Cranial Nerves

This mnemonic is the easiest way I’ve ever found to remember what each of the cranial nerves does. When I was in Fundamentals, a nurse who specialized in neuro stuff gave a lecture to our class. I don’t remember exactly what she was there talking about; it wasn’t the cranial nerves. She drew a picture like this on the board in passing when someone mentioned cranial nerves, and it’s been stuck in my head ever since. It’s awesome.

I re-created it in photoshop today for a classmate of mine, and I thought I’d post it here so that you guys can see experience the full depth of my super-nerddom. The nerd, it is strong with me.

The Turner to my Hooch

Jennifer Martin is my nursing school study buddy. Some would call her my ‘work-wife,’ my partner, or my ‘other.’ She is the Jon to my Ponch. She is the Tom to my Jerry. She is the Turner to my Hooch. We have been together for every nursing school class, every clinical, every moment.

Today, Jennifer and I (along with about 50 other students) were inducted into Sigma Theta Tau together, an international nursing honor society. We drove up to the ceremony at the same time, parked in parking spots right beside each other, and emerged from our cars wearing damn-near the exact same outfit. Blue shirt, neutral skirt, heels. We walked into the auditorium and sat in our alphabetically ordered seats right next to each other.

We laughed. Jennifer and I were destined to be nursing school partners. We are similar in a lot of ways.

Jennifer and I even look kind of similar, in that we both happen to be about 5 1/2 feet tall. We happen to wear the same size clothes, and generally have the same coloring. We are both white people with brownish hair.

We do not, however, look so much alike that one might confuse us for one another. Or at least, you wouldn’t think so. Here’s a “soft focus” (blurry, shutup) picture of the two of us we took last summer when we were still young and naive and learning how to test cranial nerves.

Similar, but not the same. I mean, if you just meet us one time, maybe you could confuse us. But what if you spent 10 10-hour days with us? Surely after spending 10 10-hour days with us, you would be able to tell us apart, right?

Apparently not. One of my past clinical instructors wandered up to me at tonight’s induction and was all, “I laughed so hard when I saw that you and Sarah were basically wearing the same outfit tonight!” I didn’t correct her. If we’re this far into the program and she still can’t tell us apart, that’s fine. I’ll just let it ride.

The commonly-mistaken identity situation might have been a problem if Jennifer and I weren’t always in an absolute dead heat grades-wise. But as it stands, she can be me and I can be her, and neither one of our names gets sullied in the process. So in times like these, I just smile, nod, and say, “Why, yes. It IS weird that I’m wearing the same outfit as Sarah. It’s like I just can’t get away from that girl.”

On Rule Breaking and Nail Painting

So, I’m a rule breaker. We all know that about me, right? I like to break the rules. We talked about this (or at least breezed by it) the other day with the personality assessment. “Sarah,” it said, “likes to break the rules, then convince you it was the right thing to do.” Yes. There is no denying it. That is exactly what I do. I didn’t even realize how much I do that, but I knew I did it. Now that I’m noticing that I do that, I see that I do it… uh… like, every day of my life. Like I said. I’m a rule-breaker. That’s not new news.

But this is not to say that I’m a criminal. I’m not. I mean, I speed. I can admit that. Everyone speeds. I used to race around like a bat outta hell. I don’t go that fast anymore. I’m no longer that asshole weaving in and out of the lanes with no blinker. In fact, sometimes I’m the asshole in the left lane (habit) that’s going 80 on the highway (shut up, that’s not outrageous) and is pissing off all sorts of people because I’m going TOO SLOW. That’s right. There are people in this world who think I’m going too slow. I know that’s hard for people (my mom, every civil servant who’s ever seen my driving record) to believe, but it’s true. Some people drive faster than me.

It should be said here, for the peace of mind of some (mom, any potential employers), that I don’t just go around breaking rules for the fun of it. I mean, the speeding rule, maybe. But the rest of them, if I break a rule, it’s because I genuinely believe that it’s a.) pointless, b.) a total non-issue or c.) wrong. And, when I’m in a position where I’m, say, at work, I do follow the rules. Meticulously. It’s within me to do such a thing. It’s necessary in nursing. I do it all the time. Nursing, fortunately, also requires a lot of problem solving. I fancy myself an effective and creative problem solver. Problem solving, by its very nature, is pretty all-consuming. When I’m all consumed, I can’t be bothered with breaking rules and/or coming up with effective justifications for my behavior. I’m too busy problem solving. This is why nursing is a good profession for me. There are rules that make sense, problems to be solved, and I can hang out with people at the same time. All while wearing scrubs. It’s a win/win/win/win. That’s a pretty seriously good deal.

I just have to survive nursing school to get there. No sweat.

Nursing school has a lot of rules. I follow the rules at nursing school because I desperately want to be a nurse, and so I just do whatever they tell me to do, however they tell me to do it. I’m a sheep. I follow blindly. I assume the school knows what they are doing. They have churned out many nurses before me, and they will continue to churn out many nurses after I am gone. Who am I to question the rules?

…..But some of the rules are weird. For instance. You’re not allowed to paint your nails while you’re in nursing school. This is a rule. I understand the purpose of the rule insofar as clinicals are concerned. When your nails are painted, you tend to wash your hands poorly, and you gather up gry. (Side Note: Gry is an actual word. It means “the dirt under your fingernails.” One time my mom won a radio contest because she knew the “three words in the English language that end in ‘gry.’” The three are hungry, angry and gry. I think I was about 7 years old when that happened. It’s weird that I remember that. I bet she doesn’t even remember that.) So it’s cool that you’re not allowed to paint your nails when you’re in the hospital. I’m not trying to roll around all day with staph hanging out in my nail beds. I don’t understand why that rule is a rule for when you’re not in the hospital. Apparently, none of the other teachers really feel like that should be a rule, either. Because they never, ever, ever say anything about whether or not your nails are painted when you’re outside of the hospital setting.

And I know that for a fact. Because, of course, I paint my nails whenever I’m not in a hospital setting.

Trick is, I never liked to paint my nails before. Like, never ever. Never ever ever. I owned nail polish, but only for my toes, which I typically keep painted because, in addition to being a rule-breaker, I am also a toe-stubber. At any given moment, it’s a safe bet to guess that I have at least one discolored toe nail. Gotta keep that crap covered up.

The very week before I started nursing school, a nail fire was lit beneath me. I can not get enough of painting my nails. I love it. I paint them almost every weekend. It’s turned into some weird stress relief for me, I guess. Well, it would be a stress relief. It would be if painting your nails wasn’t TOTALLY IMPOSSIBLE.

Perhaps this is also because I’m in nursing school (and thus, am too busy to ever slow down long enough to let them dry)? I’m not sure. I am pretty sure it’s impossible for all humans, though. Throughout the last year, I’ve become the master of the manicure. I have base coats and colors and quick-dry top coats. I can apply them with a swift accuracy that would make your head spin. I just  can’t ever make it more than an hour without gashing the paint with something. An HOUR. I can’t make it an hour.

So, today, I was determined to make it an hour. I was going to make it to All The Way Dry. I painted my nails with my research in front of me. I had all of the things out that I would need for the rest of the night — cleverly displayed in such a fashion that I could continue learning for over an hour without ever having to touch ANYTHING. It was brilliant. I don’t know why I’d never thought of it before.

But I guess somewhere in the pre-paint shuffle, I must have stirred up some dust here in the office. Because right now, I have an absolutely perfect, rule-breaking, professional-looking, gash-less manicure. Except for the blanket fiber? Cat hair? I don’t know what it is. Except for the ONE FRIGGIN’ THING that must have FLOATED DOWN upon my PERFECT GASH-LESS NAIL POLISH, whilst I was dedicatedly studying all of the documents that I wasn’t touching.

This my friends, has been a story of “Can’t win for trying.” I just have to whine about it to you. Because if I whine about it to Zack, my rule-following husband, he would simply say, “Wait, why are you painting your nails? You’re not allowed to wear nail polish.”

The Reality of Nursing

There are days when the reality of nursing starts to set in. And, oh, does it ever weigh heavily upon the shoulders.

These are the days when you realize that one medication given incorrectly could result in a life-altering or life-ending event for your patient. These are the days when it becomes clear that all of the knowledge in the world about disease processes and assessments doesn’t do you any good if you don’t know the correct intervention. The days when you begin to understand that being able to accurately identify the right thing to do from a multiple choice list is absolutely nothing like what it feels like to stand in a room and have to create your own multiple choice list with the information in your head. With an “OR ELSE” attached onto the end.

Not OR ELSE you’ll get a bad grade. Instead, OR ELSE your patient will die.

I was there today. Standing in the brilliantly white shoes of a terrified nursing student who knew just enough information to know exactly how bad the situation* was, but had absolutely no idea how to go about fixing it. The only multiple choice options in my head were a.) call a code, b.) call a doctor, c.) run and scream, d.) cry in the corner, or e.) all of the above.

It’s easy to forget what the purpose is here. It’s easy to get lost in studying for tests, to get into the habit of putting this information into the brain’s short term memory just so that we can survive from one week to the next. There are so many tests; there is so much information. And there is so little time. So, so little time.

But the purpose is bigger than the test. Studying is about more than the grade. Even though right now it feels like we are studying for our survival, we’re really not. We’re studying for someone else’s survival.

And on days like today, that truth becomes readily apparent.

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*Thankfully, this particular situation was in a simulation lab, where our instructor creates scenarios that we work through with the members of our clinical group. The patient who was dying was a plastic mannequin, but that didn’t make the reality any lighter. In the end, we saved the mannequin, and I walked away with a crisp reminder of why learning is more important than grades. I’m sure by that measure, the instructor would call the simulation experience a success.

On Washing The Dishes

Just after I graduated college (the first time), I moved to Waco to live with some of my friends there. They already had an apartment, so I just moved into the place where they lived, after I’d found a job in town. I, through my roommates, came to be friends with a girl named Katherine. When I left our cozy apartment in Waco to move to Camp Eagle (in order to convince Zack to marry me, which totally worked), Katherine wound up taking my place in the apartment.

Katherine had one particular quirk about her that made her a fantastic roommate. After I moved out, I learned that my ‘replacement’ liked to wash dishes to relieve stress. She was a pre-med student at Baylor, and her life was crazy busy. Any time it all got to be too much for her, she would get up from her studying, walk into the kitchen, and wash the dishes. The roommates told her that she was crazy. They didn’t complain, because nobody complains about having the dishes always done, but they thought she was crazy.

I’m not saying that Cold Turkey Day didn’t go well. It was fine. It really was. I will say, however, that I just found myself getting up from my studying, walking into the kitchen, and washing the dishes. I don’t know how I got there, nor do I know why I chose to start doing them. I just did. And while I was in the middle of spot checking my wine glasses, I remembered Katherine and her strange affection for hand-washing the plates, and I finally got it. Dish washing is therapy.

Workout Word Vomit

By some miracle of nature (and of prioritization), I have exercised every day this week.

Navy Bryan, (my partner in crime nursing, and apparently, exercise), decided that he wanted to start working his way though a half-marathon training program.  Because we’ve been working out after class off-and-on all summer long, he asked me if I wanted to do the program with him.  He told me that he thought it’d bring some direction and focus to our workouts.  He wants to talk as many people as he can (our whole nursing class!) into starting a half-marathon training program. Right now.  At the beginning of our 18-hour jam-packed fall semester.  He is crazy.

I gently reminded him of what happened last time I ran a half-marathon.  Navy Bryan, having been in the Navy, isn’t much one for excuses.  He was all, “Whatever.  We’re doing this.”  I agreed that I would at least run the during-the-week runs with him, and some of the long runs, too, given that my gastrointestinal tract didn’t take to turning itself inside-out again.  In the case that my GI tract does, in fact, start crying foul, I’ll take it down a notch.  I seem to be able to run up to about 6 miles* without any warning signs of IMMINENT DEATH.  So am I running another half?  Meh.  I’m not that concerned with whether I am or am not right now.  Because before I can even think about if I can run another half, I have to think about getting to where I can run 3 miles.  Then 4 miles.  Etc.  I’m not getting carried away.

So, anyway.  That brings us back to my original point.  I’ve worked out every day this week.  Having a plan of action has proven itself useful.  On Monday, I ran 3 miles on a treadmill.  I walked 2 minutes per 10 minutes of running in a desperate attempt to get my heart rate to drop to the sub-190′s.  Yeah.  I said 190.  And my resting heart rate is below 60.  You doing that math? For those of you who don’t have heart rate calculators in your favorites: allow me to explain.  190, for me, is about three beats-per-minute away from CARDIAC EXPLOSION.

Tuesday was when we played the 80 minutes of racquetball.  (Update on that: I was more sore from this activity than anything else I’ve done all week.  I had trouble removing my sports bra the next day because my shoulder, and my thighs still ache from being in an hour-long squat. The giant bruise on my thumb seems to be fading nicely, however, and I think my toenail is going to hang on.  So, good news all around.)

Wednesday, I’ve already told you about, too.  It was “The Most Beautiful Day EVAR.” Holy Miley, that was a good day.

Thursday I ran 2 miles outside, no stopping, and faster than molasses!  Okay, I still went really slow, but it was faster than the day before.  And that day was a bonus, anyway.  I was supposed to be a non-running day, but I ran anyway.

And today!  Today I rode my beautiful road bike for one whole hour with Zack!  It’s so nice outside, we couldn’t resist hopping on the bikes and taking a (15-mile out-and-back) spin down some of the local river-side trails.  I talked his ear off the whole way out.  I would have talked his ear off the whole way back, too, (I have lots of nursing information to spill these days) but I couldn’t because the sun was setting.  Which means the bugs were coming out.  Which means I was getting pelted in the face by a hoard of gnats about every three seconds.  I spent all of my extra energy trying to not yawn.  Cause yawning would have resulted in the need for bug-flossing.  And nobody likes to floss gnats out of their molars.  Nobody.

All of this to say: I feel good this week.  Next week (or the week after that), when I start to say things like, OMG AM DROWNING IN NURSING HOMEWORKZ, and HAVE TESTS, CANNOT TAKE EXTRA TIME FOR PIDDLY THINGS LIKE EATING AND SLEEPING, remind me of this.  Tell me to go back to the post that I wrote on the 27th of August and try to remember how much better I felt after 30 minutes of exercise. I’ll need your voice of reason by then.  I’m sure of it.
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*I might have just figured out the problem.  I can count on one hand the number of times I have run 6 miles.  2.  I’ve run 6 miles 2 times.  I’ve run 8 miles 1 time, and I’ve run 13.1 miles one time.  I might have just figured out the reason that my body turned itself inside out on race day.  It might have been operator error.  Whoopsie.

On Stress-Sensitive Gums

I know my dentist’s phone number by heart.

I recognize that it’s weird to know your dentist’s phone number.  I’m talking about his office number, not his home number, though I do have his cell phone number saved into my computer somewhere.  Not normal.  But this is the kind of thing that has to happen when you have Hypodontia.

I was about 5 years old when the dentist first told my mom that I was going to be missing permanent teeth.  They didn’t know how many at that time–my permanent teeth buds were just starting to form.  But he did know that I was missing my front two bottom teeth at the very least.  Mom immediately took action and started to convey two very important things to me.  First, she taught me how to smile without exposing my bottom teeth.  It didn’t matter much at the time, my baby teeth were all still fully in tact and normally sized, relative to the other teeth in my mouth.  Luckily, she had the foresight to know that if I learned to smile with all my teeth hanging out of my mouth, the habit would be hard to break later in life.  Secondly, she taught me that it was REALLY FREAKING IMPORTANT for me to take good care of my teeth.  Brushing and flossing have always been a part of my life because, honestly, she freaked me the hell out.  I was convinced that if I missed a single night of brushing my teeth, I was going to wake up the next morning with giant cavities and all my teeth would fall out and WHAMMO.  WHO’S LOOKING REAL HOMELESS? ME.

I took both of the lessons to heart.  To this day, I still smile without showing my bottom teeth, and I still brush my teeth for an asinine amount of time every morning, counting the seconds I spend on each tooth group, just like my mom and Dr. Lutz taught me.

I still have the baby teeth, by the way.  Years ago, Dr. Lutz cemented them together so they would have some extra stability.  It has worked like a charm, but I keep dental insurance at all times.  I’m convinced that the very first second that I don’t have dental insurance, both of these bad boys (and probably my 3rd* baby tooth, a molar I still have) are going to go flying out of my mouth with both of their calcified middle fingers pointed up at me.  I was supposed to have lost them sometime around high school graduation, but they’re still hanging in there.  But that’s neither here nor there.  Because believe it or not, this post isn’t really about my teeth.

It’s about my gums.  Good teeth health goes hand-in-hand with good gum health.  And hypodontia, along with my obsessive need to please everyone, go hand-in-hand with DESPERATELY NEEDING MY DENTIST’S APPROVAL.

It always seemed like every time I went to the dentist when I was young (which was A LOT), my gums would swell up like a float on Thanksgiving morning.  I couldn’t figure it out. I was brushing, flossing, taking care of my teeth, not eating hard candy, not drinking cokes.  And yet, I’d go in for a cleaning or an orthodontic adjustment and POOF.  Massively swollen gums.  It pissed me right the hell off.

In my massive embarrassment, I finally asked my dentist what was going on.  He always said, “your gums look fine, a little swollen, but totally healthy.”  After several visits in a row of having huge puffy gums the 2 or 3 days before a dentist visit, I finally made him talk to me about the problem, like, FOR REAL.  He started asking me a line of questions.  What other times do you notice this happening? Is it only when you come here, or does it happen when you’re not coming to the dentist, too?

It was pretty easy for me to recall all the instances in which my gums had ballooned up.  When they get all puffy like that, it’s really hard to eat because chewing becomes incredibly painful.  And I like to eat.  So I notice.

I started telling him about all the times.  During finals and midterms, both.  When I flew to Arizona to meet my then-boyfriend’s parents.  Every time I’m sick.

Dr. Lutz’s eyes lit up.  “Oh,” he exclaimed, “you have stress sensitive gums!  Do you worry about coming to see me?  Does coming to the dentist make you nervous?”  I said that yeah, it made me anxious because I was always afraid they were going to tell me I had cavities or that it was time to do surgery on my mouth.  He then confirmed that yes.  My gums were highly sensitive to the stress hormones in my blood, and that whenever I got stressed out, my gums were going to be the first thing to tell me.

Awesome.  Just awesome. I would have preferred to have to floss more often.  But whatever.

So on Wednesday morning when I rolled out of bed at 5:00 to meet Jennifer and do homework, only to find that the backs of my gums felt like an over-inflated inner-tube, I knew there was no denying it anymore.  I was stressed out.  I’d been playing it cool all week.  Low sleep, lots of homework, surprise papers, tests, skills check-offs, poor nutrition and being sick on top of all of that.  That sounds stressful, doesn’t it?  But I had convinced myself otherwise.  I had convinced myself that I was handling it.  No sweat.  I got this.

Sometimes I need my gums to swell up, I guess.  If for nothing else, they force me into a long-hard reality check.

After I finished the skills check-offs and the tests and the homework that I had to do on Wednesday, the swelling went down and my mouth function returned to normal.  And I’m no longer trying to fool myself into thinking that I can survive on little sleep, little food and no fun.  Zack and I are packing up the car and heading south to Camp Eagle for the holiday weekend.  I’m going to run and swim and bike and most importantly, I am going to SLEEP.  I can’t wait.  Expect short picture updates all weekend.  I’m going to be having way too much fun to bother with words.

*I am missing 8 permanent teeth total: all 4 wisdom teeth, 2 bottom central incisors, bottom left 2nd pre-molar and top right 1st pre-molar.  Since wisdom teeth don’t have “baby versions” and I lost the top-right pre-molar’s baby tooth somewhere along the way, I only have the three baby teeth left.

Revenge of the Mannequins

In nursing school, we use mannequins to help us study. They look like this:

The mannequins are shockingly life-like.  They have mouths and hands and feet and joints. The “joint” part is important.  Specifically, they have knee joints.

I arrived at the lab this morning at 6:25 to find that there was a mannequin in one of the beds we use.  While it’s important to have the dummies in the bed during Pharmacology Lab, we don’t typically use them for the lab I went to today, which was Fundamentals Lab.  This is the lab where we learn to do everything from giving a bed bath to how listen to heart and lung sounds.  We always work in pairs, and our partner is usually in the hospital bed.  Thus, the bed needs to be not occupied by an adult sized hunk of plastic.

I’m a problem solver.  I really love to solve problems.  So when I came into the lab and saw that the bed had a mannequin in it that would need to be removed, I started to move the mannequin.

I’ve been told before that these guys weigh about 70ish lbs.  70ish pounds isn’t that heavy if you’re using the leverage of dummy arms to support the weight on your shoulders.  It’s the same principle that somehow makes giving piggy back rides to people who weigh 100 lbs. more than you a feasible option.  (I didn’t say smart. I just said feasible.)

As I was pulling the dummy out of the bed, I was thinking about proper weight management.  I was not thinking about how to best avoid the dummy’s knee from touching my inner thigh.

Because as the dummy’s knee went from ‘bent’ to ‘extended’ while it was pressed against my inner thigh, it took a considerable chunk of my inner thigh and folded it into the plastic knee joint.  In layman’s terms, IT PINCHED THE SHIT OUT OF MY LEG.

After hours of icing, the vertical swelling and the overt purple hues have subsided, leaving behind a large, painful, red, aggravated, blood-filled area that is sensitive to both pressure and even the slightest touch.

Best I can figure, it was revenge of the mannequins day.  After laying dormant for years, the dummy in bed #2 finally got his long awaited opportunity to torture a nursing student as he has been tortured for so many years.

I’m never going to move a mannequin ever, ever, ever again.