as i type, i sit in ann arbor's very own sweetwater's cafe sipping a mandarin orange rooibos tea, the likes of which i've been unable to find anywhere else but this cafe in this wonderful town. our little weekend homecoming concludes what has been a much needed, hard earned, relaxing two weeks off of school; on monday i'll return to stick out as much of maternal/child nursing as i can before the bean decides to make her grand entrance. since this is a very long blog, you'll be rewarded for your patience with many pictures of the bean.
as i mentioned the last time i was afforded 4 minutes to do something other than work or study, some recent curriculum changes in my program led to a very condensed and almost impossible to survive 10 weeks that ended just two weeks ago--indeed, a full 20% of my cohort did for various reasons find it impossible to survive and won't be joining us this term. however, as it goes with most challenges, i think we all came out a little better on the other side. also, allegedly that's as bad as it will ever get, which is reassuring, especially since i'll have quite a bit more distraction in the future!
this quarter was a big turning point in my nursing career and education in general--the time finally came for me to make the leap between simply learning information and applying it to clinical situations. turns out that's a lot harder than applying information to tricky test questions...while exams can be intimidating, live humans offer so many more variables than paper, like projectile vomiting, or not breathing, for example. the good news is that a) i didn't kill anyone, and b) i can finally say i've had some legit exposure to what my actual job will be, and as it turns out, i absolutely love it.
skyline from the southside, 30 weeks
the last ten weeks were roughly divided as 2/3 of my time devoted to medical-surgical nursing and 1/3 to psychiatric nursing, both in the classroom and at the hospital. humorously, these were not my only classes, just the two i paid attention to. healthcare informatics had to take a bit of a backseat... mondays and fridays consisted of full day lectures/labs, whereas tuesday-thursday we got to test drive our skills on real live patients. after each 8 hour lecture or clinical day, i came home, spread my books across our entire couch, and read med surg until my eyes started to bleed, at which point i took a break by reading psych, which i consider to be more pleasurable by comparison. as a treat for doing a few hours of reading, i got to do a fun activity like write a nursing care plan or draw a concept map (a visual representation of all your patient's ailments and data and how the connect to each other), which were due almost every day and require a few hours of analyzing patient records.
nights typically ended with david coming home to find me passed out in a puddle of drool and shuffling me off to bed. on weekends, i got to sleep in past 5:30am and put in 12 hours of studying each day. other than that, i slept whenever i could, occasionally ate, and looking back that's really about it! 20 lecture hours, 30 clinical hours, and as many study hours as i could stay awake for...there's not much time for anything else.
despite being very busy, i really enjoyed myself. i was randomly assigned to what i humbly believe were the two best possible clinical groups. i had a phenomenal instructor on my medicine floor who does a superb job of assessing her students and figuring out the best way to help them start thinking like nurses. the nurses on our floor were also really patient and supportive and were very fond of each other--a rare combination. despite everything we'd learned in the classroom to this point, it was a real challenge for me to start figuring out how to quickly synthesize that information to optimize outcomes, but so rewarding when it started to click. by the end of the ten weeks, i could go onto the floor with confidence, hear morning report, and independently start prioritizing my care and making plans for my patients. i assure you, that sounds a lot easier than it is! i really loved going into clinical every day, even at 6:30 in the morning.
bean on the museum campus, 31 weeks
just after finishing up my finals i was crossing the street to get to my drs appointment when a lady fell in the middle of the crosswalk. after pausing for a split second to remind myself that it's now my duty to intervene in these situations, i was pleasantly surprised at how quickly my mind started working. while i would have always stopped to help someone who fell, now i perceive this situations in a whole different way. i was looking at the street, at her, the people around her, trying to figure out what happened. instead of asking if she was okay, i was asking specifically about her pain, what happened before she fell, if she's recently fallen. i was thinking about what kinds of medications she might be taking, what kind of range of motion i might do to assess her injury based on how she hit the ground. turns out she just tripped on a crack and was pretty huffy about leaving, but the fact remains that i certainly see the world differently than i did just a few short weeks ago.
anyway, after my two days running around and literally sweating my a** off on the medical floor (imagine if you can how physically grueling it is to singlehandedly give a full body bath to a 250lb obese paraplegic man, for example, and then doing it like 4 times in a row, with 5 other call lights going off, heart monitors beeping, bed alarms blaring, and generally just a lot of poop), i got to chill out on the lockdown inpatient psych unit at rush. they use a popular technique called "milieu therapy," wherein the medical staff pretty much just hangs out and puts out a calm vibe and keeps things in check. this vibe along with scheduled meds, and organized activities and meals (with a little electroconvulsive therapy when called for) works literal miracles on the patients. not surprisingly, it had a great calming effect on the students as well!
my psych rotation was incredibly valuable and educational on a lot of personally moving levels. i think it's easy in our society to feel, unless we've suffered from the issues ourselves, that psych problems are "all in your head," so to speak. as it turns out, these issues are increasingly common, particularly within a hospital. who with a chronic illness or pervasive pain wouldn't be a little depressed or anxious at least? but we unfortunately have a lot of stigma in our society about psychological illness, and those people don't get a ton of slack. within the hospital they're "problem patients" and get shipped to the spych unit long before they're medically stable enough to go there. outside of institutions, getting the care you need for these very real and very debilitating conditions is almost impossible between cost/access/the nature of the illnesses themselves. large bummer.
it was really powerful to learn again about a lot of conditions i've covered in previous psych classes, but to actually see them playing out and that they're real just like any physical problem, and respond to certain drugs and treatments just like a medical problem. that said, the two tools existing in psych care right now are drugs and the "therapeutic use of self," which makes the work pretty mentally taxing. even though i spent a lot of time just sitting around and managing the milieu, i always came home from those days thoroughly exhausted.
bean with the sears tower, 31 weeks
i saw all kinds of patients...people so depressed they had bed sores because they literally could not move or remember to bathe or feed themselves, people so manic they were talking too fast to understand anything they said and believed amazing things about their purpose in life, hallucinations, illusions, delusions, it was all there. i had patients who heard voices telling them to kill themselves, patients who had not thrown anything away in 8 years, patients who believed their only purpose in life is to marry eminem and with him give birth to the reincarnate of lil' wayne.
but as kuku as all of that sounds, i gained a lot of empathy for these patients. i learned a lot about therapeutic intervention, but also about how important it is to consider psych issues when treating any patient, or dealing with anyone, actually. i saw a lot of myself in a lot of these patients, and i spent a lot of time wondering why i happened to err on the side of functionally crazy rather than nonfunctionally so. just luck i guess, but it's certainly interesting to think about.
anyway, i know the three remaining readers of this blog only really want to hear about the bean...so here is the very brief scoop. just as i began this term, the bean and my body began to make peace with each other. i quickly regained my energy that had been severely depleted by three months of starvation/puking and started eating normally and keeping up fine on the floors and in my classes. i was tired, but everyone complained constantly about being tired. thanks to my orthopedic nursing clogs that i had to live in, i haven't had an ounce of back pain. i was very fortunate this quarter to have a very understanding bean and husband--both made life as easy as possible for me with the agreement that in return they'd be compensated with as much ben and jerry's as was necessary.
hyde park, 31 weeks
we moved seamlessly into the third trimester just as the term was ending, and i'm not sure if i'm just backed up from ten weeks of absolutely not taking care of myself at all or if it's just another pregnancy transition, but i am awfully sleepy. i've enjoyed about 9-11 hours of sleep per night easily over this break, and that feels about right. fortunately, i felt the most energized during my most demanding quarter, and i'll spend the next few weeks with a lot more time at home as i start to get more tired and rotund. everything seems to be moving along well; the bean and i are both growing as expected, feeling good, low in blood pressure and facing the right direction in utero. what more could we ask for?
the bean continues to enjoy anything spicy (especially thai curry), fruit, vegetables, 1% milk, and sweets. so, basically my normal diet. she's developed a particular affinity for dunkin donut munchkins, which are available for better or worse on every block in chicago. based on statistical averages, she weighs in at about 3lbs and is around 16 inches long. she moves around often but she's not really hyper, and she gets hiccups several times a day. we're enjoying our last few weeks cohabitating.
now, onto this great vacation. while david's vacation ended just before mine started, we've decided it actually worked out better this way. he just so happens to be on his easiest month of the next several years, anesthesia. monday through friday, no call, done in the early afternoon...we've spent more time together these two weeks than we have over the past 9 months, and it has been great. i might have starved to death during my finals if david hadn't been able to do the shopping and cooking, and he was great company during my long study days.
as soon as my last final ended, i was whisked away by a few friends to a very unexpected surprise baby shower. how totally flattering! while i was studying around the clock, my buds from school were busy coordinating, decorating, baking, and getting me presents. it was pretty awesome, and david even made a guest appearance:
the next few days were divided between running errands that had been on hold for weeks and enjoying the spring thaw in chicago. had david and i both had time totally off, we would have probably tried to travel, so it was actually really nice to appreciate the city together in a leisurely way, which literally hasn't happened since we moved here. on st. patty's day we donned our green attire and hit up the lincoln park zoo and botanical gardens, a green outing followed by a very green dinner.
the next day we went down to hyde park to walk around the u of c campus and scope out places to park and walk by the beach between our place and u of c should the urge strike us when i'm in labor.
this also happened to be match day, so the emergency medicine crew went out to celebrate the incoming class. to others this day holds significance for certain reasons--for me, it will always be remembered as they day i met the tamale man. this elusive character spends his later evenings popping into bars and vending a variety of tamales his wife probably made that morning. while others acknowledged the monumental accomplishment of the match, i sat in corner greedily eating my siplock baggie of steaming hot tamales with tomatillo salsa.
that weekend, my mom came into town for the baby shower my sister emily threw in my honor...what was more impressive than the tasty spread she put together is this awesome diaper cake she made:
since the shower was on a saturday, david had the pleasure of attending his second ever (what a good sport). check him out with his manly dad diaper bag:
david has really taken this pregnancy to heart and wants to experience as much as possible. in addition to attending almost every appointment (somehow, with his crazy schedule), every birthing class, every ultrasound, both of my baby showers, logging some serious time at babies r us (which i have vowed and thus far succeeded never to do), has diligently read all of the literature i've thrown at him, does not so much as raise an eyebrow when i pour a large bowl of cereal for myself at 11pm, he is so into it he seems to be manifesting some physiological symptoms of pregnancy as well...he's a little more forgetful and sentimental than he was a few months ago, and perhaps as a result of our recent support of ben and jerry's, we're about pound for pound in weight gain. i think it's pretty cute.
anyhow, we spent the early part of this week continuing to enjoy the sunshine and took the bean for her first walk down to the beautiful museum campus where her mom and dad used to run before she made that physically impossible. fortunately, walks are equally enjoyable, and we're pretty excited she should arrive just as the weather gets warm and sunny so she can check it out from outside the womb.
and finally, we arrive at the final great weekend of this relaxing and low key break. we headed out to ann arbor to visit friends and old haunts, and it's been a roaring success. after a delectable breakfast of egg mcmuffins (really, there are few such joys in life), we headed over to one of our favorite date spots, the humane society. we were shocked to find in the place of the ramshackle structure we knew and loved an enormous, totally renovated facility. it's got to be at least 4 times the size of the old one and everything is top of the line--the building is beautiful, can house a lot more animals and in a much more comfortable and luxurious way. it was so great to see the animals looking so much happier and healthier.
after our usual rounds petting every dog, we went through an application process to spend some quality time with a very special little puppy named teton. teton is half chow, half rottweiler, and is the sweetest, mellowest puppy we might have ever played with. he was so loving and affectionate and well behaved. as much as we love visiting the animals and have a soft spot for most of them, once in awhile we really fall for one and then we have a little scene where i start to cry and become very irrational despite the reasonable points that we already have two cats, a very tiny apartment (teton is 2 months old and already 25lbs...his dad tips the scales at 125 lbs), close to no spare time, and the whole new baby thing. these temper tantrums appear to have little to do with pregnancy as i had a really big one last spring at a redwings game when david tried to talk me out of adopting a very special puppy shortly before we left for costa rica, got married, and moved. teton and wiley are both such great dogs we know they will find loving families, but i know i will continue to cry about both of them for the indefinite future.
the rest of our time in ann arbor was spent getting our fill of our favorite food and people. try as we might, we just haven't found replacements for gems like jerusalem garden or the food coop in the city of chicago. we had dinner with our good friends will and alyssa (alyssa, david and i studied nutrition together). alyssa and i met at a very fortuitous time because she is a wonderful friend, and because i do everything she does about six months after her. i can't quantify the headaches she's spared me by having big life events like a wedding and a baby just far enough in advance to give me the cliffnotes on everything. we're likeminded enough (and she's endearingly anal enough) that i'd say i'm even a little cavalier about important things like wedding hair/makeup artists, baby carriers and breastfeeding, because i know i'll just do whatever alyssa did and it will be great. she's never led me astray...
alyssa and ava
my cousin marissa also happened to be passing through ann arbor, and got to spend a little quality time with the bean, who she hasn't seen since thanksgiving!
a wonderful vacation indeed. but as much as we enjoyed the time away, it's always nice to come home...particularly to a scene like this one:
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