Michigan vs MSU

All this week, there’s been so much hype about the Michigan vs MSU. With Coach Jim Harbargh at Michigan, Michigan football is doing better than ever. Usually, I don’t really follow but my fiancé is a huge fan (he listens to podcasts and even submits questions via Twitter, haha) and now I’m a student!!

Anyways, Michigan has been dominating the last 4 games although MSU has won all five games undefeated thus far.

Apparently people all over the country are driving or flying in, staying in the cheapest hotel almost 30 minutes area at $250, with the cheapest tickets going at $175 this year (unless you’re a student who got season tickets).

Guy Fiori is going to be at Meijers this morning. “Game Day” is happening at the Diag. Somehow my friend talked me into going so I woke up early to get some studying done before I take a morning break and start back up in the afternoon.

It’s gonna be a lot of fun.

Speaking of studying, there’s a lot of new material. There’s a final exam in physical assessment and a principles exam coming up on pediatrics, fluid and electrolytes, blood products, and part I of the anesthesia workstation (yes, I can draw the oxygen molecule from the hospital outside, through the entire machine, and to the patient circuit— wow!).

I definitely feel on edge at a much higher rate than ever before. I’m usually a pretty calm person but now more than ever, I can feel my heart racing and getting anxious. And that’s almost everyday. I try to calm my nerves by either studying more, or setting time aside to go for a walk or watch some funny TV. Taking care of myself is probably one of the most important things I can do to endure through the program.

I learned this week (amongst other things), that a “sugar high” isn’t really a sugar high. As a tasty candy bar, full of “simple sugars” or glucose or monosaccharides readily available for insulin to act on, glucose is too quickly shoved into cells, causing a hypoglycemic effect. The alpha cells in the pancreas senses the hypoglycemia and releases glucagon. Epinephrine is also released from nerve endings and adrenals. Both glucagon and epinephrine go to the liver, which then undergoes glycogenolysis, breaking down glucagon into glucose and releasing it back to the bloodstream.

However, image the little kid full of epinephrine, setting off the sympathetic nervous system, causing him to run around like crazy during recess or banging his head against the wall. So a “sugar high” is really caused by “hypoglycemia” that’s induced by our more primitive insulin that floods our bloodstream when sensing a huge amount of glucose. If instead the ingested glucose was complex such as a starch, then our insulin is a much better match, releasing the appropriate amount of insulin without going overboard.

I did a few spinals this week (how cool and amazing it is!!) but next week I will try to do more general cases. All right, enough updating. Until next time.

Jessica

PS. I know the first round of interviews is coming up so I just want to say good luck to anyone who’s interviewing at UM.

PSS. The double rainbow outside my window on Thursday is the featured photo. Nature is beautiful.

First time jumpstart a Prius

My remote stopped unlocking the 2009 Prius. The remote light lit up red every time I pushed it but the car didn’t respond. 

I went on Google to try to figure it out. I hadn’t driven my car in 5 days. I found out there are 2 batteries in a Prius– one in the front hood to start the engine and the other in back for the hybrid use portion. I was pretty sure the front one was the one with a problem. I looked up how to jumpstart a Prius because I’ve never jumpstarted any car before. 

Thank goodness for YouTube videos. And I parked in a garage. I asked one of the attendants to help me although once he heard it was a Prius, he became skeptical since in the past, he was unable to help another patron. 

First I couldn’t open the door, so I found out that there’s actually a key inside of the remote. After I took it out, I read that it may be difficult to insert the key to open the door on the driver’s side. Thankfully it was easy. 

Next, the attendant drove over a van, left the van on, popped open the hood, and attached the red positive jumper cable to the red, and black negative to the battery. 

Using the other end, he connected the red cable to my Prius (under the fuse V12 battery box on the drivers side, flip the red little box), and connected the black on the hood’s metal latch (it sparked!). We tried turning it on several times by placing my foot the brake and pushing the on button. It didn’t work. 

We sat a little longer– and took the black one on and off the metal connection several times before I saw my car lights go on, and then start emergency honking. The car turned on!

From the Prius? We took the jumper cables off — black then red. Then from the van, black then red. 

Of course, concerned about the health of the battery, we searched up how to check. It was fine. 

Anyways, that’s it. 

It’s getting real

Since I got accepted into the nurse anesthesia program at UM Flint, it’s been an exciting time in my life. I went on my first cruise, got engaged, joined a Community-Supported Agriculture (CSA) and started to really think about what this program will entail. Recently, the previous class invited the Class of 2017 to a BBQ before school starts. For me, it means it’s going to start soon. The program director sent information about what to expect (school = your life for 2 years and don’t let anyone expect you to help around the house but still have at least one evening off to decompress and hang out with loved ones), review material especially in math calculations, the autonomic nervous system and some medications we’re already familar with, and the people I’ll be with for the next couple years. 

Speaking of which, I didn’t expect my picture from the interview to go up. I wished I straightened out my hair a little better but hey, it is just a picture (see above). 

I appreciate that we’re paired up with a mentor from the Class of 2016. It makes it easier to ask questions since they just went through it first (or junior) year themselves.

Sometimes I’ll wake up nervous — but I haven’t even started yet. Then I’ll remember that it’s such a privilege to even have this opportunity. I’m not sure if anyone is ever ready for the massive amount of information that’s expected to be memorized and applied, but here it goes.

One thing I really don’t like doing is writing scholarship essays, or really any essay that involves describing ‘how amazing I am based on the criteria that you’re looking for.’ But it’s a necessary evil. One thing I don’t understand is that if we’ve already submitted our application with letters of recommendation to get into the program, why do we need to duplicate the process of submitting additional letters of recommendation when applying for scholarships? Regardless, I’m thankful to have a NYU faculty member who is not only super supportive of me but also fast in response. 

I’m thankful for everyone who’s supported me. Because life isn’t an individual event. It’s comprised of many people. So thanks.

I’m excited to start this new chapter in my life. There’s 2 and a half months left before school starts. Two more months to save money before I’ll have zero income. But it’ll be worth it.

Project GLAM – Start Your Own Dress Donation Drive

project glam

As a part of our unit’s community service project, we decided to do two projects. One of them was Project GLAMGranting Lasting Amazing Memories. Somehow I was assigned to make the flyer and ended up becoming the head cheerleader for this project. WGIRLS Inc started Project GLAM back in 2010 where you can donate your gently used prom dresses (or cocktail dresses or bridesmaid dresses) for underprivileged girls who need prom dresses!

The idea started back in January by my nurse manager where she handed me some printouts from the website. Even Oprah endorsed it, how can you go wrong?

I made the flyer and started talking about it with coworkers a week before our donation drive. I set the drive to a short amount of time (2 weeks) so that people who were interested would bring in their dresses right away. I thought the flyer should be colorful and have spring colors, as well as the logo of the project. The timing of the drive is also important — it just turned spring, just in time for spring cleaning and Earth Day (reduce, reuse, recycle!), and it is before prom session starts. The Project GLAM was also discussed in the local news, which helped bring interest.

It was exciting talking to people about it, and hearing others talk about it with others. There’s a large age range of those working on the unit so many had different ideas of which dresses they should donate — some brought their own cocktail dress or bridesmaid dress, and others brought their own daughter’s prom dress!

We collected about 10 dresses and many accessories. Next, I got in touch with Amy, the president of WGIRLS, who then put me in touch with Kristi, the VP of WGIRLS in Long Island. We decided on a location and I dropped off the dresses.

Overall, it was a successful drive and I hope that other organizations will do the same! It helps to have a group of people donating to bring a sense of community together. However, if you’re interested in donating your own dresses, drop off your dress and accessories at these locations.

Have fun with your own dress drive and make a difference. 🙂

I got into the University of Michigan-Flint / Hurley Medical Center Nurse Anesthesia Program!

official.umflint.logo_I’m really excited to say that I got into the University of Michigan-Flint / Hurley Medical Center Nurse Anesthesia Program. I am proud of my accomplishments and thankful for everyone who has encouraged me and helped me along the way.

I’m inspired to write about my journey — past, present, and future — by other blogs about Certified Registered Nurse Anesthetists (CRNA) schools (such as http://studentcrna.blogspot.com/ and http://lifectent.blogspot.com/) and the Umich Med School blog written by multiple students. My hope is to give insight into this career path and encourage those who may be interested too.

Like many others, I have varied interests, but healthcare was always in the forefront of my mind. I grew up knowing that I wanted to heal the sick and that I wanted my presence to truly make a difference in people’s life everyday.

I first went for a biology degree for pre-med. But unfortunately, as I started to explore medicine as a career, I was put off by it. Sure, a lot of friends continued on and I’m proud of them. Some decided that it wasn’t for them either. I started to explore other healthcare fields. I found my place in nursing. I was most excited when I found out about the accelerated nursing programs because it truly changed my life. Before I finished my biology degree, I took several prerequisites for nursing schools that I was interested in (because unfortunately they all differ).

After I graduated from nursing school, I knew that I wanted to go to graduate school. I took a couple of graduate courses through NYU’s dual degree program while I was working on telemetry. I was interested in nearly all the graduate nursing fields — nurse practitioner (acute, primary, pediatric, family), nursing informatics, nursing administration, and nurse anesthesia. But it wasn’t until I entered the intensive care unit before I started to really take my preparation seriously. At this point, I debated becoming a primary NP or going into nursing informatics or nurse anesthesia.

I already saw what a difference nurse practitioners do but I didn’t know if I really had it in me to do anesthesia. Life in my hands– day in and out. But I met a few UM alumni who told me that I would do a great job. I shadowed them over the summer, and saw their autonomy and teamwork abilities. I had almost all of the credentials to apply and their encouragement made me believe in myself.

I started my process of looking into schools to apply.

  1. Where is it located?
  2. Do I meet the requirements? If not, which ones are still missing?
  3. Is there an information sessions to learn more about the program?
  4. When is the due date? When does it start? How much does it cost?

I started attending information sessions in July. I went to UM-Flint information session in October. My advice is to bring transcripts. This kills two birds with one stone — (1) an opportunity to speak to the head of admissions and (2) to find out if your prerequisites meet the school’s standard. Learn how the school chooses students. Some may emphasize that three years of critical care experience is essential and any ‘outside of work’ experience is crucial. Others say that ‘you may pass all of the didactic courses but if you fail the clinical aspect, then you’re not cut out for CRNA.’ While that’s true, when I hear that comment, I feel that the school is more hostile rather than helpful. Just as you’re interested in becoming a CRNA, it is important to learn more about the school’s culture.

At the University of Michigan-Flint, admissions is based on a points system (as are many schools). For the application, objective data such as the science GPA, overall GPA, and GRE score is scored. Thankfully, I was able to submit majority of the application before tackling the admissions essay. In the essay, it is crucial to answer every question in detail. And while the CCRN is not required, it is highly recommended to take it. It shows that you take your education seriously and it helps you prepare for the interview.

At UM-Flint, there are 2 due dates: Early (10/1) and Regular (2/1). I submitted my full application a week before the due date. There was a website to check if all of your required paperwork is submitted and which ones were not completed (I loved this!). The admissions team was easy to work with and answered all my questions. Sometime during the first week of February, I was offered an interview for either February 19 or 20. I picked Friday the 20th. I made some work schedule changes and booked a flight back home. The 3 part interview (exam, panel interview, and OR with CRNA) is also based on a point system– 10 points for each section. The purpose of this is to make admissions as fair as possible (rather than getting in because you know someone on the admissions board).

  1. The exam is composed of multiple choice, fill in the blank, and essay comprising mostly of CCRN and ACLS material. Apparently, I have to work on the cardiac section.
  2. The interview is a panel interview asking typical questions as well as some ethical questions. I highly recommend practicing saying them out loud. I recommend getting the All CRNA School Guide, going over common questions.
  3. The OR time with a CRNA is comprises of short clinical questions on what you’d do in certain situations.

When I walked in, I saw that I was the last person to be interviewed. After the 3 hour interview window, I was driving back home and got the call. I was shocked that they had reached their decisions so quickly, especially since I was expecting to hear back a week or two after the interview. It may be because they’ve already interviewed everyone and scored them on a points system already and they simply picked people starting from the highest marks going down the list. But regardless, I was definitely excited.

Of course, getting in sparked another list of questions to solve. That’s what I’ve been working on since then.

  1. Where will I live?
  2. Who will I tell?
  3. When is my end date at work?
  4. How will I end my lease?
  5. How will I manage my relationship with my sister and boyfriend?
  6. Will my boyfriend stay here or move back with me?
  7. My car lease is almost up. Should I lease or buy another car considering the number of miles I will potentially drive?
  8. Taxes need to be completed. FAFSA needs to be completed. In-state or out-of-state residency needs to be determined.

I also looked up all the clinical sites and put them on Google Maps.

It’s about a nice 1 hour radius circumference from Flint, Michigan. As of right now, I’m planning to stay at home in Ann Arbor but for clinical that is more than 1 hour away, I’ll stay closer.

As for my boyfriend, he will stay in NYC. He’s doing well with his career here. And we’ve had a long distance relationship before back when we were swapped — when he was at the University of Michigan studying economics and I was in NYC. How ironic.

As for cars, lately I’ve leased Honda Civics because they are less expensive and reliable. But it is true — I really should support American Car Companies (Ford, GM, Chrysler). I plan on going to the New York Auto Show in April and hopefully I’ll get a better idea of what car I should buy.

As for saving money for tuition, I’ve been working an extra shift about every other week. Thankfully I’ve saved a bit already in my retirement funds, which can be used for higher education (I need to look into this more).

As for the order in which I told people, I first told my closest friends not from work. Then after the official letter came in, I told my nurse manager (who is really supportive!!). After that, I put it on Facebook. Prior to applying, I didn’t make it well-known that I was interested in nurse anesthesia partly because I wasn’t sure of the reactions I would receive and I’d rather just leave that part off the table. However, since getting in, I’ve received positive feedback. I think that for the most part nurses are kind and encouraging but I guess you never know.

That’s it for now.

 

 

I like wearing scrubs but not when…

I like wearing scrubs but not when it’s freezing outside! I have to wear sweatpants from my apartment to the garage just to make sure my legs don’t turn fire ice and break off. So icy cold.

I submitted my grad school application– yes!

I finally finished my essay after several drafts so I submitted my grad school application online. It really makes you think about why you want to go into a career and forces you to be certain about what you’re going to do in the next few years.

I did share my blog in the personal statement essay. In this 21st century, I hoped that was ok. After looking at Twitter, I found that the school also had a WordPress blog. Perhaps they will see what blogging can do for someone… And help many people!

It’s been somewhat of a relief to finally be done with applying for grad school. I went to two information sessions, studied and took the GRE, took the PALS classes, studied and passed the CCRN, made sure recommendation letters are completed and in (and thanked those who’ve helped me), got my Michigan license… It’s been quite a few things to coordinate. Having a timeline helped but it’s mostly been studying, studying, studying. While I welcome the break, I know that I’m going to be itching to do something again.

NYC Marathon Volunteer

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The 2014 NYC Marathon
Medical volunteer
For the first time
At mile 15
In Queens

Keep those cramps and aches at bay…
PT to the rescue!
Massage, massage
Ice, ice
In 3, 2, 1
Off you go

Don’t drink too much water otherwise
You’ll get hyponatremia
Eat some salt!
Drink Gatorade to replace electrolytes!

Vaseline for chaffed thighs

Tylenol 650, not Advil
And only once
red dot
drink it down
Off you go again

Too cold
Warm up
Sit in the warm ambulance
Keep going!

Blisters
New bandaid

Ankle hurts
Wrap, wrap

And of course,
Scan in, scan out,
The fastest documenting ever

Inspirations abound
Spirits high

Let’s go!!

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Talking to intubated patients make a difference

I’ve taken care of my fair share of intubated patients. But over the last 2 nights, I encountered something different. They went from calm to wild in just a few minutes. If the sedation was down, then I increased that. Normally it works pretty fast.

But it wasn’t so in this case. Both patients were ‘bucking the vent.’ One didn’t have a PRN order ready so for one I had my coworker help me get an order and prepare ativan. But in the meantime, I remember reading critical care nursing journals about the experiences of previously intubated patients. They said to always assume that the patient can hear you. They said that when the nurse talked to them about where they were, what’s going on, and what to do, in a strong confident voice, that the patients felt comforted by that. So that’s exactly what I did.

This patient kept biting down on the tube (which is a big no no because we don’t want a punctured tube!!). “You’re in the hospital and you’re very sick. I’m Jessica, your nurse. Right now you’re having trouble breathing so you have a breathing tube. I know it’s uncomfortable but you need this. Try to calm down and take slow breaths. Open your mouth. Your face is very red but calming down will allow you to breathe better.”

Once I said this, the patient did calm down and opened her mouth.

“Good, your face is looking better and you’re oxygenating better. We are going to turn you to the side to clean you because you had a little accident, ok?”

She was able to cooperate much more at this point. And this happened before giving the ativan. My coworker then came in, administered it (“we’re going to give you something to help you relax now”), and she was at peace again.

Even though she couldn’t focus her eyes and couldn’t follow simple commands, it seems as though what I said did make a difference.