Tuesday, November 19, 2013

Never Give Up. Never Give Up. Never Give Up!

I dedicate this post to every student who is feeling overwhelmed about his or her approaching examinations. Never consider the potential for defeat, but always consider the potential—YOUR potential—for VICTORY, and then make it your aim and goal to achieve that victory.
Never give up when you are faced with a massive amount of work. I know many—if not most of us—will be studying our entire Thanksgiving Break. While I understand that this may be necessary in order to do well on your tests, I believe it is also good to give yourself a break, even for a day. So, consider planning your study so you get at least one day completely off; your mind and body will thank you.  

In a commencement speech at his alma mater in 1941, Winston Churchill spoke these words: “Never give in, never give in, never, never, never, never-in nothing, great or small, large or petty - never give in except to convictions of honour and good sense. Never yield to force; never yield to the apparently overwhelming might of the enemy.” The enemy you will face after break is not a real adversary, yet it (finals week) is still an imposing obstacle to many of us. I want to encourage you to not fear; rather, TRUST the LORD in EVERYTHING (Proverbs 3:5-6). Do your best to prepare, and then leave the rest up to Him (Psalm 37:4-5, 55:22). The best thing I ever do with my tests is surrender the outcomes to God because, when I do, He gives me peace (Philippians 4:4-7; Psalm 62:8; Proverbs 16:3; 1 Peter 5:7). 

Stand fast (1 Corinthians 15:58). Remember how far the Lord has taken you (Isaiah 63:7). If you're a junior nursing student, you've already taken three Med/Surg and three Pharmacology exams. You’ve made it! There’s just a little bit left for you to accomplish by God’s grace (2 Corinthians 12:9-10). You can do it!  Consider your last week of school your opportunity to SHINE (Matthew 5:16).

Sunday, November 17, 2013

Where Is God in the Storms of Life?

Today, my pastor taught about Job and the great trials that bombarded him during his great trials. In the first few chapters of the book, Job loses his monetary possessions, numerous servants, and his seven sons and three daughters. In rapid succession, he received horrendous reports from the last surviving servant from each area telling him of the loss of his oxen, donkeys, sheep, camels, and dearly beloved children. In the twinkling of an eye, he was transformed from the wealthiest man in the East (Job 1:3) to a bereaved man stripped of his earthly possessions.
What struck me was his response to such grief and heartache. Instead of blaming God, he worships God in his grief.
“Then Job arose and tore his robe and shaved his head and fell on the ground and worshiped. And he said, ‘Naked I came from my mother’s womb, and naked shall I return. The Lord gave, and the Lord has taken away; blessed be the name of the Lord.’ In all this Job did not sin or charge God with wrong.” (Job 1:20-22)
These few verse challenged me today to consider, “How will I respond the next time I am faced with a trial, testing, or grief?” Will I praise God in my grief and in my trial or will I question the good and perfect character of the Lord? My desire is that I will have Job’s response. That I will not charge God with wrong but instead praise God in the storms of life because He is there in the midst of them (Mark 6:48).
Here is God’s promise to you:
’. . .Fear not, for I have redeemed you; I have called you by name, you are mine. When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you. For I am the Lord your God, the Holy One of Israel, your Savior. . .’” (Isaiah 43:1-3)

Saturday, November 9, 2013

10 Suggestions for Writing a Solid Patho Paper

1.      Figure out the main problem/diagnosis. The main medical diagnosis is usually what brought them into the hospital or it could be the root cause of their visit. For example, a patient who had a heart attack two weeks ago may present to the hospital with dyspnea and new onset heart failure. While dyspnea is their main complaint, the main problem is heart failure since it is the root cause of their difficulty breathing.

2.      Clearly structure your paper. This stems from a good outline. Before I ever sit down to write the Pathophysiology portion of my profile, I figure out what the main diagnosis/problem my patient is facing. Once you know the top problem, write down the various other issues that your patient is dealing with and then arrange your patho in a way that organizes the information in a logical fashion. For example, if your patient’s primary diagnosis is heart failure (HF) secondary to a recent myocardial infarction (MI) complicated by renal failure (RF), I would outline the paper like this: Hx of present illness, patho of HF (from macro to micro level, i.e. down to the cellular level) and how the diagnosis of HF was made (echocardiogram, BNP, etc.), patho of MI in relation to the development of HF, patho of RF which was caused by insufficient perfusion secondary to the decreased cardiac output associated with HF, discuss the patient’s current status (edema from fluid overload secondary to HF and RF, dyspnea secondary to fluid overload leading to pulmonary edema, etc.), and conclude with a paragraph discussing patient education (e.g. call the doctor about significant weight gain in short period of time) and follow-up care (nutritional consults, congestive heart failure out-patient clinic).    

3.      Spend sufficient time discussing the pathophysiology of the primary diagnosis. Write as much as you need to sufficiently cover the topic, including the normal anatomy and function, the pathophysiology of the disease, and the manifestations of the illness and what causes each of them. When discussing acute kidney injury (AKI), for instance, discuss the normal anatomy and function of the kidneys (nephrons, tubules, glomeruli and how they are involved in filtering urine and regulating fluid status), the original insult to the kidneys (e.g. decreased perfusion from low cardiac output associated with HF), the stages of renal failure, and the stage the patient is currently in and how each manifestation (peripheral edema, hypertension, and decreased urinary output) relates to the diagnosis of AKI.

4.      Be sure to include procedures and studies related to your patient’s diagnoses. If your patient has HF, discuss how it was diagnosis such as by Transesophageal echocardiogram (TEE) and BNP values. Discuss how this procedure, TEE, is performed and the physician’s interpretation of the results (ejection fraction, hypertrophy of ventricles, etc.).   

5.      Write at least one paragraph or more on the other diagnoses related to your patient’s primary condition. For instance, if the patient has HF, RF, and past MI. Discuss how the MI led to his HF, the patho of MI, and how it is currently affecting the patient (this could easily be three paragraphs). Also, discuss the patho of RF and why it resulted from HF and how it manifests in the patient.

6.      Relate the information to your patient in each paragraph. At the very minimum, include your patient (e.g. their presentation, diagnosis, etc.) in the topic sentence (usually the first sentence in a paragraph), and in the last sentence of the paragraph.

7.      Integrate your patient’s labs into your paper. This is one of the best ways to relate your topic to your patient (#3). Whenever you give your patient’s labs don’t just list their lab values, include the normal ranges (specific to age and gender) and the correct interpretation of the labs (low/high/normal). Then apply this information to the patient and their diagnosis and prognosis. For example, your patient has low hemoglobin, hematocrit, and red blood cell count; you know this because these values are lower than the normal levels for an adult male, indicating that he is anemic. After explaining this, address the reason for his anemia. For example, he could be anemic as a result of insufficient production of erythropoietin secondary to his renal failure.

8.      Integrate your patient’s medications into your patho. This shows your understanding of your patient’s condition as well as the indication for the medications which they are prescribed. For example, your patient is on a statin, ACE-inhibitor, aspirin, and beta-blocker; these are all standard medications prescribed to a patient post MI. Don’t just list the medications; instead, talk about the specific medication your patient is prescribed, its drug category, mechanism of action, and indication for your patient. For example, your patient is prescribed metoprolol (Lopressor), a cardioselective beta-blocker, which decreases heart rate and blood pressure by blocking the beta-1 adrenergic receptors in the heart. This medication is given to treat hypertension by lowering this patient’s blood pressure.

9.      Read before your write. It is so much easier to write a patho if you’ve read about the diagnosis and the related issues in your Med Surg and patho textbooks and journal articles before you start writing. By doing this, you can avoid the risk of plagiarism that arises from writing as you read. You also are able to demonstrate your understanding by writing the information in your own words.  

10.  Read your patho before submitting it. The flurry of patho writing it is easy to miss grammatical mistakes and spelling errors that you will be able to catch on your final pass over your paper. I usually like to read a paper out loud before submitting; this keeps me from just skimming the content. Remember to use spell check and Google the spelling of words you are not sure how to spell. Finally, the undergraduate writing center at Liberty University is another great resource. They usually take a few days to review your paper, so start working on your patho and send it to them early if you want to be able to update your paper based on their comments before the deadline. 

Friday, October 25, 2013

Merciful God

Recently I was challenged by an elder at my church to keep a record of the lessons that the Lord teaches me so that I can share it with my children someday. Since it's so easy to forget the little things in life the Lord does and teaches us, I have resolved to make a habit of writing down some of the lessons the Lord teaches me. Here's a little excerpt from my journal entry this afternoon.

Today, I was reading Lamentations, a book filled with the mourning of a prophet over the plight of Judah. When I came across the most famous passage in Lamentations (3:21-26), I was struck by the dramatic context of this verse. Lamentations primarily focuses on the consequences of Judah's sin--the Judgment of the Lord. After highlighting the humiliation of God's people, the writer of Lamentations breaks the rather depressing description of Judah's desolation by calling to mind their one hope--the lovingindness and mercy of their God.

When everything looks hopeless, still there is reason to rejoice for God is still on the throne (Lamentations 5:19). The Lord will never give up on us just as He never gave up on Israel. Paul and Timothy were so certain of this that they wrote the church in Philippi saying, "And I am sure of this, that he who began a good work in you will bring it to completion at the day of Jesus Christ" (Philippians 1:6).  

"Remembering mine affliction and my misery, the wormwood and the gall. My soul hath them still in remembrance, and is humbled in me. This I recall to my mind, therefore have I hope. It is of the LORD'S mercies that we are not consumed, because his compassions fail not. They are new every morning: great is thy faithfulness. The LORD is my portion, saith my soul; therefore will I hope in him. The LORD is good unto them that wait for him, to the soul that seeketh him. It is good that a man should both hope and quietly wait for the salvation of the LORD" (Lamentations 3:19-26).

Let us remember to wait quietly for the Lord's salvation and take comfort in His mercy and compassion. 

Saturday, September 21, 2013

Difference Maker

Have you ever wondered what kind of a difference you make as a Christian working in the hospital? I know I have. Unfortunately, most times we have no clue whether or not we made any impact on the lives of our patients. Then there those times when God decides to bless us with special reminders of why we do what we do—to love people like Jesus loves them and loves us. 

Within the past year, I have received notes from a family member as well as a former patient thanking me for simply caring. Many times we don’t realize how showing the love of Christ and praying with patients and their families can encourage people, especially when it’s in the darkest times of their lives.

So on the days that we feel like we’re just going through the motions, let’s remember that what we do does really make a difference. You—I—each one of us makes a difference on the world around us.

“And let us not grow weary of doing good, for in due season we will reap, if we do not give up” (Galatians 6:9).

Friday, September 20, 2013

Pray About the Little Things

Never underestimate the power of prayer. The Bible testifies that the “…fervent prayer of a righteous man availeth much” (James 5:16b, KJV). I believe we often forget to come before the Lord with the little things—the keys we’ve lost, the test we’re about to take, the patient load we find overwhelming, and the lack of sleep from studying all the time.

Recently, the Lord has been challenging me to come to Him with the little things because He cares about His children (1 Peter 5:7; Psalm 55:22). We can come before the Throne of God boldly as God’s children, confident that we will be received with open arms by our Father in Heaven.

“Let us therefore come boldly unto the throne of grace, that we may obtain mercy, and find grace to help in time of need” (Hebrews 4:16).

God promises to hear the prayers of righteous men (Proverbs 15:29; 1 Peter 3:12).

“The eyes of the Lord are on the righteous, and His ears are open to their cry” (Psalm 34:15, NKJV).

I can personally testify that the Lord really does care, and He does answer. Yesterday, I was going to log into the hospital charting system for the first time in almost a year. Because I had participated in the Richmond Program, I hadn’t logged onto a computer at this hospital in a while. Beforehand I was anxious because I wasn’t sure if I remembered my password or not, but before I attempted to log on for the first time, I bowed my head right there in the nurse’s station and asked the Lord to help me remember the right password. Then I typed in what I thought was the right one…and…it worked! I had no troubles and didn’t have to call technical support. God answered my prayer!

Earlier in the week too, I was anxious about a test I was about to take. Before the test, I prayed and told the Lord that I needed His help. I could not do this without Him. I surrendered the test AND the OUTCOME to Him. I chose to trust Him with whatever happened. Whenever I came to a question I struggled with, I prayed and asked the Lord to help me choose the right answer. Then today, I discovered yet again the faithfulness of the Lord because He gave me favor, and I received a phenomenal score on my exam. Praise the Lord! Because I depended on Him, He gets all the glory.

Tonight I want to challenge you to remember the God we serve. He knows everything. He knows what you need even before you ask (Matthew 6:8, 32). But He wants you to ask (James 4:2). Admit your dependence on Him (1 Peter 5:6). He is your Lord, Your Provider Who meets all your needs (Philippians 4:9). Remember to bring the little things to Him in prayerful surrender today.  

Tuesday, September 10, 2013

God Is So GOOD!

Isn't it good to know that we serve a loving God, who knows our needs even before we do? The other day I was feeling overwhelmed with all the things that were on my plate. I was feeling physically and emotionally drained from a long day. But before I even knew that I would be feeling this way, God knew it, and He orchestrated people and schedules so that one of my precious friends would be in the exact place where I was at the exact time when I needed some encouragement.

This friend of mine was bright and full of energy and love for the Lord. Her compassionate presence encouraged me that the Lord cared, and He was with me to bring me through and give me the strength I needed for the tasks at hand. My friend prayed for me when I needed it most.

Isn't it good to know that the Lord cares about us and can anticipate our needs better than any nurse does for her patients?

"And when you pray, do not heap up empty phrases as the Gentiles do, for they think that they will be heard for their many words. Do not be like them, for your Father knows what you need before you ask him" (Matthew 6:7-8, emphasis mine). 

Providence: The Best Daily Planner

In Ephesians 2:10 Paul unveils part of our destiny in Christ, saying "For we are his workmanship, created in Christ Jesus for good works, which God prepared beforehand, that we should walk in them." Isn’t it crazy to think that God, even before we were conceived, knew what He planned for us and has certain tasks with our name on them?

Recently I've been asking the Lord to give me divine appointments, and He's been faithful to answer my prayer. Even though I asked the Lord to send me these opportunities from Him, I somehow always seem to be surprised when they come. The scenario is always different, but God is teaching me (granted I am still a work in progress) how to better respond when He brings people into my life that need encouragement. 

Sometimes it’s just following the little promptings from the Holy Spirit to do simple things like give a friend some chocolate and let her know I care (because who doesn’t love chocolate right?!). Other times, it’s just meeting a friend in need and just being there even if it means sitting quietly until she’s ready to talk.

The real challenge is being willing to drop everything and do what God is calling me to do. It’s so easy to want to do something for God and another thing all together to obey when He’s telling you to do something that’s inconvenient. 

My prayer is that we would have the heart of Christ to seek our Father in Heaven’s will in everything, that we would trust Him to guide our steps, and that our lives would be orientated around living in a way that pleases the Lord. 

Thursday, August 29, 2013

Think About Things That Are True

Have you ever considered that you have mental conversations with yourself every day? I never really considered it until today when one of our nursing professors pointed out that we need to be careful how we talk to ourselves. It's so easy for us to want to avoid pride to the point that we go to the opposite extreme and belittle ourselves in our mind. Tearing ourselves down is NOT what Christ had in mind when the Bible says we are to be humble. 

Instead, God’s Word admonishes us to think about things that are “…true, and honorable, and right, and pure, and lovely, and admirable. Think about things that are excellent and worthy of praise” (Philippians 4:8b, NTL).

It’s amazing how what we think about can completely affect our whole outlook. Proverbs 23:7 says that as a man “…thinketh in his heart, so is he…” (KJV). Jesus also said that “out of the abundance of the heart his mouth speaks” (Luke 6:45b, ESV). In other words what we allow to fill our heart (and our mind) will come out in what we say and who we are.

Today, my professor challenged the class to speak to ourselves (in our minds) as we would speak to a close friend who we loved—honestly and truthfully, neither belittling ourselves nor puffing up our egos. She also asked us to examine our automatic thoughts. What do I think of automatically in certain situations (when I fail, when I win, when I just do “ok”, when someone else messes up)? Do my thoughts honor God? Or am I quick to demean myself or others?

The key to confidence is not self-love or pep talks to yourself but knowing who you are in Christ. This is our identity—we are the Bride of Christ—His Chosen Beloved. Instead of ruminating on our deficiencies or meditating on “how great we are”, let’s instead focus on Who Jesus is and who He says we are (Song of Solomon 6:3; 7:10).

“You keep him in perfect peace whose mind is stayed on you, because he trusts in you. Trust in the LORD forever, for the LORD GOD is an everlasting rock” (Isaiah 26:3-4, ESV).  

Monday, August 26, 2013

The Waters Shall Not Drown You

I know last year when I was a junior, there were times when I felt like I was treading water, trying my very hardest just to keep my head above water…and there were other times when my own strength failed me, and I felt myself sinking. It was in those times that I threw myself before the Lord and cried out for His mercy. I was like Peter who got out of the boat in faith, but then when he saw the wind and the waves, he was afraid. In his fear, he began to sink; he cried out “Lord save me” (Matthew 14:30), and Jesus reached out His hand and brought him up (See Matthew 14:22-32).  

You all have got out of the boat. You took a leap of faith and signed yourself up for nursing school, but you don’t have to wait until you’re drowning to cry out to God for His help. James says,“You do not have, because you do not ask” (James 4:2c). Ask for God’s aid; He is waiting for your call, and once you ask, have faith—trust Him that He will do it (1 Thessalonians 5:24).

2 Peter 1:3-4 “His divine power has granted to us all things that pertain to life and godliness, through the knowledge of him who called us to his own glory and excellence, by which he has granted to us his precious and very great promises, so that through them you may become partakers of the divine nature, having escaped from the corruption that is in the world because of sinful desire.”

Isaiah 43:2-3 “When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you. For I am the LORD your God, the Holy One of Israel, your Savior.

Friday, August 23, 2013

The Trap of Perfectionism

Growing up and even into my sophomore and junior year of nursing school, I wanted to be perfect. It didn't matter that I mentally acknowledged this to be impossible for any mortal human; I still became upset whenever I messed up and fell short of perfection.

Then one day I was speaking with one of our beloved instructors, and she made a statement, that to me, was revolutionary in that it changed my whole perspective on my performance orientation in life. She said, "There's only One person that's perfect, and that's Jesus." Of course, I knew this to be true, but I had never considered that Jesus had been perfect for me so that I don't have to be.

This revelation was liberating because it meant I didn't have to fear failure anymore. Instead of worrying about the outcome of doing something, I could have confidence when I walked into a new situation that, no matter what happened, I had the freedom to learn and would not have condemnation for failing.

I believe this truth has the power to set many fearful believers, such as I was, free. Jesus is our representative before God. He has taken away our shame and given us His righteousness. When God the Father looks at us, He sees the robes of righteousness Jesus gives us when we're saved. We should always do our best and never use our position in Christ as an excuse for any less, but we should remember who we are, God's children, and that should motivate us to achieve great things.

If you struggle with perfectionism, I encourage you to read Romans 8. God's word has the power to transform lives. I know it has changed mine.

"Therefore there is now no condemnation for those who are in Christ Jesus" (Romans 8:1). 

Sunday, August 18, 2013

Wisdom & Discernment: Hidden Treasures

“It is the glory of God to conceal a matter, But the glory of kings is to search out a matter” (Proverbs 25:2, NASB).

Have you ever considered the privilege we have as nursing students at Liberty to learn the wonders of the human body so that we may be prepared to take care of the precious people in the hospital who are our patients? I know it's easy to begin to dread beginning school again as we read over our syllabi and realize the magnitude of the task at hand, but in reality we should be excited about the great adventure ahead. 

I LOVE learning, but even I sometimes don't enjoy the work that goes along with school. It's in those times that I need a reminder of my end goal—being the best nurse I can be. My desire to do my very best is the motivating power that spurs me on to study even when I’d rather be doing something else. Thinking about the lives of my patients and how complicated their medical conditions can be motivates me to not only study what’s assigned but to search out new knowledge about the vast array of conditions that affect patients (e.g. sick sinus syndrome, Haw River syndrome, Tokotsubo cardiomyopathy, etc.).

According to Solomon, wisdom and discretion are life for our souls and keep our feet from stumbling (Proverbs 3:13-27). This is especially true in the medical field because without the right knowledge we will flounder and will not be able to provide exceptional care for our patients. With that in mind, this school year let’s search for wisdom and discernment as hidden treasure and CHOOSE to enjoy learning (Proverbs 2:1-4). 

Saturday, August 17, 2013

Seek 1st

Over and over again in both the New and the Old Testament the Lord emphasizes the need for us to make Him our first priority. We all understand why it's important to place Christ at the center of our lives (because He is God and is worthy of our all), but how many times do we push Him to the background of our attentions? I know I am guilty of allowing other things (grades, work, people, even family) to become such a focus of mine that I lose sight of what is really important—Christ and Him only. This is the point when I allow things to become idols in my life.

The only way I have found to keep competing attentions from stealing away my focus on the Lord is putting Him first in my life. It takes intentionality. For me I know this summer I allowed myself to get in a morning routine of checking my Facebook before I had my devotions. The problem I found was that I would get engrossed in Facebook and would forget until later that I still hadn’t spent time with God. The time I had wasted on Facebook forced me to cut short the time I would have liked to spend with the Lord.  

The solution I found for my predicament is not getting on my computer until after I’ve spent time with the Lord. The Old Testament speaks of offering the Lord the first fruits of the harvest (Nehemiah 10:35), but couldn’t we apply the same principle of offering the Lord the BEST of our time? Whether your best time is early in the morning or late at night, let’s all choose to give the Lord our best.   

“But SEEK FIRST the kingdom of God and his righteousness, and all these things will be added to you” (Matthew 6:33, emphasis mine).

Tuesday, August 13, 2013

God Our Provider Will Meet All Our Needs

Recently I’ve allowed myself to worry about life after college, paying off my loans, taking care of all my own bills, buying a car, and providing for myself. Even though I was fully aware of Who my God is—that He is Jehovah Jireh, “The Lord will provide”—and that He is faithful to His Word, I still allowed myself to worry about the things Jesus says in Matthew 6 only the Gentiles worry about (vv. 31-32).

This morning as I was giving God all my anxieties in prayer (1 Peter 5:7; Psalm 55:22), the Lord reminded me of His promise in Matthew 6: “Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they? And which of you by being anxious can add a single hour to his span of life? And why are you anxious about clothing? Consider the lilies of the field, how they grow: they neither toil nor spin, yet I tell you, even Solomon in all his glory was not arrayed like one of these. But if God so clothes the grass of the field, which today is alive and tomorrow is thrown into the oven, will he not much more clothe you, O you of little faith?” (vv. 26-30).

As I read the whole sixth chapter of Matthew and looked at these verses in their context, the Lord dissipated my fears and anxieties that I had allowed to creep into my mind. Over and over again, Jesus speaks of our “Father” in this chapter of Matthew, conveying the message that I have a “Father” in Heaven who cares for me and wants me to ask for Him to meet my needs and then trust Him that He will take care of me (Matthew 6:11, 25, 31-34).

I have discovered that worries about the future not only rob me of my joy from the Lord but also distract me from the real task at hand—seeking first the kingdom of God. “Therefore do not be anxious, saying, ‘What shall we eat?’ or ‘What shall we drink?’ or ‘What shall we wear?’ For the Gentiles seek after all these things, and your heavenly Father knows that you need them all. But seek first the kingdom of God and his righteousness, and all these things will be added to you” (Matthew 6:31-33).

Will I consider myself a living sacrifice unto the Lord and give my life to Him, allowing my time and resources to be spent for Him as I seek first His kingdom and His righteousness? Will I choose to be broken bread and poured out wine for my King’s glory? Will I cast all my cares on Him knowing that He cares for me and will meet all of my needs as He promised? 

Saturday, August 10, 2013

What Every Junior Needs to Know

Juniors, welcome to the year of greatest learning and your greatest gain in competency. This year you will learn each body system in detail, beyond your previous knowledge from Patho and A & P. Never stop being amazed at God’s masterpiece—the human body—or be so caught up in the exam in front of you that you forget to stop and marvel at the beauty and intricacy of God’s creation. There is so much you have learned so far, and, yet, there is so much waiting around the corner for your inquisitive minds to discover.

There are several things I would like to share with you before you begin your journey. To begin with, I would like to encourage you to put the Lord FIRST in everything. Give Him first priority in your time. I would never have been able to meet all the demands of Junior year if God had not been holding me up, strengthening my weak body when I grew weary, and giving me hope of success when my fears of failure overwhelmed me.  

Do not derive your sense of success or worth from grades or by comparing yourself with others. If you do, you will find yourself in a world of disappointment. No one is perfect. By all means, shoot for an A on every exam, but if you fall short, do not despair. I remember a time last year when I received a certain grade that left me feeling defeated. I saw one of my senior friends in the hallway of the Nursing Office, and, when I told her about my grade with tears streaming down my face, she reminded me that God’s love for me does not change. God’s love is not based on any merit I could earn by high achievements, and His love for me will not change when I fall short of my aspirations.  My worth is found in who Christ has made me to be—His Beloved Bride.

Remember to take time each week or, if you are able, every day to allow yourself some mental solace. Do whatever you find relaxing. Exercising was one of the outlets I used Junior year to alleviate stress. Do whatever makes you forget about your work, even if only for a little while, and take a break from studying and enjoy yourself.

Be balanced. Realize your limits. Assess your assets. I may never have earned the poor grade I mentioned earlier if I had been more balanced in the way I spent my time. One of my greatest weaknesses as a new Junior was perfectionism. My first clinical assignment required me to write all my profile information post-clinical. Because I was fixated on writing a good paper, I spent the greater portion of my time writing my profile than on studying for the exam that was approaching. This cost me the A on the test, which was my aim. Looking back, it would have been better for me to set a time limit for my profile writing and set a specific time for when I was to concentrate completely on studying for my exam.  Please, learn from my example; know your time limits and plan accordingly.

My last piece of advice is to use your resources. Your teachers, senior tutors, online Evolve practice questions, and ATI books are all resources intended for your benefit. Ask your instructors for clarification if you don’t understand something you’re learning. Engage your senior tutors with questions you have from studying the material. Determine areas in which you need to spend more time studying by taking practice quizzes. All this will help you be better prepared for exams and, ultimately, make you a more knowledgeable nurse. 

Thursday, August 8, 2013

Patience for Our Patients

Patience is fourth in the line of spiritual fruit listed by Paul in Galatians that is supposed to characterize believers in Christ (Galatians 5:22-23). How much more should we, who have this high calling to serve those who are sick and impoverished, continue to demonstrate patience to those in our care? 

Throughout my life I have noticed how my attitude affects my actions. When I have a good attitude, it is easy for me to be joyful, caring and compassionate. If, however, I allow myself to forget why I am here and what my purpose is (to serve others as unto the Lord), then I find that thoughts of impatience have an opportunity to creep into my mind. Although I aim to never show these emotions, they are sometimes very much there. The question is how to deal with them when they happen. 

The word of God again provides the answer. "We demolish arguments and every pretension that sets itself up against the knowledge of God, and we take captive every thought to make it obedient to Christ” (2 Corinthians 10:5). Our minds are truly a battlefield for the war between good and evil desires in our person (Romans 7:21-25; Romans 8:5-13). When I find myself thinking impatient thoughts, such as “Would this car get up the road already?!”, I have an opportunity to put in practice the virtue of patience.

Thankfully, we are not alone in our battle against evil (Romans 8:27; 2 Peter 1:3). We have many weapons of warfare at our disposal (Ephesians 6). We have the divine power of Christ in us (2 Corinthians 10:4-5), and we have the Word He has given us (Ephesians 6:17).

When I was younger, my mom taught me to pray a simple prayer whenever a wrong thought came into my head, and ever since then I have used it clear my mind of unwelcome thoughts. When I realize I am thinking about something that I shouldn’t, I pray “Lord, I ask that you would take captive this thought and make it obedient to You.” A wise person once said, you can’t help what birds fly over your head, but you can keep them from making a nest in your hair. In other words, you can’t always help what comes into your brain, but you can help what you meditate on (Philippians 4:8).

Let us commit to turning our negative thoughts into prayers. When we are beginning to feel impatient—with our patients, our coworkers, our friends, or even our family members—let’s take the opportunity to turn our frustration into prayer—for God’s grace for ourselves and His blessing for them.

Patience isn’t easy. And I have by no means mastered it. In fact, I am writing this out of a realization of how much I need to grow in this area. Since we are weak and imperfect creatures, let us remember God’s promise: “…My grace is sufficient for you, for my power is made perfect in weakness…” (2 Corinthians 12:9a).

Saturday, August 3, 2013

My Experience As An Extern

I'd like to take a moment if I can and talk about how wonderful my experience as a nurse extern at Wake Forest Baptist Medical Center was in hopes that it will encourage many of you juniors to apply this fall when the application opens up.

A typical week as an extern included working three 12-hour shifts in my home department and shadowing for four hours on another unit. My externship allowed me to rotate through two different units. I started in the Emergency Department (ED) where I learned about triage, prioritization, focused assessments, and caring for high-acuity patients. As a Nurse Aide (NA) II in the ED, I was able to sharpen my skills base and grow in knowledge about how trauma, sepsis, burns, strokes, and MIs are treated.  

During my second rotation on the General Medicine unit, I was able to care for four to six patients at a time as their primary NA. This opportunity refined my ability to prioritize, multitask, communicate, and perform NA I and II skills. Because I was often able to care for the same patients two or three days in a row, I had the opportunity to get to know my patients as well as see them improve from one day to the next. 

During my externship I was also able to shadow nurses in the Trauma Intensive Care Unit (TICU), Pediatric ED, Cath Lab, AirCare, Medical Intensive Care Unit (MICU), Rapid Response Team, Cardiac Care Unit (CCU), and Hospitalist Service. Each opportunity taught me something new about nursing and gave me new knowledge about disease processes and treatment pathways. 

I cannot express in one post the magnitude of all that I learned as a nurse extern nor express my gratitude for the friendships I developed with my coworkers. I can only encourage the next class to apply to the nurse externships in your area. If you have specific questions, please leave a comment. I'd love to aid you on your journey to success as a nursing student and a future nurse!

Wednesday, July 31, 2013

Official NCLEX Test Map

To those of you who've wondered what is actually on the National Council Licensure Examination for Registered Nurses (NCLEX-RN), here’s a PDF from the National Council of State Boards of Nursing that provides both a broad as well as detailed description of the test content for 2013. The broad description is found on pages five through eight whereas the detailed description is found on pages nine through 43. 

Happy studying!