What I Wish I Knew

This May, I graduated from the University of South Florida's College of Nursing with my Bachelor of science in Nursing. Nursing school is a world of its own and comes with many obstacles. As the first nurse in my family, I was completely unaware I was getting myself into. Unfortunately, there were a lot of lessons I had to learn the hard way.  Hopefully, you all can learn from my mistakes.

1. There are many hidden costs to nursing school.

After my first two years at USF, I assumed that I had a pretty good budget and that I had enough money to cover my next two years. I was completely blindsided by all the hidden costs of nursing school. My first semester I spent $1,000 out-of-pocket on books and supplies. I only bought what was necessary and shopped around for the best deals. I estimate that I spent another $2,000-$2,500 for the next four semesters and for boards. 

2. It pays to invest in quality equipment.

All that said, it doesn't always pay to be cheap when it comes to purchasing essential nursing equipment. Personal story time: I had a very cheap stethoscope my first semester. I could hardly hear and I had a hard time differentiating the subtle differences in lung sounds and my education suffered. It eventually broke and I had to replace it.

Tip: I recommend investing in a quality stethoscope. Personally, I have a midrange Littmann that I love. There's no need to blow $300 on a cardiac stethoscope, one for around $50 - $80 will do just fine. Also, a manual BP cuff comes in handy because that seems to be the one thing you can never find when you need it on the floor.

Quality, well-fitting scrubs are also a must. You have to wear them for 12+ hours at a time and be able to move every which way. I purchased mine from Walmart (bad idea). They did not fit well and I was constantly adjusting them.  

Tip: I recommend going to a specialty scrub store. They will be able to help you find a brand that fits your body type. When trying them on make sure you can move in every conceivable way, because I promise you, you'll have to. You might actually find a better deal at a specialty store.

3. Pursue a position as a nurse tech

This will further your education tremendously, as well as get your foot in the door. Many hospitals hire from within first. Shop around and think about where you would like to work as a nurse, and then get a tech job there. Warning, the work is hard and the patient loads are high, but the rewards are worth it. Not to mention, it will give you a job while you're studying for boards so you're not rushed or delayed due to financial concerns. On that note, PLEASE save money for the months following nursing school, you may not get a job a month out of school. I assumed I'd be working by the end of May. NOPE. So here I am blogging away at my parents because I'm too broke to stay at my apartment in Tampa.

4. Your job search starts the minute you start nursing school.

 If you are like me, you probably didn't spend much time inside a hospital before starting nursing school. Once you are inside the hospital, you will realize that it's a 'whole new world'. Politics and money are the name of the game more frequently then we'd like to admit. That said, keep your ears open and read everything you can about the hospitals in the area you would like to work. Listen to what people say about what makes a good hospital, start to understand how hospitals work, how they treat their nurses and what system they belong to. It could mean the difference between working for $19 an hour in a place that treats their nurses poorly and making $30 an hour in a hospital that gives nurses free massages.

5. There are profound spiritual implications for nursing

No matter what your personal religious beliefs, there is a spiritual side to nursing. Every day as a nurse you interact with people who are dying. Exactly how do you interact with a person who is grappling with their own mortality? What do you tell grieving family members? In nursing school you are going to have to develop some kind of cohesive understanding of death that lets you sleep at night. This takes an emotional toll that other people can't see or understand, and unfortunately it really is a path you have to walk alone. There are also a hundred different ethical issues that you need to understand. What do I think about abortion? Euthanasia? DNR's? Birth control? Sex change surgeries? It's a lot to sort through, especially when you realize that patient's lives are affected by your beliefs.

6. There will be bullies

There is much  that could be and has been said about this topic. Who hasn't heard the phrase "nurses eat their young"? It's true, but it doesn't stop there. You will see bullying from doctors, hospital staff and students.

Tip: Develop a zero tolerance policy regarding malicious gossip and behavior. When someone attempts to share malicious gossip with me, I look at them right in the eye and say very seriously "you can take that somewhere else, because I will not be a part of it" and if they have a problem with that I politely inform them that I have no qualms about reporting behavior to management or instructors. I do not tolerate abuse and neither should you. 

Big Changes

Hello All,

After several months of silence, I have returned. If you've wondered where I've gone, I have been using this time to recover from surgery. My surgery in December went well. However, the recovery has been longer and more involved than I originally expected. I am just now getting back to almost normal, though I am still coming to terms with the restrictions on my physical activity.

I am graduating from USF in a mere 22 days. I never would have imagined that my time in college would pass so quickly. If you're interested, my Nursing Professionalism Pinning Ceremony is Friday May 3 at 6:30 PM in the Marshall Student Center Ballroom and I am graduating from the University of South Florida on May 4th and 1:30 PM at the Sundome.

My focus with this blog is now going to shift from being a Christian in College to being a Christian in the nursing workforce. My goal is to start publishing once or twice a week on topics relevant to nursing practice from a Christian perspective. I will be leaving up my old content because I think much of it is still relevant.

I'm looking forward to this new stage of life with great anticipation. I have been preparing to be a nurse for the past four years and I am ready to put my knowledge into action. I'm excited to be able to serve patients in their time of need in the same way that Christ serves us.

DR day 4

Originally, today was planned to be out completely free day. However, plans changed. On day two, our clinic site got moved at the last moment. The people of the community we were supposed to go to were devastated and begged us to find a way to come to them, so this morning we sent a team of people who had the most experience and who spoke Spanish to do a half-day clinic. The other half of the group stayed behind at the monastery and inventoried all the remaining medical supplies and medicines. This trip is very well organized and planned out. Apparently we had over $60,000 in medicines to give out. Some of the supplies we donated to the Abad foundation, the local foundation we were working with.  Some we placed in a closet for a trip that’s coming in March. We ate lunch at the monastery and then we headed out to Santa Domingo.

            We didn’t get to the resort to 5:30, but the drive was so worth it. It was so beautiful. The resort was all-inclusive. We ate dinner in an open-air buffet 20 feet from the ocean. The restaurant was beautiful, so fancy. Then we went down to the ocean for a night swim. I had never done that before. I was a little nervous at first, but it was amazing. The stars were so clear; I even saw a shooting star. I went up to the room around 10 and took an amazing shower. It was such a beautiful and relaxing way to end a week of hard work. I fell sleep thinking that I had to be the happiest and most blessed person alive.

DR day 3

Today was an amazing day! Our clinic site was absolutely crazy.  We were sent to a place called San Jose. We held the clinic in a community building, I think it may have been a church and the pharmacy set up in a house across the street. And by street I mean 8-foot wide alleyway, crowded with at least 200 people ALL DAY LONG. Unfortunately, we were only able to see 128 pts. When we had to close triage there were at least 30 people still in line, a lot of people were very angry. It was very difficult to turn people away.

One thing I learned from this trip is the value of incorporating community leaders into running the clinic. We had a man who from my limited Spanish, I think was a pastor, or some sort of bible teacher who made a list of patients as they showed up an served as bouncer and door keeper to the triage room. He was so helpful and it was good to work with him.

This evening was a blast. After dinner I ended up playing soccer on the patio with three other students. It was so much fun. Unfortunately, one of the guys cut open his foot pretty badly so that ended the game. Then I got to be nurse Sarah in action bandaging it all up. After that we had a huge bonfire. I ended up staying out talking till 1 am.  Getting the bonfire lit was 30 minutes of entertainment in and off itself. Who ever had set it up did it all wrong, they had all big sticks and no kindling or tender, so of course the fire was not getting anywhere. I’m telling you there’s nothing like watching a bunch of med students figure out how to start a fire. We ended up using old gauzes and class notes as tender! We even had marshmallows and chocolate to make smores.  

This trip so far has been amazing! Everyone treats everyone else with respect. No one talks down to me because I am an undergrad. Everyone works together as a team.

DR day 2

Hello again from the DR. As I write this I am sitting in a rocking chair on the second floor balcony of the monastery watching the rain come pouring down over the mountains.  Storms always make me pause and consider the greatness of God. Us humans we are so helpless against the forces of nature. It’s only by God’s powerful hand that we are sustained.

Today was a great day. I was assigned to clinic #1 in a little village about 15 minutes from the monastery. Another bonus for today was that I got the Internet to work enough to talk to my mom briefly in the morning. I was so tired I went to bed at 8pm last night and didn’t wake up till 7am.  Needless to say, I had a lot more energy today then yesterday. Today we held the clinic in someone’s house, literally. This woman was gracious enough to open her home to the entire community. I ran triage again. Today was a bit smoother because we were outside and had more space. We saw around 120 Pts. We worked straight from 9:30-5:00 with only at 15 break at 1:40 for lunch. There were so many babies! Every adult had at least one kid with them and some had as many as four. They were so cute.

One thing I was really thinking about one of the principles from the book I was reading. Avoid paternalism. The book also discusses how poverty is more then just lack of material things. Poverty also involves emotions such as shame, hopelessness, and inferiority.  All day long I was asking myself “ Do I see these people as inferior?” Am I treating them as if they are inferior?”

Dinner tonight was amazing. Salad, white rice, meatballs, corn fritters and avocado. At first I wasn’t sure exactly what to do with the avocado, but someone suggested smashing it up in the rice. Let me tell you, best decision I’ve made in a while. It tasted so good. I love trying new food. It’s one of my favorite things about traveling. 

Tonight was amazing. After dinner I played a couple rounds of dominos, then I went over to hang out with the students who were doing a little dancing under the patio. I love dancing, but I never feel as culturally awkward as when I’m around latin styles of dance. To be perfectly honest, I just can’t get my body to move correctly to make it look natural.

I left that about 10 to go to bed. However, As I was walking I ran into two of the guys on our trip and we ended up talking about God until Midnight. It was the most fun I had in a while.

Most of the time these days, I exist in a little bubble. I go to school, I go to work, I go to church. I tend to interact with the same people everyday. It was so nice to talk about God with new people. After awhile, one of the guy left and was replaced by a reformed Jewish girl. We had a great conversation. I feel like I really learned a lot about her perspective.

Dominican Republic Day 1

Hello from the Dominican Republic! We arrived here in the DR last night at 9pm. The trip here was fairly uneventful.  Originally, we planned on arriving at 3pm, but there was a flight cancelation in Tampa and a delay in Miami.  By God’s grace, we made it through customs without a problem. After landing in Santa Domingo, we had a three-hour drive to the city Jarabacoa. We arrived in Jarabacoa at midnight and then the real fun began. On Friday, we had sorted all the meds by kind in their original bottles and packed them into suitcases. Now we had to sort it all out into the clinic bags because in the morning we were going to two different clinical sites.  We were up till 2am counting vitamins and certain medicines. Personally, I sorted about 3,000 vitamins into 30 count bags! Today they let us “sleep in” till 7:30.  We left for the clinic at 9am and ran clinic from 10-5. At our clinic site we saw a total of 83 pts and gave hygiene products and vitamins to a few dozen more. As the nursing student, I was paired with an ARNP student and we were put in charge of triage and vitals. The clinic took place in a little three room building in a rural village about 30 minutes from the Monastery. Did I mention I’m staying in a monastery? Well, it used to be a monastery. Now it’s used primarily to house groups like ours.

As far as interesting patients goes, I did see a child with polydactyly (an extra digit), He had six fingers on each hand and six toes on each foot. I also saw two patients with systolic BP’s over 180 and neither weighed over 100 lbs! For my non-medical friends, basically when your blood pressure gets that high you are at a high risk for stroke and cardiovascular complications.  

We got back to the monastery at 5:30 and had dinner at 6. We had to resort the meds again to make sure that both clinics tomorrow got enough. 

It’s so funny how quickly the extreme become the familiar. I still remember the wonder and excitement of my first international trip. I wrote pages and pages about my experiences detailing every new sight and sound. Now I can summarize my whole day in a few paragraphs.  I like that this is becoming the new normal for me.

Also, the things that were strange and bothersome when I first started traveling internationally aren’t so strange and bothersome any more. It’s just the way things are. You change your expectations. Don’t except air conditioning, don’t expect to be comfortable, and don’t expect to eat on any kind of regular schedule. Don’t expect to not be tired; don’t expect to ‘have it your way’.

I bought a book specifically for this trip. It’s called When Helping Hurts. I heard about it a few years ago, but I never got around to reading it.  The big point of the book is the difference between relief work and development work. Many of the concepts were things I had considered before. But it’s given me a lot of food for thought.  I used to just assume that these international medical brigades were a good idea. But now I’m really looking into the effects of trips like these.

I'm done feeling sorry for myself

So I haven't posted anything for awhile. Mostly because I've been busy with school, but also because everything I've sat down to write has ended up sounding like the musings of a whiny spoiled brat.

So as of today, I'm done with feeling sorry for myself. Yes, my body is still malfunctioning, but No, I'm not going to let that ruin my day. I've spent eight weeks in a pit of self-pity, I think that's more than enough time. It's time to pull myself together and get on with life.

In other news,
I finally made it to the endocrinologist today. No news. Surprise, surprise, they have to run more tests.