memories of light in the autumn

I’m going back, way back.  I’m looking 8 years ago to college days.  I’ve been having major warm and fuzzies listening to music that I used to blast in my room with my best friend, thinking about concerts that we went to and me sneaking back into the dorm from my boyfriend’s dorm to get changed before class at 8 am. 

Autumn is in full swing now and while it makes me a bit sappy, it’s surprisingly not what I would call depressing.  I type this, of course, as tears well in my eyes.  I remember the crispness in the early morning air before hiking 3 flights of stairs to the chemistry class that I dropped halfway through the semester.  I remember the dining hall food.  It was just a few days ago that I was at a diner with a friend and decided to get grilled cheese and fries, and to dunk my fries in Ranch dressing, just like we did in college. 

I’ll never forget how I met my best friend in college.  I thought she was pretty and really outgoing; she thought I was some kook in a cowboy hat (why I wore that to band camp) is beyond me), but we hit it off.  Band camp ended and classes started, with Courtney living in the dorm with no air conditioning, and I in the “Honors” dorm next door.  I didn’t like living in a quad or having a bunk bed and she didn’t like her room-mate or her room-mate’s crazy boyfriend, so by the time the “drop/add” period had passed, I moved in with my best friend.  I remember soy dogs with soy cheese and organic ketchup, pints of Haagen-Dazs crowding the mini fridge/freezer, baking experiments in the dorm kitchen and fancy lunches at P-Tux.

I must admit, I made a good deal of mistakes in college.  Let’s see, I dropped “Chem I”, opted to pass/fail “Cosmic Origins” (I passed, but still I’m pretty sure I *barely* passed), took Italian at 8 am with a guy I was sleeping with (we made it to class once a week most of the time), and spent 8 weeks narrowing down my “unknown microbe” in Microbiology before my professor said, “No, that’s not a gram positive microbe.  You should probably start over.”

My science GPA  left a lot to be desired, but I made it into nursing school.  Nursing school was it’s own “special” sort of fun.   Just ask any nurse if they really enjoyed nursing school, the instructors, or 60 page care plans and note cards written the night before clinical, only for the patient to be discharged before you arrived on site.

Almost done with day shift

Ugh. Sometimes I think it’s almost worth going hungry to get that extra half an hour added to my paycheck. There’s just so much to do and not nearly enough time to do it as well as I’d like to. Not only do I become invested in my residents, talking to all of them, whether they’re verbal or not, but I actually maintain a rapport by keeping relatively constant tabs on everybody, like how they’re feeling, what their schedule is, and what they need from me today.

I’m diligent and extremely detail oriented. Seldom do I ever leave at 3:30 on the nose, usually because I prioritize patient care over charting something in three places and checking all of those goddamned boxes on the MARs and TARs. I’m great with my documentation and progress notes. I love communicating with other departments and making sure the page I’m on is at least from the same book they’re using. I am a pretty awesome nurse.

I’ve learned so much and my psych assessment skills come in handy everyday. I work very hard to advocate for my residents and ensure that their mental health needs are addressed as well as their medical, physical or rehab needs. I’m glad to report that the consulting psych nurse trusts my assessment skills and medication suggestions or recommendations. I do my best to stay calm, cool, and collected, whether it’s a problem with another staff, a resident or a concerned family member.

The stress and work is worth it, but I’m leaving this position as a floor nurse to become a night shift supervisor. 11-7, no weekends and a $7/hour raise!

Personal growth – a look at how far I’ve come over the past 18 months

I won’t go into the details of exactly how much of a ticking time-bomb I was last year and the months preceding my descendent to rock-bottom, because I’m trying hard to leave that in the past and make new memories.  I guess it might be easiest to start with an outline and expand from there.

Work

One of the things I’m most excited about right now is a promotion that I recently accepted.  I’ll be transitioning from the role of a floor nurse to an off-shift supervisor.  I’ll be working 11p-7a, Monday through Friday, no weekends.  I’m well aware that it’s going to be a lot more responsibility and will involve both juggling cats and babysitting grown adults, but I am certain that I’ll be able to adjust, keep it together, and make progress.  One of the words that administration really kept coming back to during our informal interview was teamwork.  I’m hopefully going to work on a game plan to have a staff meeting/meet and greet with all of the night staff during my first few weeks to get my face out there.  I know two of the night shift nurses and one of them is particularly strong and the other one is hard-headed.  We also have a new nurse on nights and I’m not very confident in his performance.  Apparently, he improperly inserted a Foley catheter in a little old lady, causing her wicked abdominal pain.  I had very little difficulty inserting it and ensuring that it stayed in place, and the only Foley I’ve ever inserted was on a pregnant lady under an epidural during my OB clinical rotation. 

I’ve been working hard to be diligent, treat patients with the utmost care and respect, and set a good rapport from the start.  I’m particularly good with the sub-acute rehab patients, because they’re most often alert, oriented, and somewhat ambulatory.  They’ve got good reasons to work hard and get discharged and my care can help facilitate that process.  I’m also starting to see progress on wounds that I’ve regularly been treating.  I caught one that was getting infected a month ago, the lady was placed on IV ABT, dressings were changed three times a day rather than once, and it’s looking better now.  Infected pus is not a smell I’d like to remember.  I even had scent memory of it after a shift of working with her so even if I scrubbed myself in the shower and shed my work clothes, I could still imagine the smell!

Academics

  • Applications to FNP programs

I successfully completed the application process for September admission to the online FNP program at Georgetown.  While I was not accepted to the program, I learned a lot in the process of working with an admissions counselor and working on my application.  Not only did I work hard on a personal statement, I also created a 4 minute video essay in place of an interview.  The admissions counselor was extremely helpful throughout the process and even after I was denied admission.  She worked to pass my information on to a colleague at a different nursing program and tried to see if faculty thought I would be a candidate to re-apply at a later date.  I believe there were some flaws with my personal statement and my letters of recommendation may not have been as strong as they could have been.  My science grades also left something to be desired, so I can’t wait to take advanced level pathophysiology, pharmacology, and health assessment as pre-requisites for a Post-Master’s certificate.

  • Plans to return back to Towson University

I hope to finish my MSN in Nursing Education by the end of Spring 2015.  I had lunch earlier this week with my mentor since 2008 and we hashed out a timeline.  I’ll start with one class in the Spring 2014 semester, hopefully one that summer, two in Fall 2014, and one more class in Spring 2015.  I’d like to be admitted to a Post-Master’s program to start classes in Fall 2015.  Hopefully by that time, I’ll be able to attend classes full-time and not have to work full-time hours.

Mental wellness

  • Progress in therapy

I’ve been seeing yet another therapist since late May.  We we having sessions every week for about two and a half months before I suggested we cut back to every other week.  She went on vacation for three weeks and I was able to manage myself, so we both took that as a good sign.  Within the past month, we’ve decided to cut back even more to just monthly check-ins.

  • Positive thinking and affirmations

It’s never been easy for me to stay positive but I get a little better at it and stronger everyday.  Well, not every day, but progress is made in one direction or the other on a daily basis.  Checks and balances, right?

  • Self esteem and confidence

I’m awesome.  Michael has been trying to make me see this for who knows how long but I’ve always resisted, citing “imposter syndrome”.  I’ve started taking compliments in stride and I’m less likely to respond to a comment about how great I look and have I lost weight with “Oh, what?  Did I look like a cow before?” than I am to say, “Why yes I have lost weight.  I’m eating healthier and getting more exercise.

  • Ability to approach strangers

I used to be very meek in public.  Like if I posed a query and it was dubious at to whether the other person heard me, I’d either assume they didn’t hear me or that they didn’t want to respond, and I’d move on, feeling sheepish.  Now, I have no problem asking a stranger for help (like the nice man who helped me open shoplifting-proof packaging on something I’d recently purchased or asking the clerk at the Barnes and Noble cafe to rinse my iced mocha cup so I could fill it with free water.  Of course, I also approached a man asking if I could have the table he was sitting at because it had an outlet that he wasn’t presumably going to be using and was sitting alone and he looked at me like I was more than a little crazy and audacious to dare to ask him.  He did move, though.

  • Organization and motivation to keep things clean and organized

Of course when my best friend came to visit a few weeks ago, the living room in our apartment looked like a disaster zone, but that’s becoming more of an exception than the status quo.  More often that not, if Michael leaves me home alone, I’ll tackle a room and start sorting, organizing and trashing things.  I’ve gone through my closet and dresser, gathering at least two large black trash bags (you know the ones, right?) of clothes that don’t fit, I haven’t worn in the past year, or I don’t even remember why I bought it in the first place.  We’re going to pull winter clothes out of storage soon and there will probably be more purging done then too.

 

things are not only looking good; they’re staying good!

I picked up a 3-11 shift on a different unit last night and it was great! I think I’d be willing to pick up more 3-11 shifts in the future or maybe think about a double, because things really slowed down. Of course, I haven’t had the monkey wrench of an admission in the middle of my shift yet, but we’ll see. The pace was much more manageable, no treatments and the residents were all pretty nice. There were a few snags, mostly related to me not being familiar with any of the residents, but it was overall a good evening.

I’m taking 2 days off at the end of the month so Michael and I can have a “stay”cation.  I wanted to go out of town, to Boston, but we calculated that it’s not financially a very sound idea.  We’re going to possibly do Toby’s dinner theatre and visit the D.C. Zoo again.  Most of my work week was pretty stressful and I need a break to catch up, more than just my 2 day weekend every other week.

Michael starts his new job soon and we’ll hopefully have money to squirrel away to put to our emergency fund.  Things seem to be running pretty smoothly lately and I think I’m mentally at the level where I can handle things even if there’s an unexpected crisis.  I’m learning how to weather things and not let everything become a major big deal!

my personal growth from trauma, a lazy ex-fiance and self-destructive behaviors (part 1)

I lived with my ex-fiance for a year and a half, during my senior year of college and the summer into winter afterwards.  So much happened during that time frame that we really grew to be too different for each other, although we didn’t officially end our relationship until Summer 2010.  My 3rd semester of nursing school started off alright, but that’s also when I took my psych nursing course and noticed that I had more than a few symptoms of bipolar disorder and attention deficit disorder, primarily the inattentive ones.  I visited the counseling center on campus and started on Klonopin for anxiety and the starter pack of Lamictal for my mood.  I also started seeing a therapist.

The week after I sought psychiatric help turned everything upside down.  I had gone to the grocery store after getting off of a 3-11 shift at the local psychiatric hospital.  I was unloading groceries from the car and although I needed to make several trips, I decided not to disturb my ex-fiance as he was getting ready for bed and I’m no damsel.  I pulled another armful of bags from the front seat of the passenger side to my car and came face to face with a stranger.  I won’t do into the details because it’s irrelevant at this point, but I was raped behind the bushes near my apartment complex.  I called 911 and went straight to the ER once I got back home, he was caught within a week from raping someone before me,  he was put in jail for a long time.  I didn’t even have to testify because he took a plea bargain.  I know I should have been more upset that he took sexual assault rather than rape and kidnapping, but it’s over now and I’ve been consistently in therapy ever since (which is a good thing that came out of it).

I took a week away from classes and worked harder in school than I ever have before.  I made Dean’s list for the first and only time during my college career.  My final semester flew by more quickly than I had expected and before I knew it, I was sitting in my Kaplan review class, studying for the NCLEX-RN!  I sat for the NCLEX about a month after graduation and started my job as a psych nurse in a community hospital the Monday after I tested.

I spent 12 weeks in orientation on 7p-7a, and an additional 4 weeks because my nurse manager was unpleased and was hoping that she wouldn’t still want to fire me in another 4 weeks.  I improved enough and stayed gainfully employed. 

Unfortunately, November 2008-December 2009 didn’t go as well for my ex-fiance.  He spiraled into a depression after my rape, constantly stayed home from work as a result of his anxiety and fear for my safety, lost his job due to his attendance and remained unemployed for the duration.  He still had enough energy to play World of Warcraft, though, while I was battling the role transition from student to nurse.  I also went through a horrible trial of medication for my bipolar disorder.

My psychiatrist at the time saw it fit to put me on a combination pill of Zyprexa 5 mg and Prozac 20 mg.  It could have worked, but I’ll never see it that way, because I was so sedated all the time!  I slept until 5 pm, yelled at my ex-fiance for 30 minutes, and then drove 30 minutes to work.  (Yes, I do realize now how unsafe that was!)  I encouraged his to see a therapist and he grudgingly did, but did not maintain appointments or display any investment in suggestions his therapist made.  We could no longer afford rent and bills on solely my income and there was no way that I could comfortably pick up any overtime.  By this time, I’d been seeing a new girlfriend for a couple of months and she and her boyfriend (just google “polyamory” for me if you’re confused!) told me that they had an extra room in their row-house that they’d be interested in letting me rent.  My costs went down by 50% AND it was only 5-10 minutes from work; possibly walkable at times, depending on weather conditions (yes, I’m a wimp and would prefer it to be 80 degrees outside at all times, with minimal humidity).  I jumped all over it and was living in Baltimore City by January 2010.  My ex-fiance moved back in with his parents and we went “long distance”.

I applied to my alma mater, Towson University for their Masters in Nursing Education program and started classes in January 2010.  Working 7p-7a and taking classes at 5p on my days off was not as fun as I thought it would be, but I still managed to do well in my first class.  I took two classes during the summer of 2010 and was confident enough in myself that I dumped my now ex-fiance.  I also started working day shift, which was such a blessing!  Never again will I do 12 hour nights.  I’ll entertain 3-11 and even 11-7, and maybe I’ll do a 3p-7a double shift if I’m feeling really wacky or desperate, but never will I ever do permanent 12 hour nights. 

That’s all I’ll say for now, but I have so much more to tell. Most of it is pretty ugly, but it’s all brought me to the point of stability now.

Status update: good things and what I’ve left behind

Since I’ve last been on here, I’ve been doing really well at work.  Michael moved in at the end of July.  I’m attending yoga classes regularly.  I applied to the family nurse practitioner program at Georgetown University, to possibly start in September.  These are only physical things that have happened; there’s so much more growth I’ve experienced on the inside!

Here’s a summary of the past month or so:

Things have been great. I saw my new GP and my pdoc last week. I had a sleep study consultation for my insomnia and snoring and have my actual study in 2 weeks. 

I signed up for a set of beginner yoga classes starting tomorrow for 5 weeks. DH starts his new job soon. All of my recommendation letters are in for Georgetown, as is my completed application, as of this weekend. Work has been crazy busy and several people have been shipped to the hospital recently. I’m continuing to do really well with my residents and I’m glad that I can form longer term working relationships with them than I had in acute care. My relations with coworkers are also good. 

DH says that I’ve improved so much since last year and even since we met, especial with being neater and more organized. Hopefully the Concerta will help with my concentration, as will my continued commitment to therapy. 

I feel so much healthier and stable now, more than ever before.

My path down initial diagnosis towards mental wellness and health

Ironically, it was nursing school that made me realize that my symptoms of self-perceived madness weren’t just eccentricities. I’m sure we all were self diagnosed hypochondriacs but the shoes actually fit and it clicked that I was the symptoms and cluster of behaviors that I’d wondered about in my high school psychology class. What kind of teenager thinks to themselves, “If I had any sort of mental illness, it would probably be bipolar disorder?” I’d never done much in depth exploring of mental illness prior to being plunged head-first into it while taking my psychiatric nursing class in undergrad.

Hell, I minored in psychology and had even taken abnormal psychology, but it was learning the nursing interventions that made everything come full circle in my head. It was the group projects about coping skills that had me thinking that perhaps I had more in common with people with psychiatric illness that not. It was only when I started questioning whether I was just overthinking things and began to apply my classwork to my mundane life, like coping skills and .  It turned on a switch that triggered me to seek wellness and health and to organize the clutter inside my head.

Despite the fact that my mother and I saw a therapist while I was in high school for what she remembered as six sessions and I remember as two, I was constantly told that I was just “moody” and (my favorite) “just a teenager”. Somehow, my early symptoms of hypersexuality, irritability and impulsivity were me “acting out” or “attention seeking”. That didn’t stop my mom from calling my after-school job, picking me up in the middle of my shift with silence, and then her and my father threatening to ground me and take away all of my privileges and electronic devices because I was writing sexually explicit notes with a freshman although I was a senior getting ready to graduate and was in a relationship. I spent way too much of my french class thinking of getting into people’s pants rather than realizing the similarities between the Spanish I’d already learned and the French that was placed in front of me. That night, I threatened to walk out with none of my possessions and never come back, and I was serious. I screamed louder than I ever had in my life and though my mother threatened to drive me an hour and a half away to the only psychiatric hospital in the state that she knew of, she had no idea of what to really do with me. I spent the night at my grandmother’s house, swearing to never talk to my parents again.

There were other warning signs, like the deep pits of despair that caused me to stop “applying” myself in my classes, nearly failing AP English Lit and Biology, even though I ended up acing both of those exams at the end of the school year. There was my very first panic attack, during my timed AP biology exam where I felt like I couldn’t breathe and that I was going to implode if I couldn’t get out of the room. There were my nights of staying up until 0200 and getting up at 0600 without any problems OR caffeine. There were the notebooks full of exceptionally morbid poetry.

I’m not even going to go into more depth about my dysfunctional relationship with my family because although it certainly doesn’t make my diagnosis of mental illness any easier, it’s *MY* problem to live with. Whenever clinicians ask me about my family history of mental illness, I always have to clarify, “You mean are there *symptoms* of mental illness, right? Nobody gets diagnosed in my family.”

I spent most of my spare time at the beginning of the Fall semester reading my psych nursing textbook cover to cover, devouring everything I could about bipolar disorder, GAD, anxiety disorders and it wasn’t enough. I had quickly conceptualized what was wrong with me, but it wasn’t until I found myself sitting on the floor of my apartment after having run out to the grocery store at 0300 to buy glitter glue, die cut letters, stickers and colored paper to embellish my teaching plan for my the next day, where presentation was only worth 5% of my grade for the assignment that it actually clicked that I was likely driving everyone else around me absolutely insane and that I might be having a hypomanic episode. I was working 2-3 on campus jobs in addition to my classes and that still wasn’t enough for me to keep the bills paid and afford everything that I thought I just *NEEDED*.

I promptly scheduled an appointment with the counseling center on campus to see a therapist and then the school psychiatrist shortly after. I don’t much remember the counselor that I saw at the time, but I do remember the psychiatrist and the first few words he said to me. “I’m no better than you are. I have the prescription pad and you don’t, but you know what’s going on in between your ears better than I do.” He started me on Klonopin after our first appointment and then he started Lamictal shortly afterwards.

It’s been a whirlwind of ups and downs, back and forth, and side to side ever since. I’ve scared a therapist, who had no idea how to get me to the hospital after a session in which I told her that I just couldn’t handle things anymore. (Gee, why didn’t she just call 911?) She actually let me drive home to pack some things for the hospital, on the promise that I’d keep her posted.

It’s been almost 5 months since my last medication overhaul and although things are still shaky in my world, I feel more grounded than I ever have. I pull out all of my prescription bottles at the beginning of the week and fill two medication calendars, one for my AM/PM meds, and one for my afternoon meds. I know I’ll probably never be able to work straight night shifts ever again. I know that I need to work harder at setting limits with patients than any of my colleagues will ever have to do. I know that I need to check and double check things and then still spot check because I end up letting myself get over-confident.

It will always sting when I hear a co-worker say, “Oh that patient is just attention seeking.” (Maybe if you pay attention to what they’re doing or saying, rather than how that makes you feel, you’ll remember that they’re in the hospital for a reason.) I’ll bite my tongue when I get told, “That patient needs PRNs around the clock because they’re out of control.” (Is there something that’s triggering them that we should be more mindful of? Are we doing our best to notice warning signs and address them *before* the patient gets out of control?)

They say “It takes one to know one,” and I think that’s a pretty accurate statement.  I’m not saying that you need to have mental illness to work with patients suffering from mental illness, but a.) it helps and b.) we all have our issues and lie somewhere on the mental health/illness spectrum.  It helps to acknowledge that we’re human and mental illness is the most pervasive illness among those 18-25.  Take a look around and recognize that it’s not a death sentence but it can become one if it’s ignored or not treated. 

After all, we’re all a little bit mad, right?

Previous Older Entries

Follow

Get every new post delivered to your Inbox.

Join 282 other followers