Looking back, summarizing and wrapping up 2014

Very quick background…

First, I’m going to tell you a little about my general background so things make sense…

Since I was a teen, I’ve always been very interested in the health sciences, yearning to always understand how the body works to be able to help others. I even wanted to be a medical doctor but I was not impressed with the way doctors treated me. There seemed to be very little compassion and the meetings were rushed. I didn’t like the way the health-care system was setup, what with drugs being the go-to (symptomatic) cure and doctors not really able to have much time with their patients. For those reasons, I didn’t seriously explore options in the medical field when I was young.

Instead, I ended up getting a business degree with a focus on finance at CSUN. So for most of the 2000’s, I worked in the financial services industry. People trusted me with their finances and I took pride in being responsible with them. But when the economy tanked, if you didn’t have a large clientele, you were pretty much out of a job.  So I was re-evaluating what I wanted to do with my life, because finance was NOT it.

Registered Nurse?

It took a lot of guts and pondering, but a couple years ago I decided to go back to school with the purpose of becoming an RN.  So anyway, I realized that as a nurse, I could be the “doctor” I always wanted to be because I would get to practice direct patient care, which I enjoy greatly. I would be able to spend one-on-one time with patients and really help brighten up peoples moods (and maybe even help save their lives).  Plus, I’m naturally very patient, with an extreme attention to detail (mandatory in medical field) and things like blood and poop don’t make me feel queasy, so hey, I felt like this could be the right thing.

So, for the past couple years I’ve been fulfilling prerequisites and studying my ass off to be the best nursing student one could be with the goal of getting into UCLA’s program. In my opinion, I went beyond what a normal student would do and I will go into detail about that now.

Academic Prerequisites

I was extremely interested in my classes and badly wanted to excel in them. I knew that teaching was the shortcut to mastery, so I ended up rehashing my coursework into easily understood articles in my Science Series, containing over 260 articles that cover Human Anatomy and Physiology. I took classes beyond what was required to get a further jump start on things, such as pharmacology, advanced anatomy (with cadaver lab, yikes!), medical terminology and dosage/calculations classes, which I all aced, by the way. I actually found pharmacology to be by far, the hardest class out of all, but I am proud to say that I was one of the highest scorers, ending the class with an average of 98%.  (I documented my study habits here: 10 Study Tips and Skills to bring the genius out.) Oh and I forgot to say, I was also tutoring Anatomy students thanks to referrals from my previous Anatomy teacher, who I am so very grateful for knowing. (Thanks Coco! You will forever be an inspiration to countless people!)

Volunteering Experience

I knew academics weren’t enough to distinguish myself apart from the millions of other applicants. At the very least, I had to volunteer in a nursing environment to show that I knew what it would be like to be immersed in the field. So, I volunteered at the Cedars Sinai hospital.  It took an interview and 3 references to get in there. (It’s all very competitive!).  I ended up maximizing my time there by volunteering in every department I could that was relevant to my career goal. The volunteer manager loved my journals (we had to send journals after every shift) and I worked with her diligently to getting the most out of my time there.

I remember when I started out, I was very intimidated by the hospital and staff.  I remember very distinctively being afraid of entering patients rooms, especially the ones whose doors were closed, because I didn’t know who was behind them or what to expect. (Was it going to be a 90 year old Korean lady who didn’t know English? You never know!) But it was my responsibility to talk to every single patient in my assigned floor and teach them (and their visitors) the importance of hand hygiene to reduce the spread of infection and do my best to reduce the risk of falls!  And I would do that by getting them anti-skid socks if they needed it, cleaned up the pathway between their bed and bathroom and teach them how to call for the nurse in case they need assistance getting up and going to the bathroom.  Even if somebody looked very capable, like a person in their 20’s, I had to do it, because sometimes they would be at risk of falling due to the drugs they were on that would make them drowsy.

Reducing Fall Risk

For my last rotation (I did 3 TCAB rotations!), I was asked to be a mentor and trainer for the newcomers to the program! It felt amazing being a teacher. I envisioned how I would love to be a preceptor one day for future nursing students. Anyway, I actually made a discovery that I believe helped make an impact on falls in the hospital:

I noticed that fall-risk-patients with very large or swollen feet were not wearing their anti-skid socks because they would not fit. Despite the label that read “Universal” for the sock size, they were not actually large enough for all patients. I alerted the higher-ups and I had to push the issue a bit for it to get traction, but now, as a result, the hospital now has anti-skid socks in the XX-large size as well. This reduced the (legitimate) excuses patients would have for not wearing socks and ultimately helped reduce the number of falls. This was, what I felt, one of the small milestones into my life that provided a glimpse of myself as a potential clinical nurse leader, filling in the gaps between increasing patient safety and decreasing medical errors.

Mealtime Mate Volunteer

I also became a “Mealtime Mate” volunteer, where I would feed patients that were unable to feed themselves. I got excellent training by a registered dietitian on how to properly feed patients and make sure their food was properly received (e.g., low sugar if diabetic, pureed if unable to eat, straw if unable to drink, making sure they are upright enough, remind them to swallow, etc.)

I had to spoon feed the patients.  They were usually blind, really confused and/or frail elderly folks. (Talk about getting out of my comfort zone or what?) . It was most interesting dealing with patients with dementia.  For example, a patient with dementia once told me they were extremely depressed because their son had died. But I knew they were not actually dead because their son visited them that morning.  Instead of “acknowledging” that as fact or pretending to give value to that notion, I learned how to change the subject and ask them questions unrelated to what they just mentioned to help jog their memory in other ways. For example, I would just change the subject by asking them where they were from,  and that would somehow help them remember the reality of things and suddenly realize their son was not dead. Aging is a crazy thing.

Emergency Department

So, being a mealtime mate and TCAB volunteer felt pretty good, but I feel like I wanted MORE. I asked my manager to help me fill my cravings for wanting more experience and she referred me to the emergency department. This was another world that required a commitment for a year (which I completed) and new training. This time, I was working with an awesome team. We would actually escort the patients, prepare their beds, help shuttle stuff to the lab for the nurses and do many other random things to support the staff.  We would act like a liaison between the patients and staff making sure everything was hunky-dorey. It was always interesting seeing how stressed out soon-to-be fathers would be as I pushed the wheelchair with their pregnant wife up to the delivery area. It was also interesting seeing how frequently homeless people came in, because the hospital couldn’t refuse anybody, so they would come in sometimes because they needed a place to rest or shower. (They did, often-times, need extremely serious care, though. They do legitimately have a lot of psychological problems, unfortunately, and the hospital cannot do much about them.)

(insert photo of team)

I ended up purposely putting myself through 10-hour volunteer shifts to mimic a 12-hour shift as much as possible.

So anyway, to recap, I volunteered hundreds of hours of my time at the hospital trying to immerse myself as close to the nursing experience as much as possible. I created lots of quality articles, which still, thousands of nursing students get help from each day on this website. I aced all my classes. I got great references and I thought the cat was in the bag. I applied to UCLA with a badass statement of purpose, which I worked on for months on end by the way with the help of a dear friend who happened to be a grammar nazi who I will forever be grateful for.

Anyway, with all this work said and done, I was rejected. And of course, it was the most generic rejection letter, with no mention of why or why not. I was hoping to get into UCLA because they offered a legit masters program. I wanted to go for the gold. But it didn’t happen.

So, I was a bit bitter about the rejection at first.  I had to ponder what I was going to do. Apply other places? Go for different programs? Apply again next year? It’s too bad UCLA didn’t see the value in me. I was so adamant about helping my cohort, too.  So… you know what? That’s their loss. And on the bright side, they forced me to figure out where I was going to go from here.

So, after the rejection…

I kept going to the hospital to volunteer as usual and during those next few weeks, I started to see things differently. I started to think that maybe this is a sign.  I started to rethink that maybe nursing wasn’t for me. Maybe it was a good thing UCLA rejected me. Another blessing in disguise? Instead of being mad at them, I should be thanking them. Why? Because, well…

• I started to notice over 90% of the nurses were actually extremely stressed out individuals, not living a healthy life themselves. The 12-hour shifts were always running them into the ground. I would see them only by their 10th hour and they’d already be looking quite sickly, maybe running on pure adrenaline (or coffee) at many points. Even their lunches were rushed and they were constantly interrupted. Their break-room didn’t even have a window. (The sadness of that had motivated me to write about shitty break rooms.) They looked stressed to all hell. These are people that are literally sacrificing their own health, to great extremes, to help others. And I was starting to see that it was a bit too extreme in my view.
• I also started noticing the dark side to the hospitals… Stuff that I knew already: That by and large, it was a business first and foremost.  Let me tell you a simple story why: During my TCAB shift, remember how I found out about them not having the socks in the right size? Well, the reason it was always like that was to keep the costs low, but they actually fixed it.  So let me tell you another story…

Curtains with you!

Well, there was another problem… and that was the curtains: I’d see the custodians in the hospital cleaning the entire room top to bottom, spraying everything down, mopping the floor, providing clean bed sheets, linens, the works. So the room is clean and if people gel in/out (purell) each time and wear their contact precaution gowns and masks, then we’re good, right? WRONG.

THOSE CURTAINS ARE NASTY.  At such a distinguished hospital such as Cedars Sinai, I’ve seen curtains so dirty that you visibly SEE there’s stuff on them, both in the med-surge units and the ED.  It seems to be the weak link in their microbial security, or the loop hole, in allowing bacteria to spread. And you know, patients and visitors aren’t aware of this at all. They open/close curtains all the time without giving it a thought!

I don’t mean to be a god damned nit-picky perfectionist bitch, but then again, I DO, because we KNOW vre/mrsa is serious business.  This study showed that 92% of FRESH curtains placed in the rooms were contaminated in ONE week. (And 40% of those with VRE.) This other study tried to see how curtains with antimicrobial properties faired. They showed that it took about 14 days for them to be contaminated versus 2 days of the normal curtains.

So I brought this up to the hospital by e-mailing and first asking what their policy was. Let me tell you, nobody knew what the policy was, so a lot of people had to forward the issue to others and find out what the deal was.  Turns out, they’re ONLY changed when a terminal cleaning has to be done, which is basically only in highly serious cases (read: the patient died in there) OR if they’re VISIBLY soiled (which many of them are, but nothing is done about it). As the weeks went on and we tried to see if any change would occur in the policy with changing the curtains more regularly or finding an alternative, we were met with silence on the issue.  And here’s why: Cleaning curtains costs money.  And that’s when you’re reminded: the hospital is a business first and foremost.

I asked other nurses on reddit of this issue and almost all the other workplaces have the same problem. One of them said, they’re only changed when they have more holes in them than a hookers pantyhose. Others said they only get changed when they are VISIBLY soiled. How gross is that?  Another user said that after their last c-diff outbreak, management decided to get rid of the curtains in patients rooms all together and they haven’t had a nosocomial (hospital acquired) outbreak since!

So… this may not be a big deal to you, BUT IT WAS TO ME.  Do I want to work in a place that values money over the reality of what it takes to keep people healthy? Nah. I don’t. 

So that was another little thing that was a sign that maybe nursing wasn’t the way for me to go. Not that working in a hospital was the only option as a nursing (not at all), but it would likely be a place I would spend a good amount of time! So I was thinking… If I go through and pursue the degree, I’m going to first of all, be in lots of student debt (easily $40k+ for just tuition).  And then, to make use of my licensure (and pay off my debt), I’m going to have to work for a hospital most likely to help pay for those bills and make use of my training.  But you know what? There’s a better way to live than that. I have something not a lot of people have, and that is this website. Helping people is my real passion and the fact that I could do it through the internet in this manner, and have an actual following, is a blessing I should not neglect. That is why I ramped up my YouTube video production this year into full blast. That is why I am now a personal trainer and loving every second of it.  That is why I love teaching people how to use their body. And you know what, I won’t be making as much money as a full time registered nurse, but I am a hell of a lot happier not working the 9-5 (or 9-9 in this case) and being a slave to the system.