Murcenary

There are some days and weeks that are just harder than others to navigate. Not sure why that is, what cyclical issues are at play or what phases of the moon or tide may be involved, but they happen and i am in the midst of one right now. Part of it may be allergies (which have been nearly incapacitating some days), but I am sure most of it is stress related. I feel like I am in that period of time when the brain and body really want you to shut it down for a bit, but there isnt time for that. Every stressful event (my final demo) is followed by another task of some kind or another (a paper). The nature of the program is definitely not one of ebb and flow......but rather just flow. To keep up with that, you have to be on top of your game at all times. I have already had days here and there that arent my sharpest or best. Times where I would, and may have chosen to be, anywhere but studying. I think this program wont be so much about ability (as presumably all people who got in are capable), but it will be more about stamina and focus. It is a year, but it will likely feel a whole lot more than one.

In better news, the final demo went well. I am thinking with the write-up an 'A-' is likely in the cards. I of course forgot a lot of things I should have remembered, but it is done and I am quite pleased. In order to pass it you had to know how to do a 5 minute head to toe assessment (vitals, check for edema, bowels sounds, auscultate, etc) and know the 6 system exams thoroughly enough that you could do them all if you pulled them (you draw a name from a hat when you arrive to the examination). i pulled Abdominal which was rather short (thank goodness) and obviously did pretty well. Tia is happy I passed as well since I had to poke and prod her for days on end. i have heard that, thus far, three people have failed. I cant imagine how that would erode your confidence. But, that is why I study as much as I do.

I dont really have a lot to add. I am still doing pretty well in all my classes. There is one week to go before we move on to the next round of them. There are a lot of things to do between now and then as well. Speaking of things to do, I have work I need to get back to......then I am going to do something fun dammit! :)

My so called life

Truly, without Tia's insistence, I probably would have nothing near a life. At least she tries to make sure we do something non-school related, even if I sometimes feel guilty at this point for doing anything besides studying, writing papers, or practicing technique. She will be the reason I wont be institutionalized before the winter hits.

I dont have a lot to add in the way of school other than it is really coming up on crunch time. In the next 8 hours, I have a clinical paper due in Pathophysiology and within the next roughly 24 I have a final demo to do (because I misunderstood the instructions and hence signed up late......which is my MO of late, never seeming to get things together on time). The upside is that the demo will be done well before most other people have done their demo, the downside is that I had to (have to) learn 6 system examinations over the past few days and commit them largely to memory. As always, keep em crossed for me.

Outside of school, Tia celebrated her 26th, we went to a new fondue bar called Chocolate (you can imagine the food), and Tia and I are strongly considering the purchase of a new condo (well, new to us). It is another stressor, but will ultimately save a lot of money (mostly because you can buy a condo here for under $74,000) and time (no more lawn work, etc).

I would love to fill in more details, but school beckons.

Whew!

So the week that was is finally a 'was' instead of an 'is'. It included three exams and two write-ups and a CPR class for me. The score at the end of the week, I did well on the two Patho tests (though the second one was truly just recognition), but feel about as comfortable as a pair of tighty whiteys about the one today. Ah well, you cant win them all, and, as Garth Algar would say "live in the now man." Indeed.

Got back the scores from a bizarre test we took way back in week one: The NET (Nurse Entrance Exam). Theoretically, this exam would assess whether or not we possessed the skills necessary to make it in school and the profession. Of course, the point of giving it to us after we were already admitted is lost on me. I have doubts that if someone couldn't do math or write that they would kick them out now. The test yielded some surprising and entirely unsurprising results. First off, evidently I can do math. Yeah for me. I was in the 98% percentile. I am EXTREMELY curious to know what I missed (I missed one percentage operation), but I will be happy with how I did. I can also read fairly rapidly. However, my reading comprehension is just only above average and my knowledge of punctuation is below average?!,. (cant even figure out how to end the last sentence). Evidently I also dont have very good test taking skills (a skill they can test for apparently, though unrelated to math I would guess). However, it should be noted that my scores, as well as those of my classmates, ought to be curved somehow. We were given this test on our first Friday after all new classes, overwhelming lectures, and bustling about trying to dot every 'i'. Overall I ended up in the 88th percentile. Too bad that doesnt directly translate to school where I remain entrenched in my 55th percentile niche (it is a cozy place and I am quite comfortable).

Tia's birthday is this weekend. I got her a new bike (a surprise I cannot ruin since she already has ridden it). I am hoping to be able to clear out some time for us to do something fun on Sunday since her birthday and school match up about as poorly as Lindsay Lohan and rehab. I have a test that morning from 8-11 and classes that run until 7pm.

Off to bed. One more day to go before the weekend.

One month and where I stand

So, one month after the start of school and things are still going pretty well. Yes, it is overwhelming and yes there is a lot to do and yes it will only get harder from here......but I finally found some time today to put my grades together and was a bit shocked at how relatively well I am doing. I didnt think I was bombing out, but I thought I mostly had a smattering of B's. This could change quite a bit in the next month or so (or in the next week really as I await scoring on the last Patho exam and a paper I turned in better than a week ago), but here is the run down (mostly written for myself so I can remember when I seemed to have a handle on things):

Patho: B+
Assessment: B+
Nursing Science: A-
Genetics: A

I was shocked that I was doing that well. Not because I think I am a moron, but the program really isnt easy. The amount of things we are asked to retain in a VERY short span of time is, at times, overwhelming.

Other than that, I met with my advisor the other evening (a really great guy who happened to do my interview as well) and it looks like things will get very interesting very soon. Within a month we will be learning how to inject, hang bags, bathe people and "wipe ass." Not all parts are equally enthralling. But we will get out to see actual patients and start practicing some of the things we have learned. I am both nervous and excited. We will have quite a bit of hands on experience before we get through the summer term. Just 6 weeks ago I was trying to put together a newsletter and in another 6 god knows what i will be doing. This would be an amazing adventure were it not so incredibly expensive.

Time to study for another exam.

Cant look at the materials any more

So, I think I have about had my fill of hypo- and hypertension, SA nodes, and bradycardia (heart beat below 60) and thought it would be an opportune time to drop a quick blog and gather myself for one more comb through the material. I have been definitely feeling the "screw it"s this weekend as in, "if I dont know this stuff for the test by now, screw it." I still honestly feel like I am keeping up, but I need to really dedicate myself better to my studies. It is just hard to do when I feel like, between classes, papers, watching online videos, taking online tests, etc, it feels like I already breathe the stuff. The review sessions dont seem to help me either, seemingly just serving as a means to freak me out about all the things I dont know. I just know it is only going to ratchet up in intensity in the coming months and I have to match it with more time with my nose in a book and less time trying to keep a balanced life. That said, when I talk with Tia about class topics, I feel fairly comfortable with the meat and bones of the materials for the most part. My weak areas are the areas that were weak to being with, namely microbiology. It is one thing to say that someone is dealing with a problem needs drug A to get better, it is another thing to think of it in terms of blocking the renin-angiotensin system from operating and what that means at the cellular level. I constantly wonder how this will come into practice and/or how much of it is more or less informative, but that we will not be doctors after all.

Had a fairly lovely weekend. Lots of studying mixed in with it, but overall it was nice. Especially the picnic that Tia and I went on Sunday nite (which was also combined with studying). Speaking of studying (and I think this blog has comprised little else), I need to get back to it. 3 exams this week and two write-ups. The term ends in approximately 3-4 weeks and then we have 4 weeks of clinical prep where the schedule gets much more full.

Friendly's

What a nice reprieve. The week, as all weeks are, has been hellacious. Well, to be honest, Monday is hellacious and then Tuesdays and Thursdays are packed, but not that bad. Wednesdays and Fridays I just have lab and time to catch up on work ostensibly, though often it is used to catch up on life some.

Today I got home around 11:45, had lunch and worked on the family history genetics assignment. While working on that intermittently I also: bottle fed some kittens, played tennis, sent a few emails, went to Friendly's and read a bit of Assessment. These are the days I look forward to on Monday morning and the days I will look back on when things really get crazy in about a month.

I doubt I will post again soon unless something really incredible happens. In the coming week I have 3 exams and two write-ups due. The pace doesnt let up much after that either. I cant believe that this is week #4. Each day I cross off on the calendar is another day closer to clinicals and what will be the among the craziest forays of my life. It will be interesting to read and reflect on all of it when the year is over.....for now if I look back to long I find myself about 4 prevalent points behind in my lecture notes. If nothing else, I am remembering how hard it is to take notes and how incredibly horrid my handwriting has become. It can best be compared to hieroglyphics or the Wingdings font in Word.

Back to work.

B

stuff outside of school

I had wanted to focus this entire blog on school, but often school is either too complicated to describe, duller than 3-piece puzzle, or just plain, well, scholastic. So, I thought I would at least mention what else there is to do in Rochester (or at least what we have thus far done in the month I have been here).

1. Played disc golf (lots of courses here, though we have only visited one)
2. Went to Park Ave (mostly restaurants...........kind of like a very slimmed down version of nob hill)
3. Mall shopping
4. Going out to eat - there is a fair spectrum of choices from your typical national chains to some more or less local eateries. Lots and lots of pizza delivery places. Local fair includes three things of which I have really only tried one: frozen custard (darn good), hots (red or white hot dog), and something called a garbage plate (http://rocwiki.org/Garbage_Plates).
5. Lilac Festival -the city is rife with festivals. there is a jazz festival going on this week.
6. Charlotte (pronounced Shar-lot, not like the city) Beach - it is only 2 miles from the house but the lake water is too cold to swim in.

I am sure I am forgetting other things, but I dont want everyone to think my life is just school 24/7. I would be a raving lunatic if that were the case.

Speaking of school, I am off to get ready for it. How does one mentally prepare for 7 hours of lectures?

Nursing theory

I had to write a paper about nursing theory. The paper had to be, as all papers for this particular class have to be, 2 pages single-spaced in APA format. The point of the paper was to show how the theory you chose applied to care of patients. The point of the class, much like the point of the paper, seems to be to suck what hours it can from actually relevant classes. Not trying to be bitter, but not all classes seem to hold the same level of relevance when you are cramming them in like crab legs at an all-you-can-eat buffet.

My classes are as such:
9 credits of pathophysiology - teaching us how the body reacts to stresses like trauma or medication. The complexities of the course are beyond my explanation because they are beyond my comprehension at this point, but, for a point of reference: If a patient is on an anti-parkinsonian drugs -
1. what does that mean? Well, the body is producing too much acetylcholine (ACh) and/or not enough dopamine which is a problem because ACh is a stimulant causing all your nerves to fire continuously leading to the symptoms of Parkinson's disease.
2. What do you do? You have to up the dopamine levels which ought to balance out the ACh, but it cannot cross the Blood Brain Barrier so it L-dopa is usually combined with carbidopa (for those of you who REALLY know this stuff, sorry for any errors). The process works for awhile but is not a fix. When it stops working and the dopamine levels and GABA levels cannot counterbalance the ACh, then you try to lower the ACh production with anticholinergenics. The problem with anicholinergenics is that they have effects systemically leading to sympathetic stress responses (fight-or-flight) such as lower GI motility and secretions, dilated pupils, higher blood pressure, and the like.

This is the kind of thing we are learning for all diseases such as diabetes, Alzheimers, and depression. How the body responds to these stresses and how those responses lead to other responses and ad-infinitum down the line. It is some incredibly dense material taught to us at speeds that cause me a personal stress response. My brain feels a lot like the movie Memento because I have to keep working backwards to get to the answers.

Assessment - teaches us how to work up a patient in the most general to the more specific manners. Everything from taking pulses and BP to neurological and musculoskeletal examinations. Things we will need to know but have a hard time studying because of pathophys. It still feels a lot like a game of dress up. I cannot believe we will be doing this stuff for real so soon.

Genetics - learning how to do 3-generational punnets (like Gregor Mendal and his peas) to figure out how cousin Emma happened to get blue eyes and/or Marphan syndrome. Thankfully the class is kind of like a buffet (seems to be the theme)......try to get as much on your plate as you can, but dont think for a second you are getting it all in one trip.

Nursing Science - kind of about nursing history, theory, and various related affairs but mostly about the aforementioned papers. One of those classes that might well be interesting, but kind of like the show King of Queens. If you have time and its on, I will watch it and be amused, but when you dont have time to watch it, it wouldnt phase you at all to miss it. In this scenario, my other classes kind of feel like they are all on at the same time as King of Queens and all are shows that require I pay attention more. I wish I could wait to do this class during summer reruns.

So, those are my classes. They might not seem like a lot to some, but they take up an inordinate amount of time and my head often hurts worse than GW's after trying to pronounce the world nuclear. I can see why they tell us not to work. Some people do manage to juggle school and work (part-time) effectively, but that is for now while the clinicals remain in the distance.

As far as life outside of school, things are moving along. The schedule has finally normalized and that helps in planning studying, etc. It also allows for Tia and I to have some down time to relax and do some fun things. I met a girl who said she was giving up movies, TV, hanging out with friends etc. for the duration of the program, to which I could only smile knowing full well that she will be one of the patients we end up treating soon after we graduate. It is a balance and not an even one, but if you let life whither and die while you are in the program, you wont have a lot to look forward to when the program is done.

I need to get back to my books. Hope everyone is having a great weekend. Do something relaxing on my behalf.

Ah the weekend

It is nice to be through another week of classes. I am not in a mood to rush through it all, but there is a sense of accomplishment each time Friday classes roll around and you dont find yourself weeping uncontrollably (I have largely learned to keep the weeping to a manageable level).

So, the first tests/papers etc are in and, thus far, I am not doing too badly (not setting the world on fire, but I am not existing on the tail of the bell curve either). Started with a B on my first Pathophys, an A- on my first nursing science paper (though the grading could, at best, be labeled capricious since neither I or my roommate got any negative comments and yet garnered less than perfect scores, though she fared better than I), and got an A on my first Genetics exam. Due tomorrow by noon is our second paper for Nursing Science and Tuesday has us in another Pathophys exam, so things could change very rapidly for the better or worse.

The schedule evens out next week and becomes much more regular (well, for a month anyway). Should afford some opportunity to get into a rhythm and, at the very least, looks to be the end of the extreme days. Also, Krista and I got our rotation schedule, and we will both start in Psychiatrics which is actually a lot less arduous, from what I hear, than starting with Pediatrics. We shall see. Rotations start up at the end of summer. I cant believe we will be practicing on real people that soon.

It is really warm in the office, so I will keep this brief. Also, I have some actual work to do which takes precedence. Hope everyone has a great weekend.

What a day

I am home relaxing a bit between classes since my lab isnt until tomorrow and I thought it would be a nice time for a post, even if it will likely prove a brief one (I have to go back sometime).

Not that this counts as a typical day (thank god), but this is an idea of what kind of days we do go through in the school sometimes (like yesterday for instance).

8-10am: Lab - learning to assess neurological disorders by testing distal (far away) parts of the body to ensure whether or not any of the 12 cranial nerves are functioning improperly. Tests include various tappings, flexations, and palpations of the body. Hard to believe we will be doing this kind of thing for real in the not too distant future.

10:15-11:15: PDA training - nifty little things. Has the drug guides etc on them. Plus you can surf the internet. A good way to unravel for 10 minutes in between courses.

12-2:00: Genetics - Learning how to map genetic outcomes using punit squares (started from the easy to do 4-square punits finding out what colors eyes someone was likely to have and advanced quickly into trying to decipher if someone would have a child with an X-linked disorder if their grandmother was a recessive carrier........the classes move quick).

2:30-3:50: Got a reprieve of sorts, the class that was going to take place, Nursing Science, was moved to online. Can deal with it later and use the time to study for the first pharmacology exam.

4-5:00 - First exam. Outcome to be determined tomorrow.

5-6:30 - Pharmocology lecture on the brain...........the ENTIRE brain. Mine was full to the point of spillage when the class was done. Yikes! This is a lot of information to synthesize.

7:00 - home. Yeah!

Allright, time to go back to class. This weekend there is a Genetics test to do, a paper in Nursing Science, a write up case history on another person (my roommate and I are going to do one on each other) and studying for the next Pharmocology exam on tuesday. Keep em crossed for all of us in the program.........it is just starting to ramp up.

1 down, 51 to go

I just wanted to take a few minutes to let everyone know that the emails havent stopped because I was maimed in some horrible accident nor have I lost all faculty for the English language (although recent testing has placed some doubt in my mind about my proficiency in that arena as well), it has just been a hellacious week 1 that saw me bounding between utter bewilderment and near comprehension. Had I not had the good fortunes of meeting a number of former students prior to starting, I would be far more concerned about things. Since I have had the fortune, I am confident in saying I am not alone.

Day 1: No sense dipping your toes in to test the water when you can put your most sensitive areas to the task all at once right? Well, so goes the philosophy that I must currently subscribe too. The day began with an orientation that introduced pretty much every member of the faculty and staff that either directly or indirectly will be a part of our journey. The students all introduced themselves as well. I was pleasantly surprised to see how diverse the group was. There are approximately 100 in our cohort (potentially slightly more) and in amongst the group there are people from Guam, S. Korea, Thailand, and S. Africa. There are about 10 other men as well. Clearly some in the group have extensive experience and others, such as myself, have virtually none. I did find out that I was fortunate to receive scholarship of any kind as many people got nothing at all in free aid.

After a brief intermission, we had our first 3 hour lecture on something that could have been Pathophysiology or could have been a dissertation on the finer points of macramé presented in Klingon because I understood little to none of it. It was akin to trying to pick up HBO by putting tinfoil on top of your TV set. In the words of Ron Burgundy as he jumped into the bear pit to save Veronica, "I immediately regret this decision." Thankfully I am not weak willed or smart enough to give up that easily.

Day 2: After the torrid pace of day 1, I settled in for the torrid pace of day 2, only drawn out slower and more painfully than this season of American Idol. We arrived at 8am and classes didnt conclude until nearly 7 that evening. In amongst them were some of genuine interest and nothing that is particularly noteworthy to remark upon that I can recall (I most vividly recall thinking of my brain as a shot glass that was teetering at the meniscus line and thinking that it could not be possible to process any more new information). I came home quite defeated and camped out in front of the tv determined not to think about it again until I awoke the next day.

Day 3: Finally some things started to make sense. The lectures started to sound less like expository in some foreign tongue and more like a garbled form of English (like pig latin filtered through a Burger King drive through microphone via a cup attached to a string). The process started to slow down..........some anyway. I finally felt, for the first time since I walked through the door on day one, that I can do this.

Day 4: My first lab, which was pretty nice although way too crowded. It seems a lot like playing make believe with your friends, only at some point they will make me do this to real people. Freaks me out. I cant think of anything else like it that I have done before. This was followed up for a luncheon that helped me feel that everyone was just about as freaked as I was. It is nice not to travel that road alone. Fake it til you make it. This led into 4 hours of testing that, quite frankly made me doubt not only my understanding of the lectures this week, but also of the English language and my ability to comprehend the written word. the testing was a kind of SAT for the nursing profession (although the connection between knowing when to use 'who' rather than 'whom' and learning how to care for a person with tachycardia mystifies me at the moment...........unless maybe someone were to ask you 'Is that the patient whom you are treating?'). The absurdity of giving the testing after you are in the program is not lost on me. Would now be the best time to find out the person setting up drip bags cant calculate how much medication should go in it? The idea is to help build on your weaknesses of course. Beyond the math which i feel very competent in, I hope I dont have too many other glaring ones because I will have enough on my plate trying to cram science into my head.

We finished the day at a review session that left me with the same look on my face that the Scooby Doo gang almost always had right after they unmasked another ghost that turned out to be the caretaker engaged in some elaborate scheme (that of course would have worked if it werent for 'those pesky kids.') After class I spoke with some other students who seemed really enlightened by the session while I felt as if someone sunk my battleship in five guesses. Suffice to say, I put my bookbag on the table when I got home and havent picked it up yet.

One thing that comes with age is the knowledge that this too shall pass. I bandy about terms like 'freaked out' but I truly havent been there as yet because I feel much more comfortable in taking the time to take a deep breath before I dive back in. Life is a marathon not a sprint and while this year may feel very quick, it is a long haul. I will save pulling out my hair until after the first test at least...........coming up this Wednesday.

Additionally to all this I have to give a big blog thank you to my girlfriend Tia who was wonderful and planned a beautiful and relaxing morning/afternoon for us both today. It was the kind of day that reminds me that school may reflect heavily in life, but life is not school.

Bunny bummer

So, today is the last day before I officially become a student again. So many thoughts going through my head.........mainly about what to do for dinner at the moment, but there are school thoughts right behind those. I am honestly doing my best to not think about it much at all. Trying to make tomorrow like the moment in the reality shows where they reveal your new home/pimped-out car/clothings/etc. instead of trying to even pretend like I have any concept of what lies ahead. Therefore tomorrow's information session will either astound and interest me or find me regressing and hiding under the bed with my thumb lodged securely in my mouth. I can type one handed (albeit slowly and inaccurately) so you will hear something about it either way.

Sad news today, I found a dead rabbit in the back yard while mowing the lawn. It was really odd. We have all sorts of critters in the back yard including mice, a variety of birds, squirrels, chipmunks, and the aforementioned rabbit. It was just keeled over on its side with no visible sign of its demise. Hopefully it doesnt set an ominous tone for the week.

The time is almost nigh. Cant wait to report some actual nursing school content on here.

Fortuitous meetings

That whooshing noise you may hear is the sound of my extensive sigh of relief. I was prepared (prepared is probably not an appropriate word........perhaps more accurately I was terrified) for 10 hours a day of studying over the Memorial Day weekend and not much relief beyond it. I anticipated no more fun until the break in between terms when I would presumably black out from exhaustion nearly instantaneously and come to only minutes from the resumption of classes. It would, in my mind, provide the only sleep I might get other than snatches of microsleep stolen on the way to school the days that Krista drove. I envisioned snatches of texts sewn to the inside of my eyelids so I could student even with them firmly shut. I envisioned openly sobbing from stress and toeing the razor-thin line of insanity (that vision remains). However, the discussions with some former students of the program has, at least for the moment, drawn me back from the edge of the precipice.

Krista (the new roomie who is starting the program with me) and her boyfriend Brad and I decided that it might be interesting to see the school we will be spending countless hours and many thousands of dollars at before we start, so we headed in on Friday afternoon. After wandering the halls somewhat at random, we came upon two former students who were incredibly friendly and helpful (and just graduated today). They gave us a tour of the building, dispelled some scary rumors about the program (ie: your life as you know it should only exist in a suspended form for the next 12 months), and even gave us a head's up on some books we would need and some that we would not even open. They also gave us their contact information so we could bother them incessently throughout the program (I intend to).

Yesterday, we met up with another former student, Adam, who had finished up the program a year ago. His advice was very similar but much more detailed. Additionally, he had no medical background, like myself, so it was nice to hear someone come from a perspective of not knowing his way around a syringe or a catheter and, just 12 months later, starting work in an ICU unit. It still seems odd that you can absorb so much in so short a time.

So, what it means is that this program should be manageable, should provide excellent preparation, and seems to provide an overall positive experience. I am extremely relieved although still very nervous. One more day to chill out and then it begins. Keep em crossed for me.

Mt. Rushmore

I am having a hard time processing the fact that better than a week has passed since my departure from Portland. Seems like just yesterday I was going out for farewell meals and piling my earthly possessions into my Subaru. Whether or not a fair amount of time has elapsed, I think enough has passed to recollect about the journey.

What I learned about the country via the interstate (I understand the interstate system doesn't present the best that a state has to offer and making judgments solely upon what lies within a few miles of said road isnt fair, but unlike Fox News, I make no pretense about being 'fair and balanced'):

1. The flyover states having some pretty topography and some ugly ass cities. It almost makes you wish you could fly over them lower and more slowly, but it does not make me wish in any way that I could drive through them again. Compared to the natural beauty that surrounds these little oasis of chain restaurants and faux rustic strip plazas stand out more distinctly than 30lbs would on the Olsen twins. It is truly a shame.

2. There are more 'casinos' than people in Montana and South Dakota. Every offramp advertised them and more than that, they were roundly unimpressive in every single way. Some were scarcely more than tin sheds. We peeked at one in a gas station that amounted to 5 one-armed bandits and a stand where, presumably, you would cash out your winnings. Gambling is a hard thing to do I think: wagering your money against losing odds in the hopes you beat them this time. At least I want to feel like i am getting something out of it even if I lose, like a pleasant environ and free drinks. It would take a lot of free drinks to make these locales palatable. When you take away the appearance, all that is left is you in a dark smoky room pumping quarters into a machine that will likely give you back far less than you put in.

3. There is a HUGE difference between a Motel 6 and a Super 8. To further emphasize this difference I would propose a twofold solution: Motel 6 should rename itself "Motel you get what you pay for you cheap bastard" and Super 8, for the sake of comparison since there is nothing inherently super about it except under this circumstance, should call itself 'Super exponentially better than that other numerically named chain.' The '6' that we stayed in reeked of cigarette smoke (in our non-smoking room), had matresses that had passes their golden era prior to the Carter administration, and had a shower that reminded me unfavorably of the ones I shared with 120 dorm mates in college on a Sunday after they hadnt seen a cleaning staff since a few days prior. Additionally, the shower head was clearly installed when our land was peopled with pygmys or some other height challenged people as I had to contort my body into positions I had heretofore not been aware I was capable of in order to remove my shampoo. Adding to the degree of difficulty, the shower itself was only a few feet square and the showerhead, based on the pressure, was evidently installed to fight fires or pressure clean, not wash human bodies. I am still awaiting some kind of weird rash to appear from sleeping there.

4. Rapid city is my new least favorite city. It has all the charm and beauty of a daytime truck stop hooker. If meth was a city, this might well be it. I found a similar city on my southern trip, Carlsbad, and like that city, this one was wrapped around a landmark (in this case a man-made one, Mt. Rushmore). There were more sketchy hotels, casinos, pawn shops, and check cashing places than restaurants and I have already described our lovely Motel 6 experience there. The oddest thing was a reptile park and a few other odd places. Who would travel to Mt. Rushmore and think, "Gee, i wish there were alligators around here?" Evidently someone.

I think that covers the trip..........or most of it. i wont torture anyone with descriptions of the mundane food, copious collections of insects embedded into my car grill, or bizarrer conversations we came up with to pass the hours. The last day was a blur. 1000 miles and nearly 20 hours of driving. I still dont know how we managed it, but somehow we did. Must have been the thought of that Motel 6.

More when school starts. Financial aid has been promised soon.

Video of the "SIMMAN"

http://www.democratandchronicle.com/apps/pbcs.dll/article?AID=/20070219/VIDEO/70219043/-1/MULTIMEDIA

Odd to think I will be working with the SIMMAN soon enough.

7 days to go

Time has figuratively flown by. Not too long ago it seemed as though school would never start and I would be taking prerequisites until Britney was respectable, and then things just seemed to change (Britney remains immutable however) to me packing up all my worldly possessions, which are encroaching on Buddhism they are so spartan. I have officially passed through the 'its never going to get here' phase into the 'Hunter Thompson on an ether binge what the hell am I doing' phase. I am hoping to settle somewhere in between in the coming weeks, but there will be a lot to adjust to. I will be moving to a new city where I know few people and have a less firm grasp on the layout than our president does of the English language. School freaks me out. Partially because I have not been in school for such a long time and partially because there will be no courses that are 'known' to me. No English. No Social Studies. No Quantum Physics (checking to see if you are paying attention). It will be a challenge and wholly foreign. Exciting yes, but also incredibly daunting. Just the same, I am glad I am taking the plunge. I have never been one to be moored in one harbor for long, my path changing directions more frequently than Paris changes BFFs. I do hope this is it. If not forever, for at least a good long while. I will be shocked if, at the end of this year, I fall in like with Rochester considering my distaste of cold, grey winters (or wet ones for that matter), but who knows. Maybe I will find myself drawn into the cheap housing, decent entertainment and 4 months of non-winter. On second thought......

Still waiting on FA. They are evidently craftsman of the highest order in the FA office at UR. They are so concerned with putting out impeccable packages where nary an 'i' remains undotted nor unduly askew that it takes months where others would take days. It is an art, and true art cannot be rushed. At least that is my assumption, because were I to be somehow proven otherwise, I might have to consider seriously the idea that the office is filled with scarcely sentient simians of the lowest order banging away close fisted on antiquated typewriters trying to defy the odds and put together a comprehensible FA package. Maybe I should send some bananas just in case.

done and done

Today I finished my last prerequisite course for UR. The dreaded micro biology. I performed very well on all the courses, but I wont kid myself, they aren't nearly as difficult as the terrestrial courses will be. Just the same though, it is nice to enter school on a positive note.

In other news, I thought I would post the few emails I have received from the University. I found the most humorous to be related to working. They have been adamant about the fact that you cannot work without outright stating it (which they would like to do, but they cannot mandate how you spend your leisure time and I doubt there is a one amongst us wouldnt wish to spend leisure time in industrious pursuits. Is it just me?). Evidently a lot of emails poured in from students fully intending to work and, well, you can read the response below. The humor was that UR defines 'being able to work' as 5 hours a week or less (best of luck finding that job) and then provides the 'circle of logic' which goes a like this: we aren't eligible for grants because we already hold Bachelor's degrees, a Bachelor's degree means you can work to support yourself so you dont require a grant, and you can't work because of the nature of the program therefore rendering the fact that you hold a degree moot. Funny, but not in a haha kind of way but rather the 'isnt it funny how it always rains the very day you decide to try your new paper mache outfit and not wear skivvies underneath (we have all been there)." It didnt affect me however as they have been clear throughout that working is strongly discouraged, and in cases such as these I find I am best served by not raging against the machine. In lieu of income, I have already arranged for some of my less utilitarian organs to be harvested to cover books and lab fees. Anyone need a kidney?

The emails follow, edited of only the parts that are totally irrelevant.

A few questions were e-mailed to me and I thought the answers might be useful to all of you-

1) What about housing? You should have received a packet about housing from Nancy Kita. Especially if you want to room with other APNN students - there are several small houses nearby that rent out every year to APNNs. Also, there is a helpful web link- http://ochousing.reslife.rochester.edu Make sure the area you choose (if you don't visit first) is not too far away - you have to get up early enough for clinicals!

2) When do I get my financial aid "package" ? The main university financial aid office reserves its grant money for first-degree seeking students (the philosophy being if you already have a degree you at least have the means to work and support yourself and go to school part time - and that is an option, although not helpful to the "accelerated" part of our program!)

The three ways people pay for this program-
a) working for our hospital but you must work there a year FT (or two years PT) BEFORE the benefit kicks in, in which case students generally do the program part time (since you need to continue working at least 17.5 hours per week to keep the benefit and it is NOT recommended that full time students work- this is for PT students), but the program is tuition free that way except for a few thousand dollars.

b) there are a few limited grants the School of Nursing has received (and so then of course we are free to distribute them, but these awards - Fuld and New York State Retraining - have been made. We did offer a few people who were not named Fuld Scholars, but otherwise had very strong applications - some general School of Nursing funds, but again this is limited)

Unrelated to our school, but a possible source of $ for people who are unemployed and living in Monroe County is www.rochesterworks.org They have given several of our students money toward tuition.

The monies mentioned in "b" here usually would not cover even half of the tuition, so most students will be using

c) LOANS and the full explanation of those (5-15K govt, the rest private) was sent to you with the financial aid "graph" illustrating that APNN students virtually all pay for this program with loans

(note that this year's tuition/fees are still "officially" posted - the university votes/updates in April - and costs typically rise a few % each year - next year straight tuition will likely be 15,600/semester for each of the three semesters; other fees include about 1K for labs/tech and ~600 for a mandatory health fee, and $90 for an activity fee)

So the bottom line is your "package" from the main university will only consist of loans. The Financial Aid office is now processing FAFSAs and will send letters soon. The only grant money would be those things in "b" above or individual grants you may have found/been offered (listings of other sources and web sites).

If you have questions before that (e.g. what banks are good for private loans, what financial aid forms have been received or you need a "guesstimate" of your loan amounts/sources), please contact the financial aid office directly at

Phone:(585)275-3226
Fax: (585)756-7664
E-mail: help@finaid.rochester.edu

************************************************************************************

3) You really do need a computer since so much of our communication and course posting information are on websites. You will have online classes and every course is ofered through a platform called "Blackboard" - try out the "find it fast" link on our homne page for Blackboard and get an early start with the tutorials - you need to hit the ground running that first week, rather than be fiddling with your computer access.

As far as other things, we include the cost of the stethoscope in a lab fee, so you will get that. Uniforms, which you don’t wear until mid-July anyway, are white scrub tops and navy bottoms - here is an e-mail about that from one of your summer instructors-

To make it more streamlined and less hectic for students and staff & faculty we are going to have Scott at the medical center bookstore take care of ordering all the uniforms for students this year. Scott will arrange for try-ons and to pick up uniforms at the bookstore and take care of any order inquiries or concerns directly with the bookstore.

4) Parking - For those who have cars and don't live within walking distance, we will have time at orientation for you to go across the street to get parking passes (sticker for the window) for university lots (it's a little walk - about two short blocks - from the hospital). This year the cost was ~$20/month.

#2
I am very concerned about the few FULL TIME students who wrote that they intend to work (5 hours or per diem is not a problem, but some think they can work TWENTY HOURS - I am assuming you may not have seen the APNN schedule/calendar on the web site - check it out - you can have clinicals on Saturdays, so even working "weekends only" won’t always be possible)
As far as working, it is near impossible to get work hours in as a full time student - in the past, students have had to get these hours in on the weekend (that means a shift Saturday and Sunday) as there is no time during the week. For example, if you have clinical on a Thursday 7 am - 4 pm, you may need to go up to the hospital Wednesday evening and get the chart for your patient and go home and look up the disease, make drug cards for all the drugs, etc. In our very first group of APNN students, the ones who did not pass their boards on the first try were working too many hours (some as many as 20) and had no time to get the background reading done. The following years, we suggested students do the program PT if they want to or have to work and the improvement was dramatic. Of course, this is still your choice - we cannot legislate what folks do in their private time. I have just had several upset students in my office come the fall, saying "but I always worked full time in undergrad and grad school before!" Nursing is so time-consuming because of the hours - in college, 1 credit = 1 clock hour a week; in (any) nursing school, 1 clinical credit = 4 clock hours a week. Just something to think about...The full time program is not designed for concurrent work. Even the part time plan is unfortunately not a nice 50/50 split. It is much heavier in year 2. You would probably be able to work full time in year one (except for the first 8 weeks of summer), since it is only the straight didactic courses. Look at the part time plan so you can cross-check against the calendar and see how year 2 is very full (because we didn't want to "unbundle" the clinicals). You will then see how much class time will be needed. So for year two, you would need to cut down your employment and get your hours in on the weekends. Sorry the program isn't really "family-friendly" - it is more of an "immersion" experience!

More to come when more information comes. Still waiting for FA.

Q: When is $15K not $15K? A: When school cost $60K.

I never thought a $15K scholarship would be a mixed blessing. I thought I would find it to be overwhelmingly satisfactory actually. It most situations it would be spectacular. I can scarcely imagine any other situation in my life where walking into $15K would not be so overwhelmingly significant that i wouldnt tell that story into perpetuity while, of course, exagerrating my physique and acts of bravery which led to acquiring such a sum. My finances are such that finding a $10 bill in a jacket pocket qualifies as a good day regardless of other events.

It certainly isnt insignificant, and I would (and may) sound jaded by inferring that it is, but it pales in comparison to the cost of school. What it means is about 25%. That is the wonderful news! I would be pleased were my car or student loans 25% paid off. It also means that 75% is still in doubt, awaiting word on who will loan it to me. That is far from wonderful. Its a mixed blessing because had it been more (say 30K) I would have not thought twice about diving into the remaining debt as ludicrous as as taking out 30K sounds. Had it been 5K, I would have had to find another path to school. Reminds me of every raise I have ever received at any job I have had, it is never enough to truly make you feel appreciated or happy, but never so little as you dont accept it. Plus, I cannot shake the notion that the scholarships are just there to make the total cost appear more palatable while maintaining the veneer that you are going to a more expensive school. Much like you wouldn't find Target prices at Macy's...but you might find Macy's stuff on sale for Target prices. There is something about finding that $50 shirt on sale for 50% off vs just going out and buying a $25 shirt. Though, in the end, they both cost the identical amount.

I also just found out that two other students did not get the general academic scholarship that I got, but did get the Fuld scholarship, one person for 15K, the other for 20K. Reinforcing my belief that everyone gets something, because it makes it more palatable. I find this news both unsettling, because I did not get the Fuld but am placated by the fact that whether I got it or not, it would ultimately not mean a great difference to my bottom line. Evidently there are no double coupons and Fuld or no Fuld, we will all be neck deep in debt.

Clarity from a hygienist

Clarity about your career and how it impacts your life comes in drips and drabs. For some, it seems like they are born with an innate understanding of who they are and how they hope to parlay that into a career. Be it an artist, chef, or secretary, these are the people that continue to stupify me. I look upon them with the same queer curiosity one might examine a baboon at the zoo with. It is a familiar creature, but also a hopelessly foreign one.

Every once in awhile you run into someone that you can relate to and truly see 'it', the answer to the great mystery. This answer came in an odd package. My hygienist was a male with two small gold hoop earrings in one ear and none in the other, as if to counterbalance some minor weight disparity betwixt the two sides of his head. He was older. Age i could not guess, but too old for small gold hoop earrings. He stomach a large protrusion that loudly proclaimed a love of all things fermented of barley and hops. His face was unknowable, hidden as it was throughout by a surgical mask. So, how was this person so revelatory you may inquire? Well, despite doing something that i imagine to be repetitive, droll, and rather unpleasant (which my career choice may be to some.....as all career choices are to some actually), he was positively enamored with his vocation. He admonished me for my flossing habits (or lack thereof truly) but not in a flip manner that suggests the words were perfunctory in nature, but rather in an informed and concerned manner. He proceeded to rattle off all sorts of information while going about his task and did so happily. He did so in manner so transparent that I was compelled to compliment him about it and he told me he loved his job in a way that I would only describe a good book or film. It was at that moment that the bolts locked into their cylinders and I knew that that was what I wanted from a profession.....well, sans earrings. I want a career that I feel that way about.

I know he has to have bad days and good ones and, quite possibly, I just caught him on a good one. But I cant remember ever feeling the way he seems to about his job. I have had, and do have, some wonderful co-workers and have had the opportunity to do some enjoyable things at work, but I have not ever felt enamored of a job. Maybe nursing wont be that way for me, but I am willing to bet up to $50K that it is.

Is that a finger up my ass, or are you just happy to see me?

It amazes me the things we acclimate ourselves to as we grown older. From the relative freedoms of the less than 30 hour work week in elementary school to the rather arduous one in high school, before it scales back in college to a point in which you become so immersed in those freedoms that you don’t look both ways when crossing the street and amble out in front of the soul crushing 100 ton cement trunk of adult work life, doomed to spend the best part of every day doing things you would rather not or, at the very least, rather not every day for 8 hours or more.

I think about this as I near 30 and begin to consider my own future. It became alarmingly real as I bent over the examination table with the doctor’s heavily lubricated finger up my ass (part of a physical, not just for shits and giggles)…….I am really going to do this. Full-time or part-time, partially funded or selling any body part I have a duplicate of, it is happening. I will always be part of the machine, but I am finally starting to pick which part.

Throughout it I doubt there will be much time that I wont be terrified, doubt my abilities, or under stress, but hopefully that will lessen and not exponentially increase. Lets hope anyway.

As an addendum to this: Do you think when my doctor dreamed of going to medical school and worked hard to pull himself through it both financially and academically he thought at any moment in that time that he would spend part of any given day with his fingers in other people's orifices? I am guessing no.