Wednesday, October 24, 2007

Always Look On the Bright Side of Life

Last year my classmates and I kept hearing about how third semester was the most difficult semester in nursing school. "Difficult", we snorted. Nursing school is already difficult. I can't imagine it being more difficult than it is now.

I'm reminded of the stoning scene in Monty Python's Life of Brian. The dialogue went something like this.....

OFFICIAL: You're only making it worse for yourself!
MATTHIAS: Making it worse?! How could it be worse?! Jehovah! Jehovah! Jehovah!

Matthias has no idea what he was talking about. It can ALWAYS get worse. If you ask how it could be worse, you will find out soon enough.

I haven't been blogging much because this semster has been a special kind of hell. I'm doing okay but I feel like I'm treading water most of the time. Last year I settled into a routine quickly, got myself organized early on and stayed that way the rest of the year. This year has been completely different. I constantly lose/misplace things. I forget assignments. I'm scrambling to do things at the last minute. There are people who function well this way. I'm not that person.

I will spend the rest of the day in front of my computer working on some assignments with serious deadlines. Since I'm here anyway I thought I'd sneak in and vent a little.

Don't you find it annoying when people ask the same question over and over? If you happen to have the name of a famous person; say your name is James Bond. Don't you get sick and tired of people saying "hey double oh seven"?

Being in the medical field means you are endowed with information that most people don't have. Since you have this knowledge people continually ask questions, and often it is the same question over and over again. Or they repeat some really bad piece of information. For example when people talk about something that runs in the family, like twins or cancer of some kind. Sooner or later that person will say "but it skips a generation." Yesterday I heard someone refer to a really limber person as "double jointed." Aaaaaaaargh!

I am struggling to not get annoyed by it. I'll get there eventually, but today I'm annoyed and I felt like getting it off my chest. I found this discussion a while back. Reading it made me feel not so alone.

This past week I heard a couple of whoppers that I just can't shake. I was talking to a patient about my career goals. I mentioned that I like the OR because the atmosphere is laid back and sort of fun. She said "well if I'm the one having surgery I would insist that everyone in there refrain from having any conversations while I'm asleep because it would affect my healing." I'm sorry. I couldn't help laughing. I know I should have kept my composure and used it as a teachable moment. I could have said that the media blows things out of proportion by telling stories about people saying nasty things about patients while they are under anesthesia. I'm sure it happens, but believe me when I tell you that you aren't interesting enough for us to talk about. I could have told her that most people in the OR are professional enough not to do that even if there was something interesting about you that we want to comment on. Just like there are no rules about farting in the OR, no one does it because it's not polite. The same is true of saying unkind things about unconscious patients who are under our care. We could do it, but we would look really foolish if we did.

But I was tired and not in my right mind. Certainly the medical field could use more compassion and practice some alternative healing methods, but not this day and age of managed care hassles. Go ahead and tell an OR full of people who will be on their feet all day, working on one case after another, that you would like for them to be quiet because of some freaky New Age belief you have. Go on. I dare you. I think I managed to say "I'm sorry but I disagree." Nevertheless I'm sure I alienated her for life. She's a dialysis patient so I see her on a fairly regular basis. My bad.

Then last week while I was in ER clinicals a patient got angry with me about her blood pressure reading. She said "There has to be something wrong with that blood pressure cuff. My diastolic is always the same as my IQ."

This time I was better. I blinked a time or two, made sure there was a pregnant pause and said "I'm speechless."

What a jerk! First of all she was trying to dazzle me with the fact that she knows what a diastolic blood pressure is. Second, she was trying to dazzle me with what she feels is a high IQ. I wanted to tell her that if her diastolic were to reach what some might consider a decent IQ, she'd probably better get herself to the ICU because she would fixin' to have a stroke.

People! I swear!

I don't want to get into how the health care system has brought us to the point that we have to interact with mentally unstable folks on a regular basis because they have nowhere else to go. I don't want to talk about how we could, if things were better, take time to grant the patient's every wish and do things exactly as they want them done; at least not today. For now I am taking my cranky self off the Internet to work on my clinical log and power point presentation.

Hopefully when I return I'll have adjusted my attitude and have a brighter outlook. Until then....

Life's a piece of shit, when you look at it.

Thursday, October 18, 2007

That Smell

I wasn't sure how much longer I could go without discussing the scatological. I suppose that it was inevitable that the subject would come up eventually.

One of the most important things a nurse does is take care of a patient's basic needs - oxygen, temperature control, food, fluids, safety, pain management and elimination. The last one weirds out students and potential students. Many a nursing student has learned to his or her horror that we have to manage poop.

When we learn basic care, it was a shock to us all that we had to evaluate poop. That means we had to look at it and notice the color, size, consistency and, yep, the odor. We have to be able to tell if the odor is normal or if there might possibly be blood or infection in there.

I have to admit I wasn't sure how I would hold up under the unpleasantness myself.
And really it's not a big deal. I got over it when I had to do stool cultures on a patient, and to make it more interesting she was given a laxative that morning. I was in her poo every 15 minutes for the rest of the day. After that many excursions there really isn't any room left for feeling disgusted. It became as normal to me as doing just about any other kind of work.

Having cleaned up lots of poop over time, I began to see things more from the patient's perspective. If I were to put myself in their place, and someday I just might be there, I think I would be very grateful to have someone willing to clean me up and put me back together with a smile. I would appreciate knowing that my normal bodily function is not a source of disgust, but accepted as a normal human function. When I clean up a mishap, I try my best to make keep my facial expression neutral, get a conversation going about anything other than what is happening, and contain the aftermath quickly to keep the smell down. I know that given the choice, they would rather I not have to do that for them. But since I do, I try and make it better for both of us.

The question I hear frequently is "do you ever get used to the smell?" The answer is yes you do. Just like you get used to an unpleasant part of any job, whether it's lousy coffee, a tempermental copier, office politics or micromanaging bosses, you adapt to dealing with the smell. Some people suggest putting Vick's or a piece of gum in a surgical mask and covering your face with it before dealing with poop. My best advice is to let yourself get through it. After a couple of whiffs you don't notice it so much anymore.

Given the choice I'd rather deal with bad smells than I would a chatty co-worker who wants to share every detail of his life from the time we said goodbye yesterday until he showed up this morning; from what he had for dinner, to what he watched on television to the dead squirrel he saw on the way to work. At least the former is over rather quickly if you can manage it well.

Just please remember to wash your hands before you leave the room.

Monday, October 15, 2007

The Fire Down Below

I love nursing school. You get to have some of the best conversations on topics that are completely taboo other places.

The topic last week was cancer. The instructor was talking about how chemotherapy works on rapidly-dividing cells including cells that line the GI tract, skin cells and hair follicles. Because of that, as most people are aware, a person who gets chemotherapy loses her hair. What most people don't know is that patients lose ALL their hair including eyebrows, eyelashes and pubic hair. Nobody blinked. We're used to hearing information about woo-woos and wee-wees by now. We've seen lots of naked people and had our hands in poop too many times to count.

The kicker was what she said next. She told of a woman who lost her pubic hair and then had trouble controlling the direction of her urine. She said that every time she peed she got it all over the toilet seat now that she didn't have her pubic hair there to direct it to the right place. I saw many female heads turn to each other and mouth "what the........"

During break I talked to some of the women whom I saw squirming when they heard the pubic hair story. What I found was that a very large number of women in my class have a grooming practice that was unheard of when I was in my 20s. Many young woman shave their pubic hair. Not only do they shave but they can direct their urine to the toilet just fine.

I'm not talking about the sideburn-variety bikini wax that was common in my younger years. They shave further and more completely than anything I'd heard of before. Until recently I thought shaving pubic hair meant shaving it all. No, I'm talking about what is known as a Brazilian. Shaving the whole thing to make you look 6 years old again is called a Sphinx, and from what I've been told is fairly uncommon outside the porn industry.

The knot of people gathered around the vending machine got other people curious to find out what all the fuss was, and I was able to do a rather scientific poll of the women, and men, about their attitudes toward shaving pubic hair. Of course, the men were enthusiastic fans of the practice. What I found was that the line between women who shave and women who don't is somewhere in women in their 40s. Everyone I polled said that there was no way their mothers would consider doing such a thing. I didn't get to ask any women in their 40s if they shave their pubic hair because, once they heard what we were talking about they scampered back into the class and said nothing. I won't talk about my shaving practices because I'm sure anyone who knows me doesn't care to know me that well. I will say that my daughter told me of this nifty electric shaver about the size of an electric toothbrush that saves me tons of money on getting waxed.

So why the difference? There is definitely a shift in opinion from one generation to the next, but why? Is it possible that the 40-somethings shave but don't talk about it, or they just don't shave and also don't want to talk about it? Could it be that swimwear has changed enough to make it necessary to shave more? Is it because the Internet has made pornography more accessible and women or imitating porn stars?

When I was a child we were given "the talk" in fifth grade about babies and feminine hygiene, but the message was loud and clear; it's dirty and nasty and you don't talk about it. You ignored your genitals and pretended you didn't have any. I grew up in the so-called "sexual revolution" but that just meant that your body was even more available to be exploited by men. There was Playboy and Penthouse, but that sent the message that your genitals are for the enjoyment of men, and not yours to touch or take care of. In other words, the sexual revolution was for men. Women were still expected to keep those genitals locked away in a secret place until marriage. Until then you pretended you didn't have any and you only spoke about it in euphemisms . After all, we had Barbie as our example. Everyone who has a Barbie has taken off her clothes, examined her stem to stern, and found a smooth, plastic mound where the genitals ought to be. Yep. If we are to be like Barbie we must imagine our genitals into non-existence.

Nowadays women are much more comfortable with their bodies. They are comfortable with the fact that they have genitals, and they don't exist just for the pleasure of men, but are a part of their bodies like noses, hands and feet. Shaving their pubic hair is just another part of their regular grooming, as normal to them as washing their hair and cutting their toenails. To me, the fact that they are paying attention to their pubic hair says that they value their bodies, their WHOLE bodies, enough to pay attention and take care of them.

I even found this discussion among some nurses when a patient asked a nurse to shave her pubic hair, and the nurse was just sure the woman was trying something sexual on her. I'll save the discussion about how lesbians are not men for another day. It's not all that uncommon for men to ask for certain hygiene assistance because it turns them on, but it's rare for a woman to do this, especially from another woman, and let me put a finer point on it by saying why would you even think this when both women in question are straight?

I mean, really. Who among us would ask another woman to do something sexual to us when we are lying on our backs, not having bathed for a few days, feeling stubbly and grungy, people are constantly walking in and out so there is no privacy, you are likely in a lot of pain and scared to death of losing some body parts? That is probably the least sexy scenario I could imagine. All the candlelight and soft music in the world can't cancel it out. I don't care who you are.

Friday, October 12, 2007

I Keep Working My Way Back To You

Sorry folks. Life has kept me away from my blog this week, and I'm trying my level best to not be cranky. My SO had shoulder surgery, the fourth surgery since January, and I've been playing nurse in my personal life. It's been very time consuming, and while I don't mind doing it, it has taken me away from doing other things.

Then yesterday I had a meeting to go to at my job. As I was leaving the building at 6:00 p.m., my boss stopped me and told me I had to get recertified in water treatment (I'll explain later). Long story short, I ended up staying until 8:00 p.m. last night. It would have been nice if I had a head's up that this was happening. I would have eaten dinner BEFORE I went to the meeting.

So instead my SO and I raced to get dinner before everything closed, snarfed down our food, and now I have a tummy ache today. Today and tomorrow are my two busiest days of the week, sort of the beginning of a horrible gauntlet, and going into these two days tired before I start, does not bode well for how I'm going to feel on Sunday.

Anyway, on Sunday I'll come back and share a conversation I had with my classmates about pubic hair. I've been cogitating on the topic for days, and it's really driving me nuts that I can't get back to my computer and finish it.

Oh, I am no longer license pending. I got word yesterday that I passed my board exam and I am now a nurse.

*bowing deeply*

I have to think of a new blog name. I'm not feeling especially creative so I have no idea what to call myself.

Tuesday, October 9, 2007

Lay Down All Thoughts, Surrender To the Void

I took the LVN board exam yesterday. Here are some observations made during my experience.

1. It helps to drive to the testing center some time before the test to you know exactly where you're going.

2. Taking a dry run to the testing center doesn't help if you don't get up early enough.

3. Everyone who has a white car drives really slow in the fast lane. As I was racing to the testing center every idiot that was driving slowly in the left lane and wouldn't let me pass was driving a white car.

4. I hate white cars.

5. If you react to stress by getting a case of the trots, take some over-the-counter medication for diarrhea.

6. Taking the anti-diarrheal medication after you get to the testing center doesn't help.

7. When you take the test, you will not recognize about 75% of the information as having anything to do with what you've studied.

8. No amount of studying in the world will prepare you for this.

9. When you freak out about not understanding 75% of the test, you will not notice that there is a calculator button in the lower right corner of the test screen, and you will do all the math by hand.

10. When you stop at the convenience store to buy a pack of smokes to self-medicate following your disappointing testing experience, the clerk will humor you and ask to see your ID.

Saturday, October 6, 2007

Wake Me Up When September Ends

Holy smokes, I saw somebody die today.

I was working at my dialysis job and things happened so fast that I can't remember what made me realize something was wrong. Next thing I knew a few of us were standing around a patient shaking him, calling his name and getting no response. His eyes were wide open, mouth gaping open and he was having agonal respirations. I felt his neck for a pulse and felt nothing.

The nurse brought the crash cart and had the foresight to tell someone to put privacy screens around the chair so the other patients couldn't see what was going on. The clinic I work in has three rows of five chairs about two feet apart. Everyone can see everything that's going on.

The downside of working in dialysis is that death is frequent. It's different from other specialities because we have long-term relationships with our patients. We see them three times a week for years, sometimes decades. When someone dies it's a terrible loss for us and we grieve every time. In the hospital, especially in the ER, there isn't time to get to know someone, and if you do become acquainted with them, it's for a shorter time. That's not to say it's not difficult. Death is always sad for health care workers. For dialysis professionals it's different. These people are like our family.

We're not the only ones affected. The other patients are affected too. Whenever someone dies a wave of fear goes through the clinic. Patients with end-stage renal disease are very, very ill and usually in a long, downhill slide. They never know when they'll reach the bottom. It's especially bad if a youngish patient in seemingly fair health dies without warning. They are terrified that they might be next. Having a patient die in the chair next to them is even more horrific.

This is the first time someone has coded while I was in the clinic. I cannot imagine what the other patients were going through while this guy was coding. I applaud the nurse for putting up the privacy screen. Even though it didn't completely block the sights, and none of the sounds, anything to soften the effect was worthwhile.

When it was over my adrenaline was pumping. I understand now why people are drawn to working trauma care. It was an unbelievable high. That's something I didn't know about myself.

Later on I learned that they managed to revive the patient in the ER, but he coded twice more. Even though he was alive last I heard, I don't think he'll survive for long, and if he does he'll probably be on life support until someone makes the decision to withdraw it.

It's funny that after more than a year of nursing school, I'm just now really getting into the thick of it. For all the times I wondered if a career in nursing was the best choice for me, on days like today I have no doubt. I definitely made the right decision.

Friday, October 5, 2007

Watch Out Boy, She'll Chew You Up

It's that time of year again. There's a chill in the air, restless creatures are stirring and ghouls with murderous fangs and dangerous claws are lurking in the shadows.

Yes, it's time to start nursing school clinicals.

Nurses have this ugly reputation that has an even uglier slogan - "THEY EAT THEIR YOUNG".

Many's the time I've been warned by nurses that once I get my first nursing job, I have to watch out for the older, more experienced nurses. I've heard they are mean, nasty, unsupportive and bitchy.

You know, it doesn't sound all that different from any place I've ever worked.

Still, I wish those nurses would cut it out. They're scaring the nurslings who are still in school. Having been in clinicals for over a year now, I haven't found nurses to be all that scary. Most of the time the nurses are patient with me and enjoy teaching. That's not to say I haven't had my share of nurses who weren't very easy to get along with. From what I've seen, it's usually a personality quirk. Once in a while the nurse I'm working with and I don't get along all that well because our personalities clash. All of us can think of someone we don't like and we can't put a finger on why. We just don't like them, period. But I'm there to learn, not make friends. If the nurse and I like each other it's a bonus. It's not a requirement.

I try and put myself in her shoes. I think about how I would feel if I'm having an off day; the alarm didn't go off, the neighbors fought all night and I didn't sleep, I'm behind on my bills, the dog crapped on the floor in the middle of the night and I'm PMSing to hell and back. I get to work and here is an eager, fresh-faced nursing student brimming with enthusiams and ready to save the world. Not only do I have to struggle to put on a game face for my patients, I also have to manage a nursing student. I have to slow down and explain everything. I have to coordinate my care around what the student does. I have to figure out which patient would be the best choice for them to care for. Then I have to go behind the student and make sure they did what they were supposed to and be ready to step up and take over if they don't. Forgive me if I'm not all teddy bears and rainbows.

To make the experience better for everyone, we can do what we were taught from the time we were in grade school. Be nice. Be polite. Be helpful. Keep your snarky comments to yourself. Say please and thank you. And students, suck it up and do what you're there to do. Pay attention. Do what your instructor tells you to do. Learn.

And whatever you do, pull in your claws and give those fangs a rest. We've got work to do.

Wednesday, October 3, 2007

Are You Experienced?

Last week we took our exam on the topic of high risk OB. For a lot of people, including me, it is our worst subject. When I took the mid-curricular HESI last spring, I missed every single question on the OB portion of the exam. A lot of guys don't do well because almost every male nursing student I know hates OB.

For the women a different dynamic come into play. I would say the majority of female nursing students are mothers or have been through labor. For some of us it was as long as 20 or 30 years ago. This is a problem because what happened to us then is different then what happens to patients now. Our experience in labor and delivery is probably very different from what we need to know for the test.

This is true of nursing in general. What happens in nursing school is very different from what happens on the job. I don't have very much experience in actual patient care. The small amount of experience I do have has proven to me that there often is no direct application of what we learned in school to actual hands-on patient care.

I had written in a previous post about the pros and cons of going to nursing school at middle age. One of the problems we encounter is what we learned a long time ago may have changed. The medical field is constantly changing. New research is being done all the time. What used to be the gold standard for a certain kind of care, is later found to be either ineffective, dangerous or it doesn't matter one way or the other.

For example, pre-eclampsia. Years ago this used to be called toxemia. The treatment is still the same but the name has changed. What has changed is the treatment for preterm labor. In the past a woman who was having contractions before she was due was ordered strict bedrest. Studies have shown that there is no conclusive evidence that bedrest makes it any better or worse. In fact studies point to evidence that bedrest is actually slightly more harmful, not so much to the unborn baby, but to the mother and her quality of life. If a mother is ordered to bedrest and has other children, she needs to find someone to help her care for the other children. Nowadays most women work outside the home. If a Mom is placed on bedrest, she has to quit working which creates financial difficulty for the family. Then there is evidence that putting Mom on bedrest can cause her muscles to weaken and lose their function. This can be a problem during labor when Mom needs those muscles to help push the baby into the world.

So in weighing out the pros and the cons, the experts have figured out that the slight benefit, if any, of bedrest does not outweight the downside of being in bed. What I love about this is that more and more often medical care is focused on not just the physical aspect of a medical condition, but all the parts of a person's life that can affect their condition; their quality of life.

The problem is if you are a middle-aged woman who experienced preterm labor decades ago, you may apply your experience to the test question and not what was in the book or the lecture. The challenge is paying attention to what the information is today. When I'm taking a test I have to ask myself "okay, is what I'm thinking what I just learned, or is this something I remember from way back when?"

For the guys I have no idea how this information affects you. I cannot think of anything in urology that has come along in the past decade or so that can affect what you learned 30 years ago.

Oh wait. I just thought of something.


Think about what I talked about before. Your health problems and your choice of treatment don't just affect you, but other people in your life.

And remember, get help if your erection lasts longer than 4 hours. Not only will it be a test question, but it'll seriously cut into your action if you don't apply it to real life.

Tuesday, October 2, 2007

The Long and Winding Road

I am acquainted with someone who has been back and forth about going to nursing school. First she was working on pre-regs, then decided to start an ambulance company, then pre-regs again. Now, six weeks into the semester, I heard her say she's thinking about not going to nursing school but might go to PA school instead.

For a minute I was all smug and self-righteous. I kept thinking, "How are you ever going to finish nursing school if you keep changing your mind?" It's very difficult to get in and the only way you can get through it is to stick to the plan, keep your eyes on the prize and take one step at a time.

But then I began to think about my own circuitious path to nursing school and I simmered down. I like to tell people that it took me four years to get in. This always brings a gasp and a look of horror. Why did it take so long? When I think about it more deeply my own past is littered with near misses and coulda, shoulda, woulda moments, and my path to nursing school actually took 25 years. That's right. Twenty-five years.

So for your amazement and amusement, here is the timeline for my path to nursing school. See if you can spot the times I should have gone to nursing school but chose another path instead.

1982 - Began work in a nursing home as an activities director. Got the job because my husband at the time knew some people there. Looking through the patient's charts I was mesmerized by what I found. I found out that I love medicine.

1984 - Took a medical terminology class with the loose idea of becoming a medical secretary - "somewhere" but no real plan.

1985 - Got a job at Planned Parenthood, again because of someone my husband knew. Was hired to do community outreach but mostly worked as a medical assistant. Decided to start college.

March 1986 - Enrolled in my first college class - basic math. Dropped after 3 weeks because "it was too hard."

August 1986 - Applied for a job doing patient transport at a local hospital. Was offered a job in medical records because my work at Planned Parenthood introduced me to the concept of confidentiality, my class in medical terminology, and because I know how to type.

Early 1987 - Became a coder when my boss said "Come here and let me show you how to do this." Now coders need 2 years of college and have to pass an acreditation exam.

September 1987 - Job has benefits that include tuition assistance. Decide to enroll in a corespondence course to become an accredited records technician. I sell my car and ride my bike to work so I can afford the class.

April 1988 - Discover that 30 hours of college credit are required before a person can take the accreditation exam for medical records. Drop out of the course with plans to get the college credit classes needed, and then restart the program later.

June 1988 - Enroll in college classes. Actually finish 3 classes in one year taking one class per semester.

1989 - Move to another part of the state. Get a job in a hospital as a file clerk on weekends. Learn how to do medical transcription when my boss says "Come here and let me show you how to do this."

1990 - Discover that the local Small Town College offers an associate degree in medical records. Get financial aid and enroll full time.

1991 - Move again, this time to a large city with lots of opportunity. I look for a transcription job. The classifieds has 7 columns of transcription jobs. I find one easily.

1992 - Begin the process of enrolling in the medical records program at the Big City University only to find that the Small Town College was not accredited, and none of my credits will transfer to the University. A whole year of college down the drain.

1993-1994 - Various medical transcription jobs. Each one sucks more than the last.

1995 - Sick and tired of sucky transcription jobs, decide to get an education in something, ANYTHING, and take an algebra class.

1996 - 1999 - Life circumstances require me to work two jobs to survive. College not an option. More sucky transcription jobs. Oh well, Y2K will wipe out civilization as we know it and it won't matter.

2000 - Civilization intact. A friend tells me she can teach me to be a programmer and I can make a bazillion dollars.

Early 2001 - Friend was wrong as I am highly unteachable. Decide to pay good money and go to college to learn programming.

August 2001 - Take a class in logic required to start programming classes. I get an A. Wow!

March 2002 - Begin classes in Visual Basic. Everyone in the class has a programming background but me. I am quickly lost.

May 2002 - Get a Visual Basic certificate by the skin of my teeth. After crying for 2 hours because I can't understand my homework, in frustration I decide to go to nursing school. Hey, how hard could it be? I could start in the fall right?

September 2002 - Wrong. There are many prerequisites needed for nursing school. I look into every nursing program I can find and begin jumping through their hoops. Retake the ACT that I took back in 1977 to raise my score to what is required for school-A. Enroll in classes required for school-B as a back-up.

October 2002 - Look for a job doing Visual Basic as a way to pay for my education. All programming jobs move overseas. No jobs to be found. Continue sucky transcription jobs.

January 2003 - Register for more classes to meet requirements for what is required for school-B. Get word that my mother is terminally ill.

February 2003 - Drop all classes to be with my mother while she is dying.

June 2003 - Take 2 classes during the summer to meet requirements for school-B. Pay off student loan taken out to attend Small Town College. If you do the math, that's 13 years.

September 2003 - Take pharmacology as required to get into school-A.

December 2003 - Failed spectacularly in pharmacology. School-A says "thanks but no thanks."

January 2004 - School-A says "Awww, we were just kidding! You're in." Hastily quit job and make arrangements to start at school-A.

February 2004 - Dropped from school A because I cannot pass math. Lose my grant and have to pay for a whole semester of classes even though I was only there a month, and now I don't have a job. Apply to school-B.

March 2004 - Found a transcription job from the ever dwindling supply that haven't been sent overseas. Continue working on preregs at school-B.

April 2004 - School-B sends a letter saying "Thanks but no thanks." Spend rest of the year on preregs anyway.

January 2005 - Apply to school-B. Take entrance HESI.

April 2005 - School-B says that I have been placed on an alternate list in case a student who has been accepted doesn't attend school, I can take their place.

July 2005 - Getting close to time for school to start. Decide to find out how far on the list of alternates I am. I am number 63. Sixty-two nursing students have to die before I can get in.

August 2005 - Retake some classes to improve my chances of getting accepted. Meanwhile left transcription for good and began work as a dialysis technician to get some patient care experience. Basically took classes full time while learning a completely new career.

January 2006 - Decide to see if I can get accepted into the LVN program then maybe take a transition program later. Drop by the school to find the deadline for admission is the next day. Spend the rest of the day getting everything together that they require for my application. I make it.

February 2006 - Apply for the RN program. What the hell. Retake HESI for a better score.

March 2006 - I get accepted into the LVN program.

March 2006, one week later - Get word that I have been accepted into the ADN program. Give up my seat in the LVN program to another deserving candidate - who probably has her LVN license today.

August 2006 - Begin actual classes in nursing school.