Category Archives: Milestones & Reflections

Juggling My Nurse Residency Schedule

If you wondered what my calendar is like as a new graduate RN in a hospital residency program, this post provides some insight. I have classroom and skill sessions (didactic content) interspersed between 12-hour shifts at my hospital with a preceptor. The classroom sessions are more frequent at the beginning of the one-year residency. After the first month, there are fewer classroom and skills sessions and more shifts with a preceptor. Depending on the unit, a resident may have more or less didactic learning and preceptor shifts than other residents. For example, residents in the Emergency Department require more hours of didactic content and preceptor shifts than Med-Surge residents. I have 28 preceptor shifts for my particular unit and about 36 hours scheduled for didactic and hands-on skills sessions. The extensive orientation and formal training program are what attracted me to my hospital.

After the first 1.5 months, it seems the didactic portions take place about once or twice a month. My hospital hired me to work the night shift, and my preceptor works the night shift. During preceptorship, the resident’s schedule matches that of their preceptor. Some of my cohort-mates were hired into the night shift but have had day shift preceptors. It has been a new challenge for me, balancing working the night shift while trying to sleep and meet other obligations during the day, like spending time with my family or attending my daytime didactic sessions.

A pic of me during my online classroom session from home this past Tuesday. Pre-pandemic, I’m told classroom sessions were in-person. I attend online classroom in my daughter’s room while my husband works in another part of the house (still working from home, thanks to the pandemic). Even though I’m not at the hospital, I still have to wear scrubs and prepare to be on camera for my online sessions! And of course, gotta have my coffee – looks like I’m due for a refill!

As a resident still on preceptorship, we’re not allowed to work overtime or during the holidays. This past week, I was unable to work Monday due to the Memorial Day holiday. However, I had work scheduled Tuesday through Friday morning and Saturday through Tuesday in addition to homework and exams I needed to finish. Sprinkled in my calendar are preschool pickups or drop-offs, grocery shopping, family outings, and other life events like my dear friend’s funeral. My schedule was as follows:

Sunday: complete homework/assignments
Monday: Memorial Day holiday (not allowed to work)
Tuesday: 8a-2:30p daytime classroom session (online)
Wednesday: [7p-7:30a] night shift with preceptor A
Thursday: night shift with preceptor A
Friday: 10a – funeral/celebration of life mass
Saturday: 4a-8a phlebotomy shadow
Sunday: night shift with preceptor B
Monday: night shift with preceptor B
Tuesday: night shift with preceptor B

I mentioned my friend’s memorial mass to my preceptor Wednesday night only to ask where I might be able to shower or nap since the mass was at a church just down the street from the hospital. It wouldn’t be worth it to go home after my Thursday night shift and turn back around during rush hour traffic to attend my friend’s mass. After hearing my schedule, she offered to have me take Thursday off and reschedule that shift with her for another time. Initially, I refused, thinking it would reflect poorly on me not to work my total hours. Plus, I like my preceptor and did not want to reduce my shifts with her in the “shadowing” stage of my preceptorship. Yet, altering the rest of my schedule was impossible. I was determined to attend my friend’s mass in person Friday morning. I could not reschedule my Saturday shift since work already rescheduled it from the prior month due to the phlebotomist’s schedule. If I wanted to work the week of June 6, preceptor B was the only one available since my regular preceptor (preceptor A) would be on vacation that week for a family wedding.

As I sat there re-considering my preceptor’s offer to reschedule our Thursday shift together, I realized her offer was grace not often granted. As a resident tied to my preceptor, I’m not really on the schedule yet. My assigned preceptor is the only nurse listed on the roster for our shifts. Once I start working independently, it won’t be easy to take time off, especially since I’m only in my first year and have little paid time off accrued. I knew if I worked Thursday night, I would be drained and unable to rest Friday morning, which would add to me being an emotional wreck during my friend’s memorial mass. I returned to my preceptor and let her know I would take her up on her offer. I took Thursday night off.

I was grateful to be able to be present at my friend’s celebration of life mass. It was a blessing to be surrounded by those who loved her on Friday and remember her together. Unfortunately, not all those who lost loved ones during the pandemic had such an opportunity to gather in person. I was lucky that the pandemic death rate has slowed in our area, and churches loosened restrictions.

Part of the reason I became a nurse was to spend more time with my loved ones. I already worked 10-12 hour days in my previous job, but I worked five days a week. This past week’s events reminded me of how much I valued my loved ones and allowed me to create space for them and my well-being. I appreciate being a nurse, but I do not want work to come before loved ones (or my health) in my life.

It is Sunday afternoon. I need to be sleeping for my first three-sequential-night-shifts block, but I cannot sleep because I slept last night and have difficulty sleeping again during the day after a whole night’s sleep. I’m still figuring out a sleep schedule that works with my body. I’ve tried laying in bed, meditation, and prayer so I’ve given up sleeping today and figured I’d finish this blog post. I have never worked three shifts in a row before, let alone with the assigned preceptor (preceptor B) for the next three nights. I am nervous but excited to get a better sense of what it will be like to work three shifts per week as an independent nurse.

Wish me luck!

Never Give Up: My New Grad RN Job Search Experience

I am happy to announce that I got a job as an acute care RN and started my new grad program at a hospital! I did not post last week because I was in orientation all week and transitioning into my new role. I am thrilled to be part of my program since it is at my top choice hospital and provides comprehensive training. While I’m excited to share my good news, I wanted to discuss what led me to land a spot in my new grad program. I share my job search experience to offer encouragement, hope, and advice to future new grad nurses.

I applied to the same program after getting rejected the first time.

I got rejected the first time I applied to my program last Fall. The hospital did not even invite me to interview. I applied a second time to the new grad program in January, interviewed in March, and got an offer two weeks later. Some differences when I applied the second time:

  • I had gained several months of experience as an RN (COVID tester),
  • I had earned additional certifications to add to my resume,
  • I finally knew a couple of nurses working in the hospital, one of whom put in a good word for me to their manager,
  • I tweaked my application based on what I heard about the need and availability of positions; I emphasized wanting acute care experience instead of working in a specialty.

I applied to 74 RN positions before I got my offer at my hospital.

The new grad program at my hospital was the very first RN job to which I applied. I continued to apply to other positions, but I was narrow in my search. I focused on the specialty I was interested in and expressed this in my new grad program personal statements. After months of submitting applications and not getting any interviews, I expanded my job search to include Med-Surge/Telemetry positions. I finally landed my first acute care RN interview in a Telemetry unit. In the interview, I expressed strong interest in eventually transferring to a specialty unit within five years. I learned they were interested in me but concerned I wouldn’t be happy in the department and abandon them. They did not give me the job offer. 

As my search continued, I learned not to narrow my focus to a specialty unit when I had no hospital experience. Once hired, it’s much easier to switch positions internally than to be an external hire. I still have a strong interest in the specialty unit. However, my priority as a new grad is to gain acute care experience and develop my nursing practice in a supportive and safe environment. In my new grad program, no specialty unit positions were available where I initially focused my search. Still, I applied and was determined to have a spot in the program because of the training and development I knew it would provide me. So far, I’ve been happy with my choice and have been learning a lot!

I worked as a COVID tester and vaccinator while applying to new grad programs and acute RN positions.

One of the 74 positions I applied for was a contract RN supporting studios as a COVID tester. Thankfully, I got the job. It was a great way to get experience working as an RN while still having enough flexibility to apply to hospital RN jobs and interview. More recruiters were interested in me once I became a working RN. Also, after working several months, my employer wrote a lovely reference letter for me that I submitted with my applications and included in my portfolio. A handful of positions required an employer reference. It was nice to be able to provide an employer reference from the healthcare industry.

I interviewed at five hospitals before I accepted an offer to join my program.

I applied to many acute care RN positions, with numerous ones at the same hospital or same unit but day and night shift positions. After applying, working, and networking, I eventually got invited to interview for some hospitals. However, most of these interviews took place only because I knew someone internally who advocated for me. 

After unsuccessfully job searching on my own, I began to reach out to friends and family members in healthcare to let them know I was searching for hospital RN jobs. I also spoke with other nurses I met in my per diem job about their hospital jobs or connections. One of my coworkers got me an interview at her hospital! Most of the hospital interviews I had were because someone I knew convinced a hiring manager or director to interview me. 

If you don’t know someone, it’s not impossible to get an interview. One of the interviews I had where I knew no one in the organization resulted in an on-the-spot job offer. I eventually turned it down and accepted a spot in my current new grad program instead.

I persevered after rejections or no feedback.

I applied to many programs or positions where I received no feedback for months or not at all – I would be listed as “under consideration” several months after applying. The first time I applied to my program in September, I didn’t receive my official rejection until November, months after my application submission. I tried contacting and leaving messages with some of the recruiters for other job submissions but would still get little to no response.

It was frustrating to hear people’s surprise at my difficulty finding a job: “Isn’t there a shortage of nurses? We’re in a pandemic – don’t they need nurses?” I had to explain that organizations need experienced nurses, and I had no experience. 

My lack of experience working in healthcare was a disadvantage for me. I knew many of my classmates that quickly found jobs had prior healthcare experience working as surgical technicians, CNAs, Patient Care Associates (PCA), EMTs, or nurse extenders. The majority of my cohort completed their preceptorships at a hospital that used them after completing their clinical hours as nurse extenders or surge nurses in preparation for and during the COVID surge. I’ve learned if you can work in healthcare before you graduate, it’s much easier to find a job as a nurse.

Additionally, new grad programs were difficult to find or were highly competitive since many had been canceled or delayed. While I was disappointed at not getting accepted into programs earlier or not having acute care RN offers to consider sooner, I wonder if the rejections were God’s grace saving me from starting a job amid a COVID surge. A former classmate shared she cried before most of her shifts due to the deaths she witnessed. Another friend shared that many new grads in her unit were pulled off orientation less than two weeks into their training to help with the surge. In various ways, new and veteran nurses that worked during the surges were traumatized by the pandemic. If I had started working in a hospital sooner, COVID would have impacted my nursing experience in a much different way. In retrospect, I’m thankful for the rejections and disappointments in my life that led me to where I am today.

Never Give Up

I did not envision starting a job in a hospital almost nine months after graduating from nursing school. However, I trusted in my skills and abilities and knew that I had something to offer and had to keep trying. I was unsure of when or where I would work as an acute care RN, but I was confident in eventually getting a job somewhere and remained passionate about wanting to help people. 

If you have a calling, go for it. If it’s truly your calling, opportunities will present themselves to you to lead you to your vocation, no matter how much you try to ignore it. The road may not be easy and may come with disappointments and rejections, but it might be what you need to direct you to your ultimate calling. Good luck on your journey!

Spring Blooms and Cultivation

Last Tuesday, I had the good fortune of spending time with a good friend from Nursing School and enjoying some Spring blooms. We went to an outdoor cafe and visited a botanic garden afterward. If we had not chosen Nursing as our second career, we would have never met, nor would we be able to take a mid-week lunch across town with our previous Monday – Friday jobs. We also likely would not be fully vaccinated at this point to spend time together comfortably. Our mini outing is one of the many reasons I am happy to have chosen Nursing as a career.

My Rainbow Latte I had during brunch with my friend – I enjoyed all the colors of the day!

I took photos of the colorful flowers I saw in the garden, and I noticed some had not yet fully bloomed – they were still buds. It reminded me of us and our careers since we are only at the beginning of our nursing careers. We are both working nurses (COVID testers) but start our new grad programs at our respective hospitals in a couple of weeks.

I may feel like a “late in life bloomer,” but I look forward to what’s to come. It took patience and persistence to get where I am. I continue to be cultivated and hope I have chosen an environment that allows me to grow and thrive. I had multiple opportunities to work at different hospitals – I accepted the offer at the hospital that didn’t offer the highest pay but had the most extensive training program. I think a general life lesson I’ve learned is: Nourish yourself whenever possible and try placing yourself in conditions that enable you to develop and “bloom.”

After the lovely garden outing with my friend, I came across an old journal I had. In it, I wrote, “What friendships or relationships are restorative or allow you to grow? Cultivate those.” My “nursing school friend” has become one of my best friends. It’s hard to imagine my surviving my nursing school journey (or brutal new grad job search) without her encouragement, support, or commiseration. She is also a mom and knows what it’s like to balance family with work or school. Nursing school is over, but our friendship is not. Our friendship continues to thrive. I don’t think it’s an accident that I came across this quote this week. I think it’s an affirmation and reminder of how lucky I am to have my friend and others like her in my life. May it serve as an affirmation for you as well.

Enjoy this Spring season! Cultivate the relationships in your life, whether it be professional or personal, that nourish you and allow you to grow. Take time to appreciate the blooms and what’s about to blossom in your own life!

Vasovagal Syncope at a Mass Vaccination Clinic

Photo by RODNAE Productions on Pexels.com

I was at a week-long pop-up mass vaccination clinic last month in the parking lot of a sports stadium. We monitored patients for severe allergic and other adverse reactions after administering their vaccine injections. Luckily, we never encountered any patients needing us to treat them with an epi-pen in our tent. However, we did have a patient who fainted almost immediately after receiving their shot. The patient eventually regained consciousness, but not before being attended to by at least five nurses with medics and a doctor along the way. If a patient is going to have an adverse reaction to the vaccine, having one at a mass vaccination clinic prompts attention from an entire team of healthcare professionals!

I had never experienced a person fainting before and it was actually impressive to see so many experienced nurses quickly react and attend to the patient. I didn’t give this particular patient their shot. I didn’t even see the patient faint, since I was opposite end of the tent when it happened. I turned around from where I was and all I saw was a bunch of nurses rushing to care for this patient. Everything happened so quickly. As a new nurse, I want to share what I learned and saw so I don’t forget and can apply it to my own nursing practice!

What is Syncope? What causes it?

Fainting, or syncope, is caused by reduction of blood flow to the brain resulting in a momentarily loss of consciousness. With vasovagal syncope, this can be caused by a sudden drop in blood pressure due to dilation of blood vessels or decreased heartrate. Without knowing this patient’s full medical history, our patient’s syncope was likely an anxiety-provoked reaction to receiving the shot. Some people faint at the sight of blood, pain, or other stressors. It is thought this patient was so anxious about receiving the shot, that the patient fainted and had a vasovagal syncopal episode. I did not follow this patient back to the medic tent where the patient was further monitored and assessed. I also did not administer the shot, interview the patient, or provide the patient with the disclosure statement for verbal consent, so I have no idea if this patient has fainted before. However, what I’ve learned is if a person has a history of fainting, it is recommended for the patient to recognize what provokes the fainting (to avoid or work around triggers) and to also get a medical examination to ensure there are no other health conditions causing syncope. After our patient who fainted, we had a number of patients expressing a history of fainting after vaccinations, so we monitored them more closely and had them sit or lie down after the shot. Luckily, no other patients had a syncopal episode.

A-B-C Prioritization Always Applies

In prioritizing patient care, a nurse assesses a patient and prioritizes airway, breathing, and circulation. This is often referred to as the ABCs.

“A is for airway assessment, observing for airway obstruction which can be seen with a changed sound of voice, “see-saw” respirations, and stridor. B is for breathing assessment, observing for an abnormal respiratory rate, the use of accessory muscles for respiration, and cyanosis. C is for circulation, observing for color of hands and digits, an abnormal capillary refill time, and decreased level of consciousness (LOC). “

Picmonic.com

The patient was sitting when they fainted, and some nurses pulled the patient down from their seated position, in their wheelchair. Other nurses rushed to support the patient’s bottom, legs, and feet. After the event was over, some of the nurses wondered why the patient was pulled down from their wheelchair. After an internet search, I learned one should help a patient lie down and elevate their legs to encourage blood flow to their brain (https://www.mayoclinic.org/diseases-conditions/vasovagal-syncope/symptoms-causes/syc-20350527).

Vasovagal syncope most often occurs when a person is standing or sitting (https://www.cedars-sinai.org/health-library/diseases-and-conditions/v/vasovagal-syncope.html). Supporting a patient in the standing or sitting position while they have fainted can prolong their unconsciousness and decreased blood circulation to their brain – their blood will continue to pool in their lower vessels. The nurses pulling the patient down from the seated position were trying to improve circulation. The patient did not have a blocked airway and was able to breathe, but had fainted. The nursing intervention of changing the patient’s position was prioritizing circulation, the “C” part of A-B-C prioritization [Airway – Breathing – Circulation].

Techniques to Regain Consciousness

Because the person fainted, the person was unresponsive to verbal commands or requests. I saw a nurse perform the sternal rub in an attempt to “wake” the patient. Luckily, the patient regained consciousness after laying down and getting the sternal rub. Once the patient recovered from fainting, the patient was frightened and did not seem to understand what had happened. The startled patient grabbed at the nurses’ hats and clothing. It’s normal to be confused after fainting. The patient’s caregiver verbally reassured the patient that they were okay. By the time the patient regained consciousness, the medics from the medical tent had arrived accompanied by monitoring equipment and a doctor. The patient was calmed down and taken to the medic tent for further monitoring and observation.

It was not used, but there were ammonia sticks in our supply bin. These smelling salts can be used on a patient who has fainted, in an attempt to increase oxygenation to the brain. In the British Journal of Sports Medicine article, “Smelling Salts”, the author explains:

“Smelling salts are used to arouse consciousness because the release of ammonia (NH3) gas that accompanies their use irritates the membranes of the nose and lungs, and thereby triggers an inhalation reflex. This reflex alters the pattern of breathing, resulting in improved respiratory flow rates and possibly alertness.”

McCrory, P. (2006)

An experienced nurse shared with me that if the ammonia sticks or smelling salts are unavailable, alcohol wipes can also be used under a patient’s nose in an attempt to startle them into consciousness.

Prevention

If a patient stated they previously fainted after receiving a shot, we monitored that patient closely or had them lay down with medics present. We also monitored patients a little more critically if they had a prior allergic reaction or medical history that would warrant a longer than normal observation time of 15 minutes.

Often, people who experience vasovagal syncope have warning signs that they might faint. Some of the symptoms may include dizziness, nausea, warmth, sweaty palms, or blurred vision. If a patient experiences these symptoms, have them sit or lie down, as needed. If they can’t lie down, they can sit, bend down, and place their head between their legs. Cedars-Sinai’s website also suggests:

“Tensing your arms or crossing your legs can help prevent fainting. Passively raising or propping up your legs in the air can also help.”

Patients who experience vasovagal syncope or who have fainted before should be aware of their triggers so they can avoid them or develop ways to manage their triggers. To reduce the risk of fainting, Cedars-Sinai offers staying away from some triggers such as:

  • Standing for long periods
  • Excess heat
  • Intense emotion, such as fear
  • Intense pain
  • The sight of blood or a needle
  • Prolonged exercise
  • Dehydration
  • Skipping meals

I think the biggest impression left from the experience with the fainting patient was how important teamwork is and how quickly every nearby nurse jumped in to help. As multiple nurses were tending to the patient, other nurses were calling the medics for help. Everything happened and resolved so fast, that I didn’t have an opportunity to support them. I was proud of the nurses and what I saw (and ultimately relieved that I wasn’t the one who gave this patient their vaccine injection). As a new graduate nurse, I wonder if I would have known what to do or have been able to react so swiftly. I know for sure I’d be yelling for help. Now that this has happened, I at least have a sense of what to do, if I ever see a person faint. Hopefully, you do too!

References:

Cedars Sinai. https://www.cedars-sinai.org/health-library/diseases-and-conditions/v/vasovagal-syncope.html

Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/vasovagal-syncope/symptoms-causes/syc-20350527

McCrory P. (2006). Smelling salts. British journal of sports medicine, 40(8), 659–660. https://doi.org/10.1136/bjsm.2006.029710

Picmonic. https://www.picmonic.com/pathways/nursing/courses/standard/professional-standards-of-nursing-8246/prioritizing-care-32342/airway-breathing-circulation-abcs_8453

Why I Blog – Reflections of a Mature/Mom Student Nurse

It is surreal how my and my daughter’s lives have been paralleling one another throughout my nursing journey. When I applied to colleges to complete my nursing pre-requisites, I also submitted preschool applications for my daughter. I was shocked to learn that preschool wait-list applications cost more than college applications. Some preschool application fees/deposits were 1.5 times more than the application fee for our local community college! This week, I had a significant job interview with my top choice employer. In the same afternoon, I received a call to schedule an interview for my daughter for a language-immersion kindergarten. We’re both interviewing for something that sets the foundation and determines how our lives will be for years to come. If I get into my desired new graduate nursing program, I can see myself staying at that hospital until retirement. If she gets into this language-immersion program and accepts the spot, she commits to attending the school for the next six years. 

Most of my other nursing school classmates did not have to contend with commandeering significant change in one’s own life while being responsible for someone else’s life and wellbeing or a family budget. You may be the only parent in your class. Or, like me, you may be older than every student in your classrooms. You are not alone. Other people have been in that situation before or are in that situation currently, perhaps at another school. I write this blog because I want you to know it’s possible to earn a college degree later in life, even with kids. It’s possible to start over with a nursing career, even after a lifetime in another role. Everyone has their unique struggles or responsibilities, and while you might feel alone in yours, know that you are not. There are registered nurses who have had to repeat a semester or more of nursing school. Some nurses I know were pregnant or dealing with a loved one’s death during nursing school. I’ve read stories of students getting cancer treatments during their nursing program or single moms balancing working and nursing school with their family life. If nursing is your calling, you will find your way, as countless others have. 

Your career path may not look like the paths of other nurses or nursing students you currently know. Your burdens or responsibilities may not be the same as your classmates’. For instance, my classmates did not struggle to potty-train their child while studying for finals, as I did. However, I assure you that there is a nurse with a story similar to yours. Whether you are in nursing school or already a nurse, I invite you to share your story. There’s likely something in your nursing journey that others may find relatable or inspiring. A future nurse might need your encouragement.

I blog for the possibility that someone is encouraged by my story. I blog for the person doubting their abilities or overwhelmed by their circumstances. I blog for mature students who might recognize themselves in me. You don’t have to be a blogger to share your story. Other ideas include:

  • Accepting career day invitations for schools.
  • Being a guest speaker for after-school programs.
  • Joining your alumni association mentorship program as a mentor or recruiter for future students.
  • Providing helpful or encouraging feedback to communities for nursing students online.

Thank you for reading my blog and allowing me to share. I find when we share ourselves, it permits others to do the same. Good luck on your journey – and share your story!

Sage Reminders about Moving Forward

I attended a retreat when I was younger where the speaker talked about going on a journey in a car as a metaphor for life. As the driver of your life, you may have a map or route in mind and see the road ahead. Every once in a while, you look at your rearview mirror. While moving forward in life with your plans, it’s worthwhile to reflect periodically and look back at your life, your rearview mirror. However, no one drives a car long-distances by focusing ONLY on the rearview mirror. In the same way, to move forward with life, you cannot be stuck in the past.

As I’ve shared, I’ve been interviewing for new grad nurse positions. Some interviews have gone well, and some have not. I need to look back at my interviews to understand where I can improve and what I did well to move forward in future applications or interviews. However, it doesn’t serve me to beat myself up and ruminate over any mistakes I might have made. I can be overly critical of myself, but that’s crippling and doesn’t help me. It’s important instead to learn from my mistakes and consider what I can do differently the next time I encounter the same scenario. I suppose I needed reminders to not dwell on my shortcomings and be solutions-oriented instead – I have an important interview next week. Throughout this past week, I have noticed messages reminding me about how my focus determines my path.

My first reminder came in a reflection from a 2021 Lenten devotional I’ve been reading, “Embrace This Holy Season” by Joseph F. Sica. In the February 22 entry entitled “Getting Past the Past,” Joseph F. Sica shared:

“When you find yourself being drawn back into the pain and negative experiences, choose to focus on the present—on what is happening right now—and recognize that history is history. To get past your past, you need to accept it as it was and leave it there. Then pay deliberate attention to this moment—a time that’s never been before and is loaded with opportunities and possibilities. All you have to do is seize them.”

He then offers the helpful practice of taping the following quote to a mirror: “Never look back unless you’re planning to go that way.” It reminded me of the retreat speaker sharing the story about driving using one’s rearview mirror. While I wouldn’t suggest NEVER looking back, don’t be fixated on life’s rearview mirror.

My second reminder came in an email from Marie Forleo, an entrepreneur. She was talking about her relationship with her husband and shared the following:

“Human minds are wired to scan for what’s wrong, especially when it comes to our significant other. We criticize, correct, and attempt to control them. We’re quick to judge and point out (either in our head or out loud) what’s not working. My suggestion? Stop that ASAP. Where attention goes, energy flows. Make a commitment to keep looking for what’s right about your partner. Focus on what they did do, who they are as a soul, and what’s wonderful about them — then proactively and verbally acknowledge that to them consistently.”

While Marie Forleo was talking about relationships, her statement about energy going where our attention flows applies to life, in general. We can focus on mistakes we’ve made in the past, our shortcomings, or we can focus on our strengths and continual improvement. As someone starting over in my career, I need to acknowledge when I do things right because it is easy for me to self-criticize when I do something wrong or not exactly how I would have liked. I’m still learning and developing as a novice nurse, and I need to give myself some grace.

Finally, my third reminder came from Brene Brown, a researcher who focuses on shame and vulnerability. She has a podcast and had a guest, Dr. Edith Eger, discuss “Recognizing the Choices and Gifts in Our Lives.” Below is a quote from Dr. Eger that caught my eye while I was on LinkedIn:

I love the concept of finding an arrow and following it. We can’t move forward without an idea of our destination. Otherwise, we’re just wandering. If I make mistakes, after attempting to correct them, I need to know how to prevent them from happening again or improve myself. I’ve lived long enough to come to an understanding that God will present me with the same lesson over and over until I learn from it. Without a path to move forward, we may end up in circles.

Maybe you, too, needed gentle reminders to focus on moving forward. Perhaps you need to acknowledge your gifts and talents instead of dwelling on your shortcomings. Learn from your mistakes and move onward. Envision what you want, be assured of yourself, and head in that direction!

COVID Mass Vaccination Clinic and Lenten Encouragment

This past week was a little whirlwind filled with holidays, starting with Valentine’s Day, followed by President’s Day, Mardi Gras/Fat Tuesday, then Ash Wednesday. I worked the early part of this week at a mass vaccination site in LA County. It was the first time I had the opportunity to administer the COVID vaccine in my job. I was glad to be of service to so many in the community and happy to network with so many nurses.

It was tiring to be out in the sun, on my feet all day, in a stadium parking lot to either observe patients or give vaccines. Despite my achy feet and slight sunburn, I was grateful to contribute to the vaccine clinic. Patients were appreciative to get the vaccine. Amidst the 4,000 people we were vaccinating each day, I saw an old co-worker and friend I hadn’t seen in 3 years since I left my previous career to become a nurse. I took it as assurance that I am where I’m supposed to be, even if I’m still searching for a new grad hospital position. I also met experienced nurses who gave me suggestions and offered help in getting me a hospital job. I took that as a blessing and another sign that I’m where I’m supposed to be. The other nurses and I worked as a team and got to know one another. While supporting the community and each other, we enjoyed the perks of beautiful weather, stadium views over our lunch breaks, and food provided by the event organizers.

Fat Tuesday lunchtime views with my complimentary cheeseburger.

After a long day of work on Wednesday, I attended Ash Wednesday mass virtually at home. Ash Wednesday marks the beginning of the Lenten season. In his homily, my pastor exclaimed, “Don’t let a good pandemic go to waste!” It’s a strange thing to say, perhaps, but it offers guidance. Now, more than ever, we can slow down and not lead such hectic lives. I don’t have the excuses I once had about my pre-pandemic schedule being busy. My family and I can’t go to parties, attractions, museums, restaurants, bars, or friend’s homes like we used to. Instead of running around with our schedules filled, we can choose to spend time in meditation, prayer, or reflection. We can (re-)connect with others and build relationships using the technology available to us. (I’ve recently discovered the app, Marco Polo, and highly recommend it for connecting with others via private video messages)! I want to use this pandemic and Lent to re-focus on my spiritual well-being.

One of the things I’ve decided to do for Lent is to meditate or reflect on scripture each day. Luckily, my church is offering a daily devotional for parishioners to use during Lent, “Embrace This Holy Season” by Joseph Sica. I have enjoyed it so far.

On one of the days I had off from the vaccine clinic, I had my car serviced. I decided to pack my Med-Surge review book with me along with my devotional and bible. (I’m reviewing the Med-Surge book to prepare for an upcoming interview). The bible and “Embrace This Holy Season” were for me to complete my daily Lenten commitment. While the dealership serviced my car, I went for a walk, grabbed a coffee, and found an empty bench for me to study and meditate. I hadn’t taken time for myself like that in a very long time; it was glorious!

When I was a younger adult, I disliked the solemnity of the Lenten season. I appreciated the focus of prayer, fasting, and almsgiving, but it seemed like such a dark time. Now that I’m older, I appreciate the preparation Lent is for Easter. Lent is like a “time-out” for me to focus on my spiritual practices.

The Lenten reflection from Joseph Sica’s book for the day was about being ourselves and loving ourselves. I found it inspiring and a great reminder. I share parts of the reflection here with you, in case you need to read/hear it, too:

Some of you may not be Christian or observe Lent. Regardless, I encourage you to take time for yourself every once in a while for reflection or meditation. Create time for peace and quiet, if you can. Some of you have gratitude journals or practice hygge. This Lent, I commit to daily meditation and reflection. Even if you don’t observe Lent, maybe consider what you can do to make the most out of this pandemic. “Don’t let a good pandemic go to waste!” Can you use this time apart from others to gain clarity? Can you practice self-acceptance and appreciation? I love to hear how others practice self-care or self-love during this pandemic! Good luck on your journey!

Struggling With Boundaries and “No”

I know it’s been a while since I’ve posted. I feel like I’ve been struggling lately and don’t know what words of inspiration to provide. I find myself working when I didn’t plan to work to please my boss. I recognize that consistently not holding the boundaries I set for myself is unhealthy and causes suffering and resentment. Establishing and maintaining boundaries is a skill I have yet to master. I don’t know if I’d even call myself competent.

Sometimes I find myself working extra shifts, not because I want or need to, but because I want to keep my boss happy. I want her to give me a good recommendation when I put her down as a job reference. (I work as a COVID tester but am looking for an acute care RN role). However, when I work extra days to please my boss, it costs me a chance to recharge myself, spend time with family, job search, or blog. For example, even though I said I was unavailable to work the day after my second-dose COVID vaccination, I found myself working when I didn’t plan on it because my boss was short-staffed and begged me to work. My arm was sore, and I was tired and achy, but I had no other symptoms, so I obliged her plea for me to work. I had hoped to be taking it easy at home the day after my vaccination to fill out my daughter’s complicated kindergarten applications and other job applications for myself. Instead, I wore myself out by working the day after my second shot. By the time I got home, I felt so fatigued that all I could do was shower and lie in bed all evening. I couldn’t even pick up my daughter from her preschool; my husband did. My boss asked me to work again the following day (a day I usually have off), and I said I could not; I felt like I was fighting the flu! I found myself to the point of exhaustion before I finally said “No,” to my boss.

Being short-staffed seems to be a common theme no matter where a nurse works. (There are so many memes about this!) I am not a bad employee if I tell my boss I am not working extra days. Saying “No” is a skill I know I must strengthen to maintain the boundaries I set to keep myself healthy and balanced. [Un]Fortunately, it looks like I will have plenty of opportunities to practice saying, “No.”

Before I became a nurse, I was the type to cram a lot into my schedule. I still am this way. Usually, I enjoy it, but sometimes it’s stressful, especially when running late from event to event. However, since marrying my husband and having my daughter, I’ve been conscious of my family’s schedule and try not to burden them with too much activity. A nurse- and mom-friend told me her life coach suggested she schedule no more than three things in a day. I’ve been good with this for my family, but I am trying to uphold this goal for myself. I accomplish goals I set for myself more efficiently, and I am more satisfied and less overwhelmed when I create a manageable schedule.

I still have many goals and lots of things I feel I need to do or accomplish each day. Fortunately, I realize 1) I do not need to do everything all at once, and 2) Some things (like working or blogging) may fall off my schedule to focus on completing other things (like job and kindergarten applications). Honestly, I should make one of my goals to stop being such a people-pleaser, and I would be able to say NO guilt-free and struggle less. I am working on this, so thanks for your patience during my mini-break from blogging the past week!

Vision Boarding in Quarantine

Due to an unexpected quarantine from my daughter’s exposure to a COVID positive person, I found myself stuck at home for two weeks in January with my husband and daughter. Thankfully, all of us remained asymptomatic and tested negative for COVID. However, I adhered to the health recommendations to quarantine, and I did not work or leave the house outside of medical appointments for 14 days. Homebound, I decided to make my 2021 vision board a fun, creative activity I could do with my daughter.  

Below is the result of crafting together that day. 

My vision board / collage
My preschooler’s collage

I tend to be a visual learner and have found vision boards to be powerful tools. I’ve shared this before, but years before I became a mom, I made a vision board about being a parent. My husband and I spent over a year trying to get pregnant before I had a miscarriage. I eventually became pregnant with my daughter almost a year after our loss. It was pretty amazing to look back at that vision board, even though my dream of motherhood took some time to materialize. 

If you want to try your hand at making a vision board, below are some tips:

  1. Review your goals or vision board from the prior year (or semester or quarter). Reflect on what you’ve accomplished and acknowledge your achievements! 
  2. Do you have any remaining goals that will continue into the next year (or another timeframe)? Do you need to remove some obstacles before you’re able to achieve these goals? Consider removal of a barrier to be an initial goal.
  3. Think about your goals for your specified timeframe (year, semester, or quarter). What plans do you have for various areas of your life? You can focus on several areas of your life or many, but here are some to consider: work/career, finances, personal relationships, health/fitness, spirituality/well-being, education & development, rest & relaxation, or hobbies & fun.
  4. Are your goals S.M.A.R.T. ? S = Specific, M = Measurable, A = Achieveable, R = Realistic, T = Time-bound. If not, design them to be S.M.A.R.T.
  5. After you’ve thought about your goals (I also recommend writing them down in a planner or calendar!), gather supplies: paper, scissors, tape, glue, markers, and items with images you can use in your vision board (magazines, calendars, catalogs, or Pinterest photos/pins). 
  6. Start cutting out and collecting images or words that inspire you or remind you of the goals you have set for yourself. 
  7. Get at least one photo of yourself to place on your vision board. I also included pictures of my family in mine.
  8. Assemble your vision board, making sure to include the year or goal timeframe (e.g. Semester I 2021) and a photo of yourself!
  9. Place the vision board in an area you frequently see. I made my 2020 vision board and hung it on the wall by my desktop all last year. I replaced it with my 2021 vision board this month.

Before I made my 2021 vision board, I reviewed my 2020 vision board (per step 1 above). I posted my board last January on my FB and IG pages:

Upon review of last year’s vision board, it was reassuring to see how many things I accomplished or goals I achieved, despite a worldwide pandemic and various stay-at-home orders: 

  • The photo of a mom and her newborn in my vision board was a nod to my much-anticipated maternal newborn and pediatric rotations. I got to attend an emotionally moving c-section birth as part of my maternal newborn clinical rotation last year. My classmate and I witnessed a father cry with overwhelming joy and love for his newborn child – it was so sweet that my classmate and I were both moved to tears. I got to complete my preceptorship in a NICU. I had wonderful experiences during my rotations.
  • I had a bunch of images related to nursing, education, and graduation. I graduated from nursing school with my BSN and passed my NCLEX last year. 
  • I have “RN” and a pile of money on my board. I started my first job as a Registered Nurse before the year ended. 
  • I have travel luggage, a camera, vacation views, and photos of families having fun doing various physical activities on my 2020 board. My family and I managed to squeeze in two family vacations last year – one to Solvang (thanks to a good friend’s timeshare) and another to Bishop (as a result of tagging along on my husband’s business trip). We did not travel the way I originally envisioned after graduation, but my family enjoyed ourselves and explored new places while safely adhering to health orders.
  • I have images from “Hamilton”, the musical. I had tickets to watch the musical in-person with my husband at the Pantages in May. The show was canceled due to the pandemic. Luckily, our theatre tickets were refunded. I had to be satisfied (but “I will never be satisfied!”, a la Angelica Schuyler) watching it on Disney+. A benefit with watching the musical at home is that my daughter gets to enjoy it, too. My daughter periodically requests Alexa to play the songs, particularly the ones sung by any of the Schuyler Sisters.

Before the pandemic, I was excited to be part of the graduating class of perfect vision, 2020. I remember being a total dork and declaring this to my classmates well before the pandemic became a reality. After the pandemic started, I forgot about being part of the class of perfect vision. Earlier this year, however, my church’s mothers’ ministry had a Zoom meeting challenging members to think about how 2020 was the year of perfect vision. It was interesting to consider: I had to be laser-focused in my commitment to my goals to avoid distractions and overcome the obstacles of an unexpected pandemic. And maybe 2020 had me re-focus and let go of attachments and what I thought my life should look like. My family did not travel to other states or countries for vacation as in previous years, but we got to experience adventure and explore new places locally and within the state. My daughter speaks fondly of Solvang as much as she does of Spain (we visited in 2019). Even with letting go of attachments and expectations of what I thought things should be like, I didn’t accomplish all my 2020 goals – I still need to add more physical activity in my life and to declutter my home – but looking at my old vision board, I’m proud of what I’ve accomplished in 2020! Now, onward to 2021!