COWman's Corner of the Web

Who gets what?

2008-05-05T13:40:00.002-04:00

I came across an interesting article on Yahoo today. It seems that people are starting to realize that in cases of a pandemic disease outbreak, there will just not be enough health care to go around. This is nothing new to those of us in health care. Most of us see this, albeit on a small scale, just about every day. Every day, we see doctors trying to balance needs for medications and/or tests against what we have in house or what the patient can afford. And any of us who have been trained on mass casualty triage models know are that sometimes you have to make a difficult decisions about who not to spend resources on. In a perfect world, there would always be enought to go around all the time, but we all know that this is just not the case.

I would like to see the whole report before I pass judgement on if I agree with these guidelines or not. There are a few things that concern me though. According to the article, these groups would not receive treatment during a pandemic:

_People older than 85.
_Those with severe trauma, which could include critical injuries from car crashes and
shootings.
_Severely burned patients older than 60.
_Those with severe mental impairment, which could include advanced Alzheimer's disease.
_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly
controlled diabetes.

There just seems to be too much room for interpretation in these. How is a "severe mental impairment" defined? Would this mean that a MRDD person would be denied treatment? And 85 seems to be a rather arbitrary limit. I have had patients who were 65 with poorer chances of long term survival than some of my 90 year old patients. Simply picking a number seems a bit simplistic to me.

Of course, we will have to come up with some kind of system for situations like this. Unfortunately, almost any system is going to have to draw the line somewhere. I just hope that there are people out there a lot wiser and smarter to me working on this problem, because I know that I don't have any good answers to this question.

I....am.....Iron.....Nurse!

2008-05-04T20:44:00.007-04:00

Buster, our friend BH, and I went to see Iron Man today. Definitely one of the better comic book movies recently. If you have not gone to see it yet, you have to stay through the whole credits. There is a scene after the credits that should have all of the fan-boys out there speculating wildly about the sequel.

The pictures above came from an article on MSNBC about the history of exosuits and the uses that researchers are using them for. The 2 pictures above are suits that have been or are currently being researched in Japan for use by nurses "in helping lift patients".

Now, is it just me, or does this seem a bit excessive? Firstly, the one on the left looks more like something out of a video game (Halo anyone?). And what is he holding? Is it some new machine way of starting an IV (although it does look like something you could use for starting an IO). And Just imagine the reaction of a patient when you walk into a room dressed like some creepy cosplay reject?

Can you imagine wearing one of these things for a 12 hour shift. Neither one of these contraptions looks particularly comfortable. I doubt that suit of battle armor has a handy flap either for that one time in your shift you can actually run to the bathroom. Maybe it comes with a handy foley preinstalled.....

Scope of (blog) practice

2008-04-22T10:38:00.005-04:00

Ever nurse runs into questions about their scope practice. Recently, I've had something I've wanted to discuss here, but was not sure how much of it to reveal since it was primarily regarding my private life. Unlike many of my co-workers, I believe in keeping my private life separate and distinct from my professional life. However, the issue has been confused since I think that the reason I am in this situation is a direct result of my growth and maturation as a nurse.

After much deliberation, I have decided to keep this blog about my professional life and keep discussions of a strictly personal nature out of it. I have decided that this blog will not contain anything I would not want to talk to my boss about. There will continue to be some references to my personal life and personal relationships since it is impossible to completely separate things, but the focus of this blog will be professional. That being said, I am in the process of starting another blog where I can write about more personal things, which will of course contain some references to being a nurse and nursing. And no, it will not be linked off of this blog, or my blogger profile. That would kind of defeat the purpose of separate blogs. =)

I just realized that I am writing this on Earth Day, and I should probably have addressed that, but since I don't really have anything along those lines, this is what you get today.

Place holding post

2008-04-17T11:54:00.002-04:00

I have something I want to post, but have not quite figured out how to say it yet. This post is here just to keep me in the habit of posting.

Looking at this picture makes me giggle. If I tried to do this with either of my cats, I would be giving blood, just not in any sort of controllable, useful way. =)

I have to work all weekend (like always), so will probably not be posting over the weekend, but who knows. Hopefully by Monday, I will have this idea worked out enough to put on paper (or the Blogger or whatever.......)

Oh, the conversations you will have.....

2008-04-15T10:42:00.004-04:00

Sometimes I wonder just what nurses will *NOT* discuss amongst themselves. We had a conversation this weekend at work that made me feel much the same way as this cat here.

One of our nurse practitioners was telling us about some of her more memorable gynecological exams, most of which involved the removal of some kind of foreign body. The whole conversation was a little disturbing, but the best part of it was when she said,

"I know they say a hard penis has no conscience, but is it blind and with no sense of smell too?"

As the sole representative of the male gender in this conversation, everyone looked to me for an answer. I had to point out that I could not exactly answer that question from personal experience, but seeing some of the partners that men I know have hooked up with, I had to say the answer was probably yes.

I just never thought I would be having a conversation about preferences of the penis 1) while at work, or 2) with a woman who is probably close to the same age as my mother.

And this was just the part of the conversation that I can write about and maintain a PG-13 rating........

I feel unclean now............

This has been me

2008-04-14T10:25:00.002-04:00

Okay, so not been having any CAT scans, but I have been just about this lazy lately. I did not realize that it has been like 7 months since I made an update here. Guess it has taken me a little more time than I thought to get settled into life here in the south.

It has been a bit of a shock moving here to the deep south. Things just move at such a different pace than life in Ohio. I never thought that the midwest was especially hectic or fast paced, but in comparison, life here seems to be sssssssssllllllllllllloooooooooooooowwwwwwww. Guess there is just a different concept of time here. I predict that I will never quite adapt to it, and I will always be seen as one of those dreaded "Yanks".

I will attempt to make more updates here........ then again, I've said that before........

A successful (?) transplant

2007-09-19T10:37:00.000-04:00

Well folks, despite the lack of updates, I am still alive and kicking. I am now living in the thriving metropolis of Valdosta Georgia. I've recently started working in the ED of one of the local hospitals. I've made it through the horror that is class room orientation, and now have a couple of shifts on the floor under my belt. It didn't take long to notice how much things are the same, despite the change in scenery.

Buster seems to be settling into his new job easily enough. He's had a little bit of head start on getting settled so he should be. He seems to enjoying being the boss and everything, at least most of the time. The other night he spent some time venting to be about the "joys" of being the boss.

The move itself was uneventful enough. Of course, doing it in stages helped a lot. Also, since Buster got a moving allowance, having professionals come in with semi-trucks to load and unload went a VERY long way to make it a livable experience. It was also very nice that Buster had the house all nice and settled when I finally made it here.

I'm sure that I will start having more to say now that life is back to normal (or as close to normal as it ever gets),

I wish we could do this

2007-04-14T10:10:00.000-04:00

I soooooo wish we could set up our ER like this! But of course, in our ER, we would have to change the doors to simply clean and dirty. I realize that as an ER, our patient load has an over representation of the lower socio-economic groups, and that the area served by our hospital borders on Appalachia. And I remember from nursing school that different cultural groups have different expectations about things, including hygiene.

But still, come on people if you know that you are going to see a doctor, and you have the strength and/or energy (I can make an exception in cases of sudden injury or severe illness), do everyone a favor and wash!

It never ceases to amaze me the wonderous, olfactory experience that a day at work is. The majority of the smells come from just general, old fashioned BO, some of it older than others. This I have learned to simply tune out. I have also become pretty good at ignoring the smells of the bedside commodes/bedpans (except in cases of GI bleeds, those are a whole different animal).

Then there are the smells that I don't think I will ever get used to. The first is the smell of necrotic (dead and rotting) tissue. Last week, I had a necrotic foot ulcer. It took some major willpower to get down there close to it so that I could do an assessment. The patient tried to tell me that it developed since the last doctor's appointment, but there is no way you get that much rotted flesh in 10 days.

The other smell that I almost could not deal with was the smell of what I affectionately referred to as "Kentucky Fried Foot". I had a patient come in at 0100 saying that they spilled a pan of grease on their foot. Appearantly, they had been frying chicken and they decided to dump out the pan in their bare feet, and spilled it all over their foot. Judging from the barely pink look of their foot, I'm guessing the grease was pretty much cooled. Of course, behaviorally, you would have thought that there were third degree burns all over their whole foot. Of course, the foot was not washed before coming to the ER, so the whole area smelled like fried chicken. Again, it was a real test of will to get down close to assess that fried foot.

Don't worry nurses, I get you

2007-04-07T10:29:00.000-04:00

I found this image to be rather amusing. As we all know, a nurse in doubt should always consult his/her "readily" (and I use that word losely) available reference materials on his/her unit, and/or the unit's policies and procedures. Appearantly, where this nurse works, those materials are kept in another building, somewhere on a wind swept moor. And you thought tracking down the drug book at the nurse's station was annoying. Imagine having to put on your cape ever time you needed it.

The title of this entry is a direct quote from my hospital's chief of police during a talk he gave during our nurse education days. He said that he is married to a nurse, so therefor he has an understanding of what makes nurses tick. This got me to thinking about whether or not nurses are any different than any other group of professionals.

The answer that I came up with was a resounding "Yes". I also think that nurses in specific work areas are very different than nurses in other work areas. Personally, I can't imagine working anywhere other than a emergency room. There is just something about the barely controlled chaos, the unrelenting urgency, the collisons with coworkers at every corner, the constant interuptions, etc. that keeps me going. The idea of working on a floor, or worse, in a clinic setting, makes me want to run screaming for the hills (not that I don't appreciate those nurses or their skills, just not the place for me).

I think the best evidence that I have that I should be an ER nurse happened just after New Year's. In our current department, our trauma room opens directly into our kitchen area. Since we do not have a break room at the moment, if you want to grab a quick bite during your shift, you have to do it in the kitchen. One Sunday night, I was eating my lunch in the kitchen (since the cafeteria was closed at that point) while we had a patient come into the trauma room in full arrest. Since the rest of the department was pretty slow, a number of us were standing in the doorway watching and/or being available to help during the code. I calmly stood there eating my lunch while the code went on. Another nurse saw this and said, "You are a true ER nurse if you can eat during a code". But then again, I was not the only one doing it either.......

It's things like that which convince me that us nurses are a special group of people. We have a........... unique sense of humor, and general view of life. The more different nurse's blogs I read, the more I realize that we nurses just are not quite "right", and most of us would not have it any other way!

Returning to the blog-osphere

2007-03-31T16:09:00.000-04:00

So, I am finally getting back to blogging again. Not 100% sure why it's been so long since my last update, but here I am again.

Lots of things going on since the last time I was here. Buster has finally found a new job. He has accepted a job in Valdosta Georgia (hence the picture of the freeway sign above. It's amazing what one can find my doing a Google search). He will be going down there the first of May, and I will be following as soon as our house sells. Of course, that means anywhere from June to God(dess) only knows when. Hopefully things will not take too long to sell. We're going to be using the same real estate agent who sold us the house, and she really knows this neighborhood, which will help. Of course, if any of you out there know someone looking a nice house in a really good neighborhood in Columbus Ohio, drop me a line! =D

I've started looking at nursing jobs down there. It looks like jobs are pretty scarce in Valdosta itself (per the main hospital's website) which is not that unusual considering that there is a nursing school there in town. However, it looks like there are jobs in several different hospitals not too far from town. I'm really hoping to get into an ER down there, but I will take what I can get.

I will have to be more vigilant about this keeping up my blog. According to the workshop we had about stress reduction at work, journalling is a good way to reduce stress and something tells me that there will be some of that in my life for the foreseeable future.

Funny Email

2007-01-05T13:08:00.000-05:00

I got this in email today. I've seen it several times before, but I still find it funny.... My responses are after each set.

********************************************************************************
Graduate versus Experienced Nurses

A Graduate Nurse throws up when the patient does.
An experienced nurse calls housekeeping when a patient throws up [CHECK]

A Graduate Nurse wears so many pins on their name badge you can´t read it.
An experienced nurse doesn´t wear a name badge for liability reasons [Not applicable, due to our policies]

A Graduate Nurse charts too much. [Is there really such a thing as too much?]
An experienced nurse doesn´t chart enough.

A Graduate Nurse loves to run to codes.
An experienced nurse makes graduate nurses run to codes. [Still waiting on this one]

A Graduate Nurse wants everyone to know they are a nurse. [Still here]
An experienced nurse doesn´t want anyone to know they are a nurse.

A Graduate Nurse keeps detailed notes on a pad.
An experienced nurse writes on the back of their hand, paper scraps,napkins, etc. [I try to keep a pad, but when in a rush]

A Graduate Nurse will spend all day trying to reorient a patient.
An experienced nurse will chart the patient is disoriented and restrain them. [Restraints only if they are dangerous. Makes them too noisy otherwise]

A Graduate Nurse can hear a beeping I-med at 50 yards. [I can hear them, but tracking down which one is always the chore]
An experienced nurse can´t hear any alarms at any distance.

A Graduate Nurse loves to hear abnormal heart and breath sounds.
An experienced nurse doesn´t want to know about them unless the patient is symptomatic. [You'd be amazed what people walk around with and it doesn't even phase them...]

A Graduate Nurse spends 2 hours giving a patient a bath.
An experienced nurse lets the CNA give the patient a bath. [I personally hate giving baths. Another perk of working in an ER, we don't have the time for baths!]

A Graduate Nurse thinks people respect nurses.
An experienced nurse knows everybody blames everything on the nurse. [One day on the floor, and you know this one]

A Graduate Nurse looks for blood on a bandage hoping they will get to change it.
An experienced nurse knows a little blood never hurt anybody. [You should see it when I have to start an IV.......]

A Graduate Nurse looks for a chance "to work with the family."
An experienced nurse avoids the family. [Families are usually worse than the patients...]

A Graduate Nurse expects meds and supplies to be delivered on time.
An experienced nurse expects them to never be delivered at all. [I expect to get my orders, right before the patient is discharged/admitted]

A Graduate Nurse will spend days bladder training an incontinent patient.
An experienced nurse will insert a Foley catheter. [Foleys are a nurses best friend]

A Graduate Nurse always answers their phone.
An experienced nurse checks their caller ID before answering the phone. [Had this one before I became a nurse]

A Graduate Nurse thinks psych patients are interesting.
An experienced nurse thinks psych patients are crazy. [They can be interesting, in someone else's section]

A Graduate Nurse carries reference books in their bag.
An experienced nurse carries magazines, lunch, and some "cough syrup" in their bag. [I carried reference books for all of a day. Now if it isn't on my PDA, I don't need to know it]

A Graduate Nurse doesn´t find this funny.
An experienced nurse does. [I find this hysterical]

*******************************************************************************

Based on this test, I guess I am well on my way to being an experienced nurse........

Something Buster found

2007-01-04T16:22:00.000-05:00

You are The High Priestess

Science, Wisdom, Knowledge, Education.

The High Priestess is the card of knowledge, instinctual, supernatural, secret knowledge. She holds scrolls of arcane information that she might, or might not reveal to you. The moon crown on her head as well as the crescent by her foot indicates her willingness to illuminate what you otherwise might not see, reveal the secrets you need to know. The High Priestess is also associated with the moon however and can also indicate change or fluxuation, particularily when it comes to your moods.

What Tarot Card are You?
Take the Test to Find Out.

When I grow up

2007-01-04T15:54:00.000-05:00

You would think that by this point in my life, I would know what I want to be when I grow up. In truth, nothing is farther from the truth. I started classes (again) this week, this time in preparation for taking the MCAT. At one point, I had to ask myself, "What in God(dess)'s name do I think I am doing? I just finished school, and here I am, setting myself up for another 10 plus years of it?" Of course, shortly after this, I had to work with a doctor who had his panties in such a knot that most of the nursing staff was about ready to jump him in a dark parking lot. Then I realized why I was setting myself up for a decade of hell, so I can tell doctors like him that he is being an a**hole and to start acting like the civilized, educated, profession he is supposed to be. I realize that I could still tell him now (and probably will one night if he pisses me off enough), but people like that really do not listen if they think you are "beneath" them in some way. I guess it all goes back to the idea that if you think you can do domething better than someone else, just do it yourself.

I guess that things at work are going okay. I still have my moments that I feel like I am drowning, but I think that is just part of the job and not really a reflection on what I can or can not do. I still feel like I ask for a lot more help than other people, but I think I am starting to balance it out some by being helpful for other people when they are getting swamped. Hopefully soon, it will actually feel like I am being a useful part of the team. However, none of the supervisors have given parts of my assignments to other nurses. Actually, just the opposite, I have been asked to help out other nurses by taking a part of their assignment (in all honesty, that night, I had pretty easy patients, even with my assignment being "front beds" [meaning, the beds directly in front of the nurse's station, used for the most critical patients]). Guess I should take that as a positive sign.....

Do you know a good butt doctor?

2006-12-15T11:48:00.000-05:00

Yes, that title is exactly how the conversation started! I had stopped at a convience store on my way to the hospital Wednesday afternoon, and when I went to the checkout counter to pay, that was the first question the clerk asked me. She then went on to talk about how her current doctor was not treating her Crohn's disease and she wanted a second opinion. I explained to her that I worked in the ER, and all the doctors I worked with were exclusively ER doctors. I did tell her she could contact our referral line, and they could set her up with an appropriate doctor. I am still trying to get used to the fact that people see you in scrubs and they will tell you anything......

Last night, I was reading an article in the latest issue of Men in Nursing about where are all the men in nursing. Hmmm, with images like the one above used to represent nursing, we wonder why more men do not want to be nurses. Not too many of the men (and actually, many of the women too) I know particularly want to be considered a "Greatest Mother". I realize that this particular image is pretty old, but I can see something like this still being used today. While I'm not exactly sure how to change it, but this type of image are not helping recruit men (or women) into nursing. Okay, stepping off of the soapbox now........

Mids? Yuck!

2006-12-11T19:55:00.000-05:00

Is it just me, or is this outfit and hairstyle a little impractical for a real nurse? I mean, one chest pain patient, and her hair is going to be totally flat (unless she is using industrial strength epoxy as a styling product.......) Actually, I think this picture came from a website that was the results of a hair styling competition. I don't remember where this particular style placed, but it explains the lack of any real-world application of this particular look.

Now that I'm working my assigned schedule, I have come to the conclusion that working midshift sucks! There is just something very wrong about going to work at 3 in the afternoon, and working until 3 in the morning. Working that late pretty much ruins the next day too, since you spend a good portion of it in bed. Oh well, I'm hoping that I will only need to work this shift until next summer when we open our new ED, and we basically have to triple our staff on each shift (unless management decides to totally p**s off the nurses and drastically increase our patient ratios). I just have to put in my time, and eventually I will be able to get on days. Until then, I will just have to reset my body clock about 8 hours ahead of where it is now.

Lately I've been a bit confused about what step I want to take next, in terms of my education and career. Now that I'm working in the healthcare field, I know that it is the correct field for me, but I'm already getting frustrated with how some of the doctors do things. Not just what he/she does, but how he/she actually interacts and does her job. It's really frustrating when a patient has been waiting for an hour to see a doc, and the doc is in his work area/cubby hole looking up football scores on the internet.

Combining this frustration with the fact that I've been told for about half of my life I should be a doctor, I've looked into going to medical school. From what I've seen, I need 5 quarters worth of classes to cover the sciences I didn't take earlier and to prep for the MCAT. That being said, I paid my tuition and bought books again today. Starting in a couple of weeks, I will be taking Chemistry 2 (I have transfer credit for chem 1), Biology 1, and Physics 100. Spring quarter will be another crazy quarter with 3 classes, but after than, I will be taking 2 at a time. Over the next year, I will be taking 2 quarters of biology, 4 quarters of physics, and one hell of a lot of chemistry, including organic. Not exactly my idea of fun, but then again, it kind of is.

After all of this, I will take the MCAT. Once I see how well I do on that, I will have to sit down and make the actual decision about what my next degree will be. I will cross that bridge when I get to it......

Country Driving and other random musings.....

2006-11-10T18:07:00.000-05:00

Yes, this is me whenever I have to hook a patient up to the cardiac monitor (okay, I am still a man, but I end up looking very similar to that). I am not sure how 5 leads can get so tangled up, but they do. It doesn't seem to matter if I untangle the leads before or after I attach the pads (here's a hint for all those nursing students out there: attach the electrodes to your leads before you stick them to your patient, especially if they are the kind of electrodes with the little metal button that the clips attach to) I end up with a mess very similar to that shown above when I go to start attaching it to the patients. I guess I should not be too concerned, from what I have seen, everyone has the same problem with leads.

The last 10 years of driving in urban/suburban roads had made me forget the fun of driving on country roads. Now that I am driving through the country on my way to work and back, I get to experience the country in all it's olfactory glory. I had forgotten/repressed the glorious smell of cow pastures and dead skunks. Luckily it has been dark most of the time, so I can't play my favorite game of "Guess the Roadkill".

I've been wondering if you can actually call it working day shift, if you do not actually get to see the sun? I don't know why there are never any windows in an Emergency room, but I have never been in one with any windows to the outside world. This time of year, when I am working a 0700 to 1900 shift, I actually drive to work in the dark and leave for home in the dark. The other day, I actually had to stop and think "Did I even see the sun today?" After a couple of minutes, I decided that yes, I had because I saw outside throught the doors of the ambulance entrance. I'm not sure which is worse, the fact that I had to stop and think about that, or the answer.

Too much time on my hands.......

2006-10-25T20:08:00.000-04:00

I am going to have to get used to only working 3 days a week. It seems like I have waaaaaay to much free time. I realize that I am actually working full time by working 3, 12 hour shifts, but that is a huge change from working 5 days, and going to school most of another day. It will be better once I am out of my training period, and I can pick up some extra shifts (cha-ching!), but until then, I feel like I am cheating somehow.

I can see now why people work contingent at second hospitals. My next goal is to go back to school and work on my masters. I still might look into it, even while going to school. We will have to see how much time classes take up, and how many extra shifts I am working.

Of course, all these plans may be upset by the Spousal-Equivalent. He is applying for a couple of jobs up in suburban Detroit. Not exactly my first choice of places, but if that is where his career needs to go, then we go. One of the good things about nursing is that I can get a job just about anywhere in the country.

Well, I am off to work tomorrow. Hopefully by the end of the week, I will actually feel like I am starting to have a clue as to what I am doing around that place.

It's the little things

2006-10-19T21:03:00.000-04:00

It is funny what makes you actually feel like you've finally achieved a goal. For me, it is the fact that I can access the Pyxis (the medication station pictured above for you non-medical folks out there) on my own.

For those of you not in the know, the machine shown above is what holds the medications for a unit. The screen above is a touch screen that you use to look up patients and medications. There is also a keyboard and a fingerprint reader. You sign in with your ID and then scan your fingerprint. After that, you look up your patient and medication, and it opens the drawer and/or door and tells you where in that drawer the medication you requested is. All in all, a kind of cool process.

Of course, as a student, we are not allowed into the system since there are narcotics and other fun drugs in there. So we always had to find our instructor or a nurse to get stuff out of it for us. Now that I am a real life nurse, I can get my own medications from the system. It is a little weird that I can just walk up and get things out. Of all the things that come with getting a new job as a nurse (the big RN embroidered on our scrub tops, the letters on my ID badge, the 2 weeks of nurse orientation, etc), this is what actually makes it feel real. Like I said, it's the little things that matter sometimes.

Of course, I would LOVE it if our Pyxis was all out in the open like this one. Our medstation is crammed in the corner with a set of shelves right behind it so that you can barely get the drawers open all the way. And our supply station is out in the hallway so that you're in danger of getting run over when you are standing there getting supplies out.

A scene from inside my stomach

2006-10-16T17:36:00.000-04:00

Well, tomorrow is my first day on the unit, so I am just a little nervous. Instead of having butterflies in my stomach, I think they are a tad bigger. Probably something along the lines of these critters, only they don't have quite that much space to move in.

I am trying to stay positive about things. I know that 1) I will not just be thrown to the wolves/patients and expected to survive, and 2) I have the knowledge and skills to do the job, or else I would not be there. I will have a preceptor/mentor for as long as I need it, I just have no idea what she is like. Hopefully we'll get along good, because I would rather not go through the hassel (and interpersonal fallout) of getting a new one.

Oh well, I just need to go to my happy place........

I'm off to cook some dinner and try to unwind....... More as it develops.....

Finally an Update

2006-10-07T08:51:00.000-04:00

Okay, I realize that I'm just starting out as a nurse, but shouldn't the people in this picture actually be doing something with/for that patient?

I am finally getting around to doing another entry here. I didn't quite realize that it has been quite this long since my last update. But, until recently, I have not really had much of anything to tell.

The good news, is that I am finally working as a nurse! Woo woo wookie wookie yay! I got a job as an ER nurse at a community hopsital not too far outside the city. It's a bit of a drive (about 30 miles one way), but I will be traveling against traffic, and my shift will be at odd hours (compared to rush hour at least), so that will not be too bad. I will probably start looking for something a little closer, with a few more opportunities in a year or so, once I have worked off the "new grad" label.

This week has been nothing but orientation. I still have not set foot in the actual ED yet, other than my interview. I still have another full week of orientation before I get "let loose". Hopefully, after next week, I will actually start having some interesting adventures. I am already a little tired of classroom work. Let me at the patients!

Well, on second thought, maybe I don't want to be near them just yet...........

More to follow (hopefully).........

I got nothin' today

2006-07-14T08:19:00.000-04:00

So I just thought I would share this picture I found online.

Is it really a carnival without clowns?

2006-07-13T07:12:00.000-04:00

Come one! Come all! The latest issue of the best nursing blog carnival is up and running. Check out

As always, Kim at Emergiblog did an amazing job putting everything together. Laughter, tears, a little bit of everything. Take a peek inside your a nurse's head. It not (usually) as scary as you might think.

Some (hopefully) helpful advice

2006-07-12T07:36:00.000-04:00

Since it is time for another issue of Change of Shift, I thought I would provide some completely unsolicited and totally subjective advice about surviving the NCLEX. So, here you go. Here is the standard obvious disclaimer: the opinions expressed here are solely those of the poster and are in no way connected to anyone with an actual say in the matter. Your mileage may vary. Do not submerge. Clean with soft cloth only. May cause drowsiness; use care when driving or operating dangerous equipment......

How to Survive (but definately not enjoy) your NCLEX Experience

Breathe
Remember that you have earned the right to be there. If you were not going to pass, you would not be there. No nursing school is going to send you out to fail, and they have made sure you will pass.
Inhale, exhale, repeat as necessary
Block out the entire day, but do not schedule anything else. Set aside the entire day (7:00am to 7:00pm). You will definately not that much time, but you don't want to be worried making that afternoon appointment.
Breathe
Take your time and go slow. Read the entire question and all of the answer options before you even try to answer it. Read the question a second time, then select the appropriate answer.
Lather, rinse, repeat. (Oooops. Wrong list.....)
Keep breathing
Stay in the now. Forget a question as soon as you move to the next one. Don't worry about the next question until you see it. The only question that matters is the one on the screen. The past can not be changed (and you can't go back to change and answer) and the future is yet to happen (and you have no idea what the next question will be).
Inhale, exhale, repeat as necessary.
Don't be afraid to take a break. If you need to leave the room, do it (follow your testing center's instructions for leaving the room!!!). If nothing else, every couple of questions, just close your eyes and take a couple of cleansing breaths.
Preheat the oven to 350 degrees. (Darn it! Wrong list again..........)
Pamper yourself after you are done. Go out to a nice lunch. Sit in a park, reading your favorite trashy type of novel. Celebrate with a huge chocolate sundae. Go shopping.
Keep breathing
Remind yourself that you did your best and that is all you can do. If, for some reason, you did not pass this time, you can try again. True, it will be expensive, but your license does not say how many times you took to pass the boards. You can pass the boards, and every time you need to take the exam will make you all that more familiar and comfortable with the exam.

That pretty much sums up my completely unscientific and unofficial guide to surviving the NCLEX. Hopefully it will help someone out there pass her/his boards, or give some insight to the friends/families/people who've met them once at party of nurses about just exactly how it feels to try to survice the boards.

It's really official

2006-07-10T07:53:00.000-04:00

I found this picture on the web one day, and I just knew that I would have to use it in a post after I passed my boards. According to the caption, these are the male nurses on staff at Dixmont Hospital in Dixmont, PA sometime around 1920. My guess is that the majority of these guys were nurses in world war 1, but that is just a guess based on what I know about the history of nursing. However, it is still nice to have an idea of who my professional "forefathers" were.

Saturday afternoon I received my actual, official license in the mail. In all honesty, I was expecting something a little more. I received a "certificate" that was, and I quote, "...suitable for framing..." and a cut-it-out-yourself, paper wallet card. Not exactly anything spectacular. But, it's real and official, so that is what really matters. I would have been just as exciting to get a piece of paper with one of those stickers like we got in second grade (Okay, I just went to the idea of "What would it be a scratch and sniff of?".....).

Buster got home from Kansas last night/this morning at about 1:30. Of course, he wanted to surprise me so he did not call ahead and let me know he was coming. So I just about had a heart attack when I was awakened by footsteps in the hall in the middle of the night. And our dog, being the wonderous watch dog she is, didn't do anything except wag her tail. I'm not sure if she knew who it was and was not concerned, or if she is just getting too old to care. Scary thing is, it only took me a couple of seconds to recognize the footsteps and stop being worried too. Guess I am lucky that it was Buster and not some psychopath...... (***must refrain from making comment*****)

I just checked the state board's website......

2006-07-07T08:15:00.000-04:00

.... and I have a license number, and my status is "Approved".

OH

MY

FREAKIN'

GOD(DESS)!!!!!

I PASSED THE NCLEX, AND AM NOW OFFICIALLY A NURSE!!!!!!!!

Okay...... now that I have *that* out of my system......

Now I just have to watch the mail for my actual physical license and the assorted documentation that goes with it. The feeling of relief that came from just seeing that number on the screen will be nothing compared to actually holding that piece of paper in my hands. I made the mistake of checking this while at work (like I was actually going to wait until I got home. Yeah right). Now I have to try and focus on my current job for the remainder of the day. Now comes the fun part of trying to find a nursing job. Of course, can't do that until The-Spousal-Equivalent (Buster) figures out where he is going to be working. One thing at a time....

All over but the waiting

2006-07-06T07:36:00.000-04:00

Well, yesterday was THE day. I took my NCLEX yesterday. Now I just have to sit around and wait for the results. I can check tomorrow afternoon-ish with the testing company to see if I passed or not, if I am willing to pay for it. There is a tip circulating among nursing students about checking with your state nursing board's website and trying to verify your license. According to rumor, you should be able to tell if you're being assigned a license or not. I'm not sure if this will work here in Ohio or not, but I'll give it a try. The test itself was not quite as bad as I had worked myself up to think it would be. The security of the testing center was tight. By the time I started taking the test, I was half convinced I was getting the nuclear launch codes, not taking a freakin' test. I completely understand why security like that is important, but jeeze.

In terms of the test itself, I have no idea how I did. The test shut off at 75 questions (which I have been told is statistically, a good sign) and the majority of my questions were higher difficulty prioritization questions (again, another statistical good sign from what I've been told), and there was only 1 question where I just picked an answer becuase I had absolutely no clue. I guess that I'll know tomorrow afternoon.

I really think that we should have been given a goodie bag of chocolate and Xanax when we walked out of the testing center. Last night I was simply too drained to worry about my results. Now that I have had some sleep, I am nervous. Tomorrow afternoon will not get here quickly enough.....

I'm being bad......

2006-06-23T08:00:00.000-04:00

This weekend is the annual GLBTQ Pride celebration here in the great town of Columbus, and I am not going......

I've come up with lots of reasons why I'm not going, such as 1) I need to study for the NCLEX (but that is still a week and a half away), or 2) Buster is out of town, and I don't want to go alone (but a group of people from work is going, as well as groups of friends from other places will be going). Okay, so maybe the first reason is somewhat valid, but it's not like I could not spare a few hours to do out and celebrate.

Actually, I've come to the understanding of the real reason behind my not going: these parades annoy me. There I said it, I do not like Pride. If that makes me a bad f*g, then so be it. Yes, any straight readers, even some of us are annoyed by the jockstrap wearing leather-daddies, the extra large (in height and/or weight) drag queens, and all the other walking, talking stereotypes on display. I fully support them if that is what they want to do, and I am glad that they feel comfortable enough in their own skins to walk down the middle of the street at noon. But what is missing from these parades are the gay men like me. Where are the images of the boring, "married" f*gs who have simple homes in the suburbs (and not lavish townhomes decorated to the nines), who go to work, pay taxes, shop at Macy's (not those uber-chic little shops in the trendy part of town) and all the other boring little things in life?

Also, it seems that Pride has simply become another excuse to have a party with lots of loud dance music, body glitter, and alcohol. I mean, come on, am I the only gay man out there who pays attention to the news? Look at where we are as a community, the Republican party is using us to scare voters and they want to change the constitution to discriminate against us. We are still losing friends/families/lovers to HIV/AIDS and the rates of new infection are climbing, especially in our younger members. Crystal meth and other drugs are killing us too. GLBTQ teens are still killing themselves at higher rates than their straight counterparts. We are still in physical danger when we walk the streets. Hell, the military still classifies homosexuality as a mental illness, 30 some years after the APA stopped. True, we've made advances over the last 25-30 years, but I'm not sure we've come far enough to justify all this partying.

Okay, time to shut off the evil, bitchy queen mode. There are some NCLEX review questions calling my name..........

A great big helping of blog-gy goodness

2006-06-22T07:14:00.000-04:00

It's official. Volume 1, issue 1 of Change of Shift is ready for your reading enjoyment. If you've ever wanted to get a peek inside the head of your favorite nurse, here is your chance. A great showing for the first issue of this soon-to-be-fabulous blog carnival about nurses and nursing. Take a minute or ten and check it out.

I have a date now!!!!!!!!!!!!!!!!!!!

2006-06-21T16:52:00.000-04:00

When I got home from work tonight, I had my Authorization To Test (ATT) in my email. I immediately went on-line and scheduled my boards. Exactly 2 weeks from now, I should be done with my boards. July 5th at 9:00am is the date & time!

Now I just have to buckle down and study.................

14 days and counting

Nursing diagnosis: cooties?

2006-06-21T07:18:00.000-04:00

According to the website I found this image at, this picture was from an Italian poster around 1916. I'm sure that it is supposed to be showing the patient's gratitude to her and the humility of the nurse as she accepts his thanks. However, is it just me, or does it look more like she's afraid she's going to catch something from him? If this was happening today, that would be a very real concern, not even considering that this would almost always be considered sexual harrassment. Then again, this patient has a head wound so it's possible that there is damage to the frontal lobe of his brain and he has impulse control issues. Hmmm, I seem to have stumbled across some sort of nursing thematic aptitude test (a psychological test in which the patient makes up a story about an ambigous picture and the psychologist analysizes the themes in that story as a way of looking for psychological disorders). Okay, enough geek talk for now.........

I submitted my previous entry to Change of Shift for publication. Woo woo my first official entry into a blog-carnival. I guess that makes me an official blogger. (Okay, maybe I wasn't done with the geek talk after all...........) Kim from Emergiblog is coordinating it, so I am sure it will be great. Emergiblog is one of the few blogs that I make a point to read every day since Kim is the kind of blogger I want to be when I grow up (and judging from her posts, probably the kind nurse I want to be too). She left a very positive comment, which left me all warm and fuzzy. Maybe I am doing something right with this thing after all!

Combine that with the fact I made it into the office this morning before the thunderstorm hit, so I didn't get soaked walking into work this morning, maybe this will be a good day......

Today is where my book begins

2006-06-19T08:03:00.000-04:00

Over the weekend, I was trying to come up with something to contribute to the premier issue of Change of Shift (a blog link/carnival/round table/what have you for nurses, by nurses, about nurses), since I thought it was somewhat fitting that it is starting just about the same time as I start my career as a nurse. But for whatever reason, I was coming up blank. I will be the first to admit, that deep and meaningful prose is not exactly my strong point. Then, while listening to my XM radio while reading email, I heard a song that sums up my thoughts far better than I ever could. So, with my thanks to Ms. Natasha Bedingfield, and her song, Unwritten, here are my thoughts on becoming a nurse.

I break tradition, sometimes my tries, are outside the lines

We've been conditioned to not make mistakes, but I can't live that way

Aside from some of the more obvious "nontraditional" aspects of my life, my entire time in nursing school was also nontraditional. Being the first class of "on-line" nursing students in the area caused more than a few raised eyebrows. We even had one faculty member tell us that our program was too easy (mostly because we only had 2 hours of pharmacology lab scheduled instead of 3 hours, since we did not need an hour of lab time for teaching us math). Of course, this just inspired us to prove her wrong. And that we did, when 7th quarter came around, all 19 of us passed our outcome exam on the first try, something that no class had ever done before. If you believe in statistics, this means there is a 95% chance that we will all pass our boards on the first try.

There is also the whole aspect of being a man in nursing. I had a couple of nurses during clinicals who seemed to be someone annoyed with my presence (mostly during my OB/GYN rotation), but for the most part I've always felt welcomed on the unit. It was nice to have another man as a preceptor, and it turned out that he was an excellent nurse. Definately gave me a role model to follow in the future.

Staring at the blank page before you

Open up the dirty window

Let the sun illuminate the words that you could not find

Reaching for something in the distance
So close you can almost taste it
Release your inner visions
Feel the rain on your skin
No one else can feel it for you
Only you can let it in
No one else, no one else
Can speak the words on your lips
Drench yourself in words unspoken
Live your life with arms wide open

Today is where your book begins

As I sit here, waiting for my diploma and authorization for the boards, I'm trying to figure out what the future will be like. Between my career change, and the possibility of Buster's new job, everything ahead of me is unknown. Completing nursing school while working full time, and managing to not only maintain existing relationships, but also develop new ones, has shown me that I can do anything I want to. Nursing is a field with virtually limitless options. It is up to me to discover those options, and go after the ones I want. No one else can or will do it for me. I have an idea of where I want to go, but who knows how that vision will change. If you'd asked me 10 years ago when I graduated college the first time if I'd be finishing nursing school 10 years (almost to the day) from then, I would have said "He*l no". As of right now, I plan on going on in school and becoming a nurse practioner. Hopefully that will not take me another 1o years, but if it does, so be it. I have long ago learned to trust in fate, and to go along with what life gives you instead of fighting against it. I simply open my arms and accept it as it comes. As my mother says in her email signature "Life is like trying to hug an elephant"

Today really is where my book begins.....

PS. This metaphor is a bit scary, considering that my first quarter clinical instructor told me she one day expects to see a book of nursing care plans with my name under the title. I just remembered that as I was writing this. Not sure if this is a sign of fate, or just a really bizarre coincidence.

Of course, she also said she could see me being a neonatal transport nurse. We'll have to see on both of those things!

[Insert Witty Title Here]

2006-06-16T13:30:00.000-04:00

I was bored today at work waiting for reports to update, so I went out to find more fun pictures to include in my blog. Some of the old medication ads are just remarkably scary.

Take this ad for example. From what I can tell, this is an ad for a morning sickness pill. Of course, judging from the picture, my first guess was some sort of antidepressant, because she looks WAY too happy. Can you imagine telling a woman today that if she takes this pill while pregnant she'll be able to get up and cook breakfast. Most of the pregnant women I've known would chase you around the kitchen trying to hit you with the frying pan rather than cook with it. I realize that some women actually need medication to deal with morning sickness, however, I doubt it is so that she can spend the morning cooking (and you know she was the one doing to dishes afterwards too).

Buster should be finished with the first portion of his interview by now. He had an interview today and tomorrow up near Cleveland. I don't exactly want to move north of here, but in terms of both of our careers, this would be a very good move. From what I've seen on their websites, the hospital systems in Cleveland have a lot more openings for nurses then the ones here in Columbus. And of course, this would be a step up to top level leadership position in his job, so it would be a huge advancement for him. Of course, that means we would have to find a new house, and move all of our sh*t, but there is always a price to pay.

Kim over at Emergiblog is starting a new link sharing/blog carnivale/roving link collection (I really have no idea what you would call it) for nurses, by nurses, about nurses called "Shift Change". I am going to have to write something insightful (or snarky, or witty, or mildly amusing, or completely random) about starting my nursing career. Seems someone fitting that the first edition of "Shift Change" have something about becoming a nurse. Guess that will be my homework for the weekend.

A weekend heavy on the symbolism

2006-06-14T07:26:00.000-04:00

Last week was a bit of a crazy week for me. Now that it is over, it is a bit of a let down.

Last week was the last week of school, at least for this degree. I took vacation time from work on Wednesday through Friday, but even with 3 days off, it did not really feel like much of a break. Here is the breakdown of that crazy week.........

Wednesday: Wednesday morning was set aside for rehersal for the pinning ceremony, and then a class luncheon afterwards. We were only given the start time for rehersal, no end time and no location. Hmmmm, not exactly a welcoming sign, but I had the whole day off so I was not overly concerned. So, I penciled in 2 hours of time in my planner for the rehersal, and made an educated guess about the location. Sure enough, rehersal was in the gym (just like the ceremony would be) so my first guess was correct. Since I was right with my guess on one question, I was feeling pretty good about my guess on the other. Boy was I wrong! We spent a sum total of about 30 minutes on rehersal! Somehow, they managed to take a 2+ hour ceremony last about 30 minutes. Of course, we did not actually do the part of the ceremony which actually took the longest time (the reading of the bios/thank yous), but still seemed a bit rushed. When all was said and done (such as it was), I think everyone was more confused after rehersal than before. I left there not exactly feeling comfortable about the upcoming ceremony.

Lunch was scheduled to start at noon, but we were finished with rehersal at just after 10. Hmmmm, so what to do? Most of the class spent about a half hour just hanging out, catching up on the latest news/gossip and one of the class officer announced that the restaurant could seat us an hour early if we wanted to go there early. Since this place served alcohol, off we went to the restaurant. Over all, a good time was had by all. Much food, much alcohol (some people had more than others....), much laughing. All in all a good time. Spent the rest of the day wandering around window shopping since the cleaning lady was at the house and I did not want to be in the way.

Thursday: the actual ceremony was in the evening, so I had most of the day to sit around and relax. Of course, the closer it got to time to go downtown, the more nervous I got. Of course Buster was being feisty all day and teasing me about having to work late, or forgetting he had to be there or whatever else he could think of. Of course, I should have expected this when I told him he had to go up on stage with me and be the person to actually pin me. The ceremony actually went A LOT better than I had expected. We only had a couple of minor glitches. The biggest problem was that we had something like 600 people crammed into the gym and no where near enough ventilation. That would not have even really been a problem if people had stuck to the 100 word limit in their bios/thank yous. Our friend B who was there said they needed the music from the Oscars which started playing after a certain amount of time. Afterwards, Buster told me that he was almost crying when he was up there pinning me. Guess my thanks to him was better than I though!

Friday: was a day of recovery. I was feeling pretty drained/tired. I spent much of the day sitting on my butt playing video games. Definately needed that by this point.

Saturday: we had a wedding to go to for a lesbian couple from my work. Buster did not really want to go, partly because he had a village meeting at 8am that morning, and partly because he was not going to know anyone there (since it will be a bunch of people I know from work). Once we got there, he said he was actually having more fun than he expected. The ceremony was simply elegant and beautiful. The food at the reception was great, and the bar was open. Some of my coworkers too liberal advantage of that fact! I was a little surprised that I managed to get Buster out on the dance floor during the "couples" dance, but since the brides specifically told us to get out there and dance, it is not like we had much choice. It was a little surprising that we were one of the last couples out there when the DJ started asking people to step off based on how long the couple had been together. I guess 10 1/2 years actually IS a long time. We got home way later than I had expected, but it was a fun evening.

Sunday: was another day of recovering and dreading Monday morning. By this time, I was almost ready to go back to work, mostly because I'll be less busy there!

Man, this ended up being much longer than I had expected. I need to make more frequent updates, or have less going on in my life......

Lolly, lolly, lolly get your soapbox here

2006-06-06T07:38:00.000-04:00

Last night on the way home from work, I was listening to The Randi Rhodes Show on Air America Radio where she was discussing the stupidity going on with the whole debate over gay marriage. Needless to say, I was getting madder and madder with each mile. By the time I got home, I had decided to let my "representatives" (and I use that term loosely) know that I felt they were wasting their time and to get to work on something that actually matters. Since all of my representatives are Republicans (not my fault, I voted for Democrats), I decided to avoid talking about the fact that any ban on gay marriage is immoral, unethical, and illegal (hello, remember the "Full Faith and Credit" clause of the Constitution????) and focus on the fact that this amendment has no chance of passing (as admitted by the Republicans themselves) and redundant (remember DOMA *thanks Mr. Clinton*?). I know that it will not make any difference what so ever, but it made me feel better.

Since I did not have my representatives email addresses handy, I had to do some looking. I found a pretty cool site where you can type up a message and they will deliver it to all of your representatives, based on the zip code you enter. This site will actually work for any issue you might have too. Want to do write your elected officials in Washington DC? Go here......

Congress.Org

I didn't do too much research about this site, but judging from the comments on the site, it looks like they are nonpartisan. If I find anything different, I will post accordingly.

I really should do this more often

2006-06-05T08:15:00.000-04:00

Another image that I've spent waaaaay too much time thinking about. I'm not exactly sure what nurses or babies have to do with tires, nor do I understand what that woman is going to do with one bottle and 3 babies, nor can I figure out why these kids are on the counter. Is this some sort of cruel, bizarre Darwinistic experiment? Is she trying to teach these babies how to fly? Why does it look like she has drank a quart of uncut lemon juice/ Was there a fourth baby to correspond to a fourth tire? Like I said, I've spent way too much time thinking about this picture.

Since it has been almost a month since my last update, I guess I have some updates to give. Well, here goes.......

School: I took my last final last week! Woo woo! I'm fairly sure I should feel more excited about that fact, however, I still have the boards ahead of me. Maybe this week will generate some excitement, since on Wednesday we have rehersal for our pinning ceremony, and our ceremony itself is on Thursday night. For you non-nurse types out there, pinning is kind of like graduation just for nurses. We have speakers, give awards and stuff. We also get to have a school pin (if we wanted one) put on us by someone important in our lives (which means I'm forcing Buster to come up on stage with me). I'm not sure if we are still taking the Nightingale Pledge (the nurse's Hypocratic oath) at our school, but I guess I will know on Wednesday. After rehersal, we going out for a class luncheon. That should be a blast. It still amazes me how well we all get along. Of everything going on this week, I am looking forward to that the most.

Work: I finally had my second interview for the fellowship program that I applied for. It took them several weeks to get back to me, just to tell me that I did not get in. Hmmmm...... I'm still not sure if that is a good thing or not. I guess it means that they at least had to think about it. I guess I would have been more upset if they called me the next day and told me that I was out. I was pretty bummed about it, but as Buster pointed out, everything happens for a reason and that there is a reason that this happened. So that means that I still have to find a new job. The HR person at the hospital forwarded my info to a couple of other departments, and I have put in some applications with another hospital system here in town. I'm not overly concerned about finding a job (partly since I already have a decent job, albeit one that I do not exactly like), but I hate the whole process of it.

Buster's work: Buster finally heard back from a job that he applied for back in April. He has an interview next weekend for a job up near Cleveland. The interview actually takes place over 2 days, on Friday and Saturday. Kind of weird for that type of job, but that is how they want to do it. He drove up yesterday and looked around at the surrounding community. Sounds like a pretty expensive place to live, but then again, where we live now is not exactly cheap. We've talked a lot about what to do if he gets the job up there, but that is kind of putting the cart before the horse, so we'll see what happens during/after his interview.

Misc. updates: the other main thing going on is that we may be getting a roommate. Our friend from www.OutInColumbus.com chat, Sportinator, has moved here to Ohio from New Jersey, and has had a little bit of instability in his living situation (let's just say it involved an unkept house, numerous large dogs, and an unpaid water bill). Since we have some extra room (okay, lots of extra room), we've entered into negotiations about him moving in as a roommate. It will be kind of weird having a roommate, but it will be good to help out a friend who needs some help.

That pretty much sums up the last month (not sure if that is sad or not). I'm going to try to make more frequent updates, since in theory, I should have a little more free time.

Keep checking back for more............

Finally getting around to an update

2006-05-11T07:55:00.000-04:00

Okay, this picture is completely random (well, not exactly random but not it does not have anything to do with what I am going to talk about today), but I find it amusing. I actually have a framed version of this label, somewhere. I am so easily amused sometimes...........

I survived the month from Hades. Woo woo wookie wookie yeah!!!! A whole month of working 72 hours a week over and done with. Maybe now I can actually have something resembling a life again. My preceptor told my advisor that not only did I pass, but that I did an excellent job and that I was going to make a very good nurse. More woo woo wookie wookie yeah!!!! This was on the same night that my patient told me I was an excellent nurse. Of course she was more than a little confused/zonked out on meds, so it's difficult to say if she was actually talking to me. For all I know, she was actually talking to the IV stand. A couple of days after this, I took my first theory exam of the quarter and scored a 49/50 on it. Needless to say, been feeling pretty good about school lately!

With the end of school actually in sight now (only about 4 more weeks!), I have such a horrible case of short-timer's disease at work. Is there a med I can take for a complete and utter lack of motivation? Of course, we have had a number of things come up at work where everyone involved is "I need this now! This is urgent, urgent, urgent!" Blah blah blah yaddah yaddah yaddah. It's really hard to get all worked up about things at work when I have gotten used to dealing with things that truly are life and death matters. Well, August will be here before we realize it. Of course, it is not helping matters that many people at work are already treating me like I've left. Now, if I could just get some specific people to think I'm not here.............

Well, guess I should get back to work. After all, I am not getting paid to blog, at least not officially.

Random Amusing Bumpersticker

2006-04-16T17:35:00.000-04:00

What if the hokey pokey IS what it all about?

1/4 of the month from h, e, double hockey-sticks is over

2006-04-11T09:41:00.000-04:00

This weekend was the first weekend of my preceptorship. 12 hour night shifts on Friday, Saturday, and Sunday. Not exactly my idea of a good time, however, it is something I need to do.

All in all, it was a pretty good weekend. My preceptor is an amazing nurse, and is extremely good with his patients. Not only that, he seems to honestly enjoy his job and has fun while at work. What an unusual concept! It is a very different experience being precepted versus the normal clinical group. Being the only student around (there was another student nurse from another school in town there Saturday and Sunday night, but her preceptor was on the other end of the hall, so I did not get to talk with her), the nurses are much more open with their opinions and attitudes (or maybe this is a function of being on nights). I was able to see a lot more of the dynamics among the nursing staff. The unit I am on is fairly large (it can take up to 35 patients), so the staff is pretty large. Typically, there are 9 to 11 floor nurses, 4 to 6 techs, a unit clerk and a charge nurse. (Of course, a low census means that people will be floated out or reassigned to other jobs if needed). Needless to say, there are LOTS of interpersonal dynamics at play. Welcome to the real world.....

On a much more fun note, over at Emergiblog, she posted a really cool link: Create your own South Park Character. The picture above is an example of my handiwork from that site. I call him Student-Nurse-On-Night-Shift-With-Day-Job. Note the double handful of caffeinated beverage. Nno, that is not a beer in his left hand (alcohol and patient care do not mix, no matter what my psych clinical instructor may think), it is some kind of triple shot, high fat, high chocolate espresso drink. I have decided that caffiene and chocolate are proof that there is some sort of kind and loving higher power, and that she might actually like us!

Another bulk update

2006-04-04T07:49:00.000-04:00

Geez, I so need to keep more up to date with this whole thing.

Let's see, what has been going on during the last couple of weeks.

The major thing going on in my life has been the HESI test. Nothing like a test over a year and a half worth of class material to soak up some time. Of course, the fact that we can not graduate unless we pass this test with a certain score. Noooooo, absolutely no pressure there! So last Saturday morning, I found myself waiting outside one of the testing centers on campus (the one run by the Test-Nazi's, but that is a whole different story) waiting to see if I can graduate or not. A hour and a half and 165 questions later, I found out I had a high enough score to pass (I scored 1155, and we needed an 850). If you believe in statistics, according to this score I have a 95% chance of passing the boards when I take them. However, that is horse of a different color. Check back in July to see how that goes.

The HESI over and done with brings me that much closer to graduation. Next, I just need to get my preceptorship finished. In a way, that kind of starts today. Effective today, I am working 12 hour shifts at my paying job (I sooooooo am not looking forward to spending 12.5 hours a day sitting at this desk) and then Friday, Saturday and Sunday night doing a 12 hour shift in the hospital. Definately a very full schedule, but it will only take about a month to get my preceptorship done. This will leave me May to focus on finishing up my theory work and preparing for the NCLEX.

Last Friday, our new matress and boxspring were delivered. Sear's seems to have messed up our order and we did not get a new frame with the bed. The new bed is the same size as the old one, so we could just use the old one. One slight issue with that. The old bed was an oldfashioned mattress, no pillowtop. The new mattress is a little thicker (17 inches versus the old 5 or 6). All put together, this means the new bed is much higher. So high in fact, that I have to literally climb into it. A little scary, but it is so much more comfortable than the old bed, it is worth it.

Yesterday, Buster and I took a little roadtrip up to a suburb of Cleveland. Buster has applied for a job up there so we went to drive around and look at the city and see what it is like. Seems like a nice enough place, if not a little on the conservative side. We'll have to see how this all works out. Luckily, I am almost done with school, so I will be looking for a new job right about the time we would be moving if he gets and takes the job. One very good thing about being a nurse is that there are jobs just about everywhere, and the places there aren't nursing jobs aren't real likely to have jobs for Buster either.

Okay, enough for now. I will try to keep this more up to date, but we'll see how the next couple of weeks go.

Okay, it's been a little longer than I thought

2006-03-20T08:51:00.000-05:00

Wow...... a whole week without an update. Oooops!

The last couple of weeks have been a little weird. I went to the doctor on the 10th, and I came to the conclusion that doctors should not start any tests on a weekend. I went in to talk to him about getting new allergy meds and renewing my Nexium. I also wanted to talk to him about the discolorations that started showing up on my feet. Since I know that venous problems in the legs can lead to these types of spots, I knew I needed to get them checked. My doctor examined my feet and decided that it is most likely either a circulatory problems or diabetes. So, he then says "It's been a while since we drew any labs for you, we'll go ahead and draw blood and do a complete set of labs: sugar, liver enzymes, and so on." He also orders a set of vascular studies for me, an ankle-brachial index (ABI) and a doppler scan. Wheeeeeee....... Nothing like this to set the mood for your weekend.

On Monday, I get an email from Buster telling me that the local hospital called and I needed to call them back. Since he did not send me the whole voicemail message, I did not know if this is to schedule the vascular exam or about the fellowship that I applied for. So, I called the number back, and it was the outpatient vascular lab confirming my appointment for Tuesday. Whaaa??? Luckily, I was able to get that day off and made it to the lab without issues. I have to say, being on the other side of the hospital bed/chair was a bit odd. I got to talking with the sonographer/tech while she was doing my scans, and she said that everything looked okay from her perspective. She also said that she doesn't normally give people the results but "since I was in the field and probably would be part of the company" she would go ahead and let me know. Overall, the whole experience was actually pleasant, at least as pleasant as medical testing can be. Of course, since my circulation looks good, that means the discolorations are probably related to diabetes. But, since I have not heard anything about the results of my labs, I don't know what my glucose was at. Hmmmm, guess I will have to call and hound them about it.

On the school front, Wednesday, Thursday and Friday of last week was the review for the HESI test coming up next quarter. Trying to condense the last year and a half into three days. Needless to say, leaving there each day I felt like I had worked a 12 hours shift. So, my HESI is scheduled for the morning of April 1. A little scary, but that is one of the last 2 major hurdles before becoming a nurse.

It also looks like I finally have my preceptorship for next quarter worked out. I will be working on a medical intermediate care floor, on weekend nights (nights! ugh!). It looks like I will be able to get the necessary hours in a month. Three, 12 hour shifts a week for 4 weeks. It looks like I will not be seeing much of anything in April, but I should be done and able to focus on the future for the last month of the quarter. All I need now is final approval from my advisor on my schedule. It looks like this will all work out after all.

Hmmm, once I write it all down, it doesn't seem like all of that should have really taken two weeks after all.............

And we're coming into the home stretch

2006-03-06T10:34:00.000-05:00

This weekend was the last clinical day for the quarter. I had two patients to care for, and managed to get everthing done close to on time, even with one patient who was in soft restraints (Posey vest, wrist restraints, and a mitten on one hand) and had to be fed. My biggest issue was that I did not have key to my med drawers nor could I get my meds out of the Pyxis myself. I can't wait until I can actually do things like this for myself. I *hate* relying on the instructor to get into drawers/meds/etc. I heard rumors that next quarter we get access during our preceptorship, but I have not heard anything official on that.

Speaking of preceptorships next quarter, I just found out that my preceptor will be a weekend, night shift. I would rather not work 7p to 7a, but someone has to do it, and I did agree that I would take any shift as long as it was on the weekend. I think I can get all of my hours in 6 weeks, by working 2 shifts per week. I'll need to work 3 12 hour shifts in the cube-farm and take 4 hours of vacation for those 6 weeks, but that will still leave me some vacation time to use for graduation/pinning and boards. I may be a cranky bee-otch for those 6 weeks, but I can do anything if I know there is an end in sight.

Only 1 more assignment, and then 2 finals left in this quarter. The assignment is due by midnight tomorrow, and I already have about half of it done. I should be able to get some of it done today during lunch, so I should be in a good spot in terms of that. My trauma nursing final is a week from tomorrow, but that test will be easy since she already told us it is not comprehensive. My Med/Surg 4 final will probably be icky (pediatric psych and neuro mostly), but I have some wiggle room in that class since I did pretty good on the first 2 tests.

It's looking like a pretty easy week (of course that is how they all look at this time on Monday).

Nothing like a scholarly article to ruin a hobby

2006-03-03T07:37:00.000-05:00

http://www.rpgstudies.net/hughes/therapy_is_fantasy.html

This article is somewhat old, in an academic sense (1988), but it is still a bit funny. Basically, it is this long, dry, academic essay about why people play Role-Playing-Games (RPGs). He talks about self efficacy, character as symbol and all that. However, he misses the main reason that most people like RPGs: They are fun! I seriously doubt that too many gamers get deep into the psychology and/or sociology of the game they play, they do it because it's fun. Duh!

"You better work!"

2006-02-28T07:52:00.000-05:00

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...........

Feeling like a real nurse now

2006-02-22T08:43:00.000-05:00

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.

Yesterday I was close to evil

2006-02-16T11:32:00.000-05:00

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........

Deep thoughts on a light and fluffy day

2006-02-14T09:14:00.000-05:00

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)......

Another weekend over and done

2006-02-13T11:17:00.000-05:00

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.....

A busy couple of days

2006-02-09T09:29:00.000-05:00

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.....

Penicillin and potatoes

2006-02-03T09:54:00.000-05:00

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.

Feeling much better now

2006-02-02T11:45:00.000-05:00

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

2006-02-02T07:58:00.000-05:00

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.........

Another Flaming Hoop

2006-01-31T09:59:00.000-05:00

Sometimes I think that the school is trying to make things difficult. Yesterday, I tried to register for classes for the last time (at least with this school), and it would not go through. Since there was no one else registered for either of the sections of the class I need, I assumed that there was an issue with how the class is configured in the computer (which happens just about every quarter). Since there are more seats than students in my program, I was not too concerned about it. I figured that they would fix it, and I could register today.

Fast forward to this morning. I try to register again, and still get an error message to call the Health Records department. However, no there is someone else registered. Damn, must be a problem with my records in the system (which happens about every third quarter). So, I call them and actually manage to get someone on the first try! (anyone who has dealt with a student health records department will realize exactly how rare this occurance is). Turns out they have locked me out of registration because my annual TB test is due after classes start, like a month after classes start. Never mind that this was not an issue last year at this time. Helpful-Records-Office-Woman stammers some response about my test must have been up to date then. Okay, I guess I took 2 TB tests the previous year and just forgot about the second one.

I guess that in the big picture this is really not an issue. I can stop in my doctor's office on my lunch hour and get the test done. Since it only involves seeing a nurse and getting a quick ID shot, I can be in and out within 15 minutes each time. However, that fills 2 of my lunch hours next week (1 to get the shot, and 1 to get the results read) and arguing with the nurse about what I need for documentations (again the school tries to make things difficult by requiring very specific data).

But, I am not going to let this bother me. Today is payday, and we got a bonus on this check. We had a long-term incentive program pay out at the end of last year, and it appeared on this paycheck. While most of it is going to pay credit cards, I've decided to buy myself (and/or Buster) something fun. So, I'm going to a little shopping to see what kind of fun toy(s) I want to buy.

Some Random Fan-boy fun

2006-01-30T20:19:00.000-05:00

Interesting, and not exactly unpleasant!

Your Day in the Firefly 'Verse by howpaperrusts
Your Name
Your Job	Priest
You got in a fight with
Because you	Called Inara a whore
but you helped fight
and you hooked up with
But at the end of the day you left Serenity to go	To the Guild

Quiz created with MemeGen!

Okay we'll try this out........

2006-01-30T18:20:00.000-05:00

Okay, so the RN is a little premature, but I don't want to try and change the name later. So we'll just consider it positive visualization. But, it will be true shortly. By August, it will be official. (Which alternates between exciting and terrifying)

Not exactly sure how to start this, so I'll just start writing and see what happens.

************************************************************************************
Tonight's mood: introspective......

2006-01-30T09:15:00.000-05:00

Well, everyone else seems to be doing this......... Might as well try my hand at it too.

More to come later....