Week 8 as a level 4 nursing student

Well. It's official, my friends. I've made it halfway through this semester! Yessssssss!

I'm not sure if you could tell, but last week was pretty hard. In my assessment for one of my patients, I missed that there was a bit of necrosis on their foot until my friend (who had the same pt assignment after my shift was over) asked me about it. I felt so dumb and just couldn't get past something like that. I was so frustrated with myself for missing something I should've seen. I took the socks off and charted about a bit of a break on the OTHER side of the foot but completely overlooked the part that was actually necrotic. I look back on it now and we laugh, because it's a learning experience, isn't it? But believe you me, last weekend, I beat myself up pretty bad about it. It wasn't just the necrotic foot, it was that I plugged the NG tube with my poorly crushed meds on Thur, then the missed necrosis on BOTH days and that I thought my pt was having a heart attack on Fri morning. I haven't gone home wanting to cry that badly since level 1. In fact, I haven't felt so incompetent in a really long time. But as it always is, you're your own toughest critic, right? Don't get me wrong, I'm not discounting the fact that I should've seen it and caught on, but I am only human. Moreover, I'm still a student and still learning.

Last weekend was relaxing. I met up with two nursing friends on Sun to study for our midterm on Tue for PBL on campus, but beforehand, two of us went running around the track at school. It was so good, we ran 5 laps and talked about what crappy weeks we both had. Knowing that I wasn't alone really helped. We studied diabetes for about 4 hours on Sunday and then we had a bigger study session on Monday night, too. We did a bit of studying, had dinner together, then finished the rest of the content.

This week in clinical, I felt like a rockstar with the NG tube because I went through mishaps the previous week. I don't know if Julie purposely gave me that assignment as a test, but in retrospect, I am thinking...hey, I learned from my mistakes. And that's the beauty of learning, isn't it? To continually surpass your previous benchmarks, striving for improvement, and consistently honing on your existing skills. This week, I left clinical really happy. Why? Because I was able to actually talk with my two patients, to get to know them in depth. I've realized that's where my passion in nursing comes from - the past 3 semesters, I was able to really get to know my patients. This semester, I've become so task-oriented that I lost sight of it. I felt so fulfilled being able to have conversations with my patients about their lives, their families, and things they cared about. I've missed being able to connect with ppl.

This past week, I had my mid-term evaluation with my instructor. :) I think the thing that made me happiest to hear was that many nurses said they liked working with me and that they felt I was a really good team player. My instructor was saying she wanted me to go find her more often to go over research and whatnot. I kind of got the feeling she felt I avoided her at times, which is NOT THE CASE AT ALL!! I find her incredibly approachable and I've been trying to become more independent this entire semester, so I think I'm trying too hard to be independent. I just see this as the last semester with an instructor, so it's time I get used to not asking for answers, but she's totally right, it's different asking her for answers and proposing answers I've thought up myself (which I thought I did, but I guess I don't!) So that was a good point for me to hear. A bit disappointing, but something else to strive for, right?

Here's to an incredible latter half of the term.
I've had a pt with malaria! They were lovely. :)

Applied to volunteer at the Vancouver Friends for Life Society! I've been wanting to do this since level 2!! A whole year, I've waited!!!! Yes. The time has come to stop procrastinating for everything. I'm running in a half marathon in May, I'm volunteering at this society. I need to live in the now, not in what's to come, two, three years down the line. This is my now.

Weeks 5-7 as a level 4 nursing student

I know I've been neglecting this blog like nobody's business. I guess that goes to show how tough it's been the past 4 weeks. It's been so busy I don't even really have time to cry. I feel so overwhelmed with everything I don't know and everything I've been missing that I don't even know what to do, sometimes. I keep replying to the 'how was clinical?'s with a generic 'it was good.' because I don't have the energy to even talk about how busy school, work, St John, and life have been. I haven't been this tired for this consistent a period of time in....I don't even remember. I haven't struggled this much with nursing school ever. Stay positive, stay positive, I know. And I try. Believe you me, I try. Frontload, you say? This semester, it's been on a week-week basis. But it's ok, in hindsight, everything's 20/20. Once xmas arrives and I get together with all my friends (if they still remember me) and do our homemade gift exchange, I'll look back and laugh at my very haggard self.

Highlights:
- Knowing that what sucks for me is nothing compared to someone who's been diagnosed w kidney failure, on welfare, has a child to support, and lost their child 3 years ago.
- Knowing that my nursing friends are right where I am, and who care enough to take the time to remind me of that.
- Knowing that had my pt actually had an MI, I would have done all the right things (lol)
- Knowing that I have the ability to voice my own thoughts and rationales about why I would do things the way I do it and not just follow suit.
- Discovering that you CAN make improvements in just one day, with just one experience, and you can rock that NG tube
- Taking the time to talk to a pt and preventing them from having a fall (true story).
- Consistently realizing the need for being flexible
- Having great friends I can depend on, who know exactly what I'm going through, who I don't always have to be jolly around
- Realizing what my limitations are and being able to stand up and articulate what I can't do without feeling incompetent

I know the first part of this entry was really bleak and this post wasn't great in terms of pt experiences, but I'm on a professional practice paper writing hiatus at the moment and those articles aren't going to read themselves. Oh, and trust me when I say I will come out of this semester a champ.

Week 3 and 4 as a level 4 nursing student

In week 3, we started on days and I had one pt who was lovely, but I was also able to help out with so many pts those two days! It really felt good to be back and I was so excited to be back doing skills and working. My instructor's really laid-back but still expects us to deliver, so I really dig the style.

There was a pt vomiting blood on Fri and I was checking this pt's vital signs with my classmate. When I was checking the resp rate, I had counted for about 10 seconds and realized that there WAS no breathing. I motioned to my classmate to count with me and after about another 10 seconds, the look on our faces was pretty much the same. I knew, without words, that we were both thinking 'CODE BLUE'. It was like I was looking in a mirror, cuz I'm pretty sure that's how I looked, too. In my mind, I know I was thinking...'ok, what do I have to do? Is his airway open? Press the code button. Pull out the pillow, give two breaths....compressions....' One of the things I fear is calling a code unnecessarily...but I guess it's better to call a code than to not call one and have something even worse than embarrassment happen, right? Anyway, we made sure to do everything possible to wake him up by shaking him, grabbing his shoulder, and doing the sternal rub. After the sternal rub, he GASPED for air. Again, the look on our faces was like..."THANK GOD!!!!" Turns out it was sleep apnea, but MAN! That was intense. My heart was beating so hard and so fast...I don't think I can remember when the last time was that I felt so.....intense....but that's not even the right word for it. I'll have to think about that.

So this week, week 4, was a disaster and a half. We started at 1300 and finished at 2200. I was frantically trying to figure out what information I needed to know for my pts and their diagnoses. I was just not with it and couldn't figure out why. It was really frustrating for me, actually. Then I went home and was like....'ok. Tomorrow will be better. Tomorrow will be better.' and it KIND OF was, but still. I don't know why, but I just felt so blah. Next week will be better. This was just a weird week, I think. I'm still me, don't worry. :)

Week 2 as a level 4 student

This week was our first day back in the hospital in scrubs. We were shadowing a buddy nurse and had a three pt assignment but I didn't do many skills - just took out a saline lock :) Still, it was exciting to be able to do things and interact with pts and nurses again.

The highlight of this week was being able to connect with a pt who was a bit agitated in the beginning of my shift. He was at risk for choking, so his diet was modified to thickened fluids but could have water if supervised. After lunch, he asked for some water and I said he could have some if he took small sips, but he did have dementia, so maybe that's why he had a difficult time processing what I was saying. He ended up getting really frustrated with me and swore a few times. I was surprised that I wasn't taken aback by his outbursts and repeated what I had said firmly - not sure if that added anything to the situation at all. I gave him some and was hovering (unaware) by his side and by the suction just in case. It's funny because we talk about self-awareness, but I was so worried about him choking, that I guess my body language mimicked it because he said to me, 'relax, mate, why do you look so nervous?' I literally think I was standing with my shoulders up by my ears and my arms were like Mr Burns' from the Simpsons hahaha. I was impressed because that's another lesson learned from a pt - when in hospital, you don't want to feel any different from anyone else. You want a drink of water, something so simple to most, yet you need to be supervised. Worse yet, the person supervising you is hovering over you like you're a baby eating a grape (major choking hazard). Haha. Noone wants to feel that way. Does your mom/dad/boyfriend/girlfriend ever nag at you and watch you do something you feel perfectly competent in doing? How do you feel when that happens? A bit angry? A bit agitated? Food for thought.

Rest assured, my story has a happy ending! When I woke him to say goodbye at the end of my shift, he stirred and said 'thank you for being so kind to me.' That made my day worth it. It's all worth it.

Talking about becoming more 'emotionally intelligent' and tapping into my own emotions, I found myself feeling really unhappy yesterday. It wasn't that I was unhappy, exactly, but I felt like something was really bugging me. I couldn't put my finger on it. Part of it is being around negative ppl - I just can't take constant negativity. It totally messes with me. I think my feeling of 'unhappiness' yesterday was actually stress. Haha! It was because I was assigned a presentation on Tue for PBL and I have to present this upcoming Tue and I hadn't started yet. It was stress that I was feeling but couldn't really pinpoint until hours later. How do I not know what stress feels like....?

Ridiculous. So I made a to-do list and did some research in the hospital today. :) All better!

Learning and living and recovering from the long weekend....

WEEK 1 AS A LEVEL 4 NURSING STUDENT

Wellllllll, time has just flown by, hasn't it? I guess 3 weeks really is no time. I'm sure that will make me feel much better by the time week 7 of school hits. Hahaha!

So this week felt hectic, as usual. Luckily, my new planner has become my best friend. There was a lot of course reading to become acquainted with the guidelines and requirements.

I'm really excited about my classes - I feel like I can learn a lot about patho this semester in clinical AND PBL. It seems to me like I've learned to let the little things go. I can't quite put my finger on it, but in PBL when we were discussing group norms and presentation topics and dates, I felt a sense of zen which I hadn't felt at all before in PBL. I'm still trying to figure it out....it's not at all that I don't care about school anymore, because, hello, keener much? I think it's moreso that I'm trying to be more open and flexible to everything - Karen was right, there are a lot of things I can't control in life. I need to look and focus on what I can do, right? Is it really worth me becoming worked up over something small? On the grand scheme of things, something like calling vs texting is not a huge deal. I will always have my personal preferences, but I can only control what I do.

I'm super excited to be at SPH! Clinical rotations are on Thur/Fri and we get to do days and evenings! Evenings mean that we get off at 2200 meaning xmas lights!!! I'm so excited!!

Anyway, lots more to say, I'm sure, but I must attend to my Community Nursing discussion posting now! Until week 2, folks!

Bye bye Bangladesh and a little bit of Cassandra

Well, I’ve had my final Nurs 221 class this afternoon. I gotta say, it’s been an incredible journey. Sigh (I literally paused to take a breath there). Let’s see where to begin.

When I arrived in Bangladesh 7 weeks ago, I was nervous, intimidated, excited, apprehensive, shy (a bit), and slightly lost (literally and figuratively). When I was told that I was to teach the diagnostic lab tests of the Nurs 221 Med-Surg course, I was so scared. And worried. I looked over the content from previous years and realized that it was WAY beyond my own knowledge but was told that I could restructure the course with a nursing twist. The previous course was formulated by Med lab students who know so much about their lab tests (rightfully so). So I had a vision (partly poached from PBL). I went through the previous course material and wrote down what labs had been covered. Then I assigned the students 2 labs to look up each. They needed to put into a template (which I created for them) what the test was for, what the normal ranges were, what high/low levels indicated, and what some nursing interventions would be for high/low levels.

I gave them their assignment and gave them a week to do it (not unreasonable by BCIT standards). When I received them, I was so excited that everyone submitted their assignments on time! That sounds kind of ridiculous, right? It was kind of a personal accomplishment, that I was firm with them and said that I had very little tolerance for late submissions (it’s true and I hold myself to that as a student). Then I began editing them all and thought to myself, ‘Why am I doing this? Is it MY responsibility that THEIR assignments should have been done properly and coherently?’ Partly yes and mostly no. Because I began holding Saturday lab classes (they had a shortage of RNs to supervise them in the hospital), I was able to have them review and edit each other’s work. I was so thrilled when they came up to me and said, “Ma’am, I don’t understand what they are trying to say here.” Cuz I smiled, looked at them and said, ‘Me neither. You get to look up the answers now!’ They were able to feel the joys of being a teacher (and nurses are teachers), the trials and tribulations of delivering material in a comprehensive manner! This is learning! Don’t worry, I’m not ALL mean, I could tell when they were getting restless and we played some trivia games, too! Competitive students exist EVERYWHERE – I’m not the only one who gets riled up in trivia, fyi – clinical and PBL members, thank you very much. Haha.

So they all looked over each others work and made suggestions and corrected them. But, they all submitted them to me (so I have the master copy) but I’d already made comments on the document, so I sent it to them to look over. One thing you should know about me is that I don’t like giving answers out freely. I make you work for them. So my comments were more guiding questions to lead them to the answers. I will admit, this was slightly mean of me. I kept the master copy with all the answers and only gave suggestions and hints on the document for them to look over at home. It’s ‘mean’ but it will also help them in the long run. The more exposure you get to this information, the better it will stick! I don’t pride myself in being tough, ok? That’s not me. If you know me well (which you hopefully do by now), you will know that being mean to students makes me feel just as bad, if not worse, ok! But I only do it out of love and hope that they will learn!

They all presented, in partners, on 2 patho conditions and the labs you would use to diagnose this condition. That happened last week. I was pretty upset after last week. The amount of disrespect I saw from them towards each other really made me angry. I told them from the start that I have a zero tolerance policy on talking through someone else’s presentation and instead, they passed notes. And some were reading through their own presentation notes. I had to threaten them that I would be taking off marks before it got better. I ended up taking off 2 marks for note-passing and 5 marks for reading through your own notes. The presentation was out of 40. Slightly harsh, but I gave you fair warning before it started. I should not be wasting valuable class time teaching about the importance of respect. That is not part of adult learning. I definitely was pretty affected by that and felt like I was being tested. Like, how far can we push the new teacher before there are consequences? I do realize that students all over the world do that, but I guess it was the fact that my blatant ‘I can see you passing notes’ looks were ignored and continuance that bothered me.

This week, I wanted to incorporate PBL techniques – group process and discussion. We sat in a circle and discussed what the potential problems would be for every patho condition. From this, they need to submit a careplan around the potential problems and what their nursing interventions would be. I think I was unclear about this part of the assignment and I will have to make note of it when I leave all my documents behind. I’ll have to wait to see how the careplans are before I finalize my comments and make suggestions for the future Nurs 221 instructor.

You have no idea how excited I was to see them talk things out. I sat there with a smile I tried my best to conceal. I failed miserably. Lol. I was just so excited and proud of them! We talked about tactfully delivering alternate viewpoints, the importance of NOT being defensive, and solving differences EARLY instead of late (preventing passive aggressive behavior). Visions of PBL came screaming back at me. Now, I’m ready to leave (except not really because I feel like I haven’t had enough time here) and head to Taiwan to see my aunt, HK to see my grams and family, and finally, home to my momma bear, sister, and the Henster, and of course beloved friends.

These blogs are merely the tip of the iceberg. This journey has been so incredible and I feel like I’ve learned so much and given a part of myself away.
Luckily, ‘myself’ is like the liver – it regenerates. I’ll be back as a whole by the time I’m home in beautiful Vancouver, BC.

Love you all, see you in no time!
Cass Ma

The realities of nice-ness

So much has happened since I’ve last blogged that I can’t even remember where I left off. I literally have to refer back to my older posts to jog my mind.

In general, I try not to get swept up in the little things. I don’t normally become stressed out with assignments and a heavy workload, but moreso with interpersonal relationships. I know myself, and I know that part of myself well.

I was told right from the beginning that I could not be friends with the students but they could be friends with me. I’ve been trying really hard to make the diagnostic lab course make sense for nursing students, so I’ve been pushing them. I’ll admit it. But I’ve also tried really hard to make myself available for help – I come into the office pretty early and stay until late (by Bangladeshi standards) just in case a student is still here and needs to ask a question. These are the assignment guidelines, maybe you can tell me if it makes sense:

Each person is assigned 2 lab tests to look up what it does, the normal range, what high/low levels may indicate, and what nursing implications come from the high/low levels. For example if someone has a low hemoglobin level, this could indicate anemia, so as a nurse, we would monitor for shortness of breath, fatigue, weakness, resp rate and O2 sats. I assigned these a few weeks ago and when I received them, I was having a hard time editing them all. So I’ve started to teach an extra lab session on Saturdays because there is no RN to take them to the hospital, I’ve done some reviews on the head-to-toe assessment and then had them look over someone else’s work as an editing exercise. I did this so that they could see the importance of submitting a coherent assignment. I had made track changes in the documents they sent me, but I asked them to edit as well so they would have some practice in researching and appreciate the work that goes into marking. So I can appreciate that there may have been double the work done (students and I both had to do this) but it was the principle that I was going after. So I get it, the students are very flexible and have been, for the most part, cooperative.

I gave them the presentation assignment on July 5 and they had one week to prepare for it. In PBL, it’s pretty standard. They were put into partnerships and each set of partners were assigned two pathophysiological condition (ex. Coronary artery disease and myocardial infarction). They are to present on the patho briefly and talk about the labs that are associated with the condition. (ex. What tests would be ordered to test for CAD?) Then they had to talk about the nursing implications. Most of the labs had already been assigned previously, so most of the work (after they make revisions) has already been done. To try and make it fair, I prepared a presentation, too, on diabetes.

The problem I’m facing is that students are complaining about me giving too much work and I’ve been receiving a couple of flippant comments. It makes me feel really bad. But on that same note, I know that I have a rationale for assigning this. If you give an assignment without rhyme or reason, then why assign it? I have been trying really hard to tie it into nursing. It makes my heart really heavy. I am trying to rationalize it by saying that these aren’t my friends who are dissatisfied with me, and these aren’t my friends who are complaining about me. I am here to be their teacher, to enrich their learning experience. You can’t win them all. I can’t win them all. I’m having a really hard time trying to be assertive and friendly at the same time. I guess I need to realize and demonstrate that even though I am still a student, that I am teaching their class, that I am leading their class. I can’t be friends with everyone. Push me hard enough and disrespect me in my class one more time and I will have to take action. Respect is a two way street, right? My sister swears I’m too nice to ppl even though I don’t see it, but I guess I still am.
My time is running out here. I have 11 more days and 3 more in-class sessions with this group. I say that not meaning ‘I only have to put up with them for 3 more days’ but ‘I will overcome this within the next 3 classes’. Watch me. If I can make it this far, I can make it through.

I’ve taught my first aid classes to the faculty. My first class fell sub-par, in my opinion. I felt very pressured for time and did more talking than practical, so I felt it was very boring and grew tired of hearing my own voice. I had another class the second day and was so determined to make it better. I wrote out what I didn’t like and how I was going to make the second class better. Then, I executed my plan and found redemption. The second class was much more interactive, fun, and just…up to my liking. I threw in trivia, lots of demos and practical, humour and trust me, grown ups like trivia JUST AS MUCH AS CHILDREN! Hahaha. This class was also bigger and had more questions, though, so that may have also played a part. It was great and really rewarding.

I have to set up my class now, so I have to cut it short, but some of the most rewarding moments I’ve had here involve struggling/difficult students. I have realized that I am big on the concept of ‘tough-love’. The more you try to get away with laziness, the more assignments I give you. Works for some ppl, not for everyone, but this one particular student (story is too long to type here) was being less than hard-working so I gave him an assignment. He did it poorly so I made him redo it. My happiness lies in the fact that he was able to, with some guidance, give the right answer in front of his class based on the assignment I gave him. Did that make sense? Basically he was able to recall the hw he did and he smiled one of reward and triumph.

11 more days here to make it count.

Love you all, thinking of you all (seriously)
Cass Ma

Clinical rotation, campus guards, boat rides down the Buriganga River and the busride of near death

I know, my postings are becoming increasingly lengthy, yet you keep coming back! Welcome back, friends.

Since my last posting, I have gone on my first clinical rotation to United Hospital near the Gulshan area, right outside of Uttara (I live in Uttara, near Dhaka, the capital of Bangladesh)! Last Thursday was honestly the best full day I’ve had in Bangladesh. That’s a bold statement, hey? Haha. So I woke up and we were at the hospital around 0730. Clinical starts around 0800, but the students still have to get changed when they arrive (there’s a school van that leaves at 0700 but some students arrange for transport independently). I found it really frustrating at first. The students have around the same skills set as I do, if not more, and many of them have yet to give PO meds. That baffled me, honestly. At first, I was so disappointed with it, I thought, ‘how is that even possible?’ The possibility for me to do skills was but a distant dream, if the students weren’t even able to. Why is this the case, you ask? Apparently it’s a part of the culture over here – the nurses are not very receptive to students doing the tasks and would rather do it themselves. It was frustrating for me as well, because I didn’t see the students GOING OUT THERE and being assertive and saying what they wanted to do. I even went to the nurse to ask if she needed help with anything and if she needed help with anything to not hesitate to let me know. She said ‘no’ and then didn’t even bother looking at me after that. It didn’t bother me too much, I just let it roll right off my back. What also saddened me was that the students didn’t take their own learning into their own hands. BUTTTTT I am well aware that it’s a different culture here, the ppl here are taught to listen to their elders, not to challenge the status quo. Interestingly enough, I had a flashing image of Family Theory go through my mind, about challenging status quo, and I guess I really just take advantage of being able to do so freely.

Rest assured, friends, I did not just sit back and wallow in my frustrations. I took the opportunity to go over pharmacology with the students on my floor (cardiac floor)! I felt so alive. I can’t even begin to explain how thrilled I was to see Arif, one of the students, put two and two together after I had pointed out the pharmacokinetics of calcium channel blockers. I had to clap out of glee when he made the connection between the –prazole drugs. We looked up proton pump inhibitors at the back of the book where it listed a number of them (esomeprazole, pantoprazole, lansoprazole etc) and he mumbles, “oh, all –prazole) and you have no idea how wide my eyes were when I was staring at the top of his head. Eyes wide, face full of hope and he goes, “oh!” and it clicked. I loved it.

Next was Tanjina. I went over some drugs with her, but what I love is how I have been able to adapt things I’ve liked from all my previous levels and show it here. For example, the drug tips were from level 1 and from level 2, I remember explicitly on the first day that my instructor said, “You can usually get a pretty good glean of your pt’s condition by looking at their drugs” (ex. They might be in pain if they’re on morphine and have taken it regularly) So I’ve poached it and worked with that concept here with Tanjina. I have also been able to talk about post-op complications (ex. Why would a post-op pt be on domperidone?) in relation to their meds, so to really try and get her to understand why things are ordered and to ask questions when things don’t make sense. She seemed quite receptive and excited to make her own connections. I’m also trying to foster confidence in the students here and I do that by offering positive reinforcement and really just letting them know that they really DO know the answers, but that I just guide them there. It’s really exciting to see them smile when they get the right answer. Knowing that they’re smiling because of you is…..so heart-warming.

After I came back to school, I had 30 minutes before my first round of first aid classes to the campus security guards. Can I just say that I have never had so much fun teaching first aid in my life? These men (ages ranged from my age-50’s) were so full of life and were so captivated by the content. They loved the practical component and were so engaged in the conversation. Thank god for Shahed and Asha (senior nursing students) for coming as my translators! I laughed so hard with them and found them very endearing, actually. The second class was also fun, I had two trouble makers. You guys, they were THE cutest!! When they were checking breathing, one of them would be blowing into the other person’s ear and they would both be giggling. SOOO cute! But of course, I had to split them up cuz they were being counter-productive. I wouldn’t even let them face each other with different partners cuz they were getting each other all riled up. I took pictures, so I’ll def post some up, now that my pics are on my USB key!

On Friday, I went on a boat ride down the Buriganga River with Rhodina, hit up Hindu Street in search of Deepak’s wedding cake topper, and walked around a bunch of Bazars in old Dhaka. The boat ride was so much fun, though the boat guide made me a bit uncomfortable. He kept on saying I reminded him of his wife (no resemblance at all). We got a tour of the social housing area where he lives with his family and his neighbors. It was quite fun and I got henna done on my hand! It was fun, but also very overwhelming. The boatride was definitely a highlight of the trip, though! I’m glad I went, despite there being huge freights that wouldn’t hesitate to trample over our smalltime boat.

Busride of death. It says it all. I’ve never been on a bus SO full in my life, where I’ve been so afraid of falling out a window and been rubbed up against so much. It was both upsetting and a learning experience. I was more upset about my submissiveness than about the act. Instead of verbally telling him to stop and get away, I just moved. And he followed. And I moved again. Lather, rinse, and repeat until I finally managed to get a seat. I was just more disappointed with myself than anything. I think it was more a matter of me not knowing how to react and how others would react. I did hit him in the face with my bun multiple times. Not painful by any means, but unpleasant, especially considering how sweaty I was after that day. HAHA, sucker. Also, he’s lucky he isn’t a student at IUBAT, otherwise he’d be in for it. I’m good friends with the security guards now, you know! Haha.
Oh!! One last note, I’ve assigned the students lab values to look up and we will be going over them at the hospital instead of in class. I was very firm with them and said that I expected them to be in on time and that two days was plenty of time to look up 2 lab values (which I think is true!). I also offered them my help in any way possible and invited questions. Here’s the exciting part! This morning, three students came to me with questions! And I said I would help them as long as they had SOME work done, but I wasn’t going to do their work for them, and they came with questions ABOUT what they had already done!!! I felt so triumphant. I have high hopes for them and I know they can do it. I hope they know they can, too.

Love you all,
Cass Ma

Sprained ankle, night sweats, money changers, and language barriers

Almost three weeks in now and I’m adjusting quite well to everything and everyone.

Last weekend, in Gulshan, I managed to sprain my ankle while jaywalking, dodging a kid asking for money, and looking for oncoming traffic. I stepped off the median onto a rock and rolled my ++ weak left ankle (the one I sprain ALL the time). I fell onto all fours in the middle of the street and almost got run over by a car. For real. I was so scared. I don’t know if it was the shock, dehydration, or heat, but I was so dizzy and started seeing spots. I knew if I tried to walk, I’d pass out in the middle of the street. But no better place to hurt myself than with 3 other nurses and a decently sized crowd of hospitable strangers, n’est-ce pas? A few local ppl helped control traffic while I seeked shelter behind the gate of a restaurant. The security guard of that restaurant gave me his bench to sit on J while another person went to get me some ice for my ankle. I felt much better after about 15 minutes. As soon as the dizziness subsided, I started laughing at myself but more importantly, I was SOOOOOO angry with myself! I knew I’d have to miss clinical the next day cuz of my ankle. Luckily, I popped two Advil and then another two before I went to bed and iced my ankle for a long while. I also had it elevated (RICE!) and thank you SJA for teaching me how to help myself. J FA nerd for lyfe.

It gets pretty hot at night in my room cuz the AC is pretty much broken. I wake up drenched in sweat. I’ve not felt my prettiest in my travels. Haha. Oh well. If you can’t take reading about me at my worst you can’t have me at my best. Hahaha!

So the other day, I was so upset because I thought that I told Vincent the wrong dates for my return ( I didn’t) and I thought we missed each other by a few hours. How tragic would that have been, hey? Haha. But for real, I was so upset I started crying in the nursing office – I am so ridiculous, I’m borderline ashamed to type that. Hahaha.

So I left the office early that day cuz I had some errands to run and it totally put an Eeyore cloud over my head. I had to go buy groceries and get money changed. En route to the money changer, I hit prayer time and there were a number of devout individuals praying in front of the money changer. I didn’t want to be rude and step over them, so I stood there, pacing kind of awkwardly, trying to figure out what to do, where to stand, whether I should join in. I noticed inside the jewelry store next to the money changer, the shopkeepers were motioning for me to come inside the store to sit. So I went in, sat with them, chatted, and they were sooo friendly and nice! They gave me a pop to have while I was sitting there but I thought it might be rude to drink it in there, so I just held onto it. I love how welcoming everyone is.

Last time at the money changer, I negotiated my exchange rate with them – they wanted to give me a lower rate for my small bills and I wouldn’t give them my passport till they gave me the same rate for all my money. Haha. Small battle won. This time around, I didn’t have any 100US bills to exchange, so they wanted to give me 68 instead of the original 70 they offered when they thought I had big bills. Another battle won because the guys liked me. Hahaha. Another thing I’ve noticed is that the guys here are very direct. One of them asked for my number and offered me his phone when I said that I didn’t have one. I obviously declined and when they asked why, I said that it was because my mom always taught me to say no when someone offered me a present (it’s true). Haha.

Tomorrow I start my first med-surg clinical day at United Hospital! I’m so excited! After clinical, I come back to school around 1430 and teach my very first class of first aid to the security guards on campus! I’m excited but also so worried! There are a number of things, actually, should I organize them based on the amount of fear or alphabetically? First, the guards barely speak English, and I barely speak Bangla, so I’m not sure if I can explain everything well enough for them to understand. Next, how am I going to demonstrate my assessments if I’m not supposed to touch people of the other gender? I’m thinking if I can’t get a female student to come as a translator, I’ll ask Musa to help me bring down the ‘Alex’ doll (mannequin, same as our Terry dolls at school) for me to demonstrate. Actually, I guess it’s mostly just those two things I’m scared about…but what if they don’t get my charm!? Without that, I’ve got nothing! I guess some can find my awkward laugh and rigid body language endearing at times. Oh well, here’s to hoping. This is what I came here to do, so I’m doing it.

On our walk home yesterday, Rhodina and I were asked by the kids who live near our flat to take their pictures. We spent a good 15-20 minutes taking pictures, I think. When we finally managed to break free, the kids came running after us with shrubbery and flowers or all shapes and sizes. We had mini gardens in both hands and didn’t have the heart to throw it away while the kids were still in plain sight. Hahaha. So cute.

Love you all, thinking of you all,

Cass Ma

Spider bites, gecko poop, and candlelit showers

Exciting news, Musa set up a computer for me at my workdesk now so I don’t have to monopolize the student’s computers as I work on my powerpoint presentations! Here’s to Musa! So I’m reading my last updates and I have to apologize for carelessness in spelling/word choice. But hey, if I can put up with power outages and showering with cockroaches, you can put up with my mistakes. J
Funnily enough, those ‘mosquito bites’ that blistered up turned out to actually be spider bites, we discovered the other night over dinner. It makes sense because not all my bites had blisters on them and I was so confused as to why those particular ones had developed them. I thought it was ironic that I was bit by one of the things I’m most scared of when I’m home in Vancouver. Let me explain….Bangladesh was something I was sooo scared of yet faced anyway. After I arrived, unconsciously in my sleep, I faced another one of my fears. And then it bit me. Multiple times. And I swelled and blistered. Haha. I think it’s safe to say who won THAT battle. (me)
The diagnostics course is coming along. Since I last posted, I have completed the first aid course for senior nursing students and compiled another one for the security guards at the school gate. That one is very very basic and they don’t speak much English, so it was a challenge making that one up. I used lots of pictures which I poached from google and tried to use as many simple words as possible. A part of me felt kind of bad doing that, borderline disrespectful, but it was how I was instructed to do so. I’ve actually got 3 first aid courses to teach aside from the one scheduled for the senior nursing students! I’m quite excited about that.
I’m starting clinical rotations on Sunday at the centre for rehabilitation for people with spinal cord injuries! I intend on going every Sunday and starting next Thursday and every subsequent one, I get to go to United Hospital to help with the med-surg students! I’m so excited. I brought scrubs and my stethoscope from home!!! I finally get to use them!
I invigilated my first exam on Tuesday – hand washing. Hehehe. We have boys and girls in the class so we had to go to the cafeteria to use their sinks cuz Corina and I didn’t want to stand in the boys washroom to watch them wash their hands.
I had to lecture some students on not completing their homework the other day. I felt horrible. They had one week to do it and then one of them was copying the terms right in front of me! Not only did they not do it, but they were copying right in front of me! And kept going after I caught them! I felt really bad for doing it and Karen’s talk about ‘not being their friend’ really became clear to me. I really hope they know that I don’t mean for it to come across as a power trip because it’s not my intention. This is adult learning, is it not? If you don’t want homework checks, you need to show me that you will do your hw on your own will, right? If you want to be an adult, you need to act like an adult. I really hope they understand where I’m coming from.
I was invited by Shehad (sp) to attend their nursing student association meeting sometime next week. I’m excited about that! I want to do a classics jeopardy/trivia game with them and I can use the telus sharpies Albert gave me as prizes! Something along the lines of what does erythro mean if erythrocyte is red blood cell and erythema means redness? So eryth would mean red. Something like that might be useful for them since they were telling me yesterday that English was very difficult for them! I’ll have to talk to him about it today. I also want to do the blood pressure stand on campus with them! Apparently in previous years the student association has set up a desk and done BMI and BP with the school, so that would be cool!
On my walks to and from school, sometimes the children in the area we live run by saying ‘HI!!!” and giving us flowers. This was one of those mornings. It is soooo cute. Who’d have thought that I would like flowers? J But it’s not just flowers, the thing that really gets me is that they grab little flowers or even twigs if they can’t find flowers. It’s just the novelty of giving something to us. That’s what I love. I think it’s adorable.
I went out to buy bananas the other day nearby and got lost on my walk home. The bananas are amazing here. They totally blow Vancouver’s bananas out of the water. They’re the little ones!! They taste like banana but then there’s a hint of sourness to them and it’s awesome!!!!!! So I got lost, and thought, ‘uh oh, I don’t even have a phone. Even if I had a phone, I wouldn’t know what number to call!!!!’ I don’t even know the house I live in!! Thank god for this one apartment building I use as a landmark to get home everyday and I oriented myself around that one.
What I’m seeing here is a sense of simplicity that astounds me. In my last trip to India, I was very moved by the poverty and felt a lot of guilt. What I’m seeing here in Bangladesh, though, is a sense of contentment and hospitality despite having bare essentials. I’m moved by it in a completely different manner. For example, when I was lost, I knew that I could cut across a field to get to the path I take home from school everyday. The field, however, was where a few families have their houses, so it felt like I was trespassing and I was sure to ask if I could walk across. Not only did they smile and waggle their heads, but one of the ladies felt compelled to walk out towards me and guide me along the walking path made of cement sacs. Something about that act really touched me. In Vancouver, how territorial can we be? Something about her was so warm and made me feel just…welcomed. Ok, that may have been really dramatic for most of you, but something about that exchange just got to me. Something about kindness knowing no differences – you don’t need to speak the same language to be kind, you don’t need to be from the same country to be kind, kindness is free. And that’s powerful, to me.
Anyway, I must apologize for not being able to load any pictures. Because Lovebug is dead, I can’t upload any pics onto any computer cuz I don’t have a card reader. Let’s all take a moment and appreciate the computer tech guys we know and love (Hen).
Love you all,
Cass Ma

Beautiful Chaos

So it seems as though I cannot post onto my blog using the school computer. My little netbook, Lovebug, has passed on (possibly only on a temporary basis!!!!!!! HENRY!?!??!!) I was quite upset, I’m not gonna lie, but as my mom always says, ‘if it’s a problem that money can fix, it’s not really a problem, is it?’ J

The past few days have been good. I’ve been given permission to revamp the diagnostics lab course! Great news! I also get to review my own pathophys and incorporate it more into the course. I’ve talked about it with Rebekah (fellow volunteer) and she says that in addition to the PBL resources I have (high/low values, what the test indicates, etc) I can get them to look up clinical manifestations as homework. Or maybe I’ll do this for them and get them to do a pathophys review session for each other. Either way, I really want them to do some form of presentation to each other so that they can practice their spoken English.

I’m almost done my first aid course. Thank god I saved all my documents on my USB key, otherwise I would’ve lost EVERYTHING that was on Lovebug (all my BCIT documents, travel documents, first aid course content, PICTURES!!!!!!!) Feels like that was the one thing I’ve done right so far. It’s so easy to know what you’ve done wrong, isn’t it, that the things you do right have an inflated sense of importance. Haha.

This weekend was so awesome. I went on a small trip with three other volunteers to the Srimangal area (the North-Eastern part of Bangladesh). We stayed at a tea resort and met a tonne of cool ppl. We left Fri morning around 0600. I went on my first rickshaw ride that morning. I have decided that Bangladesh is a beautifully chaotic country. There is so much beauty in the tea estates, in the fruit plantations, yet amongst the honking and blaring of horns on the streets, so chaotic. I’m still trying to wrap my mind around the irony of this country, or maybe even life. Haha. Dork.

My swollen mosquito bites have gone down to near normal sized. I still have a few blisters but most have subsided (thank, in large part, to me popping them) Nobody ever said that I was beautiful, the country. Nor am I glamourous. The cheap knock-off Rorschach test sweat design on my shirt will attest to that (pictures to follow when I come home).

In the trek around the tea resort we stayed at, Rhodina and I met some very friendly locals. I gave a part of my heart away to a cute little boy who followed us around the tea resort. I tried 5-layer tea (more a novelty than anything) and ate a lime another boy picked off the tree for me. J

On Sat, we went to Lowacherra forest and saw great big orb (banana) spiders, went chasing after gibbons (monkeys) off-trail and was attacked by leeches, thus causing my crocs to be filled with blood and dirt. Again, so glam. I was so scared, chasing after the gibbons, but I thought, hey, what am here to do? Now I have this great experience of going monkey chasing and getting three leeches caught on my feet (so weird). You bleed a surprising amount with each leech, I tell you!

So not without surprise, I had the big D twice this weekend. Oh well, as to be expected, surprised I made it a whole week without it! Nothing I can’t overcome and get past, though. Have yet to ‘pop a squat’, as Amy so coherently worded, in a public toilet but I feel it’s only a matter of time.

It’s been one full week and it feels like I’ve been here for so long. Time to finish off my lesson, hopefully someone will help me post this!!!



Love you all, thinking of you all

Cass Ma

Canadian Student Nurse in Bangladesh

That is the current time in Bangladesh. The past 5 days have been....shocking, to say the least. I guess this time, without my sister in a country so different from Canada, I have experienced culture shock. Maybe I've become more observant than when I was in India in 2008, or maybe my sister cushioned a lot of it last time. Either way, it's been pretty difficult the past few days. My pride doesn't like me typing that out, but this is a candid blog and I'm sure, looking back 2 years from now, I will chuckle.

Let me see. I arrived Saturday night and was EXHAUSTED. I slept quite poorly on the plane and fell asleep on my journal facedown after settling into my room, which is quite comfortable. I share a room with cockroaches (too many to name) and some friendly geckos. I shower with some cockroaches, too. The baby ones I can deal with, but the big ones still scare me. My flatmate is wonderful and has taken me to exchange money and shopping for a salwar kameez. The faculty have been very friendly and hospitable. I was so taken aback by the rickshaws and the busy-ness of the streets when I first arrived at night. The roads were shockingly busy. I'm not sure why I was so suprised by that. I swear India's streets at night were less so.

I've taken to journalling a lot. I think it's because for the first few days I was slightly confused by everything and feeling quite lost. I did, however, manage to walk to school by myself after the first 2 days( a task that sounds much easier than it actually is!!!!) The puddles are HUGE on the trek to school, and the local kids shout out 'hi! good morning!' to us as we walk by. It's quite cute. On the walk home one day, I saw some kids playing cricket in one of the vacant plots of land and if I see them playing again, I will ask to join, because I've never played before.

I've assisted in teaching a class (on Tue) and that was on mouth care and bed baths. On Wed I taught that same class independently. A shout out to all the BCIT nursing ppl - you will never know how much PBL can change you until you actually have to execute it and realize that you can execute the concept of 'chairing a meeting' in a classroom so well. Major props to BCIT for teaching me that.

I'm still quite intimidated teaching fellow nursing students. The culture's slightly different here. On my first day, Karen, the department head told me not to be humble about my skills (something that I tend to do) and not to play the 'Oh, I'm still a student, JUST like youuuuu' - another one of my strategies....another thing she said was that I could not be friends with them. I could be their friend, but they could not be my friend. Yet another hurtle to jump over for me. If you know me well, you know that I have this inherent need to be friends with everyone - weakness/strength, you decide for yourself. Therein lies two major things I have to work on but I am so thrilled. This is partly what I came here for, to see how far I can push myself, right?

I'm also supposed to be teaching this diagnostics labs course in July. When I read the course material, I FREAKED out - I honestly did. It was so in depth and I couldn't even understand much of it. But after talking to Karen, she said that I could modify it so that it is more nursing related and I can give her the proposal for her to look over. This is another huge learning point for me because I will need to teach patho in each lab test. This is huge for me because patho is one of my weak points. I'm really glad I've come here. It honestly seems like everything's happening to push me to be better, as weird as that sounds.

Anyway, I have to finish up my first aid course before I go to open lab! BCIT folk, you have no idea how lucky we are to work in a lab like ours. I will post pics soon, if I can.

Love you all, thinking of you.
Cass Ma

Week 16 as a level 3 nursing student

This week was one of many learning experiences! I was able to practice so many skills but also work on teamwork and things really started to 'fall together'. I also had my first incident report filed! Tough day, but the show must go on More details to follow!

My patient this week had surgery a few days before but had to stay in the hospital for a post-op infection and it had been 5 days or so since her surgery. It's a pretty long time to stay for a pretty minor surgery, but because of the infection, they wanted to keep her in for longer. She was getting IV antibiotics and here comes the mistake, folks! I had given the med on time and flushed the line with fluid but I forgot to unclamp the line after I had hooked up the medication to the secondary line. I don't know if everyone will understand, but basically, instead of getting the medication, she got the regular fluid ordered instead of the med. When I found out, I was so scared, I went in, fixed the line, my patient was ok, so next came the daunting part of telling my instructor. I went up to her and said, "Can I talk to you about something?" and explained the story to her and she was so great about it. Because I corrected the mistake within an acceptable window of time, there was no damage done to the patient, my instructor says. She was even deciding whether or not I needed to fill out an incident report because there was no harm done to the patient and the hospital didn't consider it a medication error because it was within the 1 hour window. I ended up filling one out, though. The thing that bothered me was not the fact that I had to fill out an incident report, because it doesn't really make a difference to me, but it was more the fact that I was so careless. It was essentially, literally, a rookie mistake. I can laugh about it now, but that day was bruuuuuuuuuutal! First incident report! After I made and dealt with the mistake, I had such a heavy heart. I kind of thought, 'oh god, if I could've made that mistake, I can easily make any other mistake!!' so this was definitely a humbling experience for me.

On the plus side, I got to hang out with and feed the baby I fed in week 15! She had grown SOOOO much in one week! I was also able to do so many other tasks this week like a dressing change, multiple IV medications, syringe pump meds, and basically got to do a lot of care for patients because I had the time to. I was a bit sad to leave because I am only starting to get the hang of things now. Oh well, change is in the nature of nursing, right?

I've made it through another semester, folks! Bangladesh is a comin!

Week 15 as a level 3 Nursing Student

This week was exciting for me because I was able to hang out with a super cute baby. This was the first newborn baby I was able to feed - she wasn't my patient assignment but I had some free time, so I wanted to get as much exposure as possible. This patient was born into addiction but contrary to the assumptions we may each carry, this patient's parents were quite involved. The interesting thing to me is the notion of drug use and our own beliefs about drug use, misuse, and abuse. Which word would you choose to use and why?

The semester is slowly winding down and funnily enough, the last paper to do is the final family theory paper. My assigned patient this week was a 10 year old boy who had been diagnosed with diabetes a year ago. He had had multiple hospitalizations these past 4 months due to poorly controlled blood sugars. I was able to watch patient teaching regarding nutrition and blood glucose monitoring. I think one thing I struggle with is being firm with patients. I have an inherent need to be 'friends' with people, to be 'nice' to others, and to be liked, essentially. While this may be acceptable in my personal life, it can be a barrier to the therapeutic relationship I develop with patients. This experience exemplified this weakness to myself. When the nurse was discussing nutrition with the patient, she was firm, not mean, but firm. It's definitely more firm than myself and what I'm used to, and I could see that the patient was a bit uneasy with the talk, but I also realize that it needed to be done. This little boy needed to learn the importance of diabetes management for his own health and well-being. Another interesting point is for me is the flexibility of being a nursing student. I was able to stay with the patient during the nutritional consultation, but also able to play video games with him! It was actually a very meaningful experience for me, believe it or not.

The joys of being a nurse!

Week 14 as a level 3 nursing student!

The weeks are diminishing and I can't believe this semester is almost over - yet it also feels like this has been one LONGGGGGGGG semester.

Mon was our last PBL class for this semester! This PBL has been one of great learning for me, not in terms of the content (even though I did learn), but in terms of dealing with other ppl. I've found that I am still trying to find the line between being assertive and aggressive. One valuable lesson from this past semester is the urgency of approaching problems as they come up, instead of 'letting it lie' and in a sense, percolating.

I had no patient assignment on Tue so I had a bit of a harder time researching the diagnosis on site while still answering the questions the parents had. My patient was on contact and droplet precautions, so I had to wear a gown, mask, and gloves. Imagine trying to become friends with a 5 year old with half your face covered and coming into the room with this oversized yellow gown on! Daunting, to say the least! Tuesday was pretty rough, trying to look up information, I was getting used to the Fraser health charting, and trying to make sure that I found the right answers to the questions the parents were asking. In a nutshell, I felt incredibly disorganized.
Organization aside, I managed to get along sooooo well with my patient. She had scarlet fever and was still sooooo cooperative and adorable. I couldn't help but grow attached to her just because she was such a sweetheart. I was checking her pupils and I asked her to close her left eye and she closed her right one instead (I didn't bother correcting her, but her mom did!)!! And while I was finishing her head to toe assessment, she paused to show me how she could fold her socks together!! I also gave her stickers for each assessment I did and she was so excited every time!

Because of how Tue unfolded, I was on a mission on Wed! I felt so much better and so much more on top of things! On Tue, I was still charting at 1300, but on Wed, I was done everything including her meds by 0900! And on top of that, when I entered the room to wake her up, her mom said to her, "Honey, guess who it is, your friend's back...." Me!! I was her friend!! Never have I been so excited to be friends with someone. Hehehe! This day was so much better because she had already been on her antibiotics for over 24 hours, she was no longer on droplet/contact precautions, so I was able to go in without the gown and mask and gloves! When I went in later on to see how she was doing, she was drinking her juice. You know how some juice cups have foil on the top and you use your straw to poke a hole? Well she was sipping already and wanted to show me how she was able to poke the hole herself, so when she made another stab, I said, "That looks like a heart!" and she said, "Because I love you!" Sigh.... :)

She got discharged around 1015, so I didn't have a patient assignment, but because of this, I was able to give an intramuscular injection! And also, I was able to shadow a Dr who was giving botox injections to patients with cerebral palsy. The botox allows their muscles to relax and not tense up. It was pretty tough, though, because I had to hold someone's leg while they were screaming and crying to not get it done. That did not make me feel good at all....and I almost cried because it was so hard for me to do.

I also learned about Rett's Syndrome which is a degenerative neurocognitive genetic disorder. I don't think I'll ever be able to forget the matter-of-fact way the mum had to present information to the Dr. It's not that she's heartless, it's that this has been something she has had to deal with for many many many years. Death for everyone is imminent, but to have to be with it everyday is heartwrenching for me. I very much admired the amount of strength and perseverance that patient's mother displays on a daily basis.

But en keeping with the sandwich effect, (good, bad, good) I am very much looking forward to another week in paediatrics to see how I deal with another age group!!! And I know NOTHING about Hannah Montana, Wii, Dora, pretty much everything child related.........but I'm willing to learn! :)

Week 13 as a level 3 nursing student

Sorry for the late post! This week was my first week in paediatrics! After orientation on Tuesday, Wednesday was our on-site orientation. As usual, it was pretty much just us getting acquainted with the way things were going to be done in this particular rotation and the ward tour. Nothing incredibly eventful happened this week because there wasn't any patient interaction.

Week 12 as a level 3 nursing student

This week marked the last week in my obstetrics rotation. After this week, I feel as though I have truly found my niche. On Tuesday, I was able to connect so well with the family and was able to do my very first baby bath!!!!!!! I was so nervous but it was so exhilarating at the same time! I think it's such a special opportunity to be able to take place in such an exciting time for a family. The husband was so excited to see the baby bath that he ran back to the room to see it. When I first walked in, I was so taken aback because the mum was asking if I was her nurse or if the RN was her nurse because she couldn't be interrupted from sleep all the time. I was so shocked but I totally understood what she meant. After hours and hours of painful labour, I don't think I would be very receptive to ppl interrupting my sleep either. I don't even like being woken up normally!! But the more I got to talking, the better we got along and it's always so incredibly rewarding for me to be able to come back from a situation like that. The greatest therapeutic relationships to me are the ones where I'm not 'welcome', so to speak, in the initial encounter. It's like a bit of a challenge for me. I like to see how long it takes/ how hard I have to work in order to make someone like me. It's kind of geeky. Haha!

I always ask for a new patient because I like the extra teaching I get to do to new patients and I like building relationships with new ppl so that I can learn more and see what works in building rapport and what only works well in certain situations. This Wednesday, I had a new family I was working with and yet again, the assumptions assignment came SCREAMING back at me. In report, I heard that the mum had bipolar disorder and I didn't necessarily think - uh oh, she's got issues, but I was thinking about how to approach it. When I opened the door, the husband seemed quite stern and not too welcoming, but nice. Nice, but not friendly. As soon as I got started on my assessments, though, I did a tonne of teaching about breast feeding, checking the mum's uterus, and a tonne of other things! The mum was SUPER nice and friendly and as soon as I started teaching them what I've learned in the past 4 weeks, the husband opened up SO much! I also think that being very respectful of their own wishes helped tremendously. The whole notion of critical social theory and not overpowering a family with your own knowledge has really taken a big role in my nursing practice. When I'm offering some information to a patient now, I don't tell them, I advise, but I tell them that ultimately it is THEIR choice, but that this is what I've learned in school and it's what the literature shows. But it is their life and it is their health and these choices are theirs to make. In general, people react SO well to that! When I was doing my newborn assessment, they were so adorable! The husband was taking notes of the things I was telling them and when I made a point about it, he said, "Yea, I know, I'm a geek." And obviously, seeing my weekly blog, I have that in common with him. We had quite the chuckle and it was just so nice. I guess there really isn't a better way to put it other than 'nice'. Heartwarming, maybe? Something along those lines!

I really felt like I took initiative this week. I was asking what I could do and was actually able to do things this week. I was really proud of myself because I felt like I took my learning into my own hands. I felt as though I put myself out there and got all the opportunities available to get as much hands on experience as I could. I was able to do 3 baby baths on Wednesday and I also offered some for other students to do, but it was huge for me because I took initiative to find those baby baths because I asked. I asked because I am hugely interested in this area of nursing and I wanted as much hands on experience as I could, since it was my last week, anyway.

This was a great week and I am so thankful for this long weekend 4 more weeks to goooooooo!!! AND THEN I WILL BE HALF DONE MY NURSING EDUCATION!!!!!!

Week 11 as a level 3 nursing student

Yet again, a late entry. Sorry folks, it's been a bit crazy as of late. Week 11 was a bit frustrating for me but I was very enlightened with all the assessments I was able to perform (all.....two of them haha!). I was able to get along very well with my patient and learned so much about her. She was a fellow nursing student! I was so excited. I honestly feel that the ability to remember the names of patients and their family members really builds a fast an effective rapport. I always think about how special I feel when someone remembers my name and I try to do the same thing.

That week, I was able to do my first newborn assessment. I have had quite a bit of interaction with children and babies, in my life, I'd say. Through St John, I have been able to practice flipping babies from back onto front for the CPR protocols but flipping a REAL baby is so different. I was kind of nervous, I'm not going to lie. I know the technique, but actually executing the process is different! A bit daunting, but also very exciting. Babies are very resilient. Hehe.

Something I find very frustrating as a student is going onto a new ward and getting acquainted with all the new knowledge. I feel as though it's a constant world of not-knowing and trying not to look stupid. In week 11, we were only able to do the basic maternal assessments and we had JUST learned the baby assessments, we weren't able to do baby baths or much else. I just find it a bit frustrating when I'm trying to find something to do and I keep on asking the other nurses if there's something I can do but the things I'm able to do are so limited. Oh well, see the next entry for a more optimistic view!

In PBL, we were able to get a fair bit ahead! We were able to start class in week 12 an hour later! I was very excited to be able to sleep an additional hour for week 12.

Week 10 as a level 3 nursing student

This past week was eventful! On Tuesday, we had our very first day doing maternal assessments. We were paired up, though, so I didn't get to do one. I still felt like I learned a lot, though. On Wednesday, I was supposed to watch a live birth!!! But before you get too excited, I spent the whole day with her and her sister in law only to move into post-conference and come back out to her being 6cm dilated.

As 'boring' a day as you might think it was, I thought it was so neat. Let me explain. In our family theory class, we learn about different family dynamics and we always are taught to be open minded, that every family is different, cultures are different, etc. The neatest thing this week was for my concepts of family theory to really solidify. I can be considered a 'strong character', so it's been difficult for me to really realize that my way isn't necessarily always the right way. It's not that I haven't known it, but it's being able to accept it and work with different ways. I guess in a nutshell, flexibility is something I'm continually working on, is how I could put it. What I see as a 'family' isn't what someone else sees in a family. Just because a family is different from mine does not mean that it's dysfunctional and vice versa. I really saw that this week. Not that I went into the room thinking, "oh this family is going to be dysfunctional" but I mean that it's so interesting to see that their way of living is so different from mine yet works so well. I think I say that because I admire their family for doing things their way because I would struggle in their situations. I admire them and think it's remarkable.

I really valued this week because I was really able to connect with the family. They were so lovely and even invited me to come back after my post-conference to have cake with them! I went back, not just for the cake, but because I wanted to say goodbye and to see if she had delivered yet (she hadn't). I didn't have cake either, FYI. :)

I spent all of this weekend on my PBL paper but I don't regret it at all because it's over and done with now. I'm also done my assignments for family theory! SMOOTH SAILING THIS WEEK, FOLKS!

Also, not that there are any die-hard fans out there, but I'm going to change my update schedule to do it on Wed instead of the weekend because I find the span difficult. I don't have as clear a flow as I would if I had clinical on Thur/Fri.

Oh! Another highlight of my week was being able to prime an IV bag successfully without any glitches because I went to open lab last week! I was very proud because that was time I took out of my day and took ownership for my own learning. This past Friday, I practiced my sterile dressing changes! I was so rusty. I'm going to do it again this weekend. :)

Week 9 as a level 3 nursing student

This week has been incredibly...over whelming, to say the least. Self-induced stress, though, I suppose. We had an immunology midterm on Mon, and a pharm midterm and mental health final exam on Thur. I also decided on a whim on Monday to throw myself a bake sale on Thurs. In retrospect, what was I thinking. Haha.

Oh well, I made it through, smiling and alive - well, breathing at least! :) I kid.

Lessons this week:

Orientation day was Tuesday and reading lists were released on Monday morning. There wasn't much time and the amount of information presented was pretty hefty. I feel as though I put a lot of pressure on myself to know everything - but I just didn't have my A game on Wed at clinical. On Tuesday, I made cue cards on some things, but per Murphy's law, I didn't have one made for the questions she was asking. That's ok, it only serves as motivation for me - just have to keep pushing myself. I won't always have the answers, but for me, the key is to keep on trying and just look up what I don't know. That's the answer for me because I hate feeling confused, and I guess with factual, concrete information, it's easier for me to grasp and make cue cards on than for something like reading the dynamics of a family.

Family theory is actually very thought stimulating, for me. The themes of dignity, feeling helpful/appreciated, connecting with ppl, and phenomenology were emphasized yet again. I feel as though the activity we did was pretty well executed - we all shared a memorable nursing memory to a partner who in turn, shared it with the class. Our partner was to extract one memorable quote to put up on the board. It seems as though this class pushes us to be highly self-aware. We shall see how everything unravels :)

Something I put on my learning plan was to be more self-aware and to understand where my triggers lie. When my clinical instructor was telling us about some stories of abuse, I found it very difficult to sit there and even listen to without having a look of horror on my face. The truth is, though, I'm going to have to be unbiased in my care when the time comes for me to deal with a situation such as that. Tying in from the family theory course, what my ideals for a family are not the be-all-end-all of family dynamics. Just because I think that a family should be loving, unconditionally, that isn't the case, this is just how I interpret it.

A pretty big group of us went into open lab today to practice IV therapy, injection landmarking, and other level 2 skills. I found it both daunting and helpful. Daunting at first, because I was super rusty, helpful because I got to practice the skills hands on! It's going to be a weekly ritual, so it'll be great, especially for Bangla!

Weekend plans: finish PBL paper, make PBL handouts, DO MY OB READINGS, maybe go for a run again!

Week 8 as a level 3 nursing student

"I try to enjoy the little things in life..."

Goodbye, Riverview! I say that with a fair amount of sadness. These past 8 weeks have been both enlightening and trying, surprisingly. In talking with students from other levels, the majority of them have said that their mental health rotation experiences were super easy, etc. etc. I think it depends on what you mean by 'easy'. Task-wise it was definitely a remarkable change of pace from my surgical rotation's task-oriented ways, but in terms of communication, it was definitely a challenge. If you know me, you know I am fairly talkative, connect well with ppl (generally), and try to be friendly. However, no matter how friendly I aim to be, I still faced some apprehension when asking about certain things like delusions, hallucinations, suicidal thoughts, and topics I have not had much exposure to in my life. But that's what it ultimately is, I feel - inexperience!

The highlight of my week in clinical this week was being able to talk to one of my patients. While this may sound ridiculous and miniscule to some, it was a huge accomplishment for me because this patient is known to be reserved and reclusive. To be able to sit there with them and have them ask me back some of the questions I posed was so incredibly exciting for me. I relish in the fact that they took a genuine interest in me and even asked what kind of nursing I wanted to do after I complete school.

Ironically, the title of this blog is fitting. Because today was our last day of Mental Health Clinical, our instructor generously took us out for pizza and it was so much fun. I was in the middle of digging into a slice of pizza when someone made some comment to me and I responded with, "I TRY TO ENJOY THE LITTLE THINGS IN LIFE" and Amrit (my newly faithful reader) responded with, "THAT SHOULD BE THE TITLE OF YOUR NEXT BLOG". Haha. So while the comment I made was offhanded, it is fitting. Even though having someone ask me about my interests might seem minute to another, it spoke volumes to me and I've learned that I need to celebrate my successes, no matter how trivial they may seem. And I don't find this one trivial by any means.

Maternity, here I come! Look out, world!!

Week 6 as a level 3 nursing student

"Honest disagreement is often a good sign of progress."
- Mahatma Gandhi

Well, this post is clearly many days late. I apologize for my un-timeliness but I've been in a bit of an Olympic/baking frenzy.

Week 6! This week I learned the importance of being assertive and honest in hopes of furthering group process. In NURS 3000, PBL, I've been quite bothered by many issues and as the chairperson for this week, I wanted to bring up my grievances in a very honest and open manner. I mulled over how to do it for hours and did not sleep until 0430 Sunday night with a 0830 class Monday morning. The most important lesson I learned from this experience is that honesty goes miles. That Gandhi knew what he was talking about. I felt as though the class really progressed after that class and I was so pleased with the level of participation.

Let me see, clinical this week was different! It was my first week on the other side but we did not spend much time there. We got to learn about ECT procedure! I gotta say that it's slightly disheartening, the wide-held notion that it is cruel and inhumane. It is not the first line of treatment and it is not done to harm a patient, it is used for treatment resistant patients. So for example, someone who is manic and has not had positive results from oral medications could receive ECT. They are under general anesthesia, given muscle relaxants, and the seizure lasts for max 30 seconds. They awake in 30 min and most patients feel great afterwards. It provides for a better quality of life.

I can't believe that we only have one more week at Riverview! Having said that, however, I am totally anticipating my rotation at Surrey Memorial BABIES, HERE I COME!!!!!!!!!!!!!

Olympic break = money making, baking, and homework

Week 5 as a level 3 nursing student

Cheerie-o, everyone!

Let's see - this week was slightly hectic. I had my presentation on Monday, handed in my PBL proposal on Monday, and took my mental health midterm as well! Tuesday was a bit more relaxed - I just had to meet with my partner and immunology instructor to go over our presentation. I say more relaxed, but I left that meeting feeling seriously anxious. We're supposed to teach our class about the immunological aspects of breastfeeding and I just don't really feel prepared. We aren't teaching it until Mar 2nd, but the deadline for our presentation is Feb. 16th. I always feel so much more pressure when it's a group assignment because both of our marks are on the line.

In clinical this week, we actually got to stay on the same unit for one more week, which was exciting for me because I wanted to interview one of the patients for my PBL paper. It was disappointing, though, because I didn't get a chance to talk to him about it - I really wanted to interview him. It's the same patient who motivated me and inspired me a few weeks back...I've been reflecting lots lately and have realized that he is the first patient who has enabled me to truly empathize with someone.

Sympathy vs. empathy - you don't sympathize, that's feeling sorry for someone, empathize is when you put yourself in their shoes and truly attempt to feel what they're feeling. I was reading his chart and just saw what a hard time he had been going through. When I was talking to my colleagues, one expressed how she wished she didn't know the story behind each person because it was so sad and that it made her depressed. I had to speak up about this because I think nursing is such a collaborative profession and because I was there. I went home on Thursday and sulked for a while before realizing, "hey, despite all these events, he still wants to get better, to improve, to have his own life." It was a huge moment for me, that Thursday evening - I cried, and I'm not too proud to admit it...like I said, it's empowering, for me, to be able to see stories like these. When we talked about this, my classmate seemed really receptive to it and I learned in level 1 the importance of using your colleagues as your resources because if you find the right ones, they can help you through some pretty tough times. When I was in level 1, I grew really attached to a patient and cried pretty hard when I had to leave. That was the first time I truly questioned whether or not I could be a nurse - I felt that putting so much care into a person and having to leave was going to be chronic loss and grief for me. I'm obviously a sensitive person, but I'm finding it easier to detach enough to not cry (I'm not saying it's never going to happen again, believe-you-me) but the whole 'therapeutic relationship' concept is starting to make more sense to me.

My dad always said that you don't have to make your own mistakes in order to learn, and while there has been no specific mistake mentioned in this post, the basis of my dad's statement stands strong. Learning through others is so valuable. Sure, sometimes making your own mistakes allows you to really struggle and grow, but you don't always have to learn the hard way. Drawing on the experiences of others is one of the pillars of life, I think and this week, it really showed to me. I'm not saying that I'm oozing with experience, knowledge, expertise, or whatever, but I'm saying that I knew what my colleague was going through because I'd been there. It made me feel really bad for a while, but sometimes, taking a step back and looking on the other side can be huge. It's always easier to solve someone else's problems, right? ;)