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.

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.

A Special Welcome

I am officially blogging again after taking a break to move to my new city, and I want to give a special welcome to my family and friends who will start reading my blog now! I am going to continue using this blog to help other minority (and non-minority) nursing hopefuls with their nursing school/grad-nursing school process, but also to keep my family updated on my life all the way over "here."

Following in the footsteps of thirddegreenurse, who's blog is listed at the right, I am going to use a specific color for nursing/nursing school related info. This is so that people who are not interested in my clinical experiences (ie: how many adult diapers I had to change, vomit I had to wipe up today, etc) can skip over that medical mumbo-jumbo!

But anyway, my life this week has been hectic! Monday thru Wednesday, my orientation lasted from about 8am to 5pm. Man those were some long days, especially a 4-hour technology boot camp, and a 3-hour orientation to my first nursing class, MED SURG (medical-surgical nursing). Today we were "free" to go get a million and one things done, including:

immunization check-offs
books
HIPPA training (online)
bloodborne disease training (online)
clinical practice training (online)
IDs
registration forms signed after meeting our advisor for the year
and getting started with our blackboard modules (all classes have online components, other students will know what I'm talking about, but basically you online and print everything you need for the class - HASSLE)

Me and N have been very proactive and already have some of this done!

I also have to do some paperwork so my husband can get an ID so he can start using the services offered by the university, too!

Not to mention I already have tons of reading to do, but that's my life for the next 11 months.

My schedule for now thru December looks something like this:

Mondays: class from 8am to 3pm
Tuesdays: Clinical shift (clinical means go to the hospital and practice nursing)
Wednesdays: Clinical shift
Thursdays: class from 8 am to 3 pm
Fridays: class and clinicals, but only "sometimes" YEAH, we'll see.

I also have a workstudy job, but I don't know the schedule for that yet!

Again, welcome family and friends, and WELCOME BACK to my blogger friends who might (hopefully??) have missed me!

THANK YOU Girls Incorporated!

Girls Inc. has awarded me a $3,000 scholarship! I had no idea how or where I was going to get books for the semester, and I am really tired of sitting on a metal fold up chair in my living room, especially since we haven't gotten the bed yet. It'll be nice to have something soft to sit on. I also had no idea where we'd get more money for groceries. I am (of course) going to spread the money over three semesters, but even $1000 is enough to do what I need to do for now.

And for those of you who don't know, Girls Inc is a non-profit organization dedicated to helping girls from all different backgrounds become "strong, smart, and bold." I personally was a member of Girls Inc from age 6 to age 18. They introduced me to many things: the arts (opera, ballet, theater), exracurricular science programs, hygeine, ettiquette, and cooking classes, tutoring, computer classes, and the list goes on and on. Plus, undergraduate scholarships. People have their own ideas about the girls a place like Girls Inc serves, but I have always, always, ALWAYS been an advocate, and I will continue to do so.

Thanks again, Girls Inc. For everything.

A Longer Update

Ok, so here's a better update:

1. The apartment. It's not in the best condition, it's old. And it's one of those paint jobs where they just slather layer after layer after layer of heavy paint over e-v-e-r-y-t-h-i-n-g. The door knobs are all hanging on by a thread and a couple outlets don't work! BUT, it is very spacious. We have a studio, but it has a dining room and a dressing room...and a basement. I know, weird, huh? A basement in an apartment, and it's the size of the entire apartment! I love the space. There's nothing in it. We need furniture. But anyway, the neighborhood is good, it's on campus. It's a 30 minute walk to downtown, and we walk there all the time. The walk back sucks because it's up hill.

2. My neighbors. They're awesome. On my left there's C&M, a 3-years married couple in which the wife is white and the husband is mexican. Last night we had dinner at their place - tacos. OMG they were good! C (the wife) is in my program, her husband is looking for a job and wants to start an accelerated BSN program in the spring. On our right there's N&A, a 5-years married black couple. N (the wife) is in Family Health (one year ahead of me) and A is 2nd year law. Both graduated from an HBCU. It was heaven to see brown people, and they felt the same. We ate dinner over their house Sunday night (chinese) and played Spades! I love my neighbors. There are A LOT of kids in these apartments and a playground between each building, but it's a great thing!

3. The city. Man we need a car. Everything is far. You can't walk to a grocery store (thank god for peapod.com) or a shopping center (ie Walmart, Target, Ikea). Everything around the school is specialized. So, if you want shoes, you gotta go to a shoe store. If you want a sandwich, you gotta go to a deli. There's no "getting it all in one place." People are stuck on Tradder Joe's...it took me three days to get to a real grocery store! It's quaint. We al can imagine what the school looks like (I mean how different is one ivy from the next?) but the city is definitely black. It's amazing how if you step one blcok off the school grounds, the atmosphere changes drastically. And sad, too.

4. Us. He has been offered a job already but he didn't take it because it was not the best, or even a good, offer. He has another interview tomorrow. Wish us luck. I am ready for school to start and my house to be furnished. I received one box of books and that helped.

Thats it for now, I'm using the neighbor's computer!

The Shortest of Updates

We're here. It was a long trip. Our apartment is O.K. - a little rggedy, but very spacious! This is definitely not a place where you can can get by without a car! We will have to get one very, very soon. I have met two other girls in my class, one in my program, and the other in Family Health - both neighbors on either side of me! I've lost a few pounds, walking in the heat. I've gotten almost everything I need, and been reassured that my non-Littman, non-expensive stthoscope is just fine by someone who is a RN. What a relief! There's a lot going on (of course) and I have a lot to say, but for now, I will just say I'm glad I came two weeks before school started!

Short Break

Today is my last day of work.
It feels unbelievably good.

Two weeks of packing are ahead of me, and I think I will need every day of it.

I will be offline for the next two weeks.

The next time I post I will have made it to my new school in a new city!

A nice bed and food in the kitchen,

that's what my desire for our new home has dwindled down to.

Taking my husband into consideration, I'll add "and a big tv."

I want to simplify. I am thinking of giving away most of my little library. I really shouldn't be hauling all of these books with me, and I haven't figured out how I would anyway. What are the chances that I will read them again? How many of the clothes in my closet do I actually wear? And how many of the shoes? How many plates, cups, glasses and bowls do two people really need? Why do we have 8 place settings? I've never had a table big enough to seat 8 people. How many bath towels are too many? Some of it is inherited, my grandmother is the ultimate domestic. But I also think I've become a slave to American consumerism, and it's bothering me. Would I want red walls if I didn't spend so much time at Target or watching HGTV? Why can't I wear a uniform - blue jeans and a white tshirt - every single day? If I knew, for an absolute fact, that no one was going to visit me for an entire year, would I care if my towels matched my shower curtain or if my sheets matched my comforter?

Probably not. Why do I still care, despite the fact that the only people who will ever be staying at my house are the people who already know me intimately anyway? Part of it is that I'm trying to create "home." A sense of permanency that we have never had since getting married. I want to have a sanctuary to come home to at the end of the day, and that includes walls that don't look like institutional walls. Ok. That's all fine and good, paint fixes that. But what about this other stuff? How much does it have to cost me before I feel like I'm home? Can I really feel like I'm at home in a home without books? Why isn't home wherever me and my husband are? Why isn't home anchored inside of me?

My husband has his belongings down to one suitcase. One damn suitcase?! Why can't I do that? I am going to do that. I am giving myself ONE SUITCASE for my belongings.

I'm letting go of the clutter.

I will embrace simplicity, and hopefully gain some clarity along the way.

GradPLUS is a bust.

Remember when I was all excited about the new federal loan program for grad students? Go here to jog your memory: http://minoritynursingstudent.blogspot.com/2006/02/important-news.html

I was denied this federal loan. Supposedly as long as you had no bankruptcies or school loans in default, you were eligible (per final email before applying today) but this is not the case. I don't know what the requirements are, as there are many different "facts" out there, and they all say something different. So, there it is.

It's been a long, emotional day. I'm tired and I'm frustrated. Someone asked me why don't I just go to medical school today. My answer was "why don't you." My usual default answer is "because I do not believe in the medical model for pregnancy and childbirth" but today I didn't have the patience, nor am I in the mood.

I want to climb into a bed with real quilts and down pillows in a freezing cold room with the windows open.

I seriously want to cut off all my hair, but I'm resisting the urge.

Ramblings

School News: I ordered the required background check from the required company. The first charge was $20. Good enough. But, then I get an email saying that another $42 has been charged to my account because I had multiple addresses in multiple states and counties listed. I hope I'm not going to have to pay for each and every address I have lived at for the last ten years...that would be disastrous. Why is everything always more expensive than it's supposed to be?

New site: http://shapeofamother.blogspot.com/ This site is about how pregnancy changes the body, physically. Women post photos of their bodies with the hopes that these realistic pictures will help other women realize the beauty of their bodies, or at least the normality if they can't yet come to appreciate it as beauty. Gazing at stretch marks, love handles, and an amazing amount of skin for the last hour made me feel feel unusually good about my own body, even if it isn't post-pregnancy weight that made me this way. Well worth the visit.

Food: It's been going well. No sugar, but some whole grains. Scale still moving in my favor, and I'm very very close to my 3-months-ago weight. Feels good.

Update: It's confirmed, my friend is pregnant. (see post "Mean and Other Things") I don't know what to say or do. Do I stop by and offer my support (phone is disconnected)? Seems invasive, not respectful of her space. Do I write her a letter? Seems impersonal, especially for how close we are(don't be fooled by her secrecy about this pregnancy, we usually are very close, and now I know why we haven't been talking). I don't know what to do, any advice?

Mean and Other things

So Mean.

I have this reputation, but I think people with limited vocabularies don’t really mean it…they just don’t know what else to call it. I’ve been called a “serious” person also…I think that’s more accurate. But anyway, in the meantime, I’ve been thinking about where this came from.

We’re all in our mid-late twenties (my friends and family I spend most of my time with). It’s the men who always say that I am so mean. Well, I think one issue is that they all have very young girlfriends. Why does this matter? They aren’t women yet. They never say what they really feel, they act as though they don’t have any intelligent thoughts of their own. Therefore, in a group setting, I am the only outspoken female. That, and the fact that I have less tact than they like – nevermind the fact that the men in our group setting never ever monitor, adjust or otherwise censor what they say- makes me "mean."

Second, I hold people personally accountable for their lives. I can’t help it. If you don’t want to think about anything other than Playstation, pop culture, and bikini models, we aren’t going to have much to talk about. But, what this means is that I don’t last very long in group settings; I get bored fast. And so occasionally I ask a tough question…something like “are you looking for a job?” Man, so hard, I know.

The bottom line? I say what I want among a roomful of ego-filled men, and I don’t apologize for it and I don't pretend to like everybody. Really, I have a hard time having a beer with someone who slapped his girlfriend last night. Call me mean, but hell no I don't want to go bowling with you.

Anyway.

Last night I learned that a very, very good friend of mine might be pregnant again. I saw her not too long ago and she looked pregnant, but I dismissed it as gained weight - even though she had the pregnancy-mask face. But then my mom asked me about it, and I truthfully answered that I didn't think so. Then she asked me about it again. I said I have no idea. Yesterday, my cousin came over and said "I saw your friend at work today - you didn't tell me she was having another baby!" I said, "I don't think she is." He said "Oh yes! she is. It's obvious. She's wobbling."

Then everything started to add up. She's been incognito. For months. She didn't come to my graduation party. At the time I didn't think much of it because NONE of my friends came. (A whole 'nother post that will probably never be published, but simply put - it hurt and it sucked) But now I am realizing that she has not followed through with anything we have planned in the last few months. I haven't physically seen her for an extended period of time for over 4 months. She doesn't take my calls, but again -my other friends had stopped taking my calls too, so I just figured everybody was into their own stuff (which happens sometimes). But then there was this; my mom went to her house to visit her, and she only poked her head around the door (body hidden), she didn't let my mom in, which is very, very strange. So, now I think it might be true. What's the point? This is her 5th child. She's a good mother, but times are hard for us working poor. She doesn't have help. She's trying to do the honorable thing and raise her children without assistance form the government. But I can't imagine how this will be possible with a new little one, and only making minimum wage. I admire her tenacity.

I wish I could help her. I wish she would answer my calls. Eventually I will just show up at her house to talk to her. But how ackward. She obviously doesn't want anyone to know, but it kills me to know that she might be dealing with this without any support whatsoever. But exactly how supportive can I be, leaving in less than a month?

Wikipedia meme

I got this from Karen's blog:

http://chialing81.blogspot.com/2006_06_01_chialing81_archive.html

"Go to Wikipedia http://en.wikipedia.org/wiki/Main_Page
and look up your birthday (excluding the year). List three neat facts, two births, and one death in your journal, including the year."

Neat facts:
1873 - Censorship: The U.S. Congress enacts the Comstock Law, making it illegal to send any "obscene, lewd, or lascivious" books through the mail.

1923 - TIME magazine is published for the first time.

1991 - An amateur video captures the beating of Rodney King by Los Angeles police officers.

Births:
1962 - Jackie Joyner-Kersee, American athlete

1981 - Lil' Flip, American rapper

Death:
1937 - Amelia Earhart, American pilot (disappeared)

Tomorrow's post will be my reaction to "You so damn mean." I am giving myself a day to think about it bcecause otherwise it would be a post full of obscenities because I am so tired of hearing this...especially from black men.

4 weeks from now

I’ll be home – hopefully, both physically and mentally. I’m hoping our new city hits the spot and becomes a place we can stand to live for at least ten years. I am tired of packing, moving, and unpacking. I want red walls, wood floors, and black and white photographs on my walls. I want to cook in my own kitchen.

If you’ve been keeping up, you’ll remember my Sugar post. Well, the day after that, I gave it up. I still use sugar substitutes, and I still get plenty of sugar by eating whole fruit, but that’s it. For those of you who have never tried it, that cuts out a lot of food. Especially since I no longer eat refined carbs like white bread, flour, etc. I eat plenty of complex carbs though, and I will eat whole grain bread when I want to. Oh, and I don’t eat after 7 or 8. I found a neat little website that keeps track of everything for me: www.calorie-count.com and so far it’s going better than expected. Also, I have been walking but lately it’s been a very muggy, humid 100 degrees and walking outside is just out of the question.

Anyway, I have a school update:

I received my registration packet, and man was it thick. I had a few new tasks to do, including going online to register for (and pay for) a criminal background check, online loan entrance counseling and new promissory notes, and voter registration. Our orientation is a week long, but includes things like HIPPA training, immunization clinics, and IT seminars to designed to get our PDAs up and running. There is also a lab coat/school patch ceremony, which I think is great. There are also some built in family-friendly activities each day, including the first meeting for spouses of nursing students. I wonder if he’ll go for it.

My guess is no.

First Tuition Bill

I got my first tuition bill in the mail today. I owe $1,087.50 for the fall semester, which is more than I expected. Tuition went up more than $500 per semester, big suprise. I emailed my husband to tell him the news and he said "It isn't that bad, really." I needed to hear that. I swear, every time we manage to save over $1,000, we get a hit like this which makes us start all over again. It could be worse, I could be staring at the bill with absolutely no clue as to how I am going to pay it. It feels good to be able to pay in full and not have to make arrangements like I'm used to having to do - even if it means we're almost back to zero in savings.

I haven't been sleeping well, worried about it all. The man will have to find a job that pays what we need within 30 days so that the money will be there when we need it 60 days after arriving. I have never moved with so little saved. I am trying to tell myself "what a great adventure," but all that comes to mind is "two months away from homelessness." It's a lesson in faith, and I hope I pass.

Book List

I fell in love with this over at maryann's blog: www.thisblackgirlreads.org and I am stealing the idea (in part) by creating a list of ten books I would like to read by the end of the year! The books are listed on the lower right side of my blog.

I read a lot, but inconsistently and very narrowly. So, I am going to get some help with suggestions for the last few so that I can broaden my horizons...

Someone Else's Children

I spent a couple days last week braiding 2 of my little cousins' hair. My cousin has four children, and her brother and his wife were visiting with their two children. Over the course of the couple of days I teased the adults about all of their kids that filled the 2 bedroom apartment. Most of the time I was tired of the noise. But other times, I was filled with an overwhelming desire to go home to my husband and make babies. If only it were that simple. Don't get me wrong, we have the act of making babies down to a pleasurable, magnificent science. But it's the conceiving that hasn't worked for us over the last 6 years. We fluctuate between wanting and not wanting to have children. The wanting is what came first, but after some years, we realized that not having children is also working pretty well for us. We get to spend a lot of time together and do a lot of things people with children either do not have the opportunity to do, or can not do without a lot of planning. But I know we're missing out something, too. Even through all the screaming and turned over cups of red Kool-Aid, there was a sense of family that is a little harder to grasp when there are only two of us. So I sat there, feeling lonely despite the fact that I was surrounded by family and feeling a little empty for not being a part of the "mommy club." But then my father called, and I remembered...

Sugar

I'm addicted to it. I admit it. I've been thinking about this 25 pounds I need to lose, and my plan to lose it before school offically starts in September, but it seems unlikely as I can not stop eating sugar. I don't like to be conquered by anything, so this is really starting to bug me.

Losing My Mind

Not even five minutes ago, the eternal question resurfaced: Why *Ivy1*? I am so sick of the bullshit. I am just going to be ornery and answer "Why not?" from now on. Why in the hell is it so hard to understand? I have all of these wonderful, non-defensive answers worked out now (because I have been asked so many times) but at this point I just want to say "because I want to, and that's enough." What is wrong with people? Why must I be mediocre? And when I say mediocre, I am not comparing myself to people who don't want to go to the schools I aspired to go to, I am only comparing myself to myself. Why should I not push myself to my fullest potential? I know, and they know, that I have always wanted to be in a place where I fit in intellectually, where people don't ask silly shit like "why are you reading?" or "are you going to spend all day in the library/book store?" or "when is enough school going to be enough?" or "what does that have to do with your degree?" like the only knowledge I should attempt to acquire is that which is directly related to one freaking degree. Are you kidding me? Some people learn just for the sake of learning. Some people read simply because they can, and it feels good. Some people write because they can't not write. I am one of those people, and I can't wait to sit in a room full of other people who feel the same way. Not people who feel the same way I do about everything in life - hell, it's better when smart people disagree because that's when real discussion happens. But I can't wait to be in a room full of people who don't consider critical thinking to be abnormal. People who are pissed that the library is closing right when the article was getting good, or when they finally found the book they wanted to browse only to find out that it must remain in the library. I want to have coffee with thinkers on a regular basis, and I don't want to spend too many hours of my life trying to coordinate it. Yes, you can call me at 4 in the morning to say "I can't stop thinking about what Cosey said, did you get it?" or "I can't sleep, can u believe what professor X said in class today?" Yeah, I might ask "What time is it?" but I will talk about the topic at hand just the same, and be thankful that you gave me something new to think about.

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.

Vacationing in St. Louis

I spent a week in St. Louis for vacation, dishing it up with cousins who are like sisters to me. This photo, however, is an imposter! I didn't take any pictures over the week. We did attempt to go to the top of the arch, but we never made it up because the lines were too long. But I did touch it, if that means anything. LOL. I had a great time doing everything and nothing all at the same time. Lots of drinking and lots of riding around seeing the sites (happy hour was a staple of our diet!) We also went to Union Station, which I thought was beautiful - especially when compared to East St. Louis...

My cousins live in the burbs, as they are well-educated, young folks who have had their fill of the hoodlife - especially since they're raising children. But they took me to the east side and, like all other similar hoods in our country, it was unbelievably discouraging. Pointing out the clinics, dead hospitals, and Planned Parenthood's along the way (because that's my thing - and theirs too) it was hard to keep in mind that the buildings I saw were actually functioning dwellings. Don't get me wrong, I've seen it before...Chicago and DC come to mind...but the bars, the trash, and the neglect never become normal. It always catches you off guard, like "where are we?" even if only 1 second later you remember that you are in the United States of America. It forced me to reevaluate my coping mechanisms. I have been thinking about/writing about how I will cope with continually being in the position of helping people in the most impoverished parts of our country without losing my joy, when each and everyone one of them will remind me of myself. There is some joy in the helping, but there is also pain and the pain is what kept us from staying too long in that part of town, and why the car gets quiet when we pass through row after row of the 'jects. It is because we all know that but by the grace of God we were granted the state of mind to climb out of, or alltogether avoid, the mentality of powerlessness and victimization that was constantly forced down our throats.

UNO Dean Slaps Student...

and GETS AWAY WITH IT. There is so much I could say, but I recently posted what I think about my undergrad institution in the post titled "Article Published in the School Newspaper." No one is suprised that he hasn't been (and won't be) fired. This is the way this campus works. What I can say is, at this point, I recommend that the student go and slap the shit out this man, since there will be no consequence for the action anyway, right? People will say more violence will not help the situation. I say, if the authorities do not give you the justice you deserve, weigh the consequences, then get it for yourself.

Reading Like Hell

I have been reading anything I can get my hands on, including bell hooks. At different times in my life I have tried reading her work but haven't been able to stay focused long enough to digest anything. For me, she is like Toni Morrison, unavailable, without devoting a serious amount of time to the task of reading her. But the other day I spent almost 8 hours in a bookstore thumbing through several of her books. For those of you who don't know, a lot of her chapters can stand alone, so I often look through the table of contents, pick an interesting chapter title, and dive in. This time, I picked up Where We Stand: Class Matters. I don't know how I feel about the fact that I found this book extremely accessible just yet, but I do know that I had been waiting for something that I could relate to that talks about what it is to come from a class different than the one they eventually settle into as an adult, and about what it is to come from lower-middle class America and survive in ivy academia. I had been thinking about what my experiecnes might be like when the time comes (if it ever comes) for us to buy a home. Will people take one glance at my cornrowed husband and declare that the house has been sold?

My recent devouring of so much text has also reminded me of my own committment to writing. I had already accepted that I have a story worth telling, but I have only begun to accept that not only am I the only one who can tell it, but that I actually have the skills to do it. Being confident in those skills is a double edged sword; Accepting that I can do it, makes me feel obligated to do it, and I hate feeling obligated.

Puerto Ricans say...

"Aint we American?"

I saw Rosie Perez on The View this morning and she said that while Puerto Ricans can be drafted to the American Army (because they're Americans, as Puerto Rico is a U.S. territory) they can't vote. The fact that they can't vote wasn't news to me...but the fact that they *can* be drafted pissed me off. I also hear that this is true of citizens of DC?? I am scrambling to find out the answer to this...

Studying for the Waiver Exam

I have received the syllabus for the A&P class offered at my new school so that I can study to test out of the class. It seems pretty straightforward, and I feel like I should be able to test out of the class. I really want to test out so that I can have at least a little free time to spend with my husband my first semester. I am worried that I am moving him to a new state without any friends or family nearby and that he's going to be all alone while I'm studying 24/7...

Right now I'm setting up a study schedule based on the syllabus and committing to set study times for the next 2 months. I am also gathering the resources I used over the past year in A&P. So that's how I'm going to study.

Anyway. I've been having an interesting ongoing conversation with a friend of mine about going into private practice as a midwife vs. working for a hospital. I am pretty sure that I will work for a hospital, which she, rightfully, calls punching someone's clock. But what's more interesting to me is that I have no desire to have the full responsibility of owning my own practice, even though I obviously have an autonomous mind. (Midwives have great autonomy and personal responsibility, whether they "punch a clock" or not.) I cite not wanting to be on call every hour of my life for the next 20 years as one of the reasons to not go into private practice and I think it's a legitimate concern. But at the back of my mind I can't help but think that I might also be lazy and insecure in my ability to own my own practice, which really, really bugs me...

Spanish or Africa?

I can't decide. I will be studying abroad at some point during my graduate career, and I must choose between working in a spanish-immersion type of environment, or in some part, probably South, Africa. I have been learning French for most of my life, and have never taken a Spanish course. However, I do realize the absolute necessity of learning Spanish as a health care professional. I will take some Spanish courses, but I know from personal experience (and my undergraduate linguistics focus) that immersionis the best way for me to really learn a language. This is why I am considering the Spanish option.

But...I have been wanting to go to Africa for a while now - especially a french-speaking area. The reasons are varied: It seems Africa, as large as the continent is, is forgotten in this world. I really want to go to a place where I can look into the faces of the people and see myself. Yes, I have been able to do this with many different cultures, but I just have a feeling that this will be different...I also want to go to a place where dark is beautiful and big is, too.

Do I choose Spanish, which will be a little more useful long term, or Africa which will also be useful, but also self serving?

Progress...

is hard to come by. A few posts ago I mentioned what I had done in preparation for school, and the dent that it has made in my (and my hubby's) wallet. Today I started thinking about what I have left to do...which isn't unusual because it's all I am able to think about lately. It's probably the reason I ended up totaling my step-dad's car. Sigh.

I still need a PDA, stethoscope, nursing shoes for clinical and, hopefully, a laptop.
I still need to take the American Heart Association's BLS course.
I have three scholarships to apply for. (One is ready for mailing, hooray for small achievements)
I have an apartment's worth of belongings to sort and reduce down to 4 suitcases, each 50lbs or less, and a maximum of three boxes for mailing.

I feel like I'm forgetting something. But it's better forgotten for right now.