Tuesday, March 25, 2008

Post-Spring Break Resolve

Well, after the first week back to school after Spring Break, I have found myself less motivated to do well in school than ever before. Nursing classes are interesting, but not nearly as challanging now that I have a good chunk of Critical Care RN experience under my belt. My classical guitar lessons are pretty much the only (somewhat) academic obligations I look forward to. Other things are good, though.

Work is going alright. I feel like I know the science prett well, it's just the day-to-day application of that science that gets me. Example: My patient in Acute Renal Failure status post AAA rupture is on a Nicardipine drip @ 10mg/hr to maintain SBP below 140 mmHg. I'm concentrating on titrating the drip and monitoring vitals. An experienced RN taking my patient at shift change notices that at the concentration of Cardene we are using, 10mg/hr is 100 ml/hr, quite a bit for someone in kidney failure with practically no urine output. That is the kind of thing I never had to worry about (as much) on the general neurological floor. I guess that's why ICU has such a long orientation. Also, it seems that every time you find a critical change in your patient, the very presence of a physician undoes it. The other day I had a patient who was "rapid responsed" from the medical floor down to the ICU. He was sedated for intubation. A few hours later he was still unresponsive. I was going through all the steps of the neuro assessment, voice, touch, shouting, peripheral pain, etc. and I wasn't getting anything from him. We finally persuaded his nephrologist to give us a neuro consult. The first time the neurologist talks to him, the guy perks right up. Very embarrasing. The dialysis nurse who was with me the whole time was just as surprised as I was. Apparently the sedation was just taking a long time to wear off, frakkin' Versed. Why couldn't it have startd to wear off before we bugged the nephrologist for a neuro consult?

School = lame. Pathophysiology is interesting, but not difficult because it's a mix of ASN to BSN (Bachelor of Science in Nursing) students and straight BSN students. The unlicensed (straight BSN) students have to take some very difficult classes at the same time as patho, plus they really don't know very much yet anyway, so it keeps the class at a fairly shallow level. Nursing Research is interesting, but kind of redundant. I've already had Nursing Informatics and Nursing Statistics; research is basically the combination of those two. English W233 is laaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaame. Expository Writing. I hate this class. We write pointless papers, she marks them off for arbitrary matters of style, then we redo them. I hate general education courses. Well, I'm kind of lying about that, because in the fall, for my Gen. Ed. area IV, I'm taking: HISTORY OF ROCK AND ROLL, which I am quite excited about. I'll be taking it alongside Community and Public Health Nursin (which has a clinical component) and Transcultural Healthcare (kill me now, please... can you say: fabricated interviews with my Burmese neighbors?). A total of 11 credit hours, I've become weak in my old age. The more I get tangled up in "real life" (work, babies, taxes, and such), the less important school seems, but if I want my real life to include normal hours and comfortable environs, then I had better stay very interested in school.

My musical endeavors are actually fruitful and satisfying. I'm taking classical guitar lessons with IPFW's professor of guitar studies. It's really cool. I've never practiced my guitar in such a focused manner. I'm almost finished with Aaron Shearer's Classical Guitar Technique, Volume I. Soon I shall be truly Bach-ing out.

The baby is doing well. We're at thirty-one weeks and everything is looking good. It kicked me in the head the other day, though. Angie is doing amazingly well. She has gained exactly the right amount of weight, her blood pressure is stable, and she has little to no swelling yet. She feels pretty good most of the time.

We're still deciding on when we want to move. We're going to start going to Church at Bear Lake after the baby is born, but we're not sure we actually want to move this summer. We'll probably wait another year.

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