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...
Monday, October 30, 2006
Wednesday, October 25, 2006
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)
Monday, October 23, 2006
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.
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.
Wednesday, October 18, 2006
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.
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.
Monday, October 16, 2006
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...
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...
Wednesday, October 11, 2006
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?
I think this means I'm officially a student nurse?
Tuesday, October 10, 2006
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.
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.
Monday, October 09, 2006
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?
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?
Saturday, October 07, 2006
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...
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.
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.
Tuesday, October 03, 2006
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.
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