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PICU Reflection September 3, 2007

Posted by danucube in Nursing, Nursing School, reflections.
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Here is a short reflection paper I did for my one-day PICU observation. Hopefully this will give more of a sense what my summer was like.


What I like about the PICU is the low nurse-patient ratio. It gives one time to really focus on a patient and his/her family. It also gives one time to connect with the patients and their families, which is always important to me. I do not like environments like the ED or OR where I have very little opportunities to know my patients and their families. However, this environment comes with a price, a heavy price where the patients have multiple drips coming out and many tasks and assessments being done to the patient throughout the shift. It is an environment where one is acutely aware that the patient’s well being is literally in your hands and one has an extremely heavy responsibility as a result. It is an environment where things can get bad really fast due to the severity of the medical conditions and the fact that it is a pediatric population where things can get bad or good at lighting speed.

It is an environment where one sees the best and the worst in a family. From my extremely limited brush with the PICU, I had the privilege of working with my patient’s mother who literally knows everything about how to take care of her son. I admire her steadfast, loyal, and faithful commitment to her son. Across the other side of the room where my patient is, I have a family with a developmental delayed child who had multiple seizures. Despite the medical condition, the child has a smile that lights up the whole room. It is a smile that renews all of us who see more suffering than most people see in a lifetime. It is a smile that lightens the silent sorrows in our hearts. And her parents, it is quite obvious, that they do not see her developmental delay because they only see her smiles.

Although PICU is not my cup of tea, I am glad to have the opportunity to experience it for a brief time with great nurses, amazing patients, and their loyal and loving parents who demonstrate the best of humanity in an unbelievable stressful environment.


Fall 2006 December 22, 2006

Posted by danucube in Nursing, Nursing School, Providence, reflections.
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During Fall, I took process (another one… mostly on nursing diagnosis… a royal pain… and other stuff like connecting to patients and patient teaching which actually is quite interesting as there are so much psycho-social stuff in this area), med-surge, 2nd skills class, and my first med-surge clinical.

This semester, however, was very hard for me emotionally. Now as I looked back, I proabably was having difficulty at concentrating for at least the first half of the semester.

It was hard emotioinally because we lost one of our classmate due to some personal circumstances. I guess it would not be as hard if I was not so involved in helping my classmate (with plenty of help from other classmates also). I aslo guess that is the disadvantage of a close knit cohort as everyone were affected. Also another one of my friend who has a major influence in me going into nursing was not doing well medically.

As for my clinical this semester, got some good feedback from my clinical instructor as to what areas I might consider and what areas I should not touch with a 10-foot pole. Areas like ER or ICU, I probably would not touch with a 100-foot pole. Areas where it requires lots of pt-nurse psycho-social interactioins are areas I should look into. Some potential areas that fits this according to my instructor are Burn Nursing, Oncological Nursing, and Postpartum Nursing (aaahhhh… don’t think so…. I don’t think I’ll touch maternity related areas). Another area I notice could be Nephrological Nursing might fit. This is, of course, on top of psych nursing, pallitive nursing, and geriatric nursing (I thought I was suppose to narrow these things down, not expand them…).

And I learned something very interesting in clinical… I was emotionally prepared to see really bad things… and I did see some really sad situations in clinical and I was ok… what blind sided me was the small things…. one was when I was feeding a pt and that brought back memories of me feeding my mom when she was very illed which was ok…. another was a patient who had very high blood pressure and it was climbing, the pt was vomiting, elderly, and it was at night…. that triggered me BIG time as all I could see was when my mom first had her stroke which her blood pressure was 220/150. The vomiting trigger a little bit of the memory of my dad actually since that was what happened to him before he died. The main trigger was the one of the numbers in the BP, it was over 200.

That was a horrible clinical night as I basically blew it… like I missed whole bunch of stuff which I should have reported to the RN and these were potentially very critical stuff (I wrote them down but I did not report it, I have no idea why). When my instructor asked me a few questions and the answer was right in my notes and I was looking at my notes; I couldn’t answer the question b/c I ddi not see the answer although I was looking at it. One of my classmate noticed something was wrong and asked what was going on. The instructor also noticed something was wrong.

We stayed way over our normal hours at night to try to reverse the mistakes I made. I got a stern lecture from the instructor and also from the RN whom I was working with. But despite the horrible clinical night, there was grace. Grace in the form of two very insightful nurses (my instructor happens to be a psych nurse). They did not stop with the lecture, they digged and found out the 220 trigger. I actually could not talk at one point (got a frog in my throat) because of the 220. Both of them helped me to understand that it is not uncommon for small things to trigger big time. They were very compassionate with me. I actually gave the RN a hug (I never thought I would do that as I seldom hug normally) b/c of the many different things she taught me during that night and b/c of her compassion. My instructor told me that I would need to grief again. I did not grief… until two days later early in the morning… all of a sudden… the grief hit me. The next Monday, my instructor personally found me in lab and pulled me out of lab to check on how I was doing. I could not have a better instructor and I told her about something which I will share here.

Ever since one night I went looking for one of my very illed friend in a super dark night, with heavy rain, thunder, and lighting, I never did like rain since then. After that very dark night at clinical… it was dark (around 11:30 at night) and it was raining… a strange mysterious thing happened… my dislike of rain stopped…. the rain now signify that God was showering me with grace…. grace in the form of two very insightful and compassionate nurses who took me under their wings during that dark clinical night. Someday, when I am good enough, I hope I will pass the same kind of grace that I experienced to others around me.

Althogh it was hard emotionally this semester, there was also a third gracegrace in the middle of darkness… God provided a nursing buddy for me to study with, to share with, and to pray with. It is interesting that this semester I took a class call “Glimps of grace.” How appropriate.

We’ll see if I survive the next year… stay tune…

Sacred Ministry April 10, 2006

Posted by danucube in Nursing, Nursing School, Providence, reflections.
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I have been reading O'Brien's book because I am trying to a paper that deals with Christian nursing spirituality and Logotherapy somehow.

Mary O'Brien latest book (2006) is "The Nurse with an Alabaster Jar: A Biblical Approach to Nursing." Her other classics are "Spirituality in Nursing: Standing on Holy Ground" and "The Nurse's Calling: A Christian Spirituality of Caring for the Sick."

She really is giving me a good feel of what a vocation is. Basically nursing is a sacred calling, a noble and sacred calling from God. If I was asked why I decided to make this huge transition from computers to nursing… I would have to say I am called into it.

I am blessed to be called into this sacred ministry, a ministry where I can be God's channel of encouragment, comfort, and hope.

Good teachers and Barnabas April 4, 2006

Posted by danucube in Nursing, Nursing School, reflections.
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I just looked up some of the comments of my profs in summer if I am accepted to the accelerated program.  It will be 5 classes in summer (I never taken 5 classes in summer, the most was 2 classes).  3 out of the 5 professors have comments about being funny.  That is a good sign… nurses need humor in the midst of all kinds of suffering.  Humor gives a bigger perspective.  Also a number of profs have lots of stories to tell.  That is another good sign as these stories make remembering important points easier.  It seemed all of them are graded by student very high except one.  The one who did not get a high grade basically because she is kind of intimidating but she is very very good and she knows her stuff.  The best tip with this prof is that you have to approach her and not be intimitated because she will help you and she is actually a nice person.

I also heard that this nursing school, many of the profs actually care for their students which is encouraging (some nursing schools unfortunately have profs who are so burn out that they don't really care about their students anymore). 

A thought is that it is good to have this accelerated program because it just opened up 30 extra spots in the regular program.  The competition to get into the accelerated program is extremely intense but I wonder what kind of people are we going to have in cohort 2 of the accelerated program?  One of my brother mentioned that just having a high grade in class does not mean one is going to be a good doctor.  Thinking about this comment, this is especially true for nursing as nursing requires a person to have bio-psycho-social-spiritual skills.  It requires a compassionate and caring heart.  It requires the ability to see past the illness and see the person.  It requires a person to be a Barnabas who saw past the failure of John Mark (think that was his name) and took him under his wing while Paul did not have that ability to do that (Paul has a type A+ personality). 

2005 year end reflection December 31, 2005

Posted by danucube in Nursing, Prenursing, reflections.
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2005 has been an emotionally tough year for me due to some personal events.  I was having great difficulty in terms of focusing.  But somehow God was merciful and pulled me through.  Especially micro and nutrition, somehow got an A which I need for nursing school application. A few surprises also like getting an A in inorganic and organic chem.

In terms of course content, I enjoyed all of them (except chem classes).  Without exceptions, God has given me great teachers.  Teachers who can teach and actually care for their students.  I am very blessed.

Now next year, it looks like I will be applying for the accelerated program in my local university.  God has given me the grades for it.  Now the question is, do they have space?

We will see what kind of year God will give me next year…

The March of the Penguins reflection August 6, 2005

Posted by danucube in Nursing, reflections.
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I gave myself a treat yesterday by seeing “The March of the Penguins” since penguins are one of my favorite animals. It is an amazing movie in documenting what Emperor penguins go through just to raise a chick.

I was just reflecting on the movie and one image that stuck to my mind is that the lone penguin dies in the arctic storms. The penguins who survive the terrible arctic storms are the one who huddle together. In the film, you’ll see the penguins who try to survive the storm and at the same time protect their eggs all huddle together in this huge mass of penguins. They slowly rotate so everyone has a chance to be in the middle of the huddle which is the warmest. After the chicks were born, same thing, the chicks who huddle together are the one who survive the storms.

Another thing that stick to my mind is how the father and mother work together as a team to raise the chick.

These images sort of goes against the dominating main stream US culture where extreme independence, extreme individualism, extreme egocentricism is often highly value.

In our culture, “dependency” is bad and “independency” is good. I do not think that is actually healthy to have this view. What we want is “healthy dependency and healthy independency”. We do not want “unhealthy dependency and unhealthy independency”.

It also make me reflect on a little of what the Bible teaches. It does teach that individuals are extremely value as each individual is made in the image of God. Also we are children of God through Christ. It on the other hand also teaches dependency, or rather healthy dependency. A healthy dependency (for a Christian) is one who depends on God in everything. His/her confidence is not in himself or herself, but in the God who loves him/her just as the chicks have confidence in taking their first walk because they know their mothers are their. Another healthy dependency trait is that we are to be in some form of community to help and be help. We help within the capacity that God has given us to those who needs it with compassion, care, and love. At the same time, we with humility accept help from others when we need it. We do the good works God has prepared for us in a team. In another word, we are not created to be alone and totally self sufficient from everyone. We are created to be in a community with others and in a communion with God.

In nursing, same thing as nurses works in teams with other nurses, with doctors, with other medical and health staff to bring healing, comfort, compassion, caring, encouragement to the people we come into contact with. Also when we interact with people from other cultures in nursing, we have to keep in mind some cultures are not value independency as high as we do. They value the group more. So if we ask them to tell us about themselves and they have problems, we might switch gear and ask them about the people who play an important part of their lives. In doing so, we get our answers about themselves indirectly.