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).
Friday, March 28, 2008
Tuesday, March 25, 2008
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.
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.
Sunday, March 23, 2008
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.
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.
Wednesday, March 19, 2008
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.
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.
Wednesday, March 12, 2008
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.
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.
Monday, March 10, 2008
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.
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.
Sunday, March 09, 2008
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.
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.
Friday, March 07, 2008
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.
Speaking of getting through.......I am writing out of lucid hours and I have a lot to get accomplished before I do.
Thursday, March 06, 2008
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.
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.
Sunday, March 02, 2008
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.
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.
Friday, February 29, 2008
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/
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.
So far, this week has been far more productive than the one that preceded it. Of course, that is saying very little. The fact that I crawled out of bed for class and managed to make it to clinical at least today has already made it more productive. Anything else is gravy. Now if I could just halt the coughing fits every time I step out into the cold (and that is ALL there is here at this time of year....it was in the teens yesterday and this morning and scrub pants provide somewhat less protection than newsprint).
It is reassuring speaking to other classmates and finding that I am not alone in my ennui about the program. I am doing well enough, but there is certainly room for marked improvement if I could summon up the will to care. So long as I am passing, I have resigned myself to be happy about it. Go me! Raise a glass to minimum effort!
I had an interesting clinical experience today. A 7 yo with Cystic Fibrosis. I will be working with him tomorrow as well. I hope I get to see more then. He had a breathing test scheduled this afternoon, so he didn't put on his vest (which simulates cupping) nor take very many medications. Happily, he seems to be doing very well. It is sad that both he and his older sister are afflicted. The odds are 1 in 4 if you are a carrier. So, the parent's knew without a doubt that there was a 25% chance that he would have CF since his sister did, yet they went for it. It brings up some very interesting ethical dilemmas. The average lifespan is still under 40 for people afflicted. I don't think I could chance it. 25% is too high a failure rate.
7 days of clinical and counting. Less than 24 hours from 6 days remaining. I am pretty excited!
I got offered a job here. It is both a nice confidence boost and ultimately anticlimactic. It looks highly unlikely that we will be here come June, especially with the problems that Tia is having with the districts out here. Ultimately I will be turning them down. Still, it is good practice for the rusty interview skills. It would be a lot harder to walk away if the pay rate was better, but it isn't out here. The hospitals are definitely in collusion with one another with each hospital paying the exact same starting hourly wage and identical differentials. The only difference is a pay increase of, and I could NOT make this number up if I tried, $0.12/hr additional if you have a BSN and not just an RN and work in the Strong health Care system. That's right, a Bachelor's degree (which takes 2 additional years of schooling and two years of additional loans and two years of not earning money) will net you nearly enough money to buy a Nintendo Wii (pre-tax, not post-tax dollars) assuming you worked a full year at 40 hours a week accruing all that extra coin. I am only assuming that they set that pay increase around the time of the Great Depression when $5/week meant a car payment or something. Now, it is as close to a big FU as you can get. Anyway, if we stayed here, I would probably net about $47K-$50K including some differentials and the sign-on bonus, but it is still about $8K-$12K less than I could expect to earn out West. It is cheaper here, but not that much cheaper.
I also somehow managed to get into the nursing honor society. How that happened is still beyond me, but they evidently can't take it away from me even if I really botch up this term. Of course, I still have to decide if $95 sounds about right for a piece of resume fodder. I think I need to sleep on it. They also offer the opportunity to buy some Sigma Theta Tau bling.....up to $650 for a 14K gold Signet ring. Um, not an effing chance.
I think that about covers the spectrum of events that have occurred in the past week or so. I have 8 days until the sweet mini-release of Spring Break. Before that, I have 2 exams, a presentation, 3 more clinical days, one more extra-long, packed with BS patient write-up, and a similarly packed with BS ethics paper to complete. I will try to post when I next need to evade reality.
Thursday, February 21, 2008
Flu Log Day 5
Yep, still sick (insert profanity laced tirade railing against the unfairness of the universe and/or prayer to whatever deity you believe will elicit the most productive response here). I don't have a lot more to add to my initial succinct statement other than I NEED to get better quicker than I am. I have clinical tomorrow, which is predominantly an orientation to the unit, that I will try my damnedest to fight scratch and claw my way through even if I have to wear a Hazmat suit and slather myself in Betadine. After that, hard to say. They aren't going to be squealing with glee to have a walking disease laboratory around immuno-compromised kids battling cancer, but I also don't want to encounter problems finishing up this term because my immune system decided to take Spring Break early. Evidently the prognosis for the flu with someone who already has compromised lungs (asthma, the gift that keeps on giving) puts me on the hook for at least a few more bumpy days before I should be better. So keep your eyes peeled for my next post, "Screw the Nyquil, just get me some Rum."
On the upside, Tia's parents sent me some yummy cookies as a get well present. Thank you very much. Also, a big thank you to Tia for putting up with me 24/7 (she works from home remember).
On the upside, Tia's parents sent me some yummy cookies as a get well present. Thank you very much. Also, a big thank you to Tia for putting up with me 24/7 (she works from home remember).
Monday, February 18, 2008
Sick and tired of being sick and tired
Looks like a good news, bad news situation after seeing the doc today (they were nice enough to squeeze me in because there is evidently something going around and there were no appointments to be had). The good news is that I do not have a respiratory infection......the bad news is that I am not doing very well in spite of the good news. The doctor thinks its viral and told me to call if things worsen. How come things always worsen before and after the doctor visit? I had no fever and no wheezing there, but once I got home my temp spiked to 101.8 and I have felt like the apartment has been alternating temperatures between a turkish bath and the ice cream section of the local grocery store. Even typing this I am shaking worse than Lindsay Lohan 3 days sober. This after foolishly thinking my fever had broken following a night spent sweating heavier than Roger Clemens in front of congress. Its a good thing I sleep face up or I might have drowned.
I wish I had something substantive to add to the posting, but nothing much happens when you spend the vast majority of the day in a recumbent position alternately trying to focus your eyes long enough to read and letting them glaze over while people buy, renovate, flip, or decorate a home on TV. Since we now have cable, here is how I waste away my little bit of free time. Feel free to scoff openly, I am not proud of myself.
Celebrity rehab with Dr. Drew: I don't know if it is compelling TV, but it is definitely stretching the outer bounds of what constitutes celebrity. I didn't know being an ultimate fighting champion or a porn star constituted celebrity. Evidently so.
Millionaire matchmaker: further proof that rich men will, despite what they say, always choose a young bimbette over the better match and that young bimbettes are okay with this arrangement.
Property Ladder: No matter how little you know about home repair and how far over budget you ascend, someone will evidently buy the dump you renovated for a tidy profit as long as you don't get too greedy, because people are generally quite lazy (myself included).
Property Virgins: I know what you are thinking, "A show about abstinence pledgees on a mission from God buying real estate.......what time is that on?!?" Unfortunately, the focus is rarely if ever on the sexual proclivities of the potential home buyers. However, it is interesting watching people buy their first property. Might be as close as I get.
1 degree from hallucinations. I really hope this stops tomorrow.
I wish I had something substantive to add to the posting, but nothing much happens when you spend the vast majority of the day in a recumbent position alternately trying to focus your eyes long enough to read and letting them glaze over while people buy, renovate, flip, or decorate a home on TV. Since we now have cable, here is how I waste away my little bit of free time. Feel free to scoff openly, I am not proud of myself.
Celebrity rehab with Dr. Drew: I don't know if it is compelling TV, but it is definitely stretching the outer bounds of what constitutes celebrity. I didn't know being an ultimate fighting champion or a porn star constituted celebrity. Evidently so.
Millionaire matchmaker: further proof that rich men will, despite what they say, always choose a young bimbette over the better match and that young bimbettes are okay with this arrangement.
Property Ladder: No matter how little you know about home repair and how far over budget you ascend, someone will evidently buy the dump you renovated for a tidy profit as long as you don't get too greedy, because people are generally quite lazy (myself included).
Property Virgins: I know what you are thinking, "A show about abstinence pledgees on a mission from God buying real estate.......what time is that on?!?" Unfortunately, the focus is rarely if ever on the sexual proclivities of the potential home buyers. However, it is interesting watching people buy their first property. Might be as close as I get.
1 degree from hallucinations. I really hope this stops tomorrow.
Saturday, February 16, 2008
No vaginal birth
My experience culminated without seeing a vaginal birth. I think I was the ONLY one who didn't end up seeing one. All in the timing. They had a full board today, but no one more than 8cm dilated by the end of our shift. My patient had a lot of interesting procedures done (a blood pH on the fetus, Intra-uterine pressure device placement, and an amnioinfusion), but was not moving along. She was only 14, so they didn't even think that she would be able to deliver vaginally anyway. Ah well.
I will keep this entry short because I feel like crap. On the verge of a possible respiratory infection. God I hope not.
I will keep this entry short because I feel like crap. On the verge of a possible respiratory infection. God I hope not.
Thursday, February 14, 2008
Yeah for the last 2 days........of this rotation
Goodbyes are such sweet sorrow....except for the sorrow part.
As much as I have enjoyed working with classmates on this rotation (as with pretty much all my rotations thus far), I will not be sad to see it go. I think that OB is a great place to work as a nurse. You get to work with mostly healthy patients who, for the most part, have mostly healthy babies. You get to be an integral part in the first few days of family bonding and help the new mothers try to develop good habits for caring for their newborn. However, it isn't for me. I can definitely see the allure, but I still feel too much discomfort both in myself and in my patients. One may play off the other, but what is certain is that there are ZERO male nurses on the entire unit and there hasn't been one in years. Roughly half the people you ask say they would have no problem with a male nurse tending to them in OB, but almost no one has issue with a female nurse in the same capacity. Not that it matters for the outset of anyone's career anyway. It is a highly coveted nursing job that is mostly filled with nurses who have significant experience elsewhere.
I took the advice of my adviser and set up some interviews at local hospitals. I went to my first one yesterday. It was a very peculiar dynamic. I am acclimated to being interviews involving me desperately to stand out from the competition to get the job then waiting hopefully by the phone for the offer to come through. This was more like me interviewing them. It is REALLY nice to be able to go to an interview with ZERO stress as an organization tries to sell you on why you should work with them as opposed to in another unit at their hospital or at another hospital just down the street. It is just as nice to be able to say to them, no thanks I really want to do this instead of that. Now, if I could just get to a position where I could make salary demands too :)
I think there is still only the most minuscule chance that we will opt to stay here, but there is lengthy pro/con list for working in either place. The impression that I get is that, here in ROC, you can be very picky. They will also coddle you more than they would out West. The on-the-job training sounded impressive. However, they also pay you seventy cents on the dollar, which doesn't remotely equate to the cost of living differential. Plus, there is the whole 'living in ROC thing' that neither Tia nor I are enthralled with. In Portland, the pay is better, but they seem less inclined to so much as talk to me until I get my license and there is a far greater level of competition for jobs, meaning you need to take what will get you in the door, not what you want to do necessarily. Long term, that isn't a bad thing, but you also dont want to start with a bitter taste in a new profession. Opinions still range wildly on this.
For the second being I am caught up, so I think I will bask in the warm glow of that feeling......at least until my 4:30 group project meeting.
As much as I have enjoyed working with classmates on this rotation (as with pretty much all my rotations thus far), I will not be sad to see it go. I think that OB is a great place to work as a nurse. You get to work with mostly healthy patients who, for the most part, have mostly healthy babies. You get to be an integral part in the first few days of family bonding and help the new mothers try to develop good habits for caring for their newborn. However, it isn't for me. I can definitely see the allure, but I still feel too much discomfort both in myself and in my patients. One may play off the other, but what is certain is that there are ZERO male nurses on the entire unit and there hasn't been one in years. Roughly half the people you ask say they would have no problem with a male nurse tending to them in OB, but almost no one has issue with a female nurse in the same capacity. Not that it matters for the outset of anyone's career anyway. It is a highly coveted nursing job that is mostly filled with nurses who have significant experience elsewhere.
I took the advice of my adviser and set up some interviews at local hospitals. I went to my first one yesterday. It was a very peculiar dynamic. I am acclimated to being interviews involving me desperately to stand out from the competition to get the job then waiting hopefully by the phone for the offer to come through. This was more like me interviewing them. It is REALLY nice to be able to go to an interview with ZERO stress as an organization tries to sell you on why you should work with them as opposed to in another unit at their hospital or at another hospital just down the street. It is just as nice to be able to say to them, no thanks I really want to do this instead of that. Now, if I could just get to a position where I could make salary demands too :)
I think there is still only the most minuscule chance that we will opt to stay here, but there is lengthy pro/con list for working in either place. The impression that I get is that, here in ROC, you can be very picky. They will also coddle you more than they would out West. The on-the-job training sounded impressive. However, they also pay you seventy cents on the dollar, which doesn't remotely equate to the cost of living differential. Plus, there is the whole 'living in ROC thing' that neither Tia nor I are enthralled with. In Portland, the pay is better, but they seem less inclined to so much as talk to me until I get my license and there is a far greater level of competition for jobs, meaning you need to take what will get you in the door, not what you want to do necessarily. Long term, that isn't a bad thing, but you also dont want to start with a bitter taste in a new profession. Opinions still range wildly on this.
For the second being I am caught up, so I think I will bask in the warm glow of that feeling......at least until my 4:30 group project meeting.
Sunday, February 10, 2008
C-Section, Storm Large, -20 degrees
This is a post that continues to confound my efforts to get up online. Every time I sit down and attempt to complete it, something comes up and another day begins with another set of things to post. I refuse to be stopped this time however so, depending on occurrences outside of my control, this will be terse or my magnum opus.
I watched my first birth. It was a C-section which detracted from the experience some if only because C-sections are performed in a sterile surgical room instead of the much more hotel-like birthing suites. That aside, it was a pretty incredible thing to witness and I feel fortunate to be able to be an observer during an experience such as this in people's lives.
The surgical part was a bit gruesome to be honest. There is a lot of cutting, retracting, and some out and out pulling and yanking. Fluids were everywhere, most notably after the amniotic sac was ruptured, causing an arc of amniotic fluid more than a foot high which bathed the surgeons. The patient was obese, so there was a lot of adipose tissue to cut through as well. It was all very graphic. Ultimately, the birth took less than half the time of the repair of the incision afterwards. I followed the patient through the PACU and to her room where she will stay for the next 72 hours. The baby was fine with good Apgar scores, but was large for gestational age, so they had to do a lot of heel sticks to determine the infant's blood glucose. Mom wasn't terribly pleased by this, but procedures are procedures.
The next day I was back and hoping to see a vaginal birth. Unfortunately, the mom-to-be I was following was wholly uncooperative. How dare she hold out and try to ruin MY experience! It was quite funny because the patient's mom almost sounded that way when, after a number of hours, it became evident that the baby wasn't in any hurry to leave the womb. Every phone call she received while we were in the room sounded almost accusatory towards her daughter, as though she were intentionally withholding the child from the world. Even with a high rate of Pitocin on a constant drip, I found out she ended up having a C-section later that evening. One of my classmates got to witness that. I have one more day in labor and delivery. It will be interesting to see what happens then.
Tia and I celebrated 2 years together on Sunday by having a relatively school-free day (except for an exam I had to take that morning at 8am). We used some spa gift certificates from her mom and Sherri and I got a massage and a wonderful hour-long sports pedicure. So relaxing. Then we headed out to eat, which was a bit of a mess because the restaurant we wanted to eat at ended up being closed on Sundays, necessitating a change of plan to an expensive Vietnamese place where we were the sole customers. It was good, but no better than Vietnamese places that were half as much out in Portland. We then saw Storm Large (remember the Rockstar Supernova show?) headline a play called 'Cabaret.' Very bizarre. Lots of skin and a fair amount of gratuitous groping. I dont really no what to say about it. It was a musical on LSD. I think Wikipedia may do a better job of describing it than I can: http://en.wikipedia.org/wiki/Cabaret_(musical)
The other entertaining thing about the evening was that I experienced a new "Holy shit it is REALLY cold here moment." The temperature dipped down to the single digits (6 degrees) and, with windchill, we hit -20 here in Rochester. Perhaps to prove that the people here are a hearty lot, there was one young guy at the show who was adorned in a polo shirt with a light windbreaker and, I shit you not, cargo shorts. My guess is he lives in an ice cave on a planet further from the sun than our own regularly so it must have seemed quite tepid out. As for myself, I could barely think over my teeth chattering. We closed out the night with dessert at the Cheesecake factory. Good lord they have good desserts.
In other news, school continues to hit new lows, but I am not alone in feeling this way. For those of you who dont know me well, one of my BIGGEST pet peeves is when I feel like my time is being wasted. So, when we showed up for class yesterday for our 4-hour lecture in Women's Health with only that day's materials encompassing what will be on tonight's exam, I thought we would for sure be very productive. As usual, I was wrong. Instead we spent the first hour discussing how our respective weeks were, the next 2 hours working on case study projects that were largely opinion based and then presenting them to the class affording ZERO information to anyone and then, the last 45 minutes covering 1 of the three powerpoints that we were supposed to cover. Needless to say, when I found out we had a panel discussion arranged for today, I opted to do laundry instead. I then spent my off hour in a meeting and followed that with 3 hours of ethics lecture. I may need to arrange future spa visits for AFTER Monday.
A few of my classmates discussed sending emails to our instructor so that she would know that we are not pleased with how she opted to run our class......but as usual, nothing will come of it because the risk is greater than the reward, especially since this was our last class session with her. She will of course return, like a bad penny, to teach our NCLEX review. God help me.
Off to study for the last exam tonight. Wish me luck as always.
I watched my first birth. It was a C-section which detracted from the experience some if only because C-sections are performed in a sterile surgical room instead of the much more hotel-like birthing suites. That aside, it was a pretty incredible thing to witness and I feel fortunate to be able to be an observer during an experience such as this in people's lives.
The surgical part was a bit gruesome to be honest. There is a lot of cutting, retracting, and some out and out pulling and yanking. Fluids were everywhere, most notably after the amniotic sac was ruptured, causing an arc of amniotic fluid more than a foot high which bathed the surgeons. The patient was obese, so there was a lot of adipose tissue to cut through as well. It was all very graphic. Ultimately, the birth took less than half the time of the repair of the incision afterwards. I followed the patient through the PACU and to her room where she will stay for the next 72 hours. The baby was fine with good Apgar scores, but was large for gestational age, so they had to do a lot of heel sticks to determine the infant's blood glucose. Mom wasn't terribly pleased by this, but procedures are procedures.
The next day I was back and hoping to see a vaginal birth. Unfortunately, the mom-to-be I was following was wholly uncooperative. How dare she hold out and try to ruin MY experience! It was quite funny because the patient's mom almost sounded that way when, after a number of hours, it became evident that the baby wasn't in any hurry to leave the womb. Every phone call she received while we were in the room sounded almost accusatory towards her daughter, as though she were intentionally withholding the child from the world. Even with a high rate of Pitocin on a constant drip, I found out she ended up having a C-section later that evening. One of my classmates got to witness that. I have one more day in labor and delivery. It will be interesting to see what happens then.
Tia and I celebrated 2 years together on Sunday by having a relatively school-free day (except for an exam I had to take that morning at 8am). We used some spa gift certificates from her mom and Sherri and I got a massage and a wonderful hour-long sports pedicure. So relaxing. Then we headed out to eat, which was a bit of a mess because the restaurant we wanted to eat at ended up being closed on Sundays, necessitating a change of plan to an expensive Vietnamese place where we were the sole customers. It was good, but no better than Vietnamese places that were half as much out in Portland. We then saw Storm Large (remember the Rockstar Supernova show?) headline a play called 'Cabaret.' Very bizarre. Lots of skin and a fair amount of gratuitous groping. I dont really no what to say about it. It was a musical on LSD. I think Wikipedia may do a better job of describing it than I can: http://en.wikipedia.org/wiki/Cabaret_(musical)
The other entertaining thing about the evening was that I experienced a new "Holy shit it is REALLY cold here moment." The temperature dipped down to the single digits (6 degrees) and, with windchill, we hit -20 here in Rochester. Perhaps to prove that the people here are a hearty lot, there was one young guy at the show who was adorned in a polo shirt with a light windbreaker and, I shit you not, cargo shorts. My guess is he lives in an ice cave on a planet further from the sun than our own regularly so it must have seemed quite tepid out. As for myself, I could barely think over my teeth chattering. We closed out the night with dessert at the Cheesecake factory. Good lord they have good desserts.
In other news, school continues to hit new lows, but I am not alone in feeling this way. For those of you who dont know me well, one of my BIGGEST pet peeves is when I feel like my time is being wasted. So, when we showed up for class yesterday for our 4-hour lecture in Women's Health with only that day's materials encompassing what will be on tonight's exam, I thought we would for sure be very productive. As usual, I was wrong. Instead we spent the first hour discussing how our respective weeks were, the next 2 hours working on case study projects that were largely opinion based and then presenting them to the class affording ZERO information to anyone and then, the last 45 minutes covering 1 of the three powerpoints that we were supposed to cover. Needless to say, when I found out we had a panel discussion arranged for today, I opted to do laundry instead. I then spent my off hour in a meeting and followed that with 3 hours of ethics lecture. I may need to arrange future spa visits for AFTER Monday.
A few of my classmates discussed sending emails to our instructor so that she would know that we are not pleased with how she opted to run our class......but as usual, nothing will come of it because the risk is greater than the reward, especially since this was our last class session with her. She will of course return, like a bad penny, to teach our NCLEX review. God help me.
Off to study for the last exam tonight. Wish me luck as always.
Tuesday, February 05, 2008
Quick note
Came across this site, thought I would share it with those that I didn't manage to email it to:
http://allfunny.net/index.php/funny-pictures/proper-baby-care.html
Goes along with what I am learning.
Nothing new to report. Another day of lecture......another unbelievable amount of information to assimilate. Another day closer to being done.
http://allfunny.net/index.php
Goes along with what I am learning.
Nothing new to report. Another day of lecture......another unbelievable amount of information to assimilate. Another day closer to being done.
Monday, February 04, 2008
Righteous anger
I am sure anyone who has taken introductory college courses can empathize with the following situation: You are in some introductory requirement course or another, lets say English 101 for example. Everyone has to take this course so you and your friend end up signing up for it, only at different times with different instructors. As the weeks go by, you find yourself reading obscure treatises on the history of the umlaut and its effect on the present day English language and writing 15,000 word essays on dangling participles while your friend watches obscure French films and, if there is time, tosses off the occasional haiku. At the end of it all, you work your every loving ass off for a solid C+, which you are inexpressibly proud of because half the class failed while your friend sleeps through their final and makes a B+ because their aura was especially pink that day. Or, the exact opposite of this happens. It is really luck of the draw. You just have to accept it as the random event that it is.....or maybe your aura just wasn't especially pink at that time or place in your life (presuming, of course, that a pink aura is a good thing). When it pisses you off is when that same class and same instructor yields two disparate experiences. It pisses me off anyway.
To get down to brass tacks, the following situation has evolved: Our class is split up into 2 cohorts; A and B. Cohort A began in OB/Peds and is doing the med/surg rotation presently. Cohort B is my cohort. Cohort A managed to achieve an 18pt improvement over our first exam in med/surg and managed to better our averages on the first two exams in OB/Ped as well. Cohort A is over-represented at the top of our class academically, and not by sheer chance. What I found out today is that they got a much more focused study guide in MS (med/surg) detailing specific places to look for answers in the text, had questions that were used and counted against us in MS removed because they were deemed too difficult, had questions dropped from exams in OB/Peds (OP) because they didnt have MS previously and, to top it off, that the exams have been made harder for us in OP because we have had MS. This is all the more aggravating because we will be judged on a level playing field. Meanwhile my cohort is essentially running up hill. If I haven't expressed my disgust for this program lately, my apologies for being lax in that regard. It truly sucks.
Speaking of things sucking, I leave you with one final, and quite poignant example. Today there were questions brought up in regards to validity in OP. The situation that has arisen on both exams thus far is that material that is being tested on is not being covered until future readings. So, we are being asked questions on, for example, APGAR scores, without having exposure to any information about them until the readings for the next examination. A very clear problem with validity. When this was brought up the instructor said, and this is a DIRECT quote (you cannot make this shit up), "So, what you are saying is that you want me to only question you from material we have covered?" As if this was some kind of foreign concept and we were asking her to make unreasonable accommodations on our behalf. At this point, she could test us on the season premiere of Lost and not be any less valid.
And to think I get to wake up tomorrow and do it all over again. My aura must the be opposite of pink lately.
To get down to brass tacks, the following situation has evolved: Our class is split up into 2 cohorts; A and B. Cohort A began in OB/Peds and is doing the med/surg rotation presently. Cohort B is my cohort. Cohort A managed to achieve an 18pt improvement over our first exam in med/surg and managed to better our averages on the first two exams in OB/Ped as well. Cohort A is over-represented at the top of our class academically, and not by sheer chance. What I found out today is that they got a much more focused study guide in MS (med/surg) detailing specific places to look for answers in the text, had questions that were used and counted against us in MS removed because they were deemed too difficult, had questions dropped from exams in OB/Peds (OP) because they didnt have MS previously and, to top it off, that the exams have been made harder for us in OP because we have had MS. This is all the more aggravating because we will be judged on a level playing field. Meanwhile my cohort is essentially running up hill. If I haven't expressed my disgust for this program lately, my apologies for being lax in that regard. It truly sucks.
Speaking of things sucking, I leave you with one final, and quite poignant example. Today there were questions brought up in regards to validity in OP. The situation that has arisen on both exams thus far is that material that is being tested on is not being covered until future readings. So, we are being asked questions on, for example, APGAR scores, without having exposure to any information about them until the readings for the next examination. A very clear problem with validity. When this was brought up the instructor said, and this is a DIRECT quote (you cannot make this shit up), "So, what you are saying is that you want me to only question you from material we have covered?" As if this was some kind of foreign concept and we were asking her to make unreasonable accommodations on our behalf. At this point, she could test us on the season premiere of Lost and not be any less valid.
And to think I get to wake up tomorrow and do it all over again. My aura must the be opposite of pink lately.
Sunday, February 03, 2008
Mother & Baby = Done & Done
I still have two weeks left on my OB rotation, but the remainder of the time will be spent in Labor and Delivery. Though that is no indication that I am done being in situations that I find rather uncomfortable and embarrassing, it means I at least will be facing those situations with a health care team. Tia says that I over-emphasize my discomfort and tend to dwell on it...something I cannot argue, nor shake. I just don't feel right doing the examinations on the new mothers. I am mystified as to how I am supposed to ascertain how much blood is on the pad in their panties (Lochia) as a result of the shedding of the uterine lining as compared to that of a menstrual cycle. What constitutes heavy vs. moderate remains a mystery, but I can say that if I were losing that much blood from a flesh wound, I would suggest that I was bleeding heavily (in this I am apparently incorrect). That is just one glaring example of how hard it is to relate to what these women are going through. I imagine to some degree, working there not having carried a child of your own might prove a bit difficult for a female nurse. I would argue however, that not even having completely different apparatus is a greater impediment than that.
Despite my misgivings, there has not been a single incidence of any of my patients being outwardly uncomfortable with me. It remains entirely possible that I am transferring my own feelings to them, but I can't help the way I feel and Psych 101 is no help here. I just cannot imagine a time in my life that I will ever be at ease walking into a room to meet a woman for the first time and, shortly thereafter, peering into her underwear without a significant amount of distilled spirits involved (frowned upon in the medical profession).
That said, I feel very comfortable working with the newborn infants, offering some advice to the mom's and being in the nursery. Honestly, a greater portion of the day is spent not examining the new mothers, so it has been about 98% positive, which is a step in the right direction. I am pleasantly surprised by how good I feel about being around the newborns. Truth be told, I am not the world's most effective swaddler and I am remarkably inefficient in changing both diapers and attire on an infant, but compared to my similarly inexperienced classmates, I hold my own.
In other school related news, things are ever so slowly rounding into form. I am still struggling somewhat on the motivation front, but it appears to be a universal concern in talks I have had with classmates. The goal for the moment will just be staying afloat until Spring Break just 5 weeks in the distance. Seems minor when typing it, but 5 weeks is never minor in a program like this.
As always, keep em crossed for me.
Despite my misgivings, there has not been a single incidence of any of my patients being outwardly uncomfortable with me. It remains entirely possible that I am transferring my own feelings to them, but I can't help the way I feel and Psych 101 is no help here. I just cannot imagine a time in my life that I will ever be at ease walking into a room to meet a woman for the first time and, shortly thereafter, peering into her underwear without a significant amount of distilled spirits involved (frowned upon in the medical profession).
That said, I feel very comfortable working with the newborn infants, offering some advice to the mom's and being in the nursery. Honestly, a greater portion of the day is spent not examining the new mothers, so it has been about 98% positive, which is a step in the right direction. I am pleasantly surprised by how good I feel about being around the newborns. Truth be told, I am not the world's most effective swaddler and I am remarkably inefficient in changing both diapers and attire on an infant, but compared to my similarly inexperienced classmates, I hold my own.
In other school related news, things are ever so slowly rounding into form. I am still struggling somewhat on the motivation front, but it appears to be a universal concern in talks I have had with classmates. The goal for the moment will just be staying afloat until Spring Break just 5 weeks in the distance. Seems minor when typing it, but 5 weeks is never minor in a program like this.
As always, keep em crossed for me.
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