Dreams: On Hold

On the day that I failed nursing school, I kissed my husband & son goodbye in the wee hours of the morning, climbed into my car, & drove into the city to go to the hospital. As I was in the 2nd lane of the left turn lanes, following several other cars, preparing to turn left along came another car barreling straight towards me at what felt like ten billion miles per hour. "It's going to stop," I thought, not really expecting otherwise. That light for them was solidly in the red.

But it didn't stop. And by the time I'd processed this & swerved my car straight, it was like I could literally feel the whoosh of a near head on collision with said car. And then I went on to clinicals, had the absolute worst day in the history of mankind, and it was all over. But here's the thing..some might call me lucky(being alive is a hecka lot better then failing out of nursing school). I don't believe in luck, I know I've got a guardian angel on call 24 hours a day and I won't be leaving this planet until God deems fit. I won't say that failing has been easy to accept either, but I do know I'd make a good nurse(and maybe that will be as an LPN until I get whatever stuff together that I need to get together. The instructor made me feel a tad better by telling me that their program was the hardest one in the state,& students who have failed theirs have gone to others and passed.) It just won't be happening any time soon.

So now I'm 3/4 of an RN..starting from the beginning. The grief is still quite raw, the negative thoughts inhabit my nightmares each and every night. It is literally like a part of me has died. (And it's probably going to take awhile not to feel that way)

One day at a time.

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From the Files of a Nursing Student: Blue

It was kind of a lax weekend, and by "lax"...I mean that there were no looming tests on Monday. Not that this means that they're giving us a breather, because there's a paper due today. (fortunately for me, I have one from the previous attempt at this course, that was never graded & in my eyes, legit for round #2) Hubby is away on a business trip for 9 days, so it's me & the baby. Baby plus keeping up with this place (cats, laundry, etc.) has me so busy I'm really grateful that there isn't another test till next Monday.

Four weeks down. Four to go. On Thursday, after I took my hubby to the airport & ran to the grocery store & went home, a brief GI virus sidelined me for the rest of the day & I wasn't sure that I could drag myself around on Friday,but I felt marginally better by then. Took my cardio test & sat through 5 hours of GI lectures. I did very,very badly on the cardio test (but my average is still ok...still there's no excuse for it). I think it was a combo of feeling sub-par plus not being able to "think" it out plus total brain deadness on the math questions. I studied, I REALLY studied. Cardio is supposed to be the worst test though (other then the final) so I just need to concentrate on getting stellar grades for the 2 tests before the final. My mom is coming up to help me out for a few days this week, so that will be really helpful. (try lifesaving...she cooks me food,cleans,shops,helps with the baby. I don't know how she does it all,but she had six kids so I'm sure this is just minimal compared to back in the day) That comes with its own particular brand of stress,as she's of the opinion that the first few years of a child's life should be exclusively day-care free..let's just say that we disagree on that point. I don't think I'm emotionally scarring my child for life,& I do my best for my baby.(and I enjoy doing it,he's a good baby) He is happy,healthy, & loves people(everyone..not just his momma)in some respects I feel like the interaction is good for him as well.


Four weeks to go. (have I said that yet?feels like I've been in this course for-ev-er. At the end of this course, there's a break until Jan. because of a weird quirk in what course plan,cannot take a 3rd semester course right after a 2nd semester) I've discovered why the hospital freaks the sams hill out whenever there's a glucose value like say, 53 (or 284)...those values require follow up by the nurse & possible notification of the doctor. And if you're a tired OB, a blood glucose of 284 is likely to majorly annoy you.(especially if you have no clue how swing-ish a type 1's blood glucose can be, post-pregnancy(or pretty much any time) Their goal is to
ensure that there are no surgery complications and discharge you as soon as possible. (and diabetes kind of throws a wrench in that process)
I really think they go overkill on it,as a type 1 I do not need to see a diabetes educator every time my blood glucose goes outside of the range...but it's all very much CYA. But you've got to remember that the vast majority of PWD are type 2...and have stabl-er blood glucoses then type 1's. They often do well on sliding scales,& have residual insulin production to keep their bgs lower. However, that doesn't help me in figuring out what type they are if they are older,perhaps overweight,already have some complications,and are exclusively on insulin but were just diagnosed. (because that info isn't in the charts)Doesn't this information MATTER? (well,it does to me...apparently not to anyone else) Couldn't they try type 2 meds, or has there been any screening bloodwork for antibodies,and shouldn't they get education on counting carbs etc.etc.etc...when it comes to diabetes, I wish I had a clearer clinical picture then the one I get.


A FB friend of mine passed away last night, she was 31 years old, type 1, and had just had surgery. (we used to chat on a diabetes chat) It's so sad when things like this happen out of the blue,& the family is left to grieve. (so much of that around the DOC lately) 31 is too young to die. 40 is too young to die. Please keep those families in your thoughts & prayers. I guess I've just been going through a mini-midlife crises, one in which I've been learning (in depth) about hospitals (and the million & one things that can go wrong post surgery...clots & DVT's, heart attacks, strokes,etc) and being in my 30's, it's been a jolting realization that yes, young people have these problems too...especially PWD. Waiting till I'm 45 & in the CCU with a massive MI isn't going to do me any good,I really need to start improving my diet & exercise NOW. (regardless of cholesterol, people have heart attacks from other things) And women, especially young women, do not have a good prognosis post-heart attack. I don't want to leave behind my family just yet, I want my baby to have a mother & my hubby to have a wife. (for a good long while) Life doesn't feel very fair sometimes but its a heck of a lot fairer then to die of a complication, too young. That complication isn't always "D" related...blood clots can be a complication of any surgery, regardless of the diabetes. You can do your best to lead a healthy life with D..but things can still happen, outside of your control. I just wish there was a cure for diabetes though,because it breaks my heart every time I see a blue candle.

Nursing School: Take III

Yep, here I go again. Now with an adorable,active (almost crawling) little 7 month old...life doesn't slow down for anything.

The course in question is Medical Surgical (part 1)...and it's my third attempt. (the first attempt was a "drop out on the first day of class" affair and the 2nd,I thought I would be all SuperWomanish and do it all. Didn't work out like that & the icy,bitter shards of what went down is something I still can't talk about, even to my blog)

Third attempt. Last attempt. If I fail again,I'm out of the program. I believe that I can do this, but most of it will definitely be a mental journey (as I face some of the same individuals who did their very darnedest to make sure that I failed). Because I'm not an idiot,it wasn't the coursework that got me. There is one thing that I learned through this though,and that is that "trust" is not something to be given out lightly...I am too naive. Not all instructors are there because they want you to succeed. (Some are there just to collect a paycheck) Trust is mine,trust is not something I have to automatically give to you just because you have a string of credentials behind your name. These are lessons burned into my soul, trial by fire...still fresh from the experience.

Anyway...back to the whole "registering for school" deal. To be able to get accommodations, (aka taking tests in the testing center/being able to have food/glucose available/being able to treat highs, lows as needed) I have to go through the office of Disability Accommodations. I have to have said accommodations, or I'd get suspended for eating/suspected texting/etc. (the joys of diabetes, nu?it is is almost not worth the trouble & I wish I could just hide that I have it) So, right before the start of the new semester, I request a "renewal of accommodations" packet (through the school website) and then go to pick it up from their office. Inside that packet are three separate forms..each form is in triplicate. (white, yellow, pink)

Form #1 I take to the testing center, they sign, I sign, and they keep the yellow copy. I keep the pink copy, and return the white copy to the DSS office.

Form #2 is an instructor "memorandum" (more specifically,listing the exact accommodations needed(eat/drink in class, monitor bg,medical supplies present,1.5x time) to remind them that they have a student taking tests in the testing center, and they have to drop off a test there. (so I can take them) Instructor will sign, I will sign, they will keep the yellow copy, I will keep pink, and the white copy goes back to the DSS office.

Form #3 is the official course form/memorandum for the teacher's file. The instructor signs, I sign, and they keep the yellow copy, I keep the pink, and the white copy goes back to the DSS office.

The testing center is on the opposite side of the campus, which means that I'm usually missing half an hour(or more) of the lectures. Not that I mind, but while everyone else gets to take their test/go to lecture in the same place, I get to run around everywhere attempting to keep on track with everyone else. Yeah, this "Special Treatment" thing is not all fun and games. The lectures I could repeat in my sleep (by this point),and I'm hoping they'll use the same tests (the answers I think I'll have remembered) so that that part at least will be stress-free.

It's entirely possible to be a good mom/go to school at the same time...and I want this degree. I've been working towards this for 11+ years,and if it's not to be, it won't be because I didn't give it my all.

Questions of the Universe

And so today, I met with my course advisor...& got the deep, hard, questions rolling.

In a couple of weeks, my OB course will end...and the Medical/Surgical one is slated to begin. Now I know I'm going to sound like a total wuss, but I have my doubts as to whether or not I can hack it. A thousand questions are flooding my mind (is this going to put me in premature labor, could I have really stellar diabetes control & do better by the baby if I just didn't take this,this course is so difficult that NON-pregnant people frequently fail 1-2x, what if I manage to do well but still have some medical complication and have to drop out 3/4 of the way through(I don't want to take a course I'm just going to have to repeat anyway)...questions to which there are no answers,questions that float out there in the stratosphere.

Medical/Surgical is a demanding course, a full time course. (OB is a piece of cake, by comparison)And I'm going to be living fulltime in the doctor's office anyway, as the
third trimester brings with it increased monitoring/tests in the pregnancy. (just because things are going well now, does no mean that will be the case 10 weeks from now)

So, I have several options. I can drop out in several weeks(miss the 2nd class of the semester), start up again in March.(and be one semester behind) I can drop out in several weeks,take next semester off, and be 2 semesters behind. Or,heck,I could take the next two years off & still be eligable for readmission to the program. I don't want to do that,& I don't for see having to do that, but there are no answers out there...for either my advisor, or for me.

And LifeChange 101 is coming our way,& there's a part of me that needs time to get ready for that.(call it my "nesting" instinct)
I want to create the nursery, & get everything in order (and that includes my mountains of junk,let's hope this kid does not inherit my messiness traits) and 2-3 weeks at the end of the semester doesn't seem adequate. (especially not when you have grown so big that you don't want to move) This is what I want,& this is a decision that may never come my way again.(whereas, with nursing school, yes I could do this at age 42) This is the decision that is "best for me" as my advisor would so eloquantly put it, although no one can tell you what to do, the answer in this regard is becoming clearer.
Its admitting that I can't do everything which is a tad hard. People do this, people have emergencies/babies/circumstances routinely that they have to take time off...& get back into the program,graduate,become nurses.(it isn't some bad thing when you can't) I just really wanted to have completed the semester before I did that, it feels like a thorn in my flesh if I can't, like a task unfinished.

Time will tell, I guess. (whether or not I'm nuts enough to take on Med/Surg.)

Thoughts From the 3rd-4th Week

1.One week,you're on top of the game-the next,you do something unspeakable (or non-HIPAA compatible) & on top of feeling horrible about it,you then get to tell your instructor,the shadowing Masters Degree student,& the RN charge nurse.(the patient is fine) You then get to fill out your very first Incident Report on why the thing you did was a bad idea & burst into tears,well,just because the situation is not awkward enough.Mistakes happen,I know that(it's the sheer amount of authority figures that sent me over the edge). Live & learn.(I haven't been kicked out of the program yet,so that's a positive.)

2. I got to see a cataract operation(video from a guest lecturing ophthalmologist) as well as ten zillion pictures of the Diabetic Eye. It was both fascinating and made me want to throw up,as it seems that the winning combination of diabetes,nearsightedness,cataract surgeries,strabismus surgery,and optic neuritis spells a
near certain dearth for my left eye.(glaucoma,retinal detachment,macular degeneration,pick your poison)I really would like to keep it 'round as long as possible.(renewed vow to get myself to the optho this summer) I think that the clouding on my L.lens has progressed,I don't see as well at night(it seems to have really gone to town in the past 2 years...is it something about that 10 year post-surgeries mark? I think lasaring is in the cards for the near future which is kind of scary to think about. I hope it doesn't A.hurt or B. have any other visual side effects.I've known the day would come that I'd need lasar,it's just hard to remain calm when its an eye(s) you're talking about.

3.150 years ago last week,the Civil War began. iTunes has an incredible app called The Civil War Today which gives you a daily update through the 4 years of war. (it's an iPad app though) It's in newspaper format,& has video clips,journal accounts,quotes,trivia,photographs, etc. & really makes it come alive...it's a pretty cool app.If you love history and have an iPad,I suggest you check it out!

4.Cancelled my Endo appt,rescheduled for May 3.Hopefully my a1c won't be so off-the-charts high by then.

5. Freestyle strips without the Butterfly are becoming next to impossible to try and find. The bad thing is,both kinds have the same UPC so it's impossible for a pharmacy to know what they're getting.It's largely hit & miss trying to obtain any.(at all)
---------------------------
1.In the Event of a Fire Alarm,make darn sure you grab your meter & sugar,because you won't get back in that building for a good 45 minutes. This is not a time to go low.
2. Working in a nursing home is like working in the psych ward..one day everything is "normal", the next, the patient is wheeling all over the cafeteria,& attempting to slug you when you try to prevent disaster from occurring. (while the rest of the population looks on) I guess it's not that bad when the patient is not physically capable of hurting anything,but it was just so,so,so bizarre & the Easter Bunny was not exactly helping me in what I was expected to do in said situation.(me & Easter Bunny in room full of patients,& I couldn't leave because I was monitoring somebody else) HELPPP.(just about ready to be committed to a mental institution myself,I was not supposed to be monitoring the whole entire room) Next time, a little help, Easter Bunny?
3. Forget tiredness, I've progressed to dead. But next week,there is no homework/care plans due(Monday,Test 4) and Wed/Thurs we'll be caring for two patients EACH & then,that's the end to clinicals. Following week,we have our big Patient Presentations & the week after that,evaluations & the cumulative Final Exam and the big Nursing Convocation Dept. "party" and then it's all done! (time flies when you're having fun) I need it to be summer.
4. You may cross "morbidly obese patients" and "chemo/radiation patients" off the list of future career choices.Someone needs to do it,it just won't be me. I can't even find a pulse(anywhere) let alone formulate a good plan. I feel like whatever skills I may have acquired up to this point have not gotten me really far (in terms of a morbidly obese individual)
5.One week & 12 hours till the royal wedding! (I'm sure you're all just dying NOT to know)

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Circle of Trust

Trust. It's a tricky thing,and for a PWD,the question of ultimate trust boils down to a little red box.



In 12 years, I had only asked the question of ultimate trust one time (to a non-family member-family members have given me some,& my husband does know how to give one) It was directed to my then-EMT boyfriend(my blood sugar was under 10 mg/dl, & I was hysterically convinced that I would soon die) and he said no.Who knows why...nerves,perhaps.Or the legality of the situation.It did not matter,I was both annoyed(to the nth degree) and scared & crushed,that question of trust had been thrown back into my face & ultimately,that helped in the breakup.If you cannot trust someone completely,you have no business being together.(and I used to be an EMT & in my section of the universe,heck yes they give them.I know he knew how)

So when I asked my clinical instructor if she would be willing to administer "the shot", it was with a great deal of fear & trepidation. She said yes.(she's an ER nurse,heck yeah she knows what to do in an emergency) I ran through the basics,& what I'd be like(in such a situation). But then a dept wide email circulated RE school policy in such a situation & it was advised just to call 911,not to get involved.

Crushed,that's what I was. I dunno why it feels so important that I have someone on my side,but it felt like that trust I'd just given out for the 2nd time in 12.5 years didn't mean squat,again.Of course my clinical instructor was sympathetic but she couldn't go against dept policy. So back I went to talk to the dept head,& she said in actuality,the instructor could do as they wished-call 911 or give the shot/call 911,the schools liability insurance would cover either way. I wouldn't ever sue but there is liability insurance for everything,these days.

I am relieved..so,so relieved. I thought the school really didn't care if I lived or died,& I don't have the attitude that it's anyone's responsibility to do this..only someone I think would care enough to do so. When my clinical instructor said sure,I thought that to be the case.(she's pretty great) I have worked a retail job & in 7.5 years,never trusted anyone there (even good friends) with that burden.(said person has to be somewhat knowledgeable about medical matters) I think part of the deal here lately has to do with the lability of my blood sugars,& my desire to stay closer to 100 then to the 250's of yesteryears. A blood sugar monitor is also not always handy..like it was at my old job. You can't very well crack the meter open in the middle of a procedure.(plus you have to wash your hands a billion times a day)

I hope to never need it(on the job)but it's so wonderful to have that piece of mind.(Bgs have been all over the map lately & it may come to pass,that I need one) I need to feel safe,& more then anything else,this decision has greatly influenced that. I don't think I'm going to be having this conversation with all my clinical professors but in this rotation,I never needed that reassurance more.(nursing home in the middle of nowhere)

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Thoughts from the First Week

1. Adult bowel incontinence smells 10x worse then an infant's.(goal for this week: do not gag/vomit on patient.I'm sorry, but it does take some getting used to)

2. Paperwork is already the bane of my existence.

3. White shows everything. And I can't use it to "blot" anything, without looking like Frankenstein Nurse.

4. I wish we had lockers.But students are not really wanted, they are just tolerated,and as such, there is a long list of ridiculous rules of things that are not permitted in the facilities...among them, any type of med. Because, as you might have guessed,there was an unfortunate incident involving a resident rifling/OD'ng on a student's meds. So my insulin gets to chill in my car.(it's not freezing,and it's not hot,but still it's highly inconvenient to not have that with me)

5. I have no appetite in the nursing home, but as soon as I get out of it I'm ready to go to the nearest fast food place (or home) and down 1500 calories. I think it's the smells.

6. Looking for information in a chart is like looking for a needle in a haystack.(sorry for the cliche, but it is) I think I could literally spend all day filling out that comprehensive assessment form,it isn't organized,and it's full of conflicting info.

7. I don't know anything.Please don't leave me alone with a patient.(not to worry...the instructor knows this,& first semester we don't breathe on the patient unless said instructor is nearby.)

8. The elderly can be so sweet, and interactive. If I had to live in a nursing home I can't say I would be that way.If I was lucid, I would try and escape every chance I got.

9. Mealtimes and insulin peaks never match up,which is why every time I get a chance to eat I'm in the low 200's.(in another hour, I'd be in the 100's,but lunch is NOW)Not that I'm hungry...but I have to eat something to stop my stomach from growling. Never been close to low but I still get the occasional "are you ok" glance from the instructor.

10. BYO glucose tabs, juice,and food is absolutely imparitive. There are no vending machines/staff (kitchen/cafe) privileges (nor any access to any nearby stores)so you've got to plan for a disaster scenario and bring enough food to treat low blood sugars all day. Otherwise,you're probably in deep water. (I wanted to ask what they do if a resident has severe low blood sugars but since many of them have difficulty swallowing, I'm guessing 911 would be called. Not what I'd want done for me but I'm pretty sure I don't get to go walking around with a huge hulking glucagon kit in my pocket)

Diabetes on Demand (Disclosure)

"Who here has diabetes?"

Those were not words that I EVER imagined coming from any instructor's lips, let alone the department (semi) head. But flow they did, in response to another student's inquiry on a diabetes-related topic.

"Oh, I do, I do, I do!I got it when I was 16.5, which isn't as sucky as some ages to be diagnosed because you can take full responsibility for your disease,and can wield a needle like a pro, but still,the only good age to get diabetes is age 86(or whenever you're in your final illness) when you don't really care that much because you're nearly dead..."

(Wait a second. What am I about to DO? I'm about to tell a group of people (of which, 50% will probably turn out to be food Nazi's and hound me relentlessly for the next 1.5 years (till graduation) about how I should manage "my" diabetes. They don't need to know. This is a teachable moment,but it is not "my" teachable moment. There are 30+ people in this room & my not saying anything,will not forever influence/ruin their careers.) And so my hand(burning with the urge to go UP) stayed down.

"Some of my student's in past semesters have diabetes,and have better perspectives on that (various diagnosis ages) then I do."

I thought about that, and while it's certainly up to the individual in question whether they want to share that I don't think it's something an instructor should be asking the class. That's an extremely personal question. I have diabetes,and at this point only the disability office knows it because they're the only ones who need to know. It still feels a tad weird though (the amount of candy that flows through this class is like being in kindergarten)like you should say something (about why you're not chowing it down like the best of 'em). Nothing against the candy in question, it's usually my blood sugars that I don't want to chase for the next 6 hours. Regarding different diagnosis ages,things are very different when you're dx'd at 6,16,26, or 60. But at every age, the patient can be involved in SOME way. (6 year olds are very smart & can get concepts before adults do) Being dx'd at 17, my childhood was D-free and candy was candy.(not something to be fought over, or something that would kill me.) I didn't have major food issues because I was diagnosed in the age of carb counting(and we always ate pretty healthy, so no changes there either)Getting diabetes is so much more then "anxiety over insulin injections" such as the examples in class are portrayed. It's more like anxiety over hypo/hyperglycemia/blindness/stroke/heartattack/kidneyfailure/amputations/neuropathy/foodbattles/dating/marriage/childbirth/job/healthinsurance/bloodsugarswings/earlydeath etc.etc.etc. I guess they choose that (as something that the nurse can actually "do" something about.)You can't dive forehead deep into something, you've got to take it by degrees.

On the plus side,I've survived three tests,a math test,a presentation,and a paper (with mostly A's) so I'm not just surviving,I'm doing pretty darn good. Switching to disability accommodations in the testing center was a really good idea.(less stress,lower bgs,and the slightly extra time have really improved my test scores)I should have done this a long time ago.

Veni, Vidi, Vici

I studied.


I came, stowed all beeping electronic devices in my car,and walked into the classroom with a roll of glucose tabs in my pocket.


I(along with the rest of the class, row by row) came up and stored every possible physical belonging AT THE FRONT OF THE CLASSROOM NEXT TO THE INSTRUCTOR'S DESK.(it was like being in Kindergarten,the only thing you were allowed to have were 2 pencils(which must be non mechanical) a sheet of paper,and your test/scantron.)

And I took the test.(under meter/blood sugar anxiety)

And I went back out to my car,grabbed my meter,and tested 325 mg/dl, 1 hour and 30 minutes later.

I really,really, really need those accommodations..its one thing worrying about the test(I shouldn't have to worry about my blood sugar too). I'm not that likely to go low-I just need the freedom to be able to check(and adjust) at will. It's very obvious that I need a cranked up basal rate(and possibly an adjusted mealtime Insulin/Carb ratio as well) One test passed(grade wise)and yet it most definatly wasn't a success, diabetes wise.One Stress-a-thon seriously shoots the whole day's numbers to pot.
Still waiting on the paperwork from my Endo's office,(for the accommodations)and it looks like I'll have to take another test in much the same manner.(before it all gets straightened out) I also don't know exactly how the accommodations will play out-perhaps I'll have to take my tests in the testing center.