Birthday, continued

Today Wade and I went to his brother's house for a birthday dinner. This is Wade blowing out the candles with his nephew, Spencer.








Spencer enjoys making silly faces, so after eating cake we decided to make silly faces together. I think this picture is a real winner.

Wade's Birthday

Today is my boyfriend's 22 birthday, and I'm pretty sure that as he blew out the candles on his cake he was wishing for a girlfriend who listened better. Allow me to explain. Several weeks ago, Wade bought me minutes at Endless Summer, a tanning place about 5 minutes from campus. I decided that I didn't want to tan alone, so I convinced Wade to come too. He'd never been tanning before, and he was worried because he burnt very easily. I reassured him that everything would be just fine, and that after 10 minutes in the booth he wouldn't even get any color. He told me multiple times that he had very fair skin, and again I just brushed him off and said that he had nothing to worry about. The very tan employee behind the counter also said that 10 minutes probably wouldn't do much of anything. She handed Wade the waiver he had to sign as a first time tanner, warning him of all of the random risks. Wade looked her in the eyes and asked, "So, do I get cancer right when I sign this...or after I get out of the booth." The poor girl didn't know how to respond. However, Wade clearly had not met his daily quota for smart ass comments, and as we were touring the tanning salon, Wade mentioned that he hoped he could win the staring contest. When the employee asked him what he meant, Wade simply said, "With the light bulbs in the tanning bed."
I enjoyed my tanning session, and I felt just fine afterward. Wade was not so lucky. Later that night he said his back was itchy and painful and he wanted me to take a look at it. The second he lifted up his shirt all I could say was, "Oh my God, I'm sooo sorry."


From now on I will be listening to my boyfriend.

My Other Hobby

Besides nursing, I have one other main hobby. This is Boyfriend, and we've been together for two years.

This picture was taken on our 2 year anniversary. I like to think that I baked him love in pastry form. I also made him an awesome fleece blanket with race cars on it. He got me a toolbox full of ammo that we used while shooting handguns later that week.

Boobies

This week at clinicals, I went to a Mammography Center to see what the nurses did and what a standard procedure was like. Today the center would be doing a biopsy as a follow up to a suspicious mammogram. I was able to follow a 42 year old Hispanic woman, R., who worked the third shift at a packaging company. She was a sweetheart, and was working incredibly hard to help her daughter through law school. She was even nice enough to let me feel her breast lump before her biopsy.
Even though I enjoyed my experience, there was one part that shook me. Both the nurse and radiologist could clearly tell from the numerous calcifications on R.’s initial X-ray that she had cancer. I was even told that there was a 99% chance that this woman had breast cancer. However, when the nurse was speaking to R., she always reminded her that 80% of the biopsies turn out just fine and kept providing what I considered to be false hope. Having such intimate knowledge about a woman I barely knew while interacting with her on such a superficial level was almost unbearable. I knew that she would not be told about her cancer for another day or two, and that pathology would have to confirm, but I could not help wishing that we could just tell her now. I wanted to be there to hold her hand and to cry with her as she received this news. I desperately wanted to provide her with some hope, and to encourage her to keep living a life that she should enjoy to the fullest. Instead, all I could do was engage her in a conversation about Thanksgiving and holiday shopping to keep her mind off of the tremendous anxiety that she was feeling. The best part of nursing is knowing that you’re helping, and the worst part is not being able to help as much as you know you can.

Sometimes I have moments of clarity at the hospital that remind me of why all of the stress and sleepless nights are worth it. I had one today while I was helping to deliver my second baby. The mom, A., had her husband and 5 year old son in the room with her. A's parents were supposed to watch her son, but they live out of town and were still several hours away. It was clear that the grandparents would not be there in time, and that their son J. would be there for the birth. Both mom and dad were worried about how there son would handle the experience.
A.'s labor was quite slow to start. She was only 4cm and -1 station and her water had not been broken yet. After the doctor broke her water, she progressed to 9cm and +1 station in maybe a half hour. Her epidural helped somewhat, but any baby descending that fast is going to cause mom some discomfort. The nurse and I quickly set up for delivery. Both parents decided that dad would leave the room with J. if he freaked out during labor, leaving mom to delivery the baby alone.
The birth itself was very quick. The doctor who delivered seemed somewhat absentminded. Granted, he did a great job, but I don't think he realized that I was a student nurse. He asked how my orientation to the floor was going, and then had me suction the baby as she was being delivered. Now, I love getting hands on with patients, but I get nervous performing skills on infants. I can't mess up getting a mom ice water or putting in a catheter, but I worry constantly that I will cause some sort of permanent damage to a baby. Anyway, the baby was born without complication and weighed just over 8 pounds. J. handled the birth just fine. He stayed up by his mother's head and yelled excitedly about becoming a big brother.
As the oldest sibling myself, I fully understand the issues of "dethronement" that often accompany the birth of the second sibling. I felt the need to make sure that little J. felt included in this experience and would remember this day as a positive one. I made sure that he had a hospital bracelet just like his mom, dad, and new sister. I even wrote "big brother" on there for him before I taped it on (I couldn't figure out how to get it to stay on any other way). I noticed that during my assessments, J would sing in the corner to calm the baby down, so I invited him to stand next to the bassinet and sing to his sister. J. even started putting on gloves when the nurse and I came into the room to assess A. or the baby. When mom and dad were videotaping and taking pictures of the new baby, I suggested that everybody get together for the first photo of their new family.
While taking the picture, I had a moment of clarity. I, at 21 years old with little to no real life experience, am granted access to the most intimate and defining moments in people's lives. I am able to witness people at their most vulnerable moments, and I can bring them peace and comfort. It was both awesome and frightening to realize that in 18 months this will be my profession. Every day will require that I take control of uncontrollable situations and help my client bear their burden or celebrate their joy. Today, while taking the first picture of a new family, I finally realized the huge responsibility that I accept every day when I walk into the hospital.

My First Delivery!

I got to help deliver my very first baby today in clinicals! The mom L. was a sweetheart, and she was a little nervous considering that during her last labor she pushed for 3 hours and 40 minutes! I watched the anesthesiologist put in her epidural, and he was kind enough to explain everything to me as he got it started. The nurse I was following let me insert L's straight cath before she had to start pushing, and I even got to do a vag exam. Disregarding the fact that I put my hand in somebody's vagina, it was crazy to feel the baby's head and the mom's cervix dilated to 10.
L. had the easiest labor I could possibly imagine. During her two practice pushes, the baby's head started to pop out. During her next contraction, the doctor asked her not to push and to let the contractions do all the work. The mom only had to push once or twice to get the baby's shoulders out. The next few minutes were pretty messy. Blood was still draining out, and the mom tore a little bit. The weirdest part was watching L. immediately after birth. From the waist up she was a happy mother cuddling her new baby. From the waist down she was going through postpartum hemorrhage and ended up with an EBL of 500mL. The doctor was shoving her entire hand up inside L. and pulling out clots. The bed pads were soaked with blood, and so were the towels on the floor. Eventually this resolved, and L. was just fine. The doctor even let me watch as she sewed up L's tear.
The baby was a girl named Emily, and her face was one nasty bruise because of how fast she delivered! Otherwise she was completely healthy and happy. She had the fattest little cheeks that I've ever seen, and was a whopping 9 pounds 15.2 ounces. The nurse let me give her 2 shots and help with her first assessment.
Watching a birth in person was both surreal and exhilarating! I was also relieved to know that I can handle seeing large amounts of blood without fainting. I'm looking forward to next week when our professor takes us to watch her get a mammogram in order to use her experience as a learning experience!