Wednesday, July 30, 2008

hmmm.........interesting

It is really REALLY nice to have a day off today after having the most hellacious day I have been a part of in school or out of it on Tuesday (granted, it isn't a great breadth of experience). It is hard to explain, other than that everyone has had THAT day at some, or multiple, points in their lives. It seemed like no matter what small problem was taken care of, another one (or two or three) took its place. Even simple tasks like pushing a med through an IV line ended up taking hours as veins collapsed or IV lines were no longer patent (both on the same patient at different times during the day). For every patient awaiting discharge, two more were returning from surgery. Amidst it all there are mountains of paperwork that, somehow, you are supposed to be able to complete. I can see it on 1 patient or 2........but how you manage it on 4 or 5 is beyond me. I am guessing things aren't always entirely thorough. Just a guess.

Scrub shopping as a man is.........well, like regular shopping as a man. Most stores are 90-95% women's clothing, which are more elaborate, made with seemingly more high quality materials, and are infinitely more aesthetically pleasing. I am not asking for something with ridiculous flair or inventiveness, but it is kind of a bummer that my only options are solid colors with either 1 or 3 pockets. Couldn't they be punched up with some designs from Nike or Adidas or something? Women's scrubs are designed by Baby Phat and Grey's Anatomy to name a few. Men's scrubs look like they were designed in 1962 by a 3rd grader with remedial drawing skills and the 8 color Crayola pack and they called it done. I am just saying.

I had an interesting call today. A clinic that deals with Asthma and allergy patients called about a resume I submitted. I have an interview Tuesday of next week. Hmmm..........interesting. Having both conditions, I am acutely interested. The job will likely pay less, but afford more regular hours (translation: 5 days a week when people who don't live off of the blood of other people are awake). I will find out more on Tuesday and will, of course, post about it. In the meantime, it at least affords me something to mull over as I spend 4 of the next 6 days in the hospital and try to get a stronger feel for whether or not it is the kind of place I want to call home, or if it was just a place to pass through on my journey.

Sunday, July 27, 2008

Warm & Fuzzy

Just wanted to give a brief and sincere shout out to everyone who reads this blog and was able to make it out to our Portland reception. It was so wonderful to see everyone and my only regret is that I didn't have more time to spend talking with everyone individually. A special thank you to my mother-in-law Diane who was one of the chief orchestrators of the day from arranging the food to prep and clean up. Another special thank you to everyone who was there early to help set-up and those who stayed late to help clean up. Everyone pitched in to make it a wonderful day. It makes me feel all wamr and fuzzy to know that so many people carved time out of their schedules to celebrate with us.

My blogging has been a bit, well, patchwork of late. Owing to family visits, my new job, and the fact that my laptop needs a defibrillator or an exorcism. I think it is on the way to the laptop graveyard. I had hoped to at least sell it to pay for a bit of whatever I buy (have Apple Macbook taste, but have low end Gateway money), but now I will be lucky to salvage anything from it. I am still awaiting word from Costco, but the situation looks grim. Then again, the last time I thought that I still managed to pass the NCLEX.

The new job: what to say? what to say? Where to start might be more appropriate. The first day was as terrifying and chaotic as my first day in nursing school. At least I am getting paid instead of the other way around though. Willamette Falls does not operate like other hospitals I have been exposed to. Most hospitals have a very defined start-up process and it flows in a distinctly linear fashion. Spend 'x' number of days learning hospital policies. Spend 'x' number of days learning nursing policies. Spend 'x' number of days on skill and equipment training. Then, and only then, do you go to the floor to start your mentorship. Not so at WF. They sporadically, and seemingly haphazardly, orient new grads to both hospital and nursing policies and equipment. I am not sure the theory behind it, but I suppose it could be effective if you have fundamentally sound preceptors who are effective teachers. If not, well......it could be a long hard road.

Day 1 was spent on the unit. I was paired with a nurse who was not supposed to be paired with me per se. Unfortunately, the nurse I was supposed to be paired with was out for whatever reason. Not to denigrate the job performance of the nurse I did work with, but she was clearly not a teacher, but rather a doer. I found myself bounding along behind her like a duckling following its mom. I had no idea where anything was. I had no time to look over charts. I had no clue how to work a majority of the equipment and I still have no idea what exactly the nurses role is at WF (they were short CNAs and a lot of the normal CNA duties fell to the nurse from what I could gather..........which meant that, to my chagrin, it was not a poop free day). Hopefully this will come into focus much like when they are flipping lenses at the optometrist (usually that analogy, right now I would be the equivalent of blindfolded......in a cave.........during the winter months at the north pole. Things aren't fuzzy or blurry, they just aren't period).

Day 2 was a new grad class. It was fortuitous that I had one early on. They taught us how to use the phones, log on to the computer, and access some basic services for patients. Some people had been there for better than 6-8 weeks without such training. Makes me wonder what I won't be learning until I am there that long. Hopefully nothing critical. In the meantime, I will just try to keep my head above water. I will keep everyone as posted as I can.

I am off to Ambien dreams. Nothing like an EARLY Monday morning to make me damn near tear up in joy (wait, I meant misery not joy). Cannot wait until I start working the swing shift. Sweet sweet slumber.

Wish me a poop free day if you think about it.

Tuesday, July 22, 2008

Work

I finally made a decision on Friday, and decided that I would prefer to work at a smaller hospital with less acuity and a more communal (hopefully) feel. Plus, it was closer and, much to my shock since I had been led to believe otherwise, it paid more. I was aided on this decision mostly by my mother-in-law who (and is this kismet?) happened to speak to a nurse that not only worked for the hospital I chose (Willamette Falls), but also used to work for the one I did not opt for (Salem). Her opinion was that WF was the better choice and the better environment. Of course, as the saying goes, "opinions are like assholes, everyone has one." So, her opinion could be biased (maybe she got fired from Salem or found it overwhelming) or it could be objective (maybe WF is truly superior), but either way it was incredibly fortuitous and definitely tipped the scales.


I went and filled out background check info on Wednesday. Peed in a cup on Friday (and then proceeded to get ridiculously sloshed at a happy hour). Got called on Monday to come in Tuesday (today). Start work on Thursday. Will be freaking out tomorrow most likely (right after I buy some scrubs that is, since I have only two pair of pants presently).

The hospital's orientation is unlike any that I have seen. It is not structured in a linear manner. Typically there is an orientation to the hospital for a few days followed by a unit orientation followed by a going to the floor. At WF, I will spend Thursday shadowing on the floor, Friday I do a hospital training, and then Monday I am back on the floor. I spend most of the next 8 weeks on the unit, with a few days sprinkled in of hospital orientation and nursing orientation. Time to knock of the rust and put on a good show. Hope I'm not supposed to actually 'know' much :)

I will write more as I know more (and if my laptop can be brought back from the dead). In the meantime, wish me luck. I am wishing the same for all my cohorts who are starting out as well.

Wednesday, July 16, 2008

the vagaries of the insurance system explained

Well, not really of course. I doubt it could be explained by anyone, let alone me such is the labyrinthine nature of our current system. For example: if you have a car accident and you cause $6000 worth of damage to your vehicle and you have a $1000 deductible, you owe $1000 and the insurance company pays the remaining $5000. Simple math. However, if you have health insurance, the copays become much more convoluted. With the same deductible, you could pay many thousands more because certain things are excepted from the deductible and others are covered at a percentage over the deductible to a fixed cap. So, returning to the car analogy, it would be as though you did the $6000 in damage, but it excluded airbags, the radio, and the transmission, but covered the rest at a fixed percentage up to the $6000 dollars. You could end up covering $3000-$4000 even though you had a $1000 deductible.

To make matters worse, information such as how much procedures cost is a closely guarded secret coded in a way that would make Dan Brown jealous. Lets go back to cars (must be on the brain tonight). When you go to purchase a car, you have a wealth of information available to you in regards to price. You have the MSRP at the dealership, the invoice, the actual costs and can find out even more if you are willing to invest the time. You can read copious reviews as well and also check out other dealerships to see what prices they will offer you. You can, in effect, make an informed decision based on actual information. If only going to get medical treatments operated in a similar manner. Instead, it is like going to buy a car without even knowing how much a car should cost in the first place, have no information on the window sticker to remotely guide you as to the purchase price, knowing nothing about vehicles quality or reliability, and, if given a choice of other places to purchase the car, you are afforded no information as to whether the other vehicle is better or cheaper. To truly drive the point home, you wouldnt even find out how much the car costs until you get a bill a month later telling you what you owe (at which point you are required to pay it regardless of how fair or unfair it may seem).

What does all this even mean..........well, it means I will not be getting my gall bladder out on Friday very likely because: A. We evidently already owe better than $1000 for everything leading up to this point and B. The gall bladder removal may be up to a few thousand more. This, by the way, is with insurance and a $1000 deductible. I would like to have the procedure and move on with my life, but that isnt exactly the kind of money I have lying about at the moment and, all things considered, I am much improved to a point that I don't deem it critically necessary (thankfully considering the cost). Hopefully, down the line my hospital job will offer better health benefits...........or at the very least I will have enough income to cover the procedure. Until then, why does insurance have to be so bloody complex?!?!?

Tuesday, July 15, 2008

The results are in........

and I passed! Miraculously it seems (at least to me). Honestly, I would have given at least 3 to 1 against. That is how confident I was that I did not get enough questions right to warrant licensure. In the end, I got the maximum number of questions, 265 question in all, and spent more than 3 hours glued to a computer screen. At 100, I started to panic. At 150, it all started to seem kind of unreal. Once I reached 200 questions, I just thought it was becoming sadistic. By the end, I thought there was utterly no hope. It was much like getting repeatedly kicked in the groin. I was fully prepared to suck it up and start studying again. Why? Well, because it seemed that I studied all the wrong things.

I studied diabetes thoroughly...........I got maybe 1 or 2 questions. I studied OB and peds, learning as much as I could retain about eclampsia, HELLP syndrome, and developmental levels. I worried over lab values. I took practice test after practice test and saw no familiarity at all with the questions I was presented with. I could well have just read what I wanted to read and enjoyed my time off instead. But, ultimately, something must have stuck. Either that or the computer program just felt sorry for me.

All there is to say now is that it is OVER!!!!!! I am licensed (and to think a year ago I was just learning to take blood pressure). Now I can relax for 6-8 hours and then try to figure out where I am going to work.............and then get my gall bladder removed............and then learn a new job. I really like to pack the stress in.

Monday, July 14, 2008

crackers!

Off to take my test (gulp).

Thursday, July 10, 2008

Need an opinion......or many

Well, the good news is I was offered another position at a closer hospital. The bad news is that I still have no real information about nearly every aspect of said position because, for whatever reason, Willamette Falls (WF) is being incredibly secretive about it. Perhaps I didn't impress upon the HR representative enough that I would like to make a decision soon and need tangible information to do so. Instead, I get a benefits summary from them that pretty much states I REALLY wanted to post some actual information about both jobs and then elicit some opinions, but instead I am left with very little basis for comparison.

What I know now:

Salem:
3-12hr shifts (7pm-7:30am)
Position: cardiac telemetry (high acuity and specialization)
Nurse/Patient ratio: goal is 1 to 4
Pay rate= $1.01/per hour more than WF
Differential = $5.01/per hour for working nights (18%), $5.85/hr weekend nights (21%)
Insurance cost= $43.00/medical, $7.90/dental, $3.00/vision - monthly total= $53.90
Driving distance = 50 miles additional a week
Paid time off: 23 days a year (plus two additional floater days every anniversary)
Retirement: 0% year 1, 5.5% years 1-4 with escalations periodically thereafter

Willamette Falls
5-8hr shifts (11pm-7:30am)
Position: Medical/Surgical (higher variety, lower acuity)
Nurse/Patient ratio: goal is 1 to 5 or 6 at night
Pay rate = $1.01 less per hour, but increases by 7% year 2
Differential = despite my repeated requests, no information provided
Insurance costs = WF pays a percentage of insurance costs (there was a scene in the Simpsons I remember when Lisa was visiting the headquarters of a newspaper on a field trip and poses the following query after reading a sign saying a percentage of the newspaper is printed on recycled materials: Lisa "what percentage is recycled?" Newspaper woman "Zero. Zero is a percentage." Makes me wonder what percentage is covered when no information is given.)
Driving distance = 50 miles less per week, but more overall days of commuting
Paid time off: 24 days a year
Retirement: 1-4% (another vague figure)

Neither job is exactly what I want to do, but the jobs that I want to do aren't, at this point in my nursing career, possible. So, in the meantime, it is all about getting some experience.

I would love to hear any opinions. i know there really isn't enough information to make a fair comparison (think how I feel trying to decide between them). Please drop me a comment if you have one (I now allow anonymous comments........unbeknownst to me, I didn't before. So please, comment away).

Tuesday, July 08, 2008

As there is nothing new

Very little has changed of late.........and that isn't a bad thing. After two months of constant upheaval, it is nice to have a settled routine of sorts. Between studying, looking for nursing jobs, and working at PRE, things are pretty mellow. Of course, that all changes this weekend when I become a complete and total stress monkey, but until then it is blessed tranquility.

In lieu of an update of the normal sort, I thought I would just post on something that I like: movies. I am definitely one of those people who love movies enough that, if one is on TV that I like, I have no qualms about picking it up right in the middle and watching it to the end. Only certain movies make the cut of course..........and they aren't all cinematic masterpieces. This list is not comprehensive in the slightest, but I need a break from my studies and I thought I would share some of my favorites (in no particular order):

Cool Hand Luke: Is there a better classic guy movie? Arguments can be made I am sure, but before Paul Newman was a purveyor of many fine charitably minded consumables, he was a badass with an iron resolve that proved that, yes, a man can eat fifty eggs (and Kobayashi later proved he can eat 70 hot dogs as well).

Fear and Loathing in Las Vegas: Like escargot or Spam, it is an acquired taste. Some people may never acquire it, and while people like myself would find it a shame, those people probably aren't that broken up about the fact (hey, I hate octopus........but it doesn't adversely impact my epicurean enjoyment). It is a reason to love Johnny Depp as an actor who is so immersed in Hunter Thompson as a character I would wonder if Hunter would have performed much differently himself. If you are willing, it is worth the ride. Maybe have a drink or two first.

Very Bad Things: The words dark or black comedy get thrown around a little too liberally. Very few movies reach the inspired heights (or depths dependent on view) of a true black comedy. I can recall only a small handful that didnt make a sudden turn and end on an up note or some other pointless treacle. This one doesn't. If anything, the ending is a rousing affirmation of
all that leads up to it. Karma is a bitch.

Apocalypse Now: This film is dark and deeply disturbing and also incredibly well constructed with standout performances and some cinematic moments that are indelibly etched in hollywood history. The song 'Riders on the Storm" was virtually reinvented.

300: Pure popcorn. 2-D characters and ultimately forgettable save for the CGI and the physical look of the film. A comic book come to life.

Anchorman: I have heard it said before and I couldn't agree more fervently: the Caddyshack of my generation. Spectacularly quotable and deliciously offbeat. You will never think of San Diego the same way again. A comedy that holds up to repeated viewings, which is saying something.

Tombstone: A movie that would be good, but not great, were it not for Val Kilmer's Doc Holliday. He was to this film what Johnny Depp was to Pirates. Worth it for the scenes he is in and when the revenge heats up at the end.

Chasing Amy: Technically, this film is a disaster. No real cinematography and an amateur feel. Smith is no auteur to be certain. But, the dialogue is punchy and Jason Lee is hilarious. I am not saying much by saying this, but it is probably the best 'acting' that Ben Affleck has done as well.

Shawshank Redemption: In my mind, the most perfect film on the list. Sublimely acted and incredibly well-acted with a story that is more than a wink and a nod to the Count of Monte Cristo's style of revenge. The redemption at the end always gets to me. It is the book brought to life.

Fight Club & Seven: Both have Brad Pitt and both were directed by David Fincher so I tie them together despite little else in common. Both still resonates after repeated viewings.

Just my Luck: Lindsay Lohan's finest perform...............who am I kidding. I cant even pretend I saw it, let alone liked it. Just seeing if anyone read this far :)

If my sanity holds, I will post when more becomes apparent with jobs, exams and the like.

Friday, July 04, 2008

4th of July update

My updates have been quite scattershot of late owing largely to the fact that my life has been quite scattershot of late. There is a definite lack of focus, because so much seems to be going on. Between dealing with medical issues, trying to unpack the house, buying all the little things that you don't think about (hard to hang up a shower curtain without a the rings), and NCLEX practice, my life feels so weirdly unfocused after having school be the center of everything for a year.

Today, as most days, I should be studying. Of course, I have a fairly legitimate excuse today as, despite the holiday, they are doing seemingly unending lawn maintenance at the apartment complex. Most exasperatingly, in spite of the size of the complex, it seems a majority of the work is being done around the building my apartment is in. I don't think it would be much louder if they were doing the work in my actual apartment. Of course, without a/c my choices are muted noise and uncomfortable temperatures or windows open and the waves or grating chainsaw noise mixed with other lawn implements. I know I am just bitching, but it is a skill that I have and i would hate to dull it with disuse.

In other news, the clock is now set for the end of my time with my gall bladder: July 18th. We had some good times together, all you can eat pizza buffets, BBQ, and po boy sandwiches to name but a few, but like all relationships there comes a time that you either have to make a commitment or go your separate ways. I wasn't willing to deal with his moodiness and mercurial nature. He wasn't able to handle me...........uh, eating things. It just wasn't meant to be.

I started working finally.........though not as a nurse just yet (pesky NCLEX test still in the way). It feels nice to earn an income. It has been more than a year since that has happened. I am working at PRE for a bit to help them out and ensure that I can at least put gas in my car. It seems like a nice place. Very familial. It makes me wonder what Salem hospital (or wherever I end up) will be like. Finding a workplace is like trying out a new bed. You can lay on them at the store and get an idea that which beds are comfortable and which ones are not......but until you spend some time sleeping on them, you honestly don't know. It isn't until a couple of weeks go by (at least) that the veneer of newness dissipates and the reality of the job sets in. It will be nice to at least see the place on the 8th. Of course, since I am supposed to start there on the 21st and my gall bladder is being removed on the 18th, discussions may have to ensue about just how long I can postpone starting (or if I can at all). I have heard nothing back from any of the other places I have applied thus far.

Hope everyone has a wonderful 4th of July.