COWman's Corner of the Web

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 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.......)

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,

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........

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 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.

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!

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.

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........

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.

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.....

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........

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......

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.

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 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.

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.....

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).........

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

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.

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......

• 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.

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*****)

.... 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....

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.....

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..........

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.

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

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......

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.

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!

# posted by COWmanRN @ 8:03 AM 3 comments

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.

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......