October 2011

Well after 52 job applications, three interviews and many, many rejection letters, I have officially entered the realm of gainfully employed. I truly feel like I hit the jackpot with this job and at times find it hard to believe it’s true!  I have been hired into a full time RN residency position with 11 other new grads. I was the only one selected for the coveted ICU position. I know there were tons of qualified applicants, perhaps some more than me… I am not taking the job for granted, and I’m working my butt off to succeed and learn everyday. First hour on the unit I observed a Code Blue, and saw tons of new equipment and diagnoses… This will be a fun place!

It’s official

I am employed at Harrison Medical Center in Bremerton, WA. They hire new grad nurses once or twice a year and run a Versant Residency program. It is an evidence-based program designed to transition new grads to the real world. It is evident that they have invested time and money into this program, and I am excited to work for a company that values it’s employees.

Kate and I have bought a house in Gig Harbor, and with the extremely generous help of family and friends we’ve completely remodeled a run-down old house into an awesome first home! The nursery is nearly ready for Baby Teodoro due on 11-11-11.

OR coast trip

As I talk with other new grad RN’s from many other schools, I am still thankful I chose Regis’ ABSN program. Some people still can’t believe I went through a one year nursing program… They find it hard to believe such a short time could prepare me.

I feel that I am prepared as much as possible for my new job…and I really don’t have anything bad to say about the program!

With no care plans to write, I have time to go kiting on my days off! Seattle, WA

After working for a few weeks, there are certain topics from school that come up over and over again. If you’re in school, my recommendation is that you really put in the effort to learn and be competent in the following:

Labs:  These come up constantly. Knowing normal and abnormal levels are important. But more than memorizing values… know what they mean! Know the basics like CBC’s and BMP’s… but also spend time with liver function tests, lactic acid, amylase and lipase, troponin, CK-MB, etc.  You will see them over and over, and will understand your patients better.

Fluid/Electrolytes: Nearly every patient has fluid and/or electrolyte imbalances.  Know signs and symptoms, interventions, and causes.

ABG’s: Know the values, how to interrupt them, and what to do about, say, uncompensated respiratory alkalosis.

Assessments:
No matter where you work, you will be doing multiple assessments everyday. Get good at them, know how to describe lungs sounds, heart sounds, check the skin and be accurate!

Meds:
Everyone gets them… you need to know what and why you are giving each medication!!

Skills: NEVER turn down learning opportunities! If you are with a nurse or preceptor and they ask if you want to practice a skill… do it! You may be nervous, but they’ll walk you through it. Practice makes safe patients.

While nearly everything from school has been applicable, during my vast three weeks of experience, these are the topics that have come up constantly.

A great read… which may turn into a future career opportunity!

I have gotten some emails from current and prospective students, and love helping out any way I can! So continue to email me or comment on here.

August 2011

It’s been much too long since my last post… there is a lot to catch up on, so here goes!

Graduation: Graduation and pinning were great to be at. The tradition of pinning goes back a long ways, so it was fun to be a part of it. I had Kate pin me because without her I wouldn’t have made it through nursing school! I also got to give her belly a little rub onstage, a not-so-subtle way of telling my class that she’s pregnant! Due 11-11-11. Very exciting.

This graduation weekend was a fun time to hang out with friends from nursing school, as many people were leaving Denver and going their own ways. It is pretty weird to have gone one year with these people, side by side, nearly everyday, and knowing that most I will never see again. Many, though, I developed great relationships with, still keep in touch with and will make an effort to see in the near future. I am thankful for every person I got to meet along the way!

 

Final breakfast with fellow nurses before I took off.

Kate and I moved to Gig Harbor, WA. This is the town we grew up in, and always knew we wanted to return here someday. We figured with a baby on the way, there was no time like the present! Moving back meant time with family, friends, and more studying!

NCLEX: Just after graduation, I took a NCLEX review course. It was our entire nursing education compressed down to 4 days of focused review. I would estimate that over half of our class took a review course of some kind, and most found it helpful. I’m glad I did it, though it was tough coughing up the $350. It gave some excellent guidance for studying for the NCLEX.

For the past year, 90% of my studying was with other people. Now here I was in WA totally on my own! My chosen method of studying was practice questions. I think between graduation and NCLEX I took upwards of 4,000 practice questions, studying the rational for each one. I enjoyed studying this way. Whenever there was something I wasn’t clear about, I would crack open the books and read about drugs, physiology, diseases and everything related to the question. I had fun going off on those tangents, sort of a way of procrastinating, yet studying at the same time.

 

Had to take a study break to go four-wheeling at the sand dunes in Oregon.

I drove to Seattle early one morning and sat for the exam. I’d be lying if I said I wasn’t at least a little nervous going into it. This was a very difficult test, no way around it. You don’t know if you’re going to be sitting there for 75 questions or 265. The computer adapts the questions based on your responses. They get progressively harder until it has determined that you are competent (or not) in each subject. Well I finished the test with question #75, but felt terrible. I was confident in about 20% of my answers, and there were questions involving drugs and diseases that I have never even heard of! But after a couple jittery days of waiting, I found out I passed. Apparently I did learn something in the last year.

 Job Search:

Interview #1: I was excited to pass my test, because just a couple days later I had an interview at a local hospital for an ICU position. Interview went great, I was happy with my responses and questions, I got along great with the 4 people that interviewed me and left feeling confident about the job. The next week: Sorry Brett, we hired someone with nurse tech experience.

Interview #2: Local hospital. ICU. Great interview, good conversation, more confidence about this job. The next week: Sorry Brett, we hired an internal candidate with more experience.

 

New hospital in Gig Harbor, WA… despite what it looks like, it has been a beautiful summer in the NW!

Starting to notice a theme here? Yea, me too. I’ve been out of nursing school for 3 months, have applied to 41 jobs, had 2 interviews, and am still unemployed. (Though I do have another interview at a different hospital this week). I don’t want to sound conceited, but I feel like I am a competitive candidate with 2 bachelor degrees, great GPA, positive, outgoing, passionate about nursing and life, motivated to learn and succeed etc, etc, etc. Take home message folks: experience and networking.

In Denver I had many great contacts. From my first clinical I went out of my way to meet everyone I could at every hospital, and I made sure they knew me. I worked my tail off because it was fun, and because I wanted potential employers to know my work ethic. I am confident this would have benefited me had I stayed in Denver. Not so beneficial moving to the NW. I knew it would be challenging to make connections up here, but not this difficult. In my frustratingly clear 20/20 hindsight I would have been calling and emailing recruiters long before graduation.

The other aspect, experience, is a tough one for me… But there’s nothing I can do about it now. There are people in my class who were able to work for the last 4-6 months of the program… just 4 or 5 shifts a month as a CNA. While I can’t officially condone this, these are the people with jobs. My take on the matter is that in the accelerated program I had clinical 2 days a week, nearly every week for a year. That’s 0.6 FTE on top of full time class. If that doesn’t count as experience I don’t know what does.

There are a number of people in my class who have gotten jobs… Some in Denver, and some out of state. Many are working where they did their senior practicum. These are the people who were proactive in networking throughout the year. These are the people who worked hard and are great nurses! I want you to read this not as a frustrating reality, but as motivation to be a great nurse, and to sell yourself along the way!

 

I think it’s important to be realistic about the fact that after graduation it is not uncommon to go quite a few months without a job. Some are hired before they graduate, and some are actively looking for up to a year with no luck. The new graduate nursing industry is very unique, and can change over night. I just wish someone had told me it could be quite sometime before I start working. I know I will get a job, no question about it. I have never once regretted a career in nursing. My biggest gripe is that I miss being in the hospital! It’s fun, challenging and rewarding!

I think it’s important to be realistic about the fact that after graduation it is not uncommon to go quite a few months without a job. Some are hired before they graduate, and some are actively looking for up to a year with no luck. The new graduate nursing industry is very unique, and can change over night. I just wish someone had told me it could be quite sometime before I start working. I know I will get a job, no question about it. I have never once regretted a career in nursing. My biggest gripe is that I miss being in the hospital! It’s fun, challenging and rewarding!

 

Enjoying some time off kiteboarding at Hood River, OR

May 2011

After my last clinical

 

Senior practicum is over.  Capstone presentations have been presented. Exit interview is completed. The only thing left for Regis University’s Accelerated BSN May 2011 cohort to do is to get pinned on May 6^th, 2011, and graduate two days later!

Elizabeth got a rose for each student and said something personal about each one of us and how we impacted her year. (Notice she had little baby Jack halfway through the program)

 This has been a wild ride. 44 graduates. 15 classes. 7 clinical rotations. 6 hospitals. 756 hours in said hospitals (not counting many, many more hours arriving early, staying late, and prepping the day before). 486 cups of coffee. 97 redwood trees worth of printed powerpoints. 3 bicycles(1 stolen, 1 crashed, 1 still rolling). 2 non-school related trips to the Emergency Department. 211 days of my alarm clock quacking at me in the 5 o’clock hour. 422 snooze button pushes. All of that funneled into a couple short lines on a resume, a “BSN” after our names, and the opportunity to take a nail-biting, ulcer-inducing exam in the coming months.

Is that all this past year and $xx,xxx.xx was for? Not to me. This has been the most productive year of my life. I’ve learned about the body, about diseases processes, about medication and how they work. I’ve learned how to communicate with coworkers and other professions in the hospitals. I’ve learned how to organize and prioritize. But most of all, I’ve learned how to care for patients. How to assess, anticipate, comfort, intervene, and laugh with my patients. When I applied to nursing school I didn’t know the first thing about what nurses do day to day. However, everyday I went to clinical I was further confirmed that this is the right career for me. After 3 shifts in a row, tired, hurting, hungry and missing my wife, I still smile on my bike ride home, thankful for the place I’m in, what I was able to do and experience that day, and for the people I met.

Someone had the idea to draw a heart and have some people write/draw anything they wanted about nursing.

As I reflect on this last year, well, 2 days shy of 1 full year, I couldn’t be happier with my choice to go to Regis. This is a HUGE THANK YOU to: Professors. Lab Instructors. Clinical Instructors. Nurse Preceptors. Fellow Students. Study Buddies. Administration (who work their butt off to keep the machine working). Cleaning Crews. Hospitals. Patients. THANK YOU! You all have made my experience a memorable and positive one. Because of all of you, the bar is set high and other nursing schools are continually striving towards your standards.

We had about a week and a half or so between finishing school and our pinning ceremony. It was not a wasted week. Myself, Colin, Dylan and JJ took a trip through Utah and a quick stop in Nevada. I didn’t know any of these guys a year ago, but our friendships are a testimony to the closeness and camaraderie of the ABSN program!

Calf Creek Falls

 This is NOT the end of my blog… I’ll be posting until Regis tells me to stop and gives me the boot! I’ll be keeping you posted as I study for the NCLEX, take the test (hopefully only once), apply for jobs, and maybe even get hired! I’m still here to answer any questions you have! And I actually met the future ABSN blogger, ran into her at St. Joe’s…. I’ll just say this…you readers are in for a treat, she’s awesome!!!

That’s all for now. Time to go to a BBQ with the graduates, pick up my parents, and get pinned!

Four future nurses

April 2011

 

Last day of Med/Surg II… Megan, Courtney, Me, Lindsey, Kember

Greetings. I had a question from a soon-to-be nursing student asking whether or not 12 months is enough time for a nursing degree. It’s a valid question, I’ve gotten some cross-eyed looks from people, especially in the medical field when telling them I am in a one-year nursing program. As I sit here closing in on graduation in a couple weeks, I’m convinced this program is more than adequate.  We had to take a lot of pre-requisite classes before even applying to Regis. These pre-reqs, especially anatomy, physiology, and microbiology are the foundation of any healthcare career. The ball is already rolling months or even years before starting the 12-month countdown.

The guys playing bocce bottle between classes

From the first day of class in Regis University’s accelerated BSN program I have lived and breathed nursing. The only classes in the program are ones directly applicable to molding us into great nurses. There’s no English, statistics, or racquetball classes in this short year. This has allowed us to focus 100% on nursing; no other topics are competing for our attention. I haven’t had a job for the last year. Regis discourages working during the program. I know, there’s that whole money issue, but having the responsibility of a job would have directly had a negative impact on my education. For one year I have dedicated 99% of my life to learning how to become the best nurse I can be.  I think about disease processes, I see people in the grocery store and try to guess their diagnosis. This is the route my train of thought takes: I see a commercial on TV for an antihyperlipidemic medication… I think about it’s mechanism of action, it’s side effects. I then think about why the guy in the commercial is taking Lipitor. What are his HDL, LDL, and triglyceride levels? What are the normal values? What effects are increased values going to have on the body? Will the cardiovascular system be affected? Coronary Artery Disease will likely be part of this guy’s history. He’ll likely have decreased perfusion, causing many problems. What are the signs and symptoms of an MI? If someone has an MI in the hospital, they need MONA: Morphine, Oxygen, Nitro, Aspirin.  If this guy on TV started having chest pain, shortness of breath, etc. what would I do? If he dropped to the ground and I found no pulse what would I do? Compressions. Then I think about the new rules of CPR… C-A-B, not A-B-C. Interesting. Next I go and look at the evidence and research and figure out why the regulations have been changed. Phew! This is how I learn. I don’t memorize, I associate, connect ideas and understand the ‘why’ behind the question or situation.

Peri-Op day… In an operating room

Whether a one-year nursing program or 4-year traditional style, a massive chunk of the learning curve will be attained on the job. I have been incredibly thankful for the education I’ve received at Regis, and will greatly miss the school environment after graduation.

Friends in the program on an afternoon off… will certainly miss these people. I’d let any of them take care of me in the hospital!

Senior practicum has been such an awesome experience. It is a culmination of everything we have learned. I work with a preceptor, whatever her schedule is, that’s when I work. Everyday I gain more confidence in myself as a nurse. I have an entire team of nurses I can turn to with questions or when I need help. I love the team atmosphere. I’m on a med/surg floor at St. Joseph Hospital, a place I have come to love after spending 3 rotations there. I walk through the halls and see people I know, and people know me. I love the hospital environment. More confirmation of my career choice everyday!

Working for the last few weeks on a nurses schedule allowed us time to visit Aunt Mary in Santa Fe, NM

March 2011

I’m writing to you after my second day of clinical in the ICU. Right now I’m high. High off my body’s catecholamines: the fight-or-flight system, the hormones in our body that, when activated by certain events, prepare us for action. Heart races, blood vessels constrict shunting blood to vital organs, blood pressure increases, the heart pumps as much blood to the body as possible: our body is in survival mode. You know the feeling… a near miss auto accident, a noise in the night, even a scary movie. You feel you heart bounding in your chest, all of your senses are heightened, tunnel vision focuses on the matter at hand. Your body has a physical reaction, even though nothing physically stimulates it.

I had a few minutes of down time this afternoon, and since I’m totally enamored with the ICU, I told my nurse I was going to the other ICU wing down the hall to see if anything was going on that I could learn from. I got there, not much was happening. I said hi to a classmate, then noticed a little bit of tension in one of the rooms. I hustled over.  Within five minutes, a code was called and I found myself performing chest compressions on a man with no pulse. 2 minutes of compressions seems like an hour. You’re sweating, tired, but could actually go on for an hour thanks to those catecholamines. Soon there were 20 people in the room and outside, and I found myself in the middle, because that’s where I wanted to be. Throughout compressions the leader was calling out meds to be given… calcium, bicarb, epi, atropine, amiodarone.

-“Stop compressions, check for pulse.”

-“I have a femoral!” EKG is stable, but then he goes into V-tach… a shockable rhythm.

-“Charge the defib….CLEAR!” Silence. Shock.

-“Compressions, NOW!”

Stat blood test have come back by this time and the nurse is yelling out pH, O₂, CO₂, BiCarb, K, Ca, Na and Cl levels among others… respiratory acidosis, I think to myself as I’m taking a break from compressions, they need to blow off his CO2… Then the lead call out:

“Hyperventilate him, let’s get some albuterol, continue compressions!” Whoa….I was right!?

After 35 minutes the man had a pulse. He was by no means out of the woods, and I don’t know how he fared the rest of the afternoon.  I tried to be one of the last to leave, soak up every ounce of the experience as I can. The leadership, teamwork, and organization were incredible.

Regis teaches us to always have a pair of gloves in our pocket. Silly I used to think. But I found myself gloved and ready to work while others were fumbling around trying to prepare. It’s important in situation like this to mindful. If you’re not doing anything, get out of the way. I didn’t want to leave, so I made myself a part of the team. A very small part, but enough to justify taking up space!

A nice view from my patient’s room. Peaceful and calm outside the hospital…

I went back to my side of the hospital.  Talking to my nurse, I tell her what she already knows… only as a nurse can you be in the midst of chaos, doing chest compressions, standing on the fence between life and death…and the next minute be changing a pillow case, trying to make a sedated patient more comfortable. This is the right career for me.

March 2011

A lot has happened since my last post.

I spent the greater part of the night in the Denver Health Emergency Dept… I’ll get to this soon.

1) We wrapped up our pediatrics class… a rotation I really enjoyed. Part of that was due to the great experiences I had at The Children’s Hospital. We spent one day in the Discovery Club, a place where parents can bring their kids with disabilities, leave them with competent care, and have an afternoon to do whatever they want. I got to talk with students from other nursing programs around Denver which was interesting.  After hearing about other programs I am thankful that I chose to go to Regis. The classes, clinicals, structure and schedule that Regis offers are certainly preferable in my opinion. Regis has great connections with the community and hospitals, and the hospitals (i.e. future employers) seem to appreciate the education Regis provides.  Attn: Regis… Let me know if you need my bank routing number to pay me for this awesome plug.

2) We started Med/Surg 2. This class is the academic culmination of everything we’ve learned to date. It pulls from Health Assessment, Pharmacology, Med/Surg 1, Roles, Peds, and everything else, on top of a ton of new material. It is intense, challenging, time-consuming, and awesome! I’ve spent a ton of time studying. Between Saturday and Sunday, Colin, JJ and I hit the books for 24 hours. It was reflected in my test grade… a much needed improvement after the 1^st exam.

St. Joe’s has a long history in Denver… built in 1877, it’s the oldest private teaching hospital in Denver. This is the Mullen Building on the campus.

I’ve spent 4 days in clinical on a cardiac floor. It has been totally awesome seeing the variety of patients, and learning about their cardiac disorders and how it affects their other body systems. For the second half of clinical I’ll be in the ICU at St. Joseph’s hospital. I’m also excited to spend time there and gain some knowledge and experience about critical care nursing. We had to apply for this specific placement, answer some questions and provide a letter of reference. I feel fortunate to have been selected to have this critical care MS 2 rotation!

3) I got hit by a car. It’s true. I was riding my bike, wearing a helmet (thanks Kelly) and not wearing headphones (thanks April) when a car crossed the street in front of me. I T-boned his car, supermanned over the hood and landed across the street. I got a ride in an ambulance to Denver Health and stayed there for most the night. Some have suggested this was a ploy of mine to network with the Denver Health Emergency Department hiring staff, but I assure you it was not. This could have been a serious accident, which I respect, but thank God I was up and walking the next day. There may be some long-term knee issues but all-in-all I have no complaints.  Always striving to learn from every experience and event, I have once again seen nursing care from a patient’s point of view, and I know how I want to perform my job as a nurse… and this I promise, no patient of mine will ever go 35 minutes with an unanswered call light! I will continue to ride safely, and will ride with 5 lights at night instead of only 3.

 

Proof that we learn in nursing school… Colin mending a wound so severe it was out of the ED nurse’s scope of practice (or she didn’t notice the menial scrape).

 

4) Less than 2 months until we’ll finish nursing school, cram for the NCLEX, and battle the masses for the few coveted new-grad nursing positions.

 

A February day on the Regis campus.

 

A blog post wouldn’t be complete without me bragging about how awesome Denver is. I’ve been wearing shorts 5 days out of the last week, there me be some snow on the way, but you can pretty much count on every day being sunny and beautiful!

Happy birthday to all you March birthdays.

Thanks for reading… and watch out for those crazy bikers on the streets…thank you.

February 2011

A week ago it was warm enough to ride in a t-shirt to meet Kate on the light rail. Today it is snowing and -9.

So on my week of clinical at Children’s, my assigned patient was a middle-school aged guy, previously healthy, met all developmental milestones. One day about 3 weeks before I met him, he was at school, fell down, hit his head and had a seizure.  He was taken to Children’s via“Donde?” (where) I asked, looking for any type of sign.

“Estomago?” (stomach) No response.

“Cabeza?” (Head) No response.

“Pecho?” (Chest) No response. “Donde?”

 “Garganta” (throat) he forced out.

Whoa! He talked!? I told him it was good to hear his voice. His dad, tearing up, said it was the first time he’d heard his son talk in three weeks. He said no one had gotten him to talk thus far. Pretty cool experience to be there when something like this happens.  His throat was no doubt sore from getting intubated, a transpyloric tube and a nasogastric tube placed over his stay.

Sunrise view from Children’s

 

The next week, I was on a different wing, but noticed that this young man was still on the floor. I got a chance to go in and say hi. To my astonishment, he was fully clothed, sitting on a chair watching football with his dad. He stood up, shook my hand and we chatted for a minute or two.  The guy in front of me was not the same as I had worked with 6 days prior. Being able to witness healing like this is really, really cool. Even more positive confirmation of my career choice.

A “working” lunch with clockwise from the upside down Kayla, Laura, Roxy, April, Stacey, Jordan and Sam.

We got to tour the hospital, including the Center for Cancer and Blood Disorders. Some students got to spend a day here, I signed up for the Heart Institute which was a great learning experience.

The Hat Tree…kids can choose whatever hat they want!

Also, the “’Jans” have arrived. The new nursing class of maybe 95 students who are beginning this 1 year whirlwind adventure that I began in May. It’s fun to be a mentor to a student, and get to share all of my profound wisdom and advice I’ve developed in 9 months (yes, there was some sarcasm in there). They have the same questions and concerns we all had at the beginning. While it seems like a long road ahead of them, I’m confident they’ll be able to get into a groove, and have fun on their journey! It forces us experienced “Mays” to look back and realize that we have, in fact, learned a lot, had some struggles and had a lot of fun along the way!

                           Still able to find time for wing night with JJ.