Tuesday, November 13, 2007

Brain Damage

Ahhhh. Much better! I took my neuro exam today and got an A. I feel like I turned that failing grade around in spades. I won't get an A for the semester, but at this point I'm just happy that I'm passing. This time I made sure I was all over that material waaaay before the test.

Pardon me while I get this off my chest. Remember my classmate, Jack? He is ENRAGED that he only got an 80. He calls himself the class nerd. He meets with a group of students who have formed a study group - one I've never been invited to join - and some of the students in the group got better grades than he. He had the audacity to say "I taught them everything they know about this subject and they still did better than me." Hmmm. Wouldn't be the text, the lecture, or the Powerpoint presentation? Nope it was all him.

He has these tirades whenever he doesn't get an A on a test; and lately that means he has a hissy fit after every test. The problem, as he sees it, is "the questions aren't worded right."

Nursing school exams aren't knowledge based. They give us the knowledge in the text and in the lecture, and then we are expected to apply the knowledge in a practical way. I can't give you an example of one of these questions because it is unethical, and I could lose my sparkly new LVN license. Let me see if I can think up a non-medical question to demonstrate this logic.

The first year of nursing school our instructors started feeding us questions that were worded more like what we'll see on our exit exam and, if we graduate, the board exam. They were trying to get us used to the idea that it's not a knowledge dump format. I struggled with this mightily. I went to public school, where the method of teaching is memorize and regurgitate with no real logic involved. I've had to overcome quite a bit, but after 3 or 4 tests I figured it out and got with the program. Many of my classmates fought this and kept arguing that "they were trick questions" or "you didn't teach us that in class". I didn't fight it because I'm too old and tired to fight authority anymore. I am too self-centered and lazy to try and bring the whole nursing education system around to my point of view.

Now in our second year most of us have gotten on board with this kind of logic. Somehow though, Jack is still stuck on memorize/regurgitate. He says that tomorrow he is going to complain to the faculty because these aren't fair questions. He claims that this test is not an accurate reflection of his knowledge; that he knows all this stuff and they are just trying to trip him up. A few tests ago when he bombed big-time, he swore that the computer "didn't save his answers right." He grumbled and complained loudly enough that a few other students soon claimed that the computer didn't save their answers right either. So two of the faculty sat through all the lectures and took the same test we did. Lo and behold, all of their answers were saved correctly. Everything that was on the test had been covered in the lecture. Most interesting of all, now that the faculty was looking at it closely, everyone else's answers were saved correctly too. It's a miracle!

I feel for the guy. I wish I could tell him that the sooner he stops trying to fight this, and does his best to adapt to this kind of logic, the better off he will be overall. I want to tell him that, really dude, you are not important enough for them to try and trip you up. You are a body in a seat that they are trying to get to graduation. It is not in their best interest for you to fail.

Mostly I just wish he'd get off this ego trip and let go of his view of himself as the class nerd. Yeah, maybe he does know a lot of data, but if you can't apply the logic, it doesn't matter how much you know. It just so happens that some of my classmates who maybe aren't that great at memorizing data, are geniuses at applying the information they do have. That means they will have a better chance at passing the board exam, and probably make some damn fine nurses.

It is important to know that if a patient is twitchy, has only peed 30 mL in 6 hours, their urine specific gravity is 1.045 and their serum sodium is 125 there is a problem. More importantly is knowing what the problem is and what to do about it.....and what to do about it FIRST.

Sorry bud. Being the class nerd won't save your ass when your patient who fell on his noggin yesterday is now circling the drain with SIADH. You can stand there and look at those numbers and impress people with your fancy book learnin', but you'd better cut that IV off and get on the phone and notify the doctor. Save the bullshit for later.

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