In case anyone was wondering, just how much snow we get out there, here is an interesting site that is updated regularly. As you can see, we are right on schedule (and it is presently being added to).
http://goldensnowball.com/
Friday, February 29, 2008
Be logging
I try to post when I can and, honestly, when less preferable activities beckon and I can convince myself that this is just as important an endeavor to pursue, therein pushing those other activities further towards the periphery of my schedule. There is certainly some reading that I could be doing now...but I am having a hard time getting fired up to read about renal dysfunction in the pediatric population. Go figure.
So far, this week has been far more productive than the one that preceded it. Of course, that is saying very little. The fact that I crawled out of bed for class and managed to make it to clinical at least today has already made it more productive. Anything else is gravy. Now if I could just halt the coughing fits every time I step out into the cold (and that is ALL there is here at this time of year....it was in the teens yesterday and this morning and scrub pants provide somewhat less protection than newsprint).
It is reassuring speaking to other classmates and finding that I am not alone in my ennui about the program. I am doing well enough, but there is certainly room for marked improvement if I could summon up the will to care. So long as I am passing, I have resigned myself to be happy about it. Go me! Raise a glass to minimum effort!
I had an interesting clinical experience today. A 7 yo with Cystic Fibrosis. I will be working with him tomorrow as well. I hope I get to see more then. He had a breathing test scheduled this afternoon, so he didn't put on his vest (which simulates cupping) nor take very many medications. Happily, he seems to be doing very well. It is sad that both he and his older sister are afflicted. The odds are 1 in 4 if you are a carrier. So, the parent's knew without a doubt that there was a 25% chance that he would have CF since his sister did, yet they went for it. It brings up some very interesting ethical dilemmas. The average lifespan is still under 40 for people afflicted. I don't think I could chance it. 25% is too high a failure rate.
7 days of clinical and counting. Less than 24 hours from 6 days remaining. I am pretty excited!
I got offered a job here. It is both a nice confidence boost and ultimately anticlimactic. It looks highly unlikely that we will be here come June, especially with the problems that Tia is having with the districts out here. Ultimately I will be turning them down. Still, it is good practice for the rusty interview skills. It would be a lot harder to walk away if the pay rate was better, but it isn't out here. The hospitals are definitely in collusion with one another with each hospital paying the exact same starting hourly wage and identical differentials. The only difference is a pay increase of, and I could NOT make this number up if I tried, $0.12/hr additional if you have a BSN and not just an RN and work in the Strong health Care system. That's right, a Bachelor's degree (which takes 2 additional years of schooling and two years of additional loans and two years of not earning money) will net you nearly enough money to buy a Nintendo Wii (pre-tax, not post-tax dollars) assuming you worked a full year at 40 hours a week accruing all that extra coin. I am only assuming that they set that pay increase around the time of the Great Depression when $5/week meant a car payment or something. Now, it is as close to a big FU as you can get. Anyway, if we stayed here, I would probably net about $47K-$50K including some differentials and the sign-on bonus, but it is still about $8K-$12K less than I could expect to earn out West. It is cheaper here, but not that much cheaper.
I also somehow managed to get into the nursing honor society. How that happened is still beyond me, but they evidently can't take it away from me even if I really botch up this term. Of course, I still have to decide if $95 sounds about right for a piece of resume fodder. I think I need to sleep on it. They also offer the opportunity to buy some Sigma Theta Tau bling.....up to $650 for a 14K gold Signet ring. Um, not an effing chance.
I think that about covers the spectrum of events that have occurred in the past week or so. I have 8 days until the sweet mini-release of Spring Break. Before that, I have 2 exams, a presentation, 3 more clinical days, one more extra-long, packed with BS patient write-up, and a similarly packed with BS ethics paper to complete. I will try to post when I next need to evade reality.
So far, this week has been far more productive than the one that preceded it. Of course, that is saying very little. The fact that I crawled out of bed for class and managed to make it to clinical at least today has already made it more productive. Anything else is gravy. Now if I could just halt the coughing fits every time I step out into the cold (and that is ALL there is here at this time of year....it was in the teens yesterday and this morning and scrub pants provide somewhat less protection than newsprint).
It is reassuring speaking to other classmates and finding that I am not alone in my ennui about the program. I am doing well enough, but there is certainly room for marked improvement if I could summon up the will to care. So long as I am passing, I have resigned myself to be happy about it. Go me! Raise a glass to minimum effort!
I had an interesting clinical experience today. A 7 yo with Cystic Fibrosis. I will be working with him tomorrow as well. I hope I get to see more then. He had a breathing test scheduled this afternoon, so he didn't put on his vest (which simulates cupping) nor take very many medications. Happily, he seems to be doing very well. It is sad that both he and his older sister are afflicted. The odds are 1 in 4 if you are a carrier. So, the parent's knew without a doubt that there was a 25% chance that he would have CF since his sister did, yet they went for it. It brings up some very interesting ethical dilemmas. The average lifespan is still under 40 for people afflicted. I don't think I could chance it. 25% is too high a failure rate.
7 days of clinical and counting. Less than 24 hours from 6 days remaining. I am pretty excited!
I got offered a job here. It is both a nice confidence boost and ultimately anticlimactic. It looks highly unlikely that we will be here come June, especially with the problems that Tia is having with the districts out here. Ultimately I will be turning them down. Still, it is good practice for the rusty interview skills. It would be a lot harder to walk away if the pay rate was better, but it isn't out here. The hospitals are definitely in collusion with one another with each hospital paying the exact same starting hourly wage and identical differentials. The only difference is a pay increase of, and I could NOT make this number up if I tried, $0.12/hr additional if you have a BSN and not just an RN and work in the Strong health Care system. That's right, a Bachelor's degree (which takes 2 additional years of schooling and two years of additional loans and two years of not earning money) will net you nearly enough money to buy a Nintendo Wii (pre-tax, not post-tax dollars) assuming you worked a full year at 40 hours a week accruing all that extra coin. I am only assuming that they set that pay increase around the time of the Great Depression when $5/week meant a car payment or something. Now, it is as close to a big FU as you can get. Anyway, if we stayed here, I would probably net about $47K-$50K including some differentials and the sign-on bonus, but it is still about $8K-$12K less than I could expect to earn out West. It is cheaper here, but not that much cheaper.
I also somehow managed to get into the nursing honor society. How that happened is still beyond me, but they evidently can't take it away from me even if I really botch up this term. Of course, I still have to decide if $95 sounds about right for a piece of resume fodder. I think I need to sleep on it. They also offer the opportunity to buy some Sigma Theta Tau bling.....up to $650 for a 14K gold Signet ring. Um, not an effing chance.
I think that about covers the spectrum of events that have occurred in the past week or so. I have 8 days until the sweet mini-release of Spring Break. Before that, I have 2 exams, a presentation, 3 more clinical days, one more extra-long, packed with BS patient write-up, and a similarly packed with BS ethics paper to complete. I will try to post when I next need to evade reality.
Thursday, February 21, 2008
Flu Log Day 5
Yep, still sick (insert profanity laced tirade railing against the unfairness of the universe and/or prayer to whatever deity you believe will elicit the most productive response here). I don't have a lot more to add to my initial succinct statement other than I NEED to get better quicker than I am. I have clinical tomorrow, which is predominantly an orientation to the unit, that I will try my damnedest to fight scratch and claw my way through even if I have to wear a Hazmat suit and slather myself in Betadine. After that, hard to say. They aren't going to be squealing with glee to have a walking disease laboratory around immuno-compromised kids battling cancer, but I also don't want to encounter problems finishing up this term because my immune system decided to take Spring Break early. Evidently the prognosis for the flu with someone who already has compromised lungs (asthma, the gift that keeps on giving) puts me on the hook for at least a few more bumpy days before I should be better. So keep your eyes peeled for my next post, "Screw the Nyquil, just get me some Rum."
On the upside, Tia's parents sent me some yummy cookies as a get well present. Thank you very much. Also, a big thank you to Tia for putting up with me 24/7 (she works from home remember).
On the upside, Tia's parents sent me some yummy cookies as a get well present. Thank you very much. Also, a big thank you to Tia for putting up with me 24/7 (she works from home remember).
Monday, February 18, 2008
Sick and tired of being sick and tired
Looks like a good news, bad news situation after seeing the doc today (they were nice enough to squeeze me in because there is evidently something going around and there were no appointments to be had). The good news is that I do not have a respiratory infection......the bad news is that I am not doing very well in spite of the good news. The doctor thinks its viral and told me to call if things worsen. How come things always worsen before and after the doctor visit? I had no fever and no wheezing there, but once I got home my temp spiked to 101.8 and I have felt like the apartment has been alternating temperatures between a turkish bath and the ice cream section of the local grocery store. Even typing this I am shaking worse than Lindsay Lohan 3 days sober. This after foolishly thinking my fever had broken following a night spent sweating heavier than Roger Clemens in front of congress. Its a good thing I sleep face up or I might have drowned.
I wish I had something substantive to add to the posting, but nothing much happens when you spend the vast majority of the day in a recumbent position alternately trying to focus your eyes long enough to read and letting them glaze over while people buy, renovate, flip, or decorate a home on TV. Since we now have cable, here is how I waste away my little bit of free time. Feel free to scoff openly, I am not proud of myself.
Celebrity rehab with Dr. Drew: I don't know if it is compelling TV, but it is definitely stretching the outer bounds of what constitutes celebrity. I didn't know being an ultimate fighting champion or a porn star constituted celebrity. Evidently so.
Millionaire matchmaker: further proof that rich men will, despite what they say, always choose a young bimbette over the better match and that young bimbettes are okay with this arrangement.
Property Ladder: No matter how little you know about home repair and how far over budget you ascend, someone will evidently buy the dump you renovated for a tidy profit as long as you don't get too greedy, because people are generally quite lazy (myself included).
Property Virgins: I know what you are thinking, "A show about abstinence pledgees on a mission from God buying real estate.......what time is that on?!?" Unfortunately, the focus is rarely if ever on the sexual proclivities of the potential home buyers. However, it is interesting watching people buy their first property. Might be as close as I get.
1 degree from hallucinations. I really hope this stops tomorrow.
I wish I had something substantive to add to the posting, but nothing much happens when you spend the vast majority of the day in a recumbent position alternately trying to focus your eyes long enough to read and letting them glaze over while people buy, renovate, flip, or decorate a home on TV. Since we now have cable, here is how I waste away my little bit of free time. Feel free to scoff openly, I am not proud of myself.
Celebrity rehab with Dr. Drew: I don't know if it is compelling TV, but it is definitely stretching the outer bounds of what constitutes celebrity. I didn't know being an ultimate fighting champion or a porn star constituted celebrity. Evidently so.
Millionaire matchmaker: further proof that rich men will, despite what they say, always choose a young bimbette over the better match and that young bimbettes are okay with this arrangement.
Property Ladder: No matter how little you know about home repair and how far over budget you ascend, someone will evidently buy the dump you renovated for a tidy profit as long as you don't get too greedy, because people are generally quite lazy (myself included).
Property Virgins: I know what you are thinking, "A show about abstinence pledgees on a mission from God buying real estate.......what time is that on?!?" Unfortunately, the focus is rarely if ever on the sexual proclivities of the potential home buyers. However, it is interesting watching people buy their first property. Might be as close as I get.
1 degree from hallucinations. I really hope this stops tomorrow.
Saturday, February 16, 2008
No vaginal birth
My experience culminated without seeing a vaginal birth. I think I was the ONLY one who didn't end up seeing one. All in the timing. They had a full board today, but no one more than 8cm dilated by the end of our shift. My patient had a lot of interesting procedures done (a blood pH on the fetus, Intra-uterine pressure device placement, and an amnioinfusion), but was not moving along. She was only 14, so they didn't even think that she would be able to deliver vaginally anyway. Ah well.
I will keep this entry short because I feel like crap. On the verge of a possible respiratory infection. God I hope not.
I will keep this entry short because I feel like crap. On the verge of a possible respiratory infection. God I hope not.
Thursday, February 14, 2008
Yeah for the last 2 days........of this rotation
Goodbyes are such sweet sorrow....except for the sorrow part.
As much as I have enjoyed working with classmates on this rotation (as with pretty much all my rotations thus far), I will not be sad to see it go. I think that OB is a great place to work as a nurse. You get to work with mostly healthy patients who, for the most part, have mostly healthy babies. You get to be an integral part in the first few days of family bonding and help the new mothers try to develop good habits for caring for their newborn. However, it isn't for me. I can definitely see the allure, but I still feel too much discomfort both in myself and in my patients. One may play off the other, but what is certain is that there are ZERO male nurses on the entire unit and there hasn't been one in years. Roughly half the people you ask say they would have no problem with a male nurse tending to them in OB, but almost no one has issue with a female nurse in the same capacity. Not that it matters for the outset of anyone's career anyway. It is a highly coveted nursing job that is mostly filled with nurses who have significant experience elsewhere.
I took the advice of my adviser and set up some interviews at local hospitals. I went to my first one yesterday. It was a very peculiar dynamic. I am acclimated to being interviews involving me desperately to stand out from the competition to get the job then waiting hopefully by the phone for the offer to come through. This was more like me interviewing them. It is REALLY nice to be able to go to an interview with ZERO stress as an organization tries to sell you on why you should work with them as opposed to in another unit at their hospital or at another hospital just down the street. It is just as nice to be able to say to them, no thanks I really want to do this instead of that. Now, if I could just get to a position where I could make salary demands too :)
I think there is still only the most minuscule chance that we will opt to stay here, but there is lengthy pro/con list for working in either place. The impression that I get is that, here in ROC, you can be very picky. They will also coddle you more than they would out West. The on-the-job training sounded impressive. However, they also pay you seventy cents on the dollar, which doesn't remotely equate to the cost of living differential. Plus, there is the whole 'living in ROC thing' that neither Tia nor I are enthralled with. In Portland, the pay is better, but they seem less inclined to so much as talk to me until I get my license and there is a far greater level of competition for jobs, meaning you need to take what will get you in the door, not what you want to do necessarily. Long term, that isn't a bad thing, but you also dont want to start with a bitter taste in a new profession. Opinions still range wildly on this.
For the second being I am caught up, so I think I will bask in the warm glow of that feeling......at least until my 4:30 group project meeting.
As much as I have enjoyed working with classmates on this rotation (as with pretty much all my rotations thus far), I will not be sad to see it go. I think that OB is a great place to work as a nurse. You get to work with mostly healthy patients who, for the most part, have mostly healthy babies. You get to be an integral part in the first few days of family bonding and help the new mothers try to develop good habits for caring for their newborn. However, it isn't for me. I can definitely see the allure, but I still feel too much discomfort both in myself and in my patients. One may play off the other, but what is certain is that there are ZERO male nurses on the entire unit and there hasn't been one in years. Roughly half the people you ask say they would have no problem with a male nurse tending to them in OB, but almost no one has issue with a female nurse in the same capacity. Not that it matters for the outset of anyone's career anyway. It is a highly coveted nursing job that is mostly filled with nurses who have significant experience elsewhere.
I took the advice of my adviser and set up some interviews at local hospitals. I went to my first one yesterday. It was a very peculiar dynamic. I am acclimated to being interviews involving me desperately to stand out from the competition to get the job then waiting hopefully by the phone for the offer to come through. This was more like me interviewing them. It is REALLY nice to be able to go to an interview with ZERO stress as an organization tries to sell you on why you should work with them as opposed to in another unit at their hospital or at another hospital just down the street. It is just as nice to be able to say to them, no thanks I really want to do this instead of that. Now, if I could just get to a position where I could make salary demands too :)
I think there is still only the most minuscule chance that we will opt to stay here, but there is lengthy pro/con list for working in either place. The impression that I get is that, here in ROC, you can be very picky. They will also coddle you more than they would out West. The on-the-job training sounded impressive. However, they also pay you seventy cents on the dollar, which doesn't remotely equate to the cost of living differential. Plus, there is the whole 'living in ROC thing' that neither Tia nor I are enthralled with. In Portland, the pay is better, but they seem less inclined to so much as talk to me until I get my license and there is a far greater level of competition for jobs, meaning you need to take what will get you in the door, not what you want to do necessarily. Long term, that isn't a bad thing, but you also dont want to start with a bitter taste in a new profession. Opinions still range wildly on this.
For the second being I am caught up, so I think I will bask in the warm glow of that feeling......at least until my 4:30 group project meeting.
Sunday, February 10, 2008
C-Section, Storm Large, -20 degrees
This is a post that continues to confound my efforts to get up online. Every time I sit down and attempt to complete it, something comes up and another day begins with another set of things to post. I refuse to be stopped this time however so, depending on occurrences outside of my control, this will be terse or my magnum opus.
I watched my first birth. It was a C-section which detracted from the experience some if only because C-sections are performed in a sterile surgical room instead of the much more hotel-like birthing suites. That aside, it was a pretty incredible thing to witness and I feel fortunate to be able to be an observer during an experience such as this in people's lives.
The surgical part was a bit gruesome to be honest. There is a lot of cutting, retracting, and some out and out pulling and yanking. Fluids were everywhere, most notably after the amniotic sac was ruptured, causing an arc of amniotic fluid more than a foot high which bathed the surgeons. The patient was obese, so there was a lot of adipose tissue to cut through as well. It was all very graphic. Ultimately, the birth took less than half the time of the repair of the incision afterwards. I followed the patient through the PACU and to her room where she will stay for the next 72 hours. The baby was fine with good Apgar scores, but was large for gestational age, so they had to do a lot of heel sticks to determine the infant's blood glucose. Mom wasn't terribly pleased by this, but procedures are procedures.
The next day I was back and hoping to see a vaginal birth. Unfortunately, the mom-to-be I was following was wholly uncooperative. How dare she hold out and try to ruin MY experience! It was quite funny because the patient's mom almost sounded that way when, after a number of hours, it became evident that the baby wasn't in any hurry to leave the womb. Every phone call she received while we were in the room sounded almost accusatory towards her daughter, as though she were intentionally withholding the child from the world. Even with a high rate of Pitocin on a constant drip, I found out she ended up having a C-section later that evening. One of my classmates got to witness that. I have one more day in labor and delivery. It will be interesting to see what happens then.
Tia and I celebrated 2 years together on Sunday by having a relatively school-free day (except for an exam I had to take that morning at 8am). We used some spa gift certificates from her mom and Sherri and I got a massage and a wonderful hour-long sports pedicure. So relaxing. Then we headed out to eat, which was a bit of a mess because the restaurant we wanted to eat at ended up being closed on Sundays, necessitating a change of plan to an expensive Vietnamese place where we were the sole customers. It was good, but no better than Vietnamese places that were half as much out in Portland. We then saw Storm Large (remember the Rockstar Supernova show?) headline a play called 'Cabaret.' Very bizarre. Lots of skin and a fair amount of gratuitous groping. I dont really no what to say about it. It was a musical on LSD. I think Wikipedia may do a better job of describing it than I can: http://en.wikipedia.org/wiki/Cabaret_(musical)
The other entertaining thing about the evening was that I experienced a new "Holy shit it is REALLY cold here moment." The temperature dipped down to the single digits (6 degrees) and, with windchill, we hit -20 here in Rochester. Perhaps to prove that the people here are a hearty lot, there was one young guy at the show who was adorned in a polo shirt with a light windbreaker and, I shit you not, cargo shorts. My guess is he lives in an ice cave on a planet further from the sun than our own regularly so it must have seemed quite tepid out. As for myself, I could barely think over my teeth chattering. We closed out the night with dessert at the Cheesecake factory. Good lord they have good desserts.
In other news, school continues to hit new lows, but I am not alone in feeling this way. For those of you who dont know me well, one of my BIGGEST pet peeves is when I feel like my time is being wasted. So, when we showed up for class yesterday for our 4-hour lecture in Women's Health with only that day's materials encompassing what will be on tonight's exam, I thought we would for sure be very productive. As usual, I was wrong. Instead we spent the first hour discussing how our respective weeks were, the next 2 hours working on case study projects that were largely opinion based and then presenting them to the class affording ZERO information to anyone and then, the last 45 minutes covering 1 of the three powerpoints that we were supposed to cover. Needless to say, when I found out we had a panel discussion arranged for today, I opted to do laundry instead. I then spent my off hour in a meeting and followed that with 3 hours of ethics lecture. I may need to arrange future spa visits for AFTER Monday.
A few of my classmates discussed sending emails to our instructor so that she would know that we are not pleased with how she opted to run our class......but as usual, nothing will come of it because the risk is greater than the reward, especially since this was our last class session with her. She will of course return, like a bad penny, to teach our NCLEX review. God help me.
Off to study for the last exam tonight. Wish me luck as always.
I watched my first birth. It was a C-section which detracted from the experience some if only because C-sections are performed in a sterile surgical room instead of the much more hotel-like birthing suites. That aside, it was a pretty incredible thing to witness and I feel fortunate to be able to be an observer during an experience such as this in people's lives.
The surgical part was a bit gruesome to be honest. There is a lot of cutting, retracting, and some out and out pulling and yanking. Fluids were everywhere, most notably after the amniotic sac was ruptured, causing an arc of amniotic fluid more than a foot high which bathed the surgeons. The patient was obese, so there was a lot of adipose tissue to cut through as well. It was all very graphic. Ultimately, the birth took less than half the time of the repair of the incision afterwards. I followed the patient through the PACU and to her room where she will stay for the next 72 hours. The baby was fine with good Apgar scores, but was large for gestational age, so they had to do a lot of heel sticks to determine the infant's blood glucose. Mom wasn't terribly pleased by this, but procedures are procedures.
The next day I was back and hoping to see a vaginal birth. Unfortunately, the mom-to-be I was following was wholly uncooperative. How dare she hold out and try to ruin MY experience! It was quite funny because the patient's mom almost sounded that way when, after a number of hours, it became evident that the baby wasn't in any hurry to leave the womb. Every phone call she received while we were in the room sounded almost accusatory towards her daughter, as though she were intentionally withholding the child from the world. Even with a high rate of Pitocin on a constant drip, I found out she ended up having a C-section later that evening. One of my classmates got to witness that. I have one more day in labor and delivery. It will be interesting to see what happens then.
Tia and I celebrated 2 years together on Sunday by having a relatively school-free day (except for an exam I had to take that morning at 8am). We used some spa gift certificates from her mom and Sherri and I got a massage and a wonderful hour-long sports pedicure. So relaxing. Then we headed out to eat, which was a bit of a mess because the restaurant we wanted to eat at ended up being closed on Sundays, necessitating a change of plan to an expensive Vietnamese place where we were the sole customers. It was good, but no better than Vietnamese places that were half as much out in Portland. We then saw Storm Large (remember the Rockstar Supernova show?) headline a play called 'Cabaret.' Very bizarre. Lots of skin and a fair amount of gratuitous groping. I dont really no what to say about it. It was a musical on LSD. I think Wikipedia may do a better job of describing it than I can: http://en.wikipedia.org/wiki/Cabaret_(musical)
The other entertaining thing about the evening was that I experienced a new "Holy shit it is REALLY cold here moment." The temperature dipped down to the single digits (6 degrees) and, with windchill, we hit -20 here in Rochester. Perhaps to prove that the people here are a hearty lot, there was one young guy at the show who was adorned in a polo shirt with a light windbreaker and, I shit you not, cargo shorts. My guess is he lives in an ice cave on a planet further from the sun than our own regularly so it must have seemed quite tepid out. As for myself, I could barely think over my teeth chattering. We closed out the night with dessert at the Cheesecake factory. Good lord they have good desserts.
In other news, school continues to hit new lows, but I am not alone in feeling this way. For those of you who dont know me well, one of my BIGGEST pet peeves is when I feel like my time is being wasted. So, when we showed up for class yesterday for our 4-hour lecture in Women's Health with only that day's materials encompassing what will be on tonight's exam, I thought we would for sure be very productive. As usual, I was wrong. Instead we spent the first hour discussing how our respective weeks were, the next 2 hours working on case study projects that were largely opinion based and then presenting them to the class affording ZERO information to anyone and then, the last 45 minutes covering 1 of the three powerpoints that we were supposed to cover. Needless to say, when I found out we had a panel discussion arranged for today, I opted to do laundry instead. I then spent my off hour in a meeting and followed that with 3 hours of ethics lecture. I may need to arrange future spa visits for AFTER Monday.
A few of my classmates discussed sending emails to our instructor so that she would know that we are not pleased with how she opted to run our class......but as usual, nothing will come of it because the risk is greater than the reward, especially since this was our last class session with her. She will of course return, like a bad penny, to teach our NCLEX review. God help me.
Off to study for the last exam tonight. Wish me luck as always.
Tuesday, February 05, 2008
Quick note
Came across this site, thought I would share it with those that I didn't manage to email it to:
http://allfunny.net/index.php/funny-pictures/proper-baby-care.html
Goes along with what I am learning.
Nothing new to report. Another day of lecture......another unbelievable amount of information to assimilate. Another day closer to being done.
http://allfunny.net/index.php
Goes along with what I am learning.
Nothing new to report. Another day of lecture......another unbelievable amount of information to assimilate. Another day closer to being done.
Monday, February 04, 2008
Righteous anger
I am sure anyone who has taken introductory college courses can empathize with the following situation: You are in some introductory requirement course or another, lets say English 101 for example. Everyone has to take this course so you and your friend end up signing up for it, only at different times with different instructors. As the weeks go by, you find yourself reading obscure treatises on the history of the umlaut and its effect on the present day English language and writing 15,000 word essays on dangling participles while your friend watches obscure French films and, if there is time, tosses off the occasional haiku. At the end of it all, you work your every loving ass off for a solid C+, which you are inexpressibly proud of because half the class failed while your friend sleeps through their final and makes a B+ because their aura was especially pink that day. Or, the exact opposite of this happens. It is really luck of the draw. You just have to accept it as the random event that it is.....or maybe your aura just wasn't especially pink at that time or place in your life (presuming, of course, that a pink aura is a good thing). When it pisses you off is when that same class and same instructor yields two disparate experiences. It pisses me off anyway.
To get down to brass tacks, the following situation has evolved: Our class is split up into 2 cohorts; A and B. Cohort A began in OB/Peds and is doing the med/surg rotation presently. Cohort B is my cohort. Cohort A managed to achieve an 18pt improvement over our first exam in med/surg and managed to better our averages on the first two exams in OB/Ped as well. Cohort A is over-represented at the top of our class academically, and not by sheer chance. What I found out today is that they got a much more focused study guide in MS (med/surg) detailing specific places to look for answers in the text, had questions that were used and counted against us in MS removed because they were deemed too difficult, had questions dropped from exams in OB/Peds (OP) because they didnt have MS previously and, to top it off, that the exams have been made harder for us in OP because we have had MS. This is all the more aggravating because we will be judged on a level playing field. Meanwhile my cohort is essentially running up hill. If I haven't expressed my disgust for this program lately, my apologies for being lax in that regard. It truly sucks.
Speaking of things sucking, I leave you with one final, and quite poignant example. Today there were questions brought up in regards to validity in OP. The situation that has arisen on both exams thus far is that material that is being tested on is not being covered until future readings. So, we are being asked questions on, for example, APGAR scores, without having exposure to any information about them until the readings for the next examination. A very clear problem with validity. When this was brought up the instructor said, and this is a DIRECT quote (you cannot make this shit up), "So, what you are saying is that you want me to only question you from material we have covered?" As if this was some kind of foreign concept and we were asking her to make unreasonable accommodations on our behalf. At this point, she could test us on the season premiere of Lost and not be any less valid.
And to think I get to wake up tomorrow and do it all over again. My aura must the be opposite of pink lately.
To get down to brass tacks, the following situation has evolved: Our class is split up into 2 cohorts; A and B. Cohort A began in OB/Peds and is doing the med/surg rotation presently. Cohort B is my cohort. Cohort A managed to achieve an 18pt improvement over our first exam in med/surg and managed to better our averages on the first two exams in OB/Ped as well. Cohort A is over-represented at the top of our class academically, and not by sheer chance. What I found out today is that they got a much more focused study guide in MS (med/surg) detailing specific places to look for answers in the text, had questions that were used and counted against us in MS removed because they were deemed too difficult, had questions dropped from exams in OB/Peds (OP) because they didnt have MS previously and, to top it off, that the exams have been made harder for us in OP because we have had MS. This is all the more aggravating because we will be judged on a level playing field. Meanwhile my cohort is essentially running up hill. If I haven't expressed my disgust for this program lately, my apologies for being lax in that regard. It truly sucks.
Speaking of things sucking, I leave you with one final, and quite poignant example. Today there were questions brought up in regards to validity in OP. The situation that has arisen on both exams thus far is that material that is being tested on is not being covered until future readings. So, we are being asked questions on, for example, APGAR scores, without having exposure to any information about them until the readings for the next examination. A very clear problem with validity. When this was brought up the instructor said, and this is a DIRECT quote (you cannot make this shit up), "So, what you are saying is that you want me to only question you from material we have covered?" As if this was some kind of foreign concept and we were asking her to make unreasonable accommodations on our behalf. At this point, she could test us on the season premiere of Lost and not be any less valid.
And to think I get to wake up tomorrow and do it all over again. My aura must the be opposite of pink lately.
Sunday, February 03, 2008
Mother & Baby = Done & Done
I still have two weeks left on my OB rotation, but the remainder of the time will be spent in Labor and Delivery. Though that is no indication that I am done being in situations that I find rather uncomfortable and embarrassing, it means I at least will be facing those situations with a health care team. Tia says that I over-emphasize my discomfort and tend to dwell on it...something I cannot argue, nor shake. I just don't feel right doing the examinations on the new mothers. I am mystified as to how I am supposed to ascertain how much blood is on the pad in their panties (Lochia) as a result of the shedding of the uterine lining as compared to that of a menstrual cycle. What constitutes heavy vs. moderate remains a mystery, but I can say that if I were losing that much blood from a flesh wound, I would suggest that I was bleeding heavily (in this I am apparently incorrect). That is just one glaring example of how hard it is to relate to what these women are going through. I imagine to some degree, working there not having carried a child of your own might prove a bit difficult for a female nurse. I would argue however, that not even having completely different apparatus is a greater impediment than that.
Despite my misgivings, there has not been a single incidence of any of my patients being outwardly uncomfortable with me. It remains entirely possible that I am transferring my own feelings to them, but I can't help the way I feel and Psych 101 is no help here. I just cannot imagine a time in my life that I will ever be at ease walking into a room to meet a woman for the first time and, shortly thereafter, peering into her underwear without a significant amount of distilled spirits involved (frowned upon in the medical profession).
That said, I feel very comfortable working with the newborn infants, offering some advice to the mom's and being in the nursery. Honestly, a greater portion of the day is spent not examining the new mothers, so it has been about 98% positive, which is a step in the right direction. I am pleasantly surprised by how good I feel about being around the newborns. Truth be told, I am not the world's most effective swaddler and I am remarkably inefficient in changing both diapers and attire on an infant, but compared to my similarly inexperienced classmates, I hold my own.
In other school related news, things are ever so slowly rounding into form. I am still struggling somewhat on the motivation front, but it appears to be a universal concern in talks I have had with classmates. The goal for the moment will just be staying afloat until Spring Break just 5 weeks in the distance. Seems minor when typing it, but 5 weeks is never minor in a program like this.
As always, keep em crossed for me.
Despite my misgivings, there has not been a single incidence of any of my patients being outwardly uncomfortable with me. It remains entirely possible that I am transferring my own feelings to them, but I can't help the way I feel and Psych 101 is no help here. I just cannot imagine a time in my life that I will ever be at ease walking into a room to meet a woman for the first time and, shortly thereafter, peering into her underwear without a significant amount of distilled spirits involved (frowned upon in the medical profession).
That said, I feel very comfortable working with the newborn infants, offering some advice to the mom's and being in the nursery. Honestly, a greater portion of the day is spent not examining the new mothers, so it has been about 98% positive, which is a step in the right direction. I am pleasantly surprised by how good I feel about being around the newborns. Truth be told, I am not the world's most effective swaddler and I am remarkably inefficient in changing both diapers and attire on an infant, but compared to my similarly inexperienced classmates, I hold my own.
In other school related news, things are ever so slowly rounding into form. I am still struggling somewhat on the motivation front, but it appears to be a universal concern in talks I have had with classmates. The goal for the moment will just be staying afloat until Spring Break just 5 weeks in the distance. Seems minor when typing it, but 5 weeks is never minor in a program like this.
As always, keep em crossed for me.
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