One Year...10 Posts

I know my review of Toure's Never Drank the Kool-Aid was supposed to be next, but I have to say something else first. (But YES, he did respond to my email...more later, I promise)

It just occured to me that I started my blog one year ago this month, so I didn't want the month to end without talking about my 1-year bloggin milestone...

I started this blog in the hopes that other nursing school hopefuls, especially those who might not otherwise have anyone to ask for advice, would be able to gain some insight into what it is like to apply to and attend nursing school, especially graduate level nursing school. I also wanted to share my experiences in an accelerated "direct entry" nursing program, which is different than a traditional nursing program - mainly in that you can have an undergrad degree in anything (mine is in English-Writing and Linguistics) and get both an RN and MSN in one bridge-type program.

I am suprised by how much more I ended up writing about. I am also suprised by how personal my blog has gotten, despite the fact that it is still not "very" personal! There are some things about my blog that I am proud of; mainly, I am proud of the truth that it represents. There are others that I look back and am somewhat disappointed with - such as the overall language of the blog, which I thought would be slightly more formal than it is. In the end, while I am not exactly happy with the language, I have come to accept it because I value non-academic and non "literary" tongue and I hope that this blog remains readable because of it.

Anyway, I perused my archives, and these are my top 10 posts of the year (they will pop up below this current post):

These posts because they exemplify the mission of this blog

Because of this post, I will never forget how it felt...

This post because it marked the end of a very long journey...

This rant because it tells the truth about who I am...

This one and this one, because they articulate what marriage means to me...

This is what nursing school is really like...

But also this one, because it equally tells the truth of nursing school...

And who could forget the day they asked me to leave the program...

And last but not least,this post, because it captures the very essence of my life.

I hope you all have enjoyed the blog this year, and I hope I have helped someone, anyone. I look forward to the growth next year brings, and your cyberspace visits!

Toure

I'm going to talk about Toure's never drank the Kool-Aid next, but I am waiting on him to respond to an email I sent him about it...

More later!

Let the Lion Eat Straw

This novel is by Ellease Southerland, now known as Ebele Oseye. I picked up this book because of one very simple description I saw online: "Mamma Habblesham, an elderly midwife, lovingly tends to Abeba, a sweet little 6-year-old whom she has raised since the girl was two months old." I should have kept reading the reviews/summaries. There are few novels that I have found that have midwives as real characters. I was disappointed (for all of two seconds) when I realized that this book doesn't either. We know that Mamma is a midwife, and that she's a good one, but that's it. In fact, Abeba's life with Mamma pretty much ends 15 pages into the novel. But I kept reading after that because the novel is beautiful. It's short, and therefore words have been chosen carefully, and I like that. But that's the least of it.

I loved the way Southerland portrayed the men in the novel. Abeba's father was not afraid to love his daughter. The boys on the stoop were respectful, genuinely kind, and very supportive of Abeba, all the while Abeba's mother pointed out that they were drunks and needed some Jesus in their life. Isn't that the way people really are? It seems so rare that people are either one thing or another, a sinner or the saved. I loved how a whole Brooklyn community of poor folks paid hard earned money to gather at the school to see the play that Abeba's mother wrote where black men were kings, and astrologers, and magicians (a revamped story of King Nebuchadnezzar and David)...a play that cost 50 cents for one person, but 25 cents for two.

And I loved Abeba's resiliency. Her husband turned out to be certifiably crazy, but she stood right by him. They had 15 children, all of whom where exceptionally smart and they built business and a home and a family with very little.

It really was very beautiful. There was some horror, but what life doesn't have any? Abeba was headed for great things (ie Julliard) but she gave it up for this life with children and a husband. And to me, that was some of the horror, but what I liked about it was that at the center of this novel was a relationship between mother and daughter, and when the daughter became a woman, she took responsibility for the life she chose and made decisions accordingly.

There's so much truth in this novel, so much revelancy now, almost 30 years later.

The Interruption of Everything

I started with this novel by Terry McMillan because I had been waiting a very long time to read it. It wasn't the best one she's written, but I still enjoyed it. I have been a fan of Terry McMillan since Mama and Breaking the Ice. I remain committed to her works because I remember what reading Mama did for me; For the first time ever, I read a book and really recognized the characters. I read the whole novel in one day - a real accomplishment when you're 12 or so and it's 2 or 3 hundred pages long. It probably wasn't the first book by a black woman that I had ever read, but it's the first one I remember reading.

The Interruption of Everything is about a woman (Marilyn) entering perimenopause (thanks for talking about it) and her relationships with her family members, including her husband, children, mother and mother-in-law. She is intensely creative and has earned a creative degree, but had been mostly a stay at home mother and wife. The main plot has to do with belonging to the sandwich generation. She's just getting her kids off to college, but also taking care of her own parents. Her mother is sick, but is living with Marilyn's sister. Her mother-in-law is living with Marilyn and her husband, who is also going through a mid-life crisis. And, of course, what would a Terry McMillan novel be without girlfriends. She has two girlfriends that help her get through everything. And there's other drama that I won't get into so that I don't spoil it. The best thing about the book is the menopausal discussion.

It was entertaining enough to read in one day, but at the same time, I thought "I waited 4 years for a novel from McMillan...and this is it?"

Reading

I read a book yesterday, a book today, and even started on the one for tomorrow...the plan is to read one every day - but no pressure...

I'll be talking about them soon...

Semester One is Finally Over

The semester has ended. FINALLY. I basically slept (and read) from Thursday until now, with the exception of a trip to the grocery store yesterday to prepare for this hibernation I am about to go into.

Thursday was my final Med Surg exam. At one point, in the middle of test, I flipped the test over to calculate how many I could miss and still get the grade I wanted on the test. I didn't do it because I wanted to quit, but because I was feeling really overwhelmed by it all (hardest friggin test I've ever had in this class) and I needed some perspective...For example, I only needed a 60 on this final exam to pass the class...and even if I had of gotten a 90 my grade would still have been only a "Pass," (one of the things I hate about "Pass/Fail" system) then I figured I could miss something like 40 of the questions and still get what I needed...all of sudden the 14 questions I did not know the answer to didn't mean a damn thing and I kept moving.

Shortly after the Med Surg exam, and right at the end of a end-of-semester meeting with the program director, our professor came back in and made an announcement that although one person failed the exam, no one failed the class. We didn't lose one student this semester. It was a great feeling and the class, even if only for one moment, was unified and proud.

As tired as I was, I still took the Anatomy final afterwards (even though we had another 5 or 6 days to take it) because I wanted be done with all of this when I finally went home. I passed that, too, and that marked the end of the semester for me.

The semester didn't exactly end the way I wanted it to (I wanted High Passes), but it's over now and I can say I've learned something - a lot, actually. And despite the belief of some that we all have equal access to being successful here, I maintain my opinion that it is harder for some us than others. My view is not a popular view to have in an ivory tower because people are very uncomfortable with their privilege. But I know, because of how I feel right now, that it has been no small feat to come through this fiery first semester and although I might have suffered some smoke inhalation, I have not been burned...and I find that nothing short of miraculous.

(Almost) Unbelievable

On Nove 3rd, an ARTICLE about a med error was printed in the Wisconsin State Journal:

Nursing and hospital officials were outraged Thursday after the state filed a felony charge against the nurse whose medication error caused the death of a teenager at St. Mary's Hospital in July.

It's the first time a health- care worker has been criminally charged for an unintentional error in Wisconsin, the officials said. They said the filing could make it more difficult to recruit and retain nurses, already in short supply...She mistakenly gave Gant an epidural anesthetic intravenously, a state investigation previously revealed. Gant was supposed to receive penicillin through the IV for a strep infection. An epidural is supposed to be injected near the spine to numb the pelvic area during birth

Wow. I began to think about how possible it would be for this kind of med error to happen- I was trying to go through the steps in my head, but further down, the article provided all the steps she had to take in order for this to happen:

Improperly removed the epidural bag from a locked storage system. Gant's physician, Dr. Joseph Fok, never ordered the epidural.

Didn't scan the bar code on the epidural bag, which would have told her it was the wrong drug.

Ignored a bright pink label on the bag that said in bold letters, "FOR EPIDURAL ADMINISTRATION ONLY."

Disregarded hospital and nursing rules in failing to confirm a patient's "five rights" when receiving drugs: right patient, right route, right dose, right time and right medication.

Of course that made me think, OK she really screwed up. But also, I was trying to imagine myself in her situation (which is always hard to do, because you never really can) and I thought about of all of the little things that happen during a shift-almost absentmindedly. I still don't know how she missed this...it seems so glaring, but who am I to say? Do I have any say, as a future nurse? IF I were called to testify, would I stand up for her, my fellow nurse? I was still torn...but then I read this statement from the nurse:

I allow priority for compassion to override the need for detail.

Notice the present tense "allow" not "allowed" as in past tense mistake, but present tense. I was no longer torn. Maybe it's me, but when I'm the patient, please spare me the compassion if it comes at the price of my life.

I hope you all read the article for yourself, but in the case that you don't, the 16 year old girl died from the injection. The nurse "if convicted, faces a $25,000 fine and up to three years in prison and three years of extended supervision.

Seriously? Supervision...as in she'd still be working as a nurse? I don't think that should be an option. What do you think?

The Last Week of Semester 1

I have my final MedSurg exam tomorrow morning at 10 am and then an Anatomy final to take by Monday. My Final MedSurg exam covers respiratory, musculoskeletal, hepatic, endocrine, and EKG interpretation. Do I feel great about it? No. But I just want to get it over with.

Today we're having a breakfast in MedSurg and we're going to fill out a million observations. I'm so not in the mood, but I believe in the necessity of evaluations. We will also be evaluated on our clinicals that just ended (mine was in Oncology) Do I expect a great evaluation? No. But I do expect to pass. Honestly, my preceptor wasn't great...or even good, and I plan on discussing all of that on the evaluation - and I expect her to discuss my obvious boredom with 3/4 of the rotation!

Really, it's all about the fact that Med Surg is over (or will be tomorrow) and I will dedicate a whole post to how that makes me feel, but in one word:

FANFREAKINTASTIC.

“You’re Not Cut Out for Nursing School” Part 2

Here’s what I did after that:

I went to speak with the associate dean (this was like 2 days after the letter, before I had rebuilt my reserve and confidence). She was very supportive, and this is the benefit of having a conscious person of color in administration; They take up the battle for you, and you get to go back to concentrating on yourself. You don’t have to explain all the psychological damage, they already get it…they’ve been through it. You don’t have to convince them that you aren’t crazy – which helps because when something like this happens you really do feel like you’re losing it, and if you’re the kind of person who takes your life seriously (and thinks about it critically) you start to think you might be crazy and you’d have a hard time convincing someone else that you aren’t! She met with me and then met with him to discuss the situation on my behalf…and then encouraged me to meet with him myself later. She also made it concretely clear that I wasn’t leaving the program. But, honestly, I didn’t believe her.

Then, I gathered up all my friends, mostly students of color who I’ve built a very solid community with, and a few others, and explained what was going on. (The associate dean was very concerned about the whole “everyone one is struggling alone” thing) Another student in this little community had also had the same experience, and so there was comfort in that. And basically, they rallied around us and gave an immeasurable amount of support. I can hardly explain it, but it was the difference between trying to push against a closed door by yourself, versus having 5 other people pushing against it with you, if that makes sense. So we discussed a few strategies, made the commitment to check in on each other over the Thanksgiving holiday, and to come back with more ideas on how we could help the two of us get the scores we needed to pass the class and stay in the program. For one of the very first times in my life, here was a group of young black people who really felt like if one of us failed, we all failed, and failure was not an option. Not to be mushy, but I think this is what love looks like when it is separated from romance.

So, I went on break and I spent an enormous amount of time confronting my issues (because no one can make you feel inferior without your consent), rebuilding my confidence (because it was gone), and reassessing and recommitting to my purpose (because it’s the only way to survive this experience, I think). This involved journaling, reading my writing, including my admissions essays, and goal updating/refining. It was hard work, and, honestly, it left me exhausted, which is one of the reasons why I hope I don’t have to do it again soon.

Then I came back to school (somewhat renewed, but still a little worried, obviously) and, as promised, my friends’ suggestions started pouring in. I received a total of 36 emails in a weeks time, all concerning Biomed. I studied with different people, I was quizzed by different people, and I took the advice of every person seriously. Then I met with the professor and analyzed my last two tests. I told him my concerns and cornered him about the material a million times (Like: “Why is this the answer instead of this, when these two things are exactly the same?” or “You said to study these objectives, but the answers to the practice questions you posted do not come from these objectives, where do they come from?”) Then I took the test…early…in a room by myself, and I asked him questions during the exam, which I had never done before (thanks for that advice, K) and found that it is absolutely necessary to do so in order to get the grade you deserve. I think this is very, very problematic, but that’s for another post, another day. What matters in this moment, for this post, is this:

I needed a 77, but I got a 90.

Don’t put me in a box, don’t underestimate me, and don’t think you know me. I am serious about this thing I’m doing, and I don’t intend to change my goals based on your limited knowledge of who you think I am or what you think I can achieve. And what’s even better, my friends refuse to look up one day only to realize that one of us didn’t make it – and I am learning that of all the things that went right with this experience, that one has had the greatest impact.

"You're Not Cut Out for Nursing School" Part 1

So, here’s what happened:

Three weeks ago, on Wednesday November 15th (the day I wrote the “Creative Writing” post) also the day before my big Med Surg exam, my Biomed professor emailed me a letter suggesting that I withdraw from the program, take an A&P class, and try again next year. Or, if I wanted to, I could continue in the class. Hello??!! If I want to?!? Seriously.

It took me a minute to actually realize it was happening. He sent it to me so casually. The first thing I said aloud (in the library, sitting next to a friend) was “and you’re emailing this to me?!” Almost on cue, I received another email from him that said the hard copy would be in my mailbox, and good luck with my Med Surg exam. I’m thinking, ok so you did in fact know that I had a huge exam the next day…did you not think this would negatively impact my ability to concentrate on that…or did you simply not care…or are you angry because people like her class better than yours? But whatever, in that moment I decided not to go to my creative writing thing (in my opinion, electives are not an option if you aren’t passing the fundamentals) and had to relinquish my spot to someone else. I really wanted to participate in that workshop but, again, whatever.

This is why I was so angry:

1. I went to him after I failed the first exam, and he brushed me off, and told me “don’t worry about it, a lot of people failed it – go talk to the TA.” Ok, so, I tried not to worry about it, and went and talked to the TA like he told me to. That was disastrous. She told me that the reason I wasn’t doing well in his class was probably because I had an “attitude” toward him. Right then and there, I was done with her silly self. Whether he is good professor or not (he’s not) and whether I like him or not, I came to you to get assistance with the course, so how about you help me with the material, instead of critiquing what you think my attitude toward him is or should be. And, her advice was terrible. I did what she suggested because I thought, ok-maybe she knows something I don’t since she passed the class last year. The result of that faulty study technique was that I failed the second exam with a score even lower than I failed the first. Needless to say, meeting with her is no longer an option for me.

2. He did not EVER meet with me before he sent out the letter. I think the least he could have done was to meet with me and voice his concerns, and maybe even give me a head’s up that the letter was coming. It seems to me that there is just a way to do things, and that wasn’t it. Especially since the letter was also forwarded/cc’d to all the deans, too. How unprofessional.

3. Wouldn’t it have made sense to actually look at my file before suggesting that I take a year off to take A&P when I already took a year of A&P and am currently in the university’s A&P course? No, sir, taking yet another year of A&P is not going to help me. The letter also gave some suggestions for how I might be able to improve my grade if I was going to remain in the class. Again, these suggestions were uninformed. 5 of the 7 were things I was already doing! (ie: come to class, tape the lectures, meet with the TA) The last two things had to do with test taking (take the test in a room by myself, and I could have longer to take the exam). The exam is forty questions long and we already have 2 hours…time was never an issue. These were all things that could have been discussed, had he been willing to meet with me.

And lastly (and most importantly)…Who the hell are you to suggest I leave the program before I have even failed the class? What makes you think that I can not pull myself out of a hole, especially when all I need is 77 on the exam? How can you possibly say (and write down) that you don’t think it is possible for me to get the 77 I need - you don’t know me, or anything about me.

You might think you know but, clearly, you have no friggin’ idea.

It took me weeks of processing to understand it totally, even though I had H in my ear telling it to me all along (thanks H) but I finally organized it in my brain, and hopefully I won’t have to relearn/reconvince myself after this, because honestly it takes too much time. But basically, it came down to this:

When or if I leave this place it will be because I say so, and for no other reason. I will not be intimidated or otherwise coerced into defeat by him or any other person who is not wise enough to recognize my committment to my purpose in this world.

A Week Later...

Things are quiet around here as I prepare for Biomed Exam 3 which happens on Thursday.

The Reason I Write

I sat with the last quote for a long time, and it felt good, but then I went back to find my own encouraging words that are located in several haphazard places because I do not have a file system for my own writings (I think I am afraid someone will stumble across them) and I found this:

"I swear, people will make you feel like you're crazy if you let them. There aint nuthin wrong with me. I know exactly what I want, and I am not going to be bothered by the fact that it exceeds what you happened to have imagined for me. You should've dreamed bigger."

~ Myself

It came from this post on June 27th, 2006.

How appropriate the profound truth I uttered that day.

I found many more, including this one from my "Shoot for the Moon" journal:

"I remember the way the stars aligned to get me here. The universe wants this for me, even when I am not strong enough to want it for myself."

It occurred to me that this is one of the reasons I write; I need to be able to look back and say "I know something about the world and, more importantly, I know something about myself." This way, when someone tells me something about myself that is not true, I am able to find my own truth in my own words when I need it most desperately.

Every day we slaughter our finest impulses. That is why we get a heart-ache when we read those lines written by the hand of a master and recognize them as our own, as the tender shoots which we stifled because we lacked the faith to believe in our own powers, our own criterion of truth and beauty. Every man, when he gets quiet, when he becomes desperately honest with himself, is capable of uttering profound truths. We all derive from the same source. There is no mystery about the origin of things. We are all part of creation, all kings, all poets, all musicians; we have only to open up, to discover what is already there.

~Henry Miller, Sexus

Whatever you do, you need courage. Whatever course you decide upon, there is always someone to tell you that you are wrong. There are always difficulties arising that tempt you to believe your critics are right.

~Ralph Waldo Emerson

Fight one more round. When your arms are so tired that you can hardly lift your hands to come on guard, fight one more round. When your nose is bleeding and your eyes are black and you are so tired that you wish your opponent would crack you one on the jaw and put you to sleep, fight one more round - remembering that the man who always fights one more round is never whipped.

James Corbett

Talking to Myself

When you come to the end of your rope, tie a knot and hang on.

~Franklin D. Roosevelt

Creative Writing

I was selected to participate in a creative writing program on campus. It's a writer's workshop of sorts. The first meeting is today. Of course, tomorrow is my med surg exam, so I am not feeling like taking the break out of my day to do this. I am going to go though because I need to be able to think/write/talk about something other than nursing, and I need a break from studying. I read through some of my old writing to find something to take to workshop (no time to write anything new) and was so disappointed that I haven't been able to write much in the last few months. Reading my own writing made me remember that I *am* good at something, even if it isn't Biomed. It takes a huge mental and emotional shift to learn the material I'm learning, especially since most things I had to do as an English major came so naturally to me.

Me and my friend (M) also had a revelation: Just because we can't do happy hour on Fridays anymore, that doesn't mean happy hour is a bust...we'll just go on Wednesdays! So I'm also going to be taking a break to drink $2 margaritas from heaven and eat free burritos, cheap wings, and tasty spinach artichole dip.

Then I'll pull a semi all-nighter studying for med surg Test 3, aka "the test from hell!"

Yet Again

It's just not even funny. LOL I did worse this time than I did the first time, although I knew the information better. This is why that meeting with the dean was so necesssary. I swear, this is crazy. I just shot the professor an email, asking what he'd like me to do. The first time I did this, he told me not to worry about it, a lot of people failed it. He recommended I have a session with the TA, which I did. I followed every bit of her advice. I wonder what he will say this time...

Look at Those Errors!

I just read over my last post and was amazed at the number of errors there are! LOL I would normally edit the post, but not today. Back to Med Surg...oh and I passed the Pharm exam, now I'm waiting on Biomed...

Meeting with the Dean

Apparently some students in our class requested a class-wide meeting with the dean. We had the meeting this morning, and people got to air out all their frustrations. It was quite weird actually. Very different from my undergrad institution, probably because people can preface their comments with "I pay too much money to..." which really gives a student some power I guess. It was weird because our dean is new, this is first year on the job. She is supposedly suprised by how some classes are being handled as well, so she was in agreement with much of what was being said. Accept when it came to my comment! LOL I don't know what it is. It will be interesting to see how many changes she is actually able to implement, and ow many things somebody "sets her straight" on since she is new to the school, and maybe new to the type of institutional culture at the school. The insitutional culture definitely has an impact on how things are done, and sometimes I think some things will never change just because it is the way they have been done for, oh, about a century? LOL

The main comments were that Biomed, taught by a scientist, needs a major overhaul. (I agree, its terrible) A guy in our class said "I spent 18+ solid hurs studying for this exam, and i still didn't do well." What he forgot to mentioned was that he has a master's degree in a science field already, which would have lent more credit to his comment about the insaness of the course! BTW, we don't have our scores back yet, so I don't know how I did, other than to say I didn't know the answer to half of the questions! Pharm, taught by a pharmacist, has too many guest lecturers. The idea is that for every given topic a specialist in that field should teach the course. It the university's policy to have students "learn from the best there is." Well, ok. But sometimes we also have gest lecturers who they have selected speifically because they are grads of our program and they think it would be great for us to support these new graduates, and for them to get teaching experience, and to be possible role models for us new students. It sounds good, but the program is so accelerated that we really don't have time to be pratice students for people. I need you to give me what I need to know in as condensed (and complete) a form as possible because I get one lecture and one lecture only to know everything there is to know about AIDS. So while, yes, it is noce to see new grads doing great things, now is not the time! There was also some issue with the fact that whle we sometimes have guest lecturers, our exams are still written by the actual professor, so there is sometimes a huge gap in what we were taught versus what was on the test. We then gave many solutions to the problems we presented to the dean.

My comment, which wasn't received well, had to do with having nursing scholars/researchers/teachers actually teach Pharm and Biomed. The response (which is in no way new) to the question was basically "nurses aren't smart enough to teach the coontent" which I think is a serious problem. Does it say anything about the profession and the school to have these tougher courses taught by non-nurse scholars? What do you mean nurses aren't smart enough to teach the material? Isn't that exactly the kind of image we're trying to dispute in the profession? Our current nurse-lecturers do a better job relating the drug information to our practice than the pharmacists do, and the same goes for the biological processes in the body! Are you, the dean, really standing in front of the room and saying that your PhD educated faculty do not have the knowledge nor means to teach pharmacokinetics? That worries me. It also bothers me that we bring a men in to teach the harder courses, what are you saying, without saying anything?

Anyway, I was disappointed that everyone didn't know about the meeting before it happened. Only a handful of students knew we were having a meeting today. (I was one of the students who didn't know until the moment it was happening) There was a lot of complaining going on, but I think it was necessary, and I'm glad it happened. I can only hope that some good things come out of it. There was also a midwifery issue that had my blood boiling, but I'll tell u about that later!

Next Exam

Does it seem like I'm living exam to exam? You're not going crazy, it's true, I am. It's a strange month. I have a med surg exam Thursday. Yes, I had a biomed exam yesterday, and a pharm exam the Thursday before that, but who's counting? (I am, LOL)

I'm doing a lot of laughing. In fact, I feel loopy. Like I'm losing it, going crazy, smiling all the time like I'm drugged and don't know that I'm being hazed and that I'm supposed to be falling under the crushing pressure. LOL My friends blow me kisses in the hallway, one of us at each end with arms open wide, taking me in - "Oh you had bio med today, I just know you rocked it" with a sarcastic wink. Then they notice you're in your uniform and they say "clincal tonight, too?" - hugging me like I'm going off to battle - like we're in some ghetto version of a sweeping epic like Gone With the Wind. And you make the "I hate life" face and they say "have fun, 5 more weeks" as you continue walking, feeling blessed to have someone put the "just 5 more weeks" chant in your head. And then you turn around and yell, because you forgot to ask (this is how life is right now), "Oh shyt, how was your physical assessment check off yesterday?" And they toss their head back and laugh because they are a third-year and they no longer get stressed because they've already reached the maximum capacity for stress, so now they just go through the day with cheshire cat grins and drunken-ish sways - even if it didn't necessarily go well. Besides, what can they do about it now? They're loopy, too.

My med surg professor emailed us today. I know she's a little worried about the amount of information on this test, you can hear it in her voice when she talks to us, her boding tells me that I better not rest until Thanksgiving. But some idiot decided that we should have our 3rd pharm exam the Thursday we come back from Thanksgiving break, so really there won't even be rest then. At least I'll have some turkey and mac-n-cheese to snack on while studying. It'll be so much better than ham sandwiches or whatever else I usually eat in the absence of being able to bring cooked food into the library.

Can I tell you a secret?

(Of course I can, it's my blog!)

Here's the secret--------------> I'm loving it.

How insane does one have to be to love this madness? Who wants to have someone constantly reminding them that they don't know a damn thing about oncological disease, but, yes, your test is still on Thursday. Or, I know we didn't get a chance to cover universal precautions in MRSA patients, but, yes, it's still on your test, with a hearty helping of "I suggest you read up on that" at the end. I know that must sound crazy. But I am in love with being in charge of my own learning. I am in love with having to manipulate information until it no longer resembles what you thought it was supposed to. Building up a diagnosis (a nursing one, no less) and creating a plan of care based on that diagnosis, and then meeting the patient who bursts your bubble because while, yes, she knows cocaine is bad for her, no, she will not be taking your advice to go to rehab, nor any of your other "crazy" patient-teaching suggestions because she's a grown azz woman and doesn't want to hear your young azz telling her what to do. And, she "aint come in here for that noway." Now could you kindly give her an asthma treatment so she can get back to her 4 children who need their school clothes ironed, and her job - as a home health care aid, no less? Yes mam, I can. But first, let me tell you I know what "speedball" is, so let me at least tell you how to be safe. Did you know you can get free needles (up to ten at one time) at the pharmacy, without a prescription? "For real?" "Yes, maam, for real. So be safe."

It could have driven me nuts (last night's clinical), but, like I said, I'm loopy, and on a "this is what feels like to learn" high.

Thursdays

My new Thursday starts with class at 8 am, and ends at 10pm when clinical is over. There is a 1 hour lunch from 12-1. How did I end up with a clinical placement at the same time as my Friday anatomy class? We go to 1 hour's worth of class, but then it's off to the hospital (which is a 30 minute communte on the worst friggin interstate I have ever used) and we miss the last 2 hours of anatomy. Doesn't this seem azz-backward? I don't mind because I didn't go to the cadaver labs anyway, but the other students in my clinical group (who also have to take Anatomy) are not at all happy about it, and I completely understand why. Today I had a biomed test, which is why I am done early with class and have time to write this.

The biomed test was very frustrating. I spent hours and hours studying very productively. I had a 2 hour quizzing session early this morning with my friend who happens to being doing well in the class. I had to answer the questions without prompts from memory, which is harder than answering multiple choice questions because there's nothing to jog your memory. I did fine during this session. We both decided I knew the material. So how come I had no idea what the answer to almost 20 of the 40 questions on the test?

I am going to clinical unprepared because our preceptor was not there when we went to do chart review yesterday and so we had no access to the computers that hold all of the patient's information, and my patient's chart was missing because he wasn't on the floor (getting labs done probably).

What I want is a cocktail. Oh, wait. My weekly happy hour is now a thing of the past because I have clinical on Friday nights. Lucky me.

Sunday Brunch

Me and my friends went to brunch on Sunday at a cute little place off campus. It only had about 12 tables, but they had a serious line waiting to eat. After our 30 minute wait, we finally sat down and realized why people were so willing to wait. It was a beautiful day, the food was beautiful and tasted oh-so-good. I had french toast with whipped cream and pecans. It was amazing. Someone else had rasberry-lemon crepes which looked so good! I'm working on getting the picture so you can see it! There were about 9 of us, I think, and it really made my semester. It felt like I had been waiting to do just that for the last 6 weeks. It's the kind of thing I had imagined I would be doing, before I got here. Two of the students were third-years so they basically gave us some advice, and the rest of us just got to know eachother better!

I complain so much that I thought "I've got to tell them about this."

So there ya go, now I'm back to studying for biomed...

Crunch Time

Today when I walked into the reference room/quiet study/mini library, a girl was having a breakdown. Two classmates were trying to support her, but it was emotionally very hard to watch. I understand. The pressure is tremendous and people are very, very far from home or friends, and it's hard. I wouldn't say it's the hardest thing I've ever done, but it is very quickly approaching that extreme. Several classmates have gone to the doctor/NP and been prescribed medications to help them deal with things like depression and anxiety, and people are having panic attacks. It makes me wonder about the culture of nursing school. I know all nursing schools aren't this way, and I think these "incidents" have a lot to do with the program being accelerated more than anything else. But I wonder if they shouldn't do some kinds of stress assessments as part of the interview process? What is the consequence of this stress for people who come from cultures with strong stigmas attached to taking medications for mental health issues or even going to have their mental health assessed? Historically black women have had a hard time recognizing depression, as I'm sure other cultures have. If we aren't going to speak to mental health professionals (why aren't we) what are we doing to cope?

It's crunch time (I have a BIOMED TEST this week) and I find myself going a little nuts...I'll keep you updated...

Pharm Exam/Clinical Week 7

The Pharm exam went well enough. It takes a couple weeks to get the scores, but I'm not at all worried about it, I finished quickly and easily enough, but this week of memorization was no punk.

This was the first week of my new clinical assignment. The commute was about 30 minutes on the way there, but only 15 on the way back (traffice differences). It sucks to be holed up in the car with folks you don't really know. That, and the interstate we have to take is notoriously bad and so the whole time my eyes are closed. It was an interesting first day. We got lost (as required) which ticked me off because people would not listen to me. We just drove around in circles for 30 minutes before they finally listened to what the hell I had to say. My suggestion was to start from our school since the only directions we had started from the school. But, no, they decided they "knew" of another way to get on the interstate, so we drove around looking for it. After 30 minutes, we were right back at my house, and after I pointed this out, someone *else* had the "bright idea" that we should just go back to school and start from there. Did I mention the school is probably all of two miles from my house? Arrgh. Then, when we arrived at the hospital I informed the group that my friend had told me that we needed to get our parking ticket validated as soon as we walked into the hospital so we could pay the flat rate; otherwise, we would have to pay the hourly rate because the desk closes at 7 and we aren't done until 10. Do you think they listend to me? No. For whatever reason, they thought that it wasn't really important. And she told me "oh, don't worry about it" as we walked right pass the desk where we could have done it. Ok. Whatever.

In the mean time, we go through our first day of clinical, which does not involve taking care of a patient. We do scavenger hunt type activities to locate where everything on the floor is, we go over hospital procedures and regulations (ie How to call a CODE) and we get to know eachother. We found out that we will be doing concept maps instead of careplans for this rotation. Our preceptor is also a teacher at a diploma program. A concept map is basically a visual careplan that you can draw, color, or whatever. Fine with me. The nurses on the new floor are nice and they were excited to meet us. The patients on the floor are very sick. Many of the rooms double as hospice rooms and it has a very sad feeling to it. The exception is the outpatient room which is actually on the floor. I dont' know why they would want to have an outpatient area (where patients get chemo) on the same unit as hospice - that seems really eerie and inappropriate to me??!! There is also a notable difference in presence of clergy on this floor. I never saw any on our last floor; I saw two on this floor within the first hour.

So, to continue the previous rant, clinical ended and we started to leave when the driver realized that not only should we have gotten the ticket validated, but we needed to at least bring it IN the hospital because you actually pay for parking before you leave the building. She went to get the ticket and brought it in. We put it into the automated machine. It cost more than three times the daily rate. So everyone is forking over the cash, but I forked over less. I refused to pay the difference between how much it *should* have cost us and how much it actually cost us. Not to be the difficult one, but I don't have money to waste, and when she decided (on her own) that we didn't need to pay the daily rate, as far as I'm concerned she took responsibility for the difference in cost. Then, we got back to the car and started giving her the gas money. Earlier this week I said we should meet for second and figure out how much we should pay to whoever was driving. Again, no one thought we needed to do that. So last night when it's time to fork over the money, everyone is paying five or ten bucks. Now, this is not a problem, but I at least need to know if this is just for today, or for tomorrow, too? Why is this so hard to discuss? People probably want me to just roll with the flow. I hear that all the time. But that's not the kind of budget I'm on. You can tell me how much you expect per week, or I can make the decision for you and you will just get what I give you, but I must know how much to plan for.

In essence, I hate group dynamics. Also, as I get to know folks, I think a lot of people are here because they didn't want to work yet. For example, people are getting their THIRD master's degrees in succession. Hmmm. You're 30+ and you've yet to have a real job? Or people who have an undergrad in one thing, a master's in something else, did the peace corps for two years, taught for one year, and now they're doing this and they aren't even 30 yet??!! What's really going on? And when I hear them talking about their undergrad and grad loans from previous programs, and I remember what schools they're coming from (all Ivies), I can't help but add that up...and I realize that they are adding yet another $100,000 in loans to the loans they already racked up in undergrad and previous grad school...we're talking $200,000 easily. That's a lot of money. But it ain't my business.

Odds and Ends (again)

I don't know if I ever mentioned it, but I passed the 2nd med surg exam; there are only two left in the semester! I have an exam every week for the next 5 weeks (excluding Thanksgiving), starting this week with Pharmacology. I'm up to my elbows in flash cards.

We got our new clinical rotations. I'm at a hospital in a different city, and I'm not at all excited about the commute. I have been assigned to the cardiology floor, Thursday and Friday evenings, with a very laid back preceptor. I'm glad I am going from a tough preceptor to an easier preceptor and not the other way around, like the group we're switching with! My old preceptor will be expecting so much from them and I hear (my neighbor was in this group) that they just haven't had the experiences to gain the skills. And this is precisely why I kept my first preceptor despite others telling me to run; it is always better to be prepared, than to take the easy route and not know as much as you could know. Yeah, it was a long six weeks, but we all survived - and we can write careplans like nobody's business! Oh, and all the shows I thought I'd miss on Thursday night (Grey's Anatomy and Ugly Betty) can be seen at abc.com in full, without commercials, isn't that awesome?!

In other news, I found yet another coffee shop I like. It's a chocolate bar, and since I like hot chocolate more than I like coffee, it's the best coffee shop I've been to! I won't be able to study there though because it's a hot spot for nursing students, and no studying ever gets done.

I went to a Halloween party at the Medical dorms. It was crazy, lots of costumes, lots of dirinking. I didn't wear a costume, but when got there I thought it was interesting that at least 3 people (white people) had costumes that included big black afros (like Beyonce from the Gold Member video, and another a rapper complete with fro, pick and bling, etc), and another 3 or 4 were obiously wearing costumes of black people without afros (Run of RunDMC complete with track suit, gold link chain, and black hat, rastifarians with black dreads and rainbow hats, etc.) All I could think was thank god they didn't come black-faced. That would have really done me in. So, of course I ended up thinking about this as I was people-watching at the party, and it gave me an idea. I wore some black pants and a black casual it jacket with a shirt underneath to the party since I didn't wear a costume. But I also wore some white Pumba-ish tennis shoes because I was going for comfort, not cuteness. So, I started telling people I was ELLEN DEGENERES for Halloween, just to see their reaction. Ellen always dresses something like her doll. Little black suit with tennis shoes. People got it, but they thought it was sooooo funny that I would come to a Halloween party as a white woman. They couldn't stop laughing! But nobody seemed to make the correlation to those dressed as black people. I don't know where I was going with this, except to ask "is there a difference?" There was something very weird about having my culture be portrayed as a Halloween costume. But then again, Hip Hop and rap belongs to a whole generation, not just my culture...it seemed weird (and a little inappropriate) for me to be a lesbian white woman for Halloween! I don't know, anyway, it's just a train of thought...

Clinical Week 6/Last Clinical of 1st Rotation

I survived my first clinical rotation! And it ended with a difficult patient...

My patient this week had a whole host issues - which was, of course, sad for him, but good for me because I actually started administering meds this week. (I passed the med math exam on the second try). He was on 23 different meds, so I got a lot of practice, including some injections (insulin and heparin) but his main issue was bilateral foot amputations. He was diabetic and had periperal vascular disease which resulted in his not being able to feel his toes. And because he is also blind, he could not see that his toes were black and blue. So, they had to cut off all of his toes a few months ago. Then, he went home and was bedridden, without proper home care, so his wounds from the amputations did not heal. In fact, his feet became necrotic (all the tissue died) ---> this is also sometimes called gangrene, and so he is now scheduled for both of his feet to be amputated at the ankle, or maybe even below the knee. I had to change his wound dressings, and this was no small feat because they were "packed" wounds. Packed wounds are like holes in the body that are stuffed with gauze and then wrapped. My job was to pull all of that gauze out, inspect the hole and clean it, then repack and wrap it. It is not something you ever want to see. But, what's worse is the smell. It is the smell of necrotic (rotting) flesh. If you ever smell it, you will NEVER, EVER forget it. My preceptor coached me through the whole thing, telling me to open my mouth to breath, but I couldn't because I just didn't want to taste that smell...if that makes sense? We were low to the floor at the foot of the bed when doing the dressing change, and she told me to actually get down on my knees (as she had done) as an attempt to stay steady and not fall back, away from the wound, which is what your body wants to do. She reminded me to take a second to look at the floor to keep from showing the patient all those rude faces one makes when a smell assaults your nostrils. It was also the first time I had to practice sterile technique, so it took a very long time to complete the task because the first time you do it, it's hard to maintain a sterile field!

If you want to see what I was looking at (or as close a picture I can find), click below. The differences were that my patient had no toes, and the wound was a little deeper/more of a hole.

Big picture
or Webpage (see middle picture)

A Happy Place

I went to one of my favorite sites for decoding medical abbreviations, thefreedictionary.com, and saw that on this day in 1958, the Smurfs were invented. Instantly, I remembered watching Saturday morning cartoons. It makes me smile inside to remember my childhood. It was great. Really great. Right now I realize that I'd love to go home and climb into my mother's bed and watch a little Discovery Channel.

Storing this moment into my mental happy place rolodex.

I Always Say

...I miss fat people. Well, I have the perfect example to illustrate why that is:

Last wednesday evening, I was studying for the 2nd med surg exam with my student mentor, who also happens to be the TA for the course. Her friend and roomate is the only big girl in their class of 60+. (I am the only big girl in my class of 80+) And let me just say, by "big" I mean "not skinny, and a little past thick," or for those of you who don't mind the term, FAT. Anyway, this big girl came over to us and was distraught. For real. Why? Because someone had the audacity to come up to her and her physical assessment partner and tell her partner that he shouldn't do his physical assessment (which included a breast exam) on her because the bigger the person is, the more time it takes to do the assessment, and if you don't finish the assessment in the allotted amount of time, you get docked points. And he was risking points by choosing her as a lab partner because she was big, and her breasts were big. (This all happened a few feet away from me)

Now. Ok. This is true, it takes a little more time to do an assessment on a fat person because (duh) there's fat covering their entire body. So, when you're feeling around the stomach for example, you gotta press harder, and sometimes you still don't feel what you're looking for. It is especially hard to palpate (feel) for the liver and bladder when someone has a lot of adipose tissue (fat) or sometimes hearing the heartbeat is a little harder because (duh) the stethoscope can be much farther away from the heart depending on the amount of fat or skin. But even with that, we're talking a significant amount of fat, which no one in this program is big enough for this to be the issue. It's the difference between doing a breast exam on a small breast and a large breast - there's more breast to assess, if that makes sense.

Regardless:

1. This is the most skewed cross-section of a population I've ever seen. There are more pre-pubescent body types in our class than in an issue of 17 magazine. So here we are doing all these practice exams on people with no body fat at all, when the US population more often has a little fat than not. People had better get used to touching/feeling fat people. The day when you simply pretend they didn't exist is long gone for you, future NP. Everyday you will be confronted with us, and I dare you to act like you don't want to touch my skin.

2. Who the hell are you to walk up to two people who aren't even talking to you and voice your idiotic opinion to make some one feel inferior? Yes, I know we have the cute little saying that no one can make you feel inferior with out your consent, but I'm here to tell you, words hurt even the strong and the brave, sometimes. Hell, my feelings were hurt, and she wasn't even talking to me. Just from one fat girl to another.

3. Why the hell are we being so competitive? It's a freaking POINT. Isn't the measly point worth getting hands-on experience with someone whose body type actually mimics the actual patient population?

4. It's a d-e-m-o-n-s-t-r-a-t-i-o-n, meaning, you aren't actually trying to find something wrong, you are simply trying to demonstrate that you know *how* to look for something, you aren't actually assessing whether the person has a S3 heart sound, just that you know *where* and *how* you would put the stethoscope to hear it. So, really, you aren't spending that many more seconds than anyone else.

Maybe people are wondering why this matters so much to me. It matters because the lack of diverse body types is sometimes isolating in itself. But to have someone actually think they can actually walk up and comment on your weight/size/shape is especially troubling. I know we spend a lot of time assessing health, so it's only natural to observe those right in front of you, but there has to be respect. Being fat (or black, or jewish or anything else) does not mean that you have the right to inspect, evaluate or *touch* yes, I said touch! me. And, if you do decide to interrupt my private conversation and make a a comment *about* me, please have the decency of saying it *to* me, instead of talking about me, right in front of me, as though I am invisible.

I wanted to say something to the girl who made this comment, but I can't fight other people's battles for them.

I wanted to post something else today. I am reading Alice Walker right now, and realize that something is about to change in me. But now, I don't have the time.

Observation Week

I did not have clinical this week. Instead, I had observations. Yesterday I went to the cath lab and saw an angioplasty and stents inserted. Today I went to GI and saw colonoscopies and EGDs. It was great couple of days away from clinical (but at this point almost anything would be a great day away from clinical).

Monday morning our class had a meeting with the director of our program that was supposed to be about our study abroad rotation in July, but ended up being a meeting about nothing. They simply weren't prepared for the meeting. They had no news to share about study abroad, and basically spent the whole meeting trying to convince us to stay in this god-forsaken city for our community health rotation - despite the fact that they didn't have a list of places we could possibly do this rotation in the city. So what exactly did they have? A sheet explaining how we could find our own rotation for this last clinical. Unacceptable. Why? Because two of the very strong selling points of this university were "global opportunities" and not having to "find your own clinical." And, at $45,000 for the year, I expect you to be prepared for every meeting that you call - and if you're not, say that, and then cancel the meeting. But I was pleased that I did not have to be the angry black woman and bring all of that up, one of the men in our class did a very good job being angry for all of us, speaking is mind and receiving a round of supportive clapping from the class that said "we agree with what he's saying to you, lady." Of course she handled it like a true politician, saying she understood our concerns and would really attempt to get right on it. Ha ha. My only comment was to ask for an agenda to be emailed the night before the meeting so that we would know what was to be discussed and could make a decision as to whether it was worth getting up 2 hours earlier to attend. She said "I appreciate your comment." I said, "That doesn't answer my question." She followed, "I will send out an email." Great.

In other news, I have my 2nd Med Surg Exam tomorrow morning. I'm not as worried about it as iwas the first because it's over diabetes and its complications, renal disease, and peripheral artery/venous disease - all of which I knew something about before coming here. That hasn't reduced the studying any, but it has reduced the frustration.

Odds and Ends 2 (or Three)

I spent the weekend tending to myself as much as possible (outside of a test review session on Saturday, studying for a couple hours each day, and a million freaking flashcards).

Friday, I skipped happy hour and went to a film festival at a museum to see a documentary. It was an excellent film about a family trying to move out of some housing projects into their own home. It really was excellent. It made me think about the mentality of poverty and how if you're only used to people taking advantage of you, how will you ever trust anyone enough to allow them to do something really positive for you, like help you buy a home. You're always looking for the catch. And usually there is one, but not always. It made me wonder how come more programs like the one featured in the film (home-ownership programs) were not being utilized if they cost less than public housing to run. In the back of mind I hear "conspiracy," but I am trying to not see it that way because that leaves a sinking hole in my stomach and that's the last kind of feeling I want to deal with right now. It's one of those "call to action" type things, and I just cannot be called to any other actions outside of nursing school right now!

I also finished last season's Desperate Housewives so that I was all caught up for last night's episode, and watched one of my new favs, "Brothers and Sisters." I should take a minute to talk about my disgust at the images of black men on Desperate Housewives last season, but I don't have the energy.

I also had a very interesting conversation with someone about judgement this weekend. Ever since I got here and have been vocal about not liking a local specialty food mart (ie; organic, health mart) people have taken that as license to discuss what they perceive my eating habits to be. This ticks me off beyond belief. So now it's all about Kool-Aid jokes (one of the items I mentioned I couldn't get at said specialty mart) and how me and my husband are gonna die of diabetes (a recent lecture was on diabetes and DKA) NO KIDDING, someone actually said this to me. Needless to say, I went off. I had been keeping my mouth shut because I didn't want to be defensive about it, but once you think you can tell me when and how me and my husband are going to die, all bets are off. So, I got on my soapbox. Is this how you're going to talk to your patients? If so, say goodbye to continuity of care because I guarantee you they aren't coming back to your office. How do you know what my health outcome is before you've even asked ONE question? How do you know that my Kool-Aid isn't sweetened with Equal or Splenda? How do you know that 2 quarts lasts me a week and a half? We have to be very careful about making a diagnosis about someone just by looking at them! "Well, it's also genetic, so since you're dad has it, so will you." Careful, careful, I do believe that in order for me to aquire a disease *genetically* I must be *genetically* related to the person...I am not *genetically* related to my "dad" (because he's my stepdad) and if you had of taken the time to ASK me ONE question, you might have known that, and thereby been able to keep from putting your foot in your mouth! So, that's what the hell I'm dealing with in my classmates.

Like I've said a million times, I miss fat people. Brown people. Poor people. I hope they all contract Ecoli from their lettuce and spinanch. LOL Nah, I'm just kidding, but I do hope they learn to be less judgemental...

Week 4/ Day 2

Nuthin but s-h-i-t. All day. My patient was incontinent, with diarrhea. Can you imagine? It started even before my day technically started. I walked into the room to find him laying there, covered. Bedding covered. Everything covered. And the smell. Grown man strong. The smell. God, the smell. Three times I had to leave the room as I silently gagged. And it just happened over and over again allllllll day long. Now I swear the smell is coming out of my pores. I smell s-h-i-t all up in my nostrils. I wasn't prepared. I didn't have anything to sniff to hold my gag reflex at bay. No strong cinnamon gum to chew. Nothing.

I think this means I'm officially a student nurse?

Clinical Week 4, Day 1

First of all, YEP, I failed the biomed exam. Nuff said.

Now, today started clinical week 4. Guess what my patient said?

"Yeah, I like you too, but I want that other girl."

I think I smiled in clinical today for the first time ever. Why? Because *I* am "that other girl." His nurse and I were both in his room, but he can only see shadows of figures and ironically his nurse for the day also happened to be black. So as shadows of figures we look the same, but our voices, of course, are different. So when he asked for someone she stepped forward first to see what he needed and he started talking, but when she responded he said "oh, no I thought you were the other girl." And of course she laughed and made some funny comment about not feeling loved anymore (she's great and new and still happy and fresh as a RN) and that's when he gave her the consolation line before turning to follow my voice. You can't imagine. Here he is 80+ years old, been in the hospital for over two weeks for a heartattack because he's homeless and we can't find a nursing home placement. His girlfriend ended up in another hospital right after he came to ours, and they have been evicted from their apartment in the mean time, but he doesn't know that yet. All day he swears it's 1966...must've been a good year for him. None of his daughters visit because he has a history of violence driven by alcoholism. He apparently tried to kill their mother. Oh, and of course he, too, was restrained. Why do I always get the restrained ones? Anyway, I took his restraints off today because he wasn't threatenting to me, but it's always different at night. Patients who are combative usually become that way at night. He also is in chronic pain because of his gout and is used to numbing his pain with alcohol and percocet(oxycodone), but in the hospital he only gets Tylenol. But believe it or not they have given him beer at the hospital the first few days to help his withdrawal! (I'm shocked by this) But whatever, all that matters was that I didn't kick and scream all the way thru clinical today and that my shave, homemade heating pads, and thorough cleansing of his dentures gave me a leg up. Finally.

AND, the patient I took care of last week is still on the floor. Remember he couldn't speak and I had to ask a million questions so I could do a big careplan. Well I went to visit him and his wife and he was truly happy to see me. With his voicebox in working order again, he said "where were you? I've been looking for you." And he actually told me some of the things I had joked about. His wife had told me he had a wicked sense of humor, so I had made lots of jokes while I was giving him his bath - things like how great it must feel to have two women washing you from head to toe, and how I didn't care for his favorite topic (he is an American History PhD) because I didn't think history had been to kind to people like me and what's up with that? etc. So he finally got to talk and tell me about his life. Interesting. Anyway, my clinical day just got better and better with every word.

Then my preceptor told us we can lighten our careplans now which means less work and fewer hours! (This mainly means we only have to do 3 diagnosis for each patient instead of 5, with 4 interventions for each diagnosis instead of 6, and we only have to report abnormal labs instead of ALL labs.) I know it doesn't seem like a lot, but believe me, that's at least an hour less than we normally spend.

What a great day. Not even an F in biomed could bring me down off this high.

The Embarrassment of Ignorance

I don't know how I did on biomed yet, but the class average is below failing. (He gave us the average but no specific grades until tomorrow) People still swear they didn't have a hard time with the test. When I finished the exam I said how hard I thought it was, but most other students said they didn't think it was too bad - even though word around campus at that time was that it didn't go so well. (TAs get the scores before we do and they start the general buzz about whether it was good or bad) So what we have here is people who are unwilling to admit that they find the material difficult. The problem with this is that it makes it seem as though only one or two people have a problem - which means those one or two people should take time out of their already impossible schedule to go visit the professor on their own time, when, in fact, the class as a whole doesn't understand what's going on and therefore the material should be explained in a different way...or something.

Then, I failed the med math exam, too. Yep, I'm just failing all over the place. And, of course, everyone says they think they did well - nevermind the fact that you get your score right after you finish the exam! You should know how you did. But anyway, so I am expecting to go to the math office for my remediation tutoring and have plenty of one on one help. Ha! Instead I find at least 20 people in the damn hallway- and this is 15 minutes before the tutoring sessions even began! But everyone did so well.

It's one thing to BS your way through plot summarization in lit class, but it's a whole different world to attempt to BS your way through nursing school. You can't fake it. If you give someone the wrong med, the wrong dose, or at the wrong time you could actually kill someone, ie: K+. Potassium is what we use to kill people on death row by lethal injection. How the hell do you gloss over the fact that you don't know how to properly administer that? Is it really that embarrassing to not know all the answers? Do type A people base their self worth on how much they know, are they really that competitive? I used to think I was a Type A, but now I don't think so. I took the test and I came out 44. I guess I'm neither, which seems right. I am embarrassed by ignorance only if it seems like something I really should know. But I am not embarrassed to not get it on the first try, and I don't think anyone should be. How does one learn anything if they swear they already know everything?

Clinical Week 3/Exams

I got honors on the first Pharm exam, but I think I failed the first Biomed exam. But word around the school is that everyone failed it, so I don't feel bad.

Clinic for Week 3:

I pretty much broke down. I swear I hate clinical. It was my week to do a full interview (5 pages of questions) to complete a "big" careplan (more detailed than the usual weekly one) and my preceptor assigned me to a patient that could not speak. (Laryngectomy with disfunctional voice prosthetic due to anesthesia). He also had no gag reflex, but no one had checked that before assigning him to a "normal" diet. So he was eating his french toast and sausage , which wasn't really going down, but he was so numb he didn't know it wasn't going down, and I noticed him choking. I came over just in time to catch every ounce of puke he threw up. French toast, sausage, orange juice, and coffee. Eww. Then I gagged and almost lost it. All of this tunred into my first full bed bath, which I was dreading.

In other news, I am wondering about how midwifery fits into the nursing model. I am going to have to do some reading about this, because the fit doesn't seem to be a good one so far...

Transcending Race

I keep forgetting to talk about this, so now it’s like a nagging email that I keep forgetting to respond to. Since I’m trying to clear my inbox/mental space, I’m doing it now. A few posts ago…ok, a lot of posts ago…I mentioned that one of my friends told me that she had “stopped seeing color” and had “gotten over it.”

I don’t know what to say to that, except for “good for you…I guess.” I can understand one transcending, or rising above, their own negative, stress-inducing response to racial inequality. I can understand not limiting one’s friends based on some perceived notion of racial solidarity. I can even intellectually understand the “it doesn’t matter because it doesn’t really physically exist” theory (aka: the “there are more differences between two people of the same race than there are between two people of different races” theory). And if that were all she was talking about, this post would not exist. But her comment was in response to my excitement about the presence of minorities in my class, and my even greater excitement that we actually speak to each other.

I haven’t gotten over race, and I don’t know that I want to. Does getting over it mean that I no longer have to pay attention to it? Does it mean that, because my socioeconomic status will probably approach the upper-middle class mark, I no longer have to worry about or think about what it is like for poor people? Yep, I know that poor people ≠ black people, but we cannot separate race and class in this country, so just follow me. If I’ve transcended race, does that mean that I am no longer impacted by the reality and gravity of the issue for everyone else? In all fairness to her, I’m sure she’d say “No, of course not. It just means that you don’t spend every waking moment of your life thinking about it anymore.” I can dig that. I mean, really, when I wake up I’m usually thinking “for real?” anyway. But, what I cannot imagine is not evaluating my life, thinking critically about the state of this country, or trying to explain to my family what college is like for me, without the lens of race. So many of my everyday experiences are influenced by race. Maybe people will ask, “Why is that the case for you, but not your friend (or anyone else for that matter)?” I don’t know exactly. Maybe she evaluates her life through the lens of “woman” and while she has somehow transcended race, she still wonders if she would make more if she were a man, or if she would have been invited to speak at that conference or have a better chance at being dean of the professional school. Maybe she has so many other “desirable” characteristics (long straight hair, thinness, light skin) that she hasn’t felt the full effect of what it is to be defined by her blackness. Or, maybe she has, and just doesn’t give a damn.

But here’s one thing that does matter:

There is a grave inequality in level of, expectation for, and success in EDUCATION. This inequality leads to a disproportionately high number of poor minorities in this country. (duh) But it also negatively impacts my experiences (and non minority students) while earning my education.

What she actually said was “You’ll learn to get over it.” I hope not. And if I do, may it only be because racial diversity in programs like mine has increased so much that we are no longer surprised to see one another.

Labs, Labs, Labs

Today was a day full of labs. We practiced sterile glove technique, inserted folley catheters for practice, and learned all about IV procedures. All day long. How come people never believe you when tell them you need a certain size? Like when you swear you wear a size 18 and they insist on giving you a 14 to try. Or, like today, when I swore I needed large gloves and everybody else said oh just use medium, you'll be just fine. Hmmm. Ok. HELLO, my first oatient was HepC+, I know what size gloves I freakin wear! And it ain't medium. Do I look like I wear a medium anything? I haven't worn a medium anything since probably grade school. Give me the friggin large gloves, please.

Weekend Thoughts

I'm glad the pharm exam is over. Just to have the first one out of the way is nice. I am now studying for biomed which I went to a review session for today. The review session was helpful, but probably would have been more helpful if I had of read before hand, but where's the time. Last night my normal happy hour group went out for our routine Friday evening happy hour, but about 15 more nursing students ended up joing us. Did I mention we went yesterday, too? Lot's of drinking going on. One of my dearest friends (optometry student) started drinking more when she started her program, and now I understand why. There's so much tension, there's gotta be a release. At least the drinks are only $2.50 and there's free food to soak it all up. That, and we can walk to our place if need be. Once a week can't hurt!

We are going to finally furnish our apartment this week. Ikea here we come! I think I am going to try to do something fun and post a before and after of our living room makeover. I've always wanted to do this! I love HGTV design shows!

I remember that I was suppsed to tell you about Week 2 clinical:

Week two was better than week one in some ways, mainly because I had women patients, and I found them much easier to deal with. On the other had, I also had two patients this week because my first patient went home the first evening, which gave me a new patient for day 2 of this week. This was a huge headache. Twice the work. And, I got called out to give report (basically you sum up a whole careplan in 5 minutes or less) and I had only known the patient for a few hours. But I'm glad I got it over with and I don't have to do it again for at least 6 weeks. This weeks patients both had triple bypass surgeries and heart valve replacements. I learned a lot about the heart this week, including that you can live without a tricuspid valve! (The tricuspid valve separates the right side of the heart into a right atrium and right ventricle).
I did get somewhat frustrated with one of my patients' insistence on calling blacks people "colored" and her mixed nieces and nephews "mulattos." Sometimes you just have to look 'em dead in the eye and say, "for real?" And then they say "no offense." Well, if you must add no offense after it...it's probably offensive.

PHARM Exam Tomorrow

I gotta cram...

The One Question Blues

I missed a HP by one question. That's always the worst. I guess it's better than failing it alltogether, which a few people did. I feel sorry for those people because the lowest score was only about 4 questions from a P. I do feel relieved to have passed the test, but missing the grade you wanted by one question sucks!

Anyway, last night's potluck was AMAZING. The 3rd year students welcomed us by performing crazy, funny skits about their clinical experiences and our professors. Then the professors presented the 2nd year student with handquilted bags welcoming them to the midwifery specialty. (The first year is RN training and has very little to do with midwifery) Then, those 2nd year students read a letter that they had written to us, the pre-midwifery 1st year students, welcoming us to the program and presented us with artistic folders they had created for us full of poetry, personal letters from the classes before us, artwork of pregnant women, and a CD of empowering music. Then the alcohol started flowing and we had such a wonderful time, eating, laughing, and getting to know one another. Didn't that make you all warm inside? LOL And I learned that my professors are CRAZY. I think it's the menopause kicking in (they're all there, or past it) and it's great to be around older women who have lost the need to be anyone other than themselves!

I got a positive response from my first careplan (last week) which was phenomenal. I'll tell you about this week's clinical tomorrow when it wraps up.

The First Med Surg Exam

75 NCLEX-style questions. Please realize that when one actually takes the NCLEX exam, there is a strong possibility that they will finish the exam after 75 questions. The NCLEX is the national test taken by RN canidates to prove their knowledge, and upon passing it, you receive your RN licensure. All that to say, the questions were hard. They say we don't have grades (that's another story for another post) and so you just have to "Pass" it. I guess we'll receive some grade sheet in our mailboxes today that tells us whether we passed or failed. I don't expect to fail, and I dont' want to be suprised. But there were a lot of questions that I didn't know the answer to. I was able to reduce the 4 possible answers down to 2, but after that I was still guessing. At any rate, it's over now and the outcome is unchangable. Thanks to N (my HBCU grad neighbor friend) I was able to go home for lunch and take a nap before having to come back to school.

Now I have 2 whole days to cram for PHARM. It's really not my style to cram, but I really had to study for Med Surg - to the neglect of studying for Pharm. Here's the thing: I only have two classes on which my fall semester's grade will be based - Med Surg & Anatomy. So my whole "GPA" depends on Med Surg (Anatomy is going to be an easy pass - the tests are take home). in order to qualify for some of the scholarships i want to apply to, I need a "High Pass" (HP) in Med Surg. I will also want a HP in Pharm, but that grade isn't given until next semester, so it's less important. And, they drop the lowest test score, I hear. I hope this plan doesn't backfire on me.

I also have to find something to take the Midwifery potluck tonight, go get my patient assignment from the hospital for tomorrow's clinical, and ...GASP...do a careplan tonight. Uggh.

A Week Ago...

I could tell you what day it was, what I had for dinner the night before, and what my husband said five minutes before. Today, I couldn't do any of that. See the guy on the left? That's what I feel like. Tired. I wake up not remembering that I went to sleep, feeling like it's time for bed. In my sleep, I dream med surg. Hypokalemia, hyperkalemia, aldosterone, ADH, Lasix and the list goes on and on and on. Tuesday was my first day of clinical. I'll tell you about it in a minute. But Tuesday night was hell night. Hell night is the night you write your first care plan. It takes you hours. HOURS. And then when (if) you finally go to bed, you have to wake up at 5:30 am to start clinical all over again. I can't explain to you how hard it is to write a careplan when you've never written one before. But here's a web example: careplan
Apparently all schools do not require this level of depth, but mine does. Our careplans also have background info about the patient, including every single drug he or she is on - including the class (type) the drug belongs to, the signs and syptoms of use, the adverse effects expected, and the rationale for why he or she is on the drug. It would also include all the lab info about the patient (what tests he/she had done, why, and what the results were). And it's even more complicated because at this point in our education we usually have to look up every single abbreviation, and we don't know anything about drugs. Makes for a long night.

Anyway, I survived it, and even lived to tell about it. I have to do it all over again this week, and every week for the next ten months, but I hear it gets a lot easier as you start to learn / memorize everything.

As far as clinical goes: I hated it. I am not a med surg kind of girl. Too many men. Point me to a cervix owner. Washing "her" is like washing myself. But washing "him" is foreign. The guys in our program needed additional info about the whole "never wash from back to front" thing, and now I understand their pain. My first patient was in for a lobectomy. That is, he had part of his lung removed. 1 pack per day x 34 years = LUNG CANCER. Please stop smoking people. He was very combative. He had just been treated for tongue cancer. He was less than 50 years old, and both of his parents had died of cancer. He had no insurance and no medicare. All of that equals COMBATIVE. But I understand. What paralyzed me though, was opening the chart and seeing "Hep C positive." I was trying to maintain my composure, but all I was thinking was "God, get me the hell away from here." Everywhere I looked there were only small and medium gloves. I need a large or extra large. Everything moved in slow motion from that moment forward. If you ever get stuck with an HIV needle, there are anaphylactic drugs. If you come across Hep C, you're screwed. So here I am trying not to be an ass, remembering that Hep C is not airborne. Intellectually, I am going through the precautions in my head and being very careful physically (with gloves). But emotionally, internally I am f-r-e-a-k-i-n-g- o-u-t. So med surg just isn't my thing. Honestly, I rather eat a pot of beans, and anybody who knows me knows just how much I hate beans.

But I digress (slightly). Right now, for most of the night, and all of tomorrow too, I am going to study. My first med surg exam is Monday. Of course I am freaking out.

I rarely answer my phone anymore, and I don't return the calls I ignore. But I *am* homesick. Homesick for fat people. People who eat meat. People with nappy hair. People who know me. But if I don't call you, or you call me and I don't answer, don't take it personally. Right now you would have to have given birth to me for me to answer the phone...or have been born to the same woman who gave birth to me. Otherwise, I'll call you Tuesday. Or Wednesday. Maybe.

Remembering What I Came Here For

Tomorrow I'm going to a welcome potluck for new midwifery students.

Finally.

The midwifery students at my school are a very, very close knit group. Since there are over 80 people in my direct entry class (the class is composed of all the specialties) it will be nice to finally break off in to our smaller group. The potluck is hosted by the second and third year students specifically to welcome us, and the email sent to us said that they were here to "help us remember what we came here for." I think this is such an important concept for midwifery students in a medical nursing program because we do spend a lot of time in the hospital, which may or may not be a setting we value as much as other nurses might. We value multiple settings for childbirth. We value education, but also non-academic experience. We are eager to learn from other types of midwives, and have lessons on things not necessarily available in a textbook, and I think that makes us slightly unique. But, that is not to say that my classmates in other specialties (ie: oncology, geriatrics, etc.) are not holistic thinkers or interested in alternative methods of solving a problem. But as a group that struggles with which "kind" of practitioner we want to be - even within the role of CNM, I think it's imperative to get out of and away from the school sometimes to remember that midwifery is a diverse profession with many entry routes, and choosing this specific route does not mean any more or less than choosing another - which is kind of hard to remember when spending every waking minute and hour in an ivory tower. I also think it is surprising to some people that there are many CNM students who weren't all that interested in nursing, generally. Some students see the RN licensure period as simply a stepping stone - a necessary step in becoming the kind of midwife they have decided to become - which basically means that some people in the program are spending a whole year learning a lot of things that they don't necessarily find interesting. And that's hard.

OMG

This is an unbelieveable shitload of work. (sorry mama) But, for real, it's un-godly. I was as prepared as I could be before I came here, but this is mentally exhausting. I am trying to think of a way to explain to you all what the work load is like, but it's confusing. People have asked me what a typical day is like, but there are no typical days. As soon as you think you've gotten a routine down, it changes, and that's really hard for an organized, logically thinking person to get used to.

Just as soon as you think you've learned even the smallest nugget of information, you realize you don't know anything about it. So far I have learned (or, more acurately, been taught) the "nursing process," basic assessment, holistic nursing care, fluid & electrolyte balance (you would not believe how much there is to know about this, and it was all cramed into a two-lecture series), more than I ever, ever, ever wanted to know about the heart (with yet another lecture to come), edema, edema, and more edema and guess what. I learned all that in only 4 lectures of MED SURG class. There are 3 more classes that I could rattle off equally long lists for. (Pharmacology, Biomed, and Anatomy/Physiology) All that in 7 days of class. Not to mention the hands-on stuff we learn daily (blood pressures, temps, pulses, bed baths, restraints, how to make those darn "hospital corners." Did you just click on that link? Did you see how somebody turned making a bed into a damn 50-step process? Welcome to nursing school. All of a sudden, people who were perfectly capable of taking someone's temperature are completely clueless because someone turned that simple procedure into a 20 step process. So now you have a room full of A-type personalities and make them absolutely neurotic with details. (and did I mention we all have at least one degree? which means that we already think we should know how to do everything, lol) I also learned that my med surg (BTW, this is pronounced "med-Surge") teacher writes NCLEX questions. Everyone let out a collective "ohhhh" today because now we understand why her questions are so damn hard.

Added to the list of unbelievables is that I start clinical in less than a week. On a cardiac floor. I pray they don't let me anywhere near a patient.

Clinical Placement/Med Math

I missed the revolution. 3 of my good brown friends got the same clinical rotation! I don't know how that happened. But anyway, I got a tough preceptor...so far I have been told "She's tough, you'll learn a ton." and "Try to switch now before it starts." LOL. I'm keeping her (not that I have a choice, no one wants to switch with me). The brown girls got our actual lecture teacher as their clinical preceptor (the same woman I was raving about at the end of the last post). They will work on a general trauma floor. Their plus is *consistency*. I have been assigned to a cardiothoracic floor (people coming from heart surgery or similar). My plus is getting to know a new personality type. It's a plus. It's a plus. It's a plus. By the end of the day I'll believe it.

Oh: A preceptor is the nursing student's clinical teacher. So, when I am in clinical (on the hospital floor) she checks all my work and gives me the Pass/Fail grades. Also, I follow her around to see how to do what I have to do. Or something like that.

In other news, I just survived 1.5 hours of MED MATH. Gosh, there's a lot to know. Too many conversions. Too many formulas. Pure confusion. And what's the consequence of making a mistake...hmmm...probably DEATH. How's that for math anxiety?

Nursing school, ya gotta love it.

I Saw Dead People

I survived the first week of nursing school!

Of course, the week has started all over again and here I am studying. Sleepy, groggy, wanting to climb into bed again. I love this cartoon because it's so true. Toward the end of the day, say at about 2, I am so sleepy and ready to go home that I have a hard time concentrating. But when I get home, in my own bed, I sometimes cannot get to sleep for the life of me!

But anyway, the first week - especially the fluid balance lecture day, was tough. Lots and lots of never-studied-before science for me. Luckily, my teacher is a force of nature. She runs, screams, jumps, and curses like a sailor! It really helps keep us up and motivated. A&P, drama aside, is going to be a piece of cake lecture-wise. However, the cadaver lab is something to be reckoned with. Man! I have a hard time looking at dead people. I did manage to stay for the whole lab (with two exits for a deep breath), but I never managed to touch them. At least the smell of formaldyhyde is practically NON-EXISTENT in the new state of the art, pricey medical school building. Nevermind that the nursing school is practically a bunker.