For those of you wondering what happened on Thursday after Wednesday's fiasco........well, it was another peculiar day. We arrived at our usual time and went through our usual meetings, only the second meeting, the one with the entire staff, was performed with the truly disruptive patient (we'll call him the assclown or AC for short) was up to his antics. AC danced around, practiced his karate moves, banged on the windows, screamed profanities and was his usual AC self. We ended up not leaving the conference room for the next few hours and, ultimately, leaving the floor entirely at 11am. The lunatics do run the asylum evidently, at least at RPC. The attitude on the floor remained that of the neglectful parent better off ignoring the problems than dealing with them. Moving on.
Our new floor is one that deals with long term care patients. Patients who have been in the institution for better than 25 years in some cases. My patient had been in and out of RPC 40 times since he was 16 (61 at present). Some may wonder why you would let a person out again after their 10th, 15th or 20th admission. I do. Especially after talking to him.
My patient claims the following things: he is the wealthiest man in the world (trillions); he has located more than a half dozen nuclear weapons in and around Rochester; he is a psychic who has used his ESP to assist in the arrests of hundreds of criminals; his psychic ability makes him immortal; he is being poisoned by the staff (who work for the mafia), but has an antidote he takes daily; etc. The litany is interesting but also continues uninterrupted for long stretches. Other patients tell similar tales of oddness including the need to do abdominal exercises to "strengthen your testicles and strengthen your seed." It is so peculiar I dont think I can adequately describe it. That said, it is much much better than the other floor because they are all well medicated, have a strong rapport with staff, and the staff seems to work very well together.
ECT (electro convulsive therapy) was interesting to say the least. First off, I had no clue that they still shocked people. The second "shocking" (get it? :) thing about it was how short the duration of the actual therapy is. It encompasses all of 10 seconds of the hour the patients come in. There is no way to describe how it feels to be sitting and talking with someone and then, 20 minutes, later they are laying on a gurney, paralyzed and unconscious, getting pumped with alternating current. Within 20 minutes of this experience, they are up and walking out the door with the only caveats on their behavior being abstinence from alcohol and signing contracts. The therapy evidently works by directly stimulating your brain and, in this manner, helping to cure symptoms of depression. Interestingly, it also causes memory loss. Perhaps it just makes the patients forget what it was that was depressing them in the first place.
There is little else to add at the moment. Classes are still stupendously dull (we are having an entire 2-3 hour lecture on APA style in the research class......I expect to be admitted to RPC shortly thereafter) and there is little else to remark upon. Another week begins.....hopefully it is quick.
Saturday, September 22, 2007
Wednesday, September 19, 2007
sofa king crazy
Be careful what you wish for. Today there was definitely some excitement on the floor. Unfortunately, it wasn't like finding a $20 bill in your jacket pocket exciting. It was more like, "is that a bee in my car?" exciting.
To being the story, I should state that I had only slept 4 hours last night. I have no explanations as to why my body inexplicably determined that 2am was an appropriate bedtime, but it did. So, as I ambled into the rotation today, I will in a less than stupendous mood. We went through the usual morning progression of meetings and then things got weird. The new patient, a young muslim male in his early 20s, appeared outside of our conference room. The conference room in question is behind the nurses station and, oddly, located next to one of the quiet rooms that patients use when too much stimulus exists for them to maintain functionality. Odder still, the rooms are separated by windows that lack any mechanism to shield the persons in one room for those in the other. The patient was evidently sent to the quiet room to chill out, but that isnt what he did.
What he did do was begin to yell invectives and hop about like his ass was aflame. He also began to tap maniacally on the glass. He then spotted a classmate of mine which he believed he knew and then began to direct his vitriol towards her directly. Exclamations about where he would stick his "hairy muslim dick" (with a creative use of adjectives) leapt from his tongue with the alacrity of lies from the lips of Alberto Gonzalez. This scared my classmate to no end and awoke in me the big brother protective instinct. While we were instructed to keep our eyes averted from his antics and ignore his entreaties, I could not help but want to leave the room, wrench his scrawny arm behind his back and drag him into the room to offer formal apologies. But we arent allowed to so much as speak to him at risk of our academics, so we gathered our things and relocated. He followed to our new room and we eventually spent the remainder of our day on an outdoor patio without much interaction at all with our patients.
Why we should be put in such an awkward position is the first big question. The second might be why nothing was done to remove this patient from the floor. A litany of others might follow. But, despite any of these things we will be back there tomorrow. I hope we arent asked to endure the day again.
On a sidebar, another patient on the floor apparently came out of his room, penis hanging loosely from the front of his boxer shorts covered in what the social worker described as 'semen' telling that same social worker to come over and 'suck his dick' the evening prior. Maybe psych isnt quite the place for me......or anyone for that matter.
To being the story, I should state that I had only slept 4 hours last night. I have no explanations as to why my body inexplicably determined that 2am was an appropriate bedtime, but it did. So, as I ambled into the rotation today, I will in a less than stupendous mood. We went through the usual morning progression of meetings and then things got weird. The new patient, a young muslim male in his early 20s, appeared outside of our conference room. The conference room in question is behind the nurses station and, oddly, located next to one of the quiet rooms that patients use when too much stimulus exists for them to maintain functionality. Odder still, the rooms are separated by windows that lack any mechanism to shield the persons in one room for those in the other. The patient was evidently sent to the quiet room to chill out, but that isnt what he did.
What he did do was begin to yell invectives and hop about like his ass was aflame. He also began to tap maniacally on the glass. He then spotted a classmate of mine which he believed he knew and then began to direct his vitriol towards her directly. Exclamations about where he would stick his "hairy muslim dick" (with a creative use of adjectives) leapt from his tongue with the alacrity of lies from the lips of Alberto Gonzalez. This scared my classmate to no end and awoke in me the big brother protective instinct. While we were instructed to keep our eyes averted from his antics and ignore his entreaties, I could not help but want to leave the room, wrench his scrawny arm behind his back and drag him into the room to offer formal apologies. But we arent allowed to so much as speak to him at risk of our academics, so we gathered our things and relocated. He followed to our new room and we eventually spent the remainder of our day on an outdoor patio without much interaction at all with our patients.
Why we should be put in such an awkward position is the first big question. The second might be why nothing was done to remove this patient from the floor. A litany of others might follow. But, despite any of these things we will be back there tomorrow. I hope we arent asked to endure the day again.
On a sidebar, another patient on the floor apparently came out of his room, penis hanging loosely from the front of his boxer shorts covered in what the social worker described as 'semen' telling that same social worker to come over and 'suck his dick' the evening prior. Maybe psych isnt quite the place for me......or anyone for that matter.
Tuesday, September 18, 2007
trying to stay motivated....in spite of school
As my blog attests, the last few weeks have not provided much fodder. What I had hoped would be an experience replete with wild stories and interesting people has instead devolved into 16 hours a week in a clinical that leaves much to be desired. Instead of being involved in any nursing activities, we spend our hours playing Sorry and Uno with the patients and try to eat big chunks out of our days. We spend the first two hours of each day in meetings, the first hour with our group and the second hour with the staff on the floor. We then meander out onto the floor around 9:15 or thereabouts and, at 9:30 the patients have their first group. We can attend or not at our discretion, but if we dont attend we have to go sit in the back conference room and, ostensibly, read their chart for the 100th time. The group lets out at a quarter past 10 with the next commencing a half hour later. They lunch at noon and we often leave. When we return to the floor we try to soak up the last remaining hours chatting with our patients or writing our daily SOAP note (not worth explaining). Sure, there are a few colorful characters, but none on our floor.
Unfortunately, the classes are no better. The psych class is just as dull as the rotation, only it only takes up 6 hours (though it seems like so much more). The instructor is very fond of the sound of her own voice. It is unfortunate that I do not share her interest in it. Unlike some classes where you find the instructor reading from the powerpoint slides, she reads around them. Both kinds of instructors have their disadvantages, but neither imparts much knowledge.
The research course, which I had been looking forward to, has been a BIG disappointment thus far as well. It has been more focused on how to look up an article than how to read and evaluate research. I evidently mistook the title. I thought we would learn not how to understand research and better evaluate it......instead we are learning little more than how to use the library's computer system. To quote my roommate Krista, "Boo."
We also have a lab course that has proven, thus far, to be quite disjointed and uneven. We spent an hour today learning about ABG lab values and then the second hour practicing sterile technique while we removed a bandage around a PICC (peripherally inserted central catheter) line on a dummy. Think changing a bandage only with sterile gloving and a mask.
I am sure this whole blog post will come off negative.....and that wouldn't be inaccurate. The reality is that this will change in the coming weeks. I have another 2 1/2 in psych and then it is back to acute care (which will be another round of wiping ass and changing bed linens, but at least it will be a bit more medical than anything we are doing presently). In spring, we get into OBGYN and pediatrics, which will likely prove much more interesting. Until then, I will keep slogging along and keeping the end goal in mind.
Unfortunately, the classes are no better. The psych class is just as dull as the rotation, only it only takes up 6 hours (though it seems like so much more). The instructor is very fond of the sound of her own voice. It is unfortunate that I do not share her interest in it. Unlike some classes where you find the instructor reading from the powerpoint slides, she reads around them. Both kinds of instructors have their disadvantages, but neither imparts much knowledge.
The research course, which I had been looking forward to, has been a BIG disappointment thus far as well. It has been more focused on how to look up an article than how to read and evaluate research. I evidently mistook the title. I thought we would learn not how to understand research and better evaluate it......instead we are learning little more than how to use the library's computer system. To quote my roommate Krista, "Boo."
We also have a lab course that has proven, thus far, to be quite disjointed and uneven. We spent an hour today learning about ABG lab values and then the second hour practicing sterile technique while we removed a bandage around a PICC (peripherally inserted central catheter) line on a dummy. Think changing a bandage only with sterile gloving and a mask.
I am sure this whole blog post will come off negative.....and that wouldn't be inaccurate. The reality is that this will change in the coming weeks. I have another 2 1/2 in psych and then it is back to acute care (which will be another round of wiping ass and changing bed linens, but at least it will be a bit more medical than anything we are doing presently). In spring, we get into OBGYN and pediatrics, which will likely prove much more interesting. Until then, I will keep slogging along and keeping the end goal in mind.
Thursday, September 13, 2007
Vacate is the word
I have officially completed week #2 of my psych rotation. That and a hill of beans of course get me nowhere. It reinforces just how quickly time passes and how queerly short-lived these courses are. I have my midterm on Tuesday after a sum total of three actual class lectures. A big fat whatever.
As far as the classes go thus far, they are very disappointing. the psych lecture is kind of like watching a Jerry Bruckheimer movie.........except that it costs exponentially more and is far less entertaining. The class, like the movie, lasts about 3 hours and, after its over, you immediately forget what you saw. I thought I had contracted a terminal case of ADHD, but it turns out in surveying other members of the class that I am not alone. Ah well, hopefully the tests arent difficult.
The rotation continues to be interesting. The amalgam of disorders clustered together on the floor is quite arresting. there is one patient with a facial tattoo (among many other tattoos.......I think I can safely assume that NO ONE makes a facial tattoo their first), another that has bouts of mania expressed by singing and dancing, and yet another that claims millions in the bank if he can just get out. The sad thing is that once these patients do get out, where do they go? They either go to group homes or are sent to temporary housing (essentially a half-step up from living on the streets) and in most cases they relapse and end up in trouble with the law and return. In no way can you 'cure' any of these people. Thats what makes it really interesting though.....and probably incredibly frustrating too.
Speaking of temporary housing, my own situation is now tenuous. Tia and I are not nearly homeless, but we are also not really that far from needing another place to live. In the past week, the condo has fallen through (much to our delight considering what a massive tool the seller has been and Tia's desire to return to school somewhere other than ROC in the fall), there are now possible house renters (that it too much a story to detail here), and the possibility remains that it could be put back on the market..........or we could stay here. God knows what is going to happen. Hopefully we will soon too.
I need to go write my journal and catch up on assignments.
As far as the classes go thus far, they are very disappointing. the psych lecture is kind of like watching a Jerry Bruckheimer movie.........except that it costs exponentially more and is far less entertaining. The class, like the movie, lasts about 3 hours and, after its over, you immediately forget what you saw. I thought I had contracted a terminal case of ADHD, but it turns out in surveying other members of the class that I am not alone. Ah well, hopefully the tests arent difficult.
The rotation continues to be interesting. The amalgam of disorders clustered together on the floor is quite arresting. there is one patient with a facial tattoo (among many other tattoos.......I think I can safely assume that NO ONE makes a facial tattoo their first), another that has bouts of mania expressed by singing and dancing, and yet another that claims millions in the bank if he can just get out. The sad thing is that once these patients do get out, where do they go? They either go to group homes or are sent to temporary housing (essentially a half-step up from living on the streets) and in most cases they relapse and end up in trouble with the law and return. In no way can you 'cure' any of these people. Thats what makes it really interesting though.....and probably incredibly frustrating too.
Speaking of temporary housing, my own situation is now tenuous. Tia and I are not nearly homeless, but we are also not really that far from needing another place to live. In the past week, the condo has fallen through (much to our delight considering what a massive tool the seller has been and Tia's desire to return to school somewhere other than ROC in the fall), there are now possible house renters (that it too much a story to detail here), and the possibility remains that it could be put back on the market..........or we could stay here. God knows what is going to happen. Hopefully we will soon too.
I need to go write my journal and catch up on assignments.
Thursday, September 06, 2007
Camelot
When I think of Camelot, I used to imagine King Aurthur and the Knights of the Round Table......now I think some mentally imbalanced person is probably whipping a chair at someone. Its all contextual I guess. Spending time with people you would actively avoid on a city bus is a different context to be sure. When they say Camelot on the loudspeaker, you just hope it isn't occurring on your floor as that means something has gone awry and the calvary had to be called. So long images of Merlin, hello images of violent psychotics.
I dont mean to paint an overly dreary picture. Truth be told, we have heard the call of 4 Camelots in the 2 days we have been on the floor, but none have been in our unit. The unit I am working on is comprised of the shorter term 'consumers' whose length of stay rarely extends beyond a season. The hospital does house longer tenured residents on other floors (one gentleman just passed away who spent 44 years, the latter 2/3 of the entirety of his earthly existence, in psychiatric care), but we are not privy to their units. The floor I work on is coed, with adults ranging from 18-64 years of age, and with varied levels of mental impairment. We are each assigned a patient and my own is in his late 30s and presents asymptomatically, which is good because it is easier and bad because it may not present much of any interest. He has a very short history medically and seems wholly in denial that he has any problems to contend with. It will be interesting following him from the snapshot view I got from today on through the weeks to see if he begins to accept that he has some issues to work out (which he assuredly does even if they aren't outwardly manifesting at all times) or continues to assert that all problems and issues in his life manifest largely in those around him leaving him blameless. We shall see. Other classmates have patients that display somewhat more readily their impairments. I was anxious about this rotation, but I am now just excited to see what happens. At the very least, the likelihood that I will be cleaning up poop in the next month seems nearly nonexistent :)
I am off to seek out textbooks online for which I will pay an exorbitant amount for up front, enjoy reading little or not at all, and then sell, recouping very little monetarily because, in those few scant months, the newest edition will have been released with such earth altering changes as a new font in the preface, a superfluous rewording to page 346 and a flashy new cover photo. Admit it, no one misses that part of college.
I dont mean to paint an overly dreary picture. Truth be told, we have heard the call of 4 Camelots in the 2 days we have been on the floor, but none have been in our unit. The unit I am working on is comprised of the shorter term 'consumers' whose length of stay rarely extends beyond a season. The hospital does house longer tenured residents on other floors (one gentleman just passed away who spent 44 years, the latter 2/3 of the entirety of his earthly existence, in psychiatric care), but we are not privy to their units. The floor I work on is coed, with adults ranging from 18-64 years of age, and with varied levels of mental impairment. We are each assigned a patient and my own is in his late 30s and presents asymptomatically, which is good because it is easier and bad because it may not present much of any interest. He has a very short history medically and seems wholly in denial that he has any problems to contend with. It will be interesting following him from the snapshot view I got from today on through the weeks to see if he begins to accept that he has some issues to work out (which he assuredly does even if they aren't outwardly manifesting at all times) or continues to assert that all problems and issues in his life manifest largely in those around him leaving him blameless. We shall see. Other classmates have patients that display somewhat more readily their impairments. I was anxious about this rotation, but I am now just excited to see what happens. At the very least, the likelihood that I will be cleaning up poop in the next month seems nearly nonexistent :)
I am off to seek out textbooks online for which I will pay an exorbitant amount for up front, enjoy reading little or not at all, and then sell, recouping very little monetarily because, in those few scant months, the newest edition will have been released with such earth altering changes as a new font in the preface, a superfluous rewording to page 346 and a flashy new cover photo. Admit it, no one misses that part of college.
Sunday, September 02, 2007
Popping off the top of my esophagus
I cant believe it has been two weeks since my last posting. Which means I have spent a solid two weeks dealing with only my own concerns and not those of some poor bedridden individual. I also cant believe that the holiday is winding down.
It was a pretty wonderful, though overly rapid, break. I definitely feel like I needed a few weeks to recuperate mentally from the grind of the summer. Tia and I spent the first week in Florida with my parents and, despite the inhospitable heat and humidity that greeted us, the trip was really great. We spent a good portion of the break poring over the sands of Venice beach on the gulf coast trying to locate the now elusive prehistoric shark teeth that I spent many summers searching for with my family growing up. Unfortunately, they had recently pumped some new sand on the beach and effectively buried most of what you could locate. They were harder to find than Lindsay Lohan's dignity.
The trip to Florida, as busy at it was and as much as I enjoyed seeing my parents, sped by furiously. It still seems as if a week's time could not have transpired between our arrival and departure. The extra 5lbs of girth about my middle section reminds me that it was no mere figment however. If you are reading this, I love you mom and dad and thank you for a wonderful holiday.
The second week has been spent largely reading leisurely, trying to return to routines, and dealing with the vagaries of life that so often try all of our patience. I wont recount any of the details of the mundane aspects of it other than to say that I abhor dealing with car insurance, buying a house/condo FSBO is maddening when you are dealing with the most obtuse seller in the history of realty, and financial aid and associated monetary school concerns remain enigmatic and frustrating.
I would love to attest to my readiness and willingness to return to school, but I am not one opposed in any way to idle time. Sure, there are times where I have yearned for activity and, lacking the money to find many to occupy my time, have bemoaned my financial situation and longed for the days when I will return to school if only to finish and begin accruing money instead of hemorrhaging it, but a few deep breaths and the feeling comfortably passes. I have really tried to enjoy this week something that I think we, as American people, often take for granted.......spending our time off doing little or nothing of import or note and, quite simply, just relaxing.
Speaking of relaxing, I am off to do a little more before school begins anew and I will be afforded almost none until the winter holidays. The next term starts on Tuesday with Psychiatric nursing to begin it all. I am sure there will be plentiful stories then.
It was a pretty wonderful, though overly rapid, break. I definitely feel like I needed a few weeks to recuperate mentally from the grind of the summer. Tia and I spent the first week in Florida with my parents and, despite the inhospitable heat and humidity that greeted us, the trip was really great. We spent a good portion of the break poring over the sands of Venice beach on the gulf coast trying to locate the now elusive prehistoric shark teeth that I spent many summers searching for with my family growing up. Unfortunately, they had recently pumped some new sand on the beach and effectively buried most of what you could locate. They were harder to find than Lindsay Lohan's dignity.
The trip to Florida, as busy at it was and as much as I enjoyed seeing my parents, sped by furiously. It still seems as if a week's time could not have transpired between our arrival and departure. The extra 5lbs of girth about my middle section reminds me that it was no mere figment however. If you are reading this, I love you mom and dad and thank you for a wonderful holiday.
The second week has been spent largely reading leisurely, trying to return to routines, and dealing with the vagaries of life that so often try all of our patience. I wont recount any of the details of the mundane aspects of it other than to say that I abhor dealing with car insurance, buying a house/condo FSBO is maddening when you are dealing with the most obtuse seller in the history of realty, and financial aid and associated monetary school concerns remain enigmatic and frustrating.
I would love to attest to my readiness and willingness to return to school, but I am not one opposed in any way to idle time. Sure, there are times where I have yearned for activity and, lacking the money to find many to occupy my time, have bemoaned my financial situation and longed for the days when I will return to school if only to finish and begin accruing money instead of hemorrhaging it, but a few deep breaths and the feeling comfortably passes. I have really tried to enjoy this week something that I think we, as American people, often take for granted.......spending our time off doing little or nothing of import or note and, quite simply, just relaxing.
Speaking of relaxing, I am off to do a little more before school begins anew and I will be afforded almost none until the winter holidays. The next term starts on Tuesday with Psychiatric nursing to begin it all. I am sure there will be plentiful stories then.
Thursday, August 16, 2007
My Christening
Just thought I would write a quick blurb and let everyone know that I was christened today. I was taking care of a patient who was unable to speak or understand more than a child's handful of English and was also in a state of moderate dementia. He was on one-on-one care (meaning someone was sitting in the room watching him all day so they didnt have to put him in restraints because the restraints 'agitated' him) because he had ripped out 3 catheters (1 for sure before the balloon holding it in his bladder was deflated......make my bits and pieces ache just writing about it) and numerous IVs. So, the person watching him needed a break and, while I was watching him for a bit, he began to flail about. Thinking he was having some problems, I ran to the bedside only to find out he had undone his adult diaper. He peed all over the floor and on my arm. At least pee is sterile.......though it did NOT make me feel awfully clean.
On the upside the person doing the one-on-one care did most of the cleaning up during the day as my patient had been prescribed Colace (a laxative) the evening before. I helped out a few times but lets just say that Colace is HIGHLY effective and leave it at that.
1 to go until Florida beckons!!!
On the upside the person doing the one-on-one care did most of the cleaning up during the day as my patient had been prescribed Colace (a laxative) the evening before. I helped out a few times but lets just say that Colace is HIGHLY effective and leave it at that.
1 to go until Florida beckons!!!
Wednesday, August 15, 2007
With deference to Margie from Fargo, "I think I'm gonna barf!"
Do not read this if you are of a delicate constitution as it will likely prove a mistake. You are warned :)
I have seen quite a few things that would make anyone, myself included, squeamish since I have started school. I have walked with bags filled with human offal, I have cleansed the genitals of the more corpulent amongst us (and the more malodorous), and I have observed a welling pool of urine more blood than urea and more solid than liquid. I will not pretend (even though it is my blog and I am well within my rights to augment myself both mentally and physically) that I have dealt with any or all of it with a smile, but I certainly have tried. Today was a different breed of animal......eh, like a liger or a tigon if they were repellent.
I had the option of working with another student today and, since I am mentally on vacation already I thought why the hell not. She thought the same. Turns out we did not know what we were getting into.
The patient has been on the floor for about a month now. I am learning that acute care spans the time frame between a day and somewhere just south of a year evidently. She was admitted looking something like a burn victim having succumb to some ill effects from a medication she was on. Her husband is a medical doctor, but evidently thought better of taking her in to attend to her problems until two weeks later, hence the severity of her ailments. Her co-morbidities are plentiful and I doubt I will cover them fully here. She has 100 pack years of smoking, severe COPD, she is on oxygen therapy, she has lost better than 60lbs in the past 6 months, she is diabetic, she experiences bouts of psychosis, she is unable to ambulate, she is fed through a peg tube in her stomach, and she is on contact precautions because of ORSA (Oxacillin Resistant Staph aureus). She is presently bedridden and in restraints to keep her from pulling out her feeding tube and/or IV lines. She is also shedding skin.
When I say she is shedding skin I dont mean the kind you see sheaf off your body after too much sunbathing. I mean the type of shedding that you really would have to see to believe. It comes off in sheets and sloughs off constantly. Her skin, despite this, has the tacky texture of a linoleum floor with a three day old soda spill dried upon it's surface. Bathing her yielded a bucket of wrinkled human detritus and putting lotion on her afterward necessitated changing gloves as they gathered up more flecks of skin than a rake would leaves on a fall day. It is probably beyond my words to explain it as vividly as I would like (though it will likely spare you the images I will have for some time). The smell I will leave to your imagination as typing this has proven enough for me.
The counselor told us when seeking employment not to make a list of what we like, but rather to make one of what we do not like. This has shot to damn near the top of that list. Were the profession limited in scope in such a way that this rotation was representative of the whole, I would have removed myself from it by now, but it is no more than merest of fractions of what can yet be. I cannot wait to move on. 2 days until that happy event occurs.
I have seen quite a few things that would make anyone, myself included, squeamish since I have started school. I have walked with bags filled with human offal, I have cleansed the genitals of the more corpulent amongst us (and the more malodorous), and I have observed a welling pool of urine more blood than urea and more solid than liquid. I will not pretend (even though it is my blog and I am well within my rights to augment myself both mentally and physically) that I have dealt with any or all of it with a smile, but I certainly have tried. Today was a different breed of animal......eh, like a liger or a tigon if they were repellent.
I had the option of working with another student today and, since I am mentally on vacation already I thought why the hell not. She thought the same. Turns out we did not know what we were getting into.
The patient has been on the floor for about a month now. I am learning that acute care spans the time frame between a day and somewhere just south of a year evidently. She was admitted looking something like a burn victim having succumb to some ill effects from a medication she was on. Her husband is a medical doctor, but evidently thought better of taking her in to attend to her problems until two weeks later, hence the severity of her ailments. Her co-morbidities are plentiful and I doubt I will cover them fully here. She has 100 pack years of smoking, severe COPD, she is on oxygen therapy, she has lost better than 60lbs in the past 6 months, she is diabetic, she experiences bouts of psychosis, she is unable to ambulate, she is fed through a peg tube in her stomach, and she is on contact precautions because of ORSA (Oxacillin Resistant Staph aureus). She is presently bedridden and in restraints to keep her from pulling out her feeding tube and/or IV lines. She is also shedding skin.
When I say she is shedding skin I dont mean the kind you see sheaf off your body after too much sunbathing. I mean the type of shedding that you really would have to see to believe. It comes off in sheets and sloughs off constantly. Her skin, despite this, has the tacky texture of a linoleum floor with a three day old soda spill dried upon it's surface. Bathing her yielded a bucket of wrinkled human detritus and putting lotion on her afterward necessitated changing gloves as they gathered up more flecks of skin than a rake would leaves on a fall day. It is probably beyond my words to explain it as vividly as I would like (though it will likely spare you the images I will have for some time). The smell I will leave to your imagination as typing this has proven enough for me.
The counselor told us when seeking employment not to make a list of what we like, but rather to make one of what we do not like. This has shot to damn near the top of that list. Were the profession limited in scope in such a way that this rotation was representative of the whole, I would have removed myself from it by now, but it is no more than merest of fractions of what can yet be. I cannot wait to move on. 2 days until that happy event occurs.
Sunday, August 12, 2007
Consuming booze and gut fuel
What a bummer weekend. It went downhill faster than Britney's career. It actually wasn't altogether horrid, so you will have to excuse any hyperbole, but the condo situation is deteriorating rapidly. This could be a good thing in the long run because there is a lot less incentive to stick around ROC if we dont have inexpensive digs within spitting distance of campus. The main issues are twofold (three if you count the owner being a complete tool): there is asbestos tape on a small piece of piping coming out of the furnace that needs to be professionally removed and the piping repaired properly and one of the breakers kept shutting off and heating up whenever you turned on anything upstairs. The first problem will cost about $375 to repair and the second could range anywhere from replacing the breaker to all the wiring in the house being aluminum, bringing with it the whole 'fiery inferno' potential that, aside from those of us with an arson bend, is not appealing. So, we feel he needs to get that stuff fixed and he is the kind of guy that keeps bills in his wallet so long that the Lincoln is getting an ingrown beard. It sucks. No more looking at FSBO (for sale buy owner) homes.
In an effort to check out the other fish in the sea real-estate wise, we popped into a condo community today for a gander. The place itself is nice if a bit dated. The rooms were large (as were the taxes) and the real estate agent pretty much said outright that the owner was extremely motivated to sell. What we fell in love with was the community which includes an Olympic-sized indoor heated pool, two indoor raquetball courts, an indoor basketball court, a fitness center and the nicest people I have met. It was pretty sweet. It is closer than this house, but not as close as the other place. The downside is that it is not altogether that much less expensive. A head scratcher at the moment.
As for school......it goes. I was so nervous and excited to get to clinical, and now I can't wait to move along. I, as well as most people I have spoken with, have our eyes on the vacation ahead and have pretty much had our fill of cleaning up feces and wiping ass. We got to give meds, injections, put info in charts, and attend to other types of patient care........and that was good, but having one patient also makes for a LONG day once you have the general care down. Much like having one table as a server or one customer in retail......they will keep you moderately busy, but only for so long. The rest of the day is spent trying to busy ourselves with whatever is, or at least appears to be, productive. I am glad I feel that way though, because it beats the hell out of feeling overwhelmed.
Also, as a post script to my usual rants, check out Scott Baio is 45 and single if you get a chance. Compelling stuff.
Off to learn about the Alaris pump.
In an effort to check out the other fish in the sea real-estate wise, we popped into a condo community today for a gander. The place itself is nice if a bit dated. The rooms were large (as were the taxes) and the real estate agent pretty much said outright that the owner was extremely motivated to sell. What we fell in love with was the community which includes an Olympic-sized indoor heated pool, two indoor raquetball courts, an indoor basketball court, a fitness center and the nicest people I have met. It was pretty sweet. It is closer than this house, but not as close as the other place. The downside is that it is not altogether that much less expensive. A head scratcher at the moment.
As for school......it goes. I was so nervous and excited to get to clinical, and now I can't wait to move along. I, as well as most people I have spoken with, have our eyes on the vacation ahead and have pretty much had our fill of cleaning up feces and wiping ass. We got to give meds, injections, put info in charts, and attend to other types of patient care........and that was good, but having one patient also makes for a LONG day once you have the general care down. Much like having one table as a server or one customer in retail......they will keep you moderately busy, but only for so long. The rest of the day is spent trying to busy ourselves with whatever is, or at least appears to be, productive. I am glad I feel that way though, because it beats the hell out of feeling overwhelmed.
Also, as a post script to my usual rants, check out Scott Baio is 45 and single if you get a chance. Compelling stuff.
Off to learn about the Alaris pump.
Wednesday, August 08, 2007
A poo free day!
There haven't been many and there may not be many up ahead, but today was finally poo free. It was touch and go all shift though because my patient did wear adult briefs........but today the fates smiled upon me clearly (my patient is also morbidly obese, so it could have gotten ugly quick!) I do have the same patient tomorrow, so who knows if my luck will hold that long, but here is hoping that he chooses to do so in the care of the evening or early morning crew.
I also gave my first injections today (my mom will likely cringe just reading about it). It wasnt as bad as I thought it would be, although honestly I hadn't given it too much thought altogether. I just kind of assumed we would have to do it and I hoped that I wouldn't cause the patient too much grief. Mission accomplished. Injected some heparin (an anticoagulant) into his stomach and some insulin into his arm. I can now say this much, though I didnt really enjoy giving shots, it is both a hell of a lot better than getting them and, as you can imagine, infinitely better than the whole cleaning up poo thing that I love oh-so-well.
So far, the techs seem to love us because we do the grunt work that they no longer have to (at least for some patients in our care) and the nurse's like us because they have one less patient to tend to. i am sure the hospital digs all the free help too.
Off to read and relax. Two more days and a write-up to get to before the last pre-vacation weekend. I cant wait to have some time off, see my parents, and enjoy a real beach.
I also gave my first injections today (my mom will likely cringe just reading about it). It wasnt as bad as I thought it would be, although honestly I hadn't given it too much thought altogether. I just kind of assumed we would have to do it and I hoped that I wouldn't cause the patient too much grief. Mission accomplished. Injected some heparin (an anticoagulant) into his stomach and some insulin into his arm. I can now say this much, though I didnt really enjoy giving shots, it is both a hell of a lot better than getting them and, as you can imagine, infinitely better than the whole cleaning up poo thing that I love oh-so-well.
So far, the techs seem to love us because we do the grunt work that they no longer have to (at least for some patients in our care) and the nurse's like us because they have one less patient to tend to. i am sure the hospital digs all the free help too.
Off to read and relax. Two more days and a write-up to get to before the last pre-vacation weekend. I cant wait to have some time off, see my parents, and enjoy a real beach.
Sunday, August 05, 2007
Smells like poo
Ah clinicals, what is it about you that I love so well. Is it the early mornings? No, I hate that. Is it the white uniforms that breathe like Hefty bags? No, not a fan of that either. Must be the poo. As the song in Scrubs says, everything comes down to poo. (http://www.gibbleguts.com/scrubs-poo-song.html)
How many days does it take to get the smell out of your nose? God only knows, but I can tell you it isnt an easy thing to forget. Here is how Friday went: Our patient on Friday must have had 4-5 BMs and, instead of putting her in an adult undergarment, they seem to think that a pink pad is appropriate. Suffice to say, that can get messy........kind of like pooping directly onto your sheets. Clean up involves a lot of wet washcloths and, since the patient is largely bedridden, quite a bit of rolling her to and fro as we attempt to clean her linens (you have to roll up the dirty linens and roll the patient over top of them and onto the clean linens......not as easy as you think it might be. Next time you are extremely bored try making the bed while someone lies in it). The attending MD wanted her in her chair so, our fellow nurses (the nurse for our patient and the GN she was working with) decided we should move her with just the linens (it did not go smoothly) and then, once in the chair, the RN did not securely attach the feeding tube so the pt ended up with chocolate all over her. When we moved her to clean up, she had had another BM, so they thought we should move her back to the bed. Instead of using proper technique yet again, they opted to stand her up and pivot her, smearing poo all over her newly changed sheets (meaning we had to change them again). The patient is on contact precautions also, so while cleaning her we have to wear protective garments that are made of plastic......so now we are sweating hot on top of the smell and poo pretty much everywhere. Suffice to say, it wasnt the worlds greatest day, but mostly because the RN and GN we were working with were not pleasant (and when our NP notified the head nurse about our experience the head nurse just said, "without assigning blame, lets just say it isnt your students' fault whatsoever). We had worked directly with the head nurse and a different GN the day prior, so they knew that we did a good job. Moral of the story is that nurses (or GN in this case) with a tramp stamp are complete tools (not sure if that is a moral that can be applied elsewhere, so mold it as you see fit).
Does any of this make me want to give up? Not whatsoever......but I think we are getting to experience the worst of it for sure. I do not envy the techs and CNAs at all, but I appreciate the hell out of them. Hopefully I always remember to let them know how much I appreciate the work they have to do when I am a nurse.
On an aside rant, Tia and I went to Wegmans grocery tonite and they have the most inane alcohol policy that I have yet heard of. Tia neglected to bring her driver's license so they wouldnt sell me the beer even though I had my ID. Tia tried to argue that it was a good means to stop the sale of beer to the underaged, but that would really only prevent the sale to the truly stupid. All I would have had to do is to have Tia not be near me when I bought it and there would be no issue. Same goes for if I were 21 and was buying it for the underaged. So, all the policy really does is piss people like me off and prevents NO ONE whatsoever with a valid ID from buying beer for the underaged unless they are standing directly next to them. Kudos Wegmans!
On the other side of that coin Tia, being the overly sweet super-GF she is, went out to pick up some beer later that night. yeah for Tia and yeah for a cold Sunday night beer.
Condo inspection tomorrow. Hope everything comes our all right........or if not the inspector at least finds it. The inspector Tia had for this house couldnt have found water in the ocean.
Off to finish Potter. I am having a hard time finishing it because it will be sad that it is all over.
2 weeks til vacation!!!
How many days does it take to get the smell out of your nose? God only knows, but I can tell you it isnt an easy thing to forget. Here is how Friday went: Our patient on Friday must have had 4-5 BMs and, instead of putting her in an adult undergarment, they seem to think that a pink pad is appropriate. Suffice to say, that can get messy........kind of like pooping directly onto your sheets. Clean up involves a lot of wet washcloths and, since the patient is largely bedridden, quite a bit of rolling her to and fro as we attempt to clean her linens (you have to roll up the dirty linens and roll the patient over top of them and onto the clean linens......not as easy as you think it might be. Next time you are extremely bored try making the bed while someone lies in it). The attending MD wanted her in her chair so, our fellow nurses (the nurse for our patient and the GN she was working with) decided we should move her with just the linens (it did not go smoothly) and then, once in the chair, the RN did not securely attach the feeding tube so the pt ended up with chocolate all over her. When we moved her to clean up, she had had another BM, so they thought we should move her back to the bed. Instead of using proper technique yet again, they opted to stand her up and pivot her, smearing poo all over her newly changed sheets (meaning we had to change them again). The patient is on contact precautions also, so while cleaning her we have to wear protective garments that are made of plastic......so now we are sweating hot on top of the smell and poo pretty much everywhere. Suffice to say, it wasnt the worlds greatest day, but mostly because the RN and GN we were working with were not pleasant (and when our NP notified the head nurse about our experience the head nurse just said, "without assigning blame, lets just say it isnt your students' fault whatsoever). We had worked directly with the head nurse and a different GN the day prior, so they knew that we did a good job. Moral of the story is that nurses (or GN in this case) with a tramp stamp are complete tools (not sure if that is a moral that can be applied elsewhere, so mold it as you see fit).
Does any of this make me want to give up? Not whatsoever......but I think we are getting to experience the worst of it for sure. I do not envy the techs and CNAs at all, but I appreciate the hell out of them. Hopefully I always remember to let them know how much I appreciate the work they have to do when I am a nurse.
On an aside rant, Tia and I went to Wegmans grocery tonite and they have the most inane alcohol policy that I have yet heard of. Tia neglected to bring her driver's license so they wouldnt sell me the beer even though I had my ID. Tia tried to argue that it was a good means to stop the sale of beer to the underaged, but that would really only prevent the sale to the truly stupid. All I would have had to do is to have Tia not be near me when I bought it and there would be no issue. Same goes for if I were 21 and was buying it for the underaged. So, all the policy really does is piss people like me off and prevents NO ONE whatsoever with a valid ID from buying beer for the underaged unless they are standing directly next to them. Kudos Wegmans!
On the other side of that coin Tia, being the overly sweet super-GF she is, went out to pick up some beer later that night. yeah for Tia and yeah for a cold Sunday night beer.
Condo inspection tomorrow. Hope everything comes our all right........or if not the inspector at least finds it. The inspector Tia had for this house couldnt have found water in the ocean.
Off to finish Potter. I am having a hard time finishing it because it will be sad that it is all over.
2 weeks til vacation!!!
Thursday, August 02, 2007
A quick blurb
I havent a lot of time or energy tonite, so this will likely be shorter than Tom Cruise standing in a pothole. I just wanted to write how exciting it is (though wickedly tiring) to be on the floor doing actual nursing work. Sure, we also still do a lot of CNA/tech work, but we also get to distribute meds (oral and peg....which is through a parenteral feeding tube), take vitals, and clean wounds. Today I even put in a Foley catheter (which was actually less nerve wracking than I thought it would be, but largely because the patient has dementia). We are going to learn to give IV meds next week. I wont hide my terror at practicing injections on an orange and then trying to do it on a real person. Hopefully that patient will have dementia as well (so she/he can forget my feeble attempts at putting a needle in their arm). My only wish, and a longstanding wish at that, is that the days didnt start so bloody early. I am not now, and will likely never be, that agreeable in the early AM hours.
Off to finish Potter and then sleep. I have to know what happens.
Off to finish Potter and then sleep. I have to know what happens.
Sunday, July 29, 2007
Sundays are for bemused reflection
This program, as I have noted numerous times, is incredibly rapid and oftentimes confusing because of the speed. I have no idea what it is we are going to be doing throughout next week. I state that as there is something exciting in having no set routine or expectation of what is to come.....and also because there is certainly something to be said for the opposite of that entirely. I sometimes miss knowing what Monday will be like and the likely trajectory through the end of day Friday. I miss the confidence that comes with knowing what the hell you are doing and the comfort of working with people that come to you because of that knowledge. This program is oftentimes like the first day of a new job......except that it continues every day. Always meeting new people and being put in new situations and, on top of that, with real patients who have real problems and aren't always terribly excited to have you around. There persists a constant low-level anxiety.
Because of the nature of the program, the labs only introduce you to most concepts, and then tersely at best. Truly, the lab mannequins, while anatomically accurate, are nonetheless not animate and therefore never the least bit begrudging when you fail at one skill or another, such as repeatedly shoving catheters into their nether regions, and have to try it again. This will undoubtedly not be the case when a real patient is involved unless they are amiable beyond comprehension or seriously sadistic. I can say with no hesitation that the bath we gave the mannequin did not compare very favorably with the one I gave my patient, that diapering a mannequin was significantly less unpleasant than diapering a person (especially when you have real feces involved), and that practicing needle sticks on an orange will leave me less than confident that I will find a vein on a person. Often, the labs approximate the real settings about as well as running three miles on a treadmill approximates a marathon under the summer sun or as well as using a calculator prepares you to use a computer, which is to say not at all.
I understand the limitations however, I just miss being confident about any aspect of what I do. It is a weird lost feeling I hadnt truly felt since the first day I walked into a classroom to teach. That surreal sense of knowing you look the part, but now being expected to act it.
I hope that everyone is doing well. I had better get back to my patient write-up. Lord knows what I would do if I actually had a free weekend anymore :)
Because of the nature of the program, the labs only introduce you to most concepts, and then tersely at best. Truly, the lab mannequins, while anatomically accurate, are nonetheless not animate and therefore never the least bit begrudging when you fail at one skill or another, such as repeatedly shoving catheters into their nether regions, and have to try it again. This will undoubtedly not be the case when a real patient is involved unless they are amiable beyond comprehension or seriously sadistic. I can say with no hesitation that the bath we gave the mannequin did not compare very favorably with the one I gave my patient, that diapering a mannequin was significantly less unpleasant than diapering a person (especially when you have real feces involved), and that practicing needle sticks on an orange will leave me less than confident that I will find a vein on a person. Often, the labs approximate the real settings about as well as running three miles on a treadmill approximates a marathon under the summer sun or as well as using a calculator prepares you to use a computer, which is to say not at all.
I understand the limitations however, I just miss being confident about any aspect of what I do. It is a weird lost feeling I hadnt truly felt since the first day I walked into a classroom to teach. That surreal sense of knowing you look the part, but now being expected to act it.
I hope that everyone is doing well. I had better get back to my patient write-up. Lord knows what I would do if I actually had a free weekend anymore :)
Friday, July 27, 2007
Day 3 - embiggening the common man
What a way to wrap up your week. It actually ended on a very positive note. I have a completely new level of respect for what a CNA has to do on a daily basis.......it definitely isn't a cakewalk. Some of the students I was working on the floor with lamented how much break time the CNAs seemed to take, but I wouldn't begrudge them a minute of it. I spent the last few days hauling around plastic bags full of human excrement, changing diapers, washing bedridden patients (including in their nether regions......and then applying salves to said places) and generally seeing a lot of people with only the prospect of continuing deterioration ahead of them. And yet, as I was walking down the haul with one of the aforementioned bags filled with the waste products of a freshly changed colostomy bag, I couldnt help but feel a little giddy. Not because I was thrilled at that moment to be doing something that, 3 months ago I wouldnt have imagined myself doing in my wildest, and most displeasing, dreams, but because it didnt make my body shudder in revulsion......in fact it didnt bother me at all. I was much MUCH more discomfited by the thought of dragging my bleary behind out of bed before the sun chose to. Not only did the whole process not bother me, I actually felt good to have helped out. Over the long term, I think working at a place like a long term care facility would grind you down, but in the short term it was really a good way to get our feet wet.
On to acute care next week.
Sidebar: still no condo and now renters for the house. Might have to look at RVs.
On to acute care next week.
Sidebar: still no condo and now renters for the house. Might have to look at RVs.
Wednesday, July 25, 2007
Clinical Day 1
I think it will always be a memorable day if only because it most assuredly had some very surreal moments, the kind that will definitely stick with me.
The clinical is more a sampling of what is to come and the first taste was a long term care facility. We had to arrive at the facility at 7 in the morning which might as well be 2am to me. Not a morning person now or ever. Looks like I will have to adjust in the near future anyway. We began by participating in a brief orientation and then went up to our assigned floor in two groups of 8. My group went off to get our patient's charts. I had always thought of a chart as a compact bit of information distilled into a few scant pages in a manilla folder. These were 2" binders packed more tightly than Wal-Mart on Christmas Eve. It was interesting because I could actually understand a fair amount of what I was reading which made me somewhat happy. Unfortunately, what I was reading was mildly disturbing. My patient is morbidly obese, has a trach (and therefore isnt very communicative), a colostomy bag, is not ambulatory, has uncontrolled diabetes and an unpleasant demeanor known on the floor. It is only a three day gig, but I definitely got the prize. Should make for an interesting assessment.
I also had the pleasure (?) to witness not one but two colostomy bags being changed. It was a different experience to be sure, and not because of the odor. The strange thing was that the stoma was protruding, in both patients, a few inches. The stoma is part of the intestine outside of the body. It is a strange thing to see on the outside of the body. I had no idea it protruded to such an extent either.......like 2 or 3 inches. It was truly strange watching the nurse remove the bag and then wash the intestine. I also saw a suppository inserted and a trach cleansed. All in all, a big day. I dont know if long term care is something I would ever be interested in, but it definitely has knocked down some barriers.
Off to relax and sleep. Another early morning awaits.
The clinical is more a sampling of what is to come and the first taste was a long term care facility. We had to arrive at the facility at 7 in the morning which might as well be 2am to me. Not a morning person now or ever. Looks like I will have to adjust in the near future anyway. We began by participating in a brief orientation and then went up to our assigned floor in two groups of 8. My group went off to get our patient's charts. I had always thought of a chart as a compact bit of information distilled into a few scant pages in a manilla folder. These were 2" binders packed more tightly than Wal-Mart on Christmas Eve. It was interesting because I could actually understand a fair amount of what I was reading which made me somewhat happy. Unfortunately, what I was reading was mildly disturbing. My patient is morbidly obese, has a trach (and therefore isnt very communicative), a colostomy bag, is not ambulatory, has uncontrolled diabetes and an unpleasant demeanor known on the floor. It is only a three day gig, but I definitely got the prize. Should make for an interesting assessment.
I also had the pleasure (?) to witness not one but two colostomy bags being changed. It was a different experience to be sure, and not because of the odor. The strange thing was that the stoma was protruding, in both patients, a few inches. The stoma is part of the intestine outside of the body. It is a strange thing to see on the outside of the body. I had no idea it protruded to such an extent either.......like 2 or 3 inches. It was truly strange watching the nurse remove the bag and then wash the intestine. I also saw a suppository inserted and a trach cleansed. All in all, a big day. I dont know if long term care is something I would ever be interested in, but it definitely has knocked down some barriers.
Off to relax and sleep. Another early morning awaits.
Sunday, July 22, 2007
the weekend ends
Another week gone by the boards. This one was especially long because I didnt get my two 'sleep-in until you wake up' days because of a Saturday lab. I feel a bit cheated. The way the labs stacked up, my roomie ended up having to stay longer on days we had class, but had no school on Wednesday and none this weekend and, just prior to the start of our clinical rotations, she has Tuesday off as well. Truly we are in school the same amount of hours, but it is the time of those hours that really gets you (as those of you that know me know that mornings are not my preferred time of day).
Speaking of early and of clinical rotations, they start on Wednesday. I would say they crept up, but the truth is that nothing creeps up in this program.......at its slowest it would be fairer to say it lightly jogs up or ambles up (amble is a great word to describe movement by the way, much like gamble and saunter. Admit it, sauntering somewhere sounds a lot more interesting that walking there). The rotations are from 7-4. Meaning, I will be up prior to the sun. I am not sure if there is some cruel and unusual clause in the school's operating manual, but this would be a poor omission were it not. I would almost prefer it to be from 7pm to 4am.......its honestly a coin flip. At least I would be mostly awake for the first half of the rotation. I really hope I dont have to stick someone with a needle first thing in the AM. I can scarcely tie my shoes that early.
the labs have gotten more interesting as they have gotten more preparatory. We have spent the past week not taking vitals and percussing the hell out of each other which has been a turn for the better. Instead, we changed dressings, learned how to (on a dummy) insert a catheter, diapered each other, put on restraints, practiced a Hoyer lift, learned about respiratory treatments, practiced bed making with someone in it, and learned all about sterile technique. I am missing a lot I am sure........it was a thoroughly busy week. We have 4 weeks of class/lab/clinical and then a nice long holiday.
I am already dreaming of what I might do on the holiday, but since I have little money and two long weeks, I am thinking it will be a great time to read some books (like the Brothers K and the new Potter book) and watch movies and otherwise let my mind vegetate. Hopefully arrange for a few days driving trip to Canada or up into Vermont and Maine. Who knows. One month more and we are a full third through. Freaks me out just typing it. In the meantime, I have the next month to get through first.
I hope everyone is doing well. I am working on trying to keep up on the emails.
Until next week when I should have a lot to say about my first rotation.
Speaking of early and of clinical rotations, they start on Wednesday. I would say they crept up, but the truth is that nothing creeps up in this program.......at its slowest it would be fairer to say it lightly jogs up or ambles up (amble is a great word to describe movement by the way, much like gamble and saunter. Admit it, sauntering somewhere sounds a lot more interesting that walking there). The rotations are from 7-4. Meaning, I will be up prior to the sun. I am not sure if there is some cruel and unusual clause in the school's operating manual, but this would be a poor omission were it not. I would almost prefer it to be from 7pm to 4am.......its honestly a coin flip. At least I would be mostly awake for the first half of the rotation. I really hope I dont have to stick someone with a needle first thing in the AM. I can scarcely tie my shoes that early.
the labs have gotten more interesting as they have gotten more preparatory. We have spent the past week not taking vitals and percussing the hell out of each other which has been a turn for the better. Instead, we changed dressings, learned how to (on a dummy) insert a catheter, diapered each other, put on restraints, practiced a Hoyer lift, learned about respiratory treatments, practiced bed making with someone in it, and learned all about sterile technique. I am missing a lot I am sure........it was a thoroughly busy week. We have 4 weeks of class/lab/clinical and then a nice long holiday.
I am already dreaming of what I might do on the holiday, but since I have little money and two long weeks, I am thinking it will be a great time to read some books (like the Brothers K and the new Potter book) and watch movies and otherwise let my mind vegetate. Hopefully arrange for a few days driving trip to Canada or up into Vermont and Maine. Who knows. One month more and we are a full third through. Freaks me out just typing it. In the meantime, I have the next month to get through first.
I hope everyone is doing well. I am working on trying to keep up on the emails.
Until next week when I should have a lot to say about my first rotation.
Saturday, July 14, 2007
Without deadlines, you wouldnt be able to procrastinate
I am not sure if I got the quote quite right, but the gist of the quote that Krista told me is the same. I am just having a hell of a time getting my head together to write this final paper for Genetics. I have scads of information, a rubric to go by and still am finding it taxing to get the words organized in a cohesive manner. Plus, with Tia gone this weekend and the house on the market, I have been spending a lot of time scooping cat boxes, tidying up, and doing whatever I can think to do to get the pool from a pea-soup green color to something resembling blue. The house is listed in the paper today, so our Realtor seems o think we ought to be getting a few more people to come through and look at it. It is such a difficult situation considering that we have only a roughly formalized but yet to be signed contract on a new home (that will be much less expensive to maintain). So, if all goes well, we will end up selling this house soon and buying the new one within the next month. If not, I dont know what will happen because I know it is an expense that Tia is having a hard time bearing even with Krista paying rent and me giving Tia money as well.
I need to try to get myself motivated with some food and some caffeine. As always, wish me luck. It has been slow going thus far and, while the paper isnt due until next Friday, I have a feeling the new class wont leave a lot of time to do much of anything else.
Got three grades in:
Patho: B (1 point from a B+, I wont go into how poorly everyone seemed to do on the final paper, myself included)
Nursing Science: A- (just barely got it.......win some, lose some I guess)
Assessment: didnt do stellar on the last exam, but did enough to hold onto my B+
I need to try to get myself motivated with some food and some caffeine. As always, wish me luck. It has been slow going thus far and, while the paper isnt due until next Friday, I have a feeling the new class wont leave a lot of time to do much of anything else.
Got three grades in:
Patho: B (1 point from a B+, I wont go into how poorly everyone seemed to do on the final paper, myself included)
Nursing Science: A- (just barely got it.......win some, lose some I guess)
Assessment: didnt do stellar on the last exam, but did enough to hold onto my B+
Wednesday, July 11, 2007
mursiful heavens
We have almost surmounted our first hill. Unfortunately, cresting the first hill only shows you all the other hills to follow. In this case at least, it is better to look back than look ahead.
In looking back, i still cannot believe that we are nearing the end of 4 out of our 5 summer courses. There is still the matter of another exam tomorrow and a paper due by next Friday, but for the most part, its all but finished. My overall impressions are mixed thus far. There still seems to be a certain sense that the program is still in the process of finding a groove. There are too many incidents of paperwork getting to us just prior to deadlines and some classes feel superfluous. My thoughts in review:
Pathophysiology: An amazing class and one that I wish everyone could take, though much more slowly. Great instructor. (expected grade - B+, A-)
Nursing Science: Superfluous waste of time. Assignments were poorly explained and capriciously graded. (expected grade - B, B+, A-)
Genetics: Interesting, but not in depth enough to really garner much information. Spectacular instructor. (expected grade - A, A-)
Assessment: I have mixed feelings. The lab instructors were pretty sterling, but the class itself was middling. No consistency to the exams or papers. (expected grade - B, B+)
Overall, I think that there is definitely room to improve the program, but there are also some really strong points to build from.
The new course looks like it will teach us everything we could possibly imagine needing to know out in the field.......and once again in an incredibly short span of time. Most lessons are an hour or less with focuses of catheter insertion, bathing, and injections. Makes me fear doing it out in the field with so little practice time. Hope all the skills are easier to pick up than I presume they will be.
Not much else to report. Heard of a few students who have already dropped out/failed out of the program. A bit scary really, but the silver lining is that it is no one I know at least which would be more impacting since most people seem very competent and capable. Wish me luck on tomorrow's test. I may need it.
In looking back, i still cannot believe that we are nearing the end of 4 out of our 5 summer courses. There is still the matter of another exam tomorrow and a paper due by next Friday, but for the most part, its all but finished. My overall impressions are mixed thus far. There still seems to be a certain sense that the program is still in the process of finding a groove. There are too many incidents of paperwork getting to us just prior to deadlines and some classes feel superfluous. My thoughts in review:
Pathophysiology: An amazing class and one that I wish everyone could take, though much more slowly. Great instructor. (expected grade - B+, A-)
Nursing Science: Superfluous waste of time. Assignments were poorly explained and capriciously graded. (expected grade - B, B+, A-)
Genetics: Interesting, but not in depth enough to really garner much information. Spectacular instructor. (expected grade - A, A-)
Assessment: I have mixed feelings. The lab instructors were pretty sterling, but the class itself was middling. No consistency to the exams or papers. (expected grade - B, B+)
Overall, I think that there is definitely room to improve the program, but there are also some really strong points to build from.
The new course looks like it will teach us everything we could possibly imagine needing to know out in the field.......and once again in an incredibly short span of time. Most lessons are an hour or less with focuses of catheter insertion, bathing, and injections. Makes me fear doing it out in the field with so little practice time. Hope all the skills are easier to pick up than I presume they will be.
Not much else to report. Heard of a few students who have already dropped out/failed out of the program. A bit scary really, but the silver lining is that it is no one I know at least which would be more impacting since most people seem very competent and capable. Wish me luck on tomorrow's test. I may need it.
Friday, July 06, 2007
Murcenary
There are some days and weeks that are just harder than others to navigate. Not sure why that is, what cyclical issues are at play or what phases of the moon or tide may be involved, but they happen and i am in the midst of one right now. Part of it may be allergies (which have been nearly incapacitating some days), but I am sure most of it is stress related. I feel like I am in that period of time when the brain and body really want you to shut it down for a bit, but there isnt time for that. Every stressful event (my final demo) is followed by another task of some kind or another (a paper). The nature of the program is definitely not one of ebb and flow......but rather just flow. To keep up with that, you have to be on top of your game at all times. I have already had days here and there that arent my sharpest or best. Times where I would, and may have chosen to be, anywhere but studying. I think this program wont be so much about ability (as presumably all people who got in are capable), but it will be more about stamina and focus. It is a year, but it will likely feel a whole lot more than one.
In better news, the final demo went well. I am thinking with the write-up an 'A-' is likely in the cards. I of course forgot a lot of things I should have remembered, but it is done and I am quite pleased. In order to pass it you had to know how to do a 5 minute head to toe assessment (vitals, check for edema, bowels sounds, auscultate, etc) and know the 6 system exams thoroughly enough that you could do them all if you pulled them (you draw a name from a hat when you arrive to the examination). i pulled Abdominal which was rather short (thank goodness) and obviously did pretty well. Tia is happy I passed as well since I had to poke and prod her for days on end. i have heard that, thus far, three people have failed. I cant imagine how that would erode your confidence. But, that is why I study as much as I do.
I dont really have a lot to add. I am still doing pretty well in all my classes. There is one week to go before we move on to the next round of them. There are a lot of things to do between now and then as well. Speaking of things to do, I have work I need to get back to......then I am going to do something fun dammit! :)
In better news, the final demo went well. I am thinking with the write-up an 'A-' is likely in the cards. I of course forgot a lot of things I should have remembered, but it is done and I am quite pleased. In order to pass it you had to know how to do a 5 minute head to toe assessment (vitals, check for edema, bowels sounds, auscultate, etc) and know the 6 system exams thoroughly enough that you could do them all if you pulled them (you draw a name from a hat when you arrive to the examination). i pulled Abdominal which was rather short (thank goodness) and obviously did pretty well. Tia is happy I passed as well since I had to poke and prod her for days on end. i have heard that, thus far, three people have failed. I cant imagine how that would erode your confidence. But, that is why I study as much as I do.
I dont really have a lot to add. I am still doing pretty well in all my classes. There is one week to go before we move on to the next round of them. There are a lot of things to do between now and then as well. Speaking of things to do, I have work I need to get back to......then I am going to do something fun dammit! :)
Monday, July 02, 2007
My so called life
Truly, without Tia's insistence, I probably would have nothing near a life. At least she tries to make sure we do something non-school related, even if I sometimes feel guilty at this point for doing anything besides studying, writing papers, or practicing technique. She will be the reason I wont be institutionalized before the winter hits.
I dont have a lot to add in the way of school other than it is really coming up on crunch time. In the next 8 hours, I have a clinical paper due in Pathophysiology and within the next roughly 24 I have a final demo to do (because I misunderstood the instructions and hence signed up late......which is my MO of late, never seeming to get things together on time). The upside is that the demo will be done well before most other people have done their demo, the downside is that I had to (have to) learn 6 system examinations over the past few days and commit them largely to memory. As always, keep em crossed for me.
Outside of school, Tia celebrated her 26th, we went to a new fondue bar called Chocolate (you can imagine the food), and Tia and I are strongly considering the purchase of a new condo (well, new to us). It is another stressor, but will ultimately save a lot of money (mostly because you can buy a condo here for under $74,000) and time (no more lawn work, etc).
I would love to fill in more details, but school beckons.
I dont have a lot to add in the way of school other than it is really coming up on crunch time. In the next 8 hours, I have a clinical paper due in Pathophysiology and within the next roughly 24 I have a final demo to do (because I misunderstood the instructions and hence signed up late......which is my MO of late, never seeming to get things together on time). The upside is that the demo will be done well before most other people have done their demo, the downside is that I had to (have to) learn 6 system examinations over the past few days and commit them largely to memory. As always, keep em crossed for me.
Outside of school, Tia celebrated her 26th, we went to a new fondue bar called Chocolate (you can imagine the food), and Tia and I are strongly considering the purchase of a new condo (well, new to us). It is another stressor, but will ultimately save a lot of money (mostly because you can buy a condo here for under $74,000) and time (no more lawn work, etc).
I would love to fill in more details, but school beckons.
Thursday, June 21, 2007
Whew!
So the week that was is finally a 'was' instead of an 'is'. It included three exams and two write-ups and a CPR class for me. The score at the end of the week, I did well on the two Patho tests (though the second one was truly just recognition), but feel about as comfortable as a pair of tighty whiteys about the one today. Ah well, you cant win them all, and, as Garth Algar would say "live in the now man." Indeed.
Got back the scores from a bizarre test we took way back in week one: The NET (Nurse Entrance Exam). Theoretically, this exam would assess whether or not we possessed the skills necessary to make it in school and the profession. Of course, the point of giving it to us after we were already admitted is lost on me. I have doubts that if someone couldn't do math or write that they would kick them out now. The test yielded some surprising and entirely unsurprising results. First off, evidently I can do math. Yeah for me. I was in the 98% percentile. I am EXTREMELY curious to know what I missed (I missed one percentage operation), but I will be happy with how I did. I can also read fairly rapidly. However, my reading comprehension is just only above average and my knowledge of punctuation is below average?!,. (cant even figure out how to end the last sentence). Evidently I also dont have very good test taking skills (a skill they can test for apparently, though unrelated to math I would guess). However, it should be noted that my scores, as well as those of my classmates, ought to be curved somehow. We were given this test on our first Friday after all new classes, overwhelming lectures, and bustling about trying to dot every 'i'. Overall I ended up in the 88th percentile. Too bad that doesnt directly translate to school where I remain entrenched in my 55th percentile niche (it is a cozy place and I am quite comfortable).
Tia's birthday is this weekend. I got her a new bike (a surprise I cannot ruin since she already has ridden it). I am hoping to be able to clear out some time for us to do something fun on Sunday since her birthday and school match up about as poorly as Lindsay Lohan and rehab. I have a test that morning from 8-11 and classes that run until 7pm.
Off to bed. One more day to go before the weekend.
Got back the scores from a bizarre test we took way back in week one: The NET (Nurse Entrance Exam). Theoretically, this exam would assess whether or not we possessed the skills necessary to make it in school and the profession. Of course, the point of giving it to us after we were already admitted is lost on me. I have doubts that if someone couldn't do math or write that they would kick them out now. The test yielded some surprising and entirely unsurprising results. First off, evidently I can do math. Yeah for me. I was in the 98% percentile. I am EXTREMELY curious to know what I missed (I missed one percentage operation), but I will be happy with how I did. I can also read fairly rapidly. However, my reading comprehension is just only above average and my knowledge of punctuation is below average?!,. (cant even figure out how to end the last sentence). Evidently I also dont have very good test taking skills (a skill they can test for apparently, though unrelated to math I would guess). However, it should be noted that my scores, as well as those of my classmates, ought to be curved somehow. We were given this test on our first Friday after all new classes, overwhelming lectures, and bustling about trying to dot every 'i'. Overall I ended up in the 88th percentile. Too bad that doesnt directly translate to school where I remain entrenched in my 55th percentile niche (it is a cozy place and I am quite comfortable).
Tia's birthday is this weekend. I got her a new bike (a surprise I cannot ruin since she already has ridden it). I am hoping to be able to clear out some time for us to do something fun on Sunday since her birthday and school match up about as poorly as Lindsay Lohan and rehab. I have a test that morning from 8-11 and classes that run until 7pm.
Off to bed. One more day to go before the weekend.
Tuesday, June 19, 2007
One month and where I stand
So, one month after the start of school and things are still going pretty well. Yes, it is overwhelming and yes there is a lot to do and yes it will only get harder from here......but I finally found some time today to put my grades together and was a bit shocked at how relatively well I am doing. I didnt think I was bombing out, but I thought I mostly had a smattering of B's. This could change quite a bit in the next month or so (or in the next week really as I await scoring on the last Patho exam and a paper I turned in better than a week ago), but here is the run down (mostly written for myself so I can remember when I seemed to have a handle on things):
Patho: B+
Assessment: B+
Nursing Science: A-
Genetics: A
I was shocked that I was doing that well. Not because I think I am a moron, but the program really isnt easy. The amount of things we are asked to retain in a VERY short span of time is, at times, overwhelming.
Other than that, I met with my advisor the other evening (a really great guy who happened to do my interview as well) and it looks like things will get very interesting very soon. Within a month we will be learning how to inject, hang bags, bathe people and "wipe ass." Not all parts are equally enthralling. But we will get out to see actual patients and start practicing some of the things we have learned. I am both nervous and excited. We will have quite a bit of hands on experience before we get through the summer term. Just 6 weeks ago I was trying to put together a newsletter and in another 6 god knows what i will be doing. This would be an amazing adventure were it not so incredibly expensive.
Time to study for another exam.
Patho: B+
Assessment: B+
Nursing Science: A-
Genetics: A
I was shocked that I was doing that well. Not because I think I am a moron, but the program really isnt easy. The amount of things we are asked to retain in a VERY short span of time is, at times, overwhelming.
Other than that, I met with my advisor the other evening (a really great guy who happened to do my interview as well) and it looks like things will get very interesting very soon. Within a month we will be learning how to inject, hang bags, bathe people and "wipe ass." Not all parts are equally enthralling. But we will get out to see actual patients and start practicing some of the things we have learned. I am both nervous and excited. We will have quite a bit of hands on experience before we get through the summer term. Just 6 weeks ago I was trying to put together a newsletter and in another 6 god knows what i will be doing. This would be an amazing adventure were it not so incredibly expensive.
Time to study for another exam.
Monday, June 18, 2007
Cant look at the materials any more
So, I think I have about had my fill of hypo- and hypertension, SA nodes, and bradycardia (heart beat below 60) and thought it would be an opportune time to drop a quick blog and gather myself for one more comb through the material. I have been definitely feeling the "screw it"s this weekend as in, "if I dont know this stuff for the test by now, screw it." I still honestly feel like I am keeping up, but I need to really dedicate myself better to my studies. It is just hard to do when I feel like, between classes, papers, watching online videos, taking online tests, etc, it feels like I already breathe the stuff. The review sessions dont seem to help me either, seemingly just serving as a means to freak me out about all the things I dont know. I just know it is only going to ratchet up in intensity in the coming months and I have to match it with more time with my nose in a book and less time trying to keep a balanced life. That said, when I talk with Tia about class topics, I feel fairly comfortable with the meat and bones of the materials for the most part. My weak areas are the areas that were weak to being with, namely microbiology. It is one thing to say that someone is dealing with a problem needs drug A to get better, it is another thing to think of it in terms of blocking the renin-angiotensin system from operating and what that means at the cellular level. I constantly wonder how this will come into practice and/or how much of it is more or less informative, but that we will not be doctors after all.
Had a fairly lovely weekend. Lots of studying mixed in with it, but overall it was nice. Especially the picnic that Tia and I went on Sunday nite (which was also combined with studying). Speaking of studying (and I think this blog has comprised little else), I need to get back to it. 3 exams this week and two write-ups. The term ends in approximately 3-4 weeks and then we have 4 weeks of clinical prep where the schedule gets much more full.
Had a fairly lovely weekend. Lots of studying mixed in with it, but overall it was nice. Especially the picnic that Tia and I went on Sunday nite (which was also combined with studying). Speaking of studying (and I think this blog has comprised little else), I need to get back to it. 3 exams this week and two write-ups. The term ends in approximately 3-4 weeks and then we have 4 weeks of clinical prep where the schedule gets much more full.
Wednesday, June 13, 2007
Friendly's
What a nice reprieve. The week, as all weeks are, has been hellacious. Well, to be honest, Monday is hellacious and then Tuesdays and Thursdays are packed, but not that bad. Wednesdays and Fridays I just have lab and time to catch up on work ostensibly, though often it is used to catch up on life some.
Today I got home around 11:45, had lunch and worked on the family history genetics assignment. While working on that intermittently I also: bottle fed some kittens, played tennis, sent a few emails, went to Friendly's and read a bit of Assessment. These are the days I look forward to on Monday morning and the days I will look back on when things really get crazy in about a month.
I doubt I will post again soon unless something really incredible happens. In the coming week I have 3 exams and two write-ups due. The pace doesnt let up much after that either. I cant believe that this is week #4. Each day I cross off on the calendar is another day closer to clinicals and what will be the among the craziest forays of my life. It will be interesting to read and reflect on all of it when the year is over.....for now if I look back to long I find myself about 4 prevalent points behind in my lecture notes. If nothing else, I am remembering how hard it is to take notes and how incredibly horrid my handwriting has become. It can best be compared to hieroglyphics or the Wingdings font in Word.
Back to work.
B
Today I got home around 11:45, had lunch and worked on the family history genetics assignment. While working on that intermittently I also: bottle fed some kittens, played tennis, sent a few emails, went to Friendly's and read a bit of Assessment. These are the days I look forward to on Monday morning and the days I will look back on when things really get crazy in about a month.
I doubt I will post again soon unless something really incredible happens. In the coming week I have 3 exams and two write-ups due. The pace doesnt let up much after that either. I cant believe that this is week #4. Each day I cross off on the calendar is another day closer to clinicals and what will be the among the craziest forays of my life. It will be interesting to read and reflect on all of it when the year is over.....for now if I look back to long I find myself about 4 prevalent points behind in my lecture notes. If nothing else, I am remembering how hard it is to take notes and how incredibly horrid my handwriting has become. It can best be compared to hieroglyphics or the Wingdings font in Word.
Back to work.
B
Sunday, June 10, 2007
stuff outside of school
I had wanted to focus this entire blog on school, but often school is either too complicated to describe, duller than 3-piece puzzle, or just plain, well, scholastic. So, I thought I would at least mention what else there is to do in Rochester (or at least what we have thus far done in the month I have been here).
1. Played disc golf (lots of courses here, though we have only visited one)
2. Went to Park Ave (mostly restaurants...........kind of like a very slimmed down version of nob hill)
3. Mall shopping
4. Going out to eat - there is a fair spectrum of choices from your typical national chains to some more or less local eateries. Lots and lots of pizza delivery places. Local fair includes three things of which I have really only tried one: frozen custard (darn good), hots (red or white hot dog), and something called a garbage plate (http://rocwiki.org/Garbage_Plates).
5. Lilac Festival -the city is rife with festivals. there is a jazz festival going on this week.
6. Charlotte (pronounced Shar-lot, not like the city) Beach - it is only 2 miles from the house but the lake water is too cold to swim in.
I am sure I am forgetting other things, but I dont want everyone to think my life is just school 24/7. I would be a raving lunatic if that were the case.
Speaking of school, I am off to get ready for it. How does one mentally prepare for 7 hours of lectures?
1. Played disc golf (lots of courses here, though we have only visited one)
2. Went to Park Ave (mostly restaurants...........kind of like a very slimmed down version of nob hill)
3. Mall shopping
4. Going out to eat - there is a fair spectrum of choices from your typical national chains to some more or less local eateries. Lots and lots of pizza delivery places. Local fair includes three things of which I have really only tried one: frozen custard (darn good), hots (red or white hot dog), and something called a garbage plate (http://rocwiki.org/Garbage_Plates).
5. Lilac Festival -the city is rife with festivals. there is a jazz festival going on this week.
6. Charlotte (pronounced Shar-lot, not like the city) Beach - it is only 2 miles from the house but the lake water is too cold to swim in.
I am sure I am forgetting other things, but I dont want everyone to think my life is just school 24/7. I would be a raving lunatic if that were the case.
Speaking of school, I am off to get ready for it. How does one mentally prepare for 7 hours of lectures?
Friday, June 08, 2007
Nursing theory
I had to write a paper about nursing theory. The paper had to be, as all papers for this particular class have to be, 2 pages single-spaced in APA format. The point of the paper was to show how the theory you chose applied to care of patients. The point of the class, much like the point of the paper, seems to be to suck what hours it can from actually relevant classes. Not trying to be bitter, but not all classes seem to hold the same level of relevance when you are cramming them in like crab legs at an all-you-can-eat buffet.
My classes are as such:
9 credits of pathophysiology - teaching us how the body reacts to stresses like trauma or medication. The complexities of the course are beyond my explanation because they are beyond my comprehension at this point, but, for a point of reference: If a patient is on an anti-parkinsonian drugs -
1. what does that mean? Well, the body is producing too much acetylcholine (ACh) and/or not enough dopamine which is a problem because ACh is a stimulant causing all your nerves to fire continuously leading to the symptoms of Parkinson's disease.
2. What do you do? You have to up the dopamine levels which ought to balance out the ACh, but it cannot cross the Blood Brain Barrier so it L-dopa is usually combined with carbidopa (for those of you who REALLY know this stuff, sorry for any errors). The process works for awhile but is not a fix. When it stops working and the dopamine levels and GABA levels cannot counterbalance the ACh, then you try to lower the ACh production with anticholinergenics. The problem with anicholinergenics is that they have effects systemically leading to sympathetic stress responses (fight-or-flight) such as lower GI motility and secretions, dilated pupils, higher blood pressure, and the like.
This is the kind of thing we are learning for all diseases such as diabetes, Alzheimers, and depression. How the body responds to these stresses and how those responses lead to other responses and ad-infinitum down the line. It is some incredibly dense material taught to us at speeds that cause me a personal stress response. My brain feels a lot like the movie Memento because I have to keep working backwards to get to the answers.
Assessment - teaches us how to work up a patient in the most general to the more specific manners. Everything from taking pulses and BP to neurological and musculoskeletal examinations. Things we will need to know but have a hard time studying because of pathophys. It still feels a lot like a game of dress up. I cannot believe we will be doing this stuff for real so soon.
Genetics - learning how to do 3-generational punnets (like Gregor Mendal and his peas) to figure out how cousin Emma happened to get blue eyes and/or Marphan syndrome. Thankfully the class is kind of like a buffet (seems to be the theme)......try to get as much on your plate as you can, but dont think for a second you are getting it all in one trip.
Nursing Science - kind of about nursing history, theory, and various related affairs but mostly about the aforementioned papers. One of those classes that might well be interesting, but kind of like the show King of Queens. If you have time and its on, I will watch it and be amused, but when you dont have time to watch it, it wouldnt phase you at all to miss it. In this scenario, my other classes kind of feel like they are all on at the same time as King of Queens and all are shows that require I pay attention more. I wish I could wait to do this class during summer reruns.
So, those are my classes. They might not seem like a lot to some, but they take up an inordinate amount of time and my head often hurts worse than GW's after trying to pronounce the world nuclear. I can see why they tell us not to work. Some people do manage to juggle school and work (part-time) effectively, but that is for now while the clinicals remain in the distance.
As far as life outside of school, things are moving along. The schedule has finally normalized and that helps in planning studying, etc. It also allows for Tia and I to have some down time to relax and do some fun things. I met a girl who said she was giving up movies, TV, hanging out with friends etc. for the duration of the program, to which I could only smile knowing full well that she will be one of the patients we end up treating soon after we graduate. It is a balance and not an even one, but if you let life whither and die while you are in the program, you wont have a lot to look forward to when the program is done.
I need to get back to my books. Hope everyone is having a great weekend. Do something relaxing on my behalf.
My classes are as such:
9 credits of pathophysiology - teaching us how the body reacts to stresses like trauma or medication. The complexities of the course are beyond my explanation because they are beyond my comprehension at this point, but, for a point of reference: If a patient is on an anti-parkinsonian drugs -
1. what does that mean? Well, the body is producing too much acetylcholine (ACh) and/or not enough dopamine which is a problem because ACh is a stimulant causing all your nerves to fire continuously leading to the symptoms of Parkinson's disease.
2. What do you do? You have to up the dopamine levels which ought to balance out the ACh, but it cannot cross the Blood Brain Barrier so it L-dopa is usually combined with carbidopa (for those of you who REALLY know this stuff, sorry for any errors). The process works for awhile but is not a fix. When it stops working and the dopamine levels and GABA levels cannot counterbalance the ACh, then you try to lower the ACh production with anticholinergenics. The problem with anicholinergenics is that they have effects systemically leading to sympathetic stress responses (fight-or-flight) such as lower GI motility and secretions, dilated pupils, higher blood pressure, and the like.
This is the kind of thing we are learning for all diseases such as diabetes, Alzheimers, and depression. How the body responds to these stresses and how those responses lead to other responses and ad-infinitum down the line. It is some incredibly dense material taught to us at speeds that cause me a personal stress response. My brain feels a lot like the movie Memento because I have to keep working backwards to get to the answers.
Assessment - teaches us how to work up a patient in the most general to the more specific manners. Everything from taking pulses and BP to neurological and musculoskeletal examinations. Things we will need to know but have a hard time studying because of pathophys. It still feels a lot like a game of dress up. I cannot believe we will be doing this stuff for real so soon.
Genetics - learning how to do 3-generational punnets (like Gregor Mendal and his peas) to figure out how cousin Emma happened to get blue eyes and/or Marphan syndrome. Thankfully the class is kind of like a buffet (seems to be the theme)......try to get as much on your plate as you can, but dont think for a second you are getting it all in one trip.
Nursing Science - kind of about nursing history, theory, and various related affairs but mostly about the aforementioned papers. One of those classes that might well be interesting, but kind of like the show King of Queens. If you have time and its on, I will watch it and be amused, but when you dont have time to watch it, it wouldnt phase you at all to miss it. In this scenario, my other classes kind of feel like they are all on at the same time as King of Queens and all are shows that require I pay attention more. I wish I could wait to do this class during summer reruns.
So, those are my classes. They might not seem like a lot to some, but they take up an inordinate amount of time and my head often hurts worse than GW's after trying to pronounce the world nuclear. I can see why they tell us not to work. Some people do manage to juggle school and work (part-time) effectively, but that is for now while the clinicals remain in the distance.
As far as life outside of school, things are moving along. The schedule has finally normalized and that helps in planning studying, etc. It also allows for Tia and I to have some down time to relax and do some fun things. I met a girl who said she was giving up movies, TV, hanging out with friends etc. for the duration of the program, to which I could only smile knowing full well that she will be one of the patients we end up treating soon after we graduate. It is a balance and not an even one, but if you let life whither and die while you are in the program, you wont have a lot to look forward to when the program is done.
I need to get back to my books. Hope everyone is having a great weekend. Do something relaxing on my behalf.
Saturday, June 02, 2007
Ah the weekend
It is nice to be through another week of classes. I am not in a mood to rush through it all, but there is a sense of accomplishment each time Friday classes roll around and you dont find yourself weeping uncontrollably (I have largely learned to keep the weeping to a manageable level).
So, the first tests/papers etc are in and, thus far, I am not doing too badly (not setting the world on fire, but I am not existing on the tail of the bell curve either). Started with a B on my first Pathophys, an A- on my first nursing science paper (though the grading could, at best, be labeled capricious since neither I or my roommate got any negative comments and yet garnered less than perfect scores, though she fared better than I), and got an A on my first Genetics exam. Due tomorrow by noon is our second paper for Nursing Science and Tuesday has us in another Pathophys exam, so things could change very rapidly for the better or worse.
The schedule evens out next week and becomes much more regular (well, for a month anyway). Should afford some opportunity to get into a rhythm and, at the very least, looks to be the end of the extreme days. Also, Krista and I got our rotation schedule, and we will both start in Psychiatrics which is actually a lot less arduous, from what I hear, than starting with Pediatrics. We shall see. Rotations start up at the end of summer. I cant believe we will be practicing on real people that soon.
It is really warm in the office, so I will keep this brief. Also, I have some actual work to do which takes precedence. Hope everyone has a great weekend.
So, the first tests/papers etc are in and, thus far, I am not doing too badly (not setting the world on fire, but I am not existing on the tail of the bell curve either). Started with a B on my first Pathophys, an A- on my first nursing science paper (though the grading could, at best, be labeled capricious since neither I or my roommate got any negative comments and yet garnered less than perfect scores, though she fared better than I), and got an A on my first Genetics exam. Due tomorrow by noon is our second paper for Nursing Science and Tuesday has us in another Pathophys exam, so things could change very rapidly for the better or worse.
The schedule evens out next week and becomes much more regular (well, for a month anyway). Should afford some opportunity to get into a rhythm and, at the very least, looks to be the end of the extreme days. Also, Krista and I got our rotation schedule, and we will both start in Psychiatrics which is actually a lot less arduous, from what I hear, than starting with Pediatrics. We shall see. Rotations start up at the end of summer. I cant believe we will be practicing on real people that soon.
It is really warm in the office, so I will keep this brief. Also, I have some actual work to do which takes precedence. Hope everyone has a great weekend.
Thursday, May 31, 2007
What a day
I am home relaxing a bit between classes since my lab isnt until tomorrow and I thought it would be a nice time for a post, even if it will likely prove a brief one (I have to go back sometime).
Not that this counts as a typical day (thank god), but this is an idea of what kind of days we do go through in the school sometimes (like yesterday for instance).
8-10am: Lab - learning to assess neurological disorders by testing distal (far away) parts of the body to ensure whether or not any of the 12 cranial nerves are functioning improperly. Tests include various tappings, flexations, and palpations of the body. Hard to believe we will be doing this kind of thing for real in the not too distant future.
10:15-11:15: PDA training - nifty little things. Has the drug guides etc on them. Plus you can surf the internet. A good way to unravel for 10 minutes in between courses.
12-2:00: Genetics - Learning how to map genetic outcomes using punit squares (started from the easy to do 4-square punits finding out what colors eyes someone was likely to have and advanced quickly into trying to decipher if someone would have a child with an X-linked disorder if their grandmother was a recessive carrier........the classes move quick).
2:30-3:50: Got a reprieve of sorts, the class that was going to take place, Nursing Science, was moved to online. Can deal with it later and use the time to study for the first pharmacology exam.
4-5:00 - First exam. Outcome to be determined tomorrow.
5-6:30 - Pharmocology lecture on the brain...........the ENTIRE brain. Mine was full to the point of spillage when the class was done. Yikes! This is a lot of information to synthesize.
7:00 - home. Yeah!
Allright, time to go back to class. This weekend there is a Genetics test to do, a paper in Nursing Science, a write up case history on another person (my roommate and I are going to do one on each other) and studying for the next Pharmocology exam on tuesday. Keep em crossed for all of us in the program.........it is just starting to ramp up.
Not that this counts as a typical day (thank god), but this is an idea of what kind of days we do go through in the school sometimes (like yesterday for instance).
8-10am: Lab - learning to assess neurological disorders by testing distal (far away) parts of the body to ensure whether or not any of the 12 cranial nerves are functioning improperly. Tests include various tappings, flexations, and palpations of the body. Hard to believe we will be doing this kind of thing for real in the not too distant future.
10:15-11:15: PDA training - nifty little things. Has the drug guides etc on them. Plus you can surf the internet. A good way to unravel for 10 minutes in between courses.
12-2:00: Genetics - Learning how to map genetic outcomes using punit squares (started from the easy to do 4-square punits finding out what colors eyes someone was likely to have and advanced quickly into trying to decipher if someone would have a child with an X-linked disorder if their grandmother was a recessive carrier........the classes move quick).
2:30-3:50: Got a reprieve of sorts, the class that was going to take place, Nursing Science, was moved to online. Can deal with it later and use the time to study for the first pharmacology exam.
4-5:00 - First exam. Outcome to be determined tomorrow.
5-6:30 - Pharmocology lecture on the brain...........the ENTIRE brain. Mine was full to the point of spillage when the class was done. Yikes! This is a lot of information to synthesize.
7:00 - home. Yeah!
Allright, time to go back to class. This weekend there is a Genetics test to do, a paper in Nursing Science, a write up case history on another person (my roommate and I are going to do one on each other) and studying for the next Pharmocology exam on tuesday. Keep em crossed for all of us in the program.........it is just starting to ramp up.
Thursday, May 24, 2007
1 down, 51 to go
I just wanted to take a few minutes to let everyone know that the emails havent stopped because I was maimed in some horrible accident nor have I lost all faculty for the English language (although recent testing has placed some doubt in my mind about my proficiency in that arena as well), it has just been a hellacious week 1 that saw me bounding between utter bewilderment and near comprehension. Had I not had the good fortunes of meeting a number of former students prior to starting, I would be far more concerned about things. Since I have had the fortune, I am confident in saying I am not alone.
Day 1: No sense dipping your toes in to test the water when you can put your most sensitive areas to the task all at once right? Well, so goes the philosophy that I must currently subscribe too. The day began with an orientation that introduced pretty much every member of the faculty and staff that either directly or indirectly will be a part of our journey. The students all introduced themselves as well. I was pleasantly surprised to see how diverse the group was. There are approximately 100 in our cohort (potentially slightly more) and in amongst the group there are people from Guam, S. Korea, Thailand, and S. Africa. There are about 10 other men as well. Clearly some in the group have extensive experience and others, such as myself, have virtually none. I did find out that I was fortunate to receive scholarship of any kind as many people got nothing at all in free aid.
After a brief intermission, we had our first 3 hour lecture on something that could have been Pathophysiology or could have been a dissertation on the finer points of macramé presented in Klingon because I understood little to none of it. It was akin to trying to pick up HBO by putting tinfoil on top of your TV set. In the words of Ron Burgundy as he jumped into the bear pit to save Veronica, "I immediately regret this decision." Thankfully I am not weak willed or smart enough to give up that easily.
Day 2: After the torrid pace of day 1, I settled in for the torrid pace of day 2, only drawn out slower and more painfully than this season of American Idol. We arrived at 8am and classes didnt conclude until nearly 7 that evening. In amongst them were some of genuine interest and nothing that is particularly noteworthy to remark upon that I can recall (I most vividly recall thinking of my brain as a shot glass that was teetering at the meniscus line and thinking that it could not be possible to process any more new information). I came home quite defeated and camped out in front of the tv determined not to think about it again until I awoke the next day.
Day 3: Finally some things started to make sense. The lectures started to sound less like expository in some foreign tongue and more like a garbled form of English (like pig latin filtered through a Burger King drive through microphone via a cup attached to a string). The process started to slow down..........some anyway. I finally felt, for the first time since I walked through the door on day one, that I can do this.
Day 4: My first lab, which was pretty nice although way too crowded. It seems a lot like playing make believe with your friends, only at some point they will make me do this to real people. Freaks me out. I cant think of anything else like it that I have done before. This was followed up for a luncheon that helped me feel that everyone was just about as freaked as I was. It is nice not to travel that road alone. Fake it til you make it. This led into 4 hours of testing that, quite frankly made me doubt not only my understanding of the lectures this week, but also of the English language and my ability to comprehend the written word. the testing was a kind of SAT for the nursing profession (although the connection between knowing when to use 'who' rather than 'whom' and learning how to care for a person with tachycardia mystifies me at the moment...........unless maybe someone were to ask you 'Is that the patient whom you are treating?'). The absurdity of giving the testing after you are in the program is not lost on me. Would now be the best time to find out the person setting up drip bags cant calculate how much medication should go in it? The idea is to help build on your weaknesses of course. Beyond the math which i feel very competent in, I hope I dont have too many other glaring ones because I will have enough on my plate trying to cram science into my head.
We finished the day at a review session that left me with the same look on my face that the Scooby Doo gang almost always had right after they unmasked another ghost that turned out to be the caretaker engaged in some elaborate scheme (that of course would have worked if it werent for 'those pesky kids.') After class I spoke with some other students who seemed really enlightened by the session while I felt as if someone sunk my battleship in five guesses. Suffice to say, I put my bookbag on the table when I got home and havent picked it up yet.
One thing that comes with age is the knowledge that this too shall pass. I bandy about terms like 'freaked out' but I truly havent been there as yet because I feel much more comfortable in taking the time to take a deep breath before I dive back in. Life is a marathon not a sprint and while this year may feel very quick, it is a long haul. I will save pulling out my hair until after the first test at least...........coming up this Wednesday.
Additionally to all this I have to give a big blog thank you to my girlfriend Tia who was wonderful and planned a beautiful and relaxing morning/afternoon for us both today. It was the kind of day that reminds me that school may reflect heavily in life, but life is not school.
Day 1: No sense dipping your toes in to test the water when you can put your most sensitive areas to the task all at once right? Well, so goes the philosophy that I must currently subscribe too. The day began with an orientation that introduced pretty much every member of the faculty and staff that either directly or indirectly will be a part of our journey. The students all introduced themselves as well. I was pleasantly surprised to see how diverse the group was. There are approximately 100 in our cohort (potentially slightly more) and in amongst the group there are people from Guam, S. Korea, Thailand, and S. Africa. There are about 10 other men as well. Clearly some in the group have extensive experience and others, such as myself, have virtually none. I did find out that I was fortunate to receive scholarship of any kind as many people got nothing at all in free aid.
After a brief intermission, we had our first 3 hour lecture on something that could have been Pathophysiology or could have been a dissertation on the finer points of macramé presented in Klingon because I understood little to none of it. It was akin to trying to pick up HBO by putting tinfoil on top of your TV set. In the words of Ron Burgundy as he jumped into the bear pit to save Veronica, "I immediately regret this decision." Thankfully I am not weak willed or smart enough to give up that easily.
Day 2: After the torrid pace of day 1, I settled in for the torrid pace of day 2, only drawn out slower and more painfully than this season of American Idol. We arrived at 8am and classes didnt conclude until nearly 7 that evening. In amongst them were some of genuine interest and nothing that is particularly noteworthy to remark upon that I can recall (I most vividly recall thinking of my brain as a shot glass that was teetering at the meniscus line and thinking that it could not be possible to process any more new information). I came home quite defeated and camped out in front of the tv determined not to think about it again until I awoke the next day.
Day 3: Finally some things started to make sense. The lectures started to sound less like expository in some foreign tongue and more like a garbled form of English (like pig latin filtered through a Burger King drive through microphone via a cup attached to a string). The process started to slow down..........some anyway. I finally felt, for the first time since I walked through the door on day one, that I can do this.
Day 4: My first lab, which was pretty nice although way too crowded. It seems a lot like playing make believe with your friends, only at some point they will make me do this to real people. Freaks me out. I cant think of anything else like it that I have done before. This was followed up for a luncheon that helped me feel that everyone was just about as freaked as I was. It is nice not to travel that road alone. Fake it til you make it. This led into 4 hours of testing that, quite frankly made me doubt not only my understanding of the lectures this week, but also of the English language and my ability to comprehend the written word. the testing was a kind of SAT for the nursing profession (although the connection between knowing when to use 'who' rather than 'whom' and learning how to care for a person with tachycardia mystifies me at the moment...........unless maybe someone were to ask you 'Is that the patient whom you are treating?'). The absurdity of giving the testing after you are in the program is not lost on me. Would now be the best time to find out the person setting up drip bags cant calculate how much medication should go in it? The idea is to help build on your weaknesses of course. Beyond the math which i feel very competent in, I hope I dont have too many other glaring ones because I will have enough on my plate trying to cram science into my head.
We finished the day at a review session that left me with the same look on my face that the Scooby Doo gang almost always had right after they unmasked another ghost that turned out to be the caretaker engaged in some elaborate scheme (that of course would have worked if it werent for 'those pesky kids.') After class I spoke with some other students who seemed really enlightened by the session while I felt as if someone sunk my battleship in five guesses. Suffice to say, I put my bookbag on the table when I got home and havent picked it up yet.
One thing that comes with age is the knowledge that this too shall pass. I bandy about terms like 'freaked out' but I truly havent been there as yet because I feel much more comfortable in taking the time to take a deep breath before I dive back in. Life is a marathon not a sprint and while this year may feel very quick, it is a long haul. I will save pulling out my hair until after the first test at least...........coming up this Wednesday.
Additionally to all this I have to give a big blog thank you to my girlfriend Tia who was wonderful and planned a beautiful and relaxing morning/afternoon for us both today. It was the kind of day that reminds me that school may reflect heavily in life, but life is not school.
Monday, May 21, 2007
Bunny bummer
So, today is the last day before I officially become a student again. So many thoughts going through my head.........mainly about what to do for dinner at the moment, but there are school thoughts right behind those. I am honestly doing my best to not think about it much at all. Trying to make tomorrow like the moment in the reality shows where they reveal your new home/pimped-out car/clothings/etc. instead of trying to even pretend like I have any concept of what lies ahead. Therefore tomorrow's information session will either astound and interest me or find me regressing and hiding under the bed with my thumb lodged securely in my mouth. I can type one handed (albeit slowly and inaccurately) so you will hear something about it either way.
Sad news today, I found a dead rabbit in the back yard while mowing the lawn. It was really odd. We have all sorts of critters in the back yard including mice, a variety of birds, squirrels, chipmunks, and the aforementioned rabbit. It was just keeled over on its side with no visible sign of its demise. Hopefully it doesnt set an ominous tone for the week.
The time is almost nigh. Cant wait to report some actual nursing school content on here.
Sad news today, I found a dead rabbit in the back yard while mowing the lawn. It was really odd. We have all sorts of critters in the back yard including mice, a variety of birds, squirrels, chipmunks, and the aforementioned rabbit. It was just keeled over on its side with no visible sign of its demise. Hopefully it doesnt set an ominous tone for the week.
The time is almost nigh. Cant wait to report some actual nursing school content on here.
Sunday, May 20, 2007
Fortuitous meetings
That whooshing noise you may hear is the sound of my extensive sigh of relief. I was prepared (prepared is probably not an appropriate word........perhaps more accurately I was terrified) for 10 hours a day of studying over the Memorial Day weekend and not much relief beyond it. I anticipated no more fun until the break in between terms when I would presumably black out from exhaustion nearly instantaneously and come to only minutes from the resumption of classes. It would, in my mind, provide the only sleep I might get other than snatches of microsleep stolen on the way to school the days that Krista drove. I envisioned snatches of texts sewn to the inside of my eyelids so I could student even with them firmly shut. I envisioned openly sobbing from stress and toeing the razor-thin line of insanity (that vision remains). However, the discussions with some former students of the program has, at least for the moment, drawn me back from the edge of the precipice.
Krista (the new roomie who is starting the program with me) and her boyfriend Brad and I decided that it might be interesting to see the school we will be spending countless hours and many thousands of dollars at before we start, so we headed in on Friday afternoon. After wandering the halls somewhat at random, we came upon two former students who were incredibly friendly and helpful (and just graduated today). They gave us a tour of the building, dispelled some scary rumors about the program (ie: your life as you know it should only exist in a suspended form for the next 12 months), and even gave us a head's up on some books we would need and some that we would not even open. They also gave us their contact information so we could bother them incessently throughout the program (I intend to).
Yesterday, we met up with another former student, Adam, who had finished up the program a year ago. His advice was very similar but much more detailed. Additionally, he had no medical background, like myself, so it was nice to hear someone come from a perspective of not knowing his way around a syringe or a catheter and, just 12 months later, starting work in an ICU unit. It still seems odd that you can absorb so much in so short a time.
So, what it means is that this program should be manageable, should provide excellent preparation, and seems to provide an overall positive experience. I am extremely relieved although still very nervous. One more day to chill out and then it begins. Keep em crossed for me.
Krista (the new roomie who is starting the program with me) and her boyfriend Brad and I decided that it might be interesting to see the school we will be spending countless hours and many thousands of dollars at before we start, so we headed in on Friday afternoon. After wandering the halls somewhat at random, we came upon two former students who were incredibly friendly and helpful (and just graduated today). They gave us a tour of the building, dispelled some scary rumors about the program (ie: your life as you know it should only exist in a suspended form for the next 12 months), and even gave us a head's up on some books we would need and some that we would not even open. They also gave us their contact information so we could bother them incessently throughout the program (I intend to).
Yesterday, we met up with another former student, Adam, who had finished up the program a year ago. His advice was very similar but much more detailed. Additionally, he had no medical background, like myself, so it was nice to hear someone come from a perspective of not knowing his way around a syringe or a catheter and, just 12 months later, starting work in an ICU unit. It still seems odd that you can absorb so much in so short a time.
So, what it means is that this program should be manageable, should provide excellent preparation, and seems to provide an overall positive experience. I am extremely relieved although still very nervous. One more day to chill out and then it begins. Keep em crossed for me.
Wednesday, May 16, 2007
Mt. Rushmore
I am having a hard time processing the fact that better than a week has passed since my departure from Portland. Seems like just yesterday I was going out for farewell meals and piling my earthly possessions into my Subaru. Whether or not a fair amount of time has elapsed, I think enough has passed to recollect about the journey.
What I learned about the country via the interstate (I understand the interstate system doesn't present the best that a state has to offer and making judgments solely upon what lies within a few miles of said road isnt fair, but unlike Fox News, I make no pretense about being 'fair and balanced'):
1. The flyover states having some pretty topography and some ugly ass cities. It almost makes you wish you could fly over them lower and more slowly, but it does not make me wish in any way that I could drive through them again. Compared to the natural beauty that surrounds these little oasis of chain restaurants and faux rustic strip plazas stand out more distinctly than 30lbs would on the Olsen twins. It is truly a shame.
2. There are more 'casinos' than people in Montana and South Dakota. Every offramp advertised them and more than that, they were roundly unimpressive in every single way. Some were scarcely more than tin sheds. We peeked at one in a gas station that amounted to 5 one-armed bandits and a stand where, presumably, you would cash out your winnings. Gambling is a hard thing to do I think: wagering your money against losing odds in the hopes you beat them this time. At least I want to feel like i am getting something out of it even if I lose, like a pleasant environ and free drinks. It would take a lot of free drinks to make these locales palatable. When you take away the appearance, all that is left is you in a dark smoky room pumping quarters into a machine that will likely give you back far less than you put in.
3. There is a HUGE difference between a Motel 6 and a Super 8. To further emphasize this difference I would propose a twofold solution: Motel 6 should rename itself "Motel you get what you pay for you cheap bastard" and Super 8, for the sake of comparison since there is nothing inherently super about it except under this circumstance, should call itself 'Super exponentially better than that other numerically named chain.' The '6' that we stayed in reeked of cigarette smoke (in our non-smoking room), had matresses that had passes their golden era prior to the Carter administration, and had a shower that reminded me unfavorably of the ones I shared with 120 dorm mates in college on a Sunday after they hadnt seen a cleaning staff since a few days prior. Additionally, the shower head was clearly installed when our land was peopled with pygmys or some other height challenged people as I had to contort my body into positions I had heretofore not been aware I was capable of in order to remove my shampoo. Adding to the degree of difficulty, the shower itself was only a few feet square and the showerhead, based on the pressure, was evidently installed to fight fires or pressure clean, not wash human bodies. I am still awaiting some kind of weird rash to appear from sleeping there.
4. Rapid city is my new least favorite city. It has all the charm and beauty of a daytime truck stop hooker. If meth was a city, this might well be it. I found a similar city on my southern trip, Carlsbad, and like that city, this one was wrapped around a landmark (in this case a man-made one, Mt. Rushmore). There were more sketchy hotels, casinos, pawn shops, and check cashing places than restaurants and I have already described our lovely Motel 6 experience there. The oddest thing was a reptile park and a few other odd places. Who would travel to Mt. Rushmore and think, "Gee, i wish there were alligators around here?" Evidently someone.
I think that covers the trip..........or most of it. i wont torture anyone with descriptions of the mundane food, copious collections of insects embedded into my car grill, or bizarrer conversations we came up with to pass the hours. The last day was a blur. 1000 miles and nearly 20 hours of driving. I still dont know how we managed it, but somehow we did. Must have been the thought of that Motel 6.
More when school starts. Financial aid has been promised soon.
What I learned about the country via the interstate (I understand the interstate system doesn't present the best that a state has to offer and making judgments solely upon what lies within a few miles of said road isnt fair, but unlike Fox News, I make no pretense about being 'fair and balanced'):
1. The flyover states having some pretty topography and some ugly ass cities. It almost makes you wish you could fly over them lower and more slowly, but it does not make me wish in any way that I could drive through them again. Compared to the natural beauty that surrounds these little oasis of chain restaurants and faux rustic strip plazas stand out more distinctly than 30lbs would on the Olsen twins. It is truly a shame.
2. There are more 'casinos' than people in Montana and South Dakota. Every offramp advertised them and more than that, they were roundly unimpressive in every single way. Some were scarcely more than tin sheds. We peeked at one in a gas station that amounted to 5 one-armed bandits and a stand where, presumably, you would cash out your winnings. Gambling is a hard thing to do I think: wagering your money against losing odds in the hopes you beat them this time. At least I want to feel like i am getting something out of it even if I lose, like a pleasant environ and free drinks. It would take a lot of free drinks to make these locales palatable. When you take away the appearance, all that is left is you in a dark smoky room pumping quarters into a machine that will likely give you back far less than you put in.
3. There is a HUGE difference between a Motel 6 and a Super 8. To further emphasize this difference I would propose a twofold solution: Motel 6 should rename itself "Motel you get what you pay for you cheap bastard" and Super 8, for the sake of comparison since there is nothing inherently super about it except under this circumstance, should call itself 'Super exponentially better than that other numerically named chain.' The '6' that we stayed in reeked of cigarette smoke (in our non-smoking room), had matresses that had passes their golden era prior to the Carter administration, and had a shower that reminded me unfavorably of the ones I shared with 120 dorm mates in college on a Sunday after they hadnt seen a cleaning staff since a few days prior. Additionally, the shower head was clearly installed when our land was peopled with pygmys or some other height challenged people as I had to contort my body into positions I had heretofore not been aware I was capable of in order to remove my shampoo. Adding to the degree of difficulty, the shower itself was only a few feet square and the showerhead, based on the pressure, was evidently installed to fight fires or pressure clean, not wash human bodies. I am still awaiting some kind of weird rash to appear from sleeping there.
4. Rapid city is my new least favorite city. It has all the charm and beauty of a daytime truck stop hooker. If meth was a city, this might well be it. I found a similar city on my southern trip, Carlsbad, and like that city, this one was wrapped around a landmark (in this case a man-made one, Mt. Rushmore). There were more sketchy hotels, casinos, pawn shops, and check cashing places than restaurants and I have already described our lovely Motel 6 experience there. The oddest thing was a reptile park and a few other odd places. Who would travel to Mt. Rushmore and think, "Gee, i wish there were alligators around here?" Evidently someone.
I think that covers the trip..........or most of it. i wont torture anyone with descriptions of the mundane food, copious collections of insects embedded into my car grill, or bizarrer conversations we came up with to pass the hours. The last day was a blur. 1000 miles and nearly 20 hours of driving. I still dont know how we managed it, but somehow we did. Must have been the thought of that Motel 6.
More when school starts. Financial aid has been promised soon.
Thursday, May 03, 2007
Video of the "SIMMAN"
http://www.democratandchronicle.com/apps/pbcs.dll/article?AID=/20070219/VIDEO/70219043/-1/MULTIMEDIA
Odd to think I will be working with the SIMMAN soon enough.
Odd to think I will be working with the SIMMAN soon enough.
Monday, April 30, 2007
7 days to go
Time has figuratively flown by. Not too long ago it seemed as though school would never start and I would be taking prerequisites until Britney was respectable, and then things just seemed to change (Britney remains immutable however) to me packing up all my worldly possessions, which are encroaching on Buddhism they are so spartan. I have officially passed through the 'its never going to get here' phase into the 'Hunter Thompson on an ether binge what the hell am I doing' phase. I am hoping to settle somewhere in between in the coming weeks, but there will be a lot to adjust to. I will be moving to a new city where I know few people and have a less firm grasp on the layout than our president does of the English language. School freaks me out. Partially because I have not been in school for such a long time and partially because there will be no courses that are 'known' to me. No English. No Social Studies. No Quantum Physics (checking to see if you are paying attention). It will be a challenge and wholly foreign. Exciting yes, but also incredibly daunting. Just the same, I am glad I am taking the plunge. I have never been one to be moored in one harbor for long, my path changing directions more frequently than Paris changes BFFs. I do hope this is it. If not forever, for at least a good long while. I will be shocked if, at the end of this year, I fall in like with Rochester considering my distaste of cold, grey winters (or wet ones for that matter), but who knows. Maybe I will find myself drawn into the cheap housing, decent entertainment and 4 months of non-winter. On second thought......
Still waiting on FA. They are evidently craftsman of the highest order in the FA office at UR. They are so concerned with putting out impeccable packages where nary an 'i' remains undotted nor unduly askew that it takes months where others would take days. It is an art, and true art cannot be rushed. At least that is my assumption, because were I to be somehow proven otherwise, I might have to consider seriously the idea that the office is filled with scarcely sentient simians of the lowest order banging away close fisted on antiquated typewriters trying to defy the odds and put together a comprehensible FA package. Maybe I should send some bananas just in case.
Still waiting on FA. They are evidently craftsman of the highest order in the FA office at UR. They are so concerned with putting out impeccable packages where nary an 'i' remains undotted nor unduly askew that it takes months where others would take days. It is an art, and true art cannot be rushed. At least that is my assumption, because were I to be somehow proven otherwise, I might have to consider seriously the idea that the office is filled with scarcely sentient simians of the lowest order banging away close fisted on antiquated typewriters trying to defy the odds and put together a comprehensible FA package. Maybe I should send some bananas just in case.
Tuesday, March 27, 2007
done and done
Today I finished my last prerequisite course for UR. The dreaded micro biology. I performed very well on all the courses, but I wont kid myself, they aren't nearly as difficult as the terrestrial courses will be. Just the same though, it is nice to enter school on a positive note.
In other news, I thought I would post the few emails I have received from the University. I found the most humorous to be related to working. They have been adamant about the fact that you cannot work without outright stating it (which they would like to do, but they cannot mandate how you spend your leisure time and I doubt there is a one amongst us wouldnt wish to spend leisure time in industrious pursuits. Is it just me?). Evidently a lot of emails poured in from students fully intending to work and, well, you can read the response below. The humor was that UR defines 'being able to work' as 5 hours a week or less (best of luck finding that job) and then provides the 'circle of logic' which goes a like this: we aren't eligible for grants because we already hold Bachelor's degrees, a Bachelor's degree means you can work to support yourself so you dont require a grant, and you can't work because of the nature of the program therefore rendering the fact that you hold a degree moot. Funny, but not in a haha kind of way but rather the 'isnt it funny how it always rains the very day you decide to try your new paper mache outfit and not wear skivvies underneath (we have all been there)." It didnt affect me however as they have been clear throughout that working is strongly discouraged, and in cases such as these I find I am best served by not raging against the machine. In lieu of income, I have already arranged for some of my less utilitarian organs to be harvested to cover books and lab fees. Anyone need a kidney?
The emails follow, edited of only the parts that are totally irrelevant.
I am very concerned about the few FULL TIME students who wrote that they intend to work (5 hours or per diem is not a problem, but some think they can work TWENTY HOURS - I am assuming you may not have seen the APNN schedule/calendar on the web site - check it out - you can have clinicals on Saturdays, so even working "weekends only" won’t always be possible)
As far as working, it is near impossible to get work hours in as a full time student - in the past, students have had to get these hours in on the weekend (that means a shift Saturday and Sunday) as there is no time during the week. For example, if you have clinical on a Thursday 7 am - 4 pm, you may need to go up to the hospital Wednesday evening and get the chart for your patient and go home and look up the disease, make drug cards for all the drugs, etc. In our very first group of APNN students, the ones who did not pass their boards on the first try were working too many hours (some as many as 20) and had no time to get the background reading done. The following years, we suggested students do the program PT if they want to or have to work and the improvement was dramatic. Of course, this is still your choice - we cannot legislate what folks do in their private time. I have just had several upset students in my office come the fall, saying "but I always worked full time in undergrad and grad school before!" Nursing is so time-consuming because of the hours - in college, 1 credit = 1 clock hour a week; in (any) nursing school, 1 clinical credit = 4 clock hours a week. Just something to think about...The full time program is not designed for concurrent work. Even the part time plan is unfortunately not a nice 50/50 split. It is much heavier in year 2. You would probably be able to work full time in year one (except for the first 8 weeks of summer), since it is only the straight didactic courses. Look at the part time plan so you can cross-check against the calendar and see how year 2 is very full (because we didn't want to "unbundle" the clinicals). You will then see how much class time will be needed. So for year two, you would need to cut down your employment and get your hours in on the weekends. Sorry the program isn't really "family-friendly" - it is more of an "immersion" experience!
More to come when more information comes. Still waiting for FA.
In other news, I thought I would post the few emails I have received from the University. I found the most humorous to be related to working. They have been adamant about the fact that you cannot work without outright stating it (which they would like to do, but they cannot mandate how you spend your leisure time and I doubt there is a one amongst us wouldnt wish to spend leisure time in industrious pursuits. Is it just me?). Evidently a lot of emails poured in from students fully intending to work and, well, you can read the response below. The humor was that UR defines 'being able to work' as 5 hours a week or less (best of luck finding that job) and then provides the 'circle of logic' which goes a like this: we aren't eligible for grants because we already hold Bachelor's degrees, a Bachelor's degree means you can work to support yourself so you dont require a grant, and you can't work because of the nature of the program therefore rendering the fact that you hold a degree moot. Funny, but not in a haha kind of way but rather the 'isnt it funny how it always rains the very day you decide to try your new paper mache outfit and not wear skivvies underneath (we have all been there)." It didnt affect me however as they have been clear throughout that working is strongly discouraged, and in cases such as these I find I am best served by not raging against the machine. In lieu of income, I have already arranged for some of my less utilitarian organs to be harvested to cover books and lab fees. Anyone need a kidney?
The emails follow, edited of only the parts that are totally irrelevant.
A few questions were e-mailed to me and I thought the answers might be useful to all of you-
1) What about housing? You should have received a packet about housing from Nancy Kita. Especially if you want to room with other APNN students - there are several small houses nearby that rent out every year to APNNs. Also, there is a helpful web link- http://ochousing.reslife
2) When do I get my financial aid "package" ? The main university financial aid office reserves its grant money for first-degree seeking students (the philosophy being if you already have a degree you at least have the means to work and support yourself and go to school part time - and that is an option, although not helpful to the "accelerated" part of our program!)
The three ways people pay for this program-
a) working for our hospital but you must work there a year FT (or two years PT) BEFORE the benefit kicks in, in which case students generally do the program part time (since you need to continue working at least 17.5 hours per week to keep the benefit and it is NOT recommended that full time students work- this is for PT students), but the program is tuition free that way except for a few thousand dollars.
b) there are a few limited grants the School of Nursing has received (and so then of course we are free to distribute them, but these awards - Fuld and New York State Retraining - have been made. We did offer a few people who were not named Fuld Scholars, but otherwise had very strong applications - some general School of Nursing funds, but again this is limited)
Unrelated to our school, but a possible source of $ for people who are unemployed and living in Monroe County is www.rochesterworks.org They have given several of our students money toward tuition.
The monies mentioned in "b" here usually would not cover even half of the tuition, so most students will be using
c) LOANS and the full explanation of those (5-15K govt, the rest private) was sent to you with the financial aid "graph" illustrating that APNN students virtually all pay for this program with loans
(note that this year's tuition/fees are still "officially" posted - the university votes/updates in April - and costs typically rise a few % each year - next year straight tuition will likely be 15,600/semester for each of the three semesters; other fees include about 1K for labs/tech and ~600 for a mandatory health fee, and $90 for an activity fee)
So the bottom line is your "package" from the main university will only consist of loans. The Financial Aid office is now processing FAFSAs and will send letters soon. The only grant money would be those things in "b" above or individual grants you may have found/been offered (listings of other sources and web sites).
If you have questions before that (e.g. what banks are good for private loans, what financial aid forms have been received or you need a "guesstimate" of your loan amounts/sources), please contact the financial aid office directly at
Phone:(585)275-3226
Fax: (585)756-7664
E-mail: help@finaid.rochester.edu
******************************
As far as other things, we include the cost of the stethoscope in a lab fee, so you will get that. Uniforms, which you don’t wear until mid-July anyway, are white scrub tops and navy bottoms - here is an e-mail about that from one of your summer instructors-
To make it more streamlined and less hectic for students and staff & faculty we are going to have Scott at the medical center bookstore take care of ordering all the uniforms for students this year. Scott will arrange for try-ons and to pick up uniforms at the bookstore and take care of any order inquiries or concerns directly with the bookstore.
4) Parking - For those who have cars and don't live within walking distance, we will have time at orientation for you to go across the street to get parking passes (sticker for the window) for university lots (it's a little walk - about two short blocks - from the hospital). This year the cost was ~$20/month.
#2I am very concerned about the few FULL TIME students who wrote that they intend to work (5 hours or per diem is not a problem, but some think they can work TWENTY HOURS - I am assuming you may not have seen the APNN schedule/calendar on the web site - check it out - you can have clinicals on Saturdays, so even working "weekends only" won’t always be possible)
As far as working, it is near impossible to get work hours in as a full time student - in the past, students have had to get these hours in on the weekend (that means a shift Saturday and Sunday) as there is no time during the week. For example, if you have clinical on a Thursday 7 am - 4 pm, you may need to go up to the hospital Wednesday evening and get the chart for your patient and go home and look up the disease, make drug cards for all the drugs, etc. In our very first group of APNN students, the ones who did not pass their boards on the first try were working too many hours (some as many as 20) and had no time to get the background reading done. The following years, we suggested students do the program PT if they want to or have to work and the improvement was dramatic. Of course, this is still your choice - we cannot legislate what folks do in their private time. I have just had several upset students in my office come the fall, saying "but I always worked full time in undergrad and grad school before!" Nursing is so time-consuming because of the hours - in college, 1 credit = 1 clock hour a week; in (any) nursing school, 1 clinical credit = 4 clock hours a week. Just something to think about...The full time program is not designed for concurrent work. Even the part time plan is unfortunately not a nice 50/50 split. It is much heavier in year 2. You would probably be able to work full time in year one (except for the first 8 weeks of summer), since it is only the straight didactic courses. Look at the part time plan so you can cross-check against the calendar and see how year 2 is very full (because we didn't want to "unbundle" the clinicals). You will then see how much class time will be needed. So for year two, you would need to cut down your employment and get your hours in on the weekends. Sorry the program isn't really "family-friendly" - it is more of an "immersion" experience!
More to come when more information comes. Still waiting for FA.
Friday, March 16, 2007
Q: When is $15K not $15K? A: When school cost $60K.
I never thought a $15K scholarship would be a mixed blessing. I thought I would find it to be overwhelmingly satisfactory actually. It most situations it would be spectacular. I can scarcely imagine any other situation in my life where walking into $15K would not be so overwhelmingly significant that i wouldnt tell that story into perpetuity while, of course, exagerrating my physique and acts of bravery which led to acquiring such a sum. My finances are such that finding a $10 bill in a jacket pocket qualifies as a good day regardless of other events.
It certainly isnt insignificant, and I would (and may) sound jaded by inferring that it is, but it pales in comparison to the cost of school. What it means is about 25%. That is the wonderful news! I would be pleased were my car or student loans 25% paid off. It also means that 75% is still in doubt, awaiting word on who will loan it to me. That is far from wonderful. Its a mixed blessing because had it been more (say 30K) I would have not thought twice about diving into the remaining debt as ludicrous as as taking out 30K sounds. Had it been 5K, I would have had to find another path to school. Reminds me of every raise I have ever received at any job I have had, it is never enough to truly make you feel appreciated or happy, but never so little as you dont accept it. Plus, I cannot shake the notion that the scholarships are just there to make the total cost appear more palatable while maintaining the veneer that you are going to a more expensive school. Much like you wouldn't find Target prices at Macy's...but you might find Macy's stuff on sale for Target prices. There is something about finding that $50 shirt on sale for 50% off vs just going out and buying a $25 shirt. Though, in the end, they both cost the identical amount.
I also just found out that two other students did not get the general academic scholarship that I got, but did get the Fuld scholarship, one person for 15K, the other for 20K. Reinforcing my belief that everyone gets something, because it makes it more palatable. I find this news both unsettling, because I did not get the Fuld but am placated by the fact that whether I got it or not, it would ultimately not mean a great difference to my bottom line. Evidently there are no double coupons and Fuld or no Fuld, we will all be neck deep in debt.
It certainly isnt insignificant, and I would (and may) sound jaded by inferring that it is, but it pales in comparison to the cost of school. What it means is about 25%. That is the wonderful news! I would be pleased were my car or student loans 25% paid off. It also means that 75% is still in doubt, awaiting word on who will loan it to me. That is far from wonderful. Its a mixed blessing because had it been more (say 30K) I would have not thought twice about diving into the remaining debt as ludicrous as as taking out 30K sounds. Had it been 5K, I would have had to find another path to school. Reminds me of every raise I have ever received at any job I have had, it is never enough to truly make you feel appreciated or happy, but never so little as you dont accept it. Plus, I cannot shake the notion that the scholarships are just there to make the total cost appear more palatable while maintaining the veneer that you are going to a more expensive school. Much like you wouldn't find Target prices at Macy's...but you might find Macy's stuff on sale for Target prices. There is something about finding that $50 shirt on sale for 50% off vs just going out and buying a $25 shirt. Though, in the end, they both cost the identical amount.
I also just found out that two other students did not get the general academic scholarship that I got, but did get the Fuld scholarship, one person for 15K, the other for 20K. Reinforcing my belief that everyone gets something, because it makes it more palatable. I find this news both unsettling, because I did not get the Fuld but am placated by the fact that whether I got it or not, it would ultimately not mean a great difference to my bottom line. Evidently there are no double coupons and Fuld or no Fuld, we will all be neck deep in debt.
Sunday, March 04, 2007
Clarity from a hygienist
Clarity about your career and how it impacts your life comes in drips and drabs. For some, it seems like they are born with an innate understanding of who they are and how they hope to parlay that into a career. Be it an artist, chef, or secretary, these are the people that continue to stupify me. I look upon them with the same queer curiosity one might examine a baboon at the zoo with. It is a familiar creature, but also a hopelessly foreign one.
Every once in awhile you run into someone that you can relate to and truly see 'it', the answer to the great mystery. This answer came in an odd package. My hygienist was a male with two small gold hoop earrings in one ear and none in the other, as if to counterbalance some minor weight disparity betwixt the two sides of his head. He was older. Age i could not guess, but too old for small gold hoop earrings. He stomach a large protrusion that loudly proclaimed a love of all things fermented of barley and hops. His face was unknowable, hidden as it was throughout by a surgical mask. So, how was this person so revelatory you may inquire? Well, despite doing something that i imagine to be repetitive, droll, and rather unpleasant (which my career choice may be to some.....as all career choices are to some actually), he was positively enamored with his vocation. He admonished me for my flossing habits (or lack thereof truly) but not in a flip manner that suggests the words were perfunctory in nature, but rather in an informed and concerned manner. He proceeded to rattle off all sorts of information while going about his task and did so happily. He did so in manner so transparent that I was compelled to compliment him about it and he told me he loved his job in a way that I would only describe a good book or film. It was at that moment that the bolts locked into their cylinders and I knew that that was what I wanted from a profession.....well, sans earrings. I want a career that I feel that way about.
I know he has to have bad days and good ones and, quite possibly, I just caught him on a good one. But I cant remember ever feeling the way he seems to about his job. I have had, and do have, some wonderful co-workers and have had the opportunity to do some enjoyable things at work, but I have not ever felt enamored of a job. Maybe nursing wont be that way for me, but I am willing to bet up to $50K that it is.
Every once in awhile you run into someone that you can relate to and truly see 'it', the answer to the great mystery. This answer came in an odd package. My hygienist was a male with two small gold hoop earrings in one ear and none in the other, as if to counterbalance some minor weight disparity betwixt the two sides of his head. He was older. Age i could not guess, but too old for small gold hoop earrings. He stomach a large protrusion that loudly proclaimed a love of all things fermented of barley and hops. His face was unknowable, hidden as it was throughout by a surgical mask. So, how was this person so revelatory you may inquire? Well, despite doing something that i imagine to be repetitive, droll, and rather unpleasant (which my career choice may be to some.....as all career choices are to some actually), he was positively enamored with his vocation. He admonished me for my flossing habits (or lack thereof truly) but not in a flip manner that suggests the words were perfunctory in nature, but rather in an informed and concerned manner. He proceeded to rattle off all sorts of information while going about his task and did so happily. He did so in manner so transparent that I was compelled to compliment him about it and he told me he loved his job in a way that I would only describe a good book or film. It was at that moment that the bolts locked into their cylinders and I knew that that was what I wanted from a profession.....well, sans earrings. I want a career that I feel that way about.
I know he has to have bad days and good ones and, quite possibly, I just caught him on a good one. But I cant remember ever feeling the way he seems to about his job. I have had, and do have, some wonderful co-workers and have had the opportunity to do some enjoyable things at work, but I have not ever felt enamored of a job. Maybe nursing wont be that way for me, but I am willing to bet up to $50K that it is.
Saturday, March 03, 2007
Is that a finger up my ass, or are you just happy to see me?
Throughout it I doubt there will be much time that I wont be terrified, doubt my abilities, or under stress, but hopefully that will lessen and not exponentially increase. Lets hope anyway.
As an addendum to this: Do you think when my doctor dreamed of going to medical school and worked hard to pull himself through it both financially and academically he thought at any moment in that time that he would spend part of any given day with his fingers in other people's orifices? I am guessing no.
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