Tuesday, February 28, 2006

 

"You better work!"

Today we get our graduation/license pictures taken. Wow, guess that means things are really happening. It seems hard to believe that there is only 2 more weeks of class and 1 more week of clinicals in this quarter. I still have no official idea about my preceptorship next quarter (for you non-nursing people out there, a preceptorship for a nurse is roughly the same as residency for a doctor. I will be working 1 on 1 with a nurse, eventually taking over his/her patient load by the end of the quarter.). My advisor told me where she wanted to place me (a medical step-down unit), but at that time it was not official. I know that several of my classmates have been told who they will be working with, but not me. If I don't hear anything towards the end of the week I will just have to email her and see what is up.

I also have to take a test in Med/Surg IV this week. It only covers all of the psychiatric illnesses we covered, as well as all of the adult neurological alterations covered. Gee, that is not all that much info to cover (I think it was over 500 pages of reading and about 8 hours of lectures). I really don't know how they will boil that down to 65 questions, but I guess they have. I might take it today after pictures just to be done with it, but we'll see. There is always Thursday after class too.

This week in clinicals should be interesting. We'll be getting our quarter reviews from Scary-Instructor. Not only that, I asked to her to fill out a recommendation form for the Fellowship. Since she keeps telling us that we impress her with our abilities and she was receptive to filling out the recommendation form, I am feeling fairly comfortable that I will pass clinicals. Of course you never know...........

Wednesday, February 22, 2006

 

Feeling like a real nurse now

In yesterday's mail, I received my very first professional journal. I subscribed to The American Journal of Nursing (AJN) and Nursing2006 back in January through Amazon.com (they were having a good deal when you bought 2 subscriptions at the same time). Yesterday, I open my mailbox to find the November 2005 (whaa??) issue of AJN. Woo woo! Guess that means I really am going to be a nurse someday. I haven't sat down and actually read it yet, but I did go through and read all the article titles, and look at the pretty pictures in the ads. Man, if I was single I could make some serious money as a travel nurse! I think every ad in the magazine was for a travel nursing agency. No wonder local hospitals can't get nurses. Why would I want to practice in cold, snowy Ohio when I can frolic on the beaches of Maui or backpack through the deserts of New Mexico.

Saturday at clinicals went well too. My patient was amazingly low maintenance so I was able to keep on top of things easily. I was also able to get an IV started on the first stick. Our instructor actually gave me some advice that makes it seem like I can actually start an IV with 2 hands and not with the 3 that every other methods seems to require. And, wonder of all wonders, was that at the end of the day, our instructor told all of us that she was impressed with our performance. So either we may have a clue between the 6 of us, or she has really low expectations of our abilities. My guess is that it is probably some of both.

This week looks like it is shaping up to be a decent week. Turned in my assignments for one class, and I have an exam in Trauma Nursing tomorrow. Luckily, her exams are pretty easy so I should not have to kill myself too much studying tonight.

Thursday, February 16, 2006

 

Yesterday I was close to evil

Yesterday, Der Furher, err President (W) gave a speech at the corporate headquaters of Wendy's, which is about a mile away from where I work. I don't think that I have ever been that close to evil before. Needless to say, the entire city was a mess, and I reacted by hunkering down in the office, and hoping it was all over by the time that I left work. Luckily, there is acceptable food in our cafeteria, so I was able to get a decent lunch and go about my day. Likewise, traffic was actually better than normal when I left the office and I was able to make it home in about 15 minutes (instead of the normal 20 - 25).

Buster and I decided to go out for a nice dinner. I had a gift card I received from my co-workers at Christmas that would work at one of the fancy restaurants in town, so it was even a free, nice dinner. We had some excellent steaks (although Buster ate his way too rare, but then again, he always does) followed by an even more spectacular dessert. Neither of us took a book to dinner (which is an unusual occurance for us) and we sat and talked and ate. There were definately pauses in conversation, but they were those comfortable silences that being together for over 10 years can produce. (Good God(dess), it really has been over 10 years! Damn that means I must be getting old!) True, we missed the last of the good episodes of American Idol (it's no fun once they actually start singing. I just like watching the drama of the auditions and selection process), but I got Buster home in time for him to watch Lost. (Gotta make sure my man gets to see his stories. He can get cranky if he misses them). All in all, it was a very nice evening. I almost managed to forget about school for an entire night. Of course, this means I have to finish my reading tonight so I can start watching the lectures. Wheeee, a fun filled night curled up on the sofa, watching Survivor and reading about disorders of the peripheral nervous system. Man I lead such an exciting life.

Well, almost time for class. Today's topic is thoracic injuries. Now I know you're jealous. Chest injuries AND peripheral nervous system disorders in the same day........

Tuesday, February 14, 2006

 

Deep thoughts on a light and fluffy day

Today seems to be a day for deep thoughts, despite it being Valentine's day (which Buster does not like, so it is not usually a big deal in our house, although he manages to surprise me every so often).

I started the day off reading two amazing blogs. The first was by PaedsRN (http://geeknurse.blogspot.com/2006/02/day-in-life-ii.html) dealing with a day in his life as a nurse in a Pediatric ICU. He talks about meeting with the parents of a kid who he had taken off of life support. OH MY GAWD!!!!!! I have no idea of how he could do something like that. He talks about going off to a room and having a good cry afterwards, but I can't imagine trying to hold out long enough to get to private.

The other blog was by Jen, SN (http://jensn.ceejayoz.com/2006/02/01/preceptorship-day-2/) and it described a code she participated in. Not being especially sensitive to things I read, this still had me squirming. Then the thought struck me, "And this is what I want to do!?!?!?" Never having worked a code myself, let alone something like she describes, I don't know how it's going to affect me. I like to think that I will be able to control myself long enough to get the job done and deal with it in a healthy, constructive manner afterwards. I would also like to be thin and fabulous! Not sure which one is more likely to happen though.

This got me to thinking about if there are areas of nursing that some people are better suited for than others. I have seen a couple of my classmates blossom in different settings. One classmate, Big-D, had better go into pediatrics or the rest of the class will hound him until he does. He managed to connect with the kids in our peds rotation better than the rest of us together. The sight of him walking the halls with his patient still makes me giggle when I think about it. There is just something very amusing about a 6'5" (and change) white man in a white student nurse uniform walking the halls talking with a little 2 year old Black girl. Another classmate, Pregnant-S, managed to connect with the psych patients better than some of the regular nurses there. I don't think that I have found an area where I "clicked" quite like that. Or maybe it's one of those things that you can't see for yourself and everyone around me has seen it and just not told me. Oh well, none of this changes my plans. I still have more time on the neuro unit, and then my preceptorship next quarter. Still plenty of time to find if there is a place out there I am destined for, or if I will have to hunt for it some more.

Buster went to see a sleep specialist yesterday, and he goes in for a sleep evaluation next week. Hopefully that will go well and the doctor will be able to do something for his snoring (which has gotten AWFUL in the last 6 months or so). Not sure yet if it will be surgical or a CPAP machine, that will be determined after his sleep study. Part of me is hoping for a suggestion of surgery, but then again, that CPAP mask is so totally hot that it might be better!

The sleep doctor mentioned that his blood pressure was high. His primary doctor had mentioned it last time he was in, so I bought a blood pressure cuff at the local nursing uniform store. When I took it, it was high, not "get in the car, we're going to the emergency room" high, but high enough that I was wondering if I was doing it right (the combination of techs and automated machines on the units have made me less than confident in my auscultation abilities). We'll take it serially for a while and see what I get. The good news is that both of us have agreed that we need to make some lifestyle changes and have already been working on getting that set up. (Note, the use of the word "diet" is avoided. That implies a short term thing and neither of us can allow this to be a short term thing.)

Hmmmmm, this post has been significantly longer than I was anticipating. Either I am feeling especially introspective today, or I am avoiding doing any real work. Guess it is time to put my shoulder back to the grindstone (or hand on the mouse in this case)......

Monday, February 13, 2006

 

Another weekend over and done

I managed to survive the first day of my rotation on the neuro unit. All I have to say is that our instructor for this half of the quarter is SCARY!!!! She comes across as a complete be-otch, and almost told us flat out that she is a be-otch (I think her exact words were "I'm really tough"). Despite her being exceedingly scary and most likely cranky, I get the impression that she is DAMN good at her job. I suppose it takes a certain attitude to be a female nurse practioner in a neuro unit. I bet on a regular basis she has to show stuck-up neurologists that she has a set of gonads just as large as they do and is just as capable as they are. I only have 3 more weeks with her, but I'm going to learn as much from her as I can.

One cool thing that happened Saturday was that I got to go with a patient down to the CT lab and watch from the control room as she had her scan. It was SOOOOO cool watching the images come up on the screen. What was even more cool was that I noticed some deviation as the images where coming up. The CT tech confirmed what I saw as the patient was getting back into her wheelchair. I guess some of that schoolin' managed to sink in after all! Later in the day, I was able to find an iregularity in another set of CT scans based on the radiologist's report. Hmmm, maybe neuro is where I should be working.....

Based on the one day there, I think I could probably handle working on a neuro unit after graduation, at least for a while. It is amazing to see the range of problems brain injuries can cause. Two very similar issues will have different presentations in two different people. The brain truly is an amazing piece of meat.

Sunday was a day for me to really get my geek on (as if getting excited about being able to read a CT scan is not geeky enough). It was time for another exciting episode of our long standing role-playing game! We are currently working through a Dark Ages: Vampire chronicle (check out www.white-wolf.com for more info) which started our characters becoming vampires in 1099, and is supposed to take us to sometime in the early 21st century. Needless to say, this is not something to be done in a couple of sessions. This week also saw the introduction of a new person (and associated character). Buster invited on of his co-workers to come over and play, since she was completely fascinated with the whole idea. It was just a little scary how well she fit in!

During this week's adventure not too much happened (partly because we had to work to incorporate our new person). My character (think Shrek, but as a vampire with a slight bit of medieval European Christian fanaticism thrown in) was formally put in charge of a city in the south-eastern part of Transylvania (just a co-incidence). For some reason, which neither I nor the character understand, his sire (the vampire who made him into a vampire) wanted him to take another step toward a blood oath with him (in this universe, a blood oath turns the person drinking the blood into the other vampire's butt-monkey). Needless to say, when he refused, it was not take well. So my character is off to run a good sized city while in a questionable domestic situation, with only the help of some other vampires who he doesn't exactly trust (for a number of different reasons). Fun, fun, fun!

Hopefully this week will go smoothly. I still have about 3 chapters to read in my med-surg book and a couple of hours of lecture to watch, but that shouldn't be too terrible. Of course, this is what I say on Monday, God(dess) only knows what will happen in the next several days.....

Thursday, February 09, 2006

 

A busy couple of days

Okay, things have been a little crazy the last couple of days (imagine that, a nursing student having some crazy days!).

Things started out last Thursday (2/2), literally a couple of minutes after my last post on that day. Just before class started, my friend School-Wife tells me "Oh by the way, Crazy-Clinical-Instructor won't be our instructor anymore." Naturally curious, I asked "Why?". The response was "Oh, he showed up to his clinical group yesterday completely drunk." Well naturally, this explained A LOT about his behavior (and odor) during our Saturday clinicals.

So Saturday rolls around, and we do not know for certain who will be there for our clinicals. This is not too big of a deal since it was our last day on the "behavioral health unit" (translated: psychiatric unit), and we were only planning on bringing breakfast type foods for the staff as a thank you, doing midquarter evaluations, and then going out for a celebratory lunch. I heard a rumor that our instructor was going to be the same NP we had last quarter, which would work out very well for me since I still need a recommendation form for this fellowship after graduation. No such luck though. Our sub turns out to be one of the instructors that I have never met in person before (so much of the recommendation form). That is one of the biggest issues with doing nursing school as an on-line program; it's a little difficult to get recommendations. So, we hang out there for a couple hours, do all of our paperwork, and decide to call it a day. So off I go home to bury myself in homework.

Over the next couple of days, I had 5 lectures to watch (totally close to 4 hours of lecture time), a movie to watch and write a 3 page paper on, 3 case studies to complete, and a 30 minute presentation to compile (complete with handouts!). Needless to say, been a little too sick and tired of sitting in front of a computer to update my blog!

But, I have caught up on my homework for the next week or so. I should have a little more breathing room for a little while.

This Saturday, I start my clinical rotation in the neuro/rehad unit. I better brush up on my neuro assessment techniques before then. The scuttlebutt in class is that the instructor for this next rotation is a bit demanding. But she is also supposed to be very good and very willing to help you when you need it. I'm sort of looking forward to going back into a medical/surgical area becuase I will have things to do again! Of course, that means I have to wear that AWFUL white polyester uniform again......... Guess we have to pay for the good things in some way or another.....

Friday, February 03, 2006

 

Penicillin and potatoes

I just read a very interesting article. http://www.msnbc.msn.com/id/11148598/

Appearantly, medical clinics are opening in grocery stores and Walmarts (boo! hiss!). So, in some towns, you can stop in to pick up some groceries and have that nagging sore throat checked out at the same time. I'm not exactly sure if this is a good thing or not.

According to this article, these clinics are staffed with PAs and nurses (and assumingly NPs). They are meant to deal with "minor" illnesses. But what do they do if someone comes in with what he assumes in a minor problem, and it turns out to be a major one? It also appears that these clinics will work from sets of standing orders. While standing orders are okay in some circumstances, do we really want to reduce healthcare to a list of checkboxes on a form? Healthcare is not a one size fits all thing. Every patient should have his/her entire health situation considered during an examination. That is a little difficult to do when the background noise is the beep of cash registers.

While I support the idea of community based healthcare, and making healthcare more accessible, I'm not sure that Sam's Choice/Big K/ healthcare is the best way to do it.

Thursday, February 02, 2006

 

Feeling much better now

Well, my interview is done. It was the pretty standard, first round interview questions. "Describe your customer service philosophy.", "How do you deal with a difficult person?". Yada, yada, yada. Of course, there is more paperwork to do. Appearantly, instead of "letters of recommendation" (which is exactly what the paperwork said to get), they have this specific form to fill out. This form is about 10 questions, with a scale of 1 to 4. Like this really says anything about you.

My theory exam is over and done with too. (This has been a busy morning!) I got a 51 of 60 (85%) before any of the questions are "reviewed" (note, our tests are not curved, they are "reviewed for abnormally high item difficulty". A fancy way of saying curved.) I would have liked to have done better, but as we say in nursing school "a C means see ya next quarter!".

Well, class is getting ready to start.............

 

A little bit o' stress

Just a couple of minutes before I leave, but I will post this anyway.

In just about an hour, I will be sitting down for my first interview for a nursing job. OMG! I guess this is going to be real after all! This interview is the first of 3 for a fellowship that I really want to get. It's a 20 week fellowship in critical care nursing, and I will be able to work in an ICU or ED after the fellowship is over. This is MUCH better than putting in a year of time on a Med/Surg floor.

I am trying to remain positive about this. If this does not work out, there is a hospital just up the street that will let new grads work in the ED. But, this is only a level 3 center, so it would not get all the cool and/or crazy patients. What is meant to happen will happen in the end.

Okay, time for me to go. I'll post more after the interview.........

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