Ding! I Leveled Up.

Yes, the title is geeky. But you can hardly blame me... I've never hidden the fact that I am a part-time nerd. ^_^

This is my first week of Second Level!

This semester will focus on Med-Surg nursing. My new instructor is a short, spunky lady who is quite possibly one of the bluntest women I've ever met. One of my extremely inquisitive friends has already irritated her with too many questions, so my instructor has decided to limit her to 3 per day. This is of course sarcastic; she'll answer whatever questions need answering. But anytime my friend asks something the teacher finds superfluous, she throws up her hands and says something like "Lord, this is number two! You better be careful how you use you last one!"

What is different from first level sofar? I'll spend two days in the hospital instead of just one. I'm only taking 5 classes instead of 7, but one is Med-Surg theory and the other is Pharmacology. Argh! I've heard this called the "hard level" by many students. I'm not sure if that's because those who failed second level probably should have failed first but barely squeaked by, or because the teachers are harder on you, or if the material is fundamentally more difficult. (I can hardly credit the idea of Med-Surg being harder than critical care. Only time will tell, I'm sure.)

You know my Really Useful Page full of the all the scans and handouts from last semester? I went in to the first level BSN class today and gave all the students that website address. The teachers seemed thrilled about it (maybe I should have announced it to the class when they were still responsible for my grade?) but the students looked a little confused. I can only hope they actually make use of the thing, since it saves each person an average of $7.20, which means with 70 students... that's over $500.
I am only more determined to acquire official school webspace for this project so I can leave something behind for posterity.

So. I'll let you know how things go this next week. All of you who are aspiring nurses or techs or whatever... good luck with your new semester!

Extracurricular Surgery, then Finals.

Well, finals are over and I'm still alive. I managed four B's and three A's this semester... though 3 of those B's were 90 or 91% (remember, 92% is the lowest A). Not complaining though, I'm just glad to be on vacation!

The faculty was really nice during the last week. They brought us breakfast every day; sometimes donuts, sometimes catered stuff. My instructor made her delicious "chess cake"... which is basically tiny little cheesecake squares dusted in powdered sugar. Heavenly.

Last Saturday I had the most awesome experience.

A nurse anesthetist from my church asked me if I'd like to come shadow him at his job. I accepted and got up at 0600 to meet him at the hospital, and then stood next to him for four hours while two surgeons performed a hysterectomy. This nurse anesthetist showed me everything he was doing and explained all the equipment. He told me the names of the drugs he injected, what they acted on, what he was watching for to be sure all aspects were balanced. I gained a really detailed overview of his work. And on top of the learning, it was a very interesting surgery. I got to see this lady's uterus and intestines and stuff, it was so awesome!

I don't believe I mentioned the surgical observation experience that I had through the nursing school. Throughout the semester, students are rotated out for a single day in the OR. When I arrived for my assignment, all my classmates had already picked the most interesting cases. So I ended up observing 3 cataract surgeries, and was actually made queasy by the needle they used to inject the local anesthetic into the eye. I spent most of that morning sitting off to the side while the staff ignored me. A very boring day.
(I have no idea why the needle bothered me and the open abdomen didn't. I'm not squeamish, but they say at good third of students feel unexpectedly ill the first time they set foot in an OR. A large percentage faint, but thankfully I wasn't one of those.)

How awesome to get another chance to learn! And from someone with an advanced license! I know I want to go to grad school eventually, and while the lack of patient interaction in the OR seems a bit boring to me, I was really excited to see something new.

I gotta remember to write a thankyou note.

The Really Useful Page + The Last Patient

I run a website to help out my clinical level at NSU.

Basically, I scan all the paperwork forms into the computer so that they can be printed from the website. The copy machine is 10 cents a page, but computer lab printouts are free. My clinical level has found it invaluable, so I plan to expand the project next year. I'm thinking of requesting some official school webspace to set this up permanently. It would be a student-run thing that would fill in the gaps left by teachers who can't figure out how to use Blackboard.

Those of you at other colleges... you should look into doing this for your own school. Its a great community-support thing. (I'd link my page as an example so you could see it for yourself, but there are copyright issues involved.)

It is important for nurses to help eachother.

~~~

Today was my last day in the hospital as a first level clinical student. I can hardly believe the semester has flown by so quickly! I had an exciting ending to the semester. My patient had wildly fluctuating glucose levels and uncontrolled diabetes. Thankfully they'd gotten her down from 400 to about 200, and holding steady. Then, when we were talking about brushing her teeth, she told me she wasn't feeling right. A quick glucose check showed her level to be down in the 40's. Freak out! I was running around with orange juice and sugar packets and sticking her finger every fifteen minutes. She started to get drowsy before I got the juice in her. Thankfully she didn't pass out on me! As I left I watched her grimace as they kept re-sticking her for some blood to take down to the lab. The longer I work in the hospital, the more thankful I am that I am an "easy stick".

She was an interesting patient in more ways than one. She told me about her move into the nursing home after her daughter could no longer care for her. It was disheartening to hear; she was obviously intelligent and fully cognizant. She didn't want to bother her daughter with her depression. I found myself unable to speak. What words could I offer in the face of such suffering?

I feel this society needs a major paradigm shift when it comes to nursing homes. People think these homes are where people go to die, but that isn't the case at all. Nursing homes are places where people keep on living.

True, quality of life is often diminished from what a person once knew. Especially for a woman such as this; she is only there so health professionals can monitor her blood sugar and her tendency for falls. When I listened to her speaking in such soft, deliberate tones, she conveyed to me such profound sadness. Yet even with the sadness, her voice also held a resolve to live in spite of it. To live.

When I am old, I hope to bear myself with such dignity. When I am depressed, I hope I can find such strength of will.

Report Card

*does a dance* Who made A's on their last two tests? That's right, it was me. And it's something to be proud of; the third Pathophysiology test had a class average of 71%. (As you know, 80% is the lowest passing grade.)

Patho is going to keep a lot of people from going on to second level. One guy in my group has already calculated that he can't raise his average to 80 even with the final grade, so he's out before the semester's even over. Poor guy. Some say Patho was easier over the summer last year. I don't regret waiting to take it, and I'll be more than happy to pass with the B this year.

We're in the midst of registering for second level classes. Everyone is telling horror stories to their underclassmen. "Walker knows her stuff. If you get Landry, she'll only put you on the spot about drug cards and send you home with an F if you don't know what all your meds are". Others say "Downy is really easy, but Landry is better because she doesn't assign much paperwork". Conflicting rumors. I wonder which are true? Its so hard to judge, with everything being so subjective.

Honestly, I could care less who I end up with. If it's someone really hard... well... I know I'll be that much better a nurse for it. I may be a grade-obsessor, but I'd rather make a hard-earned C than an easy A, since I'll know for sure that I passed by sheer force of will rather than from people handing me things. Easy teachers don't make for high NCLEX scores.

A Paper and a Picture

I am writing the most inane paper.

My "Nursing as a Profession" course is exactly what it sounds: a class that studies why the career is a profession rather than simply a job. We read long chapters about the history and legalities of nursing, and compose over-researched essays on pretentious topics. Right now I have to write a two page, APA-perfect paper about a professional organization. I've chosen to do mine on the National Student Nurses' Association (NSNA) because I'm already a member. Usually when writing people complain about having to spread a little information out over several pages, right? Oh no; this one is a burden because I don't know how I'll ever fit all the criteria into so little space. I loathe this assignment far more than my "Definition of Nursing" paper from a few weeks ago. Despite having many resources, I feel like I haven't made any progress all day.

Hence this blog entry. I love to take a break.

I find my mind drifting to other things NSNA related. For example: I've finally finished my shirt designs for the school's SNA chapter. I think these designs are much more interesting than the huge school seal they've had on their backs for the last couple years. Apparently our SNA has gotten itself in trouble in the past for having questionable phrases on previous shirts. Things like "Not Tonight, I Have Clinicals". I think its hilarious personally, and not nearly so bad as some of the things we've seen at the national conventions (One group had shirts saying "Palpate THIS". If only someone walked by our Dean in one of those, hoooo boy.)

I think they turned out quite well, don't you? Sorry about the watermarks.


After I'm done with the paper, I have to study for a test on Monday. It's in Health Assessment, one of my B classes. Being the grade-obsessor I am, I'm certain I'll end up barricading myself in the room with my books until midnight. (Emerging perhaps only for Starbucks?) I can't wait until Monday as over, since after that I'll have nothing major left to do before Thanksgiving break. There IS a Thursday test in Foundations, but that class is always a breeze. Then, I can't wait to climb in the car and head up to Memphis for family, food, and fun. Thanksgiving is wonderful.

I love to take a break.

Foley Catheterization, Genitals, and Social Rules

Before we can dress, administer, or insert anything in the hospital, we must pass a clinical checkoff. Today I had a practical examination in Foley catheterization. (For those of you who don't know what that is, it's where you insert a tube into the bladder. Through the urethra. Yowza.)

The labs are filled with these pathetic looking dummies students can use to practice everything on. I say pathetic because they look worse than many of the vegetative patients I've seen in the hospitals; their plastic bodies have interchangeable parts for just about every ailment possible. You can even swap out genitals, which amuses me to no end, so today I inserted a Foley tube into a somewhat disturbing labia mold. Disturbing because the urethra was very exaggerated for easy learning, which is NOT the case in the real world. (Where the hell is the hole?)

I'm not someone who balks at nudity. (As a 96 year old woman once said to me, "If you have something I've never seen before I WANNA SEE IT.")
But I'm also not someone who thinks you can totally objectify something like this. For example: sometimes when inserting Foleys in males you can first inject this numbing gel inside the urethra. Only problem is this: you have to hold it there for five minutes. My instructor said "I've never done the gel thing, probably because I'm not one for small talk". Honestly, what do you say to someone while you hold on and wait for the stuff to kick in?

It always amazes me how willing people are to get naked for you once you wear a hospital uniform. I've had a good number of patients sofar this semester, and not a one objected to me lifting their shirts to listen to their chest, or helping them put on clean undies and a gown. Of course, they have no reason to worry about me seeing them naked; I am a professional. I'm going to see a million before I'm done. But what is it that makes them trust me with their body more than they would any other stranger? Surely it isn't the purple uniform... though I'm certain they'd be more uneasy if I was there wearing jeans and a tee-shirt.

We build up the most interesting environmental associations. Being in a certain setting, playing a certain role, and wearing a certain costume makes all the social rules change. Sometimes the roles can be de-humanizing (people expect super-human responses to their problems, especially from doctors). When someone fails while playing their role, we are disillusioned and disappointed with the role (profession!) as a whole, and not just the offending individual.

This is why I try very hard not to laugh at the plastic genitals of the practice dummies when I'm in the lab, less I undermine my professionalism. But another part of me sees that professionalism is a function of context. Objective detachment is a function of one's role. And though nursing is arguably something that becomes ingrained in one's very identity... I AM still a student.

So. Between you and me, I am seriously considering turning all the "parts" upside down one day. Just to see if anyone notices. I have the serious suspicion the instructors would find it hilarious. For all the roleplay, nurses aren't as stuffy as people think. So long as no one is watching. ^_~

I thought this was going to be a documentary

..but it is far too sparse to provide any accurate picture of what it is to be a nursing student.

Or perhaps, maybe this is the perfect example of what nursing school is... I am so busy, I am unable to find time for even the smallest tasks like blogging.

Today is a Tuesday, which means I must prepare my preclinical paperwork before going to the hospital at 0630 tomorrow. If I want to give a medicine, I must construct a "drug card" detailing the drug's action, effects, side effects, safe dosage level, half-life, nursing implications, etc. Today I (somewhat masochistically) picked a patient with no less than 17 different medications I am able to give. Quite a cocktail, that bunch. Needless to say, I'm going to be really really busy for the next seven hours.

I was set back in time a little bit by a random drug screen today. Once a semester we have to pay $30 to pee in a cup. Failure means dismissal from the program, but I'm beginning to think that it is more for money than to assure quality service. $30! Yeesh! Life is expensive.

Time to study. Good luck with your own studies, everyone.