Wow, its been a while, hasn't it...

First of all, I apologize to everyone who I've been neglecting for a while. I do still stop by your places, but I generally do it on my mobile device and don't have much time for commenting. But I'm lurking and one day plan to get back to being the old, pre-nursing school me.

Yes, I'm still here. Everything is as good as can reasonably be expected and a little stressful. It's manageable, but man, am I busy. I'm also dumping a lot of stuff on Mona because I'm always at the books. She's holding up, but it's tough on her too.

School is ok, grades are generally good with one test that was a B- (I contend the test was poorly written, my grade was top 7 or so) and a lot of busy work and more studying than I care for.

I'm at a local Panera and am taking a break right now from reading for a test on Monday. I'll pass, it's just annoying.

Clinicals are good. I'm on a medical/surgical floor on Wednesdays and doing labor and delivery on Thursday and Friday. Classes are Monday and Tuesday. Med/Surg is what it is. A couple of weeks ago I had a patient poop on the floor after telling me he didn't need to go when I asked him 3 minutes earlier. Then he pooped again. And again. The last 2 times we got him on the toilet. Oh, the glamour.

I am really liking labor and delivery. It's a good atmosphere and the nurses and the doctors all work well together. That's not really the case on most hospital floors. I hear ER is a similar environment in that regard, but I don't think I'll get to find out (long story) while I'm in school. Right now, if given a choice, I would happily go to work on L&D.

In two weeks we leave L&D and go to pediatrics. I think at least some of my time might be in the peds ER, but it's more like urgent care. Trauma and really serious stuff goes to the children's hospital at the big university 10 minutes away. That might be cool. I hear from the others that most of what they are getting is simple stuff and a fair amount of swine flu.

I took a break and went to a nursing message board and read a story about an older student who graduated and then took her Nursing Board (called the N-CLEX) exam. It's something that every graduate nurse and student fears and dreads. And I'm sure it's the same for every profession that requires a licensing exam. I've heard more than one person say they leave the testing center and vomit in the parking lot.

Anyway, I read the little story and a few of the comments and found myself starting to tear up. And then I started laughing at myself. Right in the middle of Panera. Luckily there aren't many people in here.

But that little episode tells me I might be feeling a little more stress than I'm willing to admit. Which is why I'm taking a few minutes to write this all down. Hopefully I can get at least a little of this off my chest.

I am easily in the top third of my class. I am good on the floor and in front of patients. My instructors like me, as do the nurses I work with (I'm basing this on the feedback I get from the clinical instructors).

Intellectually I know that I am going to pass all my classes and I'll pass my boards. As much as there is to know, it's not rocket science. But I still get a little freaked out from time to time. I'll be OK. Really I will.

This semester ends in mid-August. They say the third semester is a lot easier. Right now I just need to make it to August. I will make it to August.

Holy crap, why isn't it August yet??!!

Here's my nursing self diagnosis: Impaired coping related to educational and family stress as evidenced by simultaneously crying and laughing in Panera.

Not To Put Too Fine a Point On It...

... but my grade are pretty much finalized now. So I thought I'd share. I'm changing some of the names of the classes just to be a little less searchable.

How to give someone a physical, nurse style (2 Credits) A (~98%)

All the basics of Nursing and The basics of being a nurse on a psych floor (5 Credits) : A (98.3%)

An overview of nursing issues (2 Credits): A (~98%)

Drug, drugs, and more drugs (3 Credits): A- (91.6%)

How diseases work (4 Credits): A- (~92.4%)

Actually working in a hospital and in mental ward: (5 Credits) A (~97%)

That should make my GPA a 3.9

Here's the thing. I don't find it all that difficult from an intellectual standpoint. It keeps me busy, especially the parts where I have to write papers, but I don;t struggle to "understand" the content. To tell the truth, so far it's mostly been common sense.

I am pleased with my performance, but to a certain extent I feel like I'm just performing at the level that I expected. I can live with a B if its a nice high B, but in truth I expect to get A's. So getting an A doesn't feel like an achievement. It's more like a milestone to me.

I suppose that's both good and bad. Good in the sense that I hold myself to a relatively high standard, bad in that there is little joy in what amounts to very good performance. I'm also concerned that I'll expect The Peanut to always bring home A's. And that would be unfair, especially considering my high school GPA was something like a 2.5 The only C's I ever got in college were Accounting I and II. I can understand Chemistry and Physics and Statistics without a problem, but accounting remains a mystery.

At any rate, it's something that I intend to look out for. I tell her now that she's my favorite Peanut because she is so smart, so nice and so cute. I want to keep reinforcing that (hopefully in more sophisticated ways) as she gets older. I want a kid who is smart, confident and tough. But I digress.

The real upside of the GPA is that if I can keep it up I'll get into graduate school pretty easily, if that's really what I want. I got into this program with the idea that Ic ould always return to sales, but I don't know if I really want to do that. Even though you can make a heck of a good living, it's always uncertain.

But the more I go to school the more I wonder if just staying in patient care is the better choice. I think I could move into management pretty easily, just because I have a business background and I'm male. The faculty has told us to expect to move into management just on the basis of our having dual degrees. We're sort of expected to be leaders.

If I don't choose administration, I could do grad school and become a nurse practitioner. There seems to be a trend now that nurse practitioners are being replaced by DNPs. or Doctors of Nursing Practice. A DNP is actually a year shorter than doing a masters followed by nurse practitioner school. In the end the duties are the same, but you call one of them Doctor (I'm not sure how I feel about that).

The thing about doing a DNP is the income. It's a three year, part-time program that is mostly online. You can work and go to school simultaneously. Because it's a practical degree there is no research or thesis requirement. After you graduate, bang, you've pretty much guaranteed yourself an upper middle class income for life. I like the idea of not having to sweat to put The Peanut through college.

Then Mona also wants to go back to school and get a psychology masters. She wants to do early intervention type stuff with autistic kids. So add in an income like that and we'll be OK to retire someday. She's taking an online intro to psych class now and like likes what she's learned so far.

The DNP also might be cool for retirement. Mona wants to re-up with the Peace Corps when we pack it in. Part of me thinks that might be cool. With a DNP I think I could pick my post and pretty much be sure that I wouldn't be digging wells and evading guerrillas in some scary jungle somewhere.

Some people with my GPA in nursing want nurse anesthesia, but I don't think that's for me. It's another two years of full time school, and I don't know if we can really afford that. Plus, in my opinion, the OR is boring and being a nurse anesthetist looks like lots of boredom with the occasional moments of panic and a high risk for malpractice suits. That's just my opinion. If you want to be a nurse anesthetist please don't let me stop you. The people who do it seem to love it, and the money is fantastic.

At any rate, you're now up to speed.

So what do you think? Do I go back to sales and keep nursing as a fallback? Do I try for management and administration? How about Grad school and a doctorate?

If you've read this far it's my great hope that you'll share your opinion. I really appreciate hearing everyone's thoughts.

My Brain Is So Big That My Neck Can Barely Hold My Head Up

I am a genius.

Here’s why.

Today was my last day of school for five weeks. All my finals are taken, papers written and evaluations performed.

This semester I (and the rest of my class) carried 21 credit hours. The first two weeks were devoted to a single two credit course that was basically preparatory. After that we had ten weeks and 19 credit hours. 5 of those credit hours were for time spent in the hospital working with patients. The other 14 credit hours were didactic classes.

In the first clinical rotation we did two eight hour shifts per week on a medical floor at an area hospital. We worked with a patient or two and did basic stuff that I’ve already written about. My clinical instructor thought I was the cat’s PJ’s. My evaluation was really good from her and she told me that I should spend a little time doing patient care before I moved on to bigger and better. The implication was that I would most certainly be moving on to bigger and better. My written and clinical grade was 3.989 out of 4.0.

My classmates knew the instructor liked me, but since she didn’t dislike any of them there weren’t any issues with favoritism or jealousy. The instructor told us as a group that we were pretty strong, and I think the lowest grade anyone got was a 3.5.

I figured my grade was due at least a little to the fact that I was well liked, so I figured that the next rotation would sort of round things out.

Tonight I finished my psych rotation (again, two eight hour shifts per week) and got another evaluation from a different clinical instructor. She told me I got the top grade in our class, 3.875 out of 4.0. She marked me down in one category, but only because she felt that no one at this level of education or experience could possibly get a perfect score in that category. But she felt that I was very strong and plans to ask the program chair to round my grade up a little. Ultimately it won’t matter, but it’s nice to hear.

The thing that really gets me is that this instructor hasn’t shown any hints of liking anyone more than anyone else. She also says that we are a very strong group in general. My written work seems to be a little better than most because, in her opinion, I listened to her requirements and instructions and delivered what she asked for. This was not the case with some of my classmates, although they did well enough.

So that’s twice now that I’m on the top of the pile. So maybe the hype is true after all.

Here’s what I think my final grades will be:

Clinicals: A
Clinical lecture: A
Assessment: A
Intro to Nursing: A
Pathophysiology: A-
Pharmacology Low A- or High B+

85% of the Pharm grade is in, and my score is 90.7%. 91% is an A-. The final 15% is participation. I never missed a class, so hopefully that will get me that last .3%

The real upside of this is really about whether or not I want to do graduate or doctoral work. For example, if I wanted to be a nurse anesthetist (and I don’t really), I would probably need a 3.8 GPA to get into most programs.

Other programs, like Masters of Nursing or Advanced Practice Nursing probably want 3.5 or better. They also take into account whether you went into an accelerated program like the one I'm in. Apparently high grades in an accelerated program look pretty good to admissions people. They figure if you can hack it here you can deal with graduate or post graduate work.

It looks like the Nurse Practitioner degree is going to go away over the next few years. There seems to be a trend to replace it with a Doctor of Nursing Practice degree. It’s really similar but from what I understand also adds in some more about the business side of running a practice.

Someone also recently told me that the degree is done quite heavily on line, since it’s really about theory mostly. People are able to work while they’re in class. And since it’s about nursing practice there’s no thesis or research needed to have the degree awarded.

The upside socially is for these DNP’s to take up some of the slack for physicians. And it looks like we’re headed for a shortage of them too. The personal upside is Nurse Practitioners and DNPs have low six figure incomes. That’s highly appealing.

The downside is that it’s confusing for patients. “You’re Doctor Nurse?” It also upsets physicians, who see DNPs as competition for patients. I understand that, and in their shoes I might be concerned too.

As far as the title goes, I think if I did it I’d only let people call me Doctor once per day. After that it’s Jorge. Or maybe Doc.

In the short term I need to find a job and pay off student loans for tuition at a private college. Hopefully I can find an employer who has a tuition forgiveness program (that's becoming more common in some places where nurses are in demand).

But I digress. The point is that my grades are excellent. More than one critical source has now rated me Awesome. External validation rocks.

I am a genius.

Help! I'm Stuck in an Idiom!

I am now knee deep in my psychiatric nursing rotation.

I spend two days a week, usually on the afternoon shift, at a local psychiatric hospital. I'm on a locked unit and some of the patients are, in clinical terms, bat-shit crazy. There are a lot of stories, schizophrenics and delusions all the time.

It's not as scary as most people think, but it can be a little weird sometimes.

Last night I was playing cards with a patient and a couple of students. We were playing spades. When it was my turn to deal I realized that we were short 2 cards.

I was in a mental hospital. We weren't playing with a full deck. Are you kidding me? Was it an accident or does someone, patient or staff member, have a sick sense of humor?

Somewhere in that story is two or three minutes of stand up comedy.

If a joke pops into your head I hope you'll share it.

I Just Couldn't Take It

No, I haven't quit the program.

What I did do though, was walk out of a class today. In disgust.

Of course you're wondering why, and fully aware that I plan to tell you. What you are probably wondering is why I don't just get to the point. No reason.

So here goes.

I have class called Intro to Professional Nursing. It's really a blow off class, and the instructor has purposely set the bar low to allow us to focus on the hard science type classes. Everyone gets an A.

I have enjoyed the class mostly. It's a nice low stress break in the week.

Today was movie day. The instructor brought in a film related to health care, told us to watch it and explained that it would be discussed during class next week.

Why would I walk out on a movie? What could be so bad?

It was Michael Moore's "Sicko".

Whether or not you agree with the film, I hope you'll agree that it's an editorial, not a documentary. If you really think it's an unbiased work then you will likely not agree with anything that follows.

In my opinion the film was full of half truths. Like the guy who cut off his fingers on the table saw and could only afford to have one reattached. The last time I walked into an Emergency Room with an injury I was not offered a menu with prices. Why was one finger 5 times the cost of the second? Something about that smells wrong.

How about the golfer who went home for treatment in Canada instead of staying in the U.S.? U.S. Insurance usually travels. And when I do things like go SCUBA diving (which isn't covered by most insurers) I have a supplemental plan that will pay for anything I need, including being flown here from anywhere if treatment in the US is necessary. That costs me $99 a year. Canadians aren't covered by their government outside Canada. Atena covers me if I'm over there.

There are a whole bunch of other problems I have.

The thing that finally made me leave was the whole house call thing in France. The guy who talked about the service starting because a doctor with a plumbing problem decided that since he could get a plumber to come out in less than an hour, then anyone should be able to get a doctor to come to their own house that quickly too.

Yeah, plumbers are pretty much like doctors right? That's fair. Maybe if I need a neurologist one day I can just have my neighbor, the electrician, check me out. Holy shit.

It was then that I walked out.

Do I have opinions about whether or not US Healthcare sucks and how to fix it? Yes.

Am I going to share them? No.

Instead I am going to bitch about being subjected to a highly biased film in a program that is is not about opinion or or art. Nursing is and should be about fact. There are different kinds of heart attacks, and there are different treatments sometimes. But those treatments are all based on researched science. New ideas are tested rigorously. No responsible clinician passes off opinion as fact.

Blogs are the place for opinion. Classrooms should be places of fact, at least in a science based curriculum. I resent being subjected to that film. It's more than an hour of my time gone and who knows how many tuition dollars.

For the record, while I may have been less incensed, had the instructor played a 2 hours segment of something done by Rush Limbaugh I would have disapproved as well. I don't care for people with axes to grind or agendas to advance.

I am so annoyed that I can't even tie this together very coherently.

I think I'll just take a quick nap and then do some homework.

Are we bad parents?

First, a little background.

You know of course that The Peanut is out of the crib and sleeping in her big girl bed.

You may also recall that I once posted a photo of my home here. It’s a 1940 bungalow with two bedrooms and a half bath upstairs and two on the main floor with a full bath. Mona and I sleep downstairs and The Peanuts room is upstairs.

There is a baby gate up there to keep her off the stairs, but she’s pretty good on them now so we rarely use it anymore. (I know what you’re thinking, and no, she didn’t fall down the stairs. Just wait.)

This morning however we had a little incident. Somewhere around 3 AM The Peanut woke up crying and looking for her blankie. She sometimes loses it in her bed. She settled back down after a minute or two and then had another short episode about 30 minutes later.

I finally got back to sleep around 4 AM.

At 5:45 Mona’s alarm went off. She hit the snooze and I thought I heard a little cough from near the foot of the bed. I called The Peanut’s name but she didn’t answer. Mona thought I was mistaken. But as soon as we started talking a bit, The Peanut showed up.

Apparently she decided she’d had enough of the big girl bed and come downstairs. The good news is that we have a very considerate little girl. Instead of waking us up or crawling into our bed, she simply displaces one of the dogs from its doggie bed.

That’s right. The Peanut slept on the floor in the dogs bed last night. No covers, and the dog won’t stay in there with her. So she ends up sleeping on the floor without the benefit of a fur coat or even her blankie.

Would you like to know the worst part?

This was the second time it's happened.

It passed

Last Thursday we found out that Mona, along with all her co-workers, will be keeping their jobs.

We had some other plans in place, but it's nice to not need them. It's especially nice to know that at the very least we'll still have health insurance.

Spring Break was last week, I pretty much did nothing. I did see Watchmen on Friday. It was interesting, but also in my opinion mildly pornographic. The sex scenes left little to the imagination and there was a lot of full wangular nudity.

The best part about that day was the 66 degree high. I drove with my windows down and we aired out the house for a few hours.

I'm back at it this week, and Thursday starts my psych rotation. I'm told the place I'm going is basically alcohol rehab, which I imagine means dealing with a bunch of people who are sick and pissed. Great.

The Peanut is now in her big girl bed permanently. We took her crib down on Sunday.

We're also making progress with potty training. She is going pee on the potty about 80% of the time. We're still working on #2, which has only ended up in the potty a handfull of times. But any progress is fine with me. I'm ready to be done with diapers.

And that's the short version.