Silverton interview

Just completed my interview with Silverton for their internship program. Here is a copy of their description of the position which largely encompasses what I know about the program: New registered nurse residency program, 9 months of clinical and classroom training in Mother-Baby care, Medical Surgical, Same Day Surgery, and outpatient clinic nursing in preparation for selection of a primary work setting. Great opportunity for new graduates interested in joining our innovative nursing team. BSN preferred.

The interview actually went quite well (from my perspective). I was asked questions ranging from "Where do you see yourself in five years?" to "Tell us about a situation when you had conflict with another person in the workplace and how did you handle it?" Very textbook interview questions from a panel of four nurse managers. I was told they will have some answer for me by Tuesday/Wednesday of next week. I have no idea how many people were interviewed or how many people will ultimately be hired, and even if I am among that group I don't know if I would be interested. All interviews are good practice though. The experience was a lot less stressful since I have a position lined up elsewhere.

It is difficult to compare the two positions though should I be offered the one with Silverton. Salem offers specialization and a broader spectrum of opportunities to advance. Silverton provides an incredible breadth of experience, but without the same depth. Also, I have NO idea how much the Silverton position even pays which, as a rural hospital, could prove significantly less. However, money only means so much if you find a good fit, an impossible thing to evaluate since I know nothing more than the websites provide having no personal experience with either locale. Questions, questions. Anyone have a thought?

The return of the great white dope

I am back from the Florida wedding and the Caribbean vacation. 10 days of 90 degrees spent basking (intermittently) in the sun's rays. Then, the shocking return to the arctic tundra that is Rochester. High 40s and rainy. Its May 20th! From the place where summer never stops to the place where summer never begins. I knew we should have gotten off the plane for good in Charlotte where it was mid-70s and sunny.

Wedding went off without much of a hitch. Only two minor issues occurred: the losing and subsequent retrieval of Tia's veil (it apparently got cold feet and tried to take off through the parking lot. Thankfully a handicapped sign dissuaded it from leaving entirely) and the high winds that made Tia's hair and veil swirl violently about her face (but strangely did not disturb my coif whatsoever). We were badly in need of some Aquanet and DEP, but sadly for us, we didn't get married in 1987 where such things would be readily available.

The cruise was really enjoyable except for the excruciating times spent embarking and debarking. Why all cruise ships insist upon making the experiences that bookend your trip as horrible as possible still evades me. The only other major complaint I have was that the loudspeakers on the ship were all cranked up so loud as to distort most everything that was screamed through them. So, all cruisers got the dual benefit of a splitting headache and no discernible information. Add to that the fact the same process was then repeated for 4 additional languages and you have a replication of what I imagine the announcements in hell must sound like. The food was good, if not a little repetitive. The activities were quite varied (I mad it up the rock wall, but fell promptly on my backside on both attempts at surfing) and the promenade always offered good snacks and beverages. The ship itself was beautiful and immaculately maintained.

Things still remain somewhat foggy and mentally I am still rocking side-to-side a bit. There is a lot to deal with in the next week+. Selling whatever else isn't nailed down. Packing. Re-packing. The dreaded drive. Applying for more jobs. An interview with Silverton. And, of course, studying and more studying for the omnipresent specter that hover about all nursing students like paparazzi hover around Britney on a Marbolo run, the dreaded NCLEX. It is hard to even type the acronym what with the shivers crawling up my spine. At least I have a few months if need be to study. I just recently discovered, through a practice test, that I am at risk for the area of therapeutic communication. Apparently sprinkling in the occasional profanity is not considered therapeutic. Well, f**k that! :)

I promise a return to more frequent updates, especially as there will likely be much to update about in the coming weeks and months between. In the meantime, I have many more areas to prove myself at risk for on practice tests.

9 days til departure.

Today and tomorrow

Another VERY brief blurb. I will re-commit myself to the task after things simmer down. Tomorrow is the wedding. It should be really interesting. Haven't seen the location. Haven't met the person performing the ceremony. Haven't met the photographer. A lot of surprises ahead.

In nursing news: I GOT A JOB!!! Crazy as it sounds. I had an interview on Wednesday morning for about 30 minutes. They asked me a number of clinical questions and, though I stumbled through it, they must have heard something that led them to believe I wouldn't kill the patients. Starts on the 21st of July. Up next, passing the NCLEX. The only downside is that the job is in Salem, not Portland. I was contacted by another hospital as well. Will see what that leads to. It is nice to have something locked down.....helps de-emphasize the stench of desperation.

Back in a week.

Interview (another brief post)

I have my first nursing interview on Wednesday (My first out of Rochester interview anyway) for a hospital in Salem, OR. Obviously, this will be a phone interview which affords me the added benefit of not having to dress up. Hell, I don't even have to comb my hair. Not sure how to prepare though. Preparing for interviews for Rochester area hospitals seems to consist of showing up roughly on time and having a list of questions for them. It will be interesting to compare.

Grades are finally in. I did far better than I thought on my final paper. Go figure.

I will try to post after the interview. Keep em crossed. It isn't Portland, but it is a damn sight closer than Western NY.

(Deep Exhalation)

It is officially over!!!!! I have completed the program and, as a sidebar, I still have most of my sanity intact (given that there wasn't much to start with).

I am still awaiting the final numbers for Ethics, but even if I had failed to turn in the final paper I would have passed the course. So, no worries there. (As a sidebar: I wrote said paper with such minimal effort and in such a hurry that I didn't bother to even proofread it. It may well be the biggest piece of typed trash since Paris Hilton's book came out). I managed to squeak by with the bare-minimum I needed to get an 'A' in Management, which was a nice bonus for a class I scarcely attended and only lightly reviewed for (I say this not as a testament to my own intellectual acumen, but rather as an indictment of the course and the instructor). Management remains among the most superfluous courses I have ever taken. What little I gleaned was mostly related to the capstone project, and that bared so little relation to the coursework and the teachings that it could have stood apart from it completely.

The biggest piece of good news is that I succeeded in passing the dreaded exit assessment. I improved markedly from my initial performance (by 10 points). The bad news is that more people than usual will be retaking the examination. In the past 3 years 6 people had to retake the examination COMBINED. This year, two dozen (over 20%) will be retaking it. According to our resident test guru, it is due largely to the fact that the test was much more difficult than in years past. Whatever the cause, I still feel terrible for everyone who has to retake it. I am sure they will all pass it the second time, and there is no penalty to retaking it multiple times if need be, but still it would be quite debilitating to anyone's confidence. I wish them all luck the second time through.

Now to get my Oregon state license application together. I think I am finished with two of the 67 steps needed to complete it. I got the fingerprints and the physical application, but I still need a passport photo, official transcripts, a videotape of me breaking the all-time scoring record for Donkey Kong, a signed copy of the New Testament, and about $400 odd dollars in cash. I think that covers it.

Off to celebrate.

Brief update

The Management final was a cakewalk. I think it took all of 15 minutes. Interested to see the outcome.

The ERI test today was a total clusterf**k........or possibly not. I have absolutely no idea how I fared on it. I can say that the 4 day review session and the associated study materials were largely incongruent with what I encountered on the exam. The answers will be revealed this Friday supposedly. In the meantime, I have a paper to finish.

Four

Four days of review. Four days spent in chairs meant for not more than a few hours of sitting. Four more days, after today, until it is all over (give or take four hours). 444 more questions to review before Wednesday's ERI exam (I was off by 24 hours when I originally said Tuesday). Unfortunately, I have but four more brain cells with which to study.

The review session was, er, informative. I am not sure how much it helped, though with her offered test-taking strategies, I am sure it ultimately did. Mostly she offered up a lot of stories to illustrate points, to augment our meager knowledge, or for shits and giggles. Things like (I can neither confirm nor deny the veracity of any of these statements mind you):
* The origin of HIV is Africa evidently. But, the first case of the virus being activated was in a pilot. The patient 0 as it were. Regretfully, this pilot was a man of voluminous sexual appetite. Fortunately, he was also a scribe and recorded his sexual conquests, which included underage girls around the world, men, women, and his wife. His wife an he had an open relationship as well, so she helped to further the disease spread as well.
* Semen concentrates alcohol at twice the rate of blood. It can be passed on through intercourse as a woman's vagina absorbs the proteins from semen.
* Immunizations have mercury in them still, but the total amount in ALL the immunizations is so trace that their is more in a tablespoon of tuna fish. There is still no link to autism.
* Autism is, however, linked to a mitochondrial weakness. Giving the immunizations all at once has been noted to accelerate the symptoms. However, it isn't causative. The acceleration can be avoided if the immunizations are broken up into smaller groups instead of all given at one visit.
* Magic Johnson has not ever developed AIDS despite testing positive for the HIV virus over 20 years ago largely because his HLA type is middle eastern. They evidently had some form of the virus go through their population in the 1500s and have increased immunity towards it.
* The HPV vaccine in this country only protects against 70% of the types of the virus. There is another vaccine overseas that protects against the other kinds. The same company owns both patents. When the patents expire, they will be switched. They could be combined and offer 100% coverage, but fiscally this does not make sense for the company.
* The HPV vaccine is not needed if a woman waits until after her 60th menstruation to have sex (or at least unprotected sex). Something to do with the roughening of the cervix.

I just couldn't help but feel that, though the stories and odd tidbits were fascinating, the actual content was somewhat lacking. When content was provided, it seemed kind of disjointed. Questions were covered, but often the rationale for correct answers was not explained. Just as frequently, assumptions about our level of prior knowledge were made overestimating both our experiences and our content.

That said, she was a dynamic lecturer and there is obviously only so much that we can cover in a four day span. I wish very much that she had been to our school earlier because she did manage to explain quite a few things that I never picked up on the first go round in a way that was both understandable and memorable. I would have chosen her over EVERY single one of our classroom clinical area instructors (not a one for adult, psych, peds, or OB were of near the value......i was very fortunate that my clinicians on my rotations were exceptional).

I need to get my learn on once again. Class tonight, Management final tomorrow morning, ERI Wednesday afternoon, Ethics paper Thursday afternoon, and final exit assessment on Friday. Drinking starts at 1pm Friday afternoon.

ERI

ERI probably doesn't mean much to anyone outside of nursing. The acronym has a downright malevolent connotation to those of us trying to get into the nursing profession and out of school however. You see, once you graduate, no matter valedictorian nor bottom scraper, you have to pass the ERI examination to make it 'official' and move on to the next round. Sure, you may have successfully navigated the pratfalls of a long litany of courses over a short span of time, but how much did you retain.....or learn in the first place for that matter? ERI aims to find out.

Based on the preliminary exam, I fall somewhere in the purgatory of scores: not quite high risk, but not quite passing either. The upside (should one be inclined to look from a glass half full perspective) is that I am not alone there. Most of the classmates I have spoken with who are inclined to divulge their results are there as well. How i could manage to make it to this point in the program with a GPA in the 3.6somethings and know as little about what they are testing as I do is beyond me. Most of what I don't know seems to be couched in one of two camps: utterly foreign or only vaguely familiar. In essence, a split between things not taught or not retained. Of course, half that problem relates to the sheer speed of the accelerated program. You can't dwell on anything, or you risk falling woefully behind. Knowledge is gleaned quickly or not at all.

Thankfully for future patients, there was no skimping on the clinical side. There are numerous graduates from our program who are doing quite well. There are also many other such programs around the country. Even if I fell dead in the middle of all students as far as acumen and intelligence, I would likely be a very competent nurse (or at least have the capability of being trained to become one, which is the essence of your first 2 months on the floor). Even in the bottom quartile, just graduating would prove I would be functional at the least. So, there is that.

This all brings me to the next four days of my life. We are all being trained to take this ERI test and pass it when it counts (that would be next Tuesday by the way). The training takes place from 8am until 4:30pm tomorrow through Saturday and will evidently prepare us in a way that the school itself has not. We will be drilled with hundreds of questions (possibly an underestimate on my part) and their explanations. We will learn not just what they are asking, but what they are looking for behind the words. We will sit in uncomfortable chairs in a dimly lit and windowless auditorium for days on end. Pretty much just like every other test prep everywhere else. I can barely restrain my anticipation.

This test, of course, will tell us if we will be good nurses the same way that the SAT will tell you if you will be a successful college student. That is to say, that there is little to no correlation at all. It will, however, inform people that with enough training, we have the capability of passing a standardized test. What that is supposed to ultimately mean evades me. Only the truly jaded would suggest it is just a means to line pockets of policy makers and testing companies while acquiring little information of utility from students. Thank god I am not jaded.

This will all be over soon, then I can begin to worry over the next acronym: NCLEX. I should probably start taking PPIs or other acid reducers prophylactically to stem the ulcers now.

Wish me luck as always. Pretty please.

Random odds and ends

I think my friend Josh is right is saying that the little I have been reporting on doesn't accurately portray all that is happening here.....but it does pretty much accurately represent all that has been going on with school. My group is done with the PI project for Management. We had a poster presentation yesterday which, for the most part, was eerily similar to being at an elementary school science fair. All that was missing were the volcanoes that spewed forth 'lava' made of vinegar, baking soda, and dye and Styrofoam representations of the solar system. We all dressed up in our niceties and stood in front of our tri-fold carbboard displays outlining some plan or another that we wanted (the term wanted could be replaced with were required to) to implement on this unit or that one. We followed this up with a 1-hour reception and a 2 hour mandatory 'role panel discussion' that consisted primarily of nothing important or even remotely interesting. Everyone was there out of fear that I spoke with, concerned that they would lose points by not attending. The calculated gamble did not pay off, there was no attendance sheet circulated. Damn!

Speaking of Management, the class continues to remind me of a class I had in undergrad, theater appreciation. In theater appreciation, the professor sold his notes to a store across the street which turned around and made copies to sell to the students (somehow this circumvented the professor selling his own notes directly I guess.....how that makes it any more or less wrong is beyond me). I attended that course a sum total of three times. Day 1 to get the syllabus, the midterm, and the final. I got an 'A' for my troubles (or lack thereof) boosting my GPA while checking off 3 credits of humanities. I have been to Management a few more times than that, but only a few. I went to the first class, the second where we signed up for our PI projects, the midterm, the mandatory role panel last night, and I will attend the final. Thus far, I have a solid 'A' in that course as well, only this time I study by picking the most textbook sounding answer and not studying at all. Ethics is just as bad only they require us to sign in each class period or we lose points. We have an instructor for small group that I refer to as 'the substitute' because she always comes to class ill-prepared to teach, like a substitute who just got the lesson plan a few minutes ago. We tend to get out of group discussion 45 minutes to an hour before any other group. On one hand, these classes will only serve to increase my GPA, and on the other hand I am paying about $1K per credit hour for jack-squat.

Since Tia is always peeved that I don't talk about wedding stuff, I thought I would try to appease her. Her website has the countdown, but it is roughly three weeks off. We have been trying to tie up all the little loose ends that even a small wedding seems to have. Making matters infinitely more difficult are the facts that we are in NY, her parents are in Portland, and mine are in Florida. It should come together since there aren't too many stray pieces with so small an affair.

All things related to moving are still messy. We are presently in process of trying to find a place to land out West. Tia has been in contact with some people who are renting out furnished places for the summer, hopefully allowing for enough time for me to find a job so we can pick a more permanent residence (and not having to purchase furniture right off the bat would be excellent). We are still selling off things, and have done better than I had hoped for the most part. We still have more to go of course.....and it never ceases to amaze me just how much of it there is. We still need to get a hitch put on Tia's car and book the trailer as well. Big fun.

Other than those things, most of our time has been spent practicing NCLEX questions, reading, and watching TV. Have seen quite a few 'bad' movies lately as well. As critically acclaimed as they were, I really did not like No Country for Old Men (a torpid affair with an abrupt and unsatisfying ending) or Michael Clayton (stopped it before it finished). I have There Will be Blood in my mail box right now and I am not sure if I even want to watch it. Also saw American Gangster (decent), American Psycho (also decent), and a number of other films that I can't recall because of what little impact they made upon me. I am happy the Office is back at least.

I better get to work on my Ethics paper now. It is one of the few things I have left to complete. Between now and May 2nd, I have the Ethics paper, a presentation on policy, a final exam in Management, and the exit exam to get through. Plus, the 4 day 8:30-4:30 NCLEX training Wednesday-Friday of next week. Sounds action packed doesn't it.

A whole lotta nothing

I continue to be a little disappointed and extremely pleased that there has been little of note to write about of late. With nothing to report on the upshot is that nothing bad is happening with school or life in general. The downside is nothing particularly exciting or positive is happening either. I will take the peace, because a storm is on the horizon with so much going on from the end of April until I find employment in field.

My time has mostly been spent tying up group projects, selling all manner of worldly possessions, and practicing test questions for the dreaded NCLEX. I am upset at how little it seems I know, and mollified somewhat by how that dearth of knowledge is mirrored by everyone else in the program. Surely, if everyone else jumps off a cliff, you don't want to necessarily follow......but its nice to know that if you do jump, you have plenty of company on the way down.

I am not earnestly worried as yet. I feel comfortable enough in practice (which is the most important part by my measure) and have plenty of time to acquire the assorted bric-a-brac of knowledge NCLEX seems to value. The most difficult part is learning to read within the questions as they seem determined to test not just on your depth and breadth of knowledge, but also on your ability to parse out meaning from the query itself. The national pass rate is 85% on the first shot, so I think I will be A-OK.

Other than what lies in the paragraphs above, there is little to report upon. I will of course be the first to tell you here if anything does.

Trying to find something blogworthy

There was a Seinfeld episode where Elaine found out the stores stopped carrying her birth control of choice, the Today sponge, and, from that point forthwith, interviewed guys before sleeping with them, having to dub them 'spongeworthy.' In a poor attempt at a segue way, I try to find things that are worthy of blogging about (based upon my committee of 1). Nothing seems quite blogworthy of late.

The clinicals are done and the simulation day was much less arduous then we were led to believe (it ended a few hours prior to when we thought it would). In the intervening week, little of merit has occurred. We had another in the continuing series of pointless lectures in both Ethics and Management, we were thrown another random group presentation assignment in the former, and we had a meeting about what to expect from Nursing Integration (a lot of test questions and examinations meant to sharpen us up for NCLEX pretty much). The group projects continue to linger around like an obtuse party guest that can't figure out when to leave, but nothing else is hovering at the moment. I would feel free, but I still have that nagging feeling of 'this can't possibly be it.......can it?' Like the school is just lulling us into a false sense of security only to pounce and destroy our ambitions at the last second when we are least expecting it.

Til next time.

The last day of clinical

Though I am quite proficient at complaining, I cannot find much to complain about in being done with clinicals. All the early frigid mornings, the endless patient preparations, and the pre- and post-clinical wrap-ups are officially at an end. The next time I take care of a patient, I expect I will be getting paid for it.

As far as last days go, it was about as uneventful a day as you could ask for. The hardest part was not staring gape mouthed at the clock for the entirety of the shift. My patient had plenty that was/is wrong with her, but none of it was affecting her in any discernible manner on this day, so she was being discharged (eventually.....getting discharged from the hospital is akin to waiting on cable repair, there is a broad range of time when it might happen). Her mother took care of her feeding, washing, and changing. I was left to do little more than collect vital signs (twice) and check in periodically to see if anything had gone awry. Thankfully, nothing did. I am sure this did little to impress my clinical instructor, but aside from hiding out under my patient's crib I didn't see much way around moseying about the nurses station with my chart in my hand.

Tomorrow will be a simulation day. Well, mostly. It will involve a few hours of simulation and a few hours of lecture and a few hours of post conference and............well, and who gives a shit its over!!! The chapter officially closes on PEDs this coming week with a Monday exam and a midweek NCLEX style challenge for extra points. There are plenty of other things to do, but it is a HUGE relief that clinicals will not be one of them. Would I have liked to deal with full patient loads and other things that would better prepare me? Absolutely! But, UR places more emphasis on other things. Hopefully that emphasis will not prove misplaced.

The fire sale continues on our belongings and, happily, are selling briskly. We may yet condense our belongings enough. It remains to be seen of course, but optimism abounds until you actually start trying to pack it all. I will truly loathe that part. Tia's chinchilla cage weighs more than an offensive lineman and is just as big. Maybe we can strap it to the top of the trailer?

Off to some Nyquil dreams (my allergies will be the death of me yet).

This blog for sale. Slightly warn. $50 obo.

Now comes the point in our adventure when we have to start selling off our belongings (and by 'our' belongings I predominately mean Tia's belongings as my accumulation of tangible goods is rivaled by any cart-pushing vagrant) and begin, slowly at first and then with alarming rapidity, to devolve back into "first apartment in college living." The kind of living that has everyone seated around a coffee table that used to serve another purpose (like a spool for cable) until a friend finds a dining set under the stairwell that is so covered in cobwebs that the Addams family would reject it. Somehow I doubt things will go that far....but we will for sure find ourselves slumbering on an inflatable mattress, dining without benefit of a table, and sitting on the living room floor for at least a few weeks. Perhaps we will look back fondly and laugh at such inconsequential hardships, but in the interim it will be really annoying for all involved.

What this means in the long term is that we will likely be hitching up a trailer and driving across the country that way. I am sure my brother-in-law can relate to the fun that that will yield, but at least we will not be taking any mountain passes of substance until Idaho. I don't anticipate the nasty weather we encountered there in early May to be present in early June. But then again, I am incredibly naive.

I now have to actually write a fake letter to a representative about a policy issue. You might assume that my program was hijacked by a high school civics teacher, but you would be wrong. This is actual college work. Seriously.

Childe Roland to the Dark Tower came

Another week of clinicals has been put to rest. This week was harder than most, but not for any particular reason. Just the sense that things are winding down makes it seemingly harder to concentrate on the most immediate tasks and not concern yourself with what lies down the road. I understand this, but it makes it no easier. You can sense it from those around me who are settled in a job and a place. I don't want to label it a sense of inner peace, which sounds an altogether too ethereal for what it is, but they are definitely more at ease. I can't help but wonder how we will figure out what needs to come with us when we move such as: where the money for the move will come from; how to determine the value of things you have to sell vs. the cost of re-buying items you need vs. the cost of moving some of those things vs. all of them; whether or not to sell a car or keep them both; and, of a lesser concern only because I am impotent to do anything about it at the moment, where and when I will be employed both immediately upon my return to PDX and in the Fall. All of this plus trying to tie together details for the wedding and maintaining course work. May will be both a huge stressor and an enormous relief.

As for clinicals, my patients were all in good spirits in spite of their ailments. You have to give kids credit for that. They are so resilient in the face of what lies ahead, both because it is their nature and because they cannot possibly comprehend the bigger picture. The more I am there, the more I wonder about possibly working with this population down the road. We will have to wait and see. I love being able to interact with the parents and the children, but hate to see children dealing with chronic ailments. Definitely on the table. Just need to develop a better comfort level with the really little ones. I have no familiarity at all.

I finished the Dark Tower series (septology?) finally. It was quite a literary journey, but a really enjoyable one at that. As with any series as long as that, there are many places that could be trimmed and streamlined, but overall there was a whole lot to like. Now I have to find something else to tide me over when I am not knee deep in reading about pediatric neuromuscular disorders.

I hope everyone is having a good Easter Sunday howsoever you celebrate it. I don't tie any particularly religious connotations to the day, but I definitely miss being around family, snacking on chocolate and closing the day by eating an overlarge meal. Here there is just Tia and myself and, quite frankly, little is even open and operating today. It is beautiful and sunny, but still far too cold to be outside soaking it in. Maybe fate is trying to force me to study......I will do my best to fight it off.

Escape from New York (Snake Plissken edition)

What can I say about NYC? It is one of those places that has a distinct feel to it to be sure and those are few and far between with the homogenizing of America. Most cities nowadays all have the same restaurants, malls with the same stores, and the same look. The few that don't that I have visited in the US are San Francisco, Las Vegas, NYC, Washington DC, San Antonio, New Orleans, Portland, and Miami (I had hopes for others like Seattle, but take away the waterfront, and you could stick that city anywhere. I still think it looks like the Pearl in Portland, only through the whole city). That isn't to say that any of these cities are places I would want to live nor is it to say that they have a feel that is necessarily good or bad, but they stand out and thrum with a distinct energy. NYC is too dirty, expensive, noisy, and crowded for me to ever want to life there. But, it had its beauty too around Central Park and in some of the neighborhoods. It isn't a place that I will be compelled to come visit again, but I am glad i had a chance to see and explore it and that is more than I can say about a lot of places I have seen (such as Rochester).

School continues to be an overwhelming pain in the ass, but it is a muted pain anymore (perhaps a dull ache). The clock is winding down and the classes are less strenuous than they were last term. At this point, I just need to show up sober at the last few clinicals to pass PEDs, force out a few papers for Ethics and tie up a group project (and poster presentation........i hope we get to use fingerpaint!) in Management. Nice.

That said, I did just find out that that UR will be discontinuing both the management and ethics course and replacing them with more simulation time and more time in clinicals working with a larger patient load. Part of me understands that I ultimately have an easier path with those two god-awful useless courses, but part of me cant help but be upset that they always make changes that would better prepare you for the actual career the year AFTER I finish a program (I had a similar experience in elementary ed). The opportunity to work with a full patient load under the tutelage of a nurse will have to wait until I start working, which is fine if I stayed here where that is understood by local hospitals, but potentially a bit more of a problem out West. Only potentially though since I dont know what preparation occurs out West. As usual, fake it til you make it........at least I will be ethical and understand the principles of followership while doing so! :)

Lesa asked me a question that was, I thought, quite poignant, "Do I feel well prepared?" I could only answer that I do............and I don't. On one hand, I think I will be as well prepared clinically as any other student having spent a lot of time with patients on the floor. On the other hand, I will not have had more than 2 patients in any given shift. That will have to be learned and is usually part of training. On the other hand, ss for pharmacology, I am a bit underwhelmed by our preparation and feel like I wish I knew more than I do. That knowledge will also come in time and will be fairly rote once you see them over and over again on a unit. Still, I have a lot to learn. Mercifully, it is not my job or within the scope of my ability to prescribe anything. So, ultimately I think I have the tools to be trained to be a nurse, but I certainly wish I felt more confident about certain subjects within the profession.

On a completely other note, check out the show Dexter if you haven't. I don't think you will find another show (and hopefully not in real life either) where you blatantly root for the serial killer to win out in the end. Michael Hall is great in the lead role.

There is little else to tell. The countdown is most assuredly on. Less than 50 days and counting until classes recede into fading memories. Less than 75 before we are back in the Pacific NW. Hopefully less than 125 before I find someone to pay me for all this schooling.

Happy Hump Day

Hump day is Wednesday..........get your mind out of the gutter! :)

I am shocked that it is already Wednesday. My spring break is fast becoming a memory and I have little 'break' to show for it. I have been working on papers and my packet for Legacy for the most part. That will all change tomorrow though. Tomorrow Tia and I head down to NYC for what I hope will be a fun time. I think it will anyway as we are staying with a friend of Tia's there who happens to have time off to show us around. Very nice. I am not sure what we are going to do once there, but I want to see Central Park, Chinatown, and Times Square of course. There will be so much to do and see. Especially when compared to Rochester.

We had our first (probably only) moving estimate today. If we take it all, looks like $2500ish. Could be more if we take the couches. Bare bones, nearly $2000. That is juxtaposed with renting a trailer and putting a hitch on Tia's car which will be about $1000 all told, but will significantly limit our space and require some hard choices to be made. I, of course, would rather save the money than have things that we can do without in the short term. Buy some Ikea chairs and the bare minimum furniture that will get us by until I start working and pick up things like a sofa later. Short term it would work, but it isn't necessarily the most financially prudent thing long term. But, then again, I am nomadic by nature and don't like to accumulate much in the first place. Tia, on the other hand, has a much stronger affinity for things. Hard to blame her totally, most things are hers to begin with. My belongings would still all fit in my car.
However, when faced with the distinct possibility of not being gainfully employed in my profession until August and the likelihood that I will need to take a very low-paying job in the meantime, it certainly appears preferable to spend down the road. We are even discussing selling my car if we can get a good price. It should net us a few thousand, after paying it off, and we can buy something new once I find employment (something compact with exceptional gas mileage since gas is supposed to go up significantly by the summer). It would save car payments for a few months as well which would be good. I never thought I would be at a more precarious point financially out of school than in it. At least Tia is gainfully employed and can float us for awhile if we find reasonably inexpensive accommodations out in Portland. We will have to talk about my allowance first of course :)

I need to finish up my cover letter and resolve a hypothetical ethical issue for class on Monday. I will write of my NYC adventures upon return to the artic tundra in which we reside.

Job update

Since I know you are interested in my becoming financially solvent, I thought I would let you know what I have found out thus far regarding applying for positions out in Portland/Vancouver:

Providence: Applications should be held until at least late April/early May, preferably until after graduation (but can be submitted prior to NCLEX).

Legacy: Applications accepted only through internship program (which I am applying to). 1-2 positions per unit twice a year (fingers crossed so hard they are becoming cyanotic).

Kaiser Permanente: applications should be held until after graduation and preferably until NCLEX has been passed or they are screened out by recruiters and don't go to nurse managers (meaning you WILL NOT be getting hired period unless you have passed already).

SW Med: wait until graduation. 3 references needed from clinical instructors.

OHSU: wait until license. Highly competitive with low turnover according to recruiter. She kind of made it sound like a NYC apartment, like I should scan the obits and see if an OHSU nurse died so I could apply for her newly vacant position.

So, it looks EXTREMELY unlikely I will have so much as an interview prior to moving unless the Legacy internship comes through.

This is all a bit discouraging, but hopefully it just means I need to bide my time and something will come through once I get out there.

Spring Break and another foot

How spectacular to only have to think a modicum about school over the next week. I wish I could say that I intended to not think about school at all, but there are a few assignments due immediately upon the culmination of the break. Who does that? University of Rochester SON thats who. Oh yeah, and it snowed a little over a foot the past two days. We are now jsut shy of 100 inches for the winter. I miss grass, leaves on trees, and my car not being covered in more salt than an Auntie Anne pretzel.

Interesting SON story. A fellow student, lets call her M for the sake of anonymity, had an altercation with a clinical instructor, lets call her D, who already has a poor reputation within the school that, through teacher evals should bear out if not through direct complaints. Anyway, M had a rough go in her clinical with D, and thought that the attacks seemed personal rather than having anything to do with her performance. Her final student evaluation was passing, but a lot of the comments were quite negative. M was disheartened, but could really do little accept complain through her teacher eval of D. However, evidently D decided to talk to someone about M and said something to the effect that she purposefully gave her a negative write-up and thought it was funny. M was pissed and went to the school to complain about her confidential student information being made public and the fact that D was acting completely unprofessionally. Contacting a lawyer was brought up. The school reacted to that.........well, kind of. D was talked to (scolded?) and the next day D came up to M at work with a new student evaluation that has nothing but stellar things to say about M. She told M that the other eval 'was a goof' and that she hadn't meant to give it to her really. She asked M to sign it so that everyone could move on. To M's credit she told her to kiss off. It wasn't about the evaluation, but rather was about confidential information, her information, being broadcast to third parties and about the complete lack of professionalism that D had displayed. M says had she not closed the term with a very positive alternate site placement or she would have dropped out then and there. This complaint was not the first that I have heard about D.....and I am sure I have not heard them all.

Multiple choice: The school, threatened with litigation because of D, has decided to:
A. Immediately terminate her contract in light of the mounting evidence against her.
B. Suspended her while they investigated the matter further
C. Reassigned her to a non-clinical role
D. Did absolutely nothing except give her a tongue lashing

Don't think too hard about it, because you can probably guess based on my other observations that the school not only did very little, but that she is teaching another group RIGHT now. Re-god-damn-diculous!

I had an interesting clinical day yesterday. I ended up working with 2 young girls, 11mo and 14mo respectively. One had a brain tumor and had shunts in her skull to relieve the pressure. The other had a disorder that, without getting too medical, basically led to her urine going back up to her kidneys from her bladder. The girl with cancer had an NG tube, so I had to do some feedings through it and change my second ever diaper. The other girl was in the hospital for her 27th UTI infection since birth and had to be straight-cathed 4 times a day to get urine. So, I ended up straight cathing her. I am definitely getting some experiences, but I truly dislike seeing little kids in such bad places. I cannot imagine working in PEDs any more than I could imagine working in long term care. I think I would be an alcoholic by the third month.

Off to enjoy my lazy Sunday without a pressing need to read some textbook or another. Feels nice. A guy could get used to this.

Pulling out my hair

Just taking a break from my patient prep. I need to tie up a few loose ends before submitting it tomorrow morning. Also, I need to prep for both my patients tomorrow (it will be half-assed to say the least. I am not passing meds so I plan on acquiring only a passing knowledge of their uses). I spent today down in the acute care clinical for pediatrics which was surprisingly a lot better experience than I was led to believe it would be. It was fast-paced with a lot of variety, and that is what I prefer in relation to hospital care. I saw chemo therapy delivered through a spinal infusion, spinal fluid collected for testing, port access for meds, kids with colds through cancer, and even got to listen in on some phone calls from parents. Overall, about 10 times better than the babysitting we predominantly do on the pediatric unit. Oh well, like it or not, I have to get through it.

Speaking of getting through.......I am writing out of lucid hours and I have a lot to get accomplished before I do.

Some people can't find the needle, I can't find the haystack

Things are taking a turn towards both the interesting and the frustrating of late.

Out here, the recruiters seem to smell blood in the water when you contact them. It is getting kind of ridiculous how desperately they circle. They call and call, even if you schedule a set day that you will call them. It is nice to be wooed and wanted, but it almost feels a little too good to be true. Of course, considering the relatively low pay, mediocre benefits, being charged for parking and living in one of the snowiest and most crime-ridden cities in the country per capita is a dead give-away that it most assuredly isn't all that good.

It is the opposite out in the Pacific Northwest. To continue with the aquatic theme, Portland is much more akin to chumming the water hoping for a dorsal fin to pop up over the breaking surf and getting nothing. There is no sense of urgency at all. The recruiters there seem to have a "dont call us, we'll call you" mentality. This to live where we want to, instead of where we are with significantly better pay and benefits.

Both situations make me a little edgy because I feel most comfortable somewhere in the middle. I don't need to be sold on a job, any job, just because there is an opening that needs to be filled. However, I also don't want to be pushed off like I am bothering them by applying. It is discouraging. The hardest thing about Portland is that I KNOW there are jobs. Plenty of them in fact. They have innumerable opportunities at almost every hospital on their websites. Some have been posted for months and are still vacant.

Speaking of jobs, I am now trying to get my ducks in a row for an internship at Legacy. I think this illustrates the difference between Portland and Rochester pretty clearly. In Rochester, I applied with just a resume and a smile. At Legacy, I applied and was told I need to apply through the internship because that is the only way they will hire new graduates. The application opened up on the 3rd (I found out on the 4th) and will close on the 21st. In the meantime I need to get two reference forms filled out by clinical instructors. Sounds easy right? Well, it kind of is and kind of isn't. The forms have to be filled out and signed somehow by me and the clinical person, which isn't easy to do since I don't work with these people any longer. So, I thought I would just email them instead. Well, this is an issue because the forms then need to be sealed and signed across the seal (and also cannot be folded or stapled or breathed on incorrectly) while somehow I sign it too. This is in addition to a few other pieces of paperwork that also need to be included in the application. Then I have to hope that I can get an interview dependent upon my application and what two areas I select to apply to (which is its own issue because you have to guess how many new hires might be accepted and there is a possibility that some areas may not hire anyone).

On a funny job side note, I got a call from Rochester Psychiatric hospital today where I had previously interviewed. They are literally sending letters to my last three places of employment and needed the address for the school in Korea. I shit you not. I explained that they would be better served writing to just the US locales because of the English barrier, but they weren't sure what they were going to do. The chances of me working there went from 5% to less than 1% both because they aren't likely to get much of a reference from overseas and because if they are working on a letter writing campaign, by the time they would even get around to offering me a job, we will be long gone from this area. I am glad to see it is 1982 and physical letters are still be used for references. I am half surprised they didn't tie a note to a carrier pigeon's leg or send it by donkey.

I really ought to get back to work on my patient assignment, but I keep getting distracted by everything else going on. I plan on continuing to try to pester places into taking my resume next week. In the meantime, if anyone knows anyone who might be able to help with the hunt, it would be most appreciated. I am not opposed to begging. Unless a perfect job presents itself here, there is pretty much ZERO chance we will stay in ROC. Even if it does, the chance maybe creeps into numbers congruent with the weather here in the dead of winter....high teens, but a 'feels like' chance of much less.

Two more days of clinical and then a week off for Spring Break. Sweet sweet freedom.

I can't study any more today

Thought I would evade reality for a bit and post up some thoughts while I had a few minutes.

My first thought is that I must NEVER eat at Taco Bell again. I am sure there are those among the people who read this with iron constitutions who might disagree, but probably more than that who have already learned the hard lesson about eating there. Suffice to say, I think I learned my lesson this time. Damn you Montezuma and your intolerably pungent vengeance!

My second thought is that PEDS nursing is okay and quite a noble profession, but not my bag. The patient I worked with was as pleasant as he could be considering that he was restricted to his room because of ORSA precautions. It is hard to be cooped up for 2 weeks in a house, let alone being cooped up in a single room with the patience and and energy level of a 7 year old boy. I would be going insane. On top of that, he has to sit in a pneumatic vest 4 times a day (30 minutes each time) that pummels his chest and back to loosen up the thick mucus from his CF. I saw another child, also with CF but two years younger, who had had a stomach, kidney and small intestine transplant already and two young girls with cancer. D-E-P-R-E-S-S-I-N-G.

I don't know if I have a third thought at the moment other than I really don't want to wake up early the next two days to take exams, but hopefully I know just enough and all will end well. Once I get through this week it really will be the home stretch. Two months from today is the official endpoint (well, the last day of classes which is official enough for me). I can't believe I have made it successfully this far.

Josh - I will pick you up a garnet ring too. I could sense the jealousy.

Golden snowball

In case anyone was wondering, just how much snow we get out there, here is an interesting site that is updated regularly. As you can see, we are right on schedule (and it is presently being added to).

http://goldensnowball.com/

Be logging

I try to post when I can and, honestly, when less preferable activities beckon and I can convince myself that this is just as important an endeavor to pursue, therein pushing those other activities further towards the periphery of my schedule. There is certainly some reading that I could be doing now...but I am having a hard time getting fired up to read about renal dysfunction in the pediatric population. Go figure.

So far, this week has been far more productive than the one that preceded it. Of course, that is saying very little. The fact that I crawled out of bed for class and managed to make it to clinical at least today has already made it more productive. Anything else is gravy. Now if I could just halt the coughing fits every time I step out into the cold (and that is ALL there is here at this time of year....it was in the teens yesterday and this morning and scrub pants provide somewhat less protection than newsprint).

It is reassuring speaking to other classmates and finding that I am not alone in my ennui about the program. I am doing well enough, but there is certainly room for marked improvement if I could summon up the will to care. So long as I am passing, I have resigned myself to be happy about it. Go me! Raise a glass to minimum effort!

I had an interesting clinical experience today. A 7 yo with Cystic Fibrosis. I will be working with him tomorrow as well. I hope I get to see more then. He had a breathing test scheduled this afternoon, so he didn't put on his vest (which simulates cupping) nor take very many medications. Happily, he seems to be doing very well. It is sad that both he and his older sister are afflicted. The odds are 1 in 4 if you are a carrier. So, the parent's knew without a doubt that there was a 25% chance that he would have CF since his sister did, yet they went for it. It brings up some very interesting ethical dilemmas. The average lifespan is still under 40 for people afflicted. I don't think I could chance it. 25% is too high a failure rate.

7 days of clinical and counting. Less than 24 hours from 6 days remaining. I am pretty excited!
I got offered a job here. It is both a nice confidence boost and ultimately anticlimactic. It looks highly unlikely that we will be here come June, especially with the problems that Tia is having with the districts out here. Ultimately I will be turning them down. Still, it is good practice for the rusty interview skills. It would be a lot harder to walk away if the pay rate was better, but it isn't out here. The hospitals are definitely in collusion with one another with each hospital paying the exact same starting hourly wage and identical differentials. The only difference is a pay increase of, and I could NOT make this number up if I tried, $0.12/hr additional if you have a BSN and not just an RN and work in the Strong health Care system. That's right, a Bachelor's degree (which takes 2 additional years of schooling and two years of additional loans and two years of not earning money) will net you nearly enough money to buy a Nintendo Wii (pre-tax, not post-tax dollars) assuming you worked a full year at 40 hours a week accruing all that extra coin. I am only assuming that they set that pay increase around the time of the Great Depression when $5/week meant a car payment or something. Now, it is as close to a big FU as you can get. Anyway, if we stayed here, I would probably net about $47K-$50K including some differentials and the sign-on bonus, but it is still about $8K-$12K less than I could expect to earn out West. It is cheaper here, but not that much cheaper.

I also somehow managed to get into the nursing honor society. How that happened is still beyond me, but they evidently can't take it away from me even if I really botch up this term. Of course, I still have to decide if $95 sounds about right for a piece of resume fodder. I think I need to sleep on it. They also offer the opportunity to buy some Sigma Theta Tau bling.....up to $650 for a 14K gold Signet ring. Um, not an effing chance.

I think that about covers the spectrum of events that have occurred in the past week or so. I have 8 days until the sweet mini-release of Spring Break. Before that, I have 2 exams, a presentation, 3 more clinical days, one more extra-long, packed with BS patient write-up, and a similarly packed with BS ethics paper to complete. I will try to post when I next need to evade reality.

Flu Log Day 5

Yep, still sick (insert profanity laced tirade railing against the unfairness of the universe and/or prayer to whatever deity you believe will elicit the most productive response here). I don't have a lot more to add to my initial succinct statement other than I NEED to get better quicker than I am. I have clinical tomorrow, which is predominantly an orientation to the unit, that I will try my damnedest to fight scratch and claw my way through even if I have to wear a Hazmat suit and slather myself in Betadine. After that, hard to say. They aren't going to be squealing with glee to have a walking disease laboratory around immuno-compromised kids battling cancer, but I also don't want to encounter problems finishing up this term because my immune system decided to take Spring Break early. Evidently the prognosis for the flu with someone who already has compromised lungs (asthma, the gift that keeps on giving) puts me on the hook for at least a few more bumpy days before I should be better. So keep your eyes peeled for my next post, "Screw the Nyquil, just get me some Rum."

On the upside, Tia's parents sent me some yummy cookies as a get well present. Thank you very much. Also, a big thank you to Tia for putting up with me 24/7 (she works from home remember).

Sick and tired of being sick and tired

Looks like a good news, bad news situation after seeing the doc today (they were nice enough to squeeze me in because there is evidently something going around and there were no appointments to be had). The good news is that I do not have a respiratory infection......the bad news is that I am not doing very well in spite of the good news. The doctor thinks its viral and told me to call if things worsen. How come things always worsen before and after the doctor visit? I had no fever and no wheezing there, but once I got home my temp spiked to 101.8 and I have felt like the apartment has been alternating temperatures between a turkish bath and the ice cream section of the local grocery store. Even typing this I am shaking worse than Lindsay Lohan 3 days sober. This after foolishly thinking my fever had broken following a night spent sweating heavier than Roger Clemens in front of congress. Its a good thing I sleep face up or I might have drowned.

I wish I had something substantive to add to the posting, but nothing much happens when you spend the vast majority of the day in a recumbent position alternately trying to focus your eyes long enough to read and letting them glaze over while people buy, renovate, flip, or decorate a home on TV. Since we now have cable, here is how I waste away my little bit of free time. Feel free to scoff openly, I am not proud of myself.

Celebrity rehab with Dr. Drew: I don't know if it is compelling TV, but it is definitely stretching the outer bounds of what constitutes celebrity. I didn't know being an ultimate fighting champion or a porn star constituted celebrity. Evidently so.

Millionaire matchmaker: further proof that rich men will, despite what they say, always choose a young bimbette over the better match and that young bimbettes are okay with this arrangement.

Property Ladder: No matter how little you know about home repair and how far over budget you ascend, someone will evidently buy the dump you renovated for a tidy profit as long as you don't get too greedy, because people are generally quite lazy (myself included).

Property Virgins: I know what you are thinking, "A show about abstinence pledgees on a mission from God buying real estate.......what time is that on?!?" Unfortunately, the focus is rarely if ever on the sexual proclivities of the potential home buyers. However, it is interesting watching people buy their first property. Might be as close as I get.

1 degree from hallucinations. I really hope this stops tomorrow.

No vaginal birth

My experience culminated without seeing a vaginal birth. I think I was the ONLY one who didn't end up seeing one. All in the timing. They had a full board today, but no one more than 8cm dilated by the end of our shift. My patient had a lot of interesting procedures done (a blood pH on the fetus, Intra-uterine pressure device placement, and an amnioinfusion), but was not moving along. She was only 14, so they didn't even think that she would be able to deliver vaginally anyway. Ah well.

I will keep this entry short because I feel like crap. On the verge of a possible respiratory infection. God I hope not.

Yeah for the last 2 days........of this rotation

Goodbyes are such sweet sorrow....except for the sorrow part.

As much as I have enjoyed working with classmates on this rotation (as with pretty much all my rotations thus far), I will not be sad to see it go. I think that OB is a great place to work as a nurse. You get to work with mostly healthy patients who, for the most part, have mostly healthy babies. You get to be an integral part in the first few days of family bonding and help the new mothers try to develop good habits for caring for their newborn. However, it isn't for me. I can definitely see the allure, but I still feel too much discomfort both in myself and in my patients. One may play off the other, but what is certain is that there are ZERO male nurses on the entire unit and there hasn't been one in years. Roughly half the people you ask say they would have no problem with a male nurse tending to them in OB, but almost no one has issue with a female nurse in the same capacity. Not that it matters for the outset of anyone's career anyway. It is a highly coveted nursing job that is mostly filled with nurses who have significant experience elsewhere.

I took the advice of my adviser and set up some interviews at local hospitals. I went to my first one yesterday. It was a very peculiar dynamic. I am acclimated to being interviews involving me desperately to stand out from the competition to get the job then waiting hopefully by the phone for the offer to come through. This was more like me interviewing them. It is REALLY nice to be able to go to an interview with ZERO stress as an organization tries to sell you on why you should work with them as opposed to in another unit at their hospital or at another hospital just down the street. It is just as nice to be able to say to them, no thanks I really want to do this instead of that. Now, if I could just get to a position where I could make salary demands too :)

I think there is still only the most minuscule chance that we will opt to stay here, but there is lengthy pro/con list for working in either place. The impression that I get is that, here in ROC, you can be very picky. They will also coddle you more than they would out West. The on-the-job training sounded impressive. However, they also pay you seventy cents on the dollar, which doesn't remotely equate to the cost of living differential. Plus, there is the whole 'living in ROC thing' that neither Tia nor I are enthralled with. In Portland, the pay is better, but they seem less inclined to so much as talk to me until I get my license and there is a far greater level of competition for jobs, meaning you need to take what will get you in the door, not what you want to do necessarily. Long term, that isn't a bad thing, but you also dont want to start with a bitter taste in a new profession. Opinions still range wildly on this.

For the second being I am caught up, so I think I will bask in the warm glow of that feeling......at least until my 4:30 group project meeting.

C-Section, Storm Large, -20 degrees

This is a post that continues to confound my efforts to get up online. Every time I sit down and attempt to complete it, something comes up and another day begins with another set of things to post. I refuse to be stopped this time however so, depending on occurrences outside of my control, this will be terse or my magnum opus.

I watched my first birth. It was a C-section which detracted from the experience some if only because C-sections are performed in a sterile surgical room instead of the much more hotel-like birthing suites. That aside, it was a pretty incredible thing to witness and I feel fortunate to be able to be an observer during an experience such as this in people's lives.

The surgical part was a bit gruesome to be honest. There is a lot of cutting, retracting, and some out and out pulling and yanking. Fluids were everywhere, most notably after the amniotic sac was ruptured, causing an arc of amniotic fluid more than a foot high which bathed the surgeons. The patient was obese, so there was a lot of adipose tissue to cut through as well. It was all very graphic. Ultimately, the birth took less than half the time of the repair of the incision afterwards. I followed the patient through the PACU and to her room where she will stay for the next 72 hours. The baby was fine with good Apgar scores, but was large for gestational age, so they had to do a lot of heel sticks to determine the infant's blood glucose. Mom wasn't terribly pleased by this, but procedures are procedures.

The next day I was back and hoping to see a vaginal birth. Unfortunately, the mom-to-be I was following was wholly uncooperative. How dare she hold out and try to ruin MY experience! It was quite funny because the patient's mom almost sounded that way when, after a number of hours, it became evident that the baby wasn't in any hurry to leave the womb. Every phone call she received while we were in the room sounded almost accusatory towards her daughter, as though she were intentionally withholding the child from the world. Even with a high rate of Pitocin on a constant drip, I found out she ended up having a C-section later that evening. One of my classmates got to witness that. I have one more day in labor and delivery. It will be interesting to see what happens then.

Tia and I celebrated 2 years together on Sunday by having a relatively school-free day (except for an exam I had to take that morning at 8am). We used some spa gift certificates from her mom and Sherri and I got a massage and a wonderful hour-long sports pedicure. So relaxing. Then we headed out to eat, which was a bit of a mess because the restaurant we wanted to eat at ended up being closed on Sundays, necessitating a change of plan to an expensive Vietnamese place where we were the sole customers. It was good, but no better than Vietnamese places that were half as much out in Portland. We then saw Storm Large (remember the Rockstar Supernova show?) headline a play called 'Cabaret.' Very bizarre. Lots of skin and a fair amount of gratuitous groping. I dont really no what to say about it. It was a musical on LSD. I think Wikipedia may do a better job of describing it than I can: http://en.wikipedia.org/wiki/Cabaret_(musical)

The other entertaining thing about the evening was that I experienced a new "Holy shit it is REALLY cold here moment." The temperature dipped down to the single digits (6 degrees) and, with windchill, we hit -20 here in Rochester. Perhaps to prove that the people here are a hearty lot, there was one young guy at the show who was adorned in a polo shirt with a light windbreaker and, I shit you not, cargo shorts. My guess is he lives in an ice cave on a planet further from the sun than our own regularly so it must have seemed quite tepid out. As for myself, I could barely think over my teeth chattering. We closed out the night with dessert at the Cheesecake factory. Good lord they have good desserts.

In other news, school continues to hit new lows, but I am not alone in feeling this way. For those of you who dont know me well, one of my BIGGEST pet peeves is when I feel like my time is being wasted. So, when we showed up for class yesterday for our 4-hour lecture in Women's Health with only that day's materials encompassing what will be on tonight's exam, I thought we would for sure be very productive. As usual, I was wrong. Instead we spent the first hour discussing how our respective weeks were, the next 2 hours working on case study projects that were largely opinion based and then presenting them to the class affording ZERO information to anyone and then, the last 45 minutes covering 1 of the three powerpoints that we were supposed to cover. Needless to say, when I found out we had a panel discussion arranged for today, I opted to do laundry instead. I then spent my off hour in a meeting and followed that with 3 hours of ethics lecture. I may need to arrange future spa visits for AFTER Monday.

A few of my classmates discussed sending emails to our instructor so that she would know that we are not pleased with how she opted to run our class......but as usual, nothing will come of it because the risk is greater than the reward, especially since this was our last class session with her. She will of course return, like a bad penny, to teach our NCLEX review. God help me.

Off to study for the last exam tonight. Wish me luck as always.

Quick note

Came across this site, thought I would share it with those that I didn't manage to email it to:
http://allfunny.net/index.php/funny-pictures/proper-baby-care.html

Goes along with what I am learning.

Nothing new to report. Another day of lecture......another unbelievable amount of information to assimilate. Another day closer to being done.

Righteous anger

I am sure anyone who has taken introductory college courses can empathize with the following situation: You are in some introductory requirement course or another, lets say English 101 for example. Everyone has to take this course so you and your friend end up signing up for it, only at different times with different instructors. As the weeks go by, you find yourself reading obscure treatises on the history of the umlaut and its effect on the present day English language and writing 15,000 word essays on dangling participles while your friend watches obscure French films and, if there is time, tosses off the occasional haiku. At the end of it all, you work your every loving ass off for a solid C+, which you are inexpressibly proud of because half the class failed while your friend sleeps through their final and makes a B+ because their aura was especially pink that day. Or, the exact opposite of this happens. It is really luck of the draw. You just have to accept it as the random event that it is.....or maybe your aura just wasn't especially pink at that time or place in your life (presuming, of course, that a pink aura is a good thing). When it pisses you off is when that same class and same instructor yields two disparate experiences. It pisses me off anyway.

To get down to brass tacks, the following situation has evolved: Our class is split up into 2 cohorts; A and B. Cohort A began in OB/Peds and is doing the med/surg rotation presently. Cohort B is my cohort. Cohort A managed to achieve an 18pt improvement over our first exam in med/surg and managed to better our averages on the first two exams in OB/Ped as well. Cohort A is over-represented at the top of our class academically, and not by sheer chance. What I found out today is that they got a much more focused study guide in MS (med/surg) detailing specific places to look for answers in the text, had questions that were used and counted against us in MS removed because they were deemed too difficult, had questions dropped from exams in OB/Peds (OP) because they didnt have MS previously and, to top it off, that the exams have been made harder for us in OP because we have had MS. This is all the more aggravating because we will be judged on a level playing field. Meanwhile my cohort is essentially running up hill. If I haven't expressed my disgust for this program lately, my apologies for being lax in that regard. It truly sucks.

Speaking of things sucking, I leave you with one final, and quite poignant example. Today there were questions brought up in regards to validity in OP. The situation that has arisen on both exams thus far is that material that is being tested on is not being covered until future readings. So, we are being asked questions on, for example, APGAR scores, without having exposure to any information about them until the readings for the next examination. A very clear problem with validity. When this was brought up the instructor said, and this is a DIRECT quote (you cannot make this shit up), "So, what you are saying is that you want me to only question you from material we have covered?" As if this was some kind of foreign concept and we were asking her to make unreasonable accommodations on our behalf. At this point, she could test us on the season premiere of Lost and not be any less valid.

And to think I get to wake up tomorrow and do it all over again. My aura must the be opposite of pink lately.

Mother & Baby = Done & Done

I still have two weeks left on my OB rotation, but the remainder of the time will be spent in Labor and Delivery. Though that is no indication that I am done being in situations that I find rather uncomfortable and embarrassing, it means I at least will be facing those situations with a health care team. Tia says that I over-emphasize my discomfort and tend to dwell on it...something I cannot argue, nor shake. I just don't feel right doing the examinations on the new mothers. I am mystified as to how I am supposed to ascertain how much blood is on the pad in their panties (Lochia) as a result of the shedding of the uterine lining as compared to that of a menstrual cycle. What constitutes heavy vs. moderate remains a mystery, but I can say that if I were losing that much blood from a flesh wound, I would suggest that I was bleeding heavily (in this I am apparently incorrect). That is just one glaring example of how hard it is to relate to what these women are going through. I imagine to some degree, working there not having carried a child of your own might prove a bit difficult for a female nurse. I would argue however, that not even having completely different apparatus is a greater impediment than that.

Despite my misgivings, there has not been a single incidence of any of my patients being outwardly uncomfortable with me. It remains entirely possible that I am transferring my own feelings to them, but I can't help the way I feel and Psych 101 is no help here. I just cannot imagine a time in my life that I will ever be at ease walking into a room to meet a woman for the first time and, shortly thereafter, peering into her underwear without a significant amount of distilled spirits involved (frowned upon in the medical profession).

That said, I feel very comfortable working with the newborn infants, offering some advice to the mom's and being in the nursery. Honestly, a greater portion of the day is spent not examining the new mothers, so it has been about 98% positive, which is a step in the right direction. I am pleasantly surprised by how good I feel about being around the newborns. Truth be told, I am not the world's most effective swaddler and I am remarkably inefficient in changing both diapers and attire on an infant, but compared to my similarly inexperienced classmates, I hold my own.

In other school related news, things are ever so slowly rounding into form. I am still struggling somewhat on the motivation front, but it appears to be a universal concern in talks I have had with classmates. The goal for the moment will just be staying afloat until Spring Break just 5 weeks in the distance. Seems minor when typing it, but 5 weeks is never minor in a program like this.

As always, keep em crossed for me.

Senioritis?

Can you have senioritis in a one year program? I contend that you can. If not I will have to seek out psychological evaluation to more accurately discern why I feel how I do at the moment.

Right now the program feels a lot like a ride at Disney World. They have signs posted everywhere along the snaking lines telling you just how long you have to wait. Then, much sooner than you imagined, you find yourself on the precipice of the entranceway, excited that you are about to enjoy the ride......only to be confronted by a labyrinth of partitions herding you circuitously towards, what you hope, is the actual ride. Only, instead of a ride, I will be subjecting myself to onerous standardized testing and prostrating myself before potential employers at the culmination of this phase of the journey. I must be a sadist......or utterly insane.

On the other side of the street where the grass is greener, things outside of school are going as well as can be expected. Tia continues to deal as well as humanly possible with my ever shifting schedule and responsibilities. I know she finds it irritating, but she does well in masking it for the most part.

I cannot wait until May. That will be my new mantra.

Meconium

I was going to state, in grandiose fashion, that I had changed my first diaper today. Then I thought about it and realized that would be a misnomer indeed. I have changed more diapers in this program than I care to recollect. Not a one, prior to today, had been on anyone under the legal drinking age however. It was thankfully a good deal easier when you can single-handedly maneuver their body about. I will state that the stool itself, meconium, was akin to trying to remove the residue left behind after you remove a sticker. Hence, what they lack in volume, they make up for in effort required. Enough poop talk.

I also witnessed my first circumcision. It was actually pretty interesting and not altogether unpleasant. There seems to be a lot of information defending both sides of the circumcision argument and neither has enough evidence to back up their claims. Who knew a little piece of skin could inspire such controversy. I long for the day when pro-life and pro-choice is no longer debated and, instead, we have to hear our candidates discuss their stance, and reasoning, on circumcision. It would be nice to finally not hear a bunch of old white men trying to force their opinions on what women should be able to do with their uterus and instead have women duking it out on what we men can opt do with our penises.

To close this terse post out, I must reiterate how much I hate doing the early AM thing. It would be one thing if I were banking a bit of change for it, but the opposite is true. Consider this a post-bitch for today and a pre-bitch for tomorrow. Gnite.

An uneventful week

As some have thoughtfully reminded me, I haven't posted in awhile. Since I am pretty burned on reading about newborns and pregnancy for the moment, I thought I would cede to demands.

The first few days on the OB floor were relatively uneventful. The first day was really just half of one, and only a few hours were actually spent on the unit. The rest of the time was reserved for discussing postpartum examinations, breastfeeding, and expectations of the course. Needless to say, none of the information is anything I am more than passingly familiar with and the idea of having to feign any semblance of authority on any subject related to pregnancy or childbirth leaves me with no lack of anxiety. Its the same kind of anxiety I get when questioned by a mechanic about the sounds emanating from my engine or wandering around a hardware store when I don't know the technical name for the widget I am trying to locate. Hopefully as the lectures and reading catch up with what is expected of us on the floor, my feelings of inadequacy will lessen. Of course, around that time we will be moving to pediatrics.

As for experiences on the second day, I did get to see an epidural placed. It was really interesting and, thankfully, a huge relief to the woman who received it. She went from tears of agony to sublime contentment. Very nice. The same women unfortunately had a HUGE phobia about needles and incredibly small veins so, to get her peripheral line set up to get enough fluids in her to start the epidural, there was a series of missteps trying to get a line started. It was interesting to say the least and not a little blood was shed between collapsing veins, an infiltrated one (that began to puff up her hand immediately), and her flinching throughout. Three nurses tried at least two spots apiece before success. Yikes! I hope when I place them they will prove easier (at least somewhat).

The first examination has come and gone in OB as well. It is nice to be started, but god what a road to hoe. We have many more papers than in any other semester this term, so I may prove somewhat unreliable in my posts, with an ebb and flow commensurate with my chaotic schedule. Stick with it though, because this is cathartic for me and hopefully keeps everyone in the loop.

Jobs Jobs Jobs

That seems to be the topic of the moment......who accepted what job and where. They spoke to us about it in the Fall actually. There appears to be no consensus on the issue of whether to seek employment now or to not bother with it until we finish up with classes. To mix metaphors, the constant tug between a bird in the hand vs. waiting to see what lies behind door #2. Most students and former students find it advantageous to apply and accept now. Advisers and instructors seem more inclined towards waiting. Unless Tia and I decide to reside in Rochester another year, the point is a moot one for me, but an anxiety provoking one nonetheless.

It is hard to hear about the jobs that everyone else locked up and when they are going to be starting while I try to figure out how I will afford to move back to Portland and re-start a life out there. Especially since, in Portland, the few people who did speak to me (some hospitals evidently declined my inquiry outright...perhaps misliking the timbre of my voice) were not to be bothered with applications from unlicensed individuals until we are far closer to such point or, ideally, have attained said licensure. The situation feels all the more disconcerting since it is unlikely I will navigate through the convoluted licensure process and be able to begin working until July at the earliest. August is actually more probable.

There also seems to be more reluctance out West to start a new nurse with anything other than a general medical/surgical floor. The kind of floor where poop is a constant. The kind of floor I will be unhappy with. Once again there is significant disagreement. Some people feel med/surg offers the most rounded introduction to nursing and affords you the most significant opportunity to improve in the field and master skills you can take anywhere. Others feel that, should you not enjoy such an endeavor, why expose yourself to it. You will ultimately specialize in something, so why pick up habits on such a unit when you will have to relearn the specifics of where you would prefer to be. Also, on all floors you will practice, to some degree, general skills, so why subject yourself to something that is likely to turn you off of the profession. You dont go to the OR if you can't stand blood after all. It leaves much to ponder.

In the interim, I will just try to push the whole job thing aside until I can figure out how to make it through Pediatrics and OB, Ethics, and Management. But it will surely play on the fringes. As much as I work towards the Buddhist ideals of living in the moment, it is awfully hard to not look ahead.

Back to School

Tomorrow is the big return to lectures, readings, and endless hours spent in a windowless auditorium (a fact rendered less disconcerting in the winter when sunny days are less common). I am both excited and a bit disconcerted by what lies ahead. Of all the rotations, the one I was least looking forward to was OB. I cannot adequately express my discomfort with it. I am hopeful that it will be far better than I hope it to be. I just have a hard time envisioning the situation as being anything but awkward.

The next step will be pediatric oncology. In my mind, the situation goes from awkward to sad. If there is anything more depressing than a terminally ill child, I know not what. I am certain there will be many tales of recovery as well, hopefully far more than the former.

As for classes, check the blog for moral ambiguities and ethical conundrums from Ethics, poignant commentary about how to Manage Care, and, er, some flippant comments about Nursing Integration (what the hell is that anyway?).

I am so glad to have seen so many friends, family, and soon-to-be-family while out in Portland. Keep pulling for me and write when you can. Same goes for my friends and family elsewhere.

So it begins again.

7 degrees and sunny

I have already been provided the grim, and entirely typical, weather forecast for my trip out to PDX: "Rain and about 45 degrees. Repeat ad nauseum until the populace is driven suicidal." I could never be accused of loving the Portland winters. Winter in general for that matter. As horrifying cold as the temperatures have registered here lately, it has been mercifully sunny. It is the coldest place I can recall living (I can't count my time in Ohio since I spent half of it scarcely sentient and the other half sick enough to be counted not much beyond such level), and yet pleasingly sunny just frequently enough to make it bearable thus far. I forget just how much sway the sun holds over my mood.

This isn't to say that I am at all remiss to be leaving here to go to Portland, rain or no. The reality is that besides the utter lack of sun, Portland trumps Rochester in every conceivable manner. There is little enough to do here in the summer and even less when the weather in uncooperative. I still wont say that I hate it here because that is more severe than my emotions about this city run, but it isn't a place I could envision staying unless required to (say for instance, by school).

I can't wait to see everyone back in the place I now consider home. I am sure it will be all the harder to leave it again when I have to return.

Post Christmas/Pre-New Year

I have meant to put together a brief update since finishing up with school last week, but haven't found the time or energy until now. It has been an expedient week since that point in time and it scares me a bit to think that I am already one week more proximate to school and one week more distal from the onset of my vacation (had to use proximate and distal after hearing it so much in physical descriptions in school).

School finished with a flourish. Though they would have preferred I not missed any time from my unit (and I would have preferred not vomiting for a few days) it was determined that, though there existed a make-up day on the calendar, no one was willing to proctor it for me. Hence, Thursday was my last day. My final evaluation was quite good actually, with some room for growth of course. The comment I thought most intriguing was related mostly to my personality as a whole. To paraphrase the comment (since I am too lazy to look for it amongst the mess of our apartment; residuals of our recent move), my clinical instructor essentially said that I was somewhat enigmatic until she observed me in simulations because, on the floor, I often just did my own thing without being a 'squeaky wheel.' I took that as a compliment because it is just who I am. I don't ask for help for every little detail or I ask for help from whomever I can grab that might know rather than seeking my clinical instructor out constantly. I also just do what needs to be done with my patient and try to do so professionally and efficiently. So, all to the good.

As for classes, I finally broke through the barrier and got and A. Two actually. The other two grades were of the A- variety which I am still quite proud of. Does that mean anything? Not really......but it is nice to do well.

As I stated previously, the move is a memory (a lingering one, but a memory nonetheless). The house finally closed today after a few small snafus (The garbage situation has been the most laughable as they cannot seem to bring themselves to actually pick up the trash though Tia has repeatedly contacted them and has paid for the final pick-up service. Despite not picking it up, they have taken our trash can and sent a driver and a supervisor at this point to 'inspect' the remaining trash which, though bagged and set upon the end of the drive, is deemed somehow too 'trash-like' to pick up. We have also been informed that it needs to be in a can which is a problem since they collected the can and told us to just put the garbage on the curb. I cannot wait to have a patient that I need to clean up and then, instead of doing so, just observing them and telling a supervisor that they are too messy to clean up. Does this line of thinking work in ANY other job?). We are now officially apartment dwellers. I really hope we are able to sell a majority of our remaining belongings before we move again. I hate moving and have reason to having participated in not one, but two transcontinental moves and a total of 4 additional local moves in the span of three years.

Christmas was pleasant, though somewhat bare. We spent the eve of at Tia's friend Sherri's home. Her husband Kevin made mussels, risottos, Maine lobster with drawn butter and lava cakes amongst other dishes. Altogether fabulous. In contrast, we went out to eat on Christmas but only found a few asian restaurants open to accommodate us. We ended up at a mediocre Chinese restaurant with the fastest service this side of a restaurant with a drive through. I would bet even money that our harried waiter suffered a heart attack by the end of the evening. It will be nice to be near friends and family next holiday season.

I am certain that this update misses much, but that is to be expected of any posting. I hope anyone who reads this had a wonderful holiday season and has a happy and safe New Year's celebration.

Almost there

Just one more day now. I would say a couple more days, but there still exists the possibility that there will be only the 1 day without a make-up day. Even if I have to do a makeup day, it hardly dampens my excitement that it is almost over. I will be thrilled beyond imagining when I don't have another bed bath to perform for three weeks!

Today I spent out with VNS (visiting nurse service). As I thought, it was interesting going out into the community and into people's homes to provide care. As I also suspected, it is wholly incongruent with my personal interests. I worked with a pediatric nurse today. I give the nurses who work with the population I saw a lot of credit. Part of me feels so badly for these children knowing what hurdles they face because of their surroundings and the disadvantages that lie in their path coming from single teenage mothers. However, another part of me feels angry at the parent (or parents) who continue to make poor decision upon poor decision, which likely stems from their own parents making the same bad choices. One household was littered with beer cans as the 1 year old wandered around playing with whatever she picked up off the floor while the mother tended to the 1 year old (and the father watched TV in the other room). The really interesting thing to me was that, even though these people lacked much furniture, had beaten up vehicles, and often had mainly WIC appropriated food, they still had big screen televisions and cable. How badly out of whack priorities are.

Thursday marks the final day on the adult floor, which is mercifully shortened to go over our evaluation (and then the aforementioned possibility of Friday as a makeup). All in all, things haven't gone too badly when I look back and consider all the things we (Tia has shared the burden) have had to get through to make it to this point. The whole thing seems very unreal at the moment........as though the dean of the nursing school might crawl out of her office, see her shadow, and determine that there will be three more weeks of clinical (it is hard to type with a shiver crawling up your spine).

I am still awaiting one more grade to trickle in. The grade in question was a paper that encompasses a fifth of our grade in the course however so it is not nearly complete, but, unless I butchered it horribly, I don't see how I could get less than an A-. Could end up being a highly successful term. Looks like I won't know for certain for some time though........at least until Thursday when they are obligated to post them.

Looks like I just got a delivery from my roommate of a list of meds I need to look up for tomorrow......and it is doosy. I hope I am never in the position to require 13 medications at 8am every day (and more than that throughout the remainder of the day). I don't know how you would even manage the side effects of such treatment. Wish me luck that there is no required makeup.....I will do it if I have to, but I definitely don't want to.

Interventional Radiology

I spent the past two days in Interventional Radiology working with a number of patients ranging from age 2 to 72 and seeing procedures such as catheter embolizations, angiographies, and biopsies. Pretty interesting stuff by my account anyway and, best of all, not an ADL amongst them. No bed baths! No ass wiping! No bed changes! Just medications, assessments, and assisting with procedures........or ACTUAL nursing. How very novel indeed. I am quite happy I chose to observe there. Another possibility on the plus side of the column is always a good thing.

Other than that, things are still a complete mess at the house (well, not complete, but comparably it is) with unpacked boxes cluttering up the apartment. I dont think the apartment will look normal until AFTER school is done.....or until I decide the boxes are just part of the decor.

The weather has turned once again as well with 4 inches already on the ground and more to come today and this Sunday. No temptation to do any outdoorsy stuff when I should be studying I guess. Thank goodness for an apartment with free heat.

Speaking of studying.....the end is nigh! One more test to go! Two more clinical days! One more simulation! I can't stop using exclamations I am so damned happy to type this!!!!!

Moving Day

Yesterday was officially moving day, though moving is never a process accomplished in so short a time. It will be another week at least before the house is empty and another week beyond that before the apartment isn't full of cardboard boxes.

So far, the apartment is pretty nice. The rooms are spacious, we have free cable TV (and the channels come in clearly), free heat (and heat in the bathroom), copious hot water, and we are a lot closer to school and the local strip of shopping and restaurants. The downside, is that the apartment, like all apartments, has thin walls (which is painfully evident since our downstairs neighbor evidently doesn't like quiet time without the TV on......consequently we feel asleep with its murmur and I awoke to it this morning around 7:15), we have to go back to paying to do laundry, and there is this odd double door security system to get in and out. On the whole, I think it will all work out....especially with the short span of time we have left here. In two weeks, I am 2/3 done and that is followed by three weeks of holiday before the home stretch starts in January. I am giddy just thinking about it!

There is much to do and not much more to say at the moment. Back to the move.

Sick sick sick

I hate being sick!

Not the best turn of events today. Arrived at clinical feeling nauseas which quickly evolved into me puking like a sorority girl after her first kegger. Suffice to say, with a neutropenic patient you have to concern yourself with passing any kind of bugs along in their compromised immune state, let alone hocking up breakfast on them, so I ended up being picked up by Tia in the early AM and have spent the remains of the day alternately reading, sleeping, and dry heaving. Guess which one is my least favorite?

My main concern at the moment is trying to make up the days......or if I will have to. Who knows? This was obviously unplanned, but the schedule doesn't permit much in the way of catch up. I guess I will find out soon enough. In the meantime eat something savory for me. I think I will be on the BRAT (banana, rice, applesauce, toast...........though I wish it stood for bacon, red meat, apple crisp and tuna rolls) diet today and, most likely, tomorrow since my clinical instructor has already advised I stay home then as well.

Almost made it the term without illness. Almost, but not quite.

From burnt to scorched

Not sure when I will next have the time to post so, in my efforts not to fall asleep and take a 5:00 pm nap (which is like fast food, gratifying at first, but generally unpleasant afterwards) I thought I would post a quick blog.

There is too much happening at the moment to fully take in. I honestly feel pushed to the edge yet again, but will muddle through it with Tia helping to nudge me along. Right now I am just exhausted mentally and physically after a few days of sleep deprivation. Two exams to study for and a few papers to write over the weekend will do that. Now the two tests and papers are done and turned in and I just have to get my patient prep together and try to make it through yet another 2 days of clinical. I have a bad feeling that I am going to get very sick as soon as the stress stops. My body is beginning to feel the weight of it, but there is little that can be done. After clinical is over on Thursday early evening, I have another patient care plan to write, a simulation and a move to a new apartment on Friday/Saturday followed by writing up another critical appraisal on Sunday. I swear I will have one proper Sunday where all I do is read the paper and watch some football. It HAS to happen. I am really missing life of late. I am sure Tia couldn't feel less like she was living with someone presently.

The weather has turned recently for the worse, just before our move. I guess it is early for snow accumulations such as this, but mother nature rarely follows a tight schedule. Anyway, it has been windy and snowing for the past few days.....more than I have seen since I was too think about measuring such things in Ohio. I shoveled my first driveway. Hopefully we will move soon enough I will have shoveled my last driveway as well. On the plus side, the snow was so bad they sent us home early from class on Monday evening.

Computer took a recent dump on me thanks to Windows Updates. I have expended zero time on my blog bitching about Microsoft Vista because it is so low on the priority list at present, but it really sucks. I am wishing the school wasn't so opposed to Macs, because I know Krista is very happy with hers. One day I will have one too. The result of repeated calls overseas was that I can no longer accept Windows updates but must instead only get updates from the HP website that have been vetted prior to downloading. In the meantime, I lost pretty much everything again........except the important files I transferred to my jump drive (which thankfully wasn't much). I sometimes wish I could just go back to handwriting things.

On the positive side, classes are going well. I think I will do better academically than last term, which is mildly surprising. I still have a few walls to climb to get there, but at least the dogs aren't snapping at my dangling feet. Evidently, risk of failure notices went out to about 1/3 of the adult and home class.....Krista and I evaded that. Small kudos to us both.

Well, it looks like its once again time to slip on my cardigan and head out the door like Mr. Rodgers. Wish me luck on the apartment move and holding on to my health and sanity.