Sunday, June 1, 2008

Oooooops!


Boy is my face red.

Since graduating and starting my new job in acute dialysis, I haven't had much to say about being a middle-aged nursing student. Instead I've been blathering away about being a dialysis nurse....

....and I forgot to tell you. I'm so sorry!!

Anyway here is the link to my new home. If something comes up with regard to being a student, for example, if I run into a nursing student during my job, I'll come back and post about it here.

In the meantime come on over to the U No PP place and here more about patients who don't pee than you ever thought you need to know.

Monday, May 19, 2008

Toys In the Attic

For those of you too young to remember Aerosmith before they got sober, toys in the attic is a euphamism for crazy.

I don't know what it is about dialysis patients. They can be so crazy and controlling sometimes. Maybe it's all the grief and loss. Maybe it's the metabolites building up in their brain. Whatever it is, it's never a dull momement in Dialysisland.

The other day I had a patient whose husband created drama as I was leaving one night. The patient was a little hypotensive after treatment, which is not all that uncommon, but when she got to her room she told her husband she had chest pain. He came roaring out of the room demanding to know what had happened to her, and later insisting that she was allergic to one of the meds I had given her. Before I was able to get to the bottom of it, word had already spread throughout the unit that "that dialysis nurse gave her a medication she's allergic to."

By the time I arrived at her bedside the charge nurse was there trying to damage control and was fuming. I stayed with the charge nurse, trying to get to the bottom of what had really happened. I wanted to make the charge nurse understand that I was there to clean up whatever problem I might have created and that I wasn't going to dump the situation in her lap and then leave. Together we looked at the patients' record. The med I gave was prescribed by the nephrologist and had been given to her before. We checked her list of allergies and the med I gave her was not one of them.

About an hour later as we began to unravel what had happened, we realized that we were the victims of a drama king and an attempt at staff splitting. By teaming up with the charge nurse to solve the problem, we stopped the patient's husband from performing a "divide and conquer" episode with us. I'm glad I made the decision to work with the nurse and function as her ally. As things calmed down she relaxed and we were able to talk through what had happened. I could tell she was relieved that I stuck by her against the evil one and worked as a united front against him. Everything was documented thoroughly. We could feel a lawsuit in motion and thought we'd better have things written down. The next time I saw her she gave me a big smile and a wave. That made me feel pretty darn good about how we got through that difficult situation together.

Today I had a problem with my dialysis machine and was doing what I could to keep it running. Meanwhile the patient noticed I was spending a lot of time punching buttons and began a running commentary about it. "How come the other nurses don't have this problem? You don't know what you're doing. They need to get someone up here who knows what's going on." Stuff like that. I mostly ignored him and went about my business. I learned long ago that dialysis patients have lots of time on their hands and use it to invent new games to try and rattle the nurse. I've learned to deal with the crazy.

Today it took me 12 hours to run 2 patients. That's really way to long but actually it's an improvement over what I was doing before. It's going to get better. Even with all the playground games I already love this job.

Monday, May 12, 2008

Time For A Cool Change

Pinning was awewsome. Graduation was awesome. My family was awesome.

It is an interesting place to be; ending one kind of life and beginning another. In the past my life changes came on like a freight change. They were sudden and dramatic. This one is smooth and calm. It feels like moving in slow motion and it's very nice.

I have the uneasy feeling that I'm supposed to be doing something. People tell me this is normal after graduation. I still have this amazing feeling that whenever I do something fun I can keep doing it until I don't want to anymore. I can enjoy myself without guilt.

I still have to take the board exam. I had planned to spend an hour a day reviewing stuff to get ready for it. I can't quite get myself to do that yet. I just want to enjoy doing nothing for a little bit longer.

Then there's the unpleasantness of having to actually work.......full time. I haven't worked full time in 2 years. I'll be hating it for a while but eventually I'll adjust.

Meanwhile I am spending way too much time on YouTube and I Can Has Cheezburger, but what they heck. I worked hard for it.

Wednesday, May 7, 2008

I Feel Love

This weeek is filled with graduation frenzy.

My family arrived yesterday and we have not stopped partying since they landed. Last night we went out with my classmates. I've never been out with them in the evening; just lunch here and there. It was a big deal because I rarely stay awake past 10 p.m. The ideal bar for me would be one that has last call at 8:30 p.m.

Today was the pinning rehearsal. The pinning committee had put together a couple of slide show presentations. They were trying it out to see how it would work and we were all mesmerized. Our instructors saw that they could not get our attention once the slide show started so let us watch the whole thing. There were lots of photos and video of us from the past two years of nursing school. Lots of smiles, hugs, busy moments, etc. Each student also created a couple of slides thanking friends, family and whomever for helping us get through. So, yeah, all of us were riveted, waiting for our slides to appear.

Tomorow is the actual pinning. There will be plenty of Kleenex for all.

Friday is graduation. I'm pretty excited because miraculously I was able to keep my grades up and I'm graduating with honors. Yay me!

I'll write more once all the celebrating is over. For now I'm having a great time with my family, soaking up the love from my classmates and marveling at having made it through in one piece.

Peace out.

Thursday, May 1, 2008

Adapt......Or DIE

Boy, the stuff they don't teach you in nursing school.

I spent a day working with another dialysis nurse. As she hooked up the dialysis machine to the shower she said "Oh by the way. Call the manager and tell her you need a special plumbing adapter for this."

Special adapter?

Okay so I called the manager and she said she'd have someone drop off a kit at the hospital the next time I was there. A kit? I expected to find a charming little kit, maybe with fur lining and rhinestones and it would play music when you opened the lid, and a teeny little adapter inside. Instead I found this.



Inside are no less than 20 different plumbing adapters.



That's a penny on the bottom row second from the left.

I'm calm today, but when I saw this thing I just about shit a brick. What the hell am I supposed to do with all these?

Apparently what I am to do is attach an adapter to the dialysis machine and another adapter to the faucet or shower and couple things together until I get a tight seal. The one I saw the nurse use was a perfect fit for the dialysis machine and the shower head so only one piece was needed. No coupling required.

Wait it gets better.

So the other day I decided to put on my big girl panties and run a couple of patients all by myself. I get to the patient's room, introduce myself and get him all warmed up in preparation for dialysis. He's a new patient, just started dialysis a couple of days before, and so was a little edgy and nervous about the whole process. I fire up the dialysis machine and drag the hoses into the bathroom. I get out my sparkly new kit and begin trying out different adapters.

None of them fit. Oh sure, I could get one to fit the shower hose and another to fit the dialysis machine, but could not get them to fit each other.

Oh boy.

I called my manager and she said to call the machine tech. The machine tech said he could send someone over with the correct part and it would only take about an hour or so.

AN HOUR OR SO!?!

I cooled my heels in the cafeteria and played games on my Blackberry to relieve the tension. I had to get out of the room because the anxious patient set to whining and saying "well, how come the other nurse came in and hooked me up right away?"

Because I'm a lame-ass buffoon and they sent me here as a joke. April Fool!!!

The machine tech arrived with the correct adapter and threw in a pipe wrench for good measure. Thanks Dude. Much hillarity ensued and about three hours later I ran the patient and all was well with the world.

I took a lunch break and went to run my second patient and things went even further awry, but I'll save that story for another day. I'll just tell you that I spent 20 hours running two patients and I'm still trying to recover from that disaster.

The really awesome part is even with all the time I spent there that day, I still made more per hour than I did as a medical transcriptionist.

It's going to be fine. I just have to get over the hump.

Wednesday, April 23, 2008

Post HESI Survivor's Guilt

The past few days have been exhausting. After the elation of passing HESI wore off I have felt drained of energy. At first I thought maybe i was feeling a little guilty. I want to celebrate the fact that I passed, but 22 of 60 students didn't pass and I feel terrible about it. I feel traumatized by the whole experience, the preparation leading up to the test and the tension that had built up over time.

So much is at stake. If we don't pass, we can't graduate. We get several chances to try again, but only two chances before graduation and pinning. For a lot of people that means cancelling graduation plans, money wasted on plane tickets, the embarrassment of having to tell your family you didn't pass. To make matters worse some students have internships and jobs lined up that they won't be able to start if they don't graduate.

I didn't know what to do with these feelings. Fortunately another classmate who passed the test opened up to me and it turns out she feels the same way. We talked to other students and several others who passed are feeling the same strange funk.

At the beginning of the semester a classmate came up with a plan to help students succeed. She suggested that the students who pass HESI participate in tutoring sessions for the students who didn't pass.

It turned out to be a terrible idea for several reasons. The students who didn't pass are very embarrassed about it, and they feel humiliated to be in the same room with their classmates who passed. For those of us who passed, we're drained and exhausted. We feel that we just don't have anything left to give. I know that since the day of the test I have had this gnawing sense of responsibility for helping my classmates pass, and I resent it.

Then I have this classmate, the one who calls himself the class nerd, who has patronized me for every HESI I have passed. We have had three exams - one midcurricular exam, the LVN exam and now this one. I did well on all of them and he did not. He always says to me "well the reason you did so well is that you got a lot of questions on topics you're good at." Now I'd heard that the questions are random, but after talking to other classmates, I think we all had pretty much the same questions. I can safely say after taking the HESI three times and scoring more than 100 points beyond passing every time, it's not just the luck of the draw that got me through. It was hard work and staying on top of the material all the way through. There is no magic formula. It's not luck or fate. I hate it when he tries to minimize my accomplishment as a way of justifying his failure.

The other thing that bothers me is that that during our test review that was week before last, I listened to students asking questions and I realized that for many of them, this was not a review. For many of them, it was as if they were seeing the information for the first time.

As much as I would like to help my classmates succeed, I cannot teach them two years' worth of material in an afternoon study session. I'm sorry. Every once in a while during nursing school, a classmate would ask me to help him or her study, or I would be asked to join a study group. I would try and explain my study methods to them and they would always reject what I was trying to tell them or they would argue the information. I personally go straight to nursing interventions, then fill in the rest of the information later. That way if I run out of time to study before the test, I at least got the most critical information covered. I would try and convince them that, hey, you asked me how I do it, I'm telling you, you have to believe me. But okay. Have it your way. We'll go through the Powerpoints item by item if that is what you want to do.

So today in class the passers and failers eyed one another uneasily. The class nerd wouldn't even look at me, wouldn't talk to me. I take this as a sign that maybe somehow he finally gets it. I really did learn something in nursing school, and he's not really the class nerd after all. I know that the failing students have their own stories to tell. I know they have no sympathy for those of us who passed. They would trade places with us in a minute. Nevertheless, our feelings are real and we're doing our best to try and sort them out. We feel guilty as hell and we feel left alone to deal with the aftermath of this experience. We want to honor our committment to help our classmates succeed, but we're all too aware of what little we can actually do about it. I'm trying to choke down this ball of resentment mixed with guilt and it's not going down well at all.

I know the classmate who came up with the tutoring plan had her heart in the right place. I know she wanted us to bond as a class and help each other get through, but unfortunately it didn't turn out the way anybody had hoped. They say the road to hell is paved with good intentions. I never imagined the form of hell it would turn into.

But I'll be okay. It's just a weird place to be.

Monday, April 21, 2008

Acute Dialysis - Day One

It sounds great. Patient nurse ratio 1:1. Bring something to read because you'll be sitting down for four hours.

Four hours? What nursing job lets you sit for four hours straight? Wow. This my dream job. And it pays a whole lot more than any other graduate nurse job I've heard of. Some of the nurses told me that they made six figures last year. Six figures. My first year out of school. Oh man!

I figured sooner or later there would be something about this job that makes is suck bad enough that no one would want to do it. Turns out all the things that are good about it are also the things that make it suck.

Nurse-patient ratio 1:1 means the patient interprets this as meaning you are their personal servant for the day, at their beck and call. "I'm cold. Give me a blanket. Turn off the air conditioner. Give me a drink of water. My oatmeal is too cold. I need another Sweet N Low for my tea." You get the idea.

This also means we have way too much personal time with each other. The following is a sample of the verbal abuse I was treated to by my patient today.

"You aren't taking care of me right. I hope they don't ever let you take care of me again because you are a terrible nurse. You can't do anything right. You aren't very good looking are you? You're pretty fat for a nurse. If I get pneumonia I'm going to sue you. If you don't take me off this machine right now I'm going to call my lawyer. You never listen to anybody. You're just hard-headed and stubborn."

Yeah, yeah, yeah. Here's the phone, you grumpy bastard. Call your lawyer. Bring it!

Luckily I've had about three years' experience dealing with similar bullshit working in a chronic dialysis unit. I found that the best response is act like you're schizophrenic or retarded.

"I'm not good looking on purpose. I get so tired of men asking me out all the time that this works better. Really? I'm fat. Oh, if my weight is interfering with your treatment somehow, let me know what I can do differently so it won't be such a problem for you. If I'm not doing anything right how about if I heat up these pancakes for you? I'm hard-headed. You sound just like my mother. Oh, I can't tell you how many times she has told me that. You know the two of you would have so much fun talking about me. How's that oatmeal? So I was wondering, if you already have pneumonia, how are you going to sue me for giving it to you? I've never heard of this before and I'm wondering how that works."

I finally figured out how to eeeeeeeeeaase my chair back little by little until the dialysis machine was between me and his line of sight. I could still monitor him but he couldn't see me and, well, it's sort of like dealing with a baby. If he can't see you, you don't exist anymore.

Pretty soon his wife came in. A lovely woman, very attractive, every hair in place, dressed beautifully and very attentive to him. And he was a complete bastard to her. She didn't speak English and so he felt free to say ugly things about her to me.

I forgot. People suck.

Then there is the "nurses eat their own" thing. Yep. It's true. Since it was my first day on this unit I had to figure out where things were, how to make unruly equipment do what it is supposed to do, you know, just figuring stuff out. Every time I came out of the room to ask a question, I was met with much eye rolling. Once I stepped out of the room and two nurses were at the nurses' station and I asked a question. Both of them ignored me. I know they heard me. I'm loud. My mother would tell you. Finally a tech walked by and asked if I needed anything. I said "Oh thank God. For a minute there I thought I was invisible since nobody seems to notice me."

Probably not the smartest thing to say, but I'm only working near them, not with them. I could see the nurses huddling up, talking about that "stupid dialysis nurse". Wow. Eighth grade all over again, only without acne and I can smoke in front of anybody I want. And I have a driver's license. And a paycheck. Neat.

But I took the high road. When I left the unit I gave the nurse report on my patient and was all professional and business like. I thanked her for everything and said "I look forward to seeing you next week. I really enjoyed my day." If she thinks I'm crazy maybe she won't poke a stick into my cage.

The other thing that could be a negative is the ominous rumbling of many long hours. Yeah the nurses earn six figures but they earn every single penny. I'm hoping that somehow I can balance those long hours doing things I would usually do with my down time - reading, crossword puzzles, surfing the net on my Blackberry. But I get the feeling that somehow it's not quite going to work out like that.

At any rate, I can't think of any other nursing job that would work for me at this stage in my life. I won't be running up and down the hall, patient to patient, juggling hundreds of life and death details. The next patient who asks me why I'm so incompetent and stupid I'll just say "would you like some fries with that?"

Sunday, April 20, 2008

Nursing School Books

With three weeks to go until the end of nursing school, I have found myself with more time on my hands and, well, more time to goof off. But this is creative goofing off.

I desperately want to purge my office of all nursing school detritus, but I still have an exam and a final to go, so I can't just yet. I have a butt-load of books and I'm sick of looking at them. So as I sit here staring at them, watching my bookshelf groan beneath their collective weight, I got to wondering how much they weigh. Unfortunately I don't have a scale.

I don't own a scale out of principle. I find out how much I weigh once a year when I go to the doctor. That's all I need to know. I don't need to watch myself lose and regain the same five pounds over and over again. I have better things to think about.

Still I have the urge to measure my books. Since I can't weigh them I decided to stack them up and see what that looks like.

Oh I also measured the height of the stack to fullfill my need to quantify my books. The stack is 42 inches high. To the right of the stack is a 16-ounce bottle of Dr. Pepper in case you need some sort of scale. Some fools drag these things to class in their backpacks on wheels. My approach was to find a spot in my house and claim that as my work/study area and leave them alone. This worked well for me. I didn't take a single book to class - maybe once or twice in the beginning. I quickly figured out that all I needed for class was the Powerpoint presentation du jour tucked into a nice plastic folder. Voila! No backache.

So in case you're dying to know what these books are, the following is a list of books that I used during the two years of nursing school. Some of these books were purchased during pre-regs but I used them during the course of nursing school even though they aren't nursing books per se. I have two or three other books that I bought but never used, so they weren't included in the photo.

So here is the list starting from the top of the stack.

1. RN Notes. Myers
2. Nurse's Med Deck - Tenth Edition. Deglin, Vallarand
3. Mosby's Pocket Guide to Basic Skills and Procedures - Sixth Edition. Potter, Perry
4. Mosby's Diagnostic and Laboratory Test Reference - Eighth Edition. Pagana and Pagana.
5. 2008 Edition Nurse's Drug Handbook
6. Stedman's Medical Dictionary for the Health Professional and Nursing - Sixth Edition. Lippincott, Williams, Wilkins
7. Laboratory and Diagnostic Tests with Nursing Implications - Seventh Edition. Kee
8. Success In Practical Vocational Nursing - Fifth edition. Hill, Howlett
9. Nursing Diagnosis Handbook - Seventh Edition. Ackley, Ladwig
10. Live Review Course for NCLEX-RN Examination. Elsevier
11. Advanced Cardiac Life Support Provider Manual. American Heart Association
12. NCLEX-RN Strategies for the RN Licensing Examination - Kaplan
13. Pharmacology and the Nursing Process - Third Edition. Lilley, Auker
14. Introduction to Microbiology - Third Edition. Ingraham, Ingraham
15. Contemporary Psychiatric-Mental Health Nursing. Kneisl, Wilson, Trigoboff.
16. Dosage Calculations - Seventh Edition. Pickar
17. Nutrition and Diet Therapy - Sixth Edition - Cataldo, DeBryne, Whitney
18. Human Anatomy and Physiology - Sixth Edition. Marieb
19. Wong's Essentials of Pediatric Nursing - Seventh Edition. Hockenberry, Wilson, Winkelstein.
20. Clinical Nursing Skills - Sixth Edition. Smith, Duell, Martin
21. Old's Maternal-Newborn Nursing and Women's Health Across the Lifespan - Eighth Edition. Davidson, London, Ladewig
22. Medical Surgical Nursing Volumes I and II - Fifth Edition. Ignatavicious, Workman
23. NCLEX-RN Review- HESI
24. Saunders Comprehensive Review for the NCLEX-RN Examination Fourth Edition - Silvestri
25. Understanding Pathophysiology Third Edition - Huether, McCance
26. Fundamentals of Nursing Sixth Edition - Potter, Perry

I also have the urge to calculate the cost of these books, but I'm all out of goofing off time for today. My rough estimate would be $3,000.

Friday, April 18, 2008

HESI Happiness

I am pleased to report that I passed the HESI exam with flying colors. Passing score is 850. My score - 988.

I have mixed emotions. I'm elated that I was able to pass, but I am devastated that some of my classmates did not. They get another chance in 2 weeks, but it's difficult to try again once your confidence is shaken by not passing in the first place.

I wish I could tell all you future and present students what it takes to pass. I know what worked for me but everyone has to find their own way.

Okay. I'll tell you what I did.

* Stay on top of the material all the way through. If you learn it the first time around, getting ready for HESI is a review. It's not as if you are seeing the information for the first time.

* If you tank on a nursing school exam, be honest with yourself and go back and review the stuff you struggle with. Don't blame it on the test, the teacher, the weather, etc. If you aren't getting it, go back and get it.

* Stick to nursing process. Many of my classmates, even at the end, are still trying to approach the material as being able to define what something is. The test gives you a scenario with several right answers. You have to pick the BEST answer. For me the secret is this. If the question says "symptom, symptom, lab, lab, observation observation" - look for key words that tell you what the situation is. Is it heart failure? Renal failure? Pneumonia? Peripheral neuropathy? Once you establish what the disease in question is, think about what you AS A NURSE will do for this condition. In other words, go to INTERVENTIONS in your mind. Remember all those fugly care plans you had to do? HESI is the reason you had to do them.

* Know the normal labs. If the question gives you a lab result and you don't know if it's normal or not, you're dead in the water. If you know, for example, that the potassium is low, then you know what to do about it.

* Know the meds. Granted there were several medications on the test I'd never heard of, but the medication I had seen before, I knew what it was for, what the side effects are, and what a normal dose would be. So if you can't learn every med, at least know the meds you know backward and forward.

* Know medical tests. Know what an MRI is, an angiography, a barium enema, a CT scan, a hysterosalpinogram. Know if there is contrast dye involved. Know that if someone is allergic to shellfish or iodine, they can't have contrast.

* Have an understanding of the nurse practice act, delegation, legal responsibilities, therapeutic communication and cultural norms. It is tempting in the beginning of nursing school to want to skim over these topics and get to the "important stuff" like heart disease and stroke. Give these things your attention right from the start. It's not a lot of material, but you will see it over and over again. By the time you get to HESI you will have seen it so many times that it will be a no-brainer.

Many of us on the way to nursing school got really clever at figuring out to get the best grades for the least amount of effort. It got us into nursing school, but it hurt us in the long run. Some of us, and include myself, were in for a shock when we got to nursing school and found that there are no shortcuts. Those of us who made it accepted that early on and stopped looking for them.

Now that this ordeal is over I hope to gradually get my life back to what is seemingly normal. I don't have to drag a book with me everywhere I go. I can let go of some bad habits I picked up to cope with the stress. I can think about what I want to do in the abundant spare time I will now have.

And I'll blog some more. Twenty-one days from now when I graduate, I'll have to think of a new theme for my blog. It remains to be seen what direction it will take, but hopefully it will be something entertaining and maybe useful.

I don't know, but what I do know for sure is I'm going to have a spa day to celebrate my success.

Tuesday, April 15, 2008

HESI

The HESI or exit exam is this Friday. I'm trying to look over anything that I'm not quite sure of with just a little bit of time left to do it. It's nerve wracking that we must pass this test to graduate. The good news is we get two tries. If after two tries and don't pass we can remediate over the summer and try again.

I'll write more after I take the test and let you know how it goes.

Twenty-two days to graduation. Hooo-ah.

Thursday, April 10, 2008

Do You Believe in Life After.......Graduation?

As the semester winds down and graduation draws near, I'm finding it more difficult to find things to blog about that are relevant to nursing school. When I began this blog I had an acute interest in things that matter to a nursing student. Now I really couldn't care less. I suppose with a little time and distance I'll feel like blogging about it again. For now though, my mind is filled with thoughts of life after school.

As I look around my messy office I'm already making plans to purge just about everything that relates to nursing school. Some of my classmates have talked about keeping their text books "as a reference", but hell, some of the information is already outdated. What's the point?

As an update to the internship scramble, most of my classmates are settled into one job or another. I myself have taken a new job doing inpatient acute dialysis. I still work for the same company, but instead of working in a clinic and caring for four patients at a time, I'll work in the hospital and drag the machine to the patient. But don't feel sorry for me. The nurse/patient ratio is 1:1 and I get to sit down for the treatment. And read. And do crossword puzzles. And surf the net on my Blackberry. I'm sure there are some miserable details about the job that I hadn't thought of yet, but for now I want to bask in the glow of delusion and marvel at what I feel is the perfect job for me.

My classmates have done such a good job securing jobs that I have to tell this hilarious story on the subject. Our college had a health fair that we were forced asked to volunteer for. As part of the health fair, local hospitals, rehabs and nursing homes set up booths as sort of a job fair - a job fair that was not announced to anyone. So naturally no one showed up with resumes or anything.

One of my classmates was cruising the booths and scamming complimentary pens, Frisbees and candy bars when someone behind a booth began complaining loudly to her about the nursing students. The complainer said "this group of nursing students has the worst attitude of any class of nursing students I've ever seen. Not one student has brought us a resume or asked for a business card." Without missing a beat my classmate said "That's because we all have jobs already."

Oooooh. Snap! Take that, you ornery recruiter.

Tuesday, April 1, 2008

Tune In, Turn On, Clean Out Your Backpack

Remember time capsules? If you don't, I'll tell you it's part of some of the 60's stupidity that people thought would turn out to be the wave of the future, along with communal living and EST. But if you read the Wikipedia entry, there is mention of unintentional time capsules, and it turns out that I have one here in front of me.

Yesterday was my absolute last hospital clinical. I will celebrate this event by dismantling my clinical bag. Join me as I open this capsule and take a peek into 18 very interesting and stressful months of my life.

I remember putting it together thinking ever so carefully about what I might need when I would start hospital clinicals. I remember asking for advice at allnurses.com about what the well-prepared student should include in her pack. Now as I pull it out in reverse I'm laughing at what seemed like a good idea at the time, and nodding with self-knowing at what was really useful.

*RN Notes. Not useful at the time, but very useful as a review for HESI.
*Drug book. If I had it to do over I'd use a Palm Pilot or Blackberry.
*Basic Skills and Procedure Manual that I bought this last semester. I wish I had it first semester because now I don't need it.
* A clinical binder. Somewhat useful. It has folders and pockets for keeping stuff organized.
* Stuff in the folders and pockets in the clinical binder.
-A table of IV compatible drugs. Never used.
-A list of NANDA approved nursing diagnoses. Glanced over once or twice.
-An EKG rhythm strip to practice identifying rhythms. Still can't identify it.
-Pulseless VTACH algorithm. Very useful when I was getting ready for ACLS. Now that I'm certified, who cares?
-A colorful chart of most commonly abused pharmaceutical substances. Never used but might come in handy if I don't pass HESI and need to find some street drugs of my own.
-A Powerpoint presentation given by one of my classmates on Marfan syndrome. Was I even there that day? I don't even remember this.
-Some hastily scribbled post-conference notes. Might come in handy if I could just read my own writing.
-A thick sheaf of looseleaf notebook paper that I thought would be more useful than a wire-bound notebook. What the hell am I going to do with all this looseleaf notebook paper?
-An ominous list of instructions for a community clinical from first semester. Oooo, have your clinical care form with you OR ELSE!!!
-A checklist for my instructor to use when I was checked off for Foley catheter insertion........first semester? Wow. Did I get checked off or not? Will the board of nursing find out?
-A Wong faces pain scale. Lest I ever forget how to use it or I can't remember that 1 is no pain and 10 is the worst.
-Step-by-step instructions for various procedures that if you held a gun to my head I couldn't do correctly and neither could anyone I spent any time in clinicals with.
-Ten photocopied patient care worksheets that I created for when I took care of more than one patient at a time. Those actually came in pretty darn handy. I'll keep those in case I ever work in a hospital again.

This is fun. What else is in here?

A cosmetic bag with two compartments that contain.....
*A penlight. Used, oh, five or six times. Pupils never moved on anyone I ever looked at.
*Bandage scissors. Very useful.
*Pens, pencils, erasers, a small rule, write-on page tabs. All very useful.
*Ear plugs. Very useful for studying in noisy libraries. Before you were born libraries used to be quiet places where people could read in peace, and someone would come from behind the counter and shush you if you didn't whisper. I swear I'm not making it up.
*Batteries for MP3 player. First year I recorded all our lectures. I think I listened to one or two of them. This year I didn't bother.
*Breath mints, travel-sized deodorant, anti-gas tablets - all stuff that shows I care enough about my classmates to not subject them to my BO, bad breath or noxious emissions. Trust me. You get so busy in nursing school that sometimes you forget to put on deodorant before leaving the house.
*Feminine hygiene products because menopause did not visit me this year as I had hoped.
*A stick of Carmex lip balm and a travel-sized bottle of hand lotion. Probably the most-used items in the bag.
*A beaded badge holder necklace that I made myself to match our school uniform. It was completely the wrong length so as when I was putting a Foley in a patient, the ID badge got caught in the bedrail and snapped off. But hey, the necklace didn't break! That's the important thing.
*Band-aids and alcohol prep packs that I probably emptied out of my pockets during post-conference.
*Hemostats. Never used. Now, if I just knew a pothead that could use them.
*Change. Hey! I could buy a candy bar for the pothead!

Also in the bag I find.......
*One blood pressure cuff. Bought that for an assignment the second week of school where I had to interview an elderly person and take their vital signs. I never used it again.
*Candy wrappers. Those aren't mine. I swear!
*Trauma shears. These were part of a lab pack that we used first year and I took them out and put them in my bag when I lost my first pair of bandage scissors. When I overhead some nurses laughing at my trauma shears behind my back, I went out and bought some new bandage scissors and threw those shears to the bottom of the bag.
*A small plastic retractable tape measure. I can't remember what I thought I would use this for. Never used.
*A stethoscope. Oh, I remember the first time we had lab and me and my classmates marching proudly into class with our stethoscopes around our necks, looking all nursey and legit. I remember how the stethoscope was an outward symbol of all the hard work and sacrifice that went into getting ready for nursing school. Yes, it's a powerful symbol and probably the second most-used item in my bag.

*A small spiral-bound notebook to write notes about my patients. Let's see what I have in here. Hmmmm.
-Clinical instructors' cell-phone numbers. I'll keep that for future drunk dialing. Just kidding!! I don't even drink.
-Door codes to the patient nutrition room. Might come in handy. Next time I'm in the hospital visiting a friend I can raid their snack drawer and help myself to coffee.
-Some vital signs. Some lab results.
-Phone numbers for people who might be able to put in a word for me in case I want to work on a certain unit. Naaah.
-A tiny drawing explaining osmosis. Not bad!
-Pick up gift for Tara's baby shower. Shit! That was last year! The kid's probably driving now.

Sure was fun exploring my nursing school time capsule. To summarize, the most useful things to pack in your nursing bag is anything that keeps you odor free, your skin soft and prevents chapped lips. Next is your stethoscope and a little notebook to write cryptic notes that you will laugh at later.

Thank you for attending this time capsule ceremony with me. Refreshments will be served in the back. One slice of cake per customer, please.

Sunday, March 30, 2008

When A Nursing Student Is Not A Nursing Student

I had another one of those conversations the other day.

Random Person: How are things going?
Me: I'm getting ready to graduate in a few weeks.
RP: Really? You know I'm going to nursing school too.
Me: Oh really? How much longer do you have?
RP: Um. Well. I haven't actually applied yet, so what, two years?

I hate to break it to you, my brother, but it's actually more like four to six years.

I can say this now because I've been through it. I made this mistake. I woke up one day and decided I wanted to go to nursing school. I thought I would waltz over to my local community college and sign up to start the next semester. Little did I know it would take four years before I was accepted.

It's not easy getting into nursing school. Every school has its own set of criteria for accepting students. If you are someone who is thinking about nursing school, get in touch with that school and find out what their criteria are. Pay very close attention to every detail and even closer attention to deadlines. For example every school will have some sort of admission packet that must be submitted. One year I missed the dealine by SIX HOURS and so had to wait another year to try again.

Pay close attention to what the criteria are and make sure you can meet them. For example, the school I am going to requires that one take an entrance exam as part of the admission criteria. Here's the rub. You can only take that exam once a year, so if your score isn't all that great, you have to wait another year before taking it again. Even if you have everything else in order and ready to go, that's another year of waiting to get in.

My sister-in-law decided she wanted to go nursing school about the same time I decided to go, but first she decided to try some other things and see how that worked. So about a year ago she finally decided to get serious about applying and working on pre-regs. She spent all of last year working on pre-regs. Meanwhile the school she applied to told her there was a two-year waiting list. She decided to pay $75,000 and go to a private school.

After finishing the her pre-regs the private school informed her that they were full and couldn't accept her application and were now using a lottery system. In other words, names are drawn at random. You could get right in or you could never get in. It's all chance. Meanwhile, you guessed it. She took her name off the waiting list for the other school because she was so sure she would get accepted by the other one. If she had left her name on the list she'd only have to wait another year, which isn't that long when you remember, or if you read my earlier post, we made the decision six years ago to go to nursing school. Now she has put her name back on the list and they tell her now the waiting list is 3 years.

So children, if you think you want to be a nurse, get busy NOW finding a school and working on getting accepted. No whining about the admission criteria, the wait time, the tuition, the entrance exam. All of us who are nursing students had to go through it. If you really want to go, you need to understand right now, up front, that it's time consuming and difficult to get in. Otherwise do something else and quit complaining.

Oh, and another thing. If you aren't currently attending nursing school, stop telling people that you are "going to nursing school". Yes, and I'm going to die. I don't mean right now, but someday I'm going to die. But imagine the different reaction if starting tomorrow I told everyone I met that I'm going to die. There's a big difference between going to nursing school now and going to nursing school.........someday. And shame on you for making people think otherwise.

Thursday, March 27, 2008

Of Flash Cards and Powerpoints

As we close in on the final 5 weeks of nursing school, I am struck with the irony that now, after all this time, I finally figured out how to study.

I bought this book and it has been a godsend. Every topic on everything we ever learned in nursing school is covered. All the information is formatted into nice outlines. That way you only see what you need to know about the topic at hand.

If you are a nursing student, your instructors will encourage you to buy some kind of NCLEX review book to practice test questions. That way you will have the chance to see the information given to you in a bizarre and obscure fashion so you can rattle those peas in your brain. Hopefully a couple of them knock together and shake the information loose, so it will float to the front of your brain and you can choose the right answer.

I wish I had bought this book a year ago. I could have saved myself hours of pointless studying, trying to learn stuff that I will never see on a test.

Then there is that 10-inch high (I measured it) stack of Powerpoint presentations we've been given throughout the program. I was commisserating with one of my classmates about this stack of dead trees and wasted ink and he pointed out something I hadn't thought of. He said "When we first started school I was thinking how lucky we were to have those Powerpoints and we could just read those instead of the book. Now that I see how much there is I figured out it's easier to just read the book."

No kidding.

This book is even easier than that. The information is in bulleted lists. No having to tease the information out of a paragraph or table. It's the facts whittled down to just what is needed.

The authors of this book has not paid me anything to say such nice things about the book. This is one of those "I coulda had a V8" moment.

With 5 weeks to go I'm also reminded of things I meant to do during nursing school and never did. And it's too late to start now. Things like,

1. Exercise regularly.
2. Make flash cards.
3. Take stress breaks.
4. Network with nursing organizations so maybe some mucky-muck would remember by name and face and possibly hire me.

I found a stack of flash cards I started the first week of the first semester of nursing school. I laugh now at the folly of thinking this would help.

Sunday, March 16, 2008

Do The Hustle

I haven't been feeling so great about nursing school lately.

In spite of studying harder than I ever have in my life, I have the worst grades I've ever had too. I have had this creeping dread that I couldn't name.

Then I read this thread and it made me smile.

It seems that during the last semester of nursing school, all order breaks down, that bonds with classmates begin to unravel and nerves begin to fray. This comes from the competition to get internships and jobs in the area. Whenever a classmate announces their accomplishment, the rest of us die inside a little bit.

It was getting to me for a minute, but then I read the open letter above and I felt a lot better. I suppose it happens to everyone their last semester of college in whatever field they hope to enter. A gaggle of graduates tries to squeeze into a small pool of available positions. It reminds me of a National Geographic special where increasingly desperate crocodiles are writhing around in a muddy lake that is shrinking by the day.

I decided to pull myself out of the pond and stay focused on what is in front of me. Yeah I should be shopping for shoes to match my slacks. And yeah, I should be schmoozing and networking to try and get a nice internship of my own. But frankly, I don't have the stomach for it right now.

I'm worried about passing the exit exam. If I can't do that, the nicest, cushiest internship in the world won't make a difference. Besides, I've gotten reassurance from all around, from friends, coworkers, my partner and online acquaintances that I'll be fine. I've been told to just chill out; that I won't have a problem finding a job no matter what. I'll be a nurse, and even without an internship, I'll get to work with a preceptor no matter where I go. They aren't going to let me drown my first day, or week, or month on the job. I'll have support and help, and even though it may be shorter than if I had an internship, I'll still have help just the same.

Even though I have to hustle to get through these last 70-odd days of school, I'm not going to worry so much. I'm going to stop eating my heart out and be genuinely happy for my classmates who score jobs and internships. I'll be okay.

Thursday, March 6, 2008

If You Aren't Part of the Solution, You're Part of the Problem

Doncha hate those catch phrases? I hate shiny, happy motivational-type messages. You know the ones. "What doesn't kill us makes us stronger." Yeah, yeah, yeah. Just give me more money and turn your stereo down.

Truth be told I could use a motivational kick in the pants now and again. I was just reading this blog post about a hospital that instituted a "no complaining" policy and how it helped with staff morale. Some people responded in the negative, saying that complaints are justified and nurses should be treated better and paid well, etc., etc.

Then I felt guilty. You see. I am a complainer. I'm whiny. I'm self-centered. I don't like conflict. I don't like to hear babies crying at the next table when I'm eating in a restaurant. In other words, I'm perpetually 4 years old and emotionally retarded.

But I'm working on it.

Pastor Will Bowen appeared on Oprah recently to talk about his anti-complaining campaign. I didn't see the show, but I can get behind this idea. I have been a complainer for years and I'm not sure when I first realized how bad I was about it. It was probably when my girlfriend called me "whiny-ass baby" to my face. Since then I've been putting serious effort into changing. I'm working on finding the line between valid complaint and emotional immaturity.

I never realized how badly a negative attitude affects other people until I started working with someone who complains more than me. I dread it when I see I'm on the schedule with her. I know that at some point during the day she's going to corner me and go on and on about her life. I can be a supportive, good listener if I'm having a pretty good day myself. What gets to me is that this person has been complaining about the same problems for the two years that we have worked together. I had heard of energy vampires, but didn't quite get the concept until I worked with this person. Once I read more about energy vampires, I was horrified to think that I might be an energy vampire too. I have been quilty of several energy vampire actions from time to time. But knowledge is power it. Naming it means I can change it.

Anyway I haven't figured out how to tell my co-worker that she needs to make some different choices. Well, actually I have told her, but it hasn't worked. She makes the same mistakes over and over then wants to whine about it. If I came in feeling good that day, it isn't long before I feel depressed from talking to her. The good thing is now that I know how it feels to be the victim of an energy vampire, I know that I don't want other people to feel emotionally drained by me. I'm insecure enough that I want other people to like me. There. I said it.

This is what I call universal justice - something that you have done to other people comes back to visit you. Luckily I got the message and I'm working on staying positive and not drag other people into my misery and problems. But here's the thing - I have a great life. I have a lot of love and support from the people in my life. I'm lucky enough to have financial support so that I can go to nursing school full time. My children are happy and healthy. I have siblings who adore me. I attend the best nursing school hands down, and don't experience many of the horrible nursing school experiences other people have told me about. Why do I want to make myself miserable?

Because it's a bad habit. I would like to blame it on my mother, but she's not alive to defend herself. She was a miserable, unhappy person and I suppose I learned the art of complaining at her knee. But there is nothing that says I have to keep doing some 25 years since leaving home.

So I support people who are working to remind people to quit complaining. It doesn't hurt me to be reminded that complaining is a waste of energy and it drags other people down. If I want to complain that nursing pay and working conditions are wretched and we deserve better, I have options besides complaining. I can get involved politically and work on changing laws to make our job safer and our patient loads more sane. I can tell myself that it could be worse; I have worked harder for less money. I can even make the choice to not go into nursing at all.

I won't go so far as wearing the purple bracelet, but I vow to take other people into consideration before I start complaining. And thanks for reminding me. Now would you stop slurping your coffee and leaving your empty sugar packets on the counter? Thanks.

Sunday, March 2, 2008

Two Roads Diverged In A Yellow Wood

With 67 days to graduation, the push is on to find nursing internships.

I'm in a quandry. I can't decide if I want an internship or not.

Oh, an internship is sort of like a job orientation, but you get more one-on-one help with an experienced nurse preceptor, some extra classroom time, and also forgiveness if you don't get the hang of the job as quickly as one might expect.

You also have to commit to giving the hospital 18 months to 2 years of your life for this blessing.

I applied for an internship at a Hospital That Looks Like A Hotel. A couple of years ago I left my appendix there and, all things being equal, it was a great experience. As a patient it was great. As a nurse I'm not so sure. I'm spending my clinicals in this hospital my last semester of school. The halls are carpeted. I had no idea what a nightmare it was to try and push a bed down a carpeted hall until last week. I'm thinking if I had to do this on a regular basis, my poor old body won't make it to retirement.

I can't decide if this is what I want to do. I like the idea of having the equivalent of nursey training wheels. On the other hand, I want to be able to job hop for more money, or if the place I'm working is a hell hole I can't tolerate being there another day. Besides I already have the dialysis gig and it's pretty sweet. Once I get the RN license I will get a big pay bump. Plus I will be a little closer to my ultimate goal - travel nursing.

But there is that "med-surg or not med-surg" dillema. Some nurses feel that a stint in med-surg is essential for anyone starting his or her nursing career. Still others say that going right into your specialty is the way to go.

Dialysis is a specialty but I wouldn't say it's something I want to do the rest of my life. But if I am to think of it more deeply, I never set out to be a nurse in the first place. I found myself in middle age with a dwindling income, no retirement savings and a skill set that people on the other side of the world will do for half what I made. My goal is to ride this thing out to retirement and hope I arrive in one piece. Hopefully I won't be a physical wreck and I can actually enjoy my retirement. I've been in dialysis a few years now. As nursing goes it's a fairly easy job. I've already been through the fire and experienced the long learning curve.

I hear dialysis nurses are in huge demand among travel nurse specialties. Then I'm hearing more and more about nocturnal dialysis where patients come to the dialysis clinic and get their treatment overnight while they sleep. As people on dialysis are living longer, and as people are developing renal failure earlier all the time, nocturnal dialysis the way to go if you're young and want to keep your job. It's a pretty easy gig, I'm told.

For now I just need to focus on finishing. I'm getting the worst grades of my entire college career this semester.

And I don't even care.

I just want it to end.

Friday, February 22, 2008

Luck Be A Lady

Here is a celebrity quiz.

Who is the perkiest celebrity?

A. Rachel Ray
B. Richard Simmons
C. Vanna White
D. Bindi Irwin

I think it's a toss-up between Rachel and Bindi. Imagine both of them on TV at the same time. I suppressed my nausea long enough to be horrified by this interview.



Bindi? The luckiest kid in the world? Didn't her father die a freakish death like a year and a half ago?

Poor kid.

This reminds me of a patient I know. She would not win a perky award. In fact she is surly, sullen, snarky and sarcastic. After a particularly unpleasant encounter I took off my sensitive, defensive, middle-aged woman hat and put on my empathetic, professional nurse hat and had a chat with her.

Using my best nursing school therapeutic communication I asked some open-ended questions about what was happening in her life. She shared with me that everyone around her keeps telling her how lucky she is. No one wants to hear her talk about how devastated she is that she has renal failure. No one will let her express her grief over what she has lost by being on diaysis - her career, her body image, her health, her faith in God.

No. Everyone tells her how lucky she is because she can still walk, that she has a nice house, that her husband is so nice, that her children are healthy. Those things are true but they don't take away the sting of all she has lost. Over time she was getting sick and tired of not one listening to her talk about her loss. No one wanted to let her wonder why God had abandoned her; why this happened to her. No one wanted to let her ponder what she had done to deserve this. Instead they all told her that it's all part of God's plan and she should focus on the good things in her life.

I'm all for positive thinking, and I know her loved ones mean well. It was painful to see this person having to swallow her feelings and deal with her grief alone.

I wish I could say the talk changed things. It didn't. She's still sarcastic and opinionated, but at least she got a few things off her chest.

I wonder when Bindi will be able to get things off her chest. I wonder when somebody will let Bindi say "I'm sick to death of these crocodiles. I want my Daddy back."

I suppose for some people keeping busy is a way of keeping your mind of your troubles. But I wonder whose troubles are being dealt with in this way. Bindi or Bindi's Mom? If it's Mom, okay. Mom, you go ahead and travel the world making the world safe for crocodiles. If this is Bindi's choice and she loves doing it, I'm okay with that.

But let's tone down the sugar-coating a few thousand watts. Crikey. She's giving me diabetes.

Friday, February 15, 2008

Who's Your Dialysis Daddy?

Ahhh, dialysis. The life-saving procedure invented by a good doctor many decades ago, now perfected to the point where a patient can expect to live longer than ever. Not so long ago a person with renal failure was told to gather their family and say goodbye because there was nothing anyone can do.

So now, thanks to this 3-times-a-week treatment people can live for decades. Some of our patients have been on dialysis 20 years.

Unfortunately many dialysis patients are ungrateful and cranky. The majority of people with renal failure have diabetes or hypertension - a goodly portion of those have both. There is the occasional person who unfortunately blew their kidneys from a drug overdose or a reaction to contrast dye. Still others have problems with their immune system. For those with diabetes and hyperension, often they had been told YEARS AGO that they were heading down the path to renal failure. The problem with renal failure is that for a long time, the person feels fine. They figure that as long as they feel okay, that "stupid doctor" doesn't know what he's talking about. So they chose to ignore it until they woke up in ICU one day after an episode of uremic encephalopathy. In other words, their kidneys quit working, bodily waste built up in their brains, they went cuckoo and they scared the bejeepers out of their families.

Now that that's over, they have plenty of time - approximately 4 hours,3 times a week - to reflect on all the things they could have done to keep this from happening. They go through all the stages of grief - shock, denial, bargaining, anger - well, you know the stages. My two favorite stages are denial and acceptance. When the shit came down they were in shock, and everything they learned about their condition went over their heads. Now that the crisis has passed we can start educating them. I'm all for education, but in this case there seems to come a point of critical mass with education. They finally get enough information and it sinks in enough that now they're pissed.

I love it when they get past this stage and move on to acceptance. Some stay pissed though and those are the ones that I find challenging. They express their displeasure in some not-so-nice ways. Some do it by controlling the details of their treatment. "I must have 12 pieces of tape on my table. I can only have 3 x 3 gauze because the 2 x 2 gauze makes me sad. Stand on one foot, stick out your tongue and spin around twice before you cannulate me." Just kidding. I made the last one up.

Some express it by trying to manipulate their treatment time - often by constantly asking to stop treatment early. Oh, and the excuses they have for ending treatment early! Someday I'll write a book. "I have a flight to catch." Really, where would you be flying to that you have to be back day after tomorrow? "I have people coming over?" And you didn't mention to them that you have dialysis and that you don't get home until X o'clock in the afternoon? "I have a doctor's appointment?" Fascinating. So they only schedule appointments at precisely the same days and times you have dialysis. "I have to go to class." Uh huh. And you never mentioned to the clinic manager that you are taking a class so she could look into changing your appointment day, time or even find another clinic for you that has a chair time available that won't conflict with your schedule? Um hm.

Then we have the hurry-up-and-put-me-on folks. As soon as we open the door in the morning the patient's race to see who will be the first to their chair, because we put patients on in the order they come in. They practically knock each other down trying to be first. One day a patient passed out from low blood sugar on her way in the door. The other patients stepped over her prostrate body to get to their seats.

Some patients are in a hurry because they're smokers and they want to get back outside and smoke. Being a smoker, I symphasize - a little. I wear a nicotine patch during the day so I can wait until I get home to smoke. It takes the edge off. But what I've noticed is that the people who have the least going on in their lives are the most pushy about getting started on time. These patients are going to go home and sit on the couch in front of the TV. The patients who have jobs, children, errands or other activities are more willing to wait for us to get to them, and more tolerant of problems that keep them from getting started - for example machine failure or plumbing breaks. They will curl up in the chair, whip out a magazine or calmly watch television until things are okay again. Meanwhile the people who have absolutely nothing going on the rest of the day will yell at us to hurry up because they're going to miss The Price Is Right - even though they could watch it right there in their chairs.

Then a co-worker of mine told me something very disturbing. She told me that most of the male patients masturbate during treatment.

WHAT!!

I have known for a while that most men on dialysis suffer from erectile dysfunction - we can't call it impotence anymore. Usually the circulatory problems leading up to their renal failure also affected their ability to get an erection. It's all connected. So since it's all connected, when we start them on dialysis and their blood starts flowing at a faster rate, it starts flowing at a faster rate EVERYWHERE, including, you know, down there. Once they get on treatment they get the best boner of their lives.

No wonder those fools are pushing old ladies down to get to their chairs. They have a date with the dialysis goddess.

I am not naive but I guess I'm pretty dense. I've been working in this clinic for 2-1/2 years and had no idea this was going on. You might want to ask "License Pending, how dumb could you be that you couldn't see someone spankin' his monkey right in front of you?" Let me tell you why.

All these guys bring blankets with them. Dialysis makes a person cold. When their blood leaves their body and travels through tubing in room temperature air, it lowers their body temperature a bit. We can raise the temperature on the machine to warm their blood, but it only does so much. So most people bring blankets and pillows to make up for what we can't do. So while the guys are all snug and toasty under their blankets, their throbbing member right there begging for attention....well I guess, boys will be boys. I hadn't heard that women experience the same phenomenon. I suppose they do but, being that we are socialized differently, don't feel the need to, um, whatever it is women do to take care of themselves and darned if I can think of a decent euphemism for.

This information both fascinated me and traumatized me. I'm a sex positive person. I'm all for the freedom of sexual expression - in theory. I'm just a little skeeved by the sexual expression of some gnarly old men a few feet away from me. Ewwwww!
Part of me wants to be a looky-loo and see if I can catch them, but my rational side says "no, if you see that you'll ruin it for yourself and never have sex again." So I avert my eyes and go about my business as if nothing is happening.

So I'm in denial I guess. Next is bargaining. I wonder how I will eventually express my anger?

Thursday, February 14, 2008

Papa Was A Rolling Stone

In nursing school I've spent a lot of time learning how the brain and peripheral nervous system work. I've been doing this because, even though it was taught in anatomy, it usually came up towards the end of the semester, after weeks of the professor being bullied by students to push tests back because they weren't ready. So by the time the nervous system came up, we skimmed over it, barely discussing it. So I've spent the last week or so teaching myself about the nervous system.

I don't regret the time. I've learned so much. I was fascinated to learn that some nervous system disorders are not a problem with the brain, but a problem of communication. Either the brain doesn't communicate with the body, or the nerves in the body don't communicate with each other or with muscles.

I remember first becoming aware of cerebral palsy when my cousin had a child with the disorder. Like most people I didn't understand the condition. Like most people I lumped everyone with neurological disorders into the same category - retarded.

One cold winter day some 18 or so years ago, I began watching a movie that came on. The movie was My Left Foot. It is the story of Irish poet, artist and writer Christy Brown who was born with cerebral palsy. What struck me about this story is how devoted his family, especially his mother, was devoted to caring for him. He was 10 of 21 children, and yet his mother gave him the extra attention and care he needed to survive.

This made me ponder the point in human evolution when people looked down at one of their own who needed extra help to survive. Instead of moving on and allowing the person to die, someone decided to put forth the effort and care into making sure the person survived. To me, this is the first step to civilization - compassion.

I am glad that more research is being undertaken to better understand what happens when a person's mind and body are broken. They are helping understand what the parents knew all along - there's a person in there; a person with a mind and spirit, with thoughts and ideas trapped inside them. They just can't communicate them because their muscles won't obey what their brains are telling them.

Then yesterday our instructor shared with us the story of Dick and Ricky Hoyt - father and son team who compete in triathalons with Dick rolling Ricky the whole way. Read their story and watch the inspirational video below and see how Team Hoyt works together. I was very touched by how much this man loves his son. I only wish I could find the same discipline and devotion if it were my child with cerebral palsy.

Thursday, February 7, 2008

Countdown to Graduation



Oh yeah, babe.

I plan to play with it and make it look pretty, but I have to crawl off to bed.

One of my classmates drunk-dialed me earlier. At my age I thought I'd run out of virgin experiences. I so feel like a college student.

Sunday, February 3, 2008

Lime Kool-Aid With Strips of Balony

I don't know which came first - my interest in medicine or the TV series MASH. I don't know if it drew me in because I inately love medicine, or if watching it made me love medicine.

When I watch it now I realize that a lot of what passed as humor was blatent sexual harrassment. The guys were constantly propositioning any female in their vicinity. MASH the movie features or horrendous scene where the whole camp gathered to watch as the shower tent collapses revealing a nude Margaret Houlihan. It was supposed to be funny, but if I were to put myself in her place, the event would have been very traumatic.

But I don't mean to get up on my feminist soapbox. If I were to think it over, it depicts situations as they were in the 1950's when there was no such thing as sexual harrassment. Men could say and do whatever they wanted to women and it was supposed to be viewed as flattery.

What I liked best about the show was it had some of the best writing on television. I tried finding the actual dialogue for the episodes I liked best, but frankly I don't have that kind of time.

Below are some of my favorite lines from the show. They aren't verbatim but hopefully close enough for you to appreciate them.

The scene: Hawkeye and BJ are riding in a jeep. They turn too sharply and the jeep rolls over on it's side. BJ suggests that they could rock the jeep and turn it upright again. Hawkeye and BJ rock the jeep and it turns completely upside down. They both look at the jeep as the reality of their situation sinks in.
Hawkeye: So what are you waiting for? Get in.

The scene: Hawkeye and BJ are sitting together in the mess tent. Hawkeye is smelling the food and making suggestions about what it could be - smelly socks, old cheese. He offers the food for BJ to smell.
BJ: I don't want to smell your food. It's disgusting.
Hawkeye: This from a man who drinks lime Kool-Aid with strips of balony in it.

The scene: Colonel Flag has come to the camp looking for communist sympathizers. He is bragging about his ability to move about without being discovered.
Colonel Flag: I am the wind.
Hawkeye: I told you he was the wind. You said he was the moon.
BJ: You said he was the moon. I said he was the stars.

The scene:Trapper John and Hawkeye are lounging around The Swamp. An announcement comes over the PA announcing that cockroach races will be held later that evening.
Trapper: Are you going to the cockroach races?
Hawkeye: Are you kidding? People just go to those things to see a cockroach crash.

The scene:Radar and Colonel Potter are in the office making a phone call. Potter studies Radar for a moment.
Colonel Potter: How can you see anything through those filthy glasses?
Radar: I know where everything is, sir.

Tuesday, January 29, 2008

I Hope I Die Before I Get Old


Only young people think that way. Now that I am getting old, I very much want to live.

So it turns out that middle age is depressing.

Indeed it is. There are good days and bad days, but for me the depression is realizing that someday I am truly going to die. There's no escaping it.

For many years I got away with not thinking about it - it seemed so far off. Now that I've been in nursing school and have seen people my age shuffle off the mortal coil, the reality is clear. I was really freaked out to see people my age unable to turn over in bed, suffering from dementia, having limbs amputated from complications of diabetes and unable to finish a complete sentence after years of smoking.

I can't get away with not taking care of myself. In the past I told myself I would eventually get around to eating right, exercising and not smoking. No longer.

My daughter and I started a pact this week. She went for her anual check-up and found that she had gained some 30 pounds over the previous year. She decided to change her eating habits and exercise more. I want to quit smoking and so will cut down gradually. Our pact is that we will check in with each other once a week and talk about our progress, our obstacles, any problems we're having, and to give each other moral support.

If I do nothing else, at least I can be an example. My hope is that I will get back to the state of health I was in before I started nursing school. It seems like an eternity. With the end in sight, it feels doable though. Watching my daily habits will help tick off the days to graduation.

And, no, I have no idea how many days it is. It's less than 100. That's all I know.

It's probably about the number in years that I would like to live to.

Monday, January 14, 2008

Take the Long Way Home

Today begins the final stretch to finish nursing school. If I keep repeating myself either slap me or get over it because I'm getting old. But I can't believe how close I am to finishing. I spent 4 years getting into nursing school, plus 2 years actually being in nursing school. My mind is boggling about actually having a life once this is through.

It has been difficult but I know that I've grown a lot. And none of that "what doesn't kill us makes us strong" bullshit. I'm talking about how I've learned to prioritize and problem solve; how to communicate; how to work as a team. It has leaked over into other parts of my life and made me a better person. Well, not better. More effective maybe.

Still, I have noticed that now I can see the big picture where before I tended to get caught up in the mundane; the right now. Part of this has to do with actually having something to offer the world in the form of a service or a skill. It feels pretty good knowing that I can do something that makes a difference. I'm not just a body in a chair.

Maybe tomorrow I'll talk about dialysis hijinks. There have been many.

Wednesday, January 9, 2008

US Places Last on Preventable Death

Okay yeah, blah blah blah. What are they going to do about it?

Monday, January 7, 2008

Dream A Little Dream

As of tomorrow graduation is 4 months away.

Wow. After so many years of struggle it hardly seems possible. I spent years getting into nursing school. I'm trying to imagine a life where I just go to work and come home.

(thoughtful silence)

Oh, and enough money to pay bills and buy stuff just because I want it.

(more thoughtful silence)

Okay, so in no particular order, this is my wish list for after graduation

1. A laptop
2. Student loans paid off
3. A vacation - a REAL vacation where we go away for more than a weekend, stay in a hotel, eat in restaurants and go on interesting day trips and tours
4. Coming home after work, putting my feet up and watching TV until I'm in a coma - well for the first week or two anyway
5. Hobbies
6. A social life
7. A new bicycle - a nice bicycle - one that costs more than $50 and one that I can ride without feeling like I carried it the whole time
8. Laser hair removal
9. Dental care - specifically the crowns I have needed in the front for almost my whole adult life
10. Plane tickets for me and my family so we can see each other more often
11. Truck paid off
12. Swimming lessons
13. Personal trainer

There's more but that's a start.

Tuesday, January 1, 2008

WIBNI If E1 Would STFU During Class?

I'm not in school at the moment there isn't much to talk about, so I thought I'd discuss issues about school that have come up in the past that gave me pause. Today I'm thinking about cell phones.

Last year our instructor had a rule that I loved. If a person's cell phone went off during class, the person had to bring snacks for the whole class the next time we had class. We only have 30 students in the class so it was doable. I don't think it would work in a class of 100 or so. If a phone rang a cheer went up in the class. There was no way we would let the person off the hook for bringing snacks. We were all over that.

Still, it helps to drive home the point that while cell phones are a technological marvel, people around you would appreciate if you would be considerate with regards to your cell phone.

1. Keep your cell phone off. Putting on vibrate is distracting.
2. If you have an emergency, the person will leave a message and you can call them back on break. Yes, you can wait a few minutes. Truly, what could you do in five minutes anyway? If your kid fell down and split his head open, whoever is responsible for him or her while you are in class can run him to the ER and you can meet them there. Five, ten minutes won't make that much difference.
3. If you feel it is absolutely necessary to answer the phone, please get up and leave the room.

I hate to sound like my grandmother, but I can't help it. When I was your age we didn't have cell phones. If there was an emergency, a person could call the school and someone could get the message to you. In my 20+ years in college this only happened once. I arrived in class and about 10 minutes into it, someone came in the room and handed the professor a slip of paper. She said "is License Pending in this class?" I said "Yeah, that's me." She said "Do you mind if we step outside for a second?" I thought I was in trouble but once we were out of the room, she told me my child was ill and I needed to go pick her up from day care. No need to announce the whole bloody affair in front of the class. We went back inside, I quietly gathered up my things and left. The next day a few nosy concerned classmates wanted to know what happened and I told them. Otherwise it was my business, I took care of it, and I didn't disrupt the whole class over my child's runny nose and fever.

I am delighted that more and more people use text messaging instead of talking. At first I didn't see the point. Why not just talk to the person and say whatever it is you want to say? After spending the holidays with my children, I see the beauty of it. While the family was having a conversation, my daughter could check her messages and send a text before it was her turn to talk again. No having to stand up and leave the room for a conversation. She could stay right where she was and enjoy our company all the while staying in touch with her friends.

I also noticed it when I was in the library. In the past cell phone conversation went something like this.

Bleep bleep bleep bleep bleep bleep (insert ringtone of choice).
Hello? Hey. What's up? Oh nothing, just sitting here studying. What? Who? Oh really? No way! Yeah. Uh huh. Well tell him I'll be here for another 10 minutes or so. Uh huh. Uh huh. Yeah. Blah blah blah blah blah blah. Blah blah blah blah blah blah. Blah blah blah blah blah blah.

Occasionally they would remember to get up and leave the room for the discussion, but mostly not.

Now I see people sitting quietly texting like mad, and I can study undisturbed by the ugly details of their lives.

Yay texting!