Cardiovascular Recovery Unit

Umm, yes, please, I'd like to work with children. Thanks.


Today was my first hospital shift/experience of my senior year. This clinical was for my Preceptorship class on the Cardiovascular Recovery Unit. Patients come to this floor after they have open heart surgery to recover before they are transferred to another unit. And boy, what a day! There were only two patients on the floor (the floor has only 6 beds, but surgeries are done only on weekdays), who were transferred to another area, meaning that our floor could closed down for the weekend (again, because there are no surgeries on the weekends to have to stay open for). My patient had a CABG (pronounced like "cabbage"), or Coronary Artery Bypass Graft. In this surgery, a vein, usually the saphenous vein from the leg, is taken to form a "bridge" over a damaged area of the heart in order to restore bloodflow. My patient was so sweet and recovering well.


I realized today that I was still in CNE/Neonatal mode. For example, yesterday in our critical care lab, I was asked how many mL's of air to put into a patients NG tube (the tube that goes in their nose, down to their stomach. You push in air, and if the tube is correctly placed in the stomach, you can hear a burping noise over the stomach through your stethoscope) and I was close to saying 2 cc's, when I realized that that was the NICU in me talking. The adult answer is 30. THIRTY?! Gee whiz, that's a ton! So anyway, today on the floor I got slapped with a giant brick wall of reality with flashing lights that said, "now you're a nurse, not a CNE".


But I learned a few new things, and was even able to do my very first central line dressing change on a real human. If you remember back when I did my IV lab, a central line goes directly to the heart. My patient had the kind that went into the jugular vein on the neck. Changing the dressing, and doing so in a sterile manner, is important for infection control.


I also learned how quickly I can forget about the noises adults make when they cough up phlegm and mucous from their lungs.


Now, today was a "slow" day since both patients were a few days out of surgery. If I'm there when a patient comes directly from a procedure, I will be able to see and do a lot more. Not only will I be able to see a 4-6 hour open heart surgery, but I will be able to care for the patients afterwards, when they have breathing tubes, chest tubes, drains, catheters that go in their neck and run half-way through their heart.... lots of learning opportunities to come, I'm sure.


But raise your hand if you think spit is more cute on a baby.

Two For One

This post is actually going to be two posts. Why only write about one topic and then have to wait a few days to write about another when you'd rather just write about both, right now?

Ok, the first post is titled "No More Babies"

Hello Johns Hopkins NICU! I miss you.
I miss the 35ish babies that were there when I left, and I think about them.... probably every day.

Last semester, I signed up for the Critical Care Program. This included taking Preceptorship this semester, where I follow a nurse at our local hospital for a total of 90 hours. I signed up for the Intensive Care Nursery and hoped hoped hoped I would be assigned a position there. Guess what. While waiting for news of where I would be placed, Hopkins spoiled me. I now crave the 45 bed unit of the cute little ones. But, I figured the ICN here (20 bed spots?) would help me to see if I was really fit to be a Neonatal ICU nurse; the fact that the majority of the patients here are not as critically ill as those at Hopkins, I figured that I would still enjoy the experience. (I am NOT saying that the Neonatal ICU here is not good, but it is not a level 1 NICU, and I really enjoyed the cases that Hopkins dealt with).

Well, today we got our assignments, and I am in the Cardiovascular Recovery Unit. At first, I was bummed that I would not be working with any babies, but I think I will enjoy my time in the CVRU. I hear that it is a very interesting floor, full of learning opportunities. And, bonus!, this class has no class time, we just go to work and write journals about our experience after each shift.

Ok, the second post is titled "Today, We Celebrate"

Celebrate what? Eating. Food. Eating whatever I want, and whatever I can, for dinner tonight. Only Mom and Aunt Beck-a-Roobie can truly understand what I mean when I say that I don't like Blessed Herbs. 5 days of no food is too much, man.

So after class today, I stopped at Sonic's, just on a whim, and got a Caramel Mocha Java Chiller. Or something like that. It was gone within a few stop lights. I did show self-control when I only scraped the lid with my finger and not the whole cup.

I've been planning what I would eat for dinner ever since I knew I would be doing this whole fasting thing. I thought;
"Pizza?", yes.
"Mac and Cheese?", yes.
"Mexican?", yes.
"Bacon Cheesebur... Ok, wait. Don't go crazy April. Get a Domino's PASTA BREAD BOWL!", yeeees. Another bonus - it comes with a free chocolate lava cake.

Now I'm normally all about healthy, pizza on a sprouted grains crust, but tonight I'm going for the un-healthy, non-organic three cheese mac and cheese in an oven baked pizza crust.


It was everything I'd hoped it would be.

Tomorrow? It's all back to my favorite diet and yours, RAW.

Senior Year Begins

I'm back in Lynchburg, ready to begin my last year at LU. I have finished moving into the new house, which is really starting to look nice! Pictures coming up soon.

My classes don't start until Tuesday, but I already have a clinical for my Critical Care class on Friday. I don't know why I always imagine having a week off of clinicals in the beginning of the semester... it never happens. This clinical will take place in our brand new Critical Care lab from 12-3pm! I don't know where I'll be in the hospital for clinicals yet, my first choice being the ICN (Intensive Care Nursery, a.k.a Neonatal ICU), but hopefully I will find out more during lab.

Also, we have found a third roommate! She will be moving in tonight!

So Much Time, So Little To Do

Scratch that, reverse it.

Once I get home from my last summer shift in the NICU tonight, 'round 8pm, I have to start packing up to head back to LU! Luckily, the majority of my packing is clothes and random odds and ends. Mom, Dad, and Matt are home now packing up the big items, like my couch, loveseat, chair, and dresser.

I haven't begun packing anything yet, and we leave tomorrow at 6 in the morning! I'm excited to go back, and hoping that this year will be a lot more relaxing than last!

Thursday, A Long Day

My day today began at 5:00am when I decided to hit the snooze button 7 times. I started getting ready at 5:28am and was out the door by on minute before 6. I was planning to stop by Dunkin' Donuts for a bagel but accidently took a really slow route (which I never ever take to get to work, boy I guess I was really tired!) and ended up just heading straight to 95S. Once I got to work, I finished taking my medications and headed out to wash my hands, under my fingernails, and up to my elbows. It's 7am.

Head into the nurse's station and print out the census. 31 patients. 14 empty bedspots.
Check the census to see who is receiving formula and who is receiving breastmilk. Go to bedspots of babies of whom we don't know which feeds they are receiving and figure it out/place breastfeeding info packets at the bedside. It's 7:20.

Check the emergency equiptment: 3 emergency bags, 3 crash carts, transport monitors are plugged in, transilluminators for IV access uses are plugged in, EKG machine is working and full of paper and electrodes, defibrillator is working and has pedi-pads, adult pads, gel, and paper. Sign my name, It's 7: 35.

Walk around to see if anyone needs help. Help take pictures of a baby, ones that look really nice. Our printer is broken. Head over the the NICU offices to put the pics on the computer but the printer paper doesn't work, too grainy; not as good as they should be for the parents. Go to Labor and Delivery to use their printer, pictures look nice. Receive info from the L&D nurse on professional photographers that give their time to capture last memories; God is good, I've been trying to think of ways to ensure beautiful pictures for families, and He layed out my day so that I could pass such info along to our nurses in the NICU. Place pictures in memory box. I've stopped looking at the time.

Notice a baby de-saturating, turns out she spit up, so I change her shirt and blankets while I talk with her. Run an IV through tubing. Start to make name tags for babies who don't have one yet. Almost lost my goldenrod color crayon, which is the perfect color for winnie the pooh and lions. Watch and listen as doctors make rounds. Go to the storage closet down the hall and get a pop-top isolette, grab an incubator, two IV poles, and set them up in empty bedspots 32 and 14. Grab some fruit from the cafeteria. It's 11am.

Grab the elevator key and run to open the elevator for a baby going to the OR. Help prepare a baby to go to MRI. Each of the 3 IV lines need extension tubing so the metal IV pole can be outside of the MRI room. Run down 3 floors to MRI to grab 9 packs of extention tubing, run back up to the floor and run the fluids through. Un-plug the baby's bed and IV pole, grab extra blankets and diapers, get suction tubing for the baby's breathing tube, get the emergency bag, call the nurse practitioner and let her know we are leaving for MRI. Help the nurse, Nurse Practitioner, and two Respiratory Therapists to MRI. It's 3:00.

Get back from MRI. Its 5:00.

Put 15 or so sets of vital signs in the computer; we took vital signs every 5 minutes while at the MRI procedure. It's 5:20.

Go to "lunch" break until 6.

Re-stock emergency bag with what was used at MRI; a 1mL syringe, a needle, and some syringe caps. Help by getting vitals on 2 babies. It's 6:55.

Go to my locker, head down the escalator. Go home. It's 7pm.

Get home at 8. Exhausted. Don't even feel like typing full sentences.

And Matt didn't save me any pizza for dinner. "Not a slice", he said.

That's ok, I can't have pizza anyway.

The Countdown Begins

I am 8 days away from returning to Lynchburg and my final year at Liberty University! These past 3 years of college have gone by so fast, and it's hard to believe that I will be graduating!

I just received an e mail from my 3rd roommate. It turns out that she is unable to return to school this semester. My other roomie and I will be on the lookout for a third roommate. This was unexpected, but I'm sure it will all work out, and we hope our friend can return for the second semester.

I have 7 days to go in the NICU. This summer has been amazing. Johns Hopkins is such an exciting place to work. I have seen so much and been able to spend my days holding and caring for adorable little ones. God's incredible design is so evident in the small 24-weekers we admit. These early babies are amazing to watch grow outside of the womb, and the medical doctors and nurses have so much knowledge of how to help the babies develop. There is one little baby that came to us at 24 weeks and is now 2 months old. The baby is growing and improving so much and I love knowing that it was God who sustained him! There are so many other amazing things to be seen, and it shows me how God's design for the human body is perfect, and that any alteration in the body's systems causes a problem of one kind or another. I will miss being able to learn at our nations #1 hospital while I'm back at school! Thankfully, we at LU are able to work at great hospitals with fantastic teachers.

This year, I will be the photographer for the Liberty Nursing Student Association. Heather taught me how to set my camera to take a great picture. Thanks Heather!

Keep up with everything we are doing this year at www.lunursingstudents.blogspot.com, or you can follow the link to LNSA on the right hand section of this page!