours, and 51 minutes until the end of my last shift as a nursing student. It will be on December 8th from 11:30pm to 07:30am. So, on December 9th at 07:31am I will no longer be a student nurse! The excitement builds every day. Of course, this is all assuming that I pass my final practicum. Ack! I will write my RN exam on February 7th. Then, in June, I will receive the results and be an RN. Then I can figure out what I want to do with my life…since by then I will be completely burnt out and ready for a career change! LOL!

Actually, I have been throwing around the idea of finishing my Sociology degree through Athabasca after I move to Victoria, then pursuing a master’s degree. I really miss all that theoretical stuff that truly made me think. Nursing just tends to make me memorize lists or simply “tell them what they want to hear.” Sound familiar? Do any other nursing students wonder what would happen if we started telling them exactly what we think?

So, yesterday was the first day of the last Semester of school. The count is on! I will be done as of December 8th, 2006. It will be a time filled with a lot of mixed emotions.

The first day of school is always so exciting, and I can never wait to get there! I dressed nicely (a habit that I’m sure is still lasting from when I was a kid and my mother made us dress nicely on the first day of school so she could take a picture) and walked with a hop in my step. Classes were dull and boring, but it was extremely fun and exciting to see everyone again. Everyone becomes so close in nursing school. Unfortunately, I spilled carrot juice all over my shirt.

There was more discussion of our placements for the semester. As I mentioned before, I will be on a urology unit. I was happy with that placement until I kept hearing about all my friends who were placed in the ER. I went into nursing with the expectation that my final placement would be in the ER, and that I would work there following graduation.

Placements were entirely random though and I had no control over where I ended up. As a result, I don’t want to be in the ER (It’s all I ever wanted), and some of those in the ER don’t want to be there. No switches allowed. It’s a horrible system and people have been complaining about it for years with no results.

I will be fine though. It’s nice to be in the last semester. We’re discussing advanced issues like leadership, interprofessional practices, advanced assessment, etc. etc. etc. In November will be the career fair in which I will have to suck up royally to the BC person for a job in Victoria.

Tomorrow, I’m off to meet my preceptor to schedule the 38 required shifts I need to work before I graduate. I have to be honest and say that my heart just isn’t “in it.” I feel like I’m in this just to finish my shifts and get the hell out, rather than want to do the shifts. I don’t feel like learning, or being evaluated. Unfortunately, I don’t have a choice.

*sigh*