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nursing, lately

I don’t write too much about work these days since I work at a very obvious hospital and a very obvious population.  Talking about an experience with a patient who has abdominal pain is a bit less obvious than talking about someone with an oil burn to their left foot, so there’s that.  However, some exciting things have been happening in my nursing world, so let’s talk about it!

CCRN

After talking about it for about two years, I finally buckled down and studied for the Critical Care Registered Nurse exam.  It’s a test that isn’t necessary for practice, but it demonstrates that you have superior knowledge in critical care and know what’s going on under different circumstances.  You need about a year worth of hours in critical care nursing in order to take the exam, but I do think it made it easier to take the test having more experience.  That being said, the exam covers all areas of critical care and all the body systems, so for once in my life I’ll admit that it was helpful that my unit is the main ICU overflow for the neuro ICU, as I actually saw a patient go into diabetes insipidus with crazy high urine output and super high sodium levels.

That’s the only time I’ll ever admit I like neuro patients…because I don’t.  (Mainly I hate waking patients at all hours of the night for hourly neuro checks.  Whispering, “Can you tell me your name?” into someone’s ear at 3am isn’t creepy at all.)

I was so worried about taking the exam, mainly because I worry about all exams.  I used to study for a week straight for my organic chemistry exams in college, which paid off since I got A’s in both semesters.  For the CCRN exam, I used the same tactic:

photo 1 (4) Flashcards.

I still have my orgo flash cards somewhere even though I have no idea what they mean anymore.  I read through the PASS CCRN book and made flash cards out of the things I didn’t know and seemed the most important.  (Such as what types of MIs show up in which EKG leads.)  I also did a million PASS CCRN questions and read through the Laura Gasparis book from the class I took about a year and a half ago. It ended up paying off since I passed with 111 of out 125.  (Passing is 71%.)  Oddly enough, my best section was cardiac (96%…CTICU, here I come!) and worst was GI (70%).  And I definitely guessed on all the “ethicial and nursing practice” questions because the right answers aren’t what you actually do in real life.  (There, I said it.)  If any of you out there are thinking about taking it…just pick a test date and go for it.  I studied for about three weeks, so it’s not a terribly huge commitment.  (Anyone want my flashcards??)

SAFE RN

My next nursing adventure is into SAFE nursing, for which SAFE stands for “sexual assault nurse examiner.”  Perhaps I have some liking for traumatic events (because working in a burn unit isn’t full of traumatic events…), but SAFE nurses are the ones who are called in to work with victims of sexual assault when they come into the ER.  It’s a unique position compared to my usual floor nursing, as the SAFE nurse is not considered part of the medical team or the police department.  Instead, we’re solely responsible for the evidence collection including photographs of any trauma and collection of samples either through skin swabs or a vaginal/rectal exam.  The class taught us how to do these exams (speculums are fancy instruments…), as well as included talks from sex trafficking experts and a district attorney specializing in special victims.

photo (87) At work watching SAFE videos after I fishtailed my hair.  Note:  It is awkward when a patient’s family member walks in on you watching those videos…

Not that I would ever wish sexual assault on anyone, but unfortunately it happens and we need people to help these people at an incredibly tough time.  (Interestingly enough, in court you’re not allowed to mention what the victim was wearing unless it’s relevant such as “and then my shirt was ripped” since what you’re wearing or how much you’ve been drinking doesn’t mean you’re given permission to anyone.)  It will be a different angle from working on the floor, as you’re one on one with the patient with no interruptions or obligations to anyone else.  It’s a huge responsibility and allows for independent work, so I’m looking forward to it while hoping I’m never actually needed.

April is Sexual Assault Awareness Month…current statistics state that 1 in 6 women and 1 in 33 men are the victims of rape – with both numbers mostly likely higher due to underreporting.  It’s a huge problem, more so than I can simply state here.

American Burn Association

About a month ago, I headed up to Boston for the American Burn Association meeting, which is an annual conference related to all things burns.  Doctors, nurses, physical therapists, researchers, and more come from all over to present research and talk about improving care.  I volunteered for a few sessions which involved collected tickets (pretty easy for free admission to the conference…) and sat in on some presentations and talks, including research discussions from people I work with.  It was interesting to hear how other burn units work with children (ketamine and Versed for EVERY dressing change??  We give small amounts of oxycodone…yikes) and what research is being done.  Interesting but not surprising, much of the burn research comes out of military medical centers.  Nursing talks included how to standardize a precepting program so that you know a new nurse is ready to be on their own versus just relying on people saying, “Oh yeah, they’ll be fine.”

The social aspect of the ABA is also quite large, and it was fun to see my friend Amy (of Boston Marathon spectating fame) for an evening.  Another evening led us to a fancy dinner at the Boston College Club with an beautiful view of Boston.  Unfortunately, that view included the smoke from a nine alarm fire that happened that day.  A bit sobering as the Boston Fire Department lost two of their men that day, one of who had attended one of the ABA events the evening before.  It’s hard to lose a member of the burn family, but also serves as a reminder as to the power of fire and how important our work is.

On a related/slightly happier note, I was able to get out for a run in Boston.  Although I’ve been to Boston many times, I haven’t spent much time running downtown except for the finish of the marathon.  Luckily, I squeeze in eight miles along the Charles on a beautiful spring day in Boston.  It’s fitting that my run ended as a crossed this mark:

photo 2 (4)

I won’t be crossing that finish line after 26.2 miles this year, but I’m excited for those who will be doing that in a few short weeks.  It will be a meaningful day for everyone in the running community, and I can’t wait to cheer from afar.  (At work, actually!  Full circle.)

And that’s enough nursing babble for now…I know have a fair amount of fellow nursing runner readers.  Any CCRN or SAFE nurses out there?  Anyone attend conferences in their specialty?

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16

04 2014

on boston, one year later

I always say that the morning of the Boston Marathon is like Christmas morning – so many people have been waiting for this day for so long and wake up with anticipation of what the day may hold.  A year ago today, I woke up with that excitement.  It was to be my first marathon back after my back injury, the first time I would get to take on Boston with a healthy body.  I was excited and nervous – would I get that PR?  Would my legs stay strong?  Would I see Amy on the sidelines?

Never did I imagine what would happen at the end of the day.  I knew my legs could lock up, I knew I could go out too fast and I could hit the wall.  I never thought someone would inflict an act of terror onto a marathon.

Well.  Okay.  I’ve thought about it.  I remember thinking that if someone wanted to cause mass panic, the end of the New York City Marathon, with all the people and long walk out of the Central Park – that would be a perfect spot.  Call me crazy, but I’ve thought about these things.  I just never thought they would actually happen.  Why would anyone go after runners?

April 15, 2013 was one of the scariest days of my life.  Sitting in a parking garage with Amy, having no idea what was going on, how long it was going to go on, who was doing this, who was hurt, if we were even safe – I have a hard time thinking about it.  The week dragged on after that as the search went on.  Amy was staying in Watertown and gave me reports of SWAT teams combing through the neighborhood.  I was terrified for her all over again.

It’s amazing how just one day, one moment, can change a person’s life forever.  Some people will never be the same physically, others will never be the same emotionally.  But to hear stories about those affected and how they’ve overcome the challenges set before them, that’s the true strength of Boston and of the Boston Marathon.

I recently watched the National Geographic “Search for the Boston Bombers.”  I didn’t know if I really wanted to, or if I even could.  And honestly, I knew everything that happened already.  But one thing that struck me was William Evans, a Boston police commander (now the police commissioner), and his running.  He ran the marathon last year then responded to the bombings.  During his retelling of that week in Boston included what any runner would tell you – he needed to run.  In the face of everything that was going on in the city, a run is what helped him clear is mind and prepare to do more work.

I received a message this morning from one of the weekly run lists I’m on.  The run was cancelled this morning due to the rain, and one of my first thoughts on seeing it was, “Runners don’t cancel!”  We don’t cancel runs.  We run.  We run through the coldest of winters, we run through the hottest of summers.  We run in the face of adversity, we run when people tell us we can’t.  We run for the good days, we run for the bad days.  When we don’t know what else to do, we run.

I have such mixed opinions about not going to Boston this year.  (It’s also Easter weekend, so I couldn’t get off work.)  Actually, I don’t have mixed opinions…I want to be there, and I’m so, so sad that I can’t be.  A few weeks ago, I was up in Boston for a work conference, and I ran by the finish line.  I’m excited for everyone running Boston this year, especially those affected by the attacks, for those who didn’t get to finish last year. 

477

Last year I finished a post by saying:

The running community, the runner family, is a great one.  I know we’ll run strong and that we won’t be deterred.  Runners will still run Boston, and spectators will still cheer at Boston.  As a runner, as a nurse, my heart breaks for those injured, for those killed from this event.  An amazing event was ruined on Monday, but it will not be the end of it.

As runners, as spectators, as a running family, we are strong.  We are strong in that final 0.2, and we will be after as well.

Boston 2013 is a year I will never forget.  But Boston is for runners, and it always will be.

Because it’s true.  Boston, its runners, its spectators, its people, is ready to show the world that runners will run, and that Boston is for runners.  Runners will run Boston with a little more purpose in their stride this year, one that shows how strong a community we are, how we come together for one another, and how you can’t bring us down.  Good luck runners – I can’t wait to cheer you on.

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04 2014