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.

I Couldn't Even Finish

I failed the A&P test miserably. In fact, I didn't even allow myself to see the score, I just completely exited from the test. There was no need to finish because I was on question 60 (Of 87) and had only answered 10 questions-and all of those were 1-pointers! And the test just kept getting harder and harder. (I read the whole thing - in awe - just to make sure there weren't any that I knew floating around at the end)

I can't believe I'm headed right back to A&P. So many hours of my life wasted last year. What kind of education did I really get? I got decent grades in this course (a B for fall semester and a C+ for spring semester) but couldn't even begin to crack this test. 19 credit hours. I took 19 damn credit hours to fit A&P into my fall schedule. Do you know how hard that was? Apparently not hard enough.

In all fairness to my agonizing soul, the test was *incredibly* hard. I think most people made this an open note, open book test because it was online and to be taken in the privacy of your own home. I know the girl sitting next to me did. "Just use the book," she said. I could've and passed it easily, but there's that nagging matter of integrity. But are there ever moments when one gets off her internal high horse and takes the low road? Was it really worth me spending FOUR HOURS every Friday of the next three and a half months in a class I already took for a whole year? I had doubts about my ability to do the work before I got here (because I know the inadequacy of my math and science public education) but it's different when you actually begin the work. It messes you up psychologically.

So, today I experienced my first (surely over-exaggerated) catastrophe, and I am asking myself, "Are you gonna go home and cry, or open your med surg book and read for tomorrow's lecture?"

First Day of School

It is *finally* over.

It has been the longest day ever. I called a shuttle at 7am for a ride to school, and from 8 to 3:45pm I was in class, with the exception of a 30 minute break for lunch.

If you'd like to understand how busy I'll be, imagine this:

In a "normal" BSN (Bachelor of Science in Nursing) program (4 years long), a student will clock 800 hours of clinical.

In less than one year, we will clock 700 hours.

So to all those people who think we aren't really getting the experience we will need, I say "get over it." We're doing everything you're doing, just in fewer hours and a shorter amount of time. It's terribly hard, but that's what I signed up for.

The last two hours of my class was actually a panel discussion given by all the living deans of my school. Pretty neat, although heavy in history.

I also learned that according to a yearly GALLUP poll, NURSING has been *THE* (as in #1)most trusted profession every year since the second year they started the ranking. Only once have we tied for first, and that was in 2001 (ie. the year of the WTC) where we tied with firefighters! I can't think of anyone else I'd rather tie with.

Gotta take a nap.

Campus Climate

I want to say a little bit about the campus climate as I see it so far (within the school of nursing). In one word: COMMUNITY. It's a beautiful thing. Now, I understand that this is the honeymoon period, and it's highly likely that if you ask me about my school a month from now I will probably scream that I hate it here and I just want to come home, but right now it's awesome and I want to have some written record of how awesome I think it is, so that later when I ask myself "why are you paying $70,000 to this place?" I will remember!

1st things First: DIVERSITY! It exists! After visiting the school earlier this year and meeting with the students of color who were currently enrolled at the school, I was a little worried because there was NOT much diversity and the few students that were here were the "only one" in their specialty (ie: the only one in Midwifery, or the only one in Oncology) which isn't good because after this first year we aren't all together anymore - we're only with other students in our specialty. So, imagine my suprise to see so many students of color! There are about 100 entering students, and of that 100, probably 15 are underrepresented minority (Black, African, Native-American, and Latino) including a black male and two Native American women, which I think is very impressive when you consider there are only a hundred of us. And if you add the Asian-American students (who don't seem to be underrepresented) the number increases by probably 10. And BONUS: one of our new associate deans is a Black woman! Can you tell I'm excited? In a later post I am going to address one of my friend's ideas that she has somehow transcended race at her predominately white institution, and that all of the issues that plagued her in the beginning are no longer an issue because she simply "no longer sees color." Can't wait to talk about it!

Second: All students are on a first name basis with faculty and staff. Many times it was emphasized that faculty and staff were to be addressed by their first names, which is not easy to do when you're not accustomed to it. But I love the idea of it. Imagine walking around the school addressing the director of your program by her nickname (as in my case). It changes the whole tone of the academic environment. I just hope that the exceptions to the rule (aren't there always exceptions?) make themselves clear, and soon!

Third: My student mentor is great! Every new student is assigned a student mentor from the year before her, usually within the same specialty. I happened to get a student that is raved about by the administration and other students.

Fourth: The clinical+research+teaching focus is heaven for me. I have had this "you simply can't do it all" conversation with a couple of seasoned nurses, and it hasn't been a very positive experience because they say you can't teach and research and practice at the same time. But here, they seem to have figured it out, and it's a big deal. The PLUS is that we are actually taught by the people who are actually doing the research (not always the case at Research I institutions) and our clinical instructors also currently practice in the field. The CON is that our professors are really, really busy and you must adhere to the office hours to get in contact with them, AND class can be cancelled without any notice (in the case of midwifery).

So there it is. At midterm time, remind me that I love this place!

Getting Started

As it turns out, I have to take the Anatomy and Physiology waiver exam. After spending a whole year at UNO in A&P, I am dreading having to take yet another semester of it. All students are required to "drop in" on the A&P class throughout the semester, but those who are required to take the waiver exam and do not pass it, will be graded. Those who pass the waiver exam will simply audit. Of course, I want to audit. So I have one week to review a whole year of A&P. (Eww) I have to take the test by Friday, I need a 74 to pass. (We don't have letter grades, woo hoo!) I'll let you know how it goes.

Today I stood outside and waited 40 minutes for a shuttle. A shuttle that was never going to come because the shuttles don't run on the weekends. Of course I called before I walked to the shuttle stop, and they (the transportation office) told me that the shuttles DO run on the weekends, so I would have never known. But, contrary to this experience, my school actually has a very good transportation system...any time the shuttles aren't running, you can simply call and have an escort (ie: campus van) come pick you up and take you where you need to go! So five minutes after I contacted the transportation office, my own little shuttle arrived to take me to school this morning.