Child psych unit

I had an "Alternate Site Visit" today. This is an attempt on the professors to show us more than one side of psychiatric nursing. So, I was assigned to go to the child psychiatric floor at the hospital. It was very, very hard, but not for the reasons that I expected. I expected to see kids that were completely out of control and/or medicated so heavily that they were partially sedated. Instead, I met a few kids that seemed pretty okay and a couple of autistic boys.

One of the autistic boys ran up and hugged me as soon as I walked in the room. He would then grab my hand and pull me around the floor every time he got excited about something because he wanted to share it with me.

The hard part started when I was helping a little girl clean her room after breakfast. She started talking about her family and showed me a picture of her dad. Then she told me a little about her mom and her grandparents. And finally she said, "My uncle isn't nice. He threw me down the stairs and gave me two black eyes. Then he beat up my mom." She said this in the same matter of fact voice that she had used to talk about her grandparents. I was at a complete loss for words. Later on, I got the chance to look at some of the kids charts. It turns out that this little girl had been brought into the hospital when she started trying to stab her grandmother with a steak knife. She was discharged this afternoon.

Another one of the kids had been brought in because of repeated attempts to run away from home. He even tried to jump out of a 12-story building in order to get away. Last winter he was found by a snowplow driver walking along the side of the road without a jacket or shoes on. Sounds crazy, huh? Until you keep reading and see that his father beat his mom and he witnessed it. He and his mother went to live with other relatives a couple of times, but his father always found them. His mom is currently living in a battered women's shelter, which this kid has also tried to run away from.

I was only on this floor for 4 hours, but I still got to spend enough time with the kids to see that they were all capable of being very smart and very sweet. They just didn't have the chance at home and all they had been exposed to was violence and abuse. I would have been running away or stabbing people too.

Quick update

I met with the director of the Ms/PhD program here last week. She talked me through the whole program, and how to pay for it, and how to apply. It was extremely helpful, and I've now decided that I will be applying. The program lasts 4-5 years and they only take 2-3 students each year, so I'm not sure if I'll get in but I can at least apply. I'm also looking at schools in Boston, Philadelphia, and San Fransisco. And I contacted OHSU to see if I could do their Master's and PhD programs simultaneously. Unfortunately, it sounds like I'll need to get an Adult Nurse Practitioner license, which OHSU does not offer.

In other news, I've been having a great time with my housemates. Jess continues to bake cookies every night (coincidentally, I started going to the gym again) and Jordan is rarely around but when he is we generally geek out together about health stuff or gadgets like my new iPod. I've settled in well and I really love living here.

Things are still going well with Paul and I. His parents will be in town for a little while at the end of the week, so I'll probably be meeting them. Since my schedule is completely wacky and his is completely normal we have difficulty getting a lot of time together, but that'll be changing as soon as I'm done with Psych.

Speaking of psych, I hate it. I don't really feel the need to elaborate, except to say that mental health care is an oxymoron and I'm spending my clinical time angry and frustrated. I will be very glad when it's over.

We had the tail end of Hurricane Ike come through Rochester last night. Wind was gusting up to 60mph and blew down many trees and knocked our power out for about 18 hours (midnight until I got home this evening). Luckily I was in class almost all day, so it didn't really affect me too much, still very annoying and by far the longest power outage I can remember. The only casualty was our ice cream.

Sarah and I have a plan to go to the gym together three times every week starting on Monday. We'll see if it works, but I think it'll help me a lot to be responsible to someone. Ideally I'd like to be 15-20 pounds lighter by the beginning of the collegiate cycling season next spring. That should be doable, as long as I work hard at it and Jess's cookie production slows down.

School stuff

Classes started on Tuesday. I'm currently taking Psych/Mental Health, Research, and Therapeutic Interventions 2 (aka "The Tubes and Tests Course"). On Tuesday I picked up my shiny new toy, which came with a drug guide and lab tests guide. Not that I've used those yet, but they're available. I also had my first lab, where we "learned" how to take stool and urine samples (The trick is to catch the pee in the cup!), and my first psych lecture. We didn't really learn anything in psych except about the dress code.

Acceptable professional attire includes tasteful (business style) skirts, slacks, jumpers, dress blouses, tailored shirts, turtlenecks, sweaters, jackets or blazers. Please do not wear denim, jean-like, or khaki material. Lab coats should not be worn. Footwear may be any conventional color except white. No white socks, sneakers, athletic shoes, open-toed shoes, sandals or high heels. When boots are needed for inclement weather, students will need to change to appropriate shoes for their clinical work. Book bags and coats should be placed in lockers because they are not permitted in clinical sites. Minimal jewelry is recommended (for example, a wedding band, watch with second hand, plain stud earrings). Please do not wear large earrings or hoops. If you wear make-up, please wear it tastefully. Please do not wear perfume or after shave lotion. No nail polish and length of natural nails is no longer than 1/4 inch from the finger tip.

Now, that doesn't sound so bad, except I don't wear any of that stuff. I wear tank tops, t-shirts, capris, and cargo pants. Other than that, everything I own is really formal. So, I had to go shopping yesterday. I spent way too much money, but managed to get a couple of nice tops, some dress pants, and a pair of appropriate shoes. I also got myself a pair of jeans, ordered a bridesmaid dress for Matthew and Leah's wedding, did some grocery shopping and forgot to take my passport application to the post office. Still, not bad for one afternoon with a zipcar.

Today was my orientation to Rochester Psychiatric Center, which will be my clinical site for the next 5 weeks. It's going to be interesting, but I don't think I'm going to enjoy it. Because these patients can pretty much take care of all their basic needs independently, and we're not going to be allowed to pass meds there, we'll mostly be observing. But who knows, I might surprise myself. We did get to have a very interesting discussion with three recovering/recovered patients that are now "patient advocates". They come in and talk to current patients and help them get their lives figured out. Hearing about their experiences dealing with their mental illnesses was quite amazing, especially when compared with how stable they all are now. Two of them had been homeless, one had stolen a car without realizing it, all three had spent time in prison for various charges, but now they all have jobs, apartments, and are rebuilding their relationships with friends and family. It was really fascinating, and a good way to help us remember that the patients we meet will most likely recover, even if it takes years.

Housemate bonding time

Today was so much fun. Turns out Jess and I get along very well, and we both like to bake. This could be a dangerous combination. We started today by going to the Public Market, where we both bought enough food that we could barely carry any more. Me at the market without the bike limiting what I buy spells trouble. So, once we got home, we scrounged up some lunch and proceeded to bake stuff. Jess made snickerdoodles and I made zucchini muffins and everybody got to happily eat all afternoon. Then we both took naps, woke up, and started to make dinner. We decided on black bean burgers (Jordan is vegetarian, and Jess and I are both happy to eat veggie), which had me a little intimidated at first, but were amazingly easy. We didn't even follow a recipe, just sorta made it up. A combination of black beans, crumbled toast, red bell pepper, onion, parsley, chili powder, an egg, some salsa, and I think that's it. All mashed together and formed into burger-shaped things, then grilled. They tasted like a burrito turned into a burger. We also made corn (6 ears for a dollar!) and drank some really good Oregon wine. It was a delicious dinner, and I nice way to get to know my new housemates.

I wish I could spend more time with Jordan before school starts for me, but school has already started for him so he spends most of his time studying for an upcoming neuro exam. Memorizing the parts of the brain and the names of the blood vessels and stuff. And he proves to me every day that I made the right choice by not going to medical school.

Speaking of medical stuff, I got attacked by either a nasty bug of some kind or the most potent poisonous plant I've ever encountered sometime during my visit. What started as some ugly bumps on my legs first turned into angry red splotches covered in blisters and have now become scabby, weepy, nasty and even bigger than before. I'm hoping that the scabbiness means they're healing finally. I took pictures of them, but they're pretty gross so I won't post them unless requested. And, I'm starting to find new angry red bumps on my legs and now on my forearm. I'm worried that by scratching I've spread whatever the original cause of the reaction was around. But, that doesn't make sense, since these things have been there for a week and a half and there's no way I've still got residual poisonous substances on me. I just don't know, but at least I've got access to a whole lot of nurses and nurse practitioners if it doesn't start to heal up.

Oh, last night Paul and I went to see Iron Man. I know, I'm slow about these things. But, it was really good. Tomorrow we're going to go spend the afternoon/evening at his friend Eric's cottage on a lake somewhere (not Lake Ontario). It will be fun. I've started meeting more people in the Paul/Sarah/Ronen friend group, and I like them all. And they play lots of board games, which I like even more. I was a little intimidated at first by the people at a board game night on Thursday, but managed to relax after the first game or so and actually started joining in the conversation.

I think that's it for now. I'm going to go curl up with my new Neil Gaiman book stolen from Jess (I love Neil Gaiman! Why didn't I start reading this stuff earlier?) and chill out a little before bed. Two more days of vacation...

Vacation, moving, and getting ready for school

Vacation was great. I did a lot of stuff, saw a lot of people, and had a lot of fun. Highlights include: Lauren's graduation picnic, riding the Portland Century, special dance at Tuesday Blues, and several episodes of hysterical giggling over nothing in particular. I"m not going to recap the whole vacation because most of the people that read this blog were there.

I am now moved into my new home in Rochester. It's an adorable house recently bought by Jordan and Jess. He's a second year med student and she's an elementary music teacher. They're both really sweet and we get along great. Jess and I spent the afternoon shopping and admiring our respective book collections. I've already taken a few of hers and given her a few of mine. I've also spent a lot of time playing with Heidi, Jess's cat. Heidi is also very sweet and quite friendly. She's not up to sitting on my lap yet, but she's often found exploring my room or sitting in my windows. My room is huge, about twice the size of the previous one, and they funished it for me with a bed, dresser, and desk. I've got some more organizing to do, but I'm making a lot of progress on it. There's an enormous wooden headboard leaning on one wall that I can do anything I want with. So far I've considered covering it with hooks and using it to hang stuff, or maybe sticking a shelf on it, but I'm open to suggestions.

Yesterday, after the one hour it took to move my stuff, Paul and I went hiking at Mendon Ponds. I didn't realize until visiting that website that they have a raptor rescue facility there. I'll have to check it out some day. Too bad I'm too busy to be a volunteer, I could actually put my hawk glove to use again. The park is beautiful, I can't wait to see it when the leaves have changed color. After we got back, and I took a nap, we wandered over to Sarah's to visit with them and the kids. They left today for a friend's farm so this was my only chance to see her before classes start. The kids are adorable and crazy, as usual, and Sarah was stressed out as usual, but we had a good time anyway. Then I came back to my new place (less than a 5 minute walk!) and started the unpacking process. It's a long process, and still very much in progress. I'll post pictures once things are a little more sorted out here.

Tonight I think I'm going to play board games with Paul and some friends that I may or may not have met yet. Tomorrow will be more unpacking and organizing and probably involve going over to the hospital to buy my books. In the meantime I'm going to make some dinner and try to get through some of my growing stack of reading material. It's so fun having friends with good book collections!

Life, clinicals, and almost done...

Two more days before I'm finished with one third of my nursing program. I'm almost one third of a nurse. That's a little scary.

Life outside of school has been going extremely well lately. First and foremost, the bat guys came today and did their work on the house. So, there should be no more bat invasions, and no unpleasant surprises for my incoming sublettor (sublessor? sublessee? I have no idea...)

Secondly, I had dinner with my soon-to-be housemates last night. They are wonderful! And they love to cook, and are very good at it. Jordan is a second year medical student and Jessica is a music teacher who is going back to school for a Master's in counseling. They invited me over for a "simple dinner" which included panini (on their shiny new panini maker!) salad, pasta, chips and hummus, wine, and peach cobbler. And it was all fabulous. I'm going to like living with these people. One of their friends was there too, a blind pianist from Eastman School of Music who had just returned from an international piano competition in Moscow. A really amazing guy, with a lot of good stories. The four of us got along great right from the start, lots of laughing and making plans for the house, and going on outings together, and all sorts of hilarity. I had a blast, and stayed way past my bed time on a clinical night, but it was completely worthwhile. I'll be moving into the house as soon as I can after I return from Portland.

The whole Paul thing is going rather well right now too. There was a day of canoing on the Genessee River, and some cuddling, and the purchase of a webcam for me so that we can chat to each other while gallivanting around the west coast. He's currently in San Diego at a conference, and won't get back until Friday, the day before I leave for Portland. Bad timing, but the webcam/Skype thing is pretty cool. Sarah seems to be incredibly proud of herself for managing to set us up.

Lastly, school stuff. Like I said, I'm almost done with this semester. I've determined through this clinical rotation that I have no interest in working on an ENT floor. I prefer patients that can talk to me, and so far I haven't had a single one of those on this floor. A lot of them have trachs and that makes talking very difficult unless they use a speaking valve, which can make breathing difficult. Usually they choose breathing. Also, I don't enjoy phlegm and sputum. I'd honestly rather deal with vomit and diarrhea. The whole suctioning out a trach thing is quite gross to see, but even worse to listen to. My next rotation will be Psych, on the Mentally Ill/Clinically Addicted floor. That will be very different and probably really cool. I bet I'll be longing for the patients that don't talk after five weeks of patients in withdrawal, though. And then I'm on the Cardiac Surgery floor, which I'm looking forward to a lot. Oh, and there will be a ton of classes mixed in with that stuff too. Fall is supposed to be the hardest semester of this course. Can't wait.

I think that's about it for now. I don't know how much I'll be posting from Portland, but I'll definitely be getting photos of my new place up here as soon as I can after moving in. So exciting!

Weekend update

After clinicals on Friday I was pretty well exhausted, but we had our usual Friday night dinner at Sarah's planned. So I took a nap, relaxed for a little while, and then rode over there to hang out with Sarah, Ronen, Paul, and the babies. The babies were particularly fussy that night, but it didn't stop us from having a fun evening that included a good game of Settlers.

At some point during the evening Sarah and Ronen asked me if I could babysit for them that Saturday night. Of course I said yes, they've been such wonderful friends that it's the very least I could do for them. Besides, they weren't going to need me until after the babies were put to bed. At some point after that plan had been made, someone suggested that Paul should come over and keep me company while I was babysitting. He said maybe. At some other point in the evening, I asked Paul if there was a good way to bike down to David's Bridal so I could try on dresses for Matthew and Leah's wedding. The only direct route is along a road that is decidedly unsafe for bikes. He not only told me there was a route, but offered to show me personally some time this weekend. I, of course, said that I would really like that (even though the route seemed straightforward enough) and so we planned that I would give him a call when I knew what time would work best.

Fast forward to Saturday. I had a bat proofing company come at 8am to inspect the house, give an estimate, and make arrangements for them to come back and do the actual work. After that I went straight back to bed and didn't get up until noon. Then I went about my usual Saturday grocery shopping and did some minor stuff around the house and homework. Around 5:30 I called Paul and told him that Sunday around noon would be a good time to go for that bike ride. He informed me that his possible plans for that evening had been cancelled and so he'd be coming over to babysit too, which was a pleasant surprise. I then called Sarah and asked her for a ride to her place, since I knew I'd be too exhausted to ride my bike back home at midnight. She then informed me that Paul would be coming to babysit too, at which I laughed and decided that we should just do conference calls. Around 7:00 Sarah and Yasmine picked me up (apparently Yasmine was really excited that they were going to get m and insisted on coming) and I got to play with the babies for a little while before bedtime. Paul showed up during the whole bedtime process (it usually takes about 30-45 minutes, and involves no loud noises downstairs and frequent screaming from upstairs) and eventually Sarah and Ronen got to go out for their date.

Paul and I just talked for a nice long time, but just before 10pm, Maya started crying. Maya doesn't go back to sleep on her own, so I had to go up there and do my best to calm down a very upset one year old. She finally fell asleep on my shoulder after about 15 minutes, and I got her down in the crib, but as soon as I tried to open the door and leave her room she woke up screaming again. Around the half hour mark I gave in and called Sarah. She told me to just take Maya downstairs to play for a while, and she and Ronen would be home as soon as the movie was over. She didn't realize that the movie was over 2.5 hours (they saw Dark Knight). But, Paul and I managed to keep the little baby content for as long as it took, and she was awfully cute, even though she should have been asleep. When Sarah and Ronen got home they were very grateful and Paul and I were both exhausted. He gave me a ride home, and somewhere along the way asked me if I would like to go to a soccer game tomorrow evening. I said yes, gave him a very tired hug, and immediately collapsed in bed.

Today, I had to go get my rabies shot at 10am, which took almost no time at all. And then around noon, when I'd had some real breakfast and done a little bit of homework, I called up Paul and we went off on our dress trying on excursion. The ride was fun, and quite pretty along the Erie canal. Paul valiantly stuck around while I did the dress thing, and then we rode back. He left me at home so I could get a little more homework done, and a shower, before picking me up for the soccer game. The Rochester Rhinos are not a very good team, but they're a lot of fun to watch. I don't think I've been to any pro soccer games before and I really liked it. I might even have to go again some time. We cheered, and booed, and yelled at the refs, and laughed at the cheerleaders, and generally had a lot of fun. And Paul was a total gentleman and opened my car door for me, held my hand, paid for my ticket, offered me his jacket, etc. I think this might qualify as a first date.

So, this was a very good, but not terribly productive weekend. For the next week I have to write up a nursing care plan for my assigned patient from last week's clinicals, go through a mid-term evaluation with my clinical instructor, verify the transcipt that Nami and Nina put together last week, transcribe my part of this week's focus group session, and work my W,Th,F clinical shifts. It's going to be another long and exhausting week. Only two left.