Here are a few of my nursing school/CNA must haves:
- Stethoscope name tag – the etsy store is on vacation right now but she needs to hurry back! I need a new one on my adult sized stethoscope! Standard name tags are really hard to read, but if you toss this around your neck or use one of the badge reels, patients can easily see your name. (I have a badge reel for work that I love! I went through several cheaper badge reels but whatever she uses as a base is sturdy enough to handle the 18 million times a day at work that I pull out my badge to open a door!)
- Nurse cards – These are a great resource with lab values and signs/symptoms. Great for a study resource or to help you out if your brain suddenly goes blank!
- Myndology index cards – I have never been a huge fan of index cards, but I love these little pocket cards. I stick them in my pockets at work and clinicals and when I have a spare second I quiz myself.
- Pocket organizer. I have two–one for work, and one for clinicals. The one for work lives in my locker, the one for clinicals lives in my clinicals bag. Inside my work pocket organizer I keep a multi colored pen, a black pen, highlighter, sharpie, scissors, and a white board marker. Inside my clinicals organizer I keep
- Multi colored pen
- Scissors and pen light (came with the organizer)
- Alcohol wipes
- A small tube of essential oils (I like Bergamont for when I feel like I smell like the poop I’ve been cleaning up all day. I prefer the non FCF version, but it looks like they don’t carry it anymore)
- Cash + my ID/debit card (I have to remember to move these two things back and forth between my purse and the organizer. I am successful approximately 40% of the time.)
Hey! Look what I found in my drafts folder! A post almost all ready to go about our first backpacking trip–I finished it up and here it is!
Last month we backpacked for the first time as a family. I am so excited for the flexibility this offers in terms of planning. Great campsites need to be reserved 6+ months in advance, and with my schedule at the hospital changing from week to week and often unavailable to me until two weeks prior to the dates in question, this is a risky move at best. Backpacking also allows us flexibility in weather–you can go where the forecast is best!
For our first trip we chose the Horsethief Park area (located between Divide and Cripple Creek). We were looking to hike about 2 miles to test Will’s ability with his pack. We ended up hiking up to Horsethief Falls, then back to the Ring the Peak trail junction, which we then followed for about a third of a mile before finding an established campsite with a fire ring and flat area for a tent. Our backtracking meant that we were really only a mile from the car, which allowed us a nice low commitment way to gear test! We hiked to Pancake Rocks the next morning before packing up and heading out.
Nic didn’t want to go on this trip because the forecast was for thunderstorms on both Saturday and Sunday. I argued that if we waited for a summer weekend without thunderstorms, we’d never go camping. We had our camp set up before the storms rolled through Saturday evening, so we retreated to the tent for about an hour, and it worked out just as I’d expected. What I hadn’t thought about was how it would go if you had to pack everything up in the rain. Sunday we hiked up to Pancake Rocks. It started raining when we reached the top, and didn’t stop for the rest of the hike. Everything not covered by our raincoats was drenched, and though we had a tent to crawl into and dry clothes to put the kids in, we still had the prospect of packing up in the rain. Luckily the rain stopped just as we had finished packing up everything inside the tent, so we were able to put the tent away dry and the weather held for our walk to the car. But it was enough to bring me onto Team No Rain. We had wanted to go backpacking this weekend for the 4th of July, but when the forecast showed thunderstorms for everywhere we were thinking about going, we stayed home instead!
I had told my sister-in-law that the food part of backpacking was really stressing me out. It’s either heavy or complicated. She recommended that I just grab the Mountain House box of dehydrated meals from Costco. They were on sale for several weeks, which made them an even better deal–the packs are usually about $8 each, but the box of 13 was $48. We made two pouches for dinner and two pouches for breakfast and I was worried that with Will and Nic it might not be enough food, but there was more than enough. Two pouches will definitely feed a family of four even if your kids are older.
Along with the dehydrated meals I brought our usual hiking snacks – Luna bars (which Ellie is in love with) and Larabars (which both kids also eat well). It’s amazing how much tossing one of these at the kids during a hike will improve their mood 15 minutes later!
Choosing our tent was a major source of stress and our biggest logistical challenge for backpacking as a family. No one makes a true backpacking tent for four people! You go from 3lb three person tents to 7lb four person tents. It is actually better in terms of weight to take two two person tents than one four person tent. (Laws of efficiency make this just so WRONG, but there it is.) We talked about going with two two person tents, but I knew I wouldn’t be happy with that solution. So, (in keeping with most of the weight-decisions), we decided to eat the extra weight and get a light-ish four person tent.
This was one of my big revelations while planning: While I admire my ultra-light family members, we realized that as a family of four, we’re not cut out for the ultra-light mentality. Backup equipment, contingency plans, and comfort are too important when traveling with kids. When hiking with elementary school kids your distance will be low, anyway–a heavy pack isn’t as big a deal. (Says the woman carrying around a 4lb sleeping pad. No joke. My sleeping pad weighs more than most backpackers’ tents.)
Want to see our gear? Here’s what we used:
The Loads (or, Life Isn’t Fair)
We ask Ellie to carry her water and coat. Will carried his water, his clothing, his sleeping bag, his sleeping pad, and Ellie’s sleeping bag and her sleeping pad. (Telling him this was actually very helpful. When we first put the pack on him at home to test it out he acted like he was that idiot woman from Wild (my reaction to that book is so strong I probably would have been kicked out of book club over it if I hadn’t had to quit anyway because of my schedule) and just about fell over. Then I told him what was actually in his pack and he said “Is that all?” and realized that it actually wasn’t very heavy.)
The kids did beautifully. At 5 and 9 this proved to be very doable. With weight for a consideration, we didn’t have some of the usual distractions (making treats, board games, etc), but I did bring our absolute favorite thing: my Eno hammock. I also brought the lightest book I could find for bedtime (Homer Price)–which we ended up reading in the tent while it rained. Ellie found a baby tree to tend to within an inch of its life. 😛 It ended up being our only backpacking trip of the year because of our schedule and the weather on the weekends that we did have free, but if the weather and schedule had cooperated our plan had been to bump up the distance to 3 miles one-way for the next trip.
I survived the first semester of nursing school, and somehow we’re already halfway through the first bimester of my second semester! (That was a mouthful.) The good news is that the time flies. I spent a lot of time before nursing school poking around the internet trying to figure out if this was all going to be actually doable, so I feel like I need to put my own tips/experiences out into the interwebs for the next nursing student mommas coming down the line. Because YOU CAN DO THIS! You can work, and have kids and a husband and get As in nursing school and even maybe read a book. It can be done!
Here’s what I learned that I wish someone had told me (or they did tell me and I didn’t listen, so I’ll add my voice to the chorus):
- Everyone is going to tell you that you shouldn’t work during nursing school. Ignore them and figure it out for yourself. I work part time: two twelve hour shifts a week. This bimester (first half of spring semester), it’s a little ugly. Wednesday, Thursday, Friday I have clinicals from 2-10:30pm. Saturday and Sunday nights I work from 7pm-7:30am. Monday morning after work I get in my car and drive to school where I take my weekly test on the previous week’s material, and then sit through three hours of lecture. At 12:30 I get to go home and sleep until the kids get home from school (at which point I wake up and zombie around the house before going to bed again around 9). Tuesday is another 8:30-12:30 lecture and then it all starts again. Does it sound insane? Sure. But I absolutely love my job and I’m almost halfway through this particular schedule already! Which brings me to my next point:
- You can do anything X times. There are a lot of things in nursing school that you probably won’t be in love with. Tests, certain clinical rotations, certain projects, whatever it is, figure out how many times you have to do it. It’s probably not that many. Like my crazy schedule of insanity, for instance. Yes, it sounds dumb. But as I looked ahead into the semester I knew that I only had to do 7 crazy Mondays. I only had to do it 7 times. Easy, peasy. You can psych yourself out thinking about how many months or years you have left of nursing school, but the actual bad parts do not last long. There is spring break and Christmas break and summer. (SUMMER!) I find that May of 2017 seems like a very long time from now. So I look at the thing that’s daunting right now: the Mondays. And I count them. Seven. I worry about that and leave the rest for later. (It’s very Scarlet O’Hara of me, but you do what works!)
- Your family will do amazing things. Will can start a load of laundry. Nic meal plans and makes dinners and does grocery runs. This weekend he took both kids skiing by himself. Ellie had been skiing twice, Will less than a dozen times, and he got them up, got them dressed, packed a lunch, and was out before 7am to drive 2 hours for a day on the slopes! They made amazing memories, and wowed my socks off while I slept and studied between my Saturday and Sunday night shifts. If you’re going to work and go to school you aren’t going to be the do-it-all mom you used to be. You aren’t going to be there for every dinner or every outing. Embrace it. Watch in awe as your family steps up and be wowed when they rock the things you thought you had to do. You are growing with the challenges of nursing school, and in not trying to do everything you used to, you give them the opportunity to grow too! You can feel guilty about it, or you can be super proud of them. I pick proud. Because really, they’re killing this.
- You might not be top banana anymore. Seriously. Yes, even you. No, really, I mean it! In reading about nursing school, I read a lot of remarks about how nursing school is one of those small fish, big pond moments. I read it, and then arrogantly dismissed it. That wouldn’t happen to me. I mean, someone has to score the top grade. It’s usually me, so…you know….I got this. Except I didn’t. I got an 88% on the first test. And an 86% on another one. And sure, I got my As overall…but I knew that when I got 98, there would be a couple of 100s. And when I got 100, I would be in good company. My top banana days were over. The competitive part of me wanted to dig in, give more, reclaim my crown as queen of the exam…but then reason set in. Which brings me to:
- Don’t try out new medication. You are going to take pharmacology, where you will learn about anxiety meds. You will also learn about anxiety, and you will realize that this describes you perfectly. (Nursing students are type A stressed out sleep deprived perfectionist beasts. It’s less a classroom than it is a psych ward. All semester I kept coming home and saying things to Nic like “You don’t understand. *I’m* coming across as well adjusted.”) THIS IS NOT THE TIME TO GO TO YOUR DOCTOR AND ASK FOR ALL THE GREAT MEDS YOU JUST LEARNED ABOUT. We had a couple of students in our class fail or nearly fail because they either went on medication or messed around with their medication dosage during the semester. It was like watching an after school special. (And lest I come across as being above the great medication debacle, remind me to tell you some time about the day I took melatonin to help me sleep between shifts. It turns out the side effects of melatonin include headache, depression, and confusion. If you’ve never been medically depressed AND confused, you have missed a great hilarious self deprecating story.)
- Don’t get swept up in the tide. There is nothing a group of nursing students likes to do more than spiral out. You are going to hear about how difficult X is, or how many hours someone spent on Y, and it is tempting to jump into the pool of crazy and let yourself get all pruney in it. I really like my fellow classmates and enjoy learning from them and celebrating with them, but I am also cautious. I keep to myself before a test and usually try to keep to myself after it. When I don’t, I regret it.
- Follow test strategies. Our instructor made this book mandatory our first semester, and it is a fantastic resource. I already followed many of the tips (like underlining key words in the question and using symbols to mark the answers [though I use “-” and “x” instead of their “-” and “+”). It’s a really good investment of time and money. I felt like I already had my multiple choice strategies locked in, but I learned new things!
- “But Mom, there’s no such thing as more right.” “Uh, yes there is. And less right is wrong. Welcome to nursing school.” This is a conversation I had with Will one day when helping him with his math homework. He had something like “10/20” as an answer and he was trying to argue that he didn’t need to change it to 1/2 because “both were right.” The multiple choice questions in nursing school are insane. You are going to come across ones like this:
- Which of the following statements or questions made by the nurse addresses the nature of her patient’s pain? (Select all that apply.)a)”Describe your pain to me”b) “Is the pain worse in the morning or in the evening?”c) “Place your hand over the area that is uncomfortable.”d) “Rate your pain on a scale of 0 to 10.”
- The answer is “a” and “c.” The rationale given is that b is a precipitating factor and d is severity. I think that the actual rationale is that the people that write nursing exams don’t have a good grip on words. And you know, what they mean. But this is your life now, and you will eventually crack their code. Test strategies help a ton.
- Tips for the NCLEX will help you now. The NCLEX sounds like something that it is a little soon to worry about, but one of the best things you can do is start preparing for it now. Nursing school is there to get you to PASS the NCLEX, so in preparing for the NCLEX you are actually preparing for your regular tests! These little NCLEX “rules” help me out all the time:
- When prioritizing actions during emergencies, remember “ABC” (Airway, Breathing, Circulation). The actions in your question are all going to sound right, so remembering ABC will help you to choose the right answer, which will have something to do with securing the airway.
- Unless it’s an emergency, assess first. Getting vital signs or assessing lung sounds will be the right “first action” most of the time, unless the question is an emergency, in which case you drop into the ABC rule.
- Don’t pass the buck. Most of the time, there is something the nurse should do before calling the provider.
- Take NCLEX practice tests. You can find lots of NCLEX practice tests on various subjects online and in book form. While these will be geared toward the national standard and not your professor’s particular big ticket items, they help tremendously. They get you used to the mean multiple choice questions of nursing, and they help you better understand the material. This semester I’m getting a lot out of this Med Surg practice test book–I just got 98% on our big Med Surg test!
- Get really interested in something else. Anything else. The week before finals I got really interested in applying eye makeup properly and spent a lot of time watching the you tube channels of 20 year olds. The month our skills tests got really intense I listened to Carry On (the latest young adult novel from Rainbow Rowell) a dozen times. (That’s a conservative estimate.) This semester I’ve been listening to the Magicians novel series and researching houses I might want to buy and updating blog posts. In all that, I mean: give your mind something else to obsess about. Have something else going on so that you’re not just obsessing about the next test.
- You will probably fail at some point. And cry. And doubt yourself. I have yet to meet someone who didn’t cry at least once during nursing school. For me, it happened in melodramatic fashion at the point in the calendar when I was sleep deprived to epic proportions. Already in sleep debt, I got three hours of sleep and showed up for my medication skills checkoff. I forgot to aspirate before giving an IM injection and failed the checkoff. That seemed about right for that week. I was fine until I got to the car, where the stress and lack of sleep caught up with me and I cried and drove and cried and drove. I didn’t want the stress of a skills retake (fail a skills checkoff once and you retake the checkoff, fail twice and you have to retake the class). I didn’t want my undefeated skills checkoff streak to be over. All I wanted to do was go home and cry myself to sleep, but my poor grandmother was there that week to help us with fall break childcare and I didn’t want to show up weepy and defeated. I pulled over on a side street, lay down in the backseat of my car and threw a little sobfest for myself, pathetic princess style. It was not a high moment. Then I went home. Where I received a phone call from the lead instructor an hour later that said that they’d decided that I shouldn’t have failed since the rest of the med pass had gone so well and the jury is currently out on the value of aspiration anyway. She said that they were going to list this as a pass and I wouldn’t have to retake it. Which meant that I had acted like a total moron and wasted all of that emotion over absolutely nothing at all. It was ridiculous. *I* was ridiculous. BUT it was like after seeing how ridiculous it was to let my performance in nursing school define my sense of self, I was able to really let that go. The pressing-weight-style stress left. And it’s never come back. From what I can tell, it’s normal to have a meltdown or two. So if at some point you find yourself sobbing in the backseat of your car, know I’m right there with you.
It’s been over a year since I closed Real Photography, and people always ask me if I miss it. The truth is that I don’t, because I still take pictures all the time! I thought I would share some of the pictures that I took last year over the next few weeks. I’m going to start with some Christmas photos because I figure those are only going to get less seasonal and more belated!
It was Will’s tenth Christmas in the classic striped Hanna Andersson jammies, and the best year yet since our favorite babies came to join us for Second Christmas (a new event and instant annual tradition)! It began snowing about an hour after they arrived and we hurried the kids into their jammies to get some actively snowing pictures! Don’t miss my favorite outtake in which Ellie and Pippa want new families and Sam and Will think “huh. snow.” And a few pictures from Christmas morning:
When I started as a CNA in postpartum/the transition nursery, I was absolutely horrified by the difficult time I had getting an accurate newborn heart rate. CNA school prepares you for adult heart sounds, not the twice-as-fast rates you’ll hear on a newborn! I had absolutely no confidence in the numbers I was getting and so I began to search the internet for tips and asked my coworkers for advice. Now, 15 months later, I want to share my tips for any new CNAs or Peds/OB nursing students who are struggling with those tricky newborn heart rates!
- Practice. All of the nurses that I would ask over dinner would say the same thing: “it gets easier–you just need practice.” I hated that answer! I wanted something that I could do to feel confident in the numbers I was getting that week–I didn’t want to suck for a month! But they were right. It gets easier with practice. The more you hear, the more you get used to those fast heart beats, the more you’re able to separate out the S1 and S2 sounds, and the more you’re able to count quickly! Any time I had a chance at work I would listen and count. But better yet, you don’t need to be at work to practice–you can practice as often as you like using recordings available online (here is a great one).
- Use the right tools–your stethoscope. The stethoscopes we have available at the hospital are just terrible for beginners. Not only are they terrible at amplifying sound, but they are standard adult sized stethoscopes. I’ll grab one now and then in a pinch and immediately remember why I used to think that it was so hard! When I got my Littman infant stethoscope, the difference was night and day. Yes, you might be spending an entire day’s salary on it, but it’s worth it! With an adult stethoscope you practically cover the baby’s entire torso, and you pick up all sorts of additional sounds. With a small infant stethoscope you are able to zero in on just the heart sounds, and when you’re a beginner this is a HUGE plus. Especially since you will often be trying to listen to heart sounds over the sound of the baby crying!
- Use the right tools–your watch. For Christmas my first year as a CNA I asked for a new work watch. I’m normally a small watch girl, but Nic got me this boyfriend style watch, explaining that he thought it would be nice for counting heart rates. I would never have bought it for myself, but after a single shift with it I could never go back! Having the second hand move so slowly and dramatically makes it easy to start and stop at precise points. It weighs about as much as a newborn baby, but I could use more arm muscles, anyway. 😛
- It’s okay to dance along. I’d read online a few times that people recommend closing your eyes and bobbing your head or tapping your foot to get into the rhythm of a newborn’s heart rate. It works. You may look a little dumb rocking out to a newborn’s rhythm, but the good news is you won’t have to do it for long. As you gain confidence and comfort you can ditch the tricks, but it really does help in the beginning!
- Counting tricks. In the beginning, I had a really hard time counting quickly and not losing my place. I would be thinking “28, 29, 30, 31, 32…wait, did I go 29, 30 or was that 39, 30? Am I ten off?” And I was also just not used to counting two and a half numbers per second! It becomes a mental mouthful! (And yet after a few months you’ll wonder how it was possible that it was ever difficult!) While you wait for the quick counting to become second nature, there are some nice tricks out there. My preferred method was that after 19, you could go “2, 1, 2, 3, 4, 5, 6, 7, 8, 9, 3, 1, 2, 3, 4, 5, 6, 7, 8, 9, 4, 1, 2 ,3, 4, 5, 6, 7, 8, 9, 5…” so that instead of having to say “twenty-two,” you were just saying “two” mentally. Since the Air Force counts flutterkick reps like “1, 2, 3, 4, 2, 2, 3, 4, 3, 2, 3, 4….” this was a rhythm I was used to.
- Use math to double check yourself. I always take note of the numbers I’m getting as I hit 10 seconds, 15 seconds, and 20 seconds. (I usually listen for just 20 or 30 seconds and then triple or double my number unless the baby’s heart rate seems to be changing or I get an abnormal number in which case I’ll count for the full 60.) By taking note of what I’m hearing at different intervals, I can run those numbers, too. Unless you were hearing the pace change as you were listening, the rates you calculate should all be similar. If not, you know your counting went wrong somewhere!
I’ve already shared one of the Dr Seuss quilts that I made for my nieces, but I realized that I never shared the second one! This is Nic’s favorite by far, because he feels strongly that all quilts should be made with minky backs. The panels are all from their momma’s favorite book. If I had it to do over, I’d avoid quilting over the squares made by four solid triangles, but I know the babies don’t care!