Saturday, October 29, 2011

E ticket

My cousin's husband calls the small planes that fly the 60 miles between Anchorage and Kenai the "vomit comets".  Most of the flight is over the flat land on the Kenai Peninsula, but the 20 miles southwest of Anchorage are over water:  Cook Inlet as it curves to become "Turnagain Arm". 

It takes 30 minutes in the air on a 10-seater to get from point A to point B.  The drive, however, is 150 miles and takes 3 hours IF you obey the speed limit.  The highway winds through mountainous terrain and there are miles and miles of nothing but spectacular scenery.   I'm making a round trip once per week for school.   The drive was wonderful as summer wound down - I got to watch fall in all its glory along the route.  Now the leaves are gone and winter has arrived in the form of snow through the passes.

I won't drive that road in the dark.  I am afraid of hitting a moose, careening on black ice, and getting caught in a whiteout.  There are stretches with no cell phone coverage up there.  I'm too old for that s$x*(.  The sun is setting earlier and earlier these days, with our shortest day (December 21st) fast approaching.  On that day we will have no more than six hours of twilighty daylight.

I took my first flight home about 10 days ago.  I was nervous - I'm always nervous about plane travel, but this was my first trip on a plane that small.  At the airport in Anchorage I started a conversation with a young woman in the ladies' room near my boarding gate.  She said, "MAN that was a bumpy flight".  I asked her where she had flown in from and she replied that she had come from Kenai.

I took a tranquilizer.

The flight was not too bad.  It was bumpy in stretches, but I was sufficiently medicated and just glad to be home when we landed.

The day of my return flight I noted with smug satisfaction that the winds were calm.  No tranquilizer for me - I was "experienced" by then and had class later that day.  The first 15 minutes of the flight were smooth as glass.  Then, we flew out over the inlet.

I won't say all hell broke loose, because that would be an exaggeration.  I will say that it got very bumpy.  The up-down-sideways stuff.   I figured I could handle anything for the 10 remaining minutes of the flight, but noted that we weren't heading straight for Anchorage.  We bumped and twisted and bounced north of the usual route and flew over some mud flats, making two huge circles.  I could see Anchorage off to my left, and from a number of different angles as the plane tipped and jerked I longingly eyed the runway.  The seat belts on these planes are very strong and very restrictive.  One strap crosses from back to front at an angle over your shoulder, and another crosses you at the waist.  I wear mine fairly tight, and I needed it.

After what seemed like days, we made our approach to Anchorage and landed.  I smiled at the pilot and made a reference to the winds as I left the plane;  she looked at me and said, "Oh, was it bumpy?"

That afternoon NOAA posted a high wind warning for the Anchorage area.  85 mile per hour winds.

"Oh, was it bumpy?"  Yeah, it was bumpy.  Like, way bumpy. 

Just part of living the dream in Alaska.

Tuesday, October 11, 2011

The list

I've never been much of a list maker.  My life has been more of a "fly by the seat of your pants" experience, and I'm beginning to realize that if I'm going to make a good nurse, some change may be required on my part.

I'm building a list. The list consists of mistakes I've made in lab class and involve the dummies (lifelike mannikins) we use for training.  It is my wholehearted wish that I do not make these same mistakes when I am allowed to reposition, catheterize, drive needles into or provide bedpans for real people.

Today we were tested on our ability to administer medications - both the oral and inject-able kind.   You'd think that giving the oral kind would be pretty much pop one out of the bottle and hand it to the patient, but instead it is an incredibly complex process including things like checking for contraindications, cross checking the medication with the patient's medication administration record at least three times, educating the patient regarding what the drug does and knowing when, as the nurse, to wear gloves, wash hands, or call the doctor.  Medications to be injected include the same activities, however, they are further complicated by choosing needle and syringe size, figuring out which anatomical site to jab, and learning all the tricks by which nurses avoid needle sticks (and therefore avoid bloodborne diseases nobody wants).  The next time you get a flu shot, look at the person who is about to skewer you and realize that he or she is using about 7,000 snippets of information in order to administer that vaccine.

I got through most of my skill checkoff today and felt pretty good about things.  As a matter of fact, I was taking a last look at my plastic patient when I realized in horror that even though I had carried my new stethoscope into the room with me just in case my instructor wanted me to administer a particular heart medication, I had failed to use it.  I was not supposed to administer the medication if the patient's heart rate was less than 60 beats per minute and I had absolutely no earthly idea if that was the case because I had skipped that crucial step.  My eyes grew wide and I gasped while I advised my instructor that I had made a terrible mistake.  She already knew it, of course.  I said, "Is there an antidote?".  Very stupid question.  This patient is in no danger from this drug because she is plastic and therefore unable to swallow the pill in the first place.  I felt awful. 

My instructor passed me on the skill because I realized my mistake before leaving the patient's bedside, but she cautioned me to pay closer attention.  I left the college and drove to a grocery store where for the first time in my life I bought one of those gizmos they advertise on late night tv: some kind of magical chopper thing.  I felt as though I had failed the exercise, even though I had passed, and retail therapy usually works for me.

I still feel like crying.  If that had been a real patient I could have caused her complications.  This nursing thing is serious, serious business and tonight a tiny part of me is questioning whether or not I have what it takes.

One more for the list.  And tomorrow is another day.

Wednesday, October 5, 2011

sweaty palms

This afternoon I am being tested on my ability to maintain a sterile environment when changing a wound dressing or inserting a catheter.  My patient will be one of the plastic mannikins we use in our state of the art health sciences lab. These skill check experiences are nerve wracking.  I'm a high anxiety sort of person anyway.  Add something like dealing with a plastic vajayjay (as in inserting a plastic tube, no less) while the critical eyes of my instructor watch  my every move and I am sweaty-palmed.

It's hard to don sterile gloves with sweaty palms.  Frankly, I think it's hard to don sterile gloves with dry palms.  You can only touch the gloves HERE when putting on the first, and HERE when you are putting on the second.  And once they're on, you can't touch anything that isn't sterile or they're contaminated and you have to start all over again with increasingly sweaty palms.

I'm forever searching my mind for ways of making these checkoff events less stressful.  This morning I had the bright idea that I'd pretend my plastic patient is my mother; then realized that I'd probably yell at the dummy or call it "Mom" in the middle of the exercise. 

What's the worst that can happen?  I won't pass the checkoff (been there, done that) and will have to repeat it at a later date (been there, done that) and will pass it then.  Life is short.  Don't sweat the small stuff, Alyx.