Becoming Nocturnal

It's official. I survived my first week working 12-hour night shifts. I'll be honest. I thought I might die. I thought that the completely worn out feeling I had before the week even began couldn't possibly withstand staying up all night for 4 of 7 nights. But I made it. And it really wasn't so bad.

I also expected to feel much more overwhelmed than I did. I definitely learned a lot and had to really fight to think about what I needed to chart and what assessments needed to be done once 4am rolled around, but all in all I felt like I transitioned pretty smoothly into this next phase of orientation.

I had two different preceptors this week: Beth last Monday night and this past Sunday and Tina on Wednesday and Thursday nights. They were both so great...so patient and willing to answer all my questions. I couldn't have asked for better nurses to work with.

This week I only worked on Sunday night and am now taking 2 paid days off (as part of my sign-on bonus) to study for and take the NCLEX, the exam for obtaining your nursing license. This will allow me a few days to get back onto a day schedule so that I'll actually be awake and functional at 2pm on Thursday!

Since I probably wasn't going to study much anyway, I have a special visitor from Bloomington coming tomorrow! I've got a few surprises in store for him, but just in case he's reading this, I'll have to tell you about them later in the week!

This past weekend, I was up in Bloomington (again) to see Mr. Bryan Schoenecke and to attend the wedding of his good friend Joe. I worked Thursday night, slept until 3pm on Friday, and then took the train up to Bloomington. We drove up to Geneseo first thing Saturday morning since Bryan was an usher and had to be there early for pictures. It was a beautiful wedding, and we especially had a fun time dancing at the reception!

Here are a few pictures from the wedding:
















































That night we drove all the way back to St. Louis since Bryan had to be at Scott Air Force Base early Sunday morning. It was a very late night, and I felt surprisingly very awake by the time we arrived at my apartment. I didn't go to bed until after 4am, but then slept most of the next day before going into work at 6:30pm.

Today when I woke up and looked at my alarm clock, it took me a minute to figure out if it was AM or PM. That has to be a bad sign, right? Praise God. He's brought me through a challenging week in one piece and still rejoicing in Him!

If you have the time, check out this 10-minute video. It's a part of the Nooma video series by Rob Bell, and it really touched my heart. We have been given sooo much more than we need, and it takes so little to bless others.

http://player.flannel.org/compassion?utm_source=SilverpopMailing&utm_medium=email&utm_campaign=SP_ADV-0212_NOOMA%20(1)&utm_content=&referer=corner

"Do not store up for yourselves treasures on earth, where moth and rust destroy, and where thieves break in and steal. But store up for yourselves treasures in heaven, where moth and rust do not destroy, and where thieves do not break in and steal. For where your treasure is, there your heart will be also." Matthew 6:19-21

Brain Pain

When asked how NICU orientation is going, my response consists of two parts:

1. I absolutely love it! After so many years of wanting to know more about NICU nursing (but instead having to learn primarily about adult nursing to get my degree), it's sooo exciting to finally be here learning about what I'm actually going to be doing!

2. My brain hurts! Every evening I come back to my apartment convinced that my brain could not possibly hold any more information! For example, I'm currently reading the book Crazy Love by Francis Chan. It's such a great book, but I have such a terrible time concentrating on it and taking in what it says after a day of orientation!

But now the classroom portion of NICU orientation is done (except for one more week in the classroom later in July). And starting Monday, I begin 8 weeks of orientation in the unit. During this time, I will be work 3 12-hour shifts each week and will be paired up with a preceptor, who is a more experienced nurse in the unit. I am starting out on nights because my primary preceptor, Beth, is a night-shift nurse, so I'm a little anxious about working 7pm to 7am while trying to learn so much. I am anticipating being very tired next week!

I have been so impressed with the nurses I've met from the unit. They are so incredibly smart and are so good with their patients and families. I'm so honored to be a part of this team of nurses. I know it's going to take a long time before I'm as knowledgeable as they are. There is just SO much to learn beyond what we learned in nursing school. And so much of what I thought I knew is different in the NICU population.

For example, we learned all about arterial blood gases in nursing school. I thought I was pretty good at interpreting blood gas values. The normal blood pH for an adult is 7.35-7.45. Anything less than 7.35 is considered acidosis and probably requires some kind of intervention. A value of 7.2 would be critical, and I would definitely be notifying the physician. But in NICU, 7.2 might be a normal value for some of our tiniest babies. They have a low blood pH in utero, so we try to keep it in that lower range for a while after they are born as well.

This experience is definitely humbling! I'm really excited to keep learning and taking it all in. :)


Here is the unit where I work! Dr. Cole is the Medical Director of the NICU. He came to talk to us in orientation last week, and I was really touched by how deeply he cares about these babies and their families.

"Whatever you do, work at it with all your heart, as working for the Lord, not for men, since you know that you will receive an inheritance from the Lord as a reward. It is the Lord Christ you are serving." Colossians 3:23-4

Marathon pt. 2

Sorry for my extended absence! Last week was another busy week of orientation, and it was followed by another marathon weekend that took me all the way from St. Louis to Springfield to Bloomington to Chicago and back again!

My second week of orientation went well. About halfway through the week, we finished general nursing orientation and the nine of us who will be working in the neonatal intensive care unit (NICU) started meeting separately for unit-specific lectures. I was getting really bored in general orientation, so this switch was much appreciated!

We've been learning so much about taking care of the babies. For example, we had a lecture the other day on the most common medications administered in the NICU, another on how to position premature babies in their isolettes (or incubators) to promote optimum muscular/neurovascular development, and a lecture on determining when a preemie is ready to begin bottle-feeding. There are so many complex issues to consider when caring for a baby born as early as 23 weeks gestation!

This week is another 5 full days of NICU-specific lectures and speakers. It's really interesting and I'm learning so much, but I'm not sure how much more new information I can take in! I am thrilled to finally be learning so much about caring for babies though after years of dreaming about being a NICU nurse. I still can't believe I've finally made it here!





















My St. Louis Children's Hospital badge! GN stands for "Graduate Nurse." Once I've passed my boards, it will officially change to RN, BSN (for "Registered Nurse, Bachelor's of Science in Nursing")


On Friday after work, I drove up to Springfield to spend an evening with my mom and younger sister. We ate Chinese food and watched a movie together. It was a quality "girls' night" at the Ketchum household.

Then on Saturday morning, I drove up to Bloomington to see Bryan. We weren't in Bloomington long before we made our way up to Chicago for a wedding (#2 of 6 this summer!). I didn't know the bride and groom, but the groom was a good friend of Bryan's. We took lots of pictures (I've posted a few favorites below!) and enjoyed spending time together in the car and at the reception. I was also excited to get to see Tony and Kim, friends of ours who just got married a couple weeks ago. It was the first I had seen them since they arrived home from their honeymoon.

On Sunday, Bryan and I drove down to Springfield to attend a very special 50th anniversary party for my good friends, the Lockharts. We weren't there long before I had to take Bryan to the train station to head back to Bloomington and I needed to drive back to St. Louis. The weekend went by really fast, but it was so much fun!

Marathon

This past weekend felt like a marathon, but was so worth all the traveling. On Friday night after I finished orientation for the day, I drove up to Springfield to spend the evening with my mom and grandma. We went to the last night of the annual Carillon Festival out at Washington Park to watch the fireworks displays. If you live in Springfield and you've never been, you are missing out! It was so good!

On Saturday, I drove up to Bloomington to see a pretty important guy in my life. We made dinner (a.k.a. he made dinner while I talked to him) and went over to his brother Michael and sister-in-law Holly's house to play bags and hang out. Here are a few pictures from our fun evening together:
















































On Sunday, I went to church with Bryan, Michael, and Holly at Journey Family Fellowship, and then drove back to Springfield with Bryan to attend a graduation party. After the party, Bryan caught the train back to Bloomington, and I headed back to St. Louis for week 2 of my orientation.

Tomorrow is my last full day of general nursing orientation (and I'm so glad!). Some of the things we talked about today were interesting, but it mostly has to do with taking care of kids. I lost count of how many times the person lecture said, "oh, except for in the NICU." Working with the babies is so different from working with kids, so unfortunately a lot of the topics discussed in this first part of orientation don't really apply to what I'll be doing.

Fortunately though, we have NICU orientation on Wednesday and Thursday of this week in the mornings and all day on Friday! Hooray! I can't wait to learn as much as I can about being a great nurse to these babies!

"Great is the Lord and most worthy of praise; his greatness no one can fathom. One generation will commend your works to another; they will tell of your mighty acts. They will speak of the glorious splendor of your majesty, and I will meditate on your wonderful works." Psalm 145:3-5

Thank You

Thank you all for your prayers and encouragement in the past few weeks. It's been a busy time with a lot of big changes: graduation, moving home from college, moving into my new apartment in St. Louis, and starting a new job! But God is so faithful. He's put so many wonderful people in my life to encourage me and has also blessed me with some great new friends here in St. Louis. He is SO good, and I'm so undeserving of His goodness to me.

I'm officially all moved in and getting everything settled. I only have a couple more boxes to empty and am determined to find a bookcase for all my books, and then I'm good to go! My Internet is still pretty hit and miss, and I'm having a difficult time finding an Internet provider that services my apartment building for less than $50/month. For right now, I'm getting by with the occasional wireless I can pick up in my bedroom. :)

My first week of orientation is going really well. It's been relatively boring so far...a lot of review from nursing school and also boring topics such as the hospital's strategic plan or what to do in every possible emergency situation. Tomorrow is my first official day of orientation in the neonatal intensive care unit (NICU), so as you might imagine, I'm really excited! I do still have Monday through Thursday of next week on general nursing orientation, but I'm getting closer and closer to spending all my time in the NICU, which is where I really want to be!

I will try my best to keep you all up to date on my life here in St. Louis! And I would love to hear what you're up to as well. I'm struggling to keep up with emails because of my Internet problems, but would still love to hear from you and know how I can be praying for you.

so much love in Jesus,
sam

My Apartment

my apartment building














my kitchen





















lots of storage space





















my desk























my bathroom





















my balcony

My View of St. Louis

the view from my balcony














out my living room window





















a beautiful cathedral down my street
















Saint Louis University down the street

Moving Day (May 28, 2009)

the moving crew before leaving Springfield





















in the elevator with one of my fantastic helpers

















Mom, Grandma, and me after a long day of moving