My Last First Week of School...Ever?

I'm exhausted. And the semester has barely started! Last week was a week full of orientations.  Monday was spent at the Children's Center where I will be doing part of my psychiatric rotation.  It is located in a beautiful old school (Oqquirah (sp?) School) that was built in about 1895.  It has been remodeled the last few years and it absolutely gorgeous.  The Children's Center is a place when children are enrolled in preschool where special attention is placed on their individual needs.  They serve populations that either have autism, learning disorders, an array of psychiatric disabilities, or are victims of abuse or severe poverty.  I started in one of the classrooms the first day, along with 2 other of my classmates.  Good grief.  The class was made up of 7 boys, and I have never seen such destruction and foul language in my life.  The worst combinations of swear words were thrown around, along with punching, biting, and kicking.  Some would retract and be sweet for awhile, and then they would turn and be angry and out of control again.  One of my classmates is a 50-something year old man who is very loveable by children because he is quite like a child as well.  One of the kids asked him if he would be his daddy.  Unfortunate.

Tuesday morning was spent being oriented to 5 West at the U Hospital.  It is the inpatient psychiatric ward.  In movies, they portray psych wards as white walls, completely barren rooms, blinds enclosed within window panes, group rooms with music therapy where characters might be rocking back and forth uncontrollably, and nurses dresses in white suits and hats.  Well, all of this was exactly the same here except for the white outfits.  In fact, you are prohibited from wearing white at all on the floor because of the anxiety it causes the patients.  The majority of the orientation was spent going over self defense techniques and what to do if someone comes raging at you and has you in a choke hold or has your hair.  Scary.  I do three clinical days there, and I am pretty scared but it should make for some interesting blog posts.  Stay tuned.
Wednesday was just class, which was quite boring.  But Friday was my first day on my Capstone on the Infant Medical-Surgical Unit at Primary Children's.  I met my preceptor, Andrea, and I am very happy with her as my teacher.  I am her 3rd capstone student, and the two prior ones are all working on the unit now with her.  She is only about 25 years old, graduated from BYU, tightly curled brown hair, glasses, and a quirky personality.  She is a great teacher and the entire unit was so welcoming.  By the end of the day, I really felt like I had a new group of friends!

My patients were great to start out with.  One was one day post op Craniectomy.  The mother was an Indonesian woman who came to America 4 years ago, fell in love with a white man, got pregnant, and the man fled a week later after her delivery.  Welcome to America.  Apparently we breed a lot of awful people.  But the Indonesian mother was so gracious and kind, and I felt very sorry for her.  Her daughter needed the surgery because her fontanelles closed prematurely (not really linked to anything, just happens occasionally), and the pressure of the fluid within the brain would cause damage if this wasn't done.  The baby girl should recover great without any disabilities, and she was an easy patient because she mostly slept due to being on morphine, lortab, and Tylenol.

My other patient, Brenda*, was a 6 month old dream.  I completely fell in love with this little girl.  She was gorgeous and she seemed to connect with me more than any other medical staff, and her mother told me that Brenda's aunt had the same kind of red hair.  Brenda was there because she had stopped taking in fluids by mouth 3 months ago.  They had been doing different things for her, mostly giving her nutrition through a nasogastric tube, and she was here to run tests and do something final about this.  Three months ago Brenda had surgery to remove a lump on her forehead and was intubated for the surgery.  They believe that the intubation might have caused the difficulty for Brenda to swallow.  I was up and down the hospital with Brenda taking her to different radiology studies and swallow studies.  It was not a fun day for her.  She had to be straight-jacketed for many of the tests so they could get a good shot of what was going on inside, which made Brenda very mad.  The medical team concluded that she was in fact aspirating thin liquids into her lungs, and would need to start a thicker diet somewhat soon, but would need a nasal-jejunum tube for the time being.  After all was said and done, Brenda had had enough by the time it was an hour or two left in my shift.  She would not stop yelling and crying.  Her mother couldn't console her, and I knew her mother was exhausted from being in the hospital.  She came out to me exasperated and asked if she could just leave for awhile and have me hold her.  I told the mom that she should take as much time as she needed and she shouldn't feel bad at all for needing a break.  I couldn't imagine going through that much emotional stress and seeing your daughter go through that much, with no sleep, 4 hours away from your house, and having 2 other girls at home.  Brenda and I danced through the halls (literally.  For some reason, Brenda would only stop crying when I would start singing and chaseeing through the halls with her IV pole) and through moving her around in the halls and her bed through assessments, her IV line came out.  You can't feel it because it's just a bendable plastic tube, and once I saw it laying in her bed and looked down at my nursing uniform, I had a softball size of blood on my white scrub top and a pool of blood before.  The thing with blood is that it looks like a ton, but the patient wasn't in much harm.  It was just messy.  And she had just had a blown out diaper from all the barium contrast we had to load her with.

Needless to say, I didn't get out of my shift on time and my scrubs are pretty much ruined.  But I don't care.  I was too much fun to just rock little Brenda (little because she was failure to thrive) and attend to the other patients.  I took on one more patient in the late afternoon as well who was 45 days old but only 7 lbs.  He has RSV and I called him Benjamin Button because he looked like an old man in a tiny wrinkley body.  Man I love these kids and I love this job.  I feel very lucky to have landed this internship because from the sounds of it, it guarantees me a job when I graduate and if that is my only option, I would be more than content snuggling babies for a living.  At least for the time being. =)