Friday, February 27, 2015

Not as important as I thought

Was supposed to have surgery today....

The surgeon's secretary called me the day before yesterday and told me that she had to reschedule me.... now trying to reschedule this surgery is easier said than done!

When time is available for the surgeon, it isn't for me! When there is a period of time available for me, it's when I made time for clinical... which means I can't do surgery then! So we had to post pone it and when we finally found time, it's almost a month and a half away now!

Grrrrr.... I just want to get on with this and get it over with!

Only good thing is that I will be able to focus on my school work til then... the semester should be close to over by the time I'm able to have the surgery. Just hoping that I don't get pushed back even further by then... I mean I get that things come up (such as cancers and such) but damn it sucks to get pushed back.

Well I suppose I should go now and do some studying - I have an exam due this week!

Monday, February 23, 2015

I always knew I was complex

I saw the surgeon today, had some really good questions answered.

We decided that we would try the seton again - with a different grade of string...

If that doesn't work then he'll refer me to the fistula clinic "downtown".... which is something that I was hoping he would say!

We talked about the MRI I had - I have a transspincter fistula - surgeon thinks that it's the same one as before and the seton previously used didn't work.

It makes me nervous to try the seton again, I don't think it will succeed but the alternative would really suck.

Where the fistula sits puts me at ++increased risk of incontinence (stool) is excised (cut out) because it's anterior (really close to the vagina) which puts me at increased risk for incontinence (urine) and painful sex or the worst would be where I would require a colostomy.... all totally possible if we turn to surgical routes.

When he first came to talk in the room, I asked what options there were...

He "tried" to tell me - nothing.... ya we are NOT doing that (I didn't even let him finish that sentence!) - I am NOT living with this thing for the rest of my life with constant issues and pain and infections and such. This is interfering with my ability to work and therefore earn a living!

Then he commented about the seton - which is ultimately what we decided....

And surgery (see above about why we won't be doing that just yet)...

So I said, based on these options I suppose we'll go with the seton.... so I'm going under again by the end of the week.

I also asked him "Is my fistula simple or complex"... I barely got the sentence out when he said "complex.... absolutely complex".... see again above for the reasons why.



So if this doesn't work I will be going to see the pros at these sorts of things but we'll try the least invasive first. Wish me luck!

Wednesday, February 18, 2015

Hitting a brick wall and failing

6 weeks in and I'm feelin burnt out already. HOW do ppl go to school YEAR ROUND and not get burnt out.... or if they do, how in the world do they deal AND still succeed?!

I totally bombed my last exam (like ~60%), my last assignments I did poorly on (as in ~75% collectively) and I feel such a lack of motivation to do all these things. I feel like I'm failing at juggling everything on my plate. Though when I don't juggle I'm being told by one entity or another that I'm needed in that avenue (work, spouse, mommy, etc...)

I'm sucking at coping but don't really know how to get more energy or motivation. Hubby thinks that if I will it to be it will be.... sorry doesn't work that way! Been there, tried that.... not working.

Also.... they changed this course from last semester - different teachers and different format... they've changed a bunch of things and loaded the first two months of the semester (not that the last two are really  much better but it doesn't appear to be as severe) and I feel like I'm drowning in all of it. On top of this course I have my elective course that I'm having difficulty keeping up with as well. That teacher LOADS on the readings and websites that we're supposed to read...

Yep failing is not something that I like and I'm trying but feeling as though I'm getting anywhere. ERG!!!!


Saturday, February 14, 2015

Doctor Gods

Clincal's over - was good for the most part. Only one thing set me back - a doctor.

Bowel resection that post op was having difficulties urinating, regardless of the fact that 4L was received! So not really good!

At this hospital things are run a bit different and the surgeon gave report to the ER/floor doc - I was there and when they were talking I commented about something the surgeon said and "corrected" it.

Later to find out that this was "not" appreciated.... because doctor's are GODS and CANNOT be interrupted or corrected.... as my preceptor said.... "I need to learn my place"

Guess I'll be avoiding doctors for the rest of this clinical.

Monday, February 9, 2015

Ever upward and onward

So I'm coming upon my clinical time again for school. I'm doing it with a different hospital. I hope that this one goes smoothly. I'm certainly going to approach things a bit differently. I will certainly hold back some of my personality since that's what screwed me over with the last placement. I'm nervous. This is where I've been faultering and I seriously need to get past this roadblock. Wish me luck - hopefully I'll bring back a story or two.

Sunday, January 25, 2015

Having the rug pulled out from under you

Could you imagine being in the prime of your life - so between 20-40 yrs old - in the point of time where you're supposed to find the person you LOVE and get married, have children, travel some, finish school and find a job (hopefully a good one!), apply for health insurance through them so it's coming out of THEIR pocket and not yours and live a GLORIOUS life!!!

So you're in the midst of doing so...

THEN.....

BAM

You are hit with a diagnosis of HIV!!!



Thing is, you live a non risky life, you've done EVERYTHING correctly so how the HELL did you get this?! You've never had a blood transfusion, haven't travelled (unless you count going on a cruise 2 yrs ago that the riskiest thing you did was do accupuncture - I wouldn't have but we aren't talking about me!) and don't have risky sexual encounters (have been monogomous their entire life)... so how does this happen?! AND how is that you find out when you're applying for health insurance?! Geeze if THAT doesn't suck, I don't know what does!

And HOW do you, as a nurse respond when your patient just breaks DOWN - and of course you feel like shit for asking about the diagnosis - you try to be empathetic but how the hell am I supposed to relate when I have never experienced this and I can't even try to. But I CAN be sympathetic and try to lend an ear as well as a shoulder. I did that today for my pt. I hope I provided some hope for this pt.



Monday, January 12, 2015

Outbreak

Had to work a dayshift - the BANE of my existance! Of course it was a shift from hell.

Normally we carry four patients on days

#1 - pt with ALS with increased SOB (possibly pneumonia) and has a PEG tube and requires multiple IV things (antibiotics and solu medrol), plus is a total care.

#2 - a nursing home patient who was made palliative - has influenza A - and is doing better. Is a total care plus a total feed and a diabetic.

#3 - pt with GBS who is now a quadrapalegic and thereby a total care and feed, also a diabetic - plus the family is really needy.

#4 - pt is one assist. Had a stroke but seems pretty good other than some memory issues. Needed a follow up head CT and discharge was pending the result. Also a diabetic so several checks and subsequent insulin injections for those who also have diabetes.

So it's a heavier assignment but not ridiculous. The doc comes in a discharges #2 so I have to call the nursing home and let them know that the pt is coming back and asking if they want the MAR faxed or whether a photocopy will do.... package is made up for them and the ambulance is booked.... for 45 minutes later! Well about 30 minutes after that the nursing home calls us back and indicates that they're in an outbreak and the pt cannot come back. I asked what outbreak and am told it's influenza A.... I told my co-worker... "meh, it shouldn't matter, he's already infected"  HAHAHAHA

I told the doc about it and he said that if he came to the hospital during the outbreak and that he could return during the outbreak. And because the Dr decreed it, so shall it went! And off I sent him.

The other doc came in and discharged pt #4 later in the day. So then I had two discharges and two admissions I had to worry about. On top of all the regular things I have to undertake I have these things. Plus try to fit  my break into all this! UGH I hate these kinds of shifts!!!