note to self:

STOP being lame!

haha other than that I'm trying to make as many crocheted baby hats as I can before Caroline my love comes over to teach me to make knitted ones. She's a baby (hat and blankie) making machine.

my grandma

found out today that her surgery was sucessful all of the lymph nodes were clear!! All of the cancer is gone :) She'll still need to have 6 weeks of radiation but the doctor said that everything is looking good! I took all of her bandages off for her today and everything looks like it's healing beautifully.

Now keeping my thoughts and prayers with my aunt (my dad's sister) who just had a biopsy of a mass they found in her breast a couple weeks ago.

my first couple days in the NICU

Thursday was the first day of my preceptorship in the NICU at Kaiser Santa Clara. I met my preceptor and I reaaaally like her. We had two patients both grower/feeder type babies, they were soooo TINY I was in love :) She walked me through assessments and helped me with a couple feedings both gavage (tube feedings) and bottle. One of my patients was a twin born at 27 weeks and is now 32 weeks. She was having desats all day but otherwise was totally healthy and normal for her age. My other baby was a term IUGR baby whos gender was unidentifiable in utero. The baby was born with microcephaly, micro-penis (actual term), CNS hyperactivity therefore making him extremely hypertonic. So interesting. The baby was so hypertonic, his neck and back were arched at all times, he was unable to lie flat and when he was not bundled up tightly would shake constantly, looked like a really drawn out Moro reflex. The doctors did a work-up of chromosomal and endocrine studies and found that the baby was in fact a male and that the cause for many of his problems were most likelydue to his complete lack of growth hormone. His microcephaly was so severe that he was unable to produce GH. The day went very quickly and my nurse was so great about answering questions and explaining different things to me about the unit and also different patient conditions. After my nurse and I went to lunch that day she and I walked through the L&D unit so she could say Hi to some of the staff she knows. When we walked infront of the nurses station I saw my favorite nurse in the world, Stacey, and immediately she said "Mary, omg are you working here??" I couldn't believe she remembered me I was so excited! I told her how L&D was my first choice but a couple other students got it and I was really bummed. She told me she's been thinking about me and when the manager asked if she wanted to precept a student she was hoping it would be me. I wanted to CRRRRYYYYY. I was so sad. She told the charge or assistant manager or whoever was sitting there how I was her best favorite student she's had and asked if I was slow in the NICU if I would be allowed to work with her for a day (I know I'm probably not allowed but it made me feel so good that she asked!!)
Friday I showed up on the unit and my nurse was scheduled to be team leader (charge nurse). I told my nurse and the assistant nurse manager that I wasn't supposed to work with my nurse the days she is scheduled as charge. They both agreed that I should definitely stay and watch a code that was going on, on the unit. The code was for a term baby born on 9/16 and at birth suffered a stroke. The baby was stable but was immediatly taken to the NICU for observation. The next morning the baby began having seizures throughout the day and developed a cerebral hemmorhage. In the middle of the night/early in the morning the baby suffered a heart attack and developed pulmonary hypertention. The baby was intubated and put on INO (nitric oxide). When I got there the baby was so critical she was assigned to 3 nurses. The doctor had not left the bedside the entire night. The baby was on epinephrine, dopamine, dobutamine and a bunch of other drips and IV fluids. About an hour the doctor was concerned about a possible pneumo-thorax and decided to insert a chest tube (which was really interesting but sad to watch.) Throughout the morning the baby's sats were in the 30s-60s. They then decided the baby needed a Broviac in addition to the IVs and umbilical line she had in place. The pediatric surgeon came to the unit to place the Broviac and told me to pull up a stool and explained to me everything she was doing and the anatomical landmarks she looks for when inserting a central line. While doing the Broviac procedure she noticed that the baby's lymph nodes were enlarged and she and the neonatalogist agreed she should remove one and send it to pathology to determine if they reason for her declining health was due to an infection they had not yet detected. The baby was also oozing pretty badly even though she was having platelets transfused and the doctors were also determining if she may possibly had DIC.
I learned, saw and experienced SOOOO much in just my first couple days. Even though I didn't get L&D I think this will be an amazing learning experience and a way to boost my confidence working with critically ill patients.

just doing some thinking and such.

When one door of happiness closes, another opens; but often we look so long at the closed door that we do not see the one which has been opened for us.
- Helen Keller

maybe some things DO happen for a reason..just a thought :)

life :(

This week has been one of the most disappointing and sad weeks I've had in a really long time.

On Monday my grandma was diagnosed with invasive breast cancer, she'll be seeing the surgeon tomorrow to decide what she's going to do in the means of treatment/surgery etc. The breast care coordinator we spoke with said she should expect to be having surgery in 2-3 weeks. Things are moving pretty quickly and it's very scary but we're all trying to stay super positive and hope for the very best.

Also on Monday I found out I won't be having L&D as my final preceptorship. Sara and I thought she might be able to work something out but there are already too many people precepting at VMC on L&D and it wasn't possible. It sounds so pathetic but the more it's settling in I feel so upset. Seriously crying all day today...laaaaaame. I am truly disappointed and feel that it's very unfair that my experience this summer in Truckee didn't help me get the placement I wanted. It feels like I wasted my time (even though I know I didn't and it was an amazing experience.)

I'm reallllly happy to get to spend some time in the sun tomorrow and be with my nursing friends who are basically the only people who actually understand what I'm going through. xoxo

blogspot failure

Obviously I suck at keeping up with my blogspot. I guess it's because I actually don't like writing I'd rather just talk and talk and talk about things instead but I am going to actually try to be good at this thing now. I'm home from Truckee and it was the most amazing experience I've truly ever had. I feel grown up now and seriously ready to get done with school and do what I now know I really want to do. While I was there I saw about 10 deliveries. Towards the end of my preceptorship I was doing everything :) Adjusted pit rates, documented FHTs and toco readings, interpreting (with supervision) decelerations, started about 15 IV's, put in about 7 foleys/straight caths, gave more IM injections than I can count, did soo many assessments, charted like a crazy person and was seriously helping out in some very scary deliveries. One of the babies started having a huuuuuge decel (like into the 40s for almost 10 min). The doctors thought it was because the baby's head was being squeezed so they just had her push and deliver the baby vaginally like they were planning. Well AS SOON as the baby came out so did the most blood I've ever seen. The doctor called a code, the baby was WHITE..not blue not pink..WHITE and totally toneless and not crying or breathing. APGARS 1, 1, 3. Mom was totally bleeding and baby looked terrible. I knew right away it obviously was not just the head being squeezed but a placental abruption. So scary. So the code team came in and everyone..EVERYONE left with the baby..the OB, pediatrician, all the nurses and left me in the room alone with a hemmorhaging mother who had not yet delivered her placenta. She's crying, freaking out because her baby basically looked dead and I'm freaking out on the inside because all I see is blood gushing out of her. So I did the only thing I knew to do and opened up her Pitocin all the way and massaged the absolute crap out of her uterus (such professional terms I know..) Her bleeding almost stopped and finally a nurse came in to deliver her placenta which was going to be really hard since I basically firmed up her uterus and clamped shut her cervix. As the nurse was delivering the placenta soooo much more blood came out and she told me to run and get the hemmorhage kit. Mom ended up being okay. They decided to transfer the baby to Reno so it could be cared for in a NICU and recieve blood transfusions and lots of monitoring. The husband left with the baby and the mom was understandably so upset she asked me to stay with her until her mom got there. I was there from 7am-11:30pm quite the day but I learned sooo much most importantly that I can work effectively under pressure. All of the nurses and 2 of the doctors told me how impressed they were of me and how I really proved myself on the unit. It made me sooo happy. The mom called the unit a few days later asking to talk to me and told me the baby was in the NICU but was going to be able to go home in the next couple days. She also told me how she was really surprised I was a student and how comfortable she felt having me there. Made me feel pretty damn good :)

Truckee ended up not being so lonely at all after all. Jaimee and I got so close again. I've missed her and we totally rekindled our friendship (soo corny I know) and spent every waking minute together when we weren't working. I wasn't bored at all. I learned to kind of love hanging out alone and being outside taking the longest walks of my life and laying out on the lake whenever possible. It is impossible not to fall in love with Tahoe, it is seriously gorgeous.

Besides all the nursing stuff going on I just had a really great couple days. Friday I saw step brothers with my mom and sister and Sex and the City with my friend Dana. Dana and my goal for the summer was to watch every epidsode of SATC and we did it hahaha (what an impressive accomplishment huh?) The movie was awesome and I'm depressed that my sex and the city summer has come to an end lol. Saturday Jaimee, Hilary, Lisa, Dana and Lisa's little sister and I went to the John Mayer, Colbie Caillat, Brett Dennen concert and it was SOSSOSOSOSOSOSOSOoooo good. I loved every second of it and had the best time with my friends. I'm leaving to go to Tahoe again for a week on Saturday and I better get to see you (Caroline and Tricia) before I leave. I seriously really miss you. Ok thats all for now. xoxo

my 1st week as a NON- l&d nurse.

This week turned out slightly different than expected. But before I start bitching about how I did not see even one delivery or how not one person was in labor during any of the 36 hours I've worked the past 3 days I want to say that I really actually love it. The nurse I've been working with is amazing. All of the nurses here are awesome. I have truly loved my 1st 3 shifts and seriously can't wait to work more. I've learned sooo much and I've feeling more confident than I was going into this experience.
So basically so far I've done a zillion mom/babe assessments, 5 hearing screenings, passed meds (vicodin, darvocet, motrin and colace..big freaking deal), d/c'd a couple foleys and IV's, done a bunch of education etc. I am literally working post partum right now. During the down time I'm learning to read every kind of strip imaginable, watching a bunch of videos on breastfeeding, natural birthing etc (they are very hippie and al natural here, it's awesome), learning more in depth about PIH, HELLP, GDM and how to do a correct vag exam. Also, a couple moms came in to be monitored for diff reasons. One was 22weeks and came in on the 4th when she was hiking to go watch the fireworks and tripped and fell on her stomach. She felt a gush of water and couldn't feel the baby moving anymore. It was really sad and she was SO upset so we did a urine sample, set her up on the fetal heart monitor and the Dr came in to do an ultrasound to check fluid levels.
This hospital is super small, the OB unit has 3 labor rooms and 4 mom/babe rooms. I was talking to my nurse about how frustrated I was that no one has been in labor on my shift and she said that I will definitely get to see a bunch...so we'll see. I changed my schedule and I'm now working on Monday during a scheduled induction for a multipara mom so I should def be seeing something then.
Well I feel like I'm rambling on about nothing, just thought I'd fill you in on my totally un-eventful week. I'll get back to you on how next week goes ;)